ETHAN COLLIER (NPI# 1598389702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598389702 |
| Entity Type | Individual |
| Full Name | ETHAN COLLIER |
| Credential | MD |
| Practice Address |
1665 S Green St Tupelo MS 38804-6556 |
| Practice Telephone | 6623772189 |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2020-06-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | MS | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740365238 | Ethan Collier | Physical Therapist | 10121 Se Sunnyside Rd, Suite 208, Clackamas, OR 97015-5745 | 2006-10-25 |
| Street Address |
1665 S GREEN ST |
| City | TUPELO |
| State | MS |
| Zip Code | 38804-6556 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497748941 | James Lauvon Taylor IIi | Pharmacist | 1665 S Green St, Tupelo, MS 38804-6556 | 2005-08-30 |
| 1427673532 | Garrett Fratesi | Student in an Organized Health Care Education/Training Program | 1665 S Green St, Tupelo, MS 38804-6556 | 2020-06-15 |
| 1629692769 | Jeremy Keon Prince | Family Medicine | 1665 S Green St, Tupelo, MS 38804-6556 | 2020-06-04 |
| 1104440544 | Ridgeland Clay Dabbs | Student in an Organized Health Care Education/Training Program | 1665 S Green St, Tupelo, MS 38804-6556 | 2020-06-02 |
| 1366066698 | Raaj Ghosal | Student in an Organized Health Care Education/Training Program | 1665 S Green St, Tupelo, MS 38804-6556 | 2020-06-02 |
| 1720602295 | Nathaniel Thomas Sparks | Student in an Organized Health Care Education/Training Program | 1665 S Green St, Tupelo, MS 38804-6556 | 2020-06-01 |
| 1730703158 | Joseph Brooks Pratt | Student in an Organized Health Care Education/Training Program | 1665 S Green St, Tupelo, MS 38804-6556 | 2020-06-01 |
| 1053971606 | Marcus John Wilson | Student in an Organized Health Care Education/Training Program | 1665 S Green St, Tupelo, MS 38804-6556 | 2019-06-17 |
| 1952961500 | Nicholas William Bondio | Student in an Organized Health Care Education/Training Program | 1665 S Green St, Tupelo, MS 38804-6556 | 2019-06-17 |
| 1255991899 | Maribeth Barfield Hillhouse | Student in an Organized Health Care Education/Training Program | 1665 S Green St, Tupelo, MS 38804-6556 | 2019-06-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548874159 | Susan Me'chelle Oliver | Nurse Practitioner | 874 Barnes Crossing Road, Tupelo, MS 38804 | 2020-09-01 |
| 1134762784 | Kimberly J Adams | Occupational Therapy Assistant | 90 Clark Ave, Tupelo, MS 38804 | 2019-10-25 |
| 1790270924 | Megan Guntharp | Occupational Therapist | 960 Commonwealth Boulevard, Tupelo, MS 38804 | 2018-06-29 |
| 1154867562 | Urologic Ambulatory Surgery Center, LLC | Clinic/Center | 3353 N Gloster Street, Suite 300, Tupelo, MS 38804 | 2017-01-09 |
| 1790235919 | Dr Scott Dickinson D.m. D. PC | Dentist | 3999 N Gloster Street, Tupelo, MS 38804 | 2016-10-12 |
| 1326496621 | Angela Estes | Occupational Therapist | County Road 1279 House#197, Tupelo, MS 38804 | 2016-05-26 |
| 1316300080 | Eric Wade Tillotson | Family Medicine | 1665 South Green Street, Tupelo, MS 38804 | 2016-03-31 |
| 1104238898 | Stella M. Johnson | Social Worker | 2292 Camelot Cir, Tupelo, MS 38804 | 2014-05-29 |
| 1821437351 | Lenka Petersen | Student in an Organized Health Care Education/Training Program | 1665 S Green St., Nmmc, Tupelo, MS 38804 | 2013-06-18 |
| 1083966303 | Jessica M Baskett | Counselor | 398 E Main St, Tupelo, MS 38804 | 2012-10-10 |
| Find all providers in zip 38804 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An 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. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972110963 | Akira Keyana Baker | Student in an Organized Health Care Education/Training Program | 415 N Ione St, Tupelo, MS 38801-3116 | 2020-09-24 |
| 1821437351 | Lenka Petersen | Student in an Organized Health Care Education/Training Program | 1665 S Green St., Nmmc, Tupelo, MS 38804 | 2013-06-18 |
| 1427673532 | Garrett Fratesi | Student in an Organized Health Care Education/Training Program | 1665 S Green St, Tupelo, MS 38804-6556 | 2020-06-15 |
| 1104440544 | Ridgeland Clay Dabbs | Student in an Organized Health Care Education/Training Program | 1665 S Green St, Tupelo, MS 38804-6556 | 2020-06-02 |
| 1366066698 | Raaj Ghosal | Student in an Organized Health Care Education/Training Program | 1665 S Green St, Tupelo, MS 38804-6556 | 2020-06-02 |
| 1720602295 | Nathaniel Thomas Sparks | Student in an Organized Health Care Education/Training Program | 1665 S Green St, Tupelo, MS 38804-6556 | 2020-06-01 |
| 1730703158 | Joseph Brooks Pratt | Student in an Organized Health Care Education/Training Program | 1665 S Green St, Tupelo, MS 38804-6556 | 2020-06-01 |
| 1053971606 | Marcus John Wilson | Student in an Organized Health Care Education/Training Program | 1665 S Green St, Tupelo, MS 38804-6556 | 2019-06-17 |
| 1952961500 | Nicholas William Bondio | Student in an Organized Health Care Education/Training Program | 1665 S Green St, Tupelo, MS 38804-6556 | 2019-06-17 |
| 1255991899 | Maribeth Barfield Hillhouse | Student in an Organized Health Care Education/Training Program | 1665 S Green St, Tupelo, MS 38804-6556 | 2019-06-17 |
| Find all providers in TUPELO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.