Ethan Daniel Hancock

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

05014434A Issued in IN

Practice address

590 Pit Rd
Brownsburg, IN 46112-7830

Phone

(317) 456-1056

NPI assigned

Nov 21, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Indiana Luna Care Physical Therapy LLC 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Indiana Luna Care Physical Therapy LLC

  • Physical Therapist
  • Fishers, IN
  • NPI 1316627722

  IN

  Medicare reassignment Care Compare group
• Thomas a Brady Sports Medicine Center, PC

  • Orthopaedic Surgery Physician
  • Carmel, IN
  • NPI 1467484212

  IN, Single Specialty

  Medicare reassignment NPD
• Thomas a Brady Sports Medicine Center, PC

  • Orthopaedic Surgery Physician
  • Noblesville, IN
  • NPI 1407480239

  Physical Therapist

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1609345487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 PIT RD",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461127830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 PIT RD",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461127830",
            "telephone_number": "317-456-1056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 S. Washington St.",
            "address_2": "Student Center 173",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IN",
            "postal_code": "469534695",
            "country_code": "US",
            "telephone_number": "219-252-5518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "ETHAN",
        "middle_name": "DANIEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-21",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IN",
            "license": "05014434A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Haessig, MSW
• Alaina Halbur
• Danette Renee Halverson, OTR
• Gracie Hamm
• Wendy Hammon
• Danielle Harden, RBT
• Nicole Hardesty, RBT
• Savannah Jean Harker, LSW
• Tonya Marie Harlan, NBC-HWC
• Brittany Harmon, RBT

• All providers in Brownsburg, IN
• Orthopedic Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.

Verify at the official NPI Registry.