Emily Wise Ethridge, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

4765 Issued in AL

Practice address

120 Oslo Cir
Birmingham, AL 35211-5965

Phone

(205) 944-3944

Fax

(205) 413-4914

NPI assigned

Feb 10, 2021

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 names 1

• Emily Wise Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1114519253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 OSLO CIR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352115965",
            "telephone_number": "205-944-3944",
            "fax_number": "205-413-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 OSLO CIR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352115965",
            "telephone_number": "205-944-3944",
            "fax_number": "205-413-4914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 Commerce Pkwy",
            "address_purpose": "LOCATION",
            "city": "Pelham",
            "state": "AL",
            "postal_code": "351241395",
            "country_code": "US",
            "telephone_number": "205-314-2165",
            "fax_number": "205-783-1128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETHRIDGE",
        "first_name": "EMILY",
        "middle_name": "WISE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "4765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "WISE",
            "credential": "SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Senia Marie Etheredge, REGISTERED NURSE
• Kirsten Etheridge
• Luther Etheridge, DO
• Sherita Katrice Etheridge, CRNP
• Caitlyn Diane Etherington, RN
• V Jolene Ethridge, CRNP
• Jessica Clareese Etress, CRNP
• Bethany Eubanks, CRNP
• Carin Lea Eubanks, PH.D.
• Kyle Eudailey

• Speech-Language Pathologist in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Speech-Language Pathologist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.