Individual provider Active NPI

Nimesh Chandrakant Patel, RPH

  • Pharmacist
  • Medina, OH
National Provider Identifier
1639372774
Registry record updated Feb 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03-1-22754 Issued in OH
Practice address
1090 Enterprise Dr
Medina, OH 44256-1328
Phone
(844) 443-6879
Fax
(844) 329-2447
NPI assigned
Jun 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03-1-22754 OH Primary
Pharmacist 183500000X 040973 MI

Addresses

Primary practice location

1090 Enterprise Dr
Medina, OH 44256-1328

Mailing address

4913 Westminster LN
Broadview Heights, OH 44147-2070

Other identifiers 2

IdentifierTypeStateIssuer
03-1-22754OtherOHRPH LICENSE OHIO
040973OtherMIPHARMACY LICENSE

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
040973MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424995200000",
    "number": "1639372774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4913 WESTMINSTER LN",
            "city": "BROADVIEW HEIGHTS",
            "state": "OH",
            "postal_code": "441472070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 ENTERPRISE DR",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442561328",
            "telephone_number": "844-443-6879",
            "fax_number": "844-329-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NIMESH",
        "middle_name": "CHANDRAKANT",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2015-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03-1-22754",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "040973",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RPH LICENSE OHIO",
            "identifier": "03-1-22754",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "040973",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2015; 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.