ETHAN SMOLLEY
NPI 1992408017
Student in an Organized Health Care Education/Training Program in Charlottesville, VA
About Ethan Smolley NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ETHAN SMOLLEY (NPI 1992408017) is an individual student in an organized health care education/training program in Charlottesville, Virginia and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS, is affiliated with Watauga Medical Center, and is a graduate of Eastern Virginia Medical School (2023).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Ethan Smolley is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Ethan Smolley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Statesville, NC 28677
- Reassigned Medicare billing, North Carolina enrollment
- 580 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Watauga Medical Center
Acute Care Hospitals · Boone, NCCharles A Cannon Jr Memorial Hospital
Critical Access Hospitals · Linville, NCOther Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Smolley's NPI number?
The NPI number for Ethan Smolley is 1992408017. It was assigned to this individual provider in the NPPES registry on March 27, 2023.
Where is Ethan Smolley located?
Ethan Smolley practices at 1215 Lee St, Charlottesville, VA 22908. The listed phone number is (434) 924-8485.
What is Ethan Smolley'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 Smolley enrolled in Medicare?
Yes. Ethan Smolley is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Ethan Smolley's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Smolley reassigns Medicare benefits to Wake Forest Emergency Providers (Statesville, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ethan Smolley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Ethan Smolley affiliated with any hospitals?
According to CMS data, Ethan Smolley is affiliated with Watauga Medical Center and Charles A Cannon Jr Memorial Hospital.
When was this NPI record last updated?
The NPPES record for Ethan Smolley was last updated on March 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.
# Ethan Smolley · NPI 1992408017
Student in an Organized Health Care Education/Training Program provider in Charlottesville, Virginia. Individual provider, active in the CMS NPPES registry since March 27, 2023.
## Identity
- **NPI:** 1992408017 (Entity type: Individual)
- **Enumerated:** March 27, 2023
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 1215 LEE ST, Charlottesville, VA 22908-0816
- **Phone:** (434) 924-8485 · **Fax:** (434) 924-2231
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Wake Forest Emergency Providers (NPI 1396216735, Statesville, NC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Eastern Virginia Medical School, class of 2023
## Record status
- **NPPES last updated:** March 27, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1992408017) · Data from the CMS NPPES public registry.