Shannon Ethridge

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

163236 Issued in FL

Practice address

3006 Ribault Scenic Dr
Jacksonville, FL 32208-2477

Phone

(904) 554-1696

NPI assigned

Oct 6, 2020

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

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.

• Promising Love Personal & Home Care Services L.L.C

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1235904640
  NPD Authorized official

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

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1205433943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3006 RIBAULT SCENIC DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322082477",
            "telephone_number": "904-554-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3006 RIBAULT SCENIC DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322082477",
            "telephone_number": "904-554-1696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHRIDGE",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "FL",
            "license": "163236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eternity Helping Hand Inc
• Ethereal Counseling Center LLC
• Louisa Etheredge, M.ED. IN COUN. ED.
• Makayla J Etheridge
• Michelle G Etheridge
• Altagrace Etienne, HOME HEALTH AIDE
• Linda Etienne
• Medgina Etienne
• Sheena Etienne
• Sheri L. Etkowicz, MS, OTR/L

• Nurse's Aide in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Nurse's Aide in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.