Active NPI
Monika Patel
- Physical Therapist
- Locust Grove, GA
National Provider Identifier
1467874016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT011343
- Practice address
- 4959 Bill Gardner Pkwy
Ste 109
Locust Grove, GA 30248-2915 - Phone
- (770) 914-9285
- Fax
- (770) 914-9668
- NPI assigned
- Jan 16, 2014
- Last updated
- Jan 16, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT011343 | GA | Primary |
Addresses
Primary practice location
4959 Bill Gardner Pkwy
Ste 109
Locust Grove, GA 30248-2915
Mailing address
8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT011343 | Other | GA | PHYSICAL THERAPY LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT011343 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389830400000",
"number": "1467874016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8823 PRODUCTION LN",
"city": "OOLTEWAH",
"state": "TN",
"postal_code": "373636511",
"telephone_number": "423-238-7217",
"fax_number": "423-954-7408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4959 BILL GARDNER PKWY",
"address_2": "STE 109",
"city": "LOCUST GROVE",
"state": "GA",
"postal_code": "302482915",
"telephone_number": "770-914-9285",
"fax_number": "770-914-9668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "MONIKA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-16",
"last_updated": "2014-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT011343",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPY LICENSE",
"identifier": "PT011343",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Locust Grove, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.