Individual provider Active NPI

Ektaa Patel

  • Family Nurse Practitioner
  • Sandy Springs, GA
National Provider Identifier
1033694765
Registry record updated Sep 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN252727 Issued in GA
Practice address
6000 Lake Forrest Dr Ste 540
Sandy Springs, GA 30328-5902
Phone
(470) 735-5045
NPI assigned
Sep 28, 2018
Last updated
Sep 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN252727 GA Primary

Addresses

Primary practice location

6000 Lake Forrest Dr Ste 540
Sandy Springs, GA 30328-5902

Mailing address

6000 Lake Forrest Dr Ste 540
Sandy Springs, GA 30328-5902

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
I20190206002474 GA Practitioner - Nurse Practitioner 0345588976 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Preventclinic, Inc. CurrentSince Oct 19, 2018 Accepting new patients

Locations

6000 Lake Forrest Dr
Ste 540
Sandy Springs, GA 30328
Phone (470) 735-5045

Organizations & group practices 1

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": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538092800000",
    "number": "1033694765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 LAKE FORREST DR STE 540",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303285902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 LAKE FORREST DR STE 540",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303285902",
            "telephone_number": "470-735-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "EKTAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-28",
        "last_updated": "2018-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN252727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy Springs, GA

Sources for this page

Verify at the official NPI Registry.