Ethan Collins, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024183385 Issued in VA

Practice address

208W Front Street
Coeburn, VA 24230

Phone

(276) 455-5556

NPI assigned

May 17, 2021

Last updated

Feb 23, 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

Medicare fee-for-service enrollment

Enrolled in VA

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Appalachian Center for Excellence in Healthcare IncGroup PAC ID 6507108545, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lonesome Pine Hospital Hospital, Big Stone Gap, VA, CCN 490114

Medicare enrollment (NPD)

Enrolled

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.

• Appalachian Center for Excellence in Healthcare Inc

  • Family Nurse Practitioner
  • Coeburn, VA
  • NPI 1003380759
  Medicare reassignment Care Compare group NPD
• Appalachian Center for Excellence in Healthcare Inc

  • Rural Health Clinic/Center
  • Coeburn, VA
  • NPI 1669294385
  NPD

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

• Wellmont Health System

  dba Lonesome Pine Hospital

  • General Acute Care Hospital
  • Big Stone Gap, VA
  • NPI 1801826912
  Care Compare affiliation

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1336713148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90",
            "city": "COEBURN",
            "state": "VA",
            "postal_code": "242300090",
            "telephone_number": "276-455-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208W FRONT STREET",
            "city": "COEBURN",
            "state": "VA",
            "postal_code": "24230",
            "telephone_number": "276-455-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "ETHAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-17",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024183385",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "VA",
            "license": "0001238326",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Brooks
• Click Care LLC
• Coeburn Clinic, Inc
• Coeburn Taxi Service, Inc.
• Collins Facilitation Services
• Community Physicians Services Corporation
• Braxton Tyler Cordill, PHARMD
• Cross Roads Point, Inc.
• Teri Dahley
• Patricia Ann Dearmen

• Family Nurse Practitioner in Coeburn, VA
• Providers in Coeburn, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.