Individual provider Active NPI

Jody Lynn Gettleman, MD

  • Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1811968647
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
18688 Issued in AZ
Practice address
1850 N Central Ave
Ste 1600
Phoenix, AZ 85004-4633
Phone
(602) 744-4765
Fax
(602) 744-4799
NPI assigned
Jan 30, 2006
Last updated
May 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 18688 AZ Primary

Addresses

Primary practice location

1850 N Central Ave
Ste 1600
Phoenix, AZ 85004-4633

Mailing address

645 E Missouri Ave
Ste 300
Phoenix, AZ 85012-1351
Phone (602) 744-4765

Other identifiers 2

IdentifierTypeStateIssuer
050071335OtherMEDICARE RAILROAD
285389MedicaidAZ

Other names 1

  • Jody L Gettleman Other name

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
18688AZMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1811968647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 E MISSOURI AVE",
            "address_2": "STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121351",
            "telephone_number": "602-744-4765",
            "fax_number": "602-744-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 N CENTRAL AVE",
            "address_2": "STE 1600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044633",
            "telephone_number": "602-744-4765",
            "fax_number": "602-744-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GETTLEMAN",
        "first_name": "JODY",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "18688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "050071335",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285389",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODY",
            "last_name": "GETTLEMAN",
            "middle_name": "L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; 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.