John Ethan Meng, DPT

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

P23558 Issued in NC

Practice address

805 N 4TH St
Wilmington, NC 28401-3471

Phone

(910) 915-4888

NPI assigned

Nov 21, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Ethan Meng Professional name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of North Carolina at Chapel Hill School of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Change the Game Performance Therapy IncGroup PAC ID 6406380203, 6 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 and National Provider Directory roles.

• Change the Game Performance Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Wilmington, NC
  • NPI 1659141703

  Neurology

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1732147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1215752456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N 4TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284013471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N 4TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284013471",
            "telephone_number": "910-915-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENG",
        "first_name": "JOHN",
        "middle_name": "ETHAN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-21",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NC",
            "license": "P23558",
            "primary": true
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "NC",
            "license": "P23558",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NC",
            "license": "P23558",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ETHAN",
            "last_name": "MENG",
            "prefix": "DR.",
            "credential": "DPT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mackenzie Mendenhall, RDN
• Elena Marie Mendez, NP-C
• Israel Miguel Mendez, PA-C
• Dennis G. Mendleson, L.P.C.S., A.C.H.
• Stacy Menefee
• Tizita Mengistu, PHARMD
• Carrie Sue Menke, MS LPC
• Mentoring Minds for Mental Health, PLLC
• Evanne Mercer
• Rena M Mercer, PT

• Sports Physical Therapist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Sports Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.