Individual provider Active NPI

Vaishali Patel, PA

  • Physician Assistant
  • Lebanon, TN
National Provider Identifier
1366021230
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
702 S Cumberland St
Lebanon, TN 37087-4110
Phone
(615) 444-2121
NPI assigned
Apr 6, 2021
Last updated
Sep 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

702 S Cumberland St
Lebanon, TN 37087-4110

Mailing address

702 S Cumberland St
Lebanon, TN 37087-4110
Phone (615) 444-2121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20221205000141 TN Practitioner - Physician Assistant 6002285657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crossroads Urgent Care PLLCGroup PAC ID 8325117484, 181 clinicians

Practice addresses (Care Compare)

2445 Memorial Blvd
Suite C
Murfreesboro, TN 37129-5156
Phone (615) 217-6900

4024 N Mount Juliet Rd
Mt Juliet, TN 37122-3086
Phone (615) 257-2171

509 Hillsboro Rd
Franklin, TN 37064-2123
Phone (615) 472-2139

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Urgent Care PLLC Physician Assistant CurrentSince Oct 15, 2022 Accepting new patients
Crossroads Urgent Care PLLC Physician Assistant CurrentSince Oct 15, 2022 Accepting new patients
Anycare LLC CurrentSince Sep 20, 2022 Accepting new patients
Trevecca Nazarene University PastSince Apr 1, 2021 Accepting new patients

Locations

650 S Jefferson Ave
Ste 101
Cookeville, TN 38501
Phone (931) 303-0958

702 S Cumberland St
Lebanon, TN 37087
Phone (615) 444-2121

4024 N Mount Juliet Rd
Mt Juliet, TN 37122
Phone (615) 257-2171

2445 Memorial Blvd
Ste C
Murfreesboro, TN 37129
Phone (615) 217-6900

30 Burton Hills Blvd
Ste 175
Nashville, TN 37215
Phone (615) 988-2014

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1366021230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 S CUMBERLAND ST",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370874110",
            "telephone_number": "615-444-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 S CUMBERLAND ST",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370874110",
            "telephone_number": "615-444-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "VAISHALI",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, TN

Sources for this page

Verify at the official NPI Registry.