NPIMap

Organization Active NPI

Patel Medical Clinic PA

  • Internal Medicine Physician
  • Fort Mill, SC
National Provider Identifier
1528383577
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20083 Issued in SC
Legal business name
PATEL MEDICAL CLINIC PA
Practice address
515 River Crossing Dr
Suite 200
Fort Mill, SC 29715-7900
Phone
(803) 835-6500
Fax
(803) 835-1990
NPI assigned
Apr 1, 2010
Last updated
May 26, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2020

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

Authorized official

Name
Dr. Shilpesh Shantilal Patel, M.D.NPI 1669428074
Title
President
Phone
(803) 835-6500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 20083 SC Primary

Addresses

Primary practice location

515 River Crossing Dr
Suite 200
Fort Mill, SC 29715-7900

Mailing address

PO Box 1089
Fort Mill, SC 29716-1089
Phone (803) 835-6500

Other identifiers 1

IdentifierTypeStateIssuer
200838MedicaidSC

National Provider Directory

National Provider Directory

Locations

515 Rivercrossing Dr
Ste 200
Fort Mill, SC 29715
Phone (803) 835-6500

223 Herlong Ave S
Ste 110
Rock Hill, SC 29732
Phone (803) 326-3000

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590451200000",
    "number": "1528383577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1089",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297161089",
            "telephone_number": "803-835-6500",
            "fax_number": "803-835-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 RIVER CROSSING DR",
            "address_2": "SUITE 200",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297157900",
            "telephone_number": "803-835-6500",
            "fax_number": "803-835-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATEL MEDICAL CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-01",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "SHILPESH",
        "authorized_official_middle_name": "SHANTILAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-835-6500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "20083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200838",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; 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.