Individual provider Active NPI

Ethan Varner, MD

  • Pediatrics Physician
  • Wilmington, OH
National Provider Identifier
1396248357
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.155853 Issued in OH
Practice address
1150 W Locust St
Wilmington, OH 45177-2572
Phone
(937) 535-7878
NPI assigned
Mar 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.155853 OH Primary

Addresses

Primary practice location

1150 W Locust St
Wilmington, OH 45177-2572

Mailing address

1150 W Locust St
Wilmington, OH 45177-2572
Phone (937) 535-7878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250318000109 SC Practitioner - Pediatric Medicine 7719409911 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
89369SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Pediatric Associates, P.a. Pediatrics CurrentSince Apr 30, 2023 Accepting new patients
Carolina Family Care, Inc Pediatrics CurrentSince Mar 15, 2025 Accepting new patients
Carolina Family Care, Inc Pediatrics CurrentSince Mar 15, 2025 Accepting new patients
Carolina Family Care, Inc Pediatrics Past Accepting new patients

Locations

2067 Charlie Hall Blvd
Charleston, SC 29414
Phone 8435732535 ext. 3215

1208 Two Island Ct
Mt Pleasant, SC 29466
Phone (843) 884-6653

1952 Long Grove Dr
Ste 202
Mt Pleasant, SC 29464
Phone (843) 573-2535

4975 Lacross Rd
Ste 150
North Charleston, SC 29406
Phone (843) 573-2535

Interoperability endpoints

  • Direct secure messaging: evarner453067@direct.musc.edu
  • Direct secure messaging: ethan.varner.1@1152.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1396248357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 W LOCUST ST",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772572",
            "telephone_number": "937-535-7878",
            "fax_number": "513-487-4849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 W LOCUST ST",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772572",
            "telephone_number": "937-535-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARNER",
        "first_name": "ETHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-15",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.155853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, OH

Sources for this page

Verify at the official NPI Registry.