Active NPI
Ethan Showers
- Athletic Trainer
- Montoursville, PA
National Provider Identifier
1114572021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 700 Mulberry St
Montoursville, PA 17754-1922 - Phone
- (570) 772-7184
- NPI assigned
- Aug 7, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | PA | Primary |
Addresses
Primary practice location
700 Mulberry St
Montoursville, PA 17754-1922
Mailing address
809 Weldon St
Montoursville, PA 17754-1435
Phone (570) 772-7184
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565136000000",
"number": "1114572021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "809 WELDON ST",
"city": "MONTOURSVILLE",
"state": "PA",
"postal_code": "177541435",
"telephone_number": "570-772-7184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 MULBERRY ST",
"city": "MONTOURSVILLE",
"state": "PA",
"postal_code": "177541922",
"telephone_number": "570-772-7184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOWERS",
"first_name": "ETHAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-08-07",
"last_updated": "2019-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montoursville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.