Ethan Eaton, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

112508 Issued in IA

Practice address

1130 E Kimberly Rd
Davenport, IA 52807-1710

Phone

(309) 764-3613

NPI assigned

Jun 6, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great River Family WellnessGroup PAC ID 8325374010, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Great River Family Wellness

  dba Great River Family Chiropractic

  • Chiropractor
  • Moline, IL
  • NPI 1972067361

  IA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1609560390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 E KIMBERLY RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071710",
            "telephone_number": "309-764-3613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 E KIMBERLY RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071710",
            "telephone_number": "309-764-3613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "ETHAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "112508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dynamic Spine and Posture, P.L.L.C.
• E Medical Group of Iowa No 1 LLC (Angels Care Home Health of Iowa)
• Dylann Nichole Eagleson, TLMHC
• Susan Rebecca Earp, LISW
• Eastern Iowa Orthotics & Prosthetics, LLC
• Marcia Diane Echols
• Susan M. Eckert
• Pamela Eckman, BS, PHARMD
• Edgerton Women's Health Center, Inc.
• Edgerton Womens Health Center

• Chiropractor in Davenport, IA
• Providers in Davenport, IA by specialty
• Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.