Individual provider Active NPI

Bhavika Rajanikant Patel, M.D.

  • Family Medicine Physician
  • Kennesaw, GA
National Provider Identifier
1770920258
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
76120 Issued in GA
Practice address
3895 Cherokee St. NW #400
Kennesaw, GA 30144
Phone
(678) 369-7755
Fax
(844) 947-4544
NPI assigned
May 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04-40376 KS
Family Medicine Physician 207Q00000X 76120 GA Primary

Addresses

Primary practice location

3895 Cherokee St. NW #400
Kennesaw, GA 30144

Mailing address

3895 Cherokee St. NW #400
Kennesaw, GA 30144
Phone (678) 369-7755

Other practice location 1

901 SW Garfield Ave
Topeka, KS 66606-1670
Phone (785) 354-9591

Other practice location 2

3422 Sixes Rd Ste 102E
Canton, GA 30114-9120
Phone (943) 202-7670

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bpatel576320@directwellstar.org

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
I20191210003567 GA Practitioner - Family Practice 4587895503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1120 Wellstar Way
Suite 305
Holly Springs, GA 30114-9086
Phone (470) 267-0135

3422 Sixes Rd
Suite 102
Canton, GA 30114-9120
Phone (943) 202-7670

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Hospital & facility affiliations

  • Amedisys Northwest Home Health Home health agency, Jasper, GA, CCN 117064
  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-40376KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Aug 15, 2024 Accepting new patients
Iora Health Massachusetts, P.C. Past Accepting new patients
Iora Health, LLC Past Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1369353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1770920258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3895 CHEROKEE ST. NW #400",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "30144",
            "telephone_number": "678-369-7755",
            "fax_number": "844-947-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3895 CHEROKEE ST. NW #400",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "30144",
            "telephone_number": "678-369-7755",
            "fax_number": "844-947-4544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 SW Garfield Ave",
            "address_purpose": "LOCATION",
            "city": "Topeka",
            "state": "KS",
            "postal_code": "666061670",
            "country_code": "US",
            "telephone_number": "785-354-9591",
            "fax_number": "785-354-0523",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3422 Sixes Rd Ste 102E",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301149120",
            "country_code": "US",
            "telephone_number": "943-202-7670",
            "fax_number": "470-986-7143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "BHAVIKA",
        "middle_name": "RAJANIKANT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-24",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-40376",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "76120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bpatel576320@directwellstar.org",
            "affiliation": "N",
            "address_1": "3422 Sixes Rd Ste 102E",
            "city": "Canton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301149120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

Verify at the official NPI Registry.