Active NPI
Ethan Staats
- Otolaryngology Physician
- Cashiers, NC
National Provider Identifier
1194244012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 8893
- Practice address
- 391 Heaton Forest Rd
Cashiers, NC 28717 - Phone
- (828) 743-2558
- NPI assigned
- Sep 12, 2017
- 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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 8893 | GA | Primary |
Addresses
Primary practice location
391 Heaton Forest Rd
Cashiers, NC 28717
Mailing address
PO Box 2670
Cashiers, NC 28717-2670
Phone (828) 743-2558
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8893 | Other | GA | GA STATE BOARD |
| 00060299A | Medicaid | GA |
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": "1505174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505174400000",
"number": "1194244012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2670",
"city": "CASHIERS",
"state": "NC",
"postal_code": "287172670",
"telephone_number": "828-743-2558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "391 HEATON FOREST RD",
"city": "CASHIERS",
"state": "NC",
"postal_code": "28717",
"telephone_number": "828-743-2558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAATS",
"first_name": "ETHAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-09-12",
"last_updated": "2017-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Otolaryngology",
"state": "GA",
"license": "8893",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GA STATE BOARD",
"identifier": "8893",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00060299A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cashiers, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.