Ethan A Karol, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2831 Issued in WI

Practice address

2845 Greenbrier Rd Ste 240
Green Bay, WI 54311-6519

Phone

(920) 288-8280

Fax

(920) 288-8285

NPI assigned

Oct 17, 2011

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1780969246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 N BROADWAY",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032728",
            "telephone_number": "920-405-5384",
            "fax_number": "920-405-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD STE 240",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116519",
            "telephone_number": "920-288-8280",
            "fax_number": "920-288-8285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAROL",
        "first_name": "ETHAN",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-17",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Kanzenbach
• Amy Sue Karakas, NNP-BC
• Staci M Karbon, MD
• Anne Karjala-Dobbins, M.S.
• Amritha Chandrahasa Karkera, M.D.
• Rachel M Kars, OT
• Gayle M Kasdorf, M.D.
• Alex Kasel
• Matthew Braun Kaspar, MD
• Jesse C Kaster, BC HIS

• Physician Assistant in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.