Active NPI
Ethan Smallwood, PA
- Surgical Physician Assistant
- West Columbia, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 4903
- Practice address
- 222 E Medical LN Ste 101
West Columbia, SC 29169-4850 - Phone
- (803) 739-3660
- NPI assigned
- Mar 3, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 4903 | SD | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
222 E Medical LN Ste 101
West Columbia, SC 29169-4850
Mailing address
222 E Medical LN Ste 101
West Columbia, SC 29169-4850
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | esmallwood161595@direct.lexmed.com |
Medicare participation
Medicare enrollment files- 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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of South Carolina School of Medicine, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
222 E Medical LN
Suite 101
West Columbia, SC 29169-4850
Phone (803) 739-3660
2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone (803) 791-2460
3016 Longtown Commons Dr
Columbia, SC 29229-7849
4080 Augusta Hwy
Gilbert, SC 29054-8893
5535 Platt Springs Rd
Lexington, SC 29073-7519
Phone (803) 314-9510
557 Columbia Ave
Chapin, SC 29036-8324
565 Columbia Ave
Chapin, SC 29036-8324
76 Polo Rd
Columbia, SC 29223-2806
Phone (803) 699-7255
811 W Main St
Lexington, SC 29072-2500
Hospital & facility affiliations
- Lexington Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.09 of 100
- Quality
- 68.87
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 78.11
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4903 | SD | MD | Pharmacist |
| 4903 | SC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lexington Health Inc | Current | Accepting new patients | |
| Lexington County Health Services District Inc | Current | Accepting new patients | |
| Lexington Health Inc | Current | Accepting new patients | |
| Lexington County Health Services District, Inc. | Past | Accepting new patients |
Locations
3016 Longtown Commons Dr
Ste 205
Columbia, SC 29229
Phone (803) 739-3660
811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230
222 E Medical Ln
Ste 101
West Columbia, SC 29169
Phone (803) 739-3660
Interoperability endpoints
- esmallwood161595@direct.lexmed.com
Organizations & group practices 5
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.
-
- Sports Medicine (Orthopaedic Surgery) Physician
- West Columbia, SC
- NPI 1710634753
-
- General Acute Care Hospital
- West Columbia, SC
- NPI 1356366314
-
- Maternal & Fetal Medicine Physician
- West Columbia, SC
- NPI 1568060689
-
- Internal Medicine Physician
- West Columbia, SC
- NPI 1942190988
-
- Urgent Care Clinic/Center
- Columbia, SC
- NPI 1396778056
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- West Columbia, SC
- NPI 1386241834
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705363200000",
"number": "1831899459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 E MEDICAL LN STE 101",
"city": "WEST COLUMBIA",
"state": "SC",
"postal_code": "291694850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 E MEDICAL LN STE 101",
"city": "WEST COLUMBIA",
"state": "SC",
"postal_code": "291694850",
"telephone_number": "803-739-3660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMALLWOOD",
"first_name": "ETHAN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-03",
"last_updated": "2024-01-16",
"certification_date": "2024-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "SD",
"license": "4903",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "esmallwood161595@direct.lexmed.com",
"affiliation": "N",
"address_1": "222 E Medical Ln Ste 101",
"city": "West Columbia",
"state": "SC",
"country_code": "US",
"postal_code": "291694850",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in West Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.