Individual provider Active NPI

Joy Ann Ethridge, LPN

  • Licensed Practical Nurse
  • Liberty Township, OH
National Provider Identifier
1356663348
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN 137771 Issued in OH
Practice address
6773 Oleander CT
Liberty Township, OH 45044-8336
Phone
(513) 616-0701
NPI assigned
Feb 18, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN 137771 OH Primary

Addresses

Primary practice location

6773 Oleander CT
Liberty Township, OH 45044-8336

Mailing address

6773 Oleander CT
Liberty Township, OH 45044-8336
Phone (513) 616-0701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN 137771OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266451200000",
    "number": "1356663348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6773 OLEANDER CT",
            "city": "LIBERTY TOWNSHIP",
            "state": "OH",
            "postal_code": "450448336",
            "telephone_number": "513-616-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6773 OLEANDER CT",
            "city": "LIBERTY TOWNSHIP",
            "state": "OH",
            "postal_code": "450448336",
            "telephone_number": "513-616-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHRIDGE",
        "first_name": "JOY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-18",
        "last_updated": "2010-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN 137771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty Township, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; 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.