Ethan Snider

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA0000007431 Issued in TN

Practice address

719 S Main St
Springfield, TN 37172-2809

Phone

(615) 382-7979

NPI assigned

Mar 4, 2021

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

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1881289460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 BRENTWOOD PT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277904",
            "telephone_number": "615-624-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 S MAIN ST",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371722809",
            "telephone_number": "615-382-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNIDER",
        "first_name": "ETHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "PTA0000007431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Conor Smith, BSPT
• Cynthia Debruyn Smith, COTA/L
• Joshua Mikhael Smith, PTA
• Pamela Lynn Smith, PHYSICAL THERAPY AS
• Thomas Smith, APRN
• Jana Plant Socey, OD
• Sono Pro, LLC
• South Side Drug Co Inc
• South Side Drug Co., Inc.
• South Side Pharmacy, Inc.

• Physical Therapy Assistant in Springfield, TN
• Providers in Springfield, TN by specialty
• Physical Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.