Active NPI
Ethan A Davis, DPT
- Orthopedic Physical Therapist
- Orlando, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- Practice address
- 3451 Technological Ave Ste 1
Orlando, FL 32817-8353 - Phone
- (407) 681-2520
- NPI assigned
- May 29, 2019
- Last updated
- May 29, 2019
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | FL | Primary |
Addresses
Primary practice location
3451 Technological Ave Ste 1
Orlando, FL 32817-8353
Mailing address
3138 Buck Hill PL
Orlando, FL 32817-5864
Phone (407) 575-9964
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
405 Lake Howell Rd
Suite 1031
Maitland, FL 32751-5926
Phone (407) 671-0433
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.26 of 100
- Quality
- 86.58
- Improvement activities
- 40
- Cost
- 68.79
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Luna Care Physical Therapy LLC | Orthopedic | Current | Accepting new patients |
| Tript, LLC | Current | Accepting new patients |
Locations
5011 Gate Pkwy
Ste 100
Jacksonville, FL 32256
Phone (904) 326-3627
405 Lake Howell Rd
Ste 1031
Maitland, FL 32751
Phone (407) 671-0433
Networks
- Freedom Health HMO Network
Organizations & group practices 2
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.
-
- Physical Therapist
- Jacksonville, FL
- NPI 1114542032
Orthopedic
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559088000000",
"number": "1295393932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3138 BUCK HILL PL",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328175864",
"telephone_number": "407-575-9964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3451 TECHNOLOGICAL AVE STE 1",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328178353",
"telephone_number": "407-681-2520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ETHAN",
"middle_name": "A",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-29",
"last_updated": "2019-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; 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.