Active NPI
Ethan E Dupont, PTA
- Physical Therapy Assistant
- Zephyrhills, FL
National Provider Identifier
1467962373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 27683
- Practice address
- 7350 Dairy Rd
Zephyrhills, FL 33540 - Phone
- (813) 788-4300
- NPI assigned
- Oct 5, 2017
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 27683 | FL | Primary |
Addresses
Primary practice location
7350 Dairy Rd
Zephyrhills, FL 33540
Mailing address
14107 Jim Hunt Rd
Clermont, FL 34715
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 959213424 | Other | FL | UNITED HEALTH CARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27683 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507161600000",
"number": "1467962373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14107 JIM HUNT RD",
"city": "CLERMONT",
"state": "FL",
"postal_code": "34715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7350 DAIRY RD",
"city": "ZEPHYRHILLS",
"state": "FL",
"postal_code": "33540",
"telephone_number": "813-788-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUPONT",
"first_name": "ETHAN",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-05",
"last_updated": "2017-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "27683",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "959213424",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Zephyrhills, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.