Individual provider Active NPI

Dipa Ketan Patel, MSN, AGACNP-BC, NP-C

  • Family Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1033525415
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP213386 Issued in GA
Practice address
758 Old Norcross Rd Ste 100
Lawrenceville, GA 30046-3386
Phone
(770) 962-4300
Fax
(770) 339-7544
NPI assigned
Jul 7, 2014
Last updated
Nov 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP213386 GA Primary
Student in an Organized Health Care Education/Training Program 390200000X 213386 GA

Addresses

Primary practice location

758 Old Norcross Rd Ste 100
Lawrenceville, GA 30046-3386

Mailing address

758 Old Norcross Rd Ste 100
Lawrenceville, GA 30046-3386
Phone (770) 962-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151030001912 GA Practitioner - Nurse Practitioner 5890005052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resurgens, LLCGroup PAC ID 1153224142, 184 clinicians

Practice addresses (Care Compare)

758 Old Norcross Rd
Suite 100
Lawrenceville, GA 30046-3385
Phone (770) 962-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP213386GAMDFamily Nurse Practitioner
213386GAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgens, LLC CurrentSince Mar 25, 2024 Accepting new patients
Resurgens, LLC CurrentSince Mar 25, 2024 Accepting new patients
NGX Lawrenceville Ga PC CurrentSince Oct 13, 2023 Accepting new patients

Locations

1223 Friendship Rd
Ste 220
Braselton, GA 30517
Phone (470) 762-3641

1470 Lawrenceville Hwy
Lawrenceville, GA 30044
Phone (678) 486-7777

758 Old Norcross Rd
Ste 100
Lawrenceville, GA 30046
Phone (770) 962-4300

5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

Interoperability endpoints

  • Direct secure messaging: dipa.patel.1@15749.direct.athenahealth.com
  • Direct secure messaging: dipa.patel.p75@direct.tenet.nextgenshare.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764115200000",
    "number": "1033525415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 OLD NORCROSS RD STE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463386",
            "telephone_number": "770-962-4300",
            "fax_number": "770-339-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "758 OLD NORCROSS RD STE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463386",
            "telephone_number": "770-962-4300",
            "fax_number": "770-339-7544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DIPA",
        "middle_name": "KETAN",
        "credential": "MSN, AGACNP-BC, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "NP213386",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "213386",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.