Kelley Larson Etheridge, APRN/CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

7675 Issued in CT

Practice address

195 Eastern Blvd
Glastonbury, CT 06033-4312

Phone

(860) 667-9542

NPI assigned

Jul 17, 2018

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 CT

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Woodland Anesthesia Associates PCGroup PAC ID 8820083652, 172 clinicians

Anesthesiologists of Middletown, P.C.Group PAC ID 2769479781, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Middlesex Hospital Hospital, Middletown, CT, CCN 070020

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Anesthesiologists of Middletown, P.C.

  • Anesthesiology Physician
  • Middletown, CT
  • NPI 1851317135
  Medicare reassignment Care Compare group NPD
• Woodland Anesthesia Associates PC

  • Anesthesiology Physician
  • Hartford, CT
  • NPI 1437109824
  Medicare reassignment Care Compare group NPD
• Integrated Anesthesia Associates LLC

  • Anesthesiology Physician
  • Shelton, CT
  • NPI 1881636397

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

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

• Middlesex Hospital

  • General Acute Care Hospital
  • Middletown, CT
  • NPI 1760454334
  Care Compare affiliation

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1821574310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 BLACK WALNUT DR",
            "city": "DURHAM",
            "state": "CT",
            "postal_code": "064221400",
            "telephone_number": "860-575-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 EASTERN BLVD",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334312",
            "telephone_number": "860-667-9542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Woodland St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061051208",
            "country_code": "US",
            "telephone_number": "860-714-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETHERIDGE",
        "first_name": "KELLEY",
        "middle_name": "LARSON",
        "name_prefix": "Dr.",
        "credential": "APRN/CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-17",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "7675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emslie Therapy LLC
• Entyre Care Connecticut LLC (Entyre Care)
• Sean Esmende, M.D.
• Evan Fox MD, LLC
• Briana Kerr Evans, DPT
• James Owenq Evans, ATC
• Facets Counseling Services, LLC
• Denise Falbowski, LO

• Certified Registered Nurse Anesthetist in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Certified Registered Nurse Anesthetist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.