Jeanette Ethridge, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

NP1006588 Issued in DC

Practice address

7522 Greer Dr
Fort Washington, MD 20744-3319

Phone

(301) 648-5725

NPI assigned

Dec 30, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Umbrella Therapeutic Services, Inc.

  • Community/Behavioral Health Agency
  • Washington, DC
  • NPI 1003324864
  Medicare reassignment NPD
• Beautiful Minds LLC

  • Community/Behavioral Health Agency
  • Washington, DC
  • NPI 1518795590
  NPD

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1689334773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7522 GREER DR",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207443319",
            "telephone_number": "301-648-5725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7522 GREER DR",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207443319",
            "telephone_number": "301-648-5725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHRIDGE",
        "first_name": "JEANETTE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-30",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1006588",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "NP1006588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Endure Counseling and Consulting Services LLC
• Patrick Engracia, DC
• Enhanced Care Coordination Services
• Enitan Healthcare Services
• Ellen Erickson, LCSW-C
• Evelyn T Campbell-Leach PC
• Ezetech Consulting
• F&S Radiology, P.C.
• Family Orthodontics of Maryland LLC
• Abiola Adebola Faniyan, MD, MPH

• Psychiatric/Mental Health Nurse Practitioner in Fort Washington, MD
• Providers in Fort Washington, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; 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.