Individual provider Active NPI

Ethan C Winter, DPT

  • Physical Therapist
  • Wichita, KS
National Provider Identifier
1821763657
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-06868 Issued in KS
Practice address
834 N Socora St Ste 1
Wichita, KS 67212-3278
Phone
(316) 440-3731
Fax
(316) 440-3741
NPI assigned
Aug 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11-06868 KS Primary

Addresses

Primary practice location

834 N Socora St Ste 1
Wichita, KS 67212-3278

Mailing address

200 W Douglas Ave Ste 1040
Wichita, KS 67202-3017
Phone (316) 263-0003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210823001641 KS Practitioner - Physical Therapist in Private Practice 4789089129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced PT LLCGroup PAC ID 3678524709, 84 clinicians

Practice addresses (Care Compare)

834 N Socora St
Suite 1
Wichita, KS 67212-3278
Phone (316) 440-3731

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced PT LLC Physical Therapist CurrentSince Aug 23, 2021 Accepting new patients
Advanced PT LLC Physical Therapist CurrentSince Aug 23, 2021 Accepting new patients

Locations

3730 N Ridge Rd
Ste 500
Wichita, KS 67205
Phone (316) 440-4901

834 N Socora St
Ste 1
Wichita, KS 67212
Phone (316) 440-3731

200 W Douglas Ave
Ste 1040
Wichita, KS 67202
Phone (866) 412-5554

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1821763657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W DOUGLAS AVE STE 1040",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672023017",
            "telephone_number": "316-263-0003",
            "fax_number": "316-263-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 N SOCORA ST STE 1",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672123278",
            "telephone_number": "316-440-3731",
            "fax_number": "316-440-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTER",
        "first_name": "ETHAN",
        "middle_name": "C",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-13",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-06868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.