Clifford W Fetters, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01034557A Issued in IN

Practice address

11900 N Pennsylvania St
Ste 200
Carmel, IN 46032-4694

Phone

(317) 663-7123

Fax

(317) 587-0496

NPI assigned

Jul 12, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Indiana University School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health and Wellness of Carmel, LLCGroup PAC ID 8022154640, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Hospital, Indianapolis, IN, CCN 150056

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Health and Wellness of Carmel, LLC

  • Family Medicine Physician
  • Carmel, IN
  • NPI 1477786853
  Medicare reassignment Care Compare group NPD Authorized official
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indiana University Health Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1144266024
  Care Compare affiliation

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1174722946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 N PENNSYLVANIA ST",
            "address_2": "STE 200",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460324694",
            "telephone_number": "317-663-7123",
            "fax_number": "317-587-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 N PENNSYLVANIA ST",
            "address_2": "STE 200",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460324694",
            "telephone_number": "317-663-7123",
            "fax_number": "317-587-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTERS",
        "first_name": "CLIFFORD",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01034557A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100332730",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000532027",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael E Ferrante, CAA
• Nora Elizabeth Ferree, RN
• Jennifer Lynn Ferrell
• Christina Elizabeth Ferroli, PHD, RDN, LDN, FAND
• Zubin P Ferzandi, RPH
• Audrey Fiddler
• Jeremy R. Fields, PT, DPT, ATC/L
• Shannon Fife
• Danielle E Fifita, COTA
• Leslie Figueroa

• Family Medicine Physician in Carmel, IN
• Providers in Carmel, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.