Brian Etheridge, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD2007-0195 Issued in NM

Practice address

1007 N Pope St
Silver City, NM 88061-5161

Phone

(575) 388-1511

Fax

(575) 313-8236

NPI assigned

Aug 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Hidalgo Medical Services

  • Federally Qualified Health Center (FQHC)
  • Lordsburg, NM
  • NPI 1306843180
  Medicare reassignment NPD
• Hidalgo Medical Services

  • Federally Qualified Health Center (FQHC)
  • Silver City, NM
  • NPI 1063759330
  NPD
• Hidalgo Medical Services

  • Federally Qualified Health Center (FQHC)
  • Silver City, NM
  • NPI 1467971986
  NPD

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506988800000",
    "number": "1487767562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 DE MOSS ST",
            "city": "LORDSBURG",
            "state": "NM",
            "postal_code": "880452618",
            "telephone_number": "575-542-2307",
            "fax_number": "575-313-8235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 N POPE ST",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "880615161",
            "telephone_number": "575-388-1511",
            "fax_number": "575-313-8236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1007 N Pope St",
            "address_purpose": "LOCATION",
            "city": "Silver City",
            "state": "NM",
            "postal_code": "880615161",
            "country_code": "US",
            "telephone_number": "575-388-1511",
            "fax_number": "575-313-8236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETHERIDGE",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2017-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2007-0195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40906361",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Caroline Elliott, LSAA
• Sheri Epperson
• Deshaun Antwan Epps
• Jobeth Laree Erling
• Ess of Silver City, LLC
• Samantha Shaley Evans Germany, BSN CPM CA-SANE
• John Hawley Fancher, M.D.
• Amaris B Fay, MSW
• Jenny Nicole Ferranti
• Jeffrey Alan Finer, CPSW

• Pediatrics Physician in Silver City, NM
• Providers in Silver City, NM by specialty
• Pediatrics Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2017; 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.