Individual provider Active NPI

Ethan Covalt

  • Physical Therapy Assistant
  • Huntingdon, PA
National Provider Identifier
1033585138
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
TEI004324 Issued in PA
Practice address
403 6TH St
Box 870
Huntingdon, PA 16652-1518
Phone
(877) 312-6576
NPI assigned
Aug 12, 2015
Last updated
Aug 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TEI004324 PA Primary

Addresses

Primary practice location

403 6TH St
Box 870
Huntingdon, PA 16652-1518

Mailing address

560 Main Line Dr
Lewistown, PA 17044-8127
Phone (717) 462-0372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TEI004324PAMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1033585138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 MAIN LINE DR",
            "city": "LEWISTOWN",
            "state": "PA",
            "postal_code": "170448127",
            "telephone_number": "717-462-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 6TH ST",
            "address_2": "BOX 870",
            "city": "HUNTINGDON",
            "state": "PA",
            "postal_code": "166521518",
            "telephone_number": "877-312-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVALT",
        "first_name": "ETHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-12",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI004324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntingdon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.