NPIMap

Individual provider Active NPI

Priya Patel, MD

  • Family Medicine Physician
  • Lavonia, GA
National Provider Identifier
1568025443
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
90788 Issued in GA
Practice address
12192 Augusta Rd
Lavonia, GA 30553-1209
Phone
(706) 356-1072
NPI assigned
Apr 17, 2019
Last updated
Nov 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 90788 GA Primary

Addresses

Primary practice location

12192 Augusta Rd
Lavonia, GA 30553-1209

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ppatel141643@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221202002721 GA Practitioner - Family Practice 8820324940 Reassigns benefits to 2 organizations

Care Compare profile

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

Practice addresses (Care Compare)

3340 Paddock Pkwy
Suwanee, GA 30024-9119
Phone (678) 679-6210

3350 Paddocks Pkwy
Suwanee, GA 30024-9119
Phone (678) 474-9633

3380 Paddocks Pkwy
Suwanee, GA 30024-9119
Phone (678) 474-9633

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
90788GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Primary Care Professional Services, LLC CurrentSince Feb 1, 2023 Accepting new patients
Northeast Georgia Physicians Group Inc Family Medicine CurrentSince Oct 1, 2022 Accepting new patients
Northside Primary Care Professional Services,LLC Family Medicine CurrentSince Feb 1, 2023 Accepting new patients

Locations

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

12192 Augusta Rd
Lavonia, GA 30553
Phone (706) 356-1072

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

Interoperability endpoints

  • Direct secure messaging: ppatel141643@nghs.gadirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1568025443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12192 AUGUSTA RD",
            "city": "LAVONIA",
            "state": "GA",
            "postal_code": "305531209",
            "telephone_number": "706-356-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRIYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-17",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "90788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ppatel141643@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12192 Augusta Rd",
            "city": "Lavonia",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305531209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lavonia, GA

Sources for this page

Verify at the official NPI Registry.