Active NPI
Avani Kishor Patel, MD
- Psychiatry Physician
- Ridgeland, MS
National Provider Identifier
1073142105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 33565
- Practice address
- 1000 Highland Colony Pkwy Ste 5203
Ridgeland, MS 39157-2079 - Phone
- (601) 509-2015
- Fax
- (601) 851-8483
- NPI assigned
- Apr 1, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 33565 | MS | Primary |
Addresses
Primary practice location
1000 Highland Colony Pkwy Ste 5203
Ridgeland, MS 39157-2079
Mailing address
1000 Highland Colony Pkwy Ste 5203
Ridgeland, MS 39157-2079
Phone (601) 509-2015
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 31, 2024 through Dec 31, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33565 | MS | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729814400000",
"number": "1073142105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 HIGHLAND COLONY PKWY STE 5203",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "391572079",
"telephone_number": "601-509-2015",
"fax_number": "601-851-8483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 HIGHLAND COLONY PKWY STE 5203",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "391572079",
"telephone_number": "601-509-2015",
"fax_number": "601-851-8483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "AVANI",
"middle_name": "KISHOR",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-01",
"last_updated": "2024-10-25",
"certification_date": "2024-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MS",
"license": "33565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgeland, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.