Active NPI
Dharti Patel, NP
- Adult Health Clinical Nurse Specialist
- Marietta, GA
National Provider Identifier
1871788935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Clinical Nurse Specialist
- License
- RN149650
- Practice address
- 55 Whitcher St NE
Suite 350
Marietta, GA 30060-1155 - Phone
- (770) 424-6893
- Fax
- (770) 424-9095
- NPI assigned
- Sep 12, 2007
- Last updated
- Jun 11, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 209-006178 | IL | |
| Adult Health Clinical Nurse Specialist | 364SA2200X | RN149650 | GA | Primary |
Addresses
Primary practice location
55 Whitcher St NE
Suite 350
Marietta, GA 30060-1155
Mailing address
55 Whitcher St NE
Suite 350
Marietta, GA 30060-1155
Phone (770) 424-6893
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003106975A | Medicaid | GA | |
| 003106975B | Medicaid | GA | |
| 003106975C- | Medicaid | GA |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209-006178 | IL | MD | Adult Health Nurse Practitioner |
| RN149650 | GA | MD | Adult Health Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Cardiovascular Medicine, LLC | Past | Accepting new patients |
Interoperability endpoints
- dpatel26478@directwellstar.org
Organizations & group practices 1
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.
-
- Cardiovascular Disease Physician
- Marietta, GA
- NPI 1457320319
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339372800000",
"number": "1871788935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 WHITCHER ST NE",
"address_2": "SUITE 350",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601155",
"telephone_number": "770-424-6893",
"fax_number": "770-424-9095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 WHITCHER ST NE",
"address_2": "SUITE 350",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601155",
"telephone_number": "770-424-6893",
"fax_number": "770-424-9095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "DHARTI",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-12",
"last_updated": "2012-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "IL",
"license": "209-006178",
"primary": false
},
{
"code": "364SA2200X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Adult Health",
"state": "GA",
"license": "RN149650",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003106975A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003106975B",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003106975C-",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.