Tracy White Ethridge, RN-BC, CNS, LPC

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

131546 Issued in NC

Practice address

2301 Medpark Dr
Rocky Mount, NC 27804-2288

Phone

(252) 962-5000

NPI assigned

Apr 24, 2007

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)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

Practice roles

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.

• Celso B. Lobao, MD, PA

  • Specialist
  • Raleigh, NC
  • NPI 1487782835
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456876800000",
    "number": "1972722668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PERIMETER PARK DR",
            "address_2": "SUITE 200",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275608442",
            "telephone_number": "252-962-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 MEDPARK DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042288",
            "telephone_number": "252-962-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHRIDGE",
        "first_name": "TRACY",
        "middle_name": "WHITE",
        "name_prefix": "Mrs.",
        "credential": "RN-BC, CNS, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2016-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "4902",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "NC",
            "license": "131546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean M Epps, PAC
• Equipping the Community Organization, Inc.
• Yadelis Escarfullery
• Carlos Alberto Espinoza, M.D.
• Ann Ess, MSCCC-SLP
• Sarini Ettigi, PHD
• Eugene C Davenport (Davenport Family Care Home)
• Eunice Home
• Hans R Eustache
• Everest Long Term Care, LLC (Hunter Hills Nursing and Rehabilitation Center)

• Psychiatric/Mental Health Clinical Nurse Specialist in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; 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.