DR. JYOTHI NUTAKKI MD NPI 1235240359

NPI Information

  • NPI: 1235240359
  • Provider Name: DR. JYOTHI NUTAKKI, MD
  • Classification: Psychiatry & Neurology - 2084P0804X
  • Specialization: Child & Adolescent Psychiatry
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 8435 HOLLY RD
    GRAND BLANC, MI
    ZIP 48439
  • Phone: (810) 424-2400

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NPI Details

DR. Jyothi Nutakki, MD is a child and adolescent psychiatry psychiatry neurology in Grand Blanc, MI. The provider is 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. DR. Jyothi Nutakki, MD NPI is 1235240359. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

8435 HOLLY RD
GRAND BLANC, MI
ZIP 48439-812
Phone: (810) 424-2400
Fax: (810) 579-7222

The NPI 1235240359 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 9/20/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084P0800XPsychiatry & NeurologyPsychiatry4301069608MICHIGANNo
22084P0804XPsychiatry & NeurologyChild & Adolescent Psychiatry4301069608MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14518708MEDICAIDMICHIGAN
2F95467MEDICARE UPINMICHIGAN
3N73600002MEDICARE PINMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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