CMS-1500 Box 24J / 33a • NPI
1871348193
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
390200000X
Licensed & Credentialed Student in an Organized Health Care Education/Training Program
Box 32 Service Location & ZIP+4
1115 E 20TH ST, SIOUX FALLS, SD, 57105-1013
✓ 9-Digit EDI 837 ZIP+4 (57105-1013)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1871348193 (ETHAN DAVID BROWN) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
✓ Eligible
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1871348193 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | ETHAN DAVID BROWN |
| Plain-English Specialty | Licensed & Credentialed Student in an Organized Health Care Education/Training Program NUCC Code: 390200000X (Student in an Organized Health Care Education/Training Program) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 1115 E 20TH ST, SIOUX FALLS, SD, 57105-1013 |
| Practice Telephone / Fax | Tel: (605) 575-1644 |
| Administrative Mailing Address | 25857 480TH AVE, BRANDON, SD, 57005-6810 |
| Enumeration & Last Sync | Enumerated: 2024-04-19 | CMS Record Updated: 2024-04-19 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (390200000X)
What Does Taxonomy Code 390200000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 390200000X translates to:
"Licensed & Credentialed Student in an Organized Health Care Education/Training Program"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ETHAN DAVID BROWN)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
390200000X — Student in an Organized Health Care Education/Training ProgramPlain English: Licensed & Credentialed Student in an Organized Health Care Education/Training Program | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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