Etheridge Chiropractic Clinic Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

08001352 Issued in IN

Legal business name

ETHERIDGE CHIROPRACTIC CLINIC INC

Practice address

631 S 25TH Street
Terre Haute, IN 47803

Phone

(812) 232-8803

Fax

(812) 232-1305

NPI assigned

Sep 28, 2007

Reactivated

Jul 10, 2009

Last updated

Jul 10, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Eugene W Etheridge Jr., DCNPI 1427168517

Title

Doctor

Phone

(812) 232-8803

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eugene Wesley Etheridge Jr., DC

  • Chiropractor
  • Terre Haute, IN
  • NPI 1427168517
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247184000000",
    "number": "1003003534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 S 25TH STREET",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "47803",
            "telephone_number": "812-232-8803",
            "fax_number": "812-232-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 S 25TH STREET",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "47803",
            "telephone_number": "812-232-8803",
            "fax_number": "812-232-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHERIDGE CHIROPRACTIC CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2009-07-10",
        "deactivation_date": "2008-01-09",
        "reactivation_date": "2009-07-10",
        "status": "A",
        "authorized_official_last_name": "ETHERIDGE",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "812-232-8803",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peggy Sue Escobedo, MS
• Danielle Eslick, OD
• Travis Essex
• Amanda Estes
• Alfonso Q Estrada, M.D.
• Eugene Wesley Etheridge Jr., DC
• Tiffany Marie Ethridge
• Anthony Eti-Ukwu, RPH
• Abigail M Etters, DO
• Janice Fajardo Evangelista, OTR

• Chiropractor in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.