MEREDITH J ETHERIDGE (NPI# 1417128083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417128083 |
| Entity Type | Individual |
| Full Name | MEREDITH J ETHERIDGE |
| Other Name | MEREDITH J DAVENPORT |
| Credential | APRN |
| Practice Address |
225 Medical Center Dr. Suite 201 Paducah KY 42003 |
| Mailing Address |
2200 Jefferson Ave 5th Floor Mercy Pho/cvo Toledo OH 43604-7101 |
| Practice Telephone | 2704414200 |
| Practice Fax Number | 2704414249 |
| Mailing Telephone | 4192519830 |
| Mailing Fax Number | 4192511826 |
| Enumeration Date | 2008-03-21 |
| Last Update Date | 2018-02-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 3005182 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 5182P | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3005182 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
5182P | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100062510 | 05 | |
| KY | MEDICARE PTAN | K245300 | 01 |
| Street Address |
225 MEDICAL CENTER DR. SUITE 201 |
| City | PADUCAH |
| State | KY |
| Zip Code | 42003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033757638 | Wilson Medical Staffing Pllc | Nurse Practitioner | 3130 Lone Oak Rd, Paducah, KY 42003 | 2019-12-13 |
| 1417415993 | Lauren Deanne Mcclain | Nurse Practitioner | 225 Medical Center Dr Ste 205, Paducah, KY 42003 | 2019-03-04 |
| 1871057042 | Brame Psychological Assessment Center | Psychologist | Ray and Kay Eckstein Outreach Center, 435 Berger Rd, Paducah, KY 42003 | 2019-01-22 |
| 1831611219 | Elizabeth Anne Wright | Social Worker | 425 Broadway Street, Paducah, KY 42003 | 2017-07-07 |
| 1558804724 | Kayla Reshea Franklin | Behavior Technician | 2075 Husband Road, Paducah, KY 42003 | 2016-11-21 |
| 1699189308 | Sunrise Children's Services, Inc. | Foster Care Agency | 3565 Lone Oak Rd Ste 2, Paducah, KY 42003 | 2014-06-20 |
| 1326488891 | Alice Ann Higdon Wilham | Surgery | 1532 Lone Oak Rd Ste 235, Paducah, KY 42003 | 2013-06-28 |
| 1881924611 | Meghan Ashley Lee | Nurse Practitioner | 1532 Lone Oak Rd Ste 245, Paducah, KY 42003 | 2009-12-29 |
| 1174771018 | Sleep Source Kentucky, LLC | Clinic/Center | 3125 Parisa Drive, Paducah, KY 42003 | 2008-09-04 |
| 1851547426 | Zandra Bristol Farley | Registered Nurse | 1532 Lone Oak Road Suite 445, Lourdes Marshall Nemer Pavillion, Paducah, KY 42003 | 2008-08-14 |
| Find all providers in zip 42003 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677117 | Shelby A Rollings | Nurse Practitioner | 100 Clint Hill Blvd, Paducah, KY 42001-6771 | 2020-10-26 |
| 1487277000 | Emily Huff | Nurse Practitioner | 175 Pershing Way, Paducah, KY 42001-8914 | 2020-05-19 |
| 1013555028 | Kristin Calhoun | Nurse Practitioner | 3520 Lone Oak Rd, Paducah, KY 42003-5752 | 2019-12-20 |
| 1699231878 | Kristin Nicole Tynes | Nurse Practitioner | 2601 Kentucky Ave Ste 102, Paducah, KY 42003-3817 | 2019-02-13 |
| 1164966263 | Nakeisha Jo Perkins | Nurse Practitioner | 2603 Kentucky Ave Ste 102, Paducah, KY 42003-3815 | 2016-12-07 |
| 1023550761 | Desiree Albritton | Nurse Practitioner | 5439 Stevin Dr Unit B, Paducah, KY 42001-9705 | 2016-11-11 |
| 1700214947 | Keisha L Snow | Nurse Practitioner | 2605 Kentucky Ave Ste 602, Paducah, KY 42003-3806 | 2013-10-25 |
| 1679908750 | Bonita Cloyd | Nurse Practitioner | 247 Seminole Dr, Paducah, KY 42001-5425 | 2013-09-09 |
| 1447484118 | Advanced Spine & Joint | Nurse Practitioner | 2404 New Holt Rd, Paducah, KY 42001 | 2009-05-11 |
| 1033324439 | Sue Ann Cavanah | Nurse Practitioner | 970 Cindy Dr, Paducah, KY 42003-9303 | 2007-05-11 |
| Find all providers in PADUCAH | ||||
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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.