Ethan Muri, CRNP
Individual provider Active NPI Family Nurse Practitioner · Clearfield, PA
NPI 1679230262 · NPPES record last updated Nov 18, 2021
Key facts
- NPI
- 1679230262
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- SP024842 (PA)
- Practice address
- 15 N Front St
Clearfield, PA 16830-2455 - Phone
- (814) 765-6625
- Fax
- (814) 503-8553
- NPI assigned
- Nov 18, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 46
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tyrone Hospital
J C Blair Memorial Hospital
Practice addresses (Care Compare)
120 Spring St
Houtzdale, PA 16651-1400
Phone (814) 497-4297
417 Sabbath Rest Rd
Suite 3
Altoona, PA 16601-7567
Phone (814) 940-8195
Hospital & facility affiliations
- Penn Highlands Tyrone
- Penn Highlands Huntingdon
- Penn Highlands Dubois
- Mount Nittany Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220604000021 | PA | Practitioner - Nurse Practitioner | 9537547484 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP024842 | PA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tyrone Hospital | Current |
Accepting new patients | |
| J C Blair Memorial Hospital | Current |
Accepting new patients | |
| Tyrone Hospital | Current |
Accepting new patients | |
| J C Blair Memorial Hospital | Current | Accepting new patients | |
| Tyrone Hospital | Current |
Accepting new patients | |
| J C Blair Memorial Hospital | Current |
Accepting new patients | |
| J. C. Blair Memorial Hospital | Past | Accepting new patients | |
| Pinecroft Medical Center | Past | Accepting new patients |
Locations
417 Sabbath Rest Rd
Ste 3
Altoona, PA 16601
Phone (814) 940-8195
120 Spring St
Houtzdale, PA 16651
Phone (814) 497-4297
1227 Warm Springs Ave
Ste 302
Huntingdon, PA 16652
Phone (814) 643-0837
1225 Warm Springs Ave
Huntingdon, PA 16652
Phone (814) 643-8206
1227 Warm Springs Ave
Ste 201
Huntingdon, PA 16652
Phone (814) 643-8255
187 Hospital Dr
Tyrone, PA 16686
Phone (814) 342-2333
221 Hospital Dr
Tyrone, PA 16686
Phone (814) 699-9069
221 Hospital Dr
Ste 6
Tyrone, PA 16686
Phone (814) 684-3101
Interoperability endpoints
- emuri@tyronespecialties.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | SP024842 | PA | Yes |
Addresses
Primary practice location
15 N Front St
Clearfield, PA 16830-2455
Mailing address
15 N Front St
Clearfield, PA 16830-2455
Phone (814) 765-6625
Other providers in Clearfield, PA
- Samantha Leigh Morgan
- George C Mosch II
- Melanie Marie Moskel
- Mountain Laurel Opco, LLC
- Denise Lynn Mullins
- Debbie Jo Myers
- Nathaniel D. Yingling Cancer Center
- Olivia Neeper
- Melinda Noel
- Paula Michelle Norman
All providers in Clearfield, PA · Family Nurse Practitioner in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.