Individual provider Active NPI

Shiv Patel, DPT

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1114639440
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT016353 Issued in GA
Practice address
50 Executive Park S Apt 406
Atlanta, GA 30329-2233
Phone
(229) 326-9881
NPI assigned
Dec 19, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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 PT016353 GA Primary

Addresses

Primary practice location

50 Executive Park S Apt 406
Atlanta, GA 30329-2233

Mailing address

3028 Park Ave N
Tifton, GA 31794-2863
Phone (229) 326-9881

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230228001494 GA Practitioner - Physical Therapist in Private Practice 1153794854 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Philadelphia College of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Physical Therapy, LLCGroup PAC ID 1153382676, 96 clinicians

Practice addresses (Care Compare)

21 Ortho LN
Atlanta, GA 30329-2315
Phone (404) 778-3350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Physical Therapy, LLC CurrentSince Nov 22, 2024 Accepting new patients
Hands of Hope PT PC Physical Therapist CurrentSince Jan 1, 2023 Accepting new patients
Emory Physical Therapy, LLC Current Accepting new patients
Emory Physical Therapy, LLC CurrentSince Nov 22, 2024 Accepting new patients
Serene Living Home Care LLC CurrentSince Nov 1, 2024 Accepting new patients
Georgia Luna Care Physical Therapy LLC Physical Therapist CurrentSince Oct 30, 2024 Accepting new patients

Locations

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

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

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

360 McDonough Pkwy
McDonough, GA 30253
Phone (678) 532-7754

Organizations & group practices 6

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": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1114639440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3028 PARK AVE N",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317942863",
            "telephone_number": "229-326-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 EXECUTIVE PARK S APT 406",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292233",
            "telephone_number": "229-326-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHIV",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-19",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT016353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.