Individual provider Active NPI

Nishi Patel, PA-C

  • Physician Assistant
  • Mooresville, NC
National Provider Identifier
1912744764
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-15192 Issued in NC
Practice address
170 Medical Park Rd Ste 201
Mooresville, NC 28117-8541
Phone
(704) 664-4679
Fax
(704) 761-6988
NPI assigned
Jul 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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 0010-15192 NC Primary

Addresses

Primary practice location

170 Medical Park Rd Ste 201
Mooresville, NC 28117-8541

Mailing address

PO Box 1845
Statesville, NC 28687-1845
Phone (704) 873-4277

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
I20250417000159 NC Practitioner - Physician Assistant 9234654724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Healthcare PAGroup PAC ID 9638070683, 226 clinicians
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians

Practice addresses (Care Compare)

128 Medical Park Rd
Suite 102
Mooresville, NC 28117-8578
Phone (704) 978-3566

129 Sherlock Dr
Statesville, NC 28625-1916
Phone (704) 838-8245

138 Sherlock Dr
Statesville, NC 28625-1916
Phone (704) 873-1021

142 Sherlock Dr
Statesville, NC 28625-1916
Phone (704) 838-8256

150 Fairview Rd
Suite 200
Mooresville, NC 28117-9507
Phone (704) 235-6200

152 Sherlock Dr
Statesville, NC 28625-1916
Phone (704) 838-8210

170 Medical Park Rd
Mooresville, NC 28117-8540

201 McCullough Dr
Suite 310
Charlotte, NC 28262-3577
Phone (704) 547-1129

208 Old Mocksville Rd
Statesville, NC 28625-1930
Phone (704) 878-2011

357 Williamson Rd
Mooresville, NC 28117-5935
Phone (704) 664-7328

359 Williamson Rd
Mooresville, NC 28117-5935
Phone (704) 235-1838

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-15192NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Healthcare, PA CurrentSince Apr 28, 2025 Accepting new patients
Piedmont Healthcare, P.a. CurrentSince Apr 28, 2025 Accepting new patients

Locations

170 Medical Park Rd
Ste 201
Mooresville, NC 28117
Phone (704) 235-0305

650 Signal Hill Drive Ext
Statesville, NC 28625
Phone (704) 873-4277

208 Old Mocksville Rd
Statesville, NC 28625
Phone (704) 838-8215

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": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1912744764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845",
            "telephone_number": "704-873-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MEDICAL PARK RD STE 201",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178541",
            "telephone_number": "704-664-4679",
            "fax_number": "704-761-6988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NISHI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-10",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-15192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.