Ian Etheridge, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

44243 Issued in TN

Practice address

800 Ridge Lake Blvd
Memphis, TN 38120-9427

Phone

(901) 825-3165

NPI assigned

Jul 23, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1992314272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 RIDGE LAKE BLVD STE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 RIDGE LAKE BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209427",
            "telephone_number": "901-825-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHERIDGE",
        "first_name": "IAN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "TN",
            "license": "44243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNESSEE BOARD OF PHARMACY",
            "identifier": "44243",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Makenzie Estes, MD
• Mackaria Estes, LCSW
• Maria Cecilia Posada Estipona, PT
• Roque F Estipona Jr., PT
• Cynthia Etheridge, NP
• Pamela Marie Etherington
• Debra Ann Ethridge, PHARM. D
• Melissa Ruth Ethridge, LPC-MHSP
• Zoe Etkin
• Hailey Robinson Etter, MS, LPC-MHSP

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Memphis, TN
• Providers in Memphis, TN by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.