Individual provider Active NPI

Mital Keyurkumar Patel

  • Pharmacist
  • Covington, TN
National Provider Identifier
1013404359
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28975 Issued in TN
Practice address
201 Lanny Bridges Ave
Covington, TN 38019-1615
Phone
(901) 476-4648
Fax
(901) 476-3275
NPI assigned
Apr 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28975 TN Primary

Addresses

Primary practice location

201 Lanny Bridges Ave
Covington, TN 38019-1615

Mailing address

201 Lanny Bridges Ave
Covington, TN 38019-1615
Phone (901) 476-4648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
28975TNMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East LP Past Accepting new patients
Wal-Mart Stores East, LP Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1013404359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LANNY BRIDGES AVE",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380191615",
            "telephone_number": "901-476-4648",
            "fax_number": "901-476-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LANNY BRIDGES AVE",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380191615",
            "telephone_number": "901-476-4648",
            "fax_number": "901-476-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MITAL",
        "middle_name": "KEYURKUMAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-20",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "28975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.