Individual provider Active NPI

Rajakumar Thotakura, MD

  • Psychiatry Physician
  • Loxahatchee, FL
National Provider Identifier
1982789160
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
9300344 Issued in NC
Practice address
3740 185TH TRL
Loxahatchee, FL 33470-2401
Phone
(336) 486-1111
NPI assigned
Oct 26, 2006
Last updated
May 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2026

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 ME174696 FL
Psychiatry Physician 2084P0800X 9300344 NC Primary

Addresses

Primary practice location

3740 185TH TRL
Loxahatchee, FL 33470-2401

Mailing address

3740 185TH TRL
Loxahatchee, FL 33470-2401
Phone (336) 486-1111

Other practice location 1

1940 Harrison Ave
Panama City, FL 32405-4542
Phone (850) 763-0017

Other identifiers 2

IdentifierTypeStateIssuer
8983345MedicaidNC
83345OtherBCBS OF NC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20050621000482 NC Practitioner - PsychiatryPractitioner - Addiction Medicine 3173500667 Reassigns benefits to 2 organizations
Practice locations: Winston Salem, NC

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME174696FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone WSNC, LLC Past Accepting new patients

Organizations & group practices 3

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1982789160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 185TH TRL",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334702401",
            "telephone_number": "336-486-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 185TH TRL",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334702401",
            "telephone_number": "336-486-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1940 Harrison Ave",
            "address_purpose": "LOCATION",
            "city": "Panama City",
            "state": "FL",
            "postal_code": "324054542",
            "country_code": "US",
            "telephone_number": "850-763-0017",
            "fax_number": "850-692-5862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOTAKURA",
        "first_name": "RAJAKUMAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME174696",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "9300344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8983345",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "83345",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loxahatchee, FL

Sources for this page

Verify at the official NPI Registry.