Vijaya Gopal Kotha MD PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

VIJAYA GOPAL KOTHA MD PC

Practice address

22101 Moross Rd FL 6
Detroit, MI 48236-2148

Phone

(313) 343-7560

NPI assigned

May 31, 2018

Organization subpart

No

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

Authorized official

Name

Vijaya Gopal Kotha, MD

Title

Owner

Phone

(313) 595-7336

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1285126797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 LAKE SHORE RD",
            "city": "GROSSE POINTE SHORES",
            "state": "MI",
            "postal_code": "482362631",
            "telephone_number": "313-595-7336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD FL 6",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362148",
            "telephone_number": "313-343-7560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 North Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Mount Clemens",
            "state": "MI",
            "postal_code": "480431716",
            "country_code": "US",
            "telephone_number": "586-307-9010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VIJAYA GOPAL KOTHA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "KOTHA",
        "authorized_official_first_name": "VIJAYA",
        "authorized_official_middle_name": "GOPAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-595-7336",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "4301058577",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lad Joseph Vidergar, PH.D.
• Alis Despina Vidinas, MD
• Miranda Viel, OTRL
• Laura Elizabeth Vien, LAT, ATC
• Renee Marie Vigilante, NNP-BC
• Rakhi Vijayamma
• Sundeep Vikraman, M.D.
• Denice Villa, L.B.S.W.
• Kelsey Ann Villa, DPT
• Pedro Arturo Villablanca Spinetto, M.D.

• Psychiatry Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; 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.