Individual provider Active NPI

Manisha Patel, NP

  • Nurse Practitioner
  • Cumming, GA
National Provider Identifier
1295139715
Registry record updated Dec 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN242966 Issued in GA
Practice address
1800 Northside Forsyth Dr
Suite 300
Cumming, GA 30041-8416
Phone
(678) 366-2154
NPI assigned
Oct 13, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN242966 GA Primary

Addresses

Primary practice location

1800 Northside Forsyth Dr
Suite 300
Cumming, GA 30041-8416

Mailing address

2210 Avonleigh Dr
Cumming, GA 30041-2628
Phone (256) 744-6887

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141201000414 GA Practitioner - Nurse Practitioner 0648592766 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN242966GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Oct 1, 2014 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

101 W Ponce de Leon Ave
Ste 300
Decatur, GA 30030
Phone (404) 778-4889

Organizations & group practices 1

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": "1413158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481241600000",
    "number": "1295139715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 AVONLEIGH DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300412628",
            "telephone_number": "256-744-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 NORTHSIDE FORSYTH DR",
            "address_2": "SUITE 300",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300418416",
            "telephone_number": "678-366-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MANISHA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-13",
        "last_updated": "2016-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN242966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.