NPIMap

Organization Active NPI

Mahendra M Patel MD PSC

  • Nephrology Physician
  • Elizabethtown, KY
National Provider Identifier
1922464171
Registry record updated Jan 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
178718 Issued in KY
Legal business name
MAHENDRA M PATEL MD PSC
Practice address
912 Woodland Dr
Suite B
Elizabethtown, KY 42701-2795
Phone
(270) 982-5112
Fax
(270) 982-5111
NPI assigned
Jan 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2016

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

Authorized official

Name
Dr. Mahendra M Patel, MD
Title
President
Phone
(270) 982-5112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X 178718 KY Primary

Addresses

Primary practice location

912 Woodland Dr
Suite B
Elizabethtown, KY 42701-2795

Mailing address

912 Woodland Dr
Suite B
Elizabethtown, KY 42701-2795
Phone (270) 982-5112

Other identifiers 2

IdentifierTypeStateIssuer
64-178718MedicaidKY
1052298OtherKYPASSPORT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1451865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451865600000",
    "number": "1922464171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 WOODLAND DR",
            "address_2": "SUITE B",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012795",
            "telephone_number": "270-982-5112",
            "fax_number": "270-982-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 WOODLAND DR",
            "address_2": "SUITE B",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012795",
            "telephone_number": "270-982-5112",
            "fax_number": "270-982-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHENDRA M PATEL MD PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-04",
        "last_updated": "2016-01-04",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MAHENDRA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-982-5112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "KY",
            "license": "178718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64-178718",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "1052298",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.