Individual provider Active NPI

Ethan Paul Farmer, DO

  • Emergency Medicine Physician
  • Bloomington, IN
National Provider Identifier
1528684644
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
02007076A Issued in IN
Practice address
2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone
(812) 353-9515
Fax
(812) 353-9275
NPI assigned
Jun 24, 2020
Last updated
Oct 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 02007076A IN Primary
Emergency Medicine Physician 207P00000X LL83262 SC

Addresses

Primary practice location

2651 E Discovery Pkwy
Bloomington, IN 47408-9059

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

Emergency Medicine
14 Medical Park, Ste 350
Columbia, SC 29203
Phone (803) 434-3790

Other identifiers 2

IdentifierTypeStateIssuer
090540878OtherINMEDICARE PTAN
300078879MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address efarmer@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230623003038 IN Practitioner - Emergency Medicine 1052799905 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-9250

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
02007076AINMDEmergency Medicine Physician
LL83262SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Southern Indiana Physicians, LLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Aug 1, 2023 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

2651 E Discovery Pkwy
Bloomington, IN 47408
Phone (812) 353-9147

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

Interoperability endpoints

  • Direct secure messaging: efarmer@direct.iuhealth.org

Organizations & group practices 3

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 5

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": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1528684644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 E DISCOVERY PKWY",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474089059",
            "telephone_number": "812-353-9515",
            "fax_number": "812-353-9275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Emergency Medicine",
            "address_2": "14 Medical Park, Ste 350",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "29203",
            "country_code": "US",
            "telephone_number": "803-434-3790",
            "fax_number": "803-434-3946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARMER",
        "first_name": "ETHAN",
        "middle_name": "PAUL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-24",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02007076A",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "LL83262",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "090540878",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300078879",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "efarmer@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2651 E Discovery Pkwy",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474089059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.