Active NPI
James L Etheredge, M.D.
- Orthopaedic Surgery Physician
- Vero Beach, FL
National Provider Identifier
1689806093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- MD.04187R
- Practice address
- 21 S Caserea CT
Vero Beach, FL 32963-1065 - Phone
- (772) 231-4657
- NPI assigned
- Aug 18, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MD.04187R | LA | Primary |
Addresses
Primary practice location
21 S Caserea CT
Vero Beach, FL 32963-1065
Mailing address
21 S Caserea CT
Vero Beach, FL 32963-1065
Phone (772) 231-4657
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD.04187R | LA | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250553600000",
"number": "1689806093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 S CASEREA CT",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329631065",
"telephone_number": "772-231-4657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 S CASEREA CT",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329631065",
"telephone_number": "772-231-4657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETHEREDGE",
"first_name": "JAMES",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-08-18",
"last_updated": "2009-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": "LA",
"license": "MD.04187R",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vero Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.