Individual provider Active NPI

Niyomi Gandhi Patel, M.D.

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1639557481
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2021-03281 Issued in NC
Practice address
8401 Medical Plaza Dr Ste 220
Charlotte, NC 28262-8700
Phone
(704) 384-1570
Fax
(704) 384-1534
NPI assigned
May 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301107395 MI
Pediatrics Physician 208000000X 275549 MA
Pediatrics Physician 208000000X 2021-03281 NC Primary

Addresses

Primary practice location

8401 Medical Plaza Dr Ste 220
Charlotte, NC 28262-8700

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

2845 Mullholland Dr Apt 1612
Charlotte, NC 28262-6917
Phone (615) 419-4129

Other names 1

  • Niyomi Gandhi Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220107002329 NC Practitioner - Pediatric Medicine 2163738683 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Pediatrics CurrentSince Jan 1, 2022 Accepting new patients
Novant Medical Group, Inc. Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 1, 2022 Accepting new patients
Novant Health Medical Group, LLC Pediatrics CurrentSince Jan 1, 2022 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

2630 E 7th St
Ste 101
Charlotte, NC 28204
Phone (704) 344-1000

8820 Rachel Freeman Way
Charlotte, NC 28278
Phone (704) 316-3608

8401 Medical Plaza Dr
Ste 220
Charlotte, NC 28262
Phone (704) 384-1390

5325 Vinning St NW
Ste 101
Concord, NC 28027
Phone (704) 316-1040

7752 Gateway Ln NW
Ste 100
Concord, NC 28027
Phone (704) 316-4950

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: npatel1017397@direct.novanthealth.org

Organizations & group practices 7

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": "1431475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1639557481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 MEDICAL PLAZA DR STE 220",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282628700",
            "telephone_number": "704-384-1570",
            "fax_number": "704-384-1534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2845 Mullholland Dr Apt 1612",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282626917",
            "country_code": "US",
            "telephone_number": "615-419-4129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NIYOMI",
        "middle_name": "GANDHI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-13",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301107395",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "275549",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2021-03281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIYOMI",
            "last_name": "GANDHI",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.