Active NPI
Destiny Etheridge, MD
- Family Medicine Physician
- Indianapolis, IN
National Provider Identifier
1871099002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01085265A
- Practice address
- 8820 S Meridian St Ste 120
Indianapolis, IN 46217-6057 - Phone
- (317) 865-6700
- NPI assigned
- Apr 5, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 55932 | KY | |
| Family Medicine Physician | 207Q00000X | 01085265A | IN | Primary |
| Family Medicine Physician | 207Q00000X | TP282 | KY | |
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | 55932 | KY |
Addresses
Primary practice location
8820 S Meridian St Ste 120
Indianapolis, IN 46217-6057
Mailing address
250 N Shadeland Ave
Indianapolis, IN 46219-4959
Other practice location 1
1720 W Broadway Ste 107
Louisville, KY 40203-3607
Phone (502) 340-5900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300068968 | Medicaid | IN | |
| 1104334448 | Other | IN | ANTHEM PTAN |
Other names 1
- Destiny Danielle Spence
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | DETHERIDGE@DIRECT.IUHEALTH.ORG | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3 Audubon Plaza Dr
Suite LL2
Louisville, KY 40217-1360
Phone (502) 636-8095
8820 S Meridian St
Indianapolis, IN 46217-6056
Phone (888) 484-3258
Hospital & facility affiliations
- Norton Hospitals, Inc
- UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital
- University of Louisville Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.11 of 100
- Quality
- 63.34
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.68
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55932 | KY | MD | Addiction Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Medical Associates, Inc. | Family Medicine | Current | Accepting new patients |
| Community Medical Associates, Inc. | Current | Accepting new patients | |
| Community Medical Associates, Inc. | Current | Accepting new patients |
Locations
157 Towne Dr
Ste 103
Elizabethtown, KY 42701
Phone (270) 765-5926
3 Audubon Plaza Dr
Ste LL2
Louisville, KY 40217
Phone (502) 636-8005
825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165
1720 W Broadway
Ste 107
Louisville, KY 40203
Phone (502) 340-5900
4420 Dixie Hwy
Ste 114
Louisville, KY 40216
Phone (502) 449-6464
1720 W Broadway
Louisville, KY 40203
Phone (502) 456-5451
210 E Gray St
Ste 803
Louisville, KY 40202
Phone (502) 582-6900
Interoperability endpoints
- detheridge212837@direct.nortonhealthcare.org
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Louisville, KY
- NPI 1306983762
-
- General Practice Physician
- Indianapolis, IN
- NPI 1326893777
-
- Internal Medicine Physician
- Louisville, KY
- NPI 1588614994
Family Medicine
-
- Internal Medicine Physician
- Louisville, KY
- NPI 1881192409
Hospital & facility affiliations 37
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- New Albany, IN
- NPI 1902673742
-
- General Acute Care Hospital
- Louisville, KY
- NPI 1043348808
-
- General Acute Care Hospital
- Louisville, KY
- NPI 1447388335
-
- General Acute Care Hospital
- Louisville, KY
- NPI 1699514463
-
- General Acute Care Hospital
- Louisville, KY
- NPI 1831195908
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1871099002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 N SHADELAND AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462194959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8820 S MERIDIAN ST STE 120",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462176057",
"telephone_number": "317-865-6700"
}
],
"practiceLocations": [
{
"address_1": "1720 W Broadway Ste 107",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "402033607",
"country_code": "US",
"telephone_number": "502-340-5900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ETHERIDGE",
"first_name": "DESTINY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-05",
"last_updated": "2026-07-13",
"certification_date": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "55932",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01085265A",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "TP282",
"primary": false
},
{
"code": "207QA0401X",
"taxonomy_group": "",
"desc": "Family Medicine, Addiction Medicine",
"state": "KY",
"license": "55932",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300068968",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PTAN",
"identifier": "1104334448",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "DETHERIDGE@DIRECT.IUHEALTH.ORG",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "8820 S Meridian St Ste 120",
"city": "Indianapolis",
"state": "IN",
"country_code": "US",
"postal_code": "462176057",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "DESTINY",
"last_name": "SPENCE",
"middle_name": "DANIELLE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.