Ethan George Brouillette

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3110 Windemere Cir
Nashville, TN 37214-1616

Phone

(262) 483-9269

NPI assigned

Oct 18, 2022

Sex

Male

Sole proprietor

Yes

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 TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beaman Physician Services, PCGroup PAC ID 6406218130, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Beaman Physician Services, PC

  • Hospitalist Physician
  • Nashville, TN
  • NPI 1487342242
  Medicare reassignment Care Compare group
• Warner Physician Services PC

  • Hospitalist Physician
  • Nashville, TN
  • NPI 1770272221
  Medicare reassignment

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1245956580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 WINDEMERE CIR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372141616",
            "telephone_number": "262-483-9269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 WINDEMERE CIR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372141616",
            "telephone_number": "262-483-9269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUILLETTE",
        "first_name": "ETHAN",
        "middle_name": "GEORGE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-18",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Brothers
• Donald T Brothers Jr., M.D.
• Joseph Broucek, MD
• Courtney Brouillette, SLP-CCC
• Emily Brouillette, ED.S. NCSP
• Michael Jon Broussard
• Caryl Kennedy Brower, PA-C
• Laura Brown Coulam, PH.D.
• Breanna Brown Cox, PMHNP-BC, APRN
• Shirley Nikshica Brown Johnson, APRN-PMHNP-BC

• Physician Assistant in Nashville, TN
• Providers in Nashville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.