Ittamveetil Narayanan Kutty, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD0000016494 Issued in TN

Practice address

2463 Wildwood Dr
Ste 12
Kingsport, TN 37660-5800

Phone

(423) 288-7869

Fax

(423) 392-6511

NPI assigned

Jul 13, 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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Psychiatric Care of Kingsport PC

  • Psychiatry Physician
  • Kingsport, TN
  • NPI 1326732793
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338508800000",
    "number": "1609891563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 SPRATLIN PARK DRIVE",
            "address_2": "FRONTIER HEALTH",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "37615",
            "telephone_number": "423-467-3658",
            "fax_number": "423-467-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2463 WILDWOOD DR",
            "address_2": "STE 12",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376605800",
            "telephone_number": "423-288-7869",
            "fax_number": "423-392-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTTY",
        "first_name": "ITTAMVEETIL",
        "middle_name": "NARAYANAN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2012-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "MD0000016494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "069097",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3016081",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0048066",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jon R. Krutak, D.C.
• Richard T. Kubota, MD
• Evan Loren Kulbacki, MD
• April Kuntz, M.S.CCC/SLP
• Stanley J Kupchinsky, CRNA
• Kwick Transport, Inc.
• L Alan Bacon DDS PC & John Collins DDS PC
• Jessica D La Count
• Laboratory Corporation of America Holdings
• Laura Lacey, PHARMD

• Psychiatry Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Psychiatry Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; 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.