JETTY HEART CLINIC OF THE INDIANA HEART HOSPITAL LLC (NPI# 1366690257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366690257 |
| Entity Type | Organization |
| Organization Name | JETTY HEART CLINIC OF THE INDIANA HEART HOSPITAL LLC |
| Practice Address |
1210 Medical Arts Blvd Suite 217 Anderson IN 46011-3439 |
| Practice Telephone | 7652984422 |
| Practice Fax Number | 7652984926 |
| Mailing Telephone | 7652984422 |
| Mailing Fax Number | 7652984926 |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2008-10-21 |
| Authorized Official Name | THOMAS A MALASTO (CEO) |
| Authorized Official Telephone | 3176218050 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
01040154A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM | 000000586511 | 01 |
| Street Address |
1210 MEDICAL ARTS BLVD SUITE 217 |
| City | ANDERSON |
| State | IN |
| Zip Code | 46011-3439 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295739688 | Susan M Anderson | Psychiatry & Neurology | 1210 Medical Arts Blvd, Ste 102, Anderson, IN 46011-3437 | 2005-06-13 |
| 1699135152 | Neda Adams | Registered Nurse | 1210 Medical Arts Blvd, Anderson, IN 46011-3461 | 2016-02-26 |
| 1386004844 | Kristin Reedy | Registered Nurse | 1210 Medical Arts Blvd, Anderson, IN 46011-3461 | 2016-02-26 |
| 1275872673 | Josephson Wallack Munshower Nurology | Psychiatry & Neurology | 1210 Medical Arts Blvd, Ste 114, Anderson, IN 46011-3442 | 2013-02-05 |
| 1245586916 | Jennifer S Leblo | Nurse Practitioner | 1210 Medical Arts Blvd, Suite 201, Anderson, IN 46011-3461 | 2012-07-31 |
| 1992957427 | Total Life Care for Women, LLC | Specialist | 1210 Medical Arts Blvd, Suite #315, Anderson, IN 46011-3461 | 2008-10-15 |
| 1598956450 | Cheryl Kim Tweed | Nurse Practitioner | 1210 Medical Arts Blvd, 315, Anderson, IN 46011 | 2007-08-06 |
| 1649398736 | Anne L. Ford | Internal Medicine | 1210 Medical Arts Blvd, Suite 105, Anderson, IN 46011-3461 | 2007-03-27 |
| 1104923135 | Pulmonary Disease & Sleep Disorders Consultants of Madison Co., P.C. | Specialist | 1210 Medical Arts Blvd, Suite 214, Anderson, IN 46011-3461 | 2006-09-20 |
| 1578577607 | Dean Paulsen | Obstetrics & Gynecology | 1210 Medical Arts Blvd, Suite 219, Anderson, IN 46011-3461 | 2006-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124662226 | Full Circle Family Solutions, LLC | Counselor | 909 Northwood Drive, Anderson, IN 46011 | 2019-10-31 |
| 1497186563 | Andrea C Rich | Social Worker | 1317 Winding Way, Anderson, IN 46011 | 2013-11-27 |
| 1093080848 | Franklin Keith Beeler | Family Medicine | 930 Summerlin Court, Anderson, IN 46011 | 2012-03-13 |
| 1063609642 | Christopher Place At Keystone Woods Associates, LLC | Assisted Living Facility | 2334 North Madison Ave, Anderson, IN 46011 | 2007-09-27 |
| 1720155187 | Garry L Smith Dds PC | Dentist | 1528 Medical Arts Blvd, Anderson, IN 46011 | 2006-11-29 |
| 1891711586 | Suzanne Obrien Beeson | Psychologist | 1210 Medical Arts. Blvd., Suite 208, Anderson, IN 46011 | 2006-07-14 |
| 1669471199 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 1809 N Madison Ave, Anderson, IN 46011 | 2005-07-18 |
| 1265980742 | Andrew J Koehler | Counselor | 2010 Brentwood Dr, Anderson, IN 46011 | 2016-09-14 |
| 1902258866 | Audrey A. Dickerson | Physician Assistant | 1515 N Madison Ave, Anderson, IN 46011 | 2016-07-05 |
| 1104271790 | Mohammad Sami Bakdash | Internal Medicine | 1515 N Madison Ave, Anderson, IN 46011 | 2016-05-02 |
| Find all providers in zip 46011 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205013653 | Jetty Heart Clinic | Internal Medicine | 1210 B Medical Arts Boulevard, Suite 217, Anderson, IN 46011-3439 | 2008-01-29 |
| 1134333289 | Chad Michael Feldman | Internal Medicine | 141 W 22nd St Ste 109, Anderson, IN 46016-4315 | 2007-05-09 |
| 1962469510 | Preetham Jetty | Internal Medicine | 1210 A Medical Arts Blvd, Suite 105, Anderson, IN 46011-3437 | 2006-04-27 |
| 1548224199 | John Dwight Ware IIi | Internal Medicine | 105 Buford Avenue, Anderson, SC 29621-3313 | 2006-04-12 |
| 1740266725 | Brent T Mclaurin | Internal Medicine | 100 Gavotte Ln, Anderson, SC 29621-8205 | 2005-12-21 |
| 1225031966 | Thomas James Sullivan Jr. | Internal Medicine | 100 Perpetual Sq, Anderson, SC 29621-1713 | 2005-05-26 |
| 1578100095 | Anmed Health | Internal Medicine | 100 Healthy Way Ste 1210, Anderson, SC 29621-7916 | 2019-12-03 |
| 1285154914 | Anmed Health | Internal Medicine | 100 Healthy Way, Anderson, SC 29621-7915 | 2017-06-23 |
| 1831434703 | Dr Rhonda Duncan Mauldin Cardiology LLC | Internal Medicine | 803 N Fant St Ste 3a, Anderson, SC 29621-5718 | 2012-12-04 |
| 1952668964 | Brian Edward Miller | Internal Medicine | 100 Healthy Way Ste 1120, Anderson, SC 29621-7915 | 2012-04-15 |
| Find all providers in ANDERSON | ||||
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| 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.