Individual provider Active NPI

Vaishali Patel, PT

  • Physical Therapist
  • Garner, NC
National Provider Identifier
1104377720
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P21919 Issued in NC
Practice address
510 Timber Dr E Ste 102
Garner, NC 27529-5285
Phone
(919) 500-5003
NPI assigned
Oct 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X J1-0003562 DE
Physical Therapist 225100000X 296098 CA
Physical Therapist 225100000X P21919 NC Primary

Addresses

Primary practice location

510 Timber Dr E Ste 102
Garner, NC 27529-5285

Mailing address

3911 N Washington St
Wilmington, DE 19802-2147
Phone (302) 764-8192

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200205002801 NC Practitioner - Physical Therapist in Private Practice 0547541997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Activcare Physical Therapy, LLCGroup PAC ID 8628027471, 126 clinicians

Practice addresses (Care Compare)

166 Springbrook Ave
Suite 201
Clayton, NC 27520-8520
Phone (919) 535-8461

3100 NC 55 Hwy
Suite 101
Cary, NC 27519-8427
Phone (919) 290-2799

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
85.21
Promoting interoperability
99
Improvement activities
40
Cost
77.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
296098CAMDPhysical Therapist
J1-0003562DEMDPhysical Therapist
P21919NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Activcare Physical Therapy, LLC Physical Therapist CurrentSince Dec 30, 2019 Accepting new patients
Metrolina Nephrology Associates, PA PastSince Oct 13, 2024 Accepting new patients
Golden Hills Orthopedic and Sports Physical Therapy Inc. Physical Therapist PastSince Mar 4, 2019 Accepting new patients

Locations

166 Springbrook Ave
Ste 201
Clayton, NC 27520
Phone (919) 535-8461

510 Timber Dr E
Ste 102
Garner, NC 27529
Phone (919) 500-5003

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

9936 Chapel Hill Rd
Morrisville, NC 27560
Phone (919) 296-0895

3410 Executive Dr
Ste 205
Raleigh, NC 27609
Phone (919) 322-0042

Interoperability endpoints

  • Direct secure messaging: vaishali.patel.p12@direct.athleticoltd.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1104377720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 N WASHINGTON ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198022147",
            "telephone_number": "302-764-8192",
            "fax_number": "302-764-8185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 TIMBER DR E STE 102",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275295285",
            "telephone_number": "919-500-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "VAISHALI",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-19",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0003562",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "296098",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garner, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.