Active NPI
Ethan R Evert, P.T.
- Physical Therapist
- Lincoln, NE
National Provider Identifier
1578019063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2775
- Practice address
- 6540 S 84TH St
Ste 100
Lincoln, NE 68516-3909 - Phone
- (402) 770-9775
- NPI assigned
- Aug 25, 2016
- Last updated
- Dec 12, 2016
- 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 | 2775 | NE | Primary |
Addresses
Primary practice location
6540 S 84TH St
Ste 100
Lincoln, NE 68516-3909
Mailing address
PO Box 67250
Lincoln, NE 68506-7250
Phone (402) 328-8833
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Creighton University School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
8500 Mohave Dr
Suite a
Lincoln, NE 68516-9456
Phone (402) 486-0602
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Physical Therapy LLC | Physical Therapist | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapy Clinic/Center
- Lincoln, NE
- NPI 1811448640
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481500800000",
"number": "1578019063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 67250",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685067250",
"telephone_number": "402-328-8833",
"fax_number": "888-965-0959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6540 S 84TH ST",
"address_2": "STE 100",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685163909",
"telephone_number": "402-770-9775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVERT",
"first_name": "ETHAN",
"middle_name": "R",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-25",
"last_updated": "2016-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "2775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.