Ethan Ray Freeborn, M.D.
Individual provider Active NPI Emergency Medicine Physician · Pearisburg, VA
NPI 1336338656 · NPPES record last updated Jan 8, 2025
Key facts
- NPI
- 1336338656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 0101241319 (VA)
- Practice address
- 159 Hartley Way
Pearisburg, VA 24134-2471 - Phone
- (540) 921-6000
- NPI assigned
- Oct 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071231000574 | VA | Practitioner - Emergency Medicine | 4688754757 | Reassigns benefits to 7 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101241319 | VA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carilion Giles Community Hospital | Current |
Accepting new patients | |
| Carilion Emergency Services, Inc. | Current |
Accepting new patients | |
| Lake Spring Emergency Group, LLC | Emergency Medicine | Current |
Accepting new patients |
| Carilion Healthcare Corporation | Current |
Accepting new patients | |
| Carilion Rockbridge Community Hospital | Current |
Accepting new patients | |
| Carilion Giles Community Hospital | Current |
Accepting new patients | |
| Carilion Healthcare Corporation | Current |
Accepting new patients |
Locations
434 Peppers Fry Rd NW
Christiansburg, VA 24073
Phone (540) 382-6000
1 Health Cir
Lexington, VA 24450
Phone (540) 458-3300
159 Hartley Way
Pearisburg, VA 24134
Phone (540) 921-6000
213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353
2706 Ogden Rd
Roanoke, VA 24018
Phone (540) 970-8000
6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110
1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222
1900 Electric Rd
Salem, VA 24153
Phone (540) 772-3400
600 W Ridge Rd
Wytheville, VA 24382
Phone (276) 228-0200
Interoperability endpoints
- efreeborn9671@direct.carilionclinic.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 0101241319 | VA | Yes |
Addresses
Primary practice location
159 Hartley Way
Pearisburg, VA 24134-2471
Mailing address
213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5353
Other practice location 1
2900 Lamb Circle
Radford, VA 24141
Phone (540) 731-2866
Other providers in Pearisburg, VA
- Tiffany Lea Farmer
- John Randall Finch
- Richard S Frazier
- Free Clinic of the New River Valley Inc
- Free Clinic of the New River Valley, Inc
- Kate Geary
- Giles County Public Schools
- Giles Health & Family Center
- Giles Internal Medicine
- Giles Lifesaving & Rescue Squad, Inc.
All providers in Pearisburg, VA · Emergency Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.