Prakash G Ettigi, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

0101028834 Issued in VA

Practice address

6530 Hull Street Rd
Richmond, VA 23224

Phone

(804) 674-3425

NPI assigned

Aug 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Central Virginias Preferred ProvidersGroup PAC ID 1557793528, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Central Virginias Preferred Providers

  • Mental Health Counselor
  • Richmond, VA
  • NPI 1730638107
  Medicare reassignment Care Compare group NPD
• Jencare Neighborhood Medical New Market, LLC

  • Internal Medicine Physician
  • Newport News, VA
  • NPI 1568756948
  NPD
• PMR Virginia Holding, LLC

  • Specialist
  • Miami Gardens, FL
  • NPI 1083167001
  NPD

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

{
    "created_epoch": "1154822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1326057597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6530 HULL STREET RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23224",
            "telephone_number": "804-674-3425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3212 Cutshaw Ave",
            "address_2": "Suite 303",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232305024",
            "country_code": "US",
            "telephone_number": "804-353-3324",
            "fax_number": "804-353-4498",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3212 Cutshaw Ave",
            "address_2": "Suite 303",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232305024",
            "country_code": "US",
            "telephone_number": "804-353-3324",
            "fax_number": "804-353-4498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETTIGI",
        "first_name": "PRAKASH",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-06",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101028834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nenita Otadoy Estrera, M.D.
• Sanju Parvathi Eswaran
• Kathryn Carter Esworthy
• Et Richmond Taxi LLC
• Eternal Energy
• Christine Gilmore Eubanks, PH.D., CCC-A
• Treonna Eubanks, LCSW
• Bong Soo Eun, PHD
• Euphemia Huggins Williams OD PC
• Renuka Evani, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.