Susan Rachel Ethridge, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN076629 Issued in GA

Practice address

235 E Washington Ave
Ashburn, GA 31714-5224

Phone

(229) 778-9216

Fax

(229) 778-9218

NPI assigned

Dec 13, 2005

Last updated

Jun 2, 2021By the provider in NPPES

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

Enrolled in GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Crisp Regional Hospital Inc

  dba Crisp Regional Hospital

  • General Acute Care Hospital
  • Cordele, GA
  • NPI 1700851649
  Medicare reassignment NPD
• Crisp Regional Hospital, Inc

  dba Crisp Regional LTC Pharmacy

  • Long Term Care Pharmacy
  • Cordele, GA
  • NPI 1679836142
  NPD
• Phoebe Putney Memorial Hospital, Inc.

  dba Phoebe Family Medical Center - Pelham

  • Rural Health Clinic/Center
  • Pelham, GA
  • NPI 1821239765
  NPD (past)
• Phoebe Putney Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Camilla, GA
  • NPI 1821293788
  NPD (past)

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1316922206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 E WASHINGTON AVE",
            "city": "ASHBURN",
            "state": "GA",
            "postal_code": "317145224",
            "telephone_number": "229-638-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E WASHINGTON AVE",
            "city": "ASHBURN",
            "state": "GA",
            "postal_code": "317145224",
            "telephone_number": "229-778-9216",
            "fax_number": "229-778-9218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHRIDGE",
        "first_name": "SUSAN",
        "middle_name": "RACHEL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN076629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher J. White, DDS, Inc.
• Cynthia Lynn Cleghorn, NP-C
• Michael Frederick Dent, DMD
• John W. Desimone, MD
• Doctor's Pharmacy-Vital Care,Inc (Doctor's Pharmacy)
• Barbara A. Fallin, APRN-C
• Teresa Tripp Ford, FNP
• Genesis DME, Inc.
• Megan Logue Gibbs, FNP-BC
• Gracefield Personal Care LLC

• Family Nurse Practitioner in Ashburn, GA
• Providers in Ashburn, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.

Verify at the official NPI Registry.