Individual provider Active NPI

Chris Ethridge, MD

  • Addiction Medicine (Family Medicine) Physician
  • Lexington, KY
National Provider Identifier
1134547045
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
55624 Issued in KY
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

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191209001463 KY Order and Referring Only - Family PracticePractitioner - 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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
55624KYMDFamily 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

Verify at the official NPI Registry.