NPIMap

Individual provider Active NPI

William A Nettey, MD

  • Anesthesiology Physician
  • Marion, IN
National Provider Identifier
1205845252
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01048532A Issued in IN
Practice address
220 S. Norton St
Marion, IN 46952-3200
Phone
(765) 573-6656
Fax
(765) 573-6659
NPI assigned
Aug 7, 2006
Last updated
Oct 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01048532 IN
Anesthesiology Physician 207L00000X 01048532A IN Primary
Pain Medicine Physician 208VP0000X 01048532A IN

Addresses

Primary practice location

220 S. Norton St
Marion, IN 46952-3200

Mailing address

220 S Norton St
Marion, IN 46952-3200
Phone (765) 573-6656

Other identifiers 1

IdentifierTypeStateIssuer
200191360MedicaidIN

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

State licenses

LicenseStateTypeSpecialty
01048532INMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marion Anesthesiology, PC Anesthesiology Past Accepting new patients
Saint Joseph Regional Medical Center- Plymouth Campus Inc Past Accepting new patients
Great Lakes Anesthesia, P.C. Anesthesiology Past Accepting new patients
St. Joseph Valley Anesthesia P.C. Anesthesiology Past Accepting new patients

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1205845252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 S NORTON ST",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469523200",
            "telephone_number": "765-573-6656",
            "fax_number": "765-573-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S. NORTON ST",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469523200",
            "telephone_number": "765-573-6656",
            "fax_number": "765-573-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETTEY",
        "first_name": "WILLIAM",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01048532",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01048532A",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "IN",
            "license": "01048532A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200191360",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.