Ethan D Erwin

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4646 Issued in AR

Practice address

1801 Forest Hills Blvd Ste 205
Bella Vista, AR 72715-3071

Phone

(479) 855-9348

NPI assigned

Jul 15, 2021

Last updated

Jul 15, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Mountaincrest Rehab of Bella Vista, Inc.

  • Physical Therapist
  • Bella Vista, AR
  • NPI 1932165982
  NPD

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1790357945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 S COLLEGE ST APT 8",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533921",
            "telephone_number": "870-405-3435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 FOREST HILLS BLVD STE 205",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727153071",
            "telephone_number": "479-855-9348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERWIN",
        "first_name": "ETHAN",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "4646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clara Dunn
• Melody Ruth Elam
• Hayden Elliott, MD
• Sandra Ellis, DPT
• Enduro PT PLLC
• David Scott Estes, M.D.
• Melissa Ruiz Eudey, CD, CLC, RYT
• Eye Associates Leasing Company Incorporated (Boozman-Hof Optical)
• Faith Venture Pharmacy Inc (Medicap Pharmacy)
• Feet Plus of Arkansas Inc

• Physical Therapist in Bella Vista, AR
• Providers in Bella Vista, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.