Winston Psychiatric Associates PA

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

WINSTON PSYCHIATRIC ASSOCIATES PA

Practice address

125 Ashleybrook Square
Winston Salem, NC 27103

Phone

(336) 765-6577

Fax

(336) 768-2972

NPI assigned

Nov 21, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rajakumar Thotakura, MDNPI 1982789160

Title

President

Phone

(336) 765-6577

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rajakumar Thotakura, MD

  • Psychiatry Physician
  • Loxahatchee, FL
  • NPI 1982789160

  NC

  Medicare reassignment Authorized official
• Keertan Reddy, MD

  • Psychiatry Physician
  • Greensboro, NC
  • NPI 1114411105
  Medicare reassignment NPD
• Umalakshmi Kanuru Thotakura, MD

  • Psychiatry Physician
  • Winston Salem, NC
  • NPI 1689759946
  Medicare reassignment

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386719128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 ASHLEYBROOK SQUARE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-765-6577",
            "fax_number": "336-768-2972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 ASHLEYBROOK SQUARE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-765-6577",
            "fax_number": "336-768-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINSTON PSYCHIATRIC ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THOTAKURA",
        "authorized_official_first_name": "RAJAKUMAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-765-6577",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0299K",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890299K",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beverly Diane Winsted, PA-C
• Winston Eye Associates OD PA
• Winston Hearing Care Inc
• Winston Neurology, PA
• Winston Neurology, PA
• Winston Salem Dermatology & Surgery
• Winston Salem Healthcare LLC (Grace Healthcare of Winston Salem)
• Winston Salem Holdings LLC (Reynolds House)
• Winston Salem Industries for the Blind
• Winston Salem Optometric Group PA (C distinctive eyewear)

• Psychiatry Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.