Individual provider Active NPI

Pruthaben Patel

  • Physical Therapist
  • Charlotte, NC
National Provider Identifier
1467293431
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P23095 Issued in NC
Practice address
2230 Park Rd Ste 104
Charlotte, NC 28203-6664
Phone
(704) 919-1280
NPI assigned
Jun 4, 2024
Last updated
Oct 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CP035290T SC
Physical Therapist 225100000X P23095 NC Primary

Addresses

Primary practice location

2230 Park Rd Ste 104
Charlotte, NC 28203-6664

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (980) 277-8916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240716002509 NC Practitioner - Physical Therapist in Private Practice 6709321516 Reassigns benefits to 1 organization
I20241024003658 SC Practitioner - Physical Therapist in Private Practice 6709321516 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Benchmark Healthcare Services LLCGroup PAC ID 3779726468, 136 clinicians

Practice addresses (Care Compare)

131 Evergreen Rd
Suite 105
Clover, SC 29710-9263
Phone (803) 810-6012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P23095NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy - South Carolina, LLC Physical Therapist CurrentSince Oct 3, 2024 Accepting new patients
Benchmark Physical Therapy of North Carolina LLC Physical Therapist CurrentSince May 20, 2024 Accepting new patients
Benchmark Health Services Physical Therapist CurrentSince Oct 3, 2024 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Oct 3, 2024 Accepting new patients
Benchmark Physical Therapy of NC, LLC Physical Therapist CurrentSince May 20, 2024 Accepting new patients
Benchmark Healthcare Services, LLC Physical Therapist CurrentSince Oct 3, 2024 Accepting new patients
Drayer Physical Therapy-South Carolina, LLC Physical Therapist CurrentSince Oct 3, 2024 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Oct 3, 2024 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

2230 Park Rd
Ste 104
Charlotte, NC 28203
Phone (704) 919-1280

10020 Monroe Rd
Ste 160
Matthews, NC 28105
Phone (704) 841-0894

131 Evergreen Rd
Ste 105
Clover, SC 29710
Phone (803) 810-6012

1000 Tanner Ford Blvd
Ste 370
Hanahan, SC 29410
Phone (843) 718-1058

7585 Saint Andrews Rd
Irmo, SC 29063
Phone (803) 749-5031

3032 W Montague Ave
Ste 101
North Charleston, SC 29418
Phone (843) 885-8772

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1467293431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "980-277-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 PARK RD STE 104",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282036664",
            "telephone_number": "704-919-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRUTHABEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "CP035290T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P23095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.