William Wayne Etherton Jr., PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05005173A Issued in IN

Practice address

1131 W 2ND St
Mount Vernon, IN 47620-1773

Phone

(812) 838-5406

Fax

(812) 838-6786

NPI assigned

Jan 3, 2007

Last updated

Jul 8, 2007By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Med 1St of Evansville, PC

  • Physical Therapist
  • Evansville, IN
  • NPI 1881630739
  NPD (past)
• Progressive Health Rehabilitation, Inc.

  • Physical Therapist
  • Evansville, IN
  • NPI 1992743363
  NPD (past)
• Progressivehealth of Indiana, LLC

  • Rehabilitation Clinic/Center
  • Evansville, IN
  • NPI 1659596328
  NPD (past)
• Med 1St of Owensboro

  • Rehabilitation Clinic/Center
  • Owensboro, KY
  • NPI 1306958343
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396802591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6890",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477190890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 W 2ND ST",
            "city": "MOUNT VERNON",
            "state": "IN",
            "postal_code": "476201773",
            "telephone_number": "812-838-5406",
            "fax_number": "812-838-6786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHERTON",
        "first_name": "WILLIAM",
        "middle_name": "WAYNE",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05005173A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deaconess Clinc Inc (Deaconess Clinic I)
• Deaconess Clinic, Inc
• Chris Alfonso Diaz, ATC
• Amy Dickerson, PHARMD
• Carrie Dunn
• Ann Marie Fisher, COTA
• Hayden C Folz, DPT
• Leigh Ann Fromm, PMHNP, FNP
• Janos T. Fullop, D.M.D.
• Darlene Ghrist

• Physical Therapist in Mount Vernon, IN
• Providers in Mount Vernon, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.