Individual provider Active NPI

Shree Patel I, D.O.

  • Pediatrics Physician
  • Dacula, GA
National Provider Identifier
1285040238
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
91014 Issued in GA
Practice address
1862 Auburn Rd Ste 107
Dacula, GA 30019-1677
Phone
(678) 288-4142
NPI assigned
Jul 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 34.018305 OH
Pediatrics Physician 208000000X 0102206068 VA
Pediatrics Physician 208000000X 91014 GA Primary

Addresses

Primary practice location

1862 Auburn Rd Ste 107
Dacula, GA 30019-1677

Mailing address

1862 Auburn Rd Ste 107
Dacula, GA 30019-1677
Phone (678) 288-4142

Other practice location 1

200 Rockridge Rd Ste 110
Englewood, OH 45322-2751
Phone (937) 836-9921

Other practice location 2

1425 N Fairfield Rd Ste 120
Beavercreek, OH 45432-2674
Phone (937) 320-3888

Other practice location 3

6551 Centerville Business Pkwy Ste 110
Centerville, OH 45459-2696
Phone (937) 291-6850

Other practice location 4

8501 Old Troy Pike Ste 120
Huber Heights, OH 45424-1061
Phone (937) 237-4945

Other practice location 5

3333 W Tech Rd Ste 120
Miamisburg, OH 45342-0956
Phone (937) 748-6116

Other practice location 6

1152 W 3rd St Ste 102
Dayton, OH 45402-6848
Phone (937) 268-3483

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20240322000956 GA Practitioner - Pediatric Medicine 4981041209 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102206068VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Pediatrics CurrentSince Feb 13, 2024 Accepting new patients
Village Pediatrics, PC Pediatrics PastSince Jul 3, 2022 Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

2525 Cumberland Pkwy SE
Atlanta, GA 30339
Phone (770) 431-4145

Organizations & group practices 3

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": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1285040238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1862 AUBURN RD STE 107",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191677",
            "telephone_number": "678-288-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1862 AUBURN RD STE 107",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191677",
            "telephone_number": "678-288-4142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Rockridge Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "OH",
            "postal_code": "453222751",
            "country_code": "US",
            "telephone_number": "937-836-9921",
            "fax_number": "937-836-1298",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1425 N Fairfield Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454322674",
            "country_code": "US",
            "telephone_number": "937-320-3888",
            "fax_number": "937-320-3848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6551 Centerville Business Pkwy Ste 110",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454592696",
            "country_code": "US",
            "telephone_number": "937-291-6850",
            "fax_number": "937-291-6896",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8501 Old Troy Pike Ste 120",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241061",
            "country_code": "US",
            "telephone_number": "937-237-4945",
            "fax_number": "937-237-4925",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 W Tech Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453420956",
            "country_code": "US",
            "telephone_number": "937-748-6116",
            "fax_number": "937-291-6956",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1152 W 3rd St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454026848",
            "country_code": "US",
            "telephone_number": "937-268-3483",
            "fax_number": "937-268-1884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHREE",
        "name_suffix": "I",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-09",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34.018305",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0102206068",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "91014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

Verify at the official NPI Registry.