ETHAN EVANKOW (NPI# 1528580966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528580966 |
| Entity Type | Individual |
| Full Name | ETHAN EVANKOW |
| Credential | PA |
| Practice Address |
100 Hospital Dr Bennington VT 05201-5004 |
| Practice Telephone | 8024475023 |
| Mailing Telephone | 6039156118 |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2017-10-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 055.0031348 | VT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363A00000X | Physician Assistant | VT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
100 HOSPITAL DR |
| City | BENNINGTON |
| State | VT |
| Zip Code | 05201-5004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114530029 | Kelsey Buran | Anesthesiologist Assistant | 100 Hospital Dr, Bennington, VT 05201-5004 | 2020-08-29 |
| 1982212478 | Daniel Hennessey | Podiatrist | 100 Hospital Dr, Bennington, VT 05201-5004 | 2020-07-21 |
| 1306462106 | Daryl Silva | Podiatrist | 100 Hospital Dr, Bennington, VT 05201-5004 | 2020-06-18 |
| 1720625833 | William B Smith | Nurse Practitioner | 100 Hospital Dr, Bennington, VT 05201-5013 | 2019-12-09 |
| 1528613155 | Christine Lynne Burke | Nurse Practitioner | 100 Hospital Dr, Bennington, VT 05201-5004 | 2019-08-09 |
| 1508427980 | Nathalie Santos | Podiatrist | 100 Hospital Dr, Bennington, VT 05201-5004 | 2019-06-26 |
| 1588223002 | Gon Saman | Podiatrist | 100 Hospital Dr, Bennington, VT 05201-5004 | 2019-06-08 |
| 1891276374 | Tracie Ann Crawford | Nurse Practitioner | 100 Hospital Dr, Bennington, VT 05201-5004 | 2018-08-23 |
| 1922585231 | Mark Epler | Physical Therapist | 100 Hospital Dr, Bennington, VT 05201-5004 | 2018-07-20 |
| 1619453958 | Mary Campbell | Anesthesiologist Assistant | 100 Hospital Dr, Bennington, VT 05201-5004 | 2018-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154720951 | Justin Carl Wilkinson | Specialist/Technologist | 320 Elm St, Bennington, VT 05201 | 2014-08-18 |
| 1134533235 | Patrick Deedy | Specialist/Technologist | 5 Appletree Ln, Bennington, VT 05201 | 2014-06-17 |
| 1083974299 | Khola Qamar | Internal Medicine | 140 Hospital Dr Ste 307, Bennington, VT 05201 | 2012-05-22 |
| 1295039808 | Bernadette R. Potratz | Massage Therapist | 160 Benmont Ave., Suite 23, Bennington, VT 05201 | 2010-12-23 |
| 1780870642 | Aaron York | Psychiatry & Neurology | 186 North Street, Bennington Va Clinic, Bennington, VT 05201 | 2007-09-24 |
| 1053434100 | Sunrise Family Resource Center | Social Worker | 244 Union Street, Bennington, VT 05201 | 2007-04-06 |
| 1316022817 | New England Consulting Inc | Chiropractor | 125 Elm Street, Bennington, VT 05201 | 2006-10-25 |
| 1306926704 | Glen Carlisle Mackenzie | Obstetrics & Gynecology | 160 Benmont Avenue, Suite 22, Bennington, VT 05201 | 2006-10-17 |
| 1982796496 | Maureen Matthews Mcclintock | Social Worker | 655 Main St., Bennington, VT 05201 | 2006-09-29 |
| 1447270525 | Robert J Miller | Dentist | 129 Elm Street, Bennington, VT 05201 | 2006-07-20 |
| Find all providers in zip 05201 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841284270 | Janine M Carroll | Physician Assistant | 332 Dewey Street, Taconic Orthopedics PC, Bennington, VT 05201 | 2005-08-31 |
| 1063405876 | Dean D Measeck | Physician Assistant | 332 Dewey St, Bennington, VT 05201-2225 | 2005-08-26 |
| 1811410053 | Amy Wheaton | Physician Assistant | 332 Dewey St, Bennington, VT 05201-2225 | 2017-07-19 |
| 1710422951 | Madhu Martha Cornwell Khan | Physician Assistant | 357 Shields Dr, Bennington, VT 05201-9810 | 2016-12-26 |
| 1285091850 | Karena Webber | Physician Assistant | 140 Hospital Dr, Suite 111, Bennington, VT 05201-5009 | 2016-01-27 |
| 1679951909 | Crystal Labbe-hasty | Physician Assistant | 140 Hospital Dr, Suite 111, Bennington, VT 05201-5009 | 2015-05-06 |
| 1740675065 | Kelsey Lange Pierce | Physician Assistant | 140 Hospital Dr, Suite 111, Bennington, VT 05201-5009 | 2015-04-02 |
| 1225246713 | Emily A Rice | Physician Assistant | 160 Benmont Ave, Suite 22, Bennington, VT 05201-1873 | 2007-05-18 |
| 1417906082 | Clarence Paul Graether | Physician Assistant | 655 Main St, Bennington, VT 05201 | 2006-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639703796 | Blake Elizabeth Bohlig | Physician Assistant | 335 Tamarack Ln, Rutland, VT 05701-9501 | 2020-02-27 |
| 1831729532 | Emily Frances Swint | Physician Assistant | 106 E Allen St Unit 503, Winooski, VT 05404-2297 | 2020-01-22 |
| 1700416799 | Rachel Blair | Physician Assistant | L1 Stonehedge Dr, South Burlington, VT 05403-7320 | 2020-01-19 |
| 1639721186 | All Dimensions Primary Care Pllc | Physician Assistant | 92 Allen Street, Rutland, VT 05701 | 2019-07-15 |
| 1285295154 | Spencer Ciancola | Physician Assistant | 382 Elm St, Manchester Center, VT 05255-9655 | 2019-06-21 |
| 1114400611 | Jordan David Carr | Physician Assistant | 278 Vt 149, West Pawlet, VT 05775-9798 | 2018-09-11 |
| 1700378734 | Laura Amy Nixon | Physician Assistant | 41 Sherman Drive, St. Johnsbury, VT 05819 | 2018-06-05 |
| 1811494669 | Kara Katherine Hankes | Physician Assistant | 325 Dorset St, South Burlington, VT 05403-6351 | 2018-04-09 |
| 1366975328 | Elizabeth G Dunbar | Physician Assistant | 228 E Harvey Farm Rd, Waterbury Center, VT 05677-7117 | 2017-04-06 |
| 1528599297 | Irene Chamberlain | Physician Assistant | 1311 Barre-montpelier Road, Suite 200, Cvmc Expresscare, Berlin, VT 05602 | 2017-03-24 |
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| City | BENNINGTON |
| Zip Code | 05201 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.