Individual provider Active NPI

Ethan Rich, DO

  • Student in an Organized Health Care Education/Training Program
  • Minneapolis, MN
National Provider Identifier
1619789096
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
7000 Washburn Ave S
Minneapolis, MN 55423-2857
Phone
(612) 481-2723
NPI assigned
Jan 23, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

7000 Washburn Ave S
Minneapolis, MN 55423-2857

Mailing address

7000 Washburn Ave S
Minneapolis, MN 55423-2857
Phone (612) 481-2723

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20250721000482 MI Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 9739695404

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1737590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1619789096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 WASHBURN AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554232857",
            "telephone_number": "612-481-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 WASHBURN AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554232857",
            "telephone_number": "612-481-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICH",
        "first_name": "ETHAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.