Active NPI
Ethan Flynn, PT
- Physical Therapist
- Columbus, OH
National Provider Identifier
1760176259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 008771
- Practice address
- 4850 E Main St Ste 130
Columbus, OH 43213-3194 - Phone
- (614) 897-0301
- NPI assigned
- Jun 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 008771 | KY | Primary |
Addresses
Primary practice location
4850 E Main St Ste 130
Columbus, OH 43213-3194
Mailing address
4850 E Main St Ste 130
Columbus, OH 43213-3194
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008771 | KY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727740800000",
"number": "1760176259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4850 E MAIN ST STE 130",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432133194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4850 E MAIN ST STE 130",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432133194",
"telephone_number": "614-897-0301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLYNN",
"first_name": "ETHAN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-07",
"last_updated": "2024-10-01",
"certification_date": "2024-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "008771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.