Individual provider Active NPI

Morgan Weslee Ethridge

  • Family Nurse Practitioner
  • Tomball, TX
National Provider Identifier
1619695012
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1000017 Issued in TX
Practice address
16131 N Eldridge Pkwy Ste 100
Tomball, TX 77377-9130
Phone
(832) 639-1544
NPI assigned
Aug 22, 2022
Last updated
Aug 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1000017 TX Primary

Addresses

Primary practice location

16131 N Eldridge Pkwy Ste 100
Tomball, TX 77377-9130

Mailing address

1800 N Hall St Apt 514
Dallas, TX 75204-4170
Phone (501) 538-5162

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
1000017TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Synergenx Health - McKinney LLC Past Accepting new patients
Synergenx Health - Dallas North Park LLC Past Accepting new patients
Southwest Texas Two Medical Group, PLLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1619695012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N HALL ST APT 514",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752044170",
            "telephone_number": "501-538-5162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16131 N ELDRIDGE PKWY STE 100",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773779130",
            "telephone_number": "832-639-1544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHRIDGE",
        "first_name": "MORGAN",
        "middle_name": "WESLEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1000017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomball, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.