Ethan Arthur Stonerook, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-08367 Issued in NC

Practice address

1600 SW Archer Rd
Gainesville, FL 32610-3003

Phone

(352) 265-7999

NPI assigned

Jun 27, 2012

Last updated

Aug 30, 2022By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: estonerook1066101@direct.novanthealth.org
• Direct secure messaging: estonerook2791851@carolinashealthcaresystem.direct-ci.com

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.

• Novant Health Thomasville Medical Center, LLC

  dba Professional Service of Thomasville Medical Center

  • Specialist
  • Thomasville, NC
  • NPI 1033160205
  Medicare reassignment
• Novant Health Thomasville Medical Center LLC

  dba Novant Health Cancer Institute

  • Hematology & Oncology Physician
  • Winston Salem, NC
  • NPI 1649159609
  NPD
• Novant Health Thomasville Medical Center LLC

  dba Novant Health Rheumatology and Arthritis

  • Rheumatology Physician
  • Winston Salem, NC
  • NPI 1750036059
  NPD (past)

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1912261793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2255",
            "fax_number": "336-716-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-265-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONEROOK",
        "first_name": "ETHAN",
        "middle_name": "ARTHUR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106601",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006614900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peggy L. Stone, CCC/SLP
• Robert Stone
• Daniel Stoneberger
• Halle Stoner
• Samantha Barbara Stoner
• Gloria Elena Stoppello, D.D.S.
• Helen Cecile Storey, L.M.T.
• Troy Farr Storey, MD
• John J Stork, MD
• Jamie Stormer

• Physician Assistant in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.