Jack Lee Nettleton, M.D.

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

JN047780 Issued in MI

Practice address

4100 Beecher Rd
Suite a
Flint, MI 48532-3661

Phone

(810) 342-3800

Fax

(810) 342-3784

NPI assigned

Jul 28, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jack.nettleton@mclaren.direct.varian.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hesham E Gayar, M.D., P.C.

  • Radiation Oncology Physician
  • Flint, MI
  • NPI 1093839060
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254787200000",
    "number": "1174523575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1236",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484803236",
            "telephone_number": "810-342-3800",
            "fax_number": "810-342-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 BEECHER RD",
            "address_2": "SUITE A",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323661",
            "telephone_number": "810-342-3800",
            "fax_number": "810-342-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETTLETON",
        "first_name": "JACK",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2009-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MI",
            "license": "JN047780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saurav Nepal
• Nephrology & Internal Medicine PC
• Angelica Nesbitt, BA, CMHP, QMHP, QIDP
• Jennifer Aimee Nesbitt, BSW
• Justin Nettles
• Mark T Neumann, DO
• New Beginings Sober Living Inc
• New Century Adult Day Program Services, LLC
• New Century Adult Day Treatment Inc
• New Century Support Services

• Radiation Oncology Physician in Flint, MI
• Providers in Flint, MI by specialty
• Radiation Oncology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.