Active NPI
Linda D Rettger, M.D.
- Family Medicine Physician
- Mount Jewett, PA
National Provider Identifier
1073505467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD020312E
- Practice address
- 18 W Main St
Mt Jewett, PA 16740-0000 - Phone
- (814) 778-2298
- Fax
- (814) 778-7344
- NPI assigned
- Aug 22, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD020312E | PA | Primary |
Addresses
Primary practice location
18 W Main St
Mt Jewett, PA 16740-0000
Mailing address
4372 Route 6
Kane, PA 16735-3060
Phone (814) 778-2298
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000044064 | Other | PA | HIGHMARK BC/BS PROVIDER # |
| 010047693 | Other | PA | PALMETTO GBA PROVIDER # |
| 0006112770002 | Medicaid | PA | |
| 217622 | Other | PA | UPMC PROVIDER NUMBER |
| MD020312E | Other | PA | MEDICAL LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349827200000",
"number": "1073505467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4372 ROUTE 6",
"city": "KANE",
"state": "PA",
"postal_code": "167353060",
"telephone_number": "814-778-2298",
"fax_number": "814-778-7344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 W MAIN ST",
"city": "MT JEWETT",
"state": "PA",
"postal_code": "167400000",
"telephone_number": "814-778-2298",
"fax_number": "814-778-7344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RETTGER",
"first_name": "LINDA",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-22",
"last_updated": "2012-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD020312E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BC/BS PROVIDER #",
"identifier": "000044064",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO GBA PROVIDER #",
"identifier": "010047693",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0006112770002",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UPMC PROVIDER NUMBER",
"identifier": "217622",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE NUMBER",
"identifier": "MD020312E",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Jewett, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.