Shilpa Jaykrishna Patel, PT, DPT, MBA

Individual provider Active NPI Physical Therapist · Durham, NC

NPI 1467965459 · NPPES record last updated Jan 11, 2024

Key facts

NPI
1467965459
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
P21603 (NC)
Practice address
5826 Fayetteville Rd Ste 201
Durham, NC 27713-8684
Phone
(919) 914-0896
NPI assigned
Nov 13, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20180720000647 GA Practitioner - Physical Therapist in Private Practice 0042567141 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
P21603NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Physical Therapy Physical Therapist Current
since Mar 24, 2024
Accepting new patients
BJT & Associates Physical Therapist Current
since Nov 20, 2017
Accepting new patients
BJT and Associates Physical Therapist Past
since Nov 20, 2017
Accepting new patients

Locations

2669 Osborne Rd NE
Brookhaven, GA 30319
Phone (404) 477-7777

2669 Osborne Rd NE
Ste A
Brookhaven, GA 30319
Phone (404) 477-4777

5826 Fayetteville Rd
Ste 201
Durham, NC 27713
Phone (919) 246-5611

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P21603 NC Yes

Addresses

Primary practice location

5826 Fayetteville Rd Ste 201
Durham, NC 27713-8684

Mailing address

5826 Fayetteville Rd Ste 201
Durham, NC 27713-8684
Phone (919) 914-0896

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 11, 2024.

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1467965459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5826 FAYETTEVILLE RD STE 201",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277138684",
            "telephone_number": "919-914-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5826 FAYETTEVILLE RD STE 201",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277138684",
            "telephone_number": "919-914-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHILPA",
        "middle_name": "JAYKRISHNA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-13",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

All providers in Durham, NC · Physical Therapist in North Carolina

Sources for this page

Verify at the official NPI Registry.