NPIMap

Organization Active NPI

Prakash G Ettigi MDPC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Richmond, VA
National Provider Identifier
1699793711
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
0101028834 Issued in VA
Legal business name
PRAKASH G ETTIGI MDPC
Practice address
3212 Cutshaw Avenue
Suite 303
Richmond, VA 23230-5018
Phone
(804) 353-3324
Fax
(804) 353-4498
NPI assigned
Jul 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Prakash G Ettigi, MD
Title
President
Phone
(804) 353-3324

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 0101028834 VA Primary

Addresses

Primary practice location

3212 Cutshaw Avenue
Suite 303
Richmond, VA 23230-5018

Mailing address

3212 Cutshaw Avenue
Suite 303
Richmond, VA 23230-5018
Phone (804) 353-3324

Other names 1

  • Panic Anxiety and Depression center Doing business as

National Provider Directory

National Provider Directory

Locations

4906 Cutshaw Ave
Ste 200
Richmond, VA 23230
Phone (804) 353-6777

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699793711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 CUTSHAW AVENUE",
            "address_2": "SUITE 303",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232305018",
            "telephone_number": "804-353-3324",
            "fax_number": "804-353-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3212 CUTSHAW AVENUE",
            "address_2": "SUITE 303",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232305018",
            "telephone_number": "804-353-3324",
            "fax_number": "804-353-4498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAKASH G ETTIGI MDPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ETTIGI",
        "authorized_official_first_name": "PRAKASH",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-353-3324",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "VA",
            "license": "0101028834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Panic Anxiety and Depression center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.