| Winston Psychiatric Associates Pa | |
|
125 Ashleybrook Square Winston Salem NC 27103 | |
| (336) 765-6577 | |
| (336) 768-2972 |
| Full Name | Winston Psychiatric Associates Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 125 Ashleybrook Square, Winston Salem, North Carolina |
| Authorized Official Name and Position | Rajakumar Thotakura (PRESIDENT) |
| Authorized Official Contact | 3367656577 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Winston Psychiatric Associates Pa 125 Ashleybrook Square Winston Salem NC 27103 Ph: (336) 765-6577 | Winston Psychiatric Associates Pa 125 Ashleybrook Square Winston Salem NC 27103 Ph: (336) 765-6577 |
| NPI Number | 1386719128 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6002893591 |
|---|---|
| Medicare Enrollment ID | O20040701001604 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386719128 | NPI | - | NPPES |
| 0299K | Other | NC | BCBS |
| 890299K | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Vicky G Surratt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154406411 PECOS PAC ID: 5890774368 Enrollment ID: I20040717000355 |
| Provider Name | Rajakumar Thotakura |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982789160 PECOS PAC ID: 3173500667 Enrollment ID: I20050621000482 |
| Provider Name | Umalakshmi K Thotakura |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689759946 PECOS PAC ID: 8325124365 Enrollment ID: I20080401000016 |
| Provider Name | Keertan G Reddy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114411105 PECOS PAC ID: 8426305228 Enrollment ID: I20221026000401 |
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Alexander Youth Network Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8025 N Point Blvd Ste 260, Winston Salem, NC 27106 Phone: 336-724-1412 Fax: 336-724-1464 | |
Daymark Recovery Services Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 651 Highland Ave, Winston Salem, NC 27101 Phone: 336-657-8523 Fax: 336-723-0645 |