Ethan Preston, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1077676 Issued in TX

Practice address

1502 Blue Ridge Dr Ste 100
Georgetown, TX 78626-1002

Phone

(855) 220-9655

Fax

(855) 220-9655

NPI assigned

Apr 13, 2018

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

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Wiseman Family Practice PLLCGroup PAC ID 9739491564, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ethan.preston.p1@direct.lscctx.nextgenshare.com

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.

• Wiseman Family Practice PLLC

  • Family Medicine Physician
  • Cedar Park, TX
  • NPI 1598195042
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1982191169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 BLUE RIDGE DR STE 100",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786261002",
            "telephone_number": "855-220-9655",
            "fax_number": "855-220-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 BLUE RIDGE DR STE 100",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786261002",
            "telephone_number": "855-220-9655",
            "fax_number": "855-220-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "ETHAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-13",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704266333",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1077676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Prachar, LPC-S
• Genene Ann Prado, D.C.
• Zohra Ali Prasla, PT, DPT
• Present Perfect LLC
• Steven Darold Presley, PMHNP
• Ali Marie Prewit
• Brandon Matthew Price, DPT,PHD
• Deborah Dale Price, LMFT, LPC
• Sandra L Price, LMFT
• Rebekah Pridgeon, LPC

• Family Nurse Practitioner in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.