Etas Clinic, P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

21501 Issued in SC

Legal business name

ETAS CLINIC, P.C.

Practice address

400 N Fant St
Suite a
Anderson, SC 29621-5720

Phone

(864) 226-5260

Fax

(864) 226-5863

NPI assigned

May 7, 2006

Organization subpart

Yes

Parent organization

ETAS CLINIC, P.C.As reported in NPPES

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

Authorized official

Name

Ekong I. Eta, M.D.

Title

Ceo

Phone

(864) 226-5260

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Etas Clinic, P.C. Other name

Part of

Etas Clinic PC

Locations

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

{
    "created_epoch": "1146960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1699724849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N FANT ST",
            "address_2": "SUITE A",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215720",
            "telephone_number": "864-226-5260",
            "fax_number": "864-226-5863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N FANT ST",
            "address_2": "SUITE A",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215720",
            "telephone_number": "864-226-5260",
            "fax_number": "864-226-5863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETAS CLINIC, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ETAS CLINIC, P.C.",
        "enumeration_date": "2006-05-07",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "ETA",
        "authorized_official_first_name": "EKONG",
        "authorized_official_middle_name": "I.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "864-226-5260",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "21501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215011",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2896",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Etas Clinic, P.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jill R Erickson, CRNA
• Ernest C. Martin, M.D., P.a.
• Allison Chila Erskine, PA-C
• Denise Alexandria Erskine
• Ekong Ito Eta, MD
• Ethos Physical Therapy LLC
• Taia Euceda, DPT
• Evaluation Services LLC
• Beverlyn H. Evans, MCD,CCC-SLP
• Crystal C Evans, M.C.D. CC/SLP

• Internal Medicine Physician in Anderson, SC
• Providers in Anderson, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.