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JETT SURGICAL LLC
NPI 1417408964
Physician Assistant - Surgical in Marietta, GA

Active since October 19, 2016
915 RANDALL CT NW, MARIETTA, GA 30064(770) 842-1907(678) 214-5098 Get Directions Write a Review

NPPES record last updated: December 12, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 12, 2016, Oct 19, 2016 (2 updates tracked since 2016).

About Jett Surgical Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JETT SURGICAL LLC (NPI 1417408964) is a healthcare organization registered as a surgical in Marietta, Georgia and active in the NPI registry since October 2016. The organization lists Wendy Kae Jetton, Ceo, as its authorized official.

NPPES Registry Identity

NPI1417408964
Entity TypeOrganization
Primary Taxonomy363AS0400X
Legal Business NameJETT SURGICAL LLC
Location Address915 RANDALL CT NWMarietta, GA 30064-4724
Mailing AddressPo Box 422252Atlanta, GA 30342-9252 · (770) 842-1907 · Fax (678) 214-5098
Phone(770) 842-1907
Fax(678) 214-5098
Organization SubpartNo
Authorized OfficialWendy Kae JettonCeo · (770) 842-1907
Enumeration DateOctober 19, 2016
Last NPPES UpdateDecember 12, 20162 updates tracked since enumeration
✔ NPI 1417408964 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in GA · 1256
915 RANDALL CT NW, Marietta, GA 30064
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. WENDY KAE JETTON CSA
Physician Assistant (Surgical)
915 RANDALL CT NW
MARIETTA, GA 30064
Cobb County (770) 842-1907

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jett Surgical LLC's NPI number?

The NPI number for Jett Surgical LLC is 1417408964. It was assigned to this organization in the NPPES registry on October 19, 2016.

Where is Jett Surgical LLC located?

Jett Surgical LLC is located at 915 Randall Ct NW, Marietta, GA 30064. The listed phone number is (770) 842-1907.

What is Jett Surgical LLC's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Jett Surgical LLC was last updated on December 12, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.