Elise D Ethridge, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT6687 Issued in MS

Practice address

4908 Great River Dr
Meridian, MS 39305-2663

Phone

(601) 453-3632

Fax

(604) 453-3633

NPI assigned

Aug 2, 2019

Sex

Female

Sole proprietor

No

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 MS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Drayer Physical Therapy Mississippi LLCGroup PAC ID 3274834858, 113 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Drayer Physical Therapy Mississippi LLC

  • Physical Therapist
  • Louisville, MS
  • NPI 1952732448
  Medicare reassignment Care Compare group NPD
• Dpti Elite Physical Therapy LLC

  • Physical Therapist
  • Saltillo, MS
  • NPI 1386010718
  Medicare reassignment NPD
• Dpti Elite Physical Therapy LLC

  • Physical Therapist
  • Baldwyn, MS
  • NPI 1013383496
  NPD
• Drayer Physical Therapy Mississippi LLC

  • Physical Therapist
  • Crystal Springs, MS
  • NPI 1801333521
  NPD (past)

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

{
    "created_epoch": "1564704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1760037121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8205 PRESIDENTS DR",
            "city": "HUMMELSTOWN",
            "state": "PA",
            "postal_code": "170368621",
            "telephone_number": "717-839-2188",
            "fax_number": "717-565-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4908 GREAT RIVER DR",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393052663",
            "telephone_number": "601-453-3632",
            "fax_number": "604-453-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHRIDGE",
        "first_name": "ELISE",
        "middle_name": "D",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-02",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT6687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric W Bridges MD PLLC
• Erica Glover, FNP-BC, PLLC
• Coretta Ann Eskridge
• Esthetics Unlimited
• Caitlin Etheridge
• Jennifer T Eubanks, M.D.
• Joseph Whatley Eubanks
• Robert Ira Eubanks, M.D.
• Evans Optical LLC
• Clora Jamie O'Reilly Evans, DMD

• Physical Therapist in Meridian, MS
• Providers in Meridian, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; 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.