Individual provider Active NPI

Dimpleben Vikalp Patel

  • Family Nurse Practitioner
  • Olive Branch, MS
National Provider Identifier
1316559479
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
904000 Issued in MS
Practice address
4735 Robinson Loop W
Olive Branch, MS 38654-8175
Phone
(662) 910-9029
NPI assigned
Aug 20, 2020
Last updated
Aug 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 904000 MS Primary

Addresses

Primary practice location

4735 Robinson Loop W
Olive Branch, MS 38654-8175

Mailing address

4735 Robinson Loop W
Olive Branch, MS 38654-8175
Phone (662) 910-9029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20210624000100 MS Practitioner - Nurse Practitioner 4486055779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Redmed LLCGroup PAC ID 2961633656, 54 clinicians

Practice addresses (Care Compare)

12 Brookes Xing
Pontotoc, MS 38863-1009
Phone (662) 489-4044

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Redmed, LLC CurrentSince Jun 14, 2021 Accepting new patients
Redmed, LLC CurrentSince Jun 14, 2021 Accepting new patients
Redmed, LLC PastSince Aug 18, 2024 Accepting new patients

Locations

171 Lakewood Dr
Batesville, MS 38606
Phone (662) 234-6464

1250 E Commerce St
Hernando, MS 38632
Phone (662) 298-2238

188 Starlyn Ave
New Albany, MS 38652
Phone (662) 486-2700

1902B Jackson Ave W
Oxford, MS 38655
Phone (662) 234-6464

12 Brookes Crossing
Pontotoc, MS 38863
Phone (662) 489-4044

105A Quality Ln
Ste A
Senatobia, MS 38668

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1316559479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4735 ROBINSON LOOP W",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386548175",
            "telephone_number": "662-910-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 ROBINSON LOOP W",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386548175",
            "telephone_number": "662-910-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DIMPLEBEN",
        "middle_name": "VIKALP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

Verify at the official NPI Registry.