Individual provider Active NPI

Ronak Patel, PT

  • Physical Therapist
  • McDonough, GA
National Provider Identifier
1114252194
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT009784 Issued in GA
Practice address
1350 S Zack Hinton Pkwy
Suitec
McDonough, GA 30253-3361
Phone
(770) 898-5401
Fax
(770) 898-5517
NPI assigned
Oct 9, 2009
Reactivated
Sep 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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 PT009784 GA Primary

Addresses

Primary practice location

1350 S Zack Hinton Pkwy
Suitec
McDonough, GA 30253-3361

Mailing address

1350 Zack-Hinton Pkwy
Suitec
McDonough, GA 30253
Phone (770) 898-5401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1255046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1114252194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 ZACK-HINTON PKWY",
            "address_2": "SUITEC",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "30253",
            "telephone_number": "770-898-5401",
            "fax_number": "770-898-5517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S ZACK HINTON PKWY",
            "address_2": "SUITEC",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302533361",
            "telephone_number": "770-898-5401",
            "fax_number": "770-898-5517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "RONAK",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-09",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "deactivation_date": "2020-06-24",
        "reactivation_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT009784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.