DR. CHRIS PHILLIP ETHRIDGE (NPI# 1386632560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386632560 |
| Entity Type | Individual |
| Full Name | DR. CHRIS PHILLIP ETHRIDGE |
| Credential | MD |
| Practice Address |
1325 E Fortification St Jackson MS 39202-2442 |
| Practice Telephone | 6013544488 |
| Practice Fax Number | 6019145188 |
| Mailing Telephone | 6013544488 |
| Mailing Fax Number | 6019145188 |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2011-11-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
8332 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00011435 | 05 | |
| MS | MEDICARE RR | P00100821 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134547045 | Chris Ethridge | Student in an Organized Health Care Education/Training Program | 215 Central Ave Ste 100, Louisville, KY 40208-1450 | 2014-03-29 |
| Street Address |
1325 E FORTIFICATION ST |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-2442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144832130 | Georgiana Ogletree | Occupational Therapist | 1325 E Fortification St, Jackson, MS 39202-2442 | 2020-08-20 |
| 1972133353 | Justin Bryant Schopp | Physician Assistant | 1325 E Fortification St, Jackson, MS 39202-2442 | 2020-01-24 |
| 1154951739 | Hailey Daniels Kelly | Physician Assistant | 1325 E Fortification St, Jackson, MS 39202-2442 | 2020-01-22 |
| 1356903520 | James Logan Ferrell | Occupational Therapist | 1325 E Fortification St, Jackson, MS 39202-2442 | 2019-07-08 |
| 1184185472 | Jamie Jackson Garrett | Physician Assistant | 1325 E Fortification St, Jackson, MS 39202-2442 | 2019-03-28 |
| 1114494754 | Charles Taylor Knapp | Nurse Practitioner | 1325 E Fortification St, Jackson, MS 39202-2442 | 2018-11-01 |
| 1477078277 | Leah Winstead West | Physical Medicine & Rehabilitation | 1325 E Fortification St, Jackson, MS 39202-2442 | 2017-08-14 |
| 1700309374 | Van Treece Woodall | Specialist/Technologist | 1325 E Fortification St, Jackson, MS 39202-2442 | 2017-07-25 |
| 1346760220 | Megan Wallace Tyson | Nurse Practitioner | 1325 E Fortification St, Jackson, MS 39202-2442 | 2017-06-22 |
| 1083149181 | John Causey | Registered Nurse | 1325 E Fortification St, Jackson, MS 39202-2442 | 2017-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1750868691 | Katherine Walters | Nurse Practitioner | 501 Marshall St., Suite 400, Jackson, MS 39202 | 2018-07-24 |
| 1932638749 | Tylan Lee | Social Worker | 860 East River Place Suite 100, Jackson, MS 39202 | 2017-06-06 |
| 1417314725 | Euna Jyles | Counselor | 860 E River Pl, Jackson, MS 39202 | 2016-01-19 |
| 1255712048 | Edward Jonathan Breight | Specialist/Technologist | 1325 East Fortication Street, Jackson, MS 39202 | 2015-06-17 |
| 1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
| 1477876530 | Mick Inc. | Technician | 334 Josanna Street, Suite #209, Jackson, MS 39202 | 2010-03-03 |
| 1073724910 | Paul Frederic Dare | Anesthesiology | 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 | 2007-05-24 |
| 1225247703 | Lynn Kincannon Holland | Counselor | 911 Manship Street, Unit A, Jackson, MS 39202 | 2007-05-22 |
| 1457568149 | Incare Inc | Pulmonary Function Technologist | 1151 North State St, Suite 406, Jackson, MS 39202 | 2007-05-16 |
| Find all providers in zip 39202 | ||||
| Taxonomy Code | 207XS0106X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Hand Surgery |
| An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194725374 | William Bennett Geissler | Orthopaedic Surgery | 1410 E Woodrow Wilson Ave, Ste D, Jackson, MS 39216-5114 | 2005-07-28 |
| 1356888549 | W.a. Foote Memorial Hospital, Inc | Orthopaedic Surgery | 205 N. East Ave, Jackson, MI 49201 | 2017-01-25 |
| 1023281896 | West Tennessee Hand Center, Pllc | Orthopaedic Surgery | 19 Security Dr, Jackson, TN 38305-3626 | 2008-04-11 |
| 1770571002 | Sheila G Lindley | Orthopaedic Surgery | 2500 North State Street, Orthopaedic Surgery, Jackson, MS 39216 | 2005-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598045775 | Elvis Jeff Justis Jr. | Orthopaedic Surgery | 710 Longmeadow Drive, Oxford, MS 38655 | 2011-08-19 |
| 1225060056 | Aubrey Lucas | Orthopaedic Surgery | 2550 Flowood Dr, Suite 200, Flowood, MS 39232-9303 | 2006-07-06 |
| 1255360186 | Constantine P Charoglu | Orthopaedic Surgery | 3688 Veterans Memorial Dr, Suite 200, Hattiesburg, MS 39401-8246 | 2006-07-02 |
| 1942239090 | Rocco A Barbieri | Orthopaedic Surgery | 3688 Veterans Memorial Dr, Suite 200, Hattiesburg, MS 39401-8246 | 2006-07-01 |
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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.