Active NPI
Mitesh Indravadan Patel
- Pharmacist
- Thomasville, GA
National Provider Identifier
1225551294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH029959
- Practice address
- 301 S Broad St
Thomasville, GA 31792-5546 - Phone
- (229) 228-7658
- NPI assigned
- Jul 21, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH029959 | GA | Primary |
Addresses
Primary practice location
301 S Broad St
Thomasville, GA 31792-5546
Mailing address
121 Willow Ridge Cir
Thomasville, GA 31757-2834
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH029959 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500595200000",
"number": "1225551294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 WILLOW RIDGE CIR",
"city": "THOMASVILLE",
"state": "GA",
"postal_code": "317572834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 S BROAD ST",
"city": "THOMASVILLE",
"state": "GA",
"postal_code": "317925546",
"telephone_number": "229-228-7658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "MITESH",
"middle_name": "INDRAVADAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-07-21",
"last_updated": "2017-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH029959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thomasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.