Randal J Ethridge, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4460T Issued in TX

Practice address

1200 Austin Avenue
Brownwood, TX 76801

Phone

(325) 643-5511

Fax

(325) 646-1496

NPI assigned

Sep 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of Houston - College of Optometry, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DRS Ethridge and Harding, Optometrist PLLCGroup PAC ID 0345687471, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• DRS Ethridge & Harding, Optometrist PLLC

  • Optometrist
  • Brownwood, TX
  • NPI 1477254142
  Medicare reassignment Care Compare group NPD
• Comolli & Ethridge

  • Durable Medical Equipment & Medical Supplies
  • Brownwood, TX
  • NPI 1386812246
  NPD
• CVS Pharmacy Inc

  • Pharmacy
  • Stafford, TX
  • NPI 1427931351
  NPD (past)
• CVS Pharmacy Inc

  • Pharmacy
  • Brownwood, TX
  • NPI 1982708764
  NPD (past)

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1144324260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 AUSTIN AVENUE",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "76801",
            "telephone_number": "325-643-5511",
            "fax_number": "325-646-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 AUSTIN AVENUE",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "76801",
            "telephone_number": "325-643-5511",
            "fax_number": "325-646-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHRIDGE",
        "first_name": "RANDAL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4460T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Educare Community Living Corporation - Texas
• Deanne Michelle Edwards, LOT
• Sulema Enriquez
• Epic Physical Therapy LLC
• Amber Ervin, D.O.
• Jennifer Dawn Evans, P.A.
• Family Smiles of Tyler PC
• Fancy'S Day Spa
• Ferlyn Feliciano, RPT
• Ferdinand Fernandez, LMSW

• Optometrist in Brownwood, TX
• Providers in Brownwood, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.