Individual provider Active NPI

C. Rao Amara, M.D.

  • Child & Adolescent Psychiatry Physician
  • Petersburg, VA
National Provider Identifier
1942265509
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
0101049342 Issued in VA
Practice address
269 Medical Park Blvd
Petersburg, VA 23805-9337
Phone
(804) 861-0700
Fax
(804) 863-4626
NPI assigned
Apr 18, 2006
Last updated
Apr 6, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0101049342 VA
Child & Adolescent Psychiatry Physician 2084P0804X 0101049342 VA Primary

Addresses

Primary practice location

269 Medical Park Blvd
Petersburg, VA 23805-9337

Mailing address

269 Medical Park Blvd
Petersburg, VA 23805-9337
Phone (804) 861-0700

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100407000438 VA Practitioner - Psychiatry 0446250542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1978
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Virginia South Psychiatric and Family ServicesGroup PAC ID 3476443797, 35 clinicians

Practice addresses (Care Compare)

269 Medical Park Blvd
Petersburg, VA 23805-9337
Phone (804) 861-0700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101049342VAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia South Psychiatric & Family Services Psychiatry CurrentSince Apr 1, 1993 Accepting new patients
Three Rivers Treatment Center LLC Past Accepting new patients

Locations

207 N 4th Ave
Hopewell, VA 23860
Phone (804) 518-6513

13901 Coalfield Commons Pl
Ste 102
Midlothian, VA 23114
Phone (804) 378-0800

269 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 861-0700

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72142

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1942265509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059337",
            "telephone_number": "804-861-0700",
            "fax_number": "804-863-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059337",
            "telephone_number": "804-861-0700",
            "fax_number": "804-863-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMARA",
        "first_name": "C.",
        "middle_name": "RAO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101049342",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0101049342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

Verify at the official NPI Registry.