PREETHAM JETTY (NPI# 1962469510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962469510 |
| Entity Type | Individual |
| Full Name | PREETHAM JETTY |
| Other Name | PREETHAM KONDLAPOODI |
| Credential | MD |
| Practice Address |
1210 A Medical Arts Blvd Suite 105 Anderson IN 46011-3437 |
| Mailing Address |
6626 E 75th St Suite 500 Indianapolis IN 46250-2805 |
| Practice Telephone | 7652984660 |
| Practice Fax Number | 7652984926 |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2014-12-03 |
| Gender Code | M |
| Is Sole Proprietor | 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 | 000000586512 | 01 |
| IN | RR MEDICARE PTAN | P01214600 | 01 |
| IN | ANTHEM | 000000557249 | 01 |
| IN | 100120660 | 05 | |
| IN | AETNA | 4218217 | 01 |
| Street Address |
1210 A MEDICAL ARTS BLVD SUITE 105 |
| City | ANDERSON |
| State | IN |
| Zip Code | 46011-3437 |
| 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 |
| 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 |
| 1588965206 | Anmed Health | Internal Medicine | 105 Buford Ave, Anderson, SC 29621-3313 | 2010-11-11 |
| 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.