Active NPI
Ethan Patterson
- Physical Therapist
- Boone, IA
National Provider Identifier
1497551329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 117433
- Practice address
- 1015 Union St
Boone, IA 50036-4898 - Phone
- (515) 432-7729
- NPI assigned
- Feb 21, 2025
- 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 Therapist | 225100000X | 117433 | IA | Primary |
Addresses
Primary practice location
1015 Union St
Boone, IA 50036-4898
Mailing address
403 S Greene St
Boone, IA 50036-4726
Phone (515) 230-8882
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 |
|---|---|---|---|
| 117433 | IA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740096000000",
"number": "1497551329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "403 S GREENE ST",
"city": "BOONE",
"state": "IA",
"postal_code": "500364726",
"telephone_number": "515-230-8882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 UNION ST",
"city": "BOONE",
"state": "IA",
"postal_code": "500364898",
"telephone_number": "515-432-7729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "ETHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-02-21",
"last_updated": "2025-02-21",
"certification_date": "2025-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "117433",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boone, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.