Active NPI
Lynn Anderson Jetton, M.D.
- Family Medicine Physician
- Holly Pond, AL
National Provider Identifier
1346511722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4316
- Practice address
- 13335 Highway 278 East
Holly Pond, AL 35083-0367 - Phone
- (256) 796-5006
- NPI assigned
- Jan 18, 2012
- Last updated
- Jan 18, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4316 | AL | Primary |
Addresses
Primary practice location
13335 Highway 278 East
Holly Pond, AL 35083-0367
Mailing address
PO Box 367
Holly Pond, AL 35083-0367
Phone (256) 796-5006
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4316 | AL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complete Family Practice | Single Specialty | Past | Accepting new patients |
| Correct Care, Inc. | Single Specialty | Past | Accepting new patients |
| Complete Family Medicine | Single Specialty | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IDFDCD
Organizations & group practices 3
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.
-
dba Alabama Speciality Clinic
- Family Medicine Physician
- Cullman, AL
- NPI 1154362655
Single Specialty
-
dba ASC Occupational Health
- Family Medicine Physician
- Cullman, AL
- NPI 1790810950
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326844800000",
"number": "1346511722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 367",
"city": "HOLLY POND",
"state": "AL",
"postal_code": "350830367",
"telephone_number": "256-796-5006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13335 HIGHWAY 278 EAST",
"city": "HOLLY POND",
"state": "AL",
"postal_code": "350830367",
"telephone_number": "256-796-5006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JETTON",
"first_name": "LYNN",
"middle_name": "ANDERSON",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-18",
"last_updated": "2012-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "AL",
"license": "4316",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holly Pond, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.