NPI age
13 years
Enumerated 2012-07-27
● Active
Type 1 · Individual
DR. Krunal Jethwa, M.D
Jethwa is 1 of 147 family medicine providers in Marietta and 1 of 5448 in Georgia.
Primary specialty
Family Medicine
Plus 2 subspecialties
Licensed in
GA, SC
2 states
Status
Active
No deactivations on record
Last NPPES update
2021-06-18
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 5448 active family medicine providers in Georgia.
NPI age
13 years
↓ 4 yr below median (17 yr)
State licenses
2 states
Top 87% — 12% of peers are multi-state
Subspecialties
1
In the 26% of peers with subspecialties
NPI lifetime · 2012 → 2026
2012-07Enumerated in NPPES
2012
2026
Where they practice
Practice location
4800 Olde Towne Pkwy Ste 150a
Marietta, GA 300684357
Mailing address
4800 Olde Towne Pkwy Ste 150a
Marietta, GA 300684357
Specialties
-
Family Medicine PrimaryFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of...
-
Student in an Organized Health Care Education/Training ProgramAn individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (SC) | 394013 | |
| 01 (SC) | SC91676121 | MEDICARE PIN |
| 01 (SC) | SC91675193 | MEDICARE PIN |
| 01 (SC) | SC9167J577 | MEDICARE PIN |
| 01 (SC) | SC91676067 | MEDICARE PIN |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.