Active NPI
Sonal Jaiprakash Patel
- Pediatrics Physician
- Charleston, SC
National Provider Identifier
1205400660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- LL86167
- Practice address
- 169 Ashley Ave RM 202
Charleston, SC 29425-8905 - Phone
- (937) 272-4976
- NPI assigned
- May 19, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | LL86167 | SC | Primary |
Addresses
Primary practice location
169 Ashley Ave RM 202
Charleston, SC 29425-8905
Mailing address
Prisma Health Children'S Hospital Outpatient Center
14 Medical Park, Suite 400
Columbia, SC 29203
Phone (803) 434-6155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210809003788 | SC | Order and Referring Only - Pediatric Medicine | 9436553740 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL86167 | SC | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718841600000",
"number": "1205400660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PRISMA HEALTH CHILDREN'S HOSPITAL OUTPATIENT CENTER",
"address_2": "14 MEDICAL PARK, SUITE 400",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29203",
"telephone_number": "803-434-6155",
"fax_number": "803-434-6979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 ASHLEY AVE RM 202",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294258905",
"telephone_number": "937-272-4976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "SONAL",
"middle_name": "JAIPRAKASH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-19",
"last_updated": "2024-06-20",
"certification_date": "2024-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "LL86167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.