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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| P21603 | NC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grace Physical Therapy | Physical Therapist | Current |
Accepting new patients |
| BJT & Associates | Physical Therapist | Current |
Accepting new patients |
| BJT and Associates | Physical Therapist | Past |
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
{
"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
- Radha Atul Patel
- Richa Patel
- Rishay Samir Patel
- Sapna S. Patel
- Seema Hasmukh Patel
- Shivani Patel
- Sonal Ramesh Patel
- Surya Ravi Patel
- Sweta Mahesh Patel
- Tulsi Patel
All providers in Durham, NC · Physical Therapist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2024. 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.