NPIMap

Organization Active NPI

Patel Familymedicine

Doing business as Plymouth Family Medicine

  • Family Medicine Physician
  • Mishawaka, IN
National Provider Identifier
1417265349
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01063921A Issued in IN
Legal business name
PATEL FAMILYMEDICINE
Doing business as
Plymouth Family Medicine
Practice address
1625 Jefferson Ave
Mishawaka, IN 46545
Phone
(574) 255-1400
Fax
(574) 485-1781
NPI assigned
Sep 14, 2010
Last updated
Sep 14, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
UNITED SURGEONS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Authorized official

Name
Viraj Patel, M.D.NPI 1093938979
Title
Physician
Phone
(574) 936-3178

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01063921A IN Primary

Addresses

Primary practice location

1625 Jefferson Ave
Mishawaka, IN 46545

Mailing address

1904 Lake Ave
Plymouth, IN 46563-7828
Phone (574) 936-3178

Other names 1

  • PLYMOUTH FAMILY MEDICINE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Esolutions Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284422400000",
    "number": "1417265349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 LAKE AVE",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465637828",
            "telephone_number": "574-936-3178",
            "fax_number": "574-936-1084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 JEFFERSON AVE",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "46545",
            "telephone_number": "574-255-1400",
            "fax_number": "574-485-1781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATEL FAMILYMEDICINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNITED SURGEONS LLC",
        "enumeration_date": "2010-09-14",
        "last_updated": "2010-09-14",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "VIRAJ",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "574-936-3178",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01063921A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PLYMOUTH FAMILY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mishawaka, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.