Active NPI
Patel Family Medicine LLC
Doing business as Family Medicine Center of Plymouth
- Clinic/Center
- Plymouth, IN
National Provider Identifier
1225348584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- 01063921A
- Legal business name
- PATEL FAMILY MEDICINE LLC
- Doing business as
- Family Medicine Center of Plymouth
- Practice address
- 105 Water St
Plymouth, IN 46563-2148 - Phone
- (574) 936-3178
- Fax
- (574) 936-1084
- NPI assigned
- Oct 20, 2010
- Last updated
- Aug 6, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kimberly Miller
- Title
- Director Or RCM
- Phone
- (248) 331-7908
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 01063921A | IN | Primary |
Addresses
Primary practice location
105 Water St
Plymouth, IN 46563-2148
Mailing address
PO Box 5635
Carol Stream, IL 60197-5635
Phone (248) 607-0037
Other practice location 1
1251 N Eddy St Ste 200
South Bend, IN 46617-1478
Phone (574) 936-3178
Other names 1
- Family Medicine Center of Plymouth
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service | Other | eSolutions Inc |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D2055893 | Patel Family Medicine Ctr of Plymouth | Certificate of waiver | Mar 18, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Esolutions Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Plymouth Family Medicine
- Family Medicine Physician
- Mishawaka, IN
- NPI 1417265349
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Unity Physicians Hospital
- General Acute Care Hospital
- Mishawaka, IN
- NPI 1518197011
Member Of
Locations
105 Water St
Plymouth, IN 46563
Phone (574) 540-2052
Practitioners & affiliated clinicians
Practitioners 16
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Granger, IN
- NPI 1518180512
-
- Family Medicine Physician
- Plymouth, IN
- NPI 1093938979
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287532800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1785974400000",
"number": "1225348584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5635",
"city": "CAROL STREAM",
"state": "IL",
"postal_code": "601975635",
"telephone_number": "248-607-0037",
"fax_number": "734-462-0344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 WATER ST",
"city": "PLYMOUTH",
"state": "IN",
"postal_code": "465632148",
"telephone_number": "574-936-3178",
"fax_number": "574-936-1084"
}
],
"practiceLocations": [
{
"address_1": "1251 N Eddy St Ste 200",
"address_purpose": "LOCATION",
"city": "South Bend",
"state": "IN",
"postal_code": "466171478",
"country_code": "US",
"telephone_number": "574-936-3178",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "PATEL FAMILY MEDICINE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-10-20",
"last_updated": "2026-08-06",
"certification_date": "2026-08-06",
"status": "A",
"authorized_official_last_name": "MILLER",
"authorized_official_first_name": "KIMBERLY",
"authorized_official_title_or_position": "DIRECTOR OR RCM",
"authorized_official_telephone_number": "248-331-7908"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "IN",
"license": "01063921A",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.1066.1",
"affiliationName": "eSolutions Inc",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CSV",
"address_1": "8215 W 108th Ter",
"city": "Overland Park",
"state": "KS",
"country_code": "US",
"postal_code": "662101661",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Family Medicine Center of Plymouth",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Plymouth, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.