Individual provider Active NPI

Nimish Kantilal Patel, MD

  • Family Medicine Physician
  • Indian Land, SC
National Provider Identifier
1710141668
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32108 Issued in SC
Practice address
1040 Edgewater Corporate Pkwy Suite 101
Indian Land, SC 29707-7177
Phone
(803) 548-7007
NPI assigned
Jul 10, 2008
Last updated
Jan 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32108 SC Primary
Family Medicine Physician 207Q00000X 2008-01850 NC
Family Medicine Physician 207Q00000X 25MA08503500 NJ
Family Medicine Physician 207Q00000X 4301091628 MI

Addresses

Primary practice location

1040 Edgewater Corporate Pkwy Suite 101
Indian Land, SC 29707-7177

Mailing address

1040 Edgewater Corp Pkwy Ste 101
Indian Land, SC 29707-4514
Phone (803) 548-7007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100225000947 SC Practitioner - Family Practice 2163566357 Reassigns benefits to 3 organizations
I20130508000485 NC Practitioner - Family Practice 2163566357 Reassigns benefits to 1 organization
Practice locations: Charlotte, NC

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CMP Senior Healthcare LLCGroup PAC ID 4183091242, 2 clinicians
Carolina Medical Partners PLLCGroup PAC ID 4385058833, 2 clinicians

Practice addresses (Care Compare)

1028 Edgewater Corporate Pkwy
Suite 103
Indian Land, SC 29707-0187
Phone (803) 547-8660

10535 Flennigan Way
Charlotte, NC 28277-1417
Phone (803) 547-8660

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301091628MIMDFamily Medicine Physician
2008-01850NCMDFamily Medicine Physician
25MA08503500NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Medical Group, PLLC Multi-Specialty CurrentSince Jan 1, 2010 Accepting new patients
CMP Senior Healthcare LLC Multi-Specialty CurrentSince Jul 21, 2022 Accepting new patients
Carolina Medical Partners PLLC Multi-Specialty CurrentSince Oct 1, 2020 Accepting new patients
Palmetto Medical Group, PLLC Multi-Specialty CurrentSince Jan 1, 2010 Accepting new patients

Locations

1028 Edgewater Corporate Pkwy
Ste 103
Indian Land, SC 29707
Phone (803) 393-4611

1040 Edgewater Corporate Pkwy
Ste 101
Indian Land, SC 29707
Phone (803) 548-7007

1040 Edgewater Corporate Pkwy
Ste 103
Indian Land, SC 29707
Phone (803) 547-8660

Interoperability endpoints

  • Direct secure messaging: nimish.patel@130915503177732.direct.elationemr.com
  • Direct secure messaging: nimish.patel@356474464829444.direct.elationemr.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1710141668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 EDGEWATER CORP PKWY STE 101",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297074514",
            "telephone_number": "803-548-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 EDGEWATER CORPORATE PKWY SUITE 101",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297077177",
            "telephone_number": "803-548-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NIMISH",
        "middle_name": "KANTILAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "32108",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2008-01850",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA08503500",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301091628",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Land, SC

Sources for this page

Verify at the official NPI Registry.