Ethan Jeremy Ledbetter, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

303086 Issued in NC

Practice address

8560 Cook St
Mt Pleasant, NC 28124-7686

Phone

(704) 436-6521

Fax

(704) 436-9505

NPI assigned

Apr 16, 2021

Last updated

May 21, 2021By the provider in NPPES

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 SC

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

Specialty

Family Practice

Education

Brody School of Medicine at East Carolina University, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McLeod Loris Seacoast HospitalGroup PAC ID 9133394398, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLeod Loris Hospital Hospital, Loris, SC, CCN 420105
• McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eledbetter92032@directmcleodehealth.org

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.

• McLeod Loris Seacoast Hospital

  dba McLeod Loris/Seacoast Physicians

  • Certified Registered Nurse Anesthetist
  • Loris, SC
  • NPI 1265708119
  Medicare reassignment Care Compare group NPD
• McLeod Loris Seacoast Hospital

  dba McLeod Choice Pharmacy Seacoast

  • Community/Retail Pharmacy
  • Little River, SC
  • NPI 1629387352
  NPD
• McLeod Loris Seacoast Hospital

  dba Loris Community Hospital

  • General Acute Care Hospital
  • Loris, SC
  • NPI 1306123344
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• McLeod Loris Seacoast Hospital

  dba Loris Community Hospital

  • General Acute Care Hospital
  • Loris, SC
  • NPI 1306123344
  Care Compare affiliation
• McLeod Regional Medical Center of the Pee Dee, Inc.

  • General Acute Care Hospital
  • Florence, SC
  • NPI 1699756221
  Care Compare affiliation

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1780265389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 COPPERFIELD BLVD NE STE 202",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252441",
            "telephone_number": "704-721-2060",
            "fax_number": "704-403-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8560 COOK ST",
            "city": "MT PLEASANT",
            "state": "NC",
            "postal_code": "281247686",
            "telephone_number": "704-436-6521",
            "fax_number": "704-436-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDBETTER",
        "first_name": "ETHAN",
        "middle_name": "JEREMY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-16",
        "last_updated": "2021-05-21",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "303086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jo Ann Kimble-Hahn, FNP, MSN
• Jade Kimble, PA
• Kristy Kirk, LMBT
• Jacob Kozecke, LCSW
• Robert Aaron Lambert, MD
• Jackson Long, M.D.
• Robin Louise Long, HOME HEALTH CARE
• Michael L. Mock, DDS PA
• Madelyn Marie Miller
• Audra Griffin Misenheimer, MA, NCC, LPC

• Family Medicine Physician in Mount Pleasant, NC
• Providers in Mount Pleasant, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.