Active NPI
Brooke Ethington, PA-C
- Physician Assistant
- Mesa, AZ
National Provider Identifier
1366808610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 6303
- Practice address
- 1635 N Greenfield Rd
Mesa, AZ 85205-4005 - Phone
- (480) 840-3075
- NPI assigned
- Dec 31, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 6303 | AZ | Primary |
Addresses
Primary practice location
1635 N Greenfield Rd
Mesa, AZ 85205-4005
Mailing address
1250 S Clearview Ave
Suite 100
Mesa, AZ 85209-3378
Phone (480) 423-4670
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6303 | AZ | MD | Physician Assistant |
Interoperability endpoints
- brooke.ethington@166622370791428.direct.elationemr.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455926400000",
"number": "1366808610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 S CLEARVIEW AVE",
"address_2": "SUITE 100",
"city": "MESA",
"state": "AZ",
"postal_code": "852093378",
"telephone_number": "480-423-4670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1635 N GREENFIELD RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852054005",
"telephone_number": "480-840-3075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETHINGTON",
"first_name": "BROOKE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-31",
"last_updated": "2016-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "6303",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.