Ethan Paul Reid, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

APRN9283538 Issued in FL

Practice address

1839 Central Ave.
St. Petersburg, FL 33713-8900

Phone

(727) 322-1054

Fax

(727) 821-7213

NPI assigned

Sep 14, 2017

Last updated

Apr 14, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medi Clinics Primary Care LLCGroup PAC ID 6608029152, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Angels Care Home Health Home health agency, Tampa, FL, CCN 108063
• Trulife Home Health LLC Home health agency, Land O Lakes, FL, CCN 687258
• Angels Care Home Health Home health agency, Land O Lakes, FL, CCN 103135

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medi Clinics Primary Care LLC

  • Multi-Specialty Clinic/Center
  • Tampa, FL
  • NPI 1609120534
  Medicare reassignment Care Compare group NPD
• Health First Primary Care, L.L.C

  • General Practice Physician
  • Tampa, FL
  • NPI 1609218098
  Medicare reassignment NPD
• Nulife Medical Group LLC

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1750140885
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alcrista Investments, Inc.

  dba Angels Care Home Health

  • Home Health Agency
  • Clearwater, FL
  • NPI 1346560422
  Care Compare affiliation
• E-Med Source of Florida, Inc.

  dba Angels Care Home Health

  • Home Health Agency
  • Tampa, FL
  • NPI 1023189321
  Care Compare affiliation
• Trulife Home Health LLC

  • Home Health Agency
  • Land O' Lakes, FL
  • NPI 1356078182
  Care Compare affiliation

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1265951891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE.",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-322-1054",
            "fax_number": "727-821-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE.",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-322-1054",
            "fax_number": "727-821-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "ETHAN",
        "middle_name": "PAUL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-14",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9283538",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN9283538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022437600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "S59UH",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rehabilitation Center of St Petersburg Inc (Rehabilitation Center of St Pete)
• Carisa Chantal Rehbein
• Mohamed A Rehman, M.D.
• Ernest C Rehnke, M.D.
• Robert Dickerson Rehnke, M.D.
• Jeanette B Reid, PHD
• Quiana Reid
• Ruth K Reid, RNFA
• Taguna Martinez Reid
• Elizabeth M Reilly Hays, MD

• Adult Health Nurse Practitioner in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; 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.