Melissa Jennifer Etheridge, PHARMACISTS

Primary specialty

Nuclear PharmacistTaxonomy code 1835N0905X

License

12000 Issued in SC

Practice address

405 Old House Rd
Unit 101
Ridgeland, SC 29936

Phone

(843) 645-8388

Fax

(843) 645-8389

NPI assigned

Oct 13, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Melissa Jennifer Etheridge Professional 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": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1245515055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 OLD HOUSE RD UNIT 101",
            "city": "RIDGELAND",
            "state": "SC",
            "postal_code": "29936",
            "telephone_number": "843-645-8388",
            "fax_number": "843-645-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 OLD HOUSE RD",
            "address_2": "UNIT 101",
            "city": "RIDGELAND",
            "state": "SC",
            "postal_code": "29936",
            "telephone_number": "843-645-8388",
            "fax_number": "843-645-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHERIDGE",
        "first_name": "MELISSA",
        "middle_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "PHARMACISTS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-13",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "12000",
            "primary": false
        },
        {
            "code": "1835N0905X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nuclear",
            "state": "SC",
            "license": "12000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "ETHERIDGE",
            "middle_name": "JENNIFER",
            "prefix": "DR.",
            "credential": "PHARMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Earl Bostick,Sr. D.M.D.
• East Coast Isotopes
• Josieann Mauro Eccles, PA
• Charles Eggleston
• Energy Home Care, LLC
• Tricia L Etheridge, M.D.
• Kendra Evans, LISW-CP
• FBTC Transitional Sub, LLC
• Daranaiza Ferguson
• Shaquanna Ferguson

• Pharmacist in Ridgeland, SC
• Providers in Ridgeland, SC by specialty
• Pharmacist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; 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.