Willow Psychiatry Limited

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

0101254626 Issued in VA

Legal business name

WILLOW PSYCHIATRY LIMITED

Practice address

20925 Professional PLZ
310
Ashburn, VA 20147-3403

Phone

(571) 620-5151

Fax

(571) 421-1963

NPI assigned

Feb 16, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Radha Gayatri Agepati, MD

Title

President

Phone

(571) 620-5151

Specialties & licenses 1

Addresses

Practitioners 1

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

• Suman Manchireddy, MD

  • Internal Medicine Physician
  • Leesburg, VA
  • NPI 1164676037
  NPD (past)

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

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424044800000",
    "number": "1255722005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41912 CLOVER VALLEY CT",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201481765",
            "telephone_number": "571-620-5151",
            "fax_number": "571-421-1963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20925 PROFESSIONAL PLZ",
            "address_2": "310",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201473403",
            "telephone_number": "571-620-5151",
            "fax_number": "571-421-1963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW PSYCHIATRY LIMITED",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-16",
        "last_updated": "2015-02-16",
        "status": "A",
        "authorized_official_last_name": "AGEPATI",
        "authorized_official_first_name": "RADHA",
        "authorized_official_middle_name": "GAYATRI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "571-620-5151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101254626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Williams
• June Elizabeth Williams
• Sakinah Williams
• Tarell Andre Williams
• Jade Imani Willis
• Jason Shane Wilson, PHARMD
• Melissa Joi Wisner, M.D.
• Stephen Alan Wohlgemuth, M.D.
• Lee Wong-Holland, PSY.D.
• Joselyn Victoria Wong

• Psychiatry Physician in Ashburn, VA
• Providers in Ashburn, VA by specialty
• Psychiatry Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; 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.