Prasad Potaraju MD., Inc.,

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

74490 Issued in OH

Legal business name

PRASAD POTARAJU MD., INC.,

Practice address

5858 Myrick Rd
Dublin, OH 43016-7934

Phone

(614) 389-3353

Fax

(614) 389-3353

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Prasad Potaraju, M.D.

Title

President

Phone

(614) 389-3353

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417392000000",
    "number": "1942311923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5858 MYRICK RD",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430167934",
            "telephone_number": "614-389-3353",
            "fax_number": "614-389-3353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5858 MYRICK RD",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430167934",
            "telephone_number": "614-389-3353",
            "fax_number": "614-389-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRASAD POTARAJU MD., INC.,",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-12-01",
        "status": "A",
        "authorized_official_last_name": "POTARAJU",
        "authorized_official_first_name": "PRASAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-389-3353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "74490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2865163",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Dublin, OH
• Providers in Dublin, OH by specialty
• Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; 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.