Individual provider Active NPI

Mohit Patel, PHARMD

  • Pharmacist
  • Fort Wayne, IN
National Provider Identifier
1366038531
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26022931A Issued in IN
Practice address
5802 S Anthony Blvd
Fort Wayne, IN 46816-3702
Phone
(260) 456-5518
Fax
(260) 456-0577
NPI assigned
Dec 11, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 26022931A IN Primary

Addresses

Primary practice location

5802 S Anthony Blvd
Fort Wayne, IN 46816-3702

Mailing address

6327 Shadow Ridge Run
Fort Wayne, IN 46804-4290
Phone (317) 260-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
26022931AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1366038531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6327 SHADOW RIDGE RUN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044290",
            "telephone_number": "317-260-8800",
            "fax_number": "260-456-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5802 S ANTHONY BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468163702",
            "telephone_number": "260-456-5518",
            "fax_number": "260-456-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MOHIT",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26022931A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.