Allison Denise Etheredge, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1146986 Issued in TX

Practice address

1628 19TH St
Lubbock, TX 79401-4832

Phone

(806) 219-0500

Fax

(806) 766-1286

NPI assigned

Apr 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lubbock Independent School District

  • Developmental Disabilities Clinic/Center
  • Lubbock, TX
  • NPI 1669543401
  NPD (past)

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1053434522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 19TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794014832",
            "telephone_number": "806-219-0500",
            "fax_number": "806-766-1286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 19TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794014832",
            "telephone_number": "806-219-0500",
            "fax_number": "806-766-1286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHEREDGE",
        "first_name": "ALLISON",
        "middle_name": "DENISE",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1146986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1754251-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXECUTIVE COUNCIL OF PHYSICAL THERAPY AND OCCUPATIONAL THERAPY EXAMINERS",
            "identifier": "114986",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ess of Lubbock, LLC
• Essilor Laboratories of America, L.P.
• Adrienne Brent Gamis Estabillo, MD
• Jasmine Estelle
• Veronica Lee Estrada, FNP-C
• Delaney Ashlin Etzler
• Adriana Eubanks, LPC ASSOCIATE
• Kathy Elaine Eubanks, M.D.
• Krysta L Eugenis, P.A.
• Eulas Services LLC

• Physical Therapist in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.