ETHAN BAILEY (NPI# 1679023345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679023345 |
| Entity Type | Individual |
| Full Name | ETHAN BAILEY |
| Practice Address |
703 Trent Dr Greenwood IN 46143-7424 |
| Mailing Address |
703 Trent Drive Greenwood IN 46143 |
| Practice Telephone | 3173130708 |
| Mailing Telephone | 3173130708 |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2016-10-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
703 TRENT DR |
| City | GREENWOOD |
| State | IN |
| Zip Code | 46143-7424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395299 | Tiffany Smirat | Pharmacist | 882 S Sr 135, Greenwood, IN 46143 | 2020-10-27 |
| 1083250138 | Benajmin Thomas Nyboer | Pharmacist | 5961 North State Road 135, Kroger Pharmacy, Greenwood, IN 46143 | 2019-11-25 |
| 1609417260 | Orthopaedics-indianapolis, Inc | Orthopaedic Surgery | 1579 Olive Branch Parke Lane, Suite 130, Greenwood, IN 46143 | 2019-10-04 |
| 1194282525 | Homebased Mental Health Service | Case Management | 2244 Blossom Dr, Greenwood, IN 46143 | 2019-02-21 |
| 1710478078 | Anne E Packard | Pharmacist | 333 E County Line Rd # 101, Greenwood, IN 46143 | 2018-05-22 |
| 1033607924 | Ez Clinic Inc. | Nurse Practitioner | 494 S Emerson Ave Ste I, Greenwood, IN 46143 | 2018-04-25 |
| 1891246633 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 5961 N Sr 135, Greenwood, IN 46143 | 2016-10-17 |
| 1477919637 | Ourhealth Physicians Group, LLC | Clinic/Center | 1273 N Emerson Ave Ste H, Greenwood, IN 46143 | 2016-01-04 |
| 1003212655 | American Health Network of Indiana, LLC | Non-Pharmacy Dispensing Site | 2355 Endress Place St A, Healthy Measures Wellness Clinic, Greenwood, IN 46143 | 2014-11-10 |
| 1265831366 | Katie D'agosto | Counselor | 3000 S State Road 135 Ste 230, Greenwood, IN 46143 | 2014-08-14 |
| Find all providers in zip 46143 | ||||
| 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 |
|---|---|---|---|---|
| 1922623826 | Shelbi Ashlyn Robinson | Student in an Organized Health Care Education/Training Program | 1314 Kenwood Dr, Greenwood, IN 46143-8101 | 2020-06-16 |
| 1740744515 | Danielle Renee Allison | Student in an Organized Health Care Education/Training Program | 1014 Peggy Dr., Greenwood, MO 64034 | 2019-01-25 |
| 1497219398 | Kelly Godbey | Student in an Organized Health Care Education/Training Program | 1303 Willow Dr, Greenwood, MO 64034-9110 | 2019-01-24 |
| 1346865318 | Taylor Bachert | Student in an Organized Health Care Education/Training Program | 533 E County Line Rd Ste 101, Greenwood, IN 46143-1074 | 2020-06-15 |
| 1871118836 | Jordan Phelps | Student in an Organized Health Care Education/Training Program | 533 E County Line Rd Ste 101, Greenwood, IN 46143-1074 | 2020-06-15 |
| 1205451283 | Taylor Daggett | Student in an Organized Health Care Education/Training Program | 533 E County Line Rd Ste 101, Greenwood, IN 46143-1074 | 2020-06-15 |
| 1710502794 | William Long | Student in an Organized Health Care Education/Training Program | 533 E County Line Rd Ste 101, Greenwood, IN 46143-1074 | 2020-06-15 |
| 1407470198 | Helen Grey | Student in an Organized Health Care Education/Training Program | 155 Academy Ave, Greenwood, SC 29646-3869 | 2020-05-29 |
| 1396369922 | Davis Reed | Student in an Organized Health Care Education/Training Program | 155 Academy Ave, Greenwood, SC 29646-3869 | 2020-05-29 |
| 1730703364 | Jacob Standard | Student in an Organized Health Care Education/Training Program | 155 Academy Ave, Greenwood, SC 29646-3869 | 2020-05-29 |
| Find all providers in GREENWOOD | ||||
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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.