Albert A Etheart, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50001006 Issued in OH

Practice address

20300 Chargrin Blvd
Shaker Heights, OH 44122-4412

Phone

(614) 505-7633

NPI assigned

Nov 11, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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.

• Medina Emergency Associates LTD

  • Emergency Medicine Physician
  • Medina, OH
  • NPI 1174525620
  NPD (past)

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1366423600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30790",
            "address_2": "MEDINA EMERGENCY ASSOCIATES LTD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441300790",
            "telephone_number": "330-654-1185",
            "fax_number": "330-654-9086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20300 CHARGRIN BLVD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441224412",
            "telephone_number": "614-505-7633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 E Washington",
            "address_2": "Medina General Hospital Emergency Dept",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "OH",
            "postal_code": "44256",
            "country_code": "US",
            "telephone_number": "330-654-1185",
            "fax_number": "330-654-9086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETHEART",
        "first_name": "ALBERT",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50001006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas D. Eppright, M.D.
• Errands for Elderly LLC
• Essential Healthcare Services, Inc
• Essential Healthcare Services, Inc.
• Tarin Estvanko
• Haley Evert, CCC-SLP
• Vanessa Exum
• Rose E Fagan
• Loraine R Farmer, LSW
• Loretta Jean Farmer, BA-SLP.,M.ED., R.S.

• Physician Assistant in Shaker Heights, OH
• Providers in Shaker Heights, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; 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.