Active NPI
Hunter Etheridge
- Physical Therapist
- Durham, NC
National Provider Identifier
1447988902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P21498
- Practice address
- 5832 Fayetteville Rd Ste 106
Durham, NC 27713-6291 - Phone
- (919) 410-8840
- NPI assigned
- Aug 11, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | P21498 | NC | Primary |
Addresses
Primary practice location
5832 Fayetteville Rd Ste 106
Durham, NC 27713-6291
Mailing address
5832 Fayetteville Rd Ste 106
Durham, NC 27713-6291
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Endpoint |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Duke University Health System, Inc
Practice addresses (Care Compare)
40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 684-8111
5832 Fayetteville Rd
Suite 106
Durham, NC 27713-6291
Phone (919) 410-8840
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P21498 | NC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina Center for Physical Therapy | Physical Therapist | Current | Accepting new patients |
Locations
5832 Fayetteville Rd
Ste 106
Durham, NC 27713
Phone (919) 410-8840
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660176000000",
"number": "1447988902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5832 FAYETTEVILLE RD STE 106",
"city": "DURHAM",
"state": "NC",
"postal_code": "277136291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5832 FAYETTEVILLE RD STE 106",
"city": "DURHAM",
"state": "NC",
"postal_code": "277136291",
"telephone_number": "919-410-8840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETHERIDGE",
"first_name": "HUNTER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-11",
"last_updated": "2022-08-11",
"certification_date": "2022-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P21498",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Endpoint",
"affiliation": "N",
"address_1": "5832 Fayetteville Rd Ste 106",
"city": "Durham",
"state": "NC",
"country_code": "US",
"postal_code": "277136291",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.