Ethan Powell, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2024010681 Issued in MO

Practice address

2521 N Broadway St
Pittsburg, KS 66762-2620

Phone

(620) 235-1737

NPI assigned

Mar 21, 2024

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 KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kannarr Eye Care LLCGroup PAC ID 4688720790, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Kannarr Eye Care, LLC

  • Optometrist
  • Pittsburg, KS
  • NPI 1629209051
  Medicare reassignment Care Compare group NPD
• Kannarr Eye Care, LLC

  • Optometrist
  • Girard, KS
  • NPI 1396116935
  NPD

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1811757289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 N BROADWAY ST",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667622620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 N BROADWAY ST",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667622620",
            "telephone_number": "620-235-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "ETHAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2024010681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pittsburg State University
• Pittsburg Usd250
• Christina M Platt-Waggoner
• Barry James Plumlee, LMFT
• Jean-Daniel Policard, M.D.
• Jennifer Powers, PHARMD
• Kaitlyn Powers
• Brandon Prado
• Jordan Zachary Press, AU.D.
• Progressive Orthotic & Prosthetic Services, Inc

• Optometrist in Pittsburg, KS
• Providers in Pittsburg, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.