Active NPI
Ethan James Hall, PA-C
- Physician Assistant
- Lebanon, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1633 W Main St
Lebanon, TN 37087-3423 - Phone
- (615) 547-6930
- NPI assigned
- Sep 3, 2019
- Last updated
- Aug 14, 2023
- Sex
- Male
- 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 | Primary |
Addresses
Primary practice location
1633 W Main St
Lebanon, TN 37087-3423
Mailing address
2650 Strawbridge PL
Owensboro, KY 42303-1553
Phone (270) 903-2102
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Deaconess Clinic Inc
Practice addresses (Care Compare)
1204 Williams St
Oakland City, IN 47660-1001
Phone (812) 749-6187
1700 US Hwy 60 W
Morganfield, KY 42437-6242
Phone (270) 389-0031
2242 US Hwy 41 N
Henderson, KY 42420-2375
Phone (270) 844-8515
2622 Menards Dr
Evansville, IN 47715-8075
Phone (812) 450-2622
421 Chestnut St
Evansville, IN 47713-1227
Phone (812) 426-6645
4506 1St Ave
Evansville, IN 47710-3624
Phone (812) 428-6161
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4327 | TN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deaconess Clinc Inc | Current | Accepting new patients | |
| Deaconess Clinic, Inc. | Current | Accepting new patients | |
| Deaconess Clinic Inc | Physician Assistant | Current | Accepting new patients |
| Deaconess Clinic, Inc | Past | Accepting new patients |
Locations
3150 Warrick Dr
Boonville, IN 47601
Phone (812) 450-6430
120 SE 4th St
Evansville, IN 47708
Phone (812) 426-6638
2622 Menards Dr
Evansville, IN 47715
Phone (812) 450-2622
421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645
4506 N 1st Ave
Evansville, IN 47710
Phone (812) 428-6161
545 S Boehne Camp Rd
Evansville, IN 47712
Phone (812) 402-1264
4011 Gateway Blvd
Ste 100
Newburgh, IN 47630
Phone (812) 858-2100
1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187
1414 W Broadway St
Princeton, IN 47670
Phone (812) 385-5283
2242 US Highway 41 N
Henderson, KY 42420
Phone (270) 844-8515
2242 US Highway 41 N
Ste 2
Henderson, KY 42420
1700 US Highway 60 W
Morganfield, KY 42437
Phone (270) 389-0031
2710 Heartland Crossing Blvd
Ste A
Owensboro, KY 42303
Phone (270) 561-0140
Interoperability endpoints
- ehall959662@direct.deaconess.com
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Evansville, IN
- NPI 1619123585
-
dba Deaconess Clinic I
- Family Medicine Physician
- Morganfield, KY
- NPI 1891941688
-
dba Deaconess Clinic Dermatology Madisonville
- Dermatology Physician
- Madisonville, KY
- NPI 1053077107
-
dba Deaconess Clinic - Behavioral Health Psychology
- Psychologist
- Evansville, IN
- NPI 1275390502
-
dba Deaconess Clinic I
- Rural Health Clinic/Center
- Petersburg, IN
- NPI 1831345792
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba The Women's Hospital
- General Acute Care Hospital
- Newburgh, IN
- NPI 1780535427
-
- General Acute Care Hospital
- Evansville, IN
- NPI 1053361642
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691971200000",
"number": "1437707478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2650 STRAWBRIDGE PL",
"city": "OWENSBORO",
"state": "KY",
"postal_code": "423031553",
"telephone_number": "270-903-2102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1633 W MAIN ST",
"city": "LEBANON",
"state": "TN",
"postal_code": "370873423",
"telephone_number": "615-547-6930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "ETHAN",
"middle_name": "JAMES",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-03",
"last_updated": "2023-08-14",
"certification_date": "2023-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lebanon, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.