DR. DAVID LOUIS JETMORE (MD) – Otolaryngology Physician, NPI 1215939467
Otolaryngology Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
242 OTOLARYNGOLOGY in IN
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Provider Addresses for DR. DAVID LOUIS JETMORE (MD)
Reid Health, 1100, Reid Parkway, Richmond, Wayne County, Indiana, 47374, United States
MEDICAL STAFF SERVICES
RICHMOND, IN 473741157
Phone: (765) 983-3127
Fax: (765) 983-3219
Type: Mailing
Chester Boulevard, Richmond, Wayne County, Indiana, 47374, United States
RICHMOND, IN 473741919
Phone: (765) 966-1600
Fax: (765) 962-9641
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-10-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20101025001372 | I | Otolaryngology | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 254 | 254 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 230 | 230 | $0 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 206 | 205 | $0 |
| 90480 | Admn sarscov2 vacc 1 dose | 185 | 185 | $0 |
| 90686 | Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage | 21 | 21 | $0 |
Insurance plans in this area (ZIP 47374)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OK | |
| Internal Medicine | IN | |
| Family Practice | IN | |
| - | NC | |
| - | IN | |
| P S Y C H I A T R Y | OH | |
| Nurse Practitioner | IN | |
| - | GA | |
| Nurse Practitioner | IN | |
| - | IN |
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