Purvita Ajitbhai Patel, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY003496 Issued in GA

Practice address

6264 Hospital Way
Douglasville, GA 30134-1944

Phone

(678) 977-8300

Fax

(866) 489-2642

NPI assigned

Sep 27, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• West Georgia Psychological Services

  • Clinical Psychologist
  • Douglasville, GA
  • NPI 1962543579
  NPD (past)

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1689957466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1916",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301331916",
            "telephone_number": "678-977-8300",
            "fax_number": "866-489-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6264 HOSPITAL WAY",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341944",
            "telephone_number": "678-977-8300",
            "fax_number": "866-489-2642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PURVITA",
        "middle_name": "AJITBHAI",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003496",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "GA",
            "license": "PSY003496",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jigisha K Patel, DENTIST
• Meek Harshvadan Patel, OD
• Milan Alpesh Patel, P.A.
• Parikshit Patel
• Priyesh Patel, PHARMD
• Satyajeet Patel, MD
• Tejaskumar Bhailalbhai Patel, BSN RN
• Tushar Patel, RPH
• Ladonia Patterson, N.P.
• Sharon Patton

• Clinical Psychologist in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; 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.