Rosalie Etherington, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

ND 268 Issued in ND

Practice address

1712 Elmwood PL
Jamestown, ND 58401-5748

Phone

(701) 269-2979

NPI assigned

Jan 30, 2007

Last updated

Mar 27, 2023By the provider in NPPES

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

Other identifiers 1

Other names 1

• Dr. Rosalie Etherington-Dodson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Dakota State Hospital

  dba North Dakota State Hospital Pharmacy

  • Institutional Pharmacy
  • Jamestown, ND
  • NPI 1043260722
  NPD Authorized official

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1770629164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 ELMWOOD PL",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584015748",
            "telephone_number": "701-269-2979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 ELMWOOD PL",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584015748",
            "telephone_number": "701-269-2979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHERINGTON",
        "first_name": "ROSALIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ND",
            "license": "ND 268",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ND",
            "license": "268",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1460283",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSALIE",
            "last_name": "ETHERINGTON-DODSON",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alyssa Eppen-Tanem
• Beth Erbele, RN
• Kala Erickson, OTR/L
• Dale J Ernster, MD
• Randal Essler
• Eventide Jamestown LLC
• Daniel D Everson, LCAC
• Samantha Everson
• Lori Mae Evjen, LAC
• Nancy Ann Exner, LPCC, LAC, LSW

• Psychologist in Jamestown, ND
• Providers in Jamestown, ND by specialty
• Psychologist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.