Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jaron Lee Pettis

Individual provider Surgery Physician · NPI 1366903015

Jaron Lee Pettis is a General Surgery in LA Porte, Indiana. Graduated from University of South Carolina School of Medicine in 2019, 7 years ago. Practices with La Porte Clinic Company LLC, a 66-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
7
Trained at
University of South Carolina School of Medicine
Licensed in
IN
In the registry since
2019

Practice location Address checks out

1331 State St Ste 340
LA Porte, IN 46350-3112
Phone: (219) 379-3166
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 01094579A (IN)

Record details

NPI number1366903015
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 26, 2019
Last updated in NPPESAugust 26, 2024
Certification dateAugust 26, 2024
Mailing address1331 State St Ste 340, La Porte, IN 46350-3112

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolUNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Graduated 2019 (7 years in practice)
Group practice La Porte Clinic Company Llc — 66 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations8 on file with Medicare

Other providers in LA Porte