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

Jetter Robertson, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1760802508

Jetter Robertson, DO is a Neurology in Minneapolis, Minnesota. Graduated from Nova Southeastern Univ College of Dental Medicine in 2014, 12 years ago. Practices with Grand Itasca Clinic and Hospital, a 325-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
12
Trained at
Nova Southeastern Univ College of Dental Medicine
Licensed in
MN
In the registry since
2014
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

909 Fulton St SE
Minneapolis, MN 55455
Phone: (612) 672-7422
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X · Licence 63736 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1760802508
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedApril 20, 2014
Last updated in NPPESMay 15, 2018

Medicare enrollment

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

Medicare specialtyNEUROLOGY
Medical schoolNOVA SOUTHEASTERN UNIV COLLEGE OF DENTAL MEDICINE
Graduated 2014 (12 years in practice)
Group practice Grand Itasca Clinic And Hospital — 325 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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