ETHAN P BALDRIDGE (NPI# 1073031712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073031712 |
| Entity Type | Individual |
| Full Name | ETHAN P BALDRIDGE |
| Credential | RD |
| Practice Address |
7 Shackleford Blvd W Little Rock AR 72211-3886 |
| Mailing Address |
7 Shackleford West Blvd Little Rock AR 72211-3886 |
| Practice Telephone | 5016645860 |
| Mailing Telephone | 5019783780 |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2017-09-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 1699 | AR | Dietary & Nutritional Service Providers |
| Street Address |
7 SHACKLEFORD BLVD W |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72211-3886 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760004618 | Samantha Lenore Hilborn | Behavior Technician | 1525 Merrill Drive Suite 100, Little Rock, AR 72211 | 2020-05-14 |
| 1003437740 | Centers for Youth and Families, Inc. | Community/Behavioral Health | 1521 Merrill Drive, Suite D220 and E200, Little Rock, AR 72211 | 2020-05-05 |
| 1962040568 | Erica N Taylor | Nurse Practitioner | 11800 Financial Center Parkway, Ste 290, Little Rock, AR 72211 | 2019-12-13 |
| 1568932119 | Katie Jones | Nurse Practitioner | 1children's Way, Little Rock, AR 72211 | 2018-11-27 |
| 1356828651 | Kayleigh King | Dietitian, Registered | 4 Shackleford Plz Ste 209, Little Rock, AR 72211 | 2018-07-19 |
| 1699283838 | Kara Elizabeth Simmons | Physician Assistant | 11215 Hermitage Rd Ste 103, Little Rock, AR 72211 | 2018-01-22 |
| 1194241463 | Wendy Newsam Pllc | Counselor | 1 Innwood Circle, Suite 107, Little Rock, AR 72211 | 2017-08-18 |
| 1861915159 | Sarah Renee Beall | Counselor | 10800 Financial Centre #290, Little Rock, AR 72211 | 2017-07-19 |
| 1457873127 | Restore Hope Counseling Center, Pllc | Counselor | One Innwood Circle, Suite 201, Little Rock, AR 72211 | 2017-07-13 |
| 1447707500 | University of Arkansas for Medical Sciences | Durable Medical Equipment & Medical Supplies | 601 Autumn Road, Little Rock, AR 72211 | 2016-09-07 |
| Find all providers in zip 72211 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475805 | Arkansas Health Group | Dietitian, Registered | 10915 Rodney Parham Road, Suite G, Little Rock, AR 72212 | 2020-10-20 |
| 1639776883 | Gail Lange-smith | Dietitian, Registered | 805 Beechwood St Apt 3, Little Rock, AR 72205-1974 | 2020-10-01 |
| 1427679075 | Christina Kilton | Dietitian, Registered | 13400 Abinger Dr, Little Rock, AR 72212-3704 | 2020-05-05 |
| 1386286540 | Tatiana I Leakey | Dietitian, Registered | 4817 Lafayette Ave, Little Rock, AR 72205-3722 | 2019-10-09 |
| 1356828651 | Kayleigh King | Dietitian, Registered | 4 Shackleford Plz Ste 209, Little Rock, AR 72211 | 2018-07-19 |
| 1477049237 | Elizabeth Page Hawley | Dietitian, Registered | 17 Emerald Ct, Little Rock, AR 72212-2106 | 2018-07-05 |
| 1447740220 | Carly Nicole Davis | Dietitian, Registered | 414 E Capitol Ave Apt 313, Little Rock, AR 72202-2478 | 2018-05-16 |
| 1114423902 | Kirstine Olivia Talbert | Dietitian, Registered | 14 Eds Ln, Little Rock, AR 72223-3501 | 2018-04-02 |
| 1639671993 | Amanda Hines | Dietitian, Registered | 16000 Rushmore Ave Apt 6206, Little Rock, AR 72223-7021 | 2018-03-02 |
| 1780196998 | Vanessa Roberson | Dietitian, Registered | 5608 C St, Little Rock, AR 72205-3314 | 2017-10-27 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72211 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.