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ETHAN BLACK
NPI 1952249377
Student in an Organized Health Care Education/Training Program in Columbus, OH

Active since March 24, 2026PECOS Enrolled
5100 W BROAD ST, COLUMBUS, OH 43228(614) 544-1745 Get Directions Write a Review

NPPES record last updated: March 24, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ethan Black NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN BLACK (NPI 1952249377) is an individual student in an organized health care education/training program in Columbus, Ohio and active in the NPI registry since March 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1952249377
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameETHAN BLACK
Location Address5100 W BROAD STColumbus, OH 43228-1607
Mailing Address5100 W Broad StColumbus, OH 43228-1607
Phone(614) 544-1745
Sole ProprietorNo
Enumeration DateMarch 24, 2026
NPPES CertifiedMarch 24, 2026
✔ NPI 1952249377 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
5100 W BROAD ST, Columbus, OH 43228
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethan Black is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANDREW CAO CECOL DO
Student in an Organized Health Care Education/Training Program
5100 W BROAD ST
COLUMBUS, OH 43228
Franklin County (614) 544-1000
NIKOLE RENEE PATTON F.N.P.
Nurse Practitioner (Family)
5100 W BROAD ST
COLUMBUS, OH 43228
Franklin County (614) 544-1810
DR. HEATHER MICHELLE CHILDERS D.O.
Emergency Medicine
5100 W BROAD ST
COLUMBUS, OH 43228
Franklin County (614) 544-1000
MEGAN TEE ATKINSON CNP
Nurse Practitioner (Family)
5100 W BROAD ST
COLUMBUS, OH 43228
Franklin County (614) 544-2058
DR. TIMOTHY JAMES BARLEY DO
Student in an Organized Health Care Education/Training Program
5100 W BROAD ST
COLUMBUS, OH 43228
Franklin County (614) 544-1000
SHELBY CORNELIUS
Student in an Organized Health Care Education/Training Program
5100 W BROAD ST
COLUMBUS, OH 43228
Franklin County (614) 544-1976
DR. CECILIA GUTIERREZ HANSEN DO
Emergency Medicine
5100 W BROAD ST
COLUMBUS, OH 43228
Franklin County (614) 544-1000
DR. KAITLIN MARIE BOWERS D.O.
Emergency Medicine
5100 W BROAD ST
COLUMBUS, OH 43228
Franklin County (614) 554-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Black's NPI number?

The NPI number for Ethan Black is 1952249377. It was assigned to this individual provider in the NPPES registry on March 24, 2026.

Where is Ethan Black located?

Ethan Black practices at 5100 W Broad St, Columbus, OH 43228. The listed phone number is (614) 544-1745.

What is Ethan Black's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Ethan Black enrolled in Medicare?

Yes. Ethan Black is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ethan Black was last updated on March 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.