NPIMap

Individual provider Active NPI

Timothy D Jetton, M.D.

  • Family Medicine Physician
  • The Villages, FL
National Provider Identifier
1295708139
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME86253 Issued in FL
Practice address
1400 N US Highway 441 Ste 930
The Villages, FL 32159-6812
Phone
(352) 750-2108
Fax
(352) 750-1836
NPI assigned
Feb 10, 2006
Last updated
Aug 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME86253 FL Primary

Addresses

Primary practice location

1400 N US Highway 441 Ste 930
The Villages, FL 32159-6812

Mailing address

1400 N US Highway 441 Ste 930
The Villages, FL 32159-6812
Phone (352) 750-2108

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address TJetton@centerwell.com Direct

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
ME86253FLMDFamily Medicine Physician
27450TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care FL Inc Family Medicine Current Accepting new patients
Primary Care in Your Home LLC Past Accepting new patients
Florida Department of Children and Families Past Accepting new patients
Collier Hma Physician Management LLC Family Medicine Past Accepting new patients
Florida Hospital Medical Group Inc Past Accepting new patients
Ante Rudez MD PA Family Medicine Past Accepting new patients
Collier Boulevard Hma Physician Management LLC Family Medicine Past Accepting new patients
Dna Center LLC Past Accepting new patients
Southwest Alabama Emergency Physicians, LLC Past Accepting new patients
South Lake Internal Medicine PA Past Accepting new patients
Central Florida Internists, Inc. Family Medicine Past Accepting new patients
Orlando Family Physicians, LLC PastSince Jan 5, 2025 Accepting new patients
Express Care of Belleview, LLC Family Medicine Past Accepting new patients

Locations

4700 Millenia Blvd
Ste 650
Orlando, FL 32839
Phone (407) 533-6837

5997 S Goldenrod Rd
Orlando, FL 32822
Phone (407) 241-8957

Interoperability endpoints

  • Direct secure messaging: tjetton@centerwell.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1295708139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 N US HIGHWAY 441 STE 930",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321596812",
            "telephone_number": "352-750-2108",
            "fax_number": "352-750-1836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N US HIGHWAY 441 STE 930",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321596812",
            "telephone_number": "352-750-2108",
            "fax_number": "352-750-1836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETTON",
        "first_name": "TIMOTHY",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME86253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TJetton@centerwell.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1400 N US Highway 441 Ste 930",
            "city": "The Villages",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321596812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.