Alan Ettinger, DPM PA

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

0469 Issued in TX

Practice address

1001 12TH St Ste 104
Fort Worth, TX 76104-3928

Phone

(817) 738-1931

Fax

(817) 738-6990

NPI assigned

Jun 28, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Dr. Alan Ettinger DPM PA

  • Durable Medical Equipment & Medical Supplies
  • Fort Worth, TX
  • NPI 1598943219
  NPD (past) Authorized official
• Ged Medical Management Inc

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Fort Worth, TX
  • NPI 1942424452
  NPD (past) Authorized official

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255564800000",
    "number": "1295762771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 12TH ST STE 104",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043928",
            "telephone_number": "817-738-1931",
            "fax_number": "817-738-6990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 12TH ST STE 104",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043928",
            "telephone_number": "817-738-1931",
            "fax_number": "817-738-6990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTINGER",
        "first_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DPM PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2009-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "TX",
            "license": "0469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092827702",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4097506",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ethical Family Healthcare & Wound Experts Inc
• Raphna Etienne
• Seta Seta Etim
• Josephine Nzima Etta, APRN-PMHNP
• Gary Lee Etter, MD
• Emmanuel Etuokwu, AGNP-C, PMHNP-BC
• Briyet Sigala Eubanks, ATP
• Matthew Glenn Eubanks, LPC
• Eudaimonia Neurology PA
• Lyndi Jo Eudy, SLP

• Primary Podiatric Medicine Podiatrist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Primary Podiatric Medicine Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.