Amanda Leeann Etheridge, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

145435 Issued in CA

Practice address

11234 Anderson St
Loma Linda, CA 92354

Phone

(618) 599-9904

NPI assigned

Jun 12, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, WY2 enrollments

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 2

Specialty

Internal Medicine

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sound Physicians of Wyoming LLCGroup PAC ID 8325214828, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Wyoming Medical Center Hospital, Casper, WY, CCN 530012
• Sagewest Health Care Hospital, Riverton, WY, CCN 530008
• Memorial Hospital of Converse County Hospital, Douglas, WY, CCN 531302
• Cody Regional Health Hospital, Cody, WY, CCN 531312

Merit-based Incentive Payment System (MIPS)

Final score

88.87 of 100Reported as group

Quality

72.13

Promoting interoperability

80

Improvement activities

40

Cost

77.36

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/dcf3b1c6-3971-4673-962e-8b2cce0ff827/
• Direct secure messaging: aetheridge81528@direct.llu.edu

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.

• Sound Physicians of Wyoming, LLC

  • Hospitalist Physician
  • Casper, WY
  • NPI 1982982708

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment NPD
• Faculty Physicians and Surgeons of Llusm

  • Pediatrics Physician
  • Moreno Valley, CA
  • NPI 1073563748
  NPD
• Wyoming Medical Center Inc

  • General Acute Care Hospital
  • Casper, WY
  • NPI 1346332954
  NPD (past)

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

• Cody Regional Health EMS

  • Land Ambulance
  • Cody, WY
  • NPI 1366432197

  Hospital

  Care Compare affiliation
• Memorial Hospital of Converse County

  • Critical Access Hospital
  • Douglas, WY
  • NPI 1326085408
  Care Compare affiliation
• Riverton Memorial Hospital LLC

  • Rural Acute Care Hospital
  • Lander, WY
  • NPI 1245337286
  Care Compare affiliation
• West Park Hospital District

  • Critical Access Hospital
  • Cody, WY
  • NPI 1558351536
  Care Compare affiliation
• Wyoming Medical Center Inc

  • General Acute Care Hospital
  • Casper, WY
  • NPI 1346332954
  Care Compare affiliation

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1699156943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1498 BROOKSIDE AVE",
            "address_2": "APT A-103",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734454",
            "telephone_number": "618-599-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92354",
            "telephone_number": "618-599-9904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHERIDGE",
        "first_name": "AMANDA",
        "middle_name": "LEEANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "145435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esther Lillian Estanque
• Molly Estes, M.D.
• Ignacio Minguillan Estrada
• Maria De Jesus Estrada
• Ryan Michael Estrada, LVN
• Teresa Ethridge
• James Robert Etteldorf, N.P.
• Evan Hyun-Jin Chung MD Inc
• Nicole Evangelista
• Dwight Charles Evans, M.D.

• Internal Medicine Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.
• 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.