DR. JYOTHI NUTAKKI (NPI# 1235240359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235240359 |
| Entity Type | Individual |
| Full Name | DR. JYOTHI NUTAKKI |
| Credential | MD |
| Practice Address |
8435 Holly Rd Grand Blanc MI 48439-1812 |
| Mailing Address |
3495 S Center Rd Burton MI 48519-1455 |
| Practice Telephone | 8104242400 |
| Practice Fax Number | 8105797222 |
| Mailing Telephone | 8104242007 |
| Mailing Fax Number | 8107431099 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-09-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
4301069608 | MI | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
4301069608 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4518708 | 05 |
| Street Address |
8435 HOLLY RD |
| City | GRAND BLANC |
| State | MI |
| Zip Code | 48439-1812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427024934 | Rachelle Yvonne Mcgarry | Social Worker | 8435 Holly Rd, Grand Blanc, MI 48439-1812 | 2006-02-24 |
| 1972073757 | Hannah Arion | Social Worker | 8435 Holly Rd, Grand Blanc, MI 48439-1812 | 2018-12-05 |
| 1750803870 | Janet Popp | Social Worker | 8435 Holly Rd, Grand Blanc, MI 48439-1812 | 2017-07-11 |
| 1285084921 | Tara Pauley | Social Worker | 8435 Holly Rd, Grand Blanc, MI 48439-1812 | 2016-06-14 |
| 1568825990 | Naveen Praphullarama Sharma | Psychiatry & Neurology | 8435 Holly Rd, Grand Blanc, MI 48439-1812 | 2016-04-02 |
| 1124407937 | Denise Smith | Social Worker | 8435 Holly Rd, Grand Blanc, MI 48439-1812 | 2015-05-26 |
| 1548662802 | Christina M Russell | Nurse Practitioner | 8435 Holly Rd, Grand Blanc, MI 48439-1812 | 2014-09-18 |
| 1750792347 | Jill Bills | Counselor | 8435 Holly Rd, Grand Blanc, MI 48439-1812 | 2014-05-16 |
| 1861839839 | Alicia Marie Wofford | Counselor | 8435 Holly Rd, Grand Blanc, MI 48439-1812 | 2013-05-30 |
| 1952654758 | Genesys Practice Partners | Psychologist | 8435 Holly Rd, Grand Blanc, MI 48439-1812 | 2012-10-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811598931 | Fady Essi | Pharmacist | 6160 S Saginaw Road, Grand Blanc, 48439, USA 48439 | 2020-11-04 |
| 1407456254 | Bradley Dwane Murphy | Pharmacist | 6170 S Saginaw, Grand Blanc, MI 48439 | 2020-10-30 |
| 1457975476 | Lauren Nicole Holmes | Obstetrics & Gynecology | Gme Department, 1 Genesys Pkwy, Grand Blanc, MI 48439 | 2020-06-05 |
| 1366063927 | Hadeel Ghazi Barrawi | Family Medicine | Ascension Genesys Hospital, Office of Medical Education, One Genesys Parkway, Grand Blanc, MI 48439 | 2020-05-05 |
| 1245851427 | Adriana Sharp | Surgery | 1 Genesys, Grand Blanc, MI 48439 | 2020-04-29 |
| 1114485109 | Kristen Milefchik | Case Manager/Care Coordinator | 278 Fox Chase Blvd, Grand Blanc, MI 48439 | 2019-03-08 |
| 1588134175 | Audrie Brook Mullin | Registered Nurse | 2313 E. Hill Rd, Grand Blanc, MI 48439 | 2018-11-27 |
| 1457845703 | Michael Patrick Tuczynski | Family Medicine | One Genesys Parkway Ascension Genesys Hospital, Attn: Debra Shuck, Grand Blanc, MI 48439 | 2018-06-20 |
| 1104318112 | Wellbridge At Genesys Health Park, LLC | Skilled Nursing Facility | 3139 East Baldwin Road, Grand Blanc, MI 48439 | 2018-06-05 |
| 1336648393 | Raedeane Kenway | Dental Hygienist | 8542 Holly Rd, Grand Blanc, MI 48439 | 2018-02-06 |
| Find all providers in zip 48439 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730167248 | Louise Desgranges | Psychiatry & Neurology | G 8145 S Saginaw Street, Suite C, Grand Blanc, MI 48439 | 2006-01-04 |
| 1962423186 | Genesys Practice Partners, Inc. | Psychiatry & Neurology | 8435 Holly Rd, Grand Blanc, MI 48439-1812 | 2006-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316376056 | Esmaeil Emami | Psychiatry & Neurology | 2955 Franklin Rd, Bloomfield Hills, MI 48302-0917 | 2013-11-04 |
| 1154760312 | Samantha Fugate Kennedy | Psychiatry & Neurology | 909 Fee Rd Ste B119, East Lansing, MI 48824 | 2013-06-21 |
| 1407199961 | David Donald Krohn | Psychiatry & Neurology | 563 Highland Park Dr, Traverse City, MI 49686-2863 | 2013-04-03 |
| 1164712055 | Tatjana Maric | Psychiatry & Neurology | 420 Baltimore Dr Ne, Grand Rapids, MI 49503-3934 | 2011-04-12 |
| 1972893824 | Katherine Barbara Krive | Psychiatry & Neurology | 801 S Waverly Rd Ste 100, Lansing, MI 48917-4200 | 2011-04-12 |
| 1104128602 | Hope Network Behavioral Health Services | Psychiatry & Neurology | 3361 36th Street, Grand Rapids, MI 49512 | 2010-12-03 |
| 1295056653 | Veronica Yap Tan | Psychiatry & Neurology | 23354 Portage Way, Apt. 2212, Novi, MI 48375 | 2010-06-18 |
| 1548588874 | Katie Alanna Keller | Psychiatry & Neurology | 79 Alexandrine West, Detroit, MI 48201 | 2010-05-11 |
| 1538390133 | Behavioral Health Associates Pllc | Psychiatry & Neurology | 19500 Middlebelt Rd, Suite 350e, Livonia, MI 48152-2196 | 2009-07-30 |
| 1235375775 | Kristine Baker | Psychiatry & Neurology | 721 Cherokee St, Traverse City, MI 49684-1401 | 2009-01-06 |
| Find all providers with the same taxonomy | ||||
| City | GRAND BLANC |
| Zip Code | 48439 |
Please comment or provide details below to improve the information on DR. JYOTHI NUTAKKI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.