Active NPI
Shantu Nagin Patel, MD
- Physical Medicine & Rehabilitation Physician
- Tifton, GA
National Provider Identifier
1831161652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 051173
- Practice address
- 1610 John Orr Dr Ste a
Tifton, GA 31794-3662 - Phone
- (229) 386-5222
- Fax
- (229) 382-6191
- NPI assigned
- Feb 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 051173 | GA | Primary |
Addresses
Primary practice location
1610 John Orr Dr Ste a
Tifton, GA 31794-3662
Mailing address
PO Box 7630
Tifton, GA 31793-7630
Phone (229) 386-5222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051173 | GA | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185235200000",
"number": "1831161652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7630",
"city": "TIFTON",
"state": "GA",
"postal_code": "317937630",
"telephone_number": "229-386-5222",
"fax_number": "229-382-6191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1610 JOHN ORR DR STE A",
"city": "TIFTON",
"state": "GA",
"postal_code": "317943662",
"telephone_number": "229-386-5222",
"fax_number": "229-382-6191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "SHANTU",
"middle_name": "NAGIN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-06",
"last_updated": "2007-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "GA",
"license": "051173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tifton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.