Kavita Shanker-Patel, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2022-01815 Issued in NC

Practice address

3614 Providence Rd S Ste 200
Waxhaw, NC 28173-6310

Phone

(704) 384-8640

Fax

(704) 384-8650

NPI assigned

Apr 9, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

The Weston Group IncGroup PAC ID 8123936796, shared by 8 NPIs, 215 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Charlotte, NC, CCN 347091
• Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
• Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
• Novant Health Ballantyne Medical Center Hospital, Charlotte, NC, CCN 340195

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kshankerpatel1071658@direct.novanthealth.org

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.

• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group NPD
• Novant Health Medical Group, LLC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  • Family Medicine Physician
  • Waxhaw, NC
  • NPI 1568400729
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Novant Health Ballantyne Medical Center LLC

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1740998020
  Care Compare affiliation
• Novant Health Matthews Medical Center LLC

  • General Acute Care Hospital
  • Matthews, NC
  • NPI 1063463156
  Care Compare affiliation
• The Presbyterian Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1396798591

  Hospital

  Care Compare affiliation
• The Presbyterian Hospital

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1497708838
  Care Compare affiliation
• The Presbyterian Hospital

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1881647204
  Care Compare affiliation
• The Presbyterian Hospital

  • Skilled Nursing Facility
  • Charlotte, NC
  • NPI 1891871901

  Hospital

  Care Compare affiliation
• Total Care Home Health of North Carolina, LLC

  • Home Health Agency
  • Charlotte, NC
  • NPI 1497782924
  Care Compare affiliation

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1124384789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3614 PROVIDENCE RD S STE 200",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281736310",
            "telephone_number": "704-384-8640",
            "fax_number": "704-384-8650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 S Gary Ave",
            "address_purpose": "LOCATION",
            "city": "Bloomingdale",
            "state": "IL",
            "postal_code": "601082228",
            "country_code": "US",
            "telephone_number": "630-924-4009",
            "fax_number": "630-924-9671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANKER-PATEL",
        "first_name": "KAVITA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-09",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036138106",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125061830",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2022-01815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (GROUP)",
            "identifier": "920540",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "F400250954",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "036138106",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott'S Ancillary Services, Inc.
• Kayla Selena Sease, BSW,MSW, LCSW
• Kristine Diane Selzer, RPH
• Liz Valentina Sepulveda Gomez, BCBA
• Shane Markey DDS Ms PLLC
• Brianna Elizabeth Sharpe
• Sydney Shepard
• Lynda Jane Shorter, M.S., CCC-SLP
• Resha Shrestha, MD
• Timothy Ray Sieges, PHD

• Family Medicine Physician in Waxhaw, NC
• Providers in Waxhaw, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.
• 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.