David Louis Jetmore, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

01023140A Issued in IN

Practice address

1434 Chester Blvd.
Richmond, IN 47374-1919

Phone

(765) 966-1600

Fax

(765) 962-9641

NPI assigned

Jun 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

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

Otolaryngology

Education

Indiana University School of Medicine, 1970

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reid Physician Associates IncGroup PAC ID 6406910769, 427 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Reid Health Hospital, Richmond, IN, CCN 150048

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: djetmore301072@ecommunitydirect.com
• Direct secure messaging: djetmore301072@reidhealth.direct-ci.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.

• Reid Physician Associates, Inc.

  • Internal Medicine Physician
  • Richmond, IN
  • NPI 1265689111
  Medicare reassignment Care Compare group
• Wayne County Auditor

  • Public Health or Welfare Agency
  • Richmond, IN
  • NPI 1093246332
  NPD
• Reid Hospital & Health Care Services Inc

  • Internal Medicine Physician
  • Richmond, IN
  • NPI 1982633236
  NPD (past)
• Reid Hospital & Health Care Services, Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Richmond, IN
  • NPI 1437188786
  NPD (past)

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

• Reid Hospital & Health Care Services, Inc

  • General Acute Care Hospital
  • Richmond, IN
  • NPI 1063457380
  Care Compare affiliation

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1215939467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741157",
            "telephone_number": "765-983-3127",
            "fax_number": "765-983-3219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1434 CHESTER BLVD.",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741919",
            "telephone_number": "765-966-1600",
            "fax_number": "765-962-9641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETMORE",
        "first_name": "DAVID",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "01023140A",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01023140A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000841132",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0544192",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100256310",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "djetmore301072@ReidHealth.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Reid Physician Associates, Inc.",
            "address_1": "1434 Chester Blvd.",
            "city": "Richmond",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473741919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emily Jarboe
• Heather L Jarboe, AGNP-C
• Larry Jenkins
• Emilie Jean Jennings, O.D.
• Amanda Jessee
• Thomas Jetmore, M.D.
• Sydney Jiang, M.D.
• Jill Kramer Counseling, LLC
• Cyriac John, MD
• Aaron Dwight Johnson, MD

• Otolaryngology Physician in Richmond, IN
• Providers in Richmond, IN by specialty
• Otolaryngology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; 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.