{"npi":"1962469510","type":"NPI-1","status":"active","name":{"display":"Preetham Jetty MD","other":[{"code":"5","type":"Also known as","value":"KONDLAPOODI, PREETHAM"}],"first":"PREETHAM","last":"JETTY","credential":"MD"},"specialty":{"primary_taxonomy":"207RC0000X","primary_taxonomy_description":"Cardiovascular Disease","slug":"cardiology","schema_org_specialty":"Cardiovascular","all":[{"code":"207RC0000X","description":"Cardiovascular Disease","primary":true,"state":"IN","license":"01040154A"}]},"addresses":[{"purpose":"LOCATION","street_1":"1210 A MEDICAL ARTS BLVD","city":"ANDERSON","state":"IN","postal_code":"460113437","country_code":"US","street_2":"SUITE 105","phone":"7652984660","fax":"7652984926"},{"purpose":"MAILING","street_1":"6626 E 75TH ST","city":"INDIANAPOLIS","state":"IN","postal_code":"462502805","country_code":"US","street_2":"SUITE 500"}],"license":{"state":"IN","number":"01040154A"},"identifiers":[{"type_code":"01","label":"Other","value":"4218217","state":"IN","issuer":"AETNA"},{"type_code":"05","label":"Medicaid","value":"100120660","state":"IN","issuer":null},{"type_code":"01","label":"Other","value":"000000557249","state":"IN","issuer":"ANTHEM"},{"type_code":"01","label":"Other","value":"000000586512","state":"IN","issuer":"ANTHEM"},{"type_code":"01","label":"Other","value":"P01214600","state":"IN","issuer":"RR MEDICARE PTAN"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20040909000457","type_code":"14-06","type_desc":"PRACTITIONER - CARDIOVASCULAR DISEASE (CARDIOLOGY)","state":"IN","pac_id":"8022084177"}]},"enumeration_date":"2006-04-27","last_updated":"2021-06-11","_meta":{"source":"NPPES","snapshot_date":"2021-06-11","doc_url":"https://findmynpi.com/api"}}