Individual provider Active NPI

Ethan James Hall, PA-C

  • Physician Assistant
  • Lebanon, TN
National Provider Identifier
1437707478
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1633 W Main St
Lebanon, TN 37087-3423
Phone
(615) 547-6930
NPI assigned
Sep 3, 2019
Last updated
Aug 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200205003161 KY Practitioner - Physician Assistant 2466888607 Reassigns benefits to 1 organization
I20250805000482 IN Practitioner - Physician Assistant 2466888607 Reassigns benefits to 1 organization

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 IncGroup PAC ID 3375610116, shared by 10 NPIs, 411 clinicians

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

LicenseStateTypeSpecialty
4327TNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinc Inc CurrentSince Jun 30, 2025 Accepting new patients
Deaconess Clinic, Inc. CurrentSince Jun 30, 2025 Accepting new patients
Deaconess Clinic Inc Physician Assistant CurrentSince Jun 30, 2025 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.