Kanubhai M Patel, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036-048978 Issued in IL

Practice address

3165 Myrtle Ave
Granite City, IL 62040-5012

Phone

(618) 877-3066

Fax

(618) 877-3060

NPI assigned

Jul 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: kpatel08@yourcarecommunity.org

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1649278185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3165 MYRTLE AVE",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620405012",
            "telephone_number": "618-877-3066",
            "fax_number": "618-877-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3165 MYRTLE AVE",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620405012",
            "telephone_number": "618-877-3066",
            "fax_number": "618-877-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KANUBHAI",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-048978",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036-048978",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036048978",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201849601",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Joseph Pace, M.D.
• Cody James Palmer, APN
• John K Parker, M.D., M.P.H.
• Amanda Leigh Parsley, D.O.
• Avni Patel
• Joellyn Marie Patterson, BA, CADC
• Janice M Pautler, RD,LD
• Albert Pelate, RPH
• Oscar Adrian Perez, PA-C
• Phillips Chiropractic LLC

• Internal Medicine Physician in Granite City, IL
• Providers in Granite City, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.