Individual provider Active NPI

Rima Dipak Patel, ADVANCED PRACTICE NP

  • Adult Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1720604556
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
RN232106 Issued in GA
Practice address
310 Philip Blvd
Lawrenceville, GA 30046-8700
Phone
(678) 971-2020
NPI assigned
Jun 17, 2020
Last updated
Jun 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X RN232106 GA Primary

Addresses

Primary practice location

310 Philip Blvd
Lawrenceville, GA 30046-8700

Mailing address

PO Box 857
Suwanee, GA 30024-0029
Phone (404) 789-0452

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230217002356 GA Practitioner - Nurse Practitioner 2163894213 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Medical Consulting, P.C. CurrentSince Apr 17, 2024 Accepting new patients
Southeast Medical Group, P.C. CurrentSince Jan 31, 2023 Accepting new patients
Georgia Mso LLC CurrentSince Aug 18, 2025 Accepting new patients

Locations

3715 Northside Pkwy NW
Bldg 2100
Atlanta, GA 30327
Phone (770) 938-1757

1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350

4300 Northpoint Pkwy
Ste 300
Johns Creek, GA 30022
Phone (770) 518-4406

771 Old Norcross Rd
Ste 225
Lawrenceville, GA 30046
Phone (678) 802-4045

310 Philip Blvd
Lawrenceville, GA 30046
Phone (678) 985-0238

1640 Powers Ferry Rd SE
Bldg 15
Marietta, GA 30067
Phone (770) 722-9595

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1720604556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 857",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300240029",
            "telephone_number": "404-789-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 PHILIP BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468700",
            "telephone_number": "678-971-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "RIMA",
        "middle_name": "DIPAK",
        "credential": "ADVANCED PRACTICE NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "GA",
            "license": "RN232106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.