Prasad B Guttikonda, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35-047510G Issued in OH

Practice address

4505 Logan Way
Hubbard, OH 44425-3311

Phone

(330) 259-3664

Fax

(330) 259-3665

NPI assigned

Jul 12, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tomas Psychological Services, Inc

  • Clinical Psychologist
  • Hubbard, OH
  • NPI 1144259037
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1962427864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 LOGAN WAY",
            "city": "HUBBARD",
            "state": "OH",
            "postal_code": "444253311",
            "telephone_number": "330-259-3664",
            "fax_number": "330-259-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 LOGAN WAY",
            "city": "HUBBARD",
            "state": "OH",
            "postal_code": "444253311",
            "telephone_number": "330-259-3664",
            "fax_number": "330-259-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTTIKONDA",
        "first_name": "PRASAD",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35-047510G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000252888",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0502638",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Giorgetti, PH.D.
• Julia Grady
• Haley N Grimwood, RDN, LDN
• Brent Devlin Groscost, RPH
• Robin Lynn Groscost
• Melissa Hardesty, STNA
• Keymonnie Harris
• Tara Lynn Hartman, PHARMD, RPH
• Heavenly Hands Home Health Care
• Lulu Herman

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.