Ethan Harbert, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.013835 Issued in IL

Practice address

10A S Poplar St
Pana, IL 62557-1402

Phone

(217) 562-9214

Fax

(217) 562-4771

NPI assigned

Jan 17, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Beyers Chiropractic PCGroup PAC ID 5890899702, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Beyers Chiropractic PC

  • Chiropractor
  • Pana, IL
  • NPI 1144359902
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1093466468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10A S POPLAR ST",
            "city": "PANA",
            "state": "IL",
            "postal_code": "625571402",
            "telephone_number": "217-562-9214",
            "fax_number": "217-562-4771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10A S POPLAR ST",
            "city": "PANA",
            "state": "IL",
            "postal_code": "625571402",
            "telephone_number": "217-562-9214",
            "fax_number": "217-562-4771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARBERT",
        "first_name": "ETHAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-17",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randall Dean Floyd, DMD
• Bryce Fortner, PT, DPT
• Jamie Gillett, RD
• Michelle Dianne Goodrich, RPH
• Jason Grotts
• Neely Taylor Rose Harris, MD
• Tara Herbord, LCPC
• Heritage Manor - Pana, LLC (Heritage Health - Pana)
• Heritage Manor Pana, LLC (Heritage Health - Pana)
• Hickory Estates of Pana LLC

• Chiropractor in Pana, IL
• Providers in Pana, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.