Individual provider Active NPI

Kaushal Patel, RPH

  • Pharmacist
  • Savannah, GA
National Provider Identifier
1508455973
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH028252 Issued in GA
Practice address
418 W Broughton St
Savannah, GA 31401-3218
Phone
(912) 999-6101
Fax
(912) 777-5953
NPI assigned
Jan 11, 2021
Last updated
Jan 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X RPH028252 GA Primary

Addresses

Primary practice location

418 W Broughton St
Savannah, GA 31401-3218

Mailing address

418 W Broughton St
Savannah, GA 31401-3218
Phone (912) 999-6101

Other practice location 1

111 Canal St Ste 101
Pooler, GA 31322-4054
Phone (912) 988-7185

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)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPH028252GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pavan Putra Pharmacy Inc CurrentSince Jan 17, 2021 Accepting new patients
Pavan Putra Investment Group LLC Current Accepting new patients

Locations

111 Canal St
Ste 101
Pooler, GA 31322
Phone (912) 988-7185

418 W Broughton St
Savannah, GA 31401
Phone (912) 659-0019

Organizations & group practices 2

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": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1508455973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 W BROUGHTON ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314013218",
            "telephone_number": "912-999-6101",
            "fax_number": "912-777-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 W BROUGHTON ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314013218",
            "telephone_number": "912-999-6101",
            "fax_number": "912-777-5953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Canal St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Pooler",
            "state": "GA",
            "postal_code": "313224054",
            "country_code": "US",
            "telephone_number": "912-988-7185",
            "fax_number": "912-988-1045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KAUSHAL",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH028252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.