Active NPI
Chris Ethridge, MD
- Addiction Medicine (Family Medicine) Physician
- Lexington, KY
National Provider Identifier
1134547045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Family Medicine) Physician
- License
- 55624
- Practice address
- 101 N Eagle Creek Dr
Lexington, KY 40509-1806 - Phone
- (859) 275-4878
- NPI assigned
- Mar 29, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | 55624 | KY | Primary |
| Family Medicine Physician | 207Q00000X | 55624 | KY |
Addresses
Primary practice location
101 N Eagle Creek Dr
Lexington, KY 40509-1806
Mailing address
496 Southland Dr
Lexington, KY 40503-1827
Phone (859) 288-2425
Other practice location 1
3101 Beaumont Centre Cir
Lexington, KY 40513-1961
Phone (859) 323-5544
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191209001463 | KY | Order and Referring Only - Family Practice | 1254764004 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55624 | KY | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785456000000",
"number": "1134547045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "496 SOUTHLAND DR",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405031827",
"telephone_number": "859-288-2425",
"fax_number": "859-288-7510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 N EAGLE CREEK DR",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405091806",
"telephone_number": "859-275-4878"
}
],
"practiceLocations": [
{
"address_1": "3101 Beaumont Centre Cir",
"address_purpose": "LOCATION",
"city": "Lexington",
"state": "KY",
"postal_code": "405131961",
"country_code": "US",
"telephone_number": "859-323-5544",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ETHRIDGE",
"first_name": "CHRIS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-29",
"last_updated": "2026-07-31",
"certification_date": "2026-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0401X",
"taxonomy_group": "",
"desc": "Family Medicine, Addiction Medicine",
"state": "KY",
"license": "55624",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "55624",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.