Individual provider Active NPI

Kishan Patel, DPT

  • Physical Therapy Clinic/Center
  • Hinesville, GA
National Provider Identifier
1912628769
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT016239 Issued in GA
Practice address
475 S Main St
Hinesville, GA 31313-4312
Phone
(912) 368-4131
NPI assigned
Sep 9, 2022
Last updated
Sep 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT016239 GA Primary

Addresses

Primary practice location

475 S Main St
Hinesville, GA 31313-4312

Mailing address

860 Forest St
Hinesville, GA 31313-4140
Phone (912) 321-8719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230628000884 GA Practitioner - Physical Therapist in Private Practice 4880052539 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Care Medical Center LLCGroup PAC ID 6406807015, 28 clinicians

Practice addresses (Care Compare)

2804 N Oak St
Suite C
Valdosta, GA 31602-5913
Phone (229) 241-8925

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Care Medical Center LLC Physical Therapy CurrentSince Nov 3, 2023 Accepting new patients
Effingham Rehab Services, LLC CurrentSince May 20, 2023 Accepting new patients
Care Medical Center LLC Physical Therapy CurrentSince Nov 3, 2023 Accepting new patients
Effingham Rehab Services, LLC Current Accepting new patients
Effingham Rehab Services, LLC CurrentSince May 20, 2023 Accepting new patients
Effingham Rehab Services, LLC Past Accepting new patients

Locations

475 S Main St
Hinesville, GA 31313
Phone (912) 353-9378

172 Tower Rd
Jesup, GA 31545
Phone (912) 427-4290

936 S 1st St
Jesup, GA 31545
Phone (912) 427-3444

123 Canal St
Ste 203
Pooler, GA 31322
Phone (912) 388-1283

2804 N Oak St
Ste C
Valdosta, GA 31602
Phone (229) 241-8925

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

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": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1912628769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 FOREST ST",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134140",
            "telephone_number": "912-321-8719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 S MAIN ST",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134312",
            "telephone_number": "912-368-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KISHAN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-09",
        "last_updated": "2022-09-09",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "GA",
            "license": "PT016239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.