Pravinchandra P. Patel, MD P.C.
Organization Active NPI Family Medicine Physician · Coldwater, MS
NPI 1457527475 · NPPES record last updated Mar 16, 2010
Key facts
- NPI
- 1457527475
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MS 07838 (MS)
- Legal business name
- PRAVINCHANDRA P. PATEL, MD P.C.
- Practice address
- 423 Central Ave
Coldwater, MS 38618-3915 - Phone
- (662) 622-7011
- Fax
- (662) 622-0257
- NPI assigned
- Apr 30, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Pravinchandra Patel, MD
- Title
- Dr.
- Phone
- (662) 622-7011
Practitioners 10
-
Amit Bhagwanji Patel, M.D.
-
Pravin P Patel, MD
-
Jennifer Lynn McKee, FNP-BC
-
Audra Blye Lewis, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080514000023 | MS | Part B Supplier - Clinic/Group Practice | 8325117500 |
Receives reassigned benefits from 10 practitioners Practice locations: Coldwater, MS; Olive Branch, MS |
National Provider Directory
Locations
431 Central Ave
Coldwater, MS 38618
Phone (662) 622-7011
6965 Oak Forest Dr
Olive Branch, MS 38654
Phone (662) 622-7011
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IIHEBD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | MS 07838 | MS | Yes |
Addresses
Primary practice location
423 Central Ave
Coldwater, MS 38618-3915
Mailing address
PO Box 1060
Coldwater, MS 38618-1060
Phone (662) 622-7011
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09015376 | Medicaid | MS | |
| 3963799 | Other | MS | CIGNA |
| 0004324215 | Other | AETNA | |
| 00122592 | Other | MS | INDIVIDUAL MEDICAID |
| 080183850 | Other | MS | RAILROAD MEDICARE |
| 587274863D | Other | MS | BLUE CROSS BLUE SHIELD |
| 1124098603 | Other | MS | MEDICARE INDIVIDUAL NPI |
Other providers in Coldwater, MS
- Amit Bhagwanji Patel
- Pravin P Patel
- Edward Lee Phelps
- Pioneer Express Respiratory Care
- Pravincha P. Patel, M.D.
- Tara Puckett
- Michael Saulsberry
- Lori Shackleford
- Holley Harris Smith
- April Starkey
All providers in Coldwater, MS · Family Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.