Individual provider Active NPI

Avaniben Patel

  • Physical Therapist
  • Suwanee, GA
National Provider Identifier
1043801475
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT014999 Issued in GA
Practice address
4060 Johns Creek Pkwy Ste H
Suwanee, GA 30024-1230
Phone
(770) 622-5344
Fax
(770) 622-5388
NPI assigned
Jan 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT014999 GA Primary

Addresses

Primary practice location

4060 Johns Creek Pkwy Ste H
Suwanee, GA 30024-1230

Mailing address

4060 Johns Creek Pkwy Ste H
Suwanee, GA 30024-1230
Phone (770) 622-5344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210303003399 GA Practitioner - Physical Therapist in Private Practice 8325454028 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Luna Care Physical Therapy LLCGroup PAC ID 4082027727, 167 clinicians

Practice addresses (Care Compare)

260 Peachtree St NW
Suite 2200
Atlanta, GA 30303-1292
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT014999GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Luna Care Physical Therapy LLC Physical Therapist CurrentSince Nov 17, 2025 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Nov 17, 2025 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Nov 17, 2025 Accepting new patients

Locations

260 Peachtree St NW
Ste 2200
Atlanta, GA 30303
Phone (669) 231-6870

21 Ortho Ln
Atlanta, GA 30329
Phone (404) 778-2516

1968 Hawks Ln NE
Brookhaven, GA 30329
Phone (404) 251-2537

1845 Satellite Blvd
Ste 750
Duluth, GA 30097
Phone (404) 778-6490

Organizations & group practices 4

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": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1043801475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 JOHNS CREEK PKWY STE H",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241230",
            "telephone_number": "770-622-5344",
            "fax_number": "770-622-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 JOHNS CREEK PKWY STE H",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241230",
            "telephone_number": "770-622-5344",
            "fax_number": "770-622-5388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "AVANIBEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.