Individual provider Active NPI

Meena Patel Dave, PHYSICIANS ASSISTANT

  • Physician Assistant
  • Lillington, NC
National Provider Identifier
1851421390
Registry record updated Aug 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
101946 Issued in NC
Practice address
350 Pine State St
Lillington, NC 27546-9428
Phone
(910) 893-9700
Fax
(910) 893-9747
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 101946 NC Primary

Addresses

Primary practice location

350 Pine State St
Lillington, NC 27546-9428

Mailing address

207 Kalvesta Drive
Morrisville, NC 27560
Phone (919) 656-4905

Other identifiers 1

IdentifierTypeStateIssuer
101946OtherNCPA LICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20050415000722 NC Practitioner - Physician Assistant 4385693985 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
101946NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Radiology Associates PA PastSince Apr 2, 2005 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: meenadave@napm.allscriptsdirect.net

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1851421390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 KALVESTA DRIVE",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "27560",
            "telephone_number": "919-656-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 PINE STATE ST",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275469428",
            "telephone_number": "910-893-9700",
            "fax_number": "910-893-9747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVE",
        "first_name": "MEENA",
        "middle_name": "PATEL",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIANS ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "101946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE #",
            "identifier": "101946",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lillington, NC

Sources for this page

Verify at the official NPI Registry.