Individual provider Active NPI

Anita Patel

  • Primary Care Nurse Practitioner
  • Norcross, GA
National Provider Identifier
1306548284
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
NCO-000003 Issued in GA
Practice address
1235 Indian Trail Rd Ste 200
Norcross, GA 30093-5553
Phone
(770) 931-1333
NPI assigned
Mar 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X NCO-000003 GA Primary

Addresses

Primary practice location

1235 Indian Trail Rd Ste 200
Norcross, GA 30093-5553

Mailing address

1235 Indian Trail Rd Ste 200
Norcross, GA 30093-5553

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
I20231011003274 GA Practitioner - Nurse Practitioner 9638524655 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NCO-000003GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Medical Clinic, P.C. CurrentSince Sep 28, 2023 Accepting new patients

Locations

1235 Indian Trail Rd
Ste 200
Norcross, GA 30093
Phone (770) 931-1333

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": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1306548284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 INDIAN TRAIL RD STE 200",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300935553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 INDIAN TRAIL RD STE 200",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300935553",
            "telephone_number": "770-931-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ANITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "NCO-000003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

Verify at the official NPI Registry.