Active NPI
Ethan Burt Navarro, MED CF-SLP
- Speech-Language Pathologist
- Lynchburg, VA
National Provider Identifier
1033729272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2204000571
- Practice address
- 1912 Memorial Ave
Lynchburg, VA 24501-1708 - Phone
- (434) 845-8765
- NPI assigned
- Aug 3, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2204000571 | VA | Primary |
Addresses
Primary practice location
1912 Memorial Ave
Lynchburg, VA 24501-1708
Mailing address
1912 Memorial Ave
Lynchburg, VA 24501-1708
Phone (434) 845-8765
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2204000571 | VA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596412800000",
"number": "1033729272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1912 MEMORIAL AVE",
"city": "LYNCHBURG",
"state": "VA",
"postal_code": "245011708",
"telephone_number": "434-845-8765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1912 MEMORIAL AVE",
"city": "LYNCHBURG",
"state": "VA",
"postal_code": "245011708",
"telephone_number": "434-845-8765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAVARRO",
"first_name": "ETHAN",
"middle_name": "BURT",
"credential": "MED CF-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-03",
"last_updated": "2020-08-03",
"certification_date": "2020-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "VA",
"license": "2204000571",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynchburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.