Mark Etheridge, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

1-080454 Issued in AL

Practice address

2451 Fillingim St
Mobile, AL 36617-2238

Phone

(251) 471-7035

Fax

(251) 471-7042

NPI assigned

Sep 21, 2005

Sex

Male

Sole proprietor

Yes

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 AL, NY2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Joseph'S Physician Health PCGroup PAC ID 9436041431, 125 clinicians

Jefferson Anesthesiologist Services PCGroup PAC ID 0840289260, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Samaritan Medical Center Hospital, Watertown, NY, CCN 330157
• St Joseph'S Hospital Health Center Hospital, Syracuse, NY, CCN 330140

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11347/brand/1/csg/1/fhir/r4

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.

• Jefferson Anesthesiologist Services PC

  • Anesthesiology Physician
  • Watertown, NY
  • NPI 1508818014
  Medicare reassignment Care Compare group NPD
• St. Joseph'S Physician Health, P.C.

  • Anesthesiology Physician
  • Troy, NY
  • NPI 1154376770
  Medicare reassignment Care Compare group NPD
• Anesthesiologists Associated PC

  • Anesthesiology Physician
  • Birmingham, AL
  • NPI 1851371850

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Cahaba Medical Care Foundation

  • Federally Qualified Health Center (FQHC)
  • Centreville, AL
  • NPI 1316201809
  Medicare reassignment NPD
• Physynergy, LLC

  • Anesthesiology Physician
  • Huntsville, AL
  • NPI 1134465560

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Medstream Anesthesia PLLC

  • Anesthesiology Physician
  • Richardson, TX
  • NPI 1649616160

  AL, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Premier Anesthesia of New York, P.C.

  • Anesthesiology Physician
  • Saranac Lake, NY
  • NPI 1063658961

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesiologists Associated PC

  • Critical Care Medicine (Internal Medicine) Physician
  • Birmingham, AL
  • NPI 1396353280
  NPD
• Cahaba Medical Care Foundation

  • Federally Qualified Health Center (FQHC)
  • Centreville, AL
  • NPI 1316542624
  NPD
• Physynergy, LLC

  • Anesthesiology Physician
  • Mobile, AL
  • NPI 1093173502

  Nurse Anesthetist, Certified Registered

  NPD
• North American Partners in Anesthesia LLP

  • Anesthesiology Physician
  • Melville, NY
  • NPI 1649264706
  NPD
• Cahaba Medical Care Foundation

  • Multi-Specialty Clinic/Center
  • Centreville, AL
  • NPI 1093058133
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Samaritan Medical Center

  • General Acute Care Hospital
  • Watertown, NY
  • NPI 1598713745
  Care Compare affiliation
• St Josephs Hospital Health Center

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1508815333
  Care Compare affiliation

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1659367035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5680 SHELBY LN",
            "city": "WILMER",
            "state": "AL",
            "postal_code": "365876800",
            "telephone_number": "251-645-2529",
            "fax_number": "251-645-2529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 FILLINGIM ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366172238",
            "telephone_number": "251-471-7035",
            "fax_number": "251-471-7042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHERIDGE",
        "first_name": "MARK",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-080454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051552967",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Ross Estes, CRNP
• Julie M Estis, PH.D., CCC-SLP
• Kelly Diantha Estle, LCSW
• Benjamin Estrada, MD
• Benjamin Joseph Estrada
• Chaketta Ethridge
• Alexandria Maria Eubanks
• April Henry Eubanks, PHARM D.
• Justin Boyd Eubanks, PHARMD
• Kelly Marie Eubanks, B.A, D.C.

• Certified Registered Nurse Anesthetist in Mobile, AL
• Providers in Mobile, AL by specialty
• Certified Registered Nurse Anesthetist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; 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.

Verify at the official NPI Registry.