Jetty Psychiatric Services LLC

Primary specialty

Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X

Legal business name

JETTY PSYCHIATRIC SERVICES LLC

Practice address

401 Tuscaloosa Ave SW
Suite 110
Birmingham, AL 35211-1416

Phone

(205) 785-2000

Fax

(205) 785-2945

NPI assigned

Sep 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Praveen Jetty, M.D.

Title

Owner/M.D.

Phone

(205) 785-2000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1750576815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 382664",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352382664",
            "telephone_number": "205-785-2000",
            "fax_number": "205-785-2954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 TUSCALOOSA AVE SW",
            "address_2": "SUITE 110",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352111416",
            "telephone_number": "205-785-2000",
            "fax_number": "205-785-2945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JETTY PSYCHIATRIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "JETTY",
        "authorized_official_first_name": "PRAVEEN",
        "authorized_official_title_or_position": "OWNER/M.D.",
        "authorized_official_telephone_number": "205-785-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessie Chu DMD LLC
• Traci Jester, MD
• Benjamin Alan Jeter, P.A.
• Deborah Jeter
• Lanitra Faye Jeter
• Praveen Jetty, M.D.
• Natalie Nicole Jewett, MD
• Harishanker Jeyarajan, MBBS
• Nan Jiang, M.D.
• Wenyun Jiang

• Geriatric Psychiatry Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Geriatric Psychiatry Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.