Individual provider Active NPI

Meagan Ethridge, NP

  • Acute Care Nurse Practitioner
  • Suffolk, VA
National Provider Identifier
1023817269
Registry record updated Apr 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
000001143958 Issued in VA
Practice address
5839 Harbor View Blvd Ste 100a
Suffolk, VA 23435-3797
Phone
(757) 397-4200
NPI assigned
Mar 11, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 000001143958 VA Primary

Addresses

Primary practice location

5839 Harbor View Blvd Ste 100a
Suffolk, VA 23435-3797

Mailing address

5839 Harbour View Blvd Ste 100
Suffolk, VA 23435-3797
Phone (757) 397-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250523000229 VA Practitioner - Nurse Practitioner 8628597515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peninsula Cancer Institute, LLCGroup PAC ID 8729031638, 30 clinicians

Practice addresses (Care Compare)

5839 Harbor View Blvd
Suite 100
Suffolk, VA 23435-3797
Phone (757) 397-4200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
000001143958VAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Cancer Institute LLC CurrentSince May 20, 2025 Accepting new patients
Peninsula Cancer Institute LLC Past Accepting new patients

Locations

110 Wimbledon Sq
Ste E
Chesapeake, VA 23320
Phone (757) 436-1492

110 Wimbledon Sq
Ste E1
Chesapeake, VA 23320
Phone (757) 436-2995

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

5839 Harbour View Blvd
Ste 100A
Suffolk, VA 23435
Phone (757) 397-4200

5839 Harbour View Blvd
Ste 100
Suffolk, VA 23435
Phone (757) 397-4200

1200 First Colonial Rd
Ste 204A
Virginia Beach, VA 23454
Phone (757) 363-8212

120 Kings Way
Ste 3100
Williamsburg, VA 23185
Phone (757) 345-5724

Interoperability endpoints

  • Direct secure messaging: methridge6734@direct.rivhs.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1741651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745625600000",
    "number": "1023817269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5839 HARBOUR VIEW BLVD STE 100",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353797",
            "telephone_number": "757-397-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5839 HARBOR VIEW BLVD STE 100A",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353797",
            "telephone_number": "757-397-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHRIDGE",
        "first_name": "MEAGAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-11",
        "last_updated": "2025-04-26",
        "certification_date": "2025-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "000001143958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.