Individual provider Active NPI

Nishaben M Patel, DPT

  • Physical Therapist
  • Jackson, MS
National Provider Identifier
1508599333
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6996 Issued in MS
Practice address
120 District Blvd Ste D102
Jackson, MS 39211-6304
Phone
(604) 345-2343
Fax
(769) 235-2751
NPI assigned
Jul 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT6996 MS Primary

Addresses

Primary practice location

120 District Blvd Ste D102
Jackson, MS 39211-6304

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 206-4158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240813002062 FL Practitioner - Physical Therapist in Private Practice 3476927765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4343 W Newberry Rd
Suite 4
Gainesville, FL 32607-2822
Phone (352) 373-6565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT6996MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fit for Life Physical Therapy, Inc Physical Therapist CurrentSince Jul 15, 2024 Accepting new patients
Fit for Life Physical Therapy, Inc Physical Therapist CurrentSince Jul 15, 2024 Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist Past Accepting new patients

Locations

4343 Newberry Rd
Ste 4
Gainesville, FL 32607
Phone (352) 373-6565

3305 SW 34th Cir
Ste 203
Ocala, FL 34474
Phone (352) 351-5019

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.

NPI Registry JSON

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1508599333",
    "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": "423-206-4158",
            "fax_number": "717-773-4654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 DISTRICT BLVD STE D102",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392116304",
            "telephone_number": "604-345-2343",
            "fax_number": "769-235-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NISHABEN",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-08",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT6996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; 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.