Ethan S Ko, DO

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

010220875 Issued in VA

Practice address

609 Jefferson Davis Hwy
201
Fredericksburg, VA 22401-4436

Phone

(540) 899-3107

Fax

(540) 899-3183

NPI assigned

Sep 25, 2008

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 DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

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.

• Hospitalist Medicine Physicians of Virginia LLC

  • Internal Medicine Physician
  • Winchester, VA
  • NPI 1770756991

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1992955058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 JEFFERSON DAVIS HWY",
            "address_2": "201",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014436",
            "telephone_number": "540-899-3107",
            "fax_number": "540-899-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 JEFFERSON DAVIS HWY",
            "address_2": "201",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014436",
            "telephone_number": "540-899-3107",
            "fax_number": "540-899-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "ETHAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-25",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "54475",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "VA",
            "license": "010220875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Dustin Knight
• Sarah Knoll
• Chaney Adele Knott
• Heather Nicole Knox, DPT
• Ellen Ko, PHARMD
• Brianna Marie Koch, BCBA, LBA
• Jean Theresa Koch, D.C.
• Giorgi Kochiashvili, M.D.
• Frank Lawrence Koenig III, MD
• Gerd Koerber, D.C.

• Nephrology Physician in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Nephrology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.