Individual provider Active NPI

Manu Hira Patel, M.D.

  • Family Medicine Physician
  • Gastonia, NC
National Provider Identifier
1396732707
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9501047 Issued in NC
Practice address
2711 X Ray Dr
Gastonia, NC 28054-7491
Phone
(704) 834-2420
Fax
(704) 834-2426
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9501047 NC Primary

Addresses

Primary practice location

2711 X Ray Dr
Gastonia, NC 28054-7491

Mailing address

2240 Remount Rd
Gastonia, NC 28054-4725
Phone (704) 671-5311

Other identifiers 2

IdentifierTypeStateIssuer
8965789MedicaidNC
N01047MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041103001172 NC Practitioner - Family Practice 5597727255 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9501047NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc Family Medicine CurrentSince Dec 16, 1996 Accepting new patients
Caromont Medical Group Inc Family Medicine Current Accepting new patients
Caromont Medical Group Inc Family Medicine CurrentSince Dec 16, 1996 Accepting new patients
Caromont Medical Group Inc Family Medicine Past Accepting new patients

Locations

2711 X Ray Dr
Gastonia, NC 28054
Phone (704) 834-2420

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

2711 X Ray Dr
#3106
Gastonia, NC 28054

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

2240 Remount Rd
Gastonia, NC 28054
Phone (704) 671-5311

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194912000000",
    "number": "1396732707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 REMOUNT RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544725",
            "telephone_number": "704-671-5311",
            "fax_number": "704-671-5308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 X RAY DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547491",
            "telephone_number": "704-834-2420",
            "fax_number": "704-834-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MANU",
        "middle_name": "HIRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2007-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9501047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8965789",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N01047",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.