Individual provider Active NPI

Madhubala A Patel, MD

  • Psychiatry Physician
  • Dalton, GA
National Provider Identifier
1699847616
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
030181 Issued in GA
Practice address
900 Shugart Rd
Dalton, GA 30720-2467
Phone
(706) 270-5100
Fax
(706) 270-5066
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 030181 GA Primary

Addresses

Primary practice location

900 Shugart Rd
Dalton, GA 30720-2467

Mailing address

1401 Applewood Drive
Suite 1
Dalton, GA 30720-2699
Phone (706) 270-5003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20080527000649 GA Practitioner - Psychiatry 3173692548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lookout Mountain Community ServicesGroup PAC ID 4880682822, 18 clinicians

Practice addresses (Care Compare)

501 Mize St
La Fayette, GA 30728-3346
Phone (706) 638-5580

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lookout Mountain Community Services Current Accepting new patients
Lookout Mountain Community Services CurrentSince Jun 24, 2017 Accepting new patients

Locations

110 Hedekin Cir
Ft Oglethorpe, GA 30742
Phone (706) 866-5945

501 Mize St
La Fayette, GA 30728
Phone (706) 638-5584

Organizations & group practices 2

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1699847616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 APPLEWOOD DRIVE",
            "address_2": "SUITE 1",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202699",
            "telephone_number": "706-270-5003",
            "fax_number": "706-270-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SHUGART RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202467",
            "telephone_number": "706-270-5100",
            "fax_number": "706-270-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MADHUBALA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "030181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.