Individual provider Active NPI

Ethan Watson

  • Student in an Organized Health Care Education/Training Program
  • Terre Haute, IN
National Provider Identifier
1396644530
Registry record updated Nov 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2170 N 13TH St Apt 205
Terre Haute, IN 47804-3199
Phone
(765) 505-1018
NPI assigned
Nov 3, 2026
Last updated
Nov 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2170 N 13TH St Apt 205
Terre Haute, IN 47804-3199

Mailing address

2170 N 13TH St Apt 205
Terre Haute, IN 47804-3199
Phone (765) 505-1018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1793664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793664000000",
    "number": "1396644530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2170 N 13TH ST APT 205",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478043199",
            "telephone_number": "765-505-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170 N 13TH ST APT 205",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478043199",
            "telephone_number": "765-505-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ETHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-11-03",
        "last_updated": "2026-11-03",
        "certification_date": "2026-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.