Nicole Ethridge, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP013955 Issued in GA

Practice address

110 Pipemakers Cir Ste 115
Pooler, GA 31322-4168

Phone

(912) 988-1526

Fax

(912) 988-1537

NPI assigned

Mar 22, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Cornerstone Speech Therapy, LLC

  • Speech-Language Pathologist
  • Allen, TX
  • NPI 1366887382
  NPD
• Chatterbox Pediatric Therapy

  • Speech-Language Pathologist
  • Pooler, GA
  • NPI 1700160355
  NPD (past)

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

{
    "created_epoch": "1711065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1891545950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PIPEMAKERS CIR STE 115",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224168",
            "telephone_number": "912-988-1526",
            "fax_number": "912-988-1537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PIPEMAKERS CIR STE 115",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224168",
            "telephone_number": "912-988-1526",
            "fax_number": "912-988-1537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHRIDGE",
        "first_name": "NICOLE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-22",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP013955",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "120148",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Empowered Virtual Solutions, Inc.
• Enhanced Chiropractic, LLC
• Wesley Don Ensley, MD
• Lindsay Erickson, RNFA
• Leanne Estrada, PT
• Eye Pros
• Eyes on Pooler, LLC
• F Christopher Pettigrew MD PC
• Lance Copeland Faglie, PHARM.D.
• Family Medicine of Pooler, LLC

• Speech-Language Pathologist in Pooler, GA
• Providers in Pooler, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; 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.