Dana Etheredge

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2106556 Issued in TX

Practice address

4681 College Park
Round Rock, TX 78665-1526

Phone

(512) 663-0718

Fax

(512) 706-1956

NPI assigned

Dec 10, 2014

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

Other names 1

• Mrs. Dana M McArthur Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1418169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1851799605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1913 PAYNE AVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787573203",
            "telephone_number": "512-785-5742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4681 COLLEGE PARK",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651526",
            "telephone_number": "512-663-0718",
            "fax_number": "512-706-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHEREDGE",
        "first_name": "DANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-10",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2106556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANA",
            "last_name": "MCARTHUR",
            "middle_name": "M",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Matthew Bruce Evans, PHARM.D.
• Sally Evans
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• Physical Therapy Assistant in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; 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.