Individual provider Active NPI

Ethan White, MSPT

  • Physical Therapist
  • Birmingham, AL
National Provider Identifier
1154414167
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH2033 Issued in AL
Practice address
3125 Independence Drive
300B
Birmingham, AL 35209
Phone
(205) 879-7501
Fax
(205) 879-0675
NPI assigned
Oct 2, 2006
Last updated
Aug 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH2033 AL Primary

Addresses

Primary practice location

3125 Independence Drive
300B
Birmingham, AL 35209

Mailing address

3125 Independence Drive
300B
Birmingham, AL 35209
Phone (205) 879-7501

Other identifiers 3

IdentifierTypeStateIssuer
6400002OtherALUNITED HEALTH CARE
51094044OtherALBLUE CROSS
418961932OtherALTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111121000072 AL Practitioner - Physical Therapist in Private Practice 8426049651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.2 of 100Reported as group
Quality
95.91
Improvement activities
40
Cost
74.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH2033ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ew Motion Therapy Liberty Park LLC Physical Therapist CurrentSince Mar 6, 2024 Accepting new patients
Ew Motion Therapy Homewood LLC Physical Therapist CurrentSince Jul 1, 2003 Accepting new patients
Ew Motion Therapy Meadowbrook LLC Physical Therapist Current Accepting new patients

Locations

3125 Independence Dr
Ste 300B
Homewood, AL 35209
Phone (205) 263-2770

4 Office Park Cir
Ste 217
Mountain Brk, AL 35223
Phone (205) 263-2770

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1154414167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 INDEPENDENCE DRIVE",
            "address_2": "300B",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35209",
            "telephone_number": "205-879-7501",
            "fax_number": "205-879-0675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 INDEPENDENCE DRIVE",
            "address_2": "300B",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35209",
            "telephone_number": "205-879-7501",
            "fax_number": "205-879-0675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ETHAN",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH2033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "6400002",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51094044",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "418961932",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.