CALEB ELISHA ETHERIDGE


Address: 1825 Martha Berry Blvd Nw, Rome, GA 30165-1625
Phone: 7622352700

CALEB ELISHA ETHERIDGE (NPI# 1225670532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1225670532
Entity Type Individual
Full Name CALEB ELISHA ETHERIDGE
Credential PA-C
Practice Address 1825 Martha Berry Blvd Nw
Rome
GA 30165-1625
Mailing Address 221 Technology Pkwy Nw
Rome
GA 30165-1369
Practice Telephone 7622352700
Practice Fax Number 7062366437
Mailing Telephone 7622351000
Enumeration Date 2019-10-09
Last Update Date 2020-05-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant 9480 GA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1825 MARTHA BERRY BLVD NW
City ROME
State GA
Zip Code 30165-1625

Providers in the same location

NPI Name Taxonomy Address Enumeration
1932104924 Natasha Amanda Sands Family Medicine 1825 Martha Berry Blvd Nw, Rome, GA 30165-1625 2005-06-16
1922605401 Lauryn Goss Vines Nurse Practitioner 1825 Martha Berry Blvd Nw, Rome, GA 30165-1625 2020-10-07
1508479536 Emily Adams Thornberry Nurse Practitioner 1825 Martha Berry Blvd Nw, Rome, GA 30165-1625 2020-08-28
1831738368 Lori Patricia Bain Nurse Practitioner 1825 Martha Berry Blvd Nw, Rome, GA 30165-1625 2020-01-01
1306498118 Allison Heidi Pledger Nurse Practitioner 1825 Martha Berry Blvd Nw, Rome, GA 30165-1625 2019-07-11
1396301180 Julie Goulding Shrewsbury Nurse Practitioner 1825 Martha Berry Blvd Nw, Rome, GA 30165-1625 2019-05-16
1346725264 Lacy Holland Lacey Nurse Practitioner 1825 Martha Berry Blvd Nw, Rome, GA 30165-1625 2018-09-26
1215439286 Swaraj Suhas Hublikar Physician Assistant 1825 Martha Berry Blvd Nw, Rome, GA 30165-1625 2018-03-06
1245740828 Ashley Marie Gaulin Physician Assistant 1825 Martha Berry Blvd Nw, Rome, GA 30165-1625 2017-10-09
1609394261 Mollie Lynn Mccormick Physician Assistant 1825 Martha Berry Blvd Nw, Rome, GA 30165-1625 2017-09-05
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1346868775 Heather Bowman Physical Therapist 600 Eagle, E Lake Dr, Rome, GA 30165 2020-07-13
1205451101 Kristopher Nelson Student in an Organized Health Care Education/Training Program 4256, 304 Shorter Ave Nw #201, Rome, GA 30165 2020-06-16
1962061457 Stuart Paul Shaklee Occupational Therapy Assistant 1356 Redmond Road, Rome, GA 30165 2019-06-10
1386001055 Autumn Streetman Counselor 6 Mathis Drive, Rome, GA 30165 2016-01-26
1144695784 Gabrador Milligan Counselor 6 Mathis Road, Rome, GA 30165 2015-12-08
1386041952 Theresa Suits Registered Nurse 1 Woodbine Avenue, Rome, GA 30165 2014-11-26
1942561147 Nicole C. Christian Clinical Neuropsychologist 305 Redmond Rd, Rome, GA 30165 2012-06-04
1679832711 Niki Pareshkumar Bhavsar Internal Medicine 3041 Turner Mccall Blvd, Rome, GA 30165 2012-05-10
1285927491 Amanda Fischer Reeves Family Medicine 304 Shorter Ave Nw Ste 102, Rome, GA 30165 2011-05-20
1033436647 Northland Hearing Centers, Inc. Hearing Instrument Specialist 4 Coosawattee Ave, Rome, GA 30165 2010-04-23
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1518587781 Chandler Holcombe Physician Assistant 100 Three Rivers Dr Ne, Rome, GA 30161-4999 2020-04-17
1609400886 Morgan Elise Benson Baker Physician Assistant 123 Three Rivers Dr Ne, Rome, GA 30161-2300 2020-02-26
1548805401 Mallory Elizabeth Osborne Physician Assistant 330 Turner Mccall Blvd Sw, Rome, GA 30165-5630 2019-11-14
1710522933 William Edward Johnson Physician Assistant 550 Redmond Rd Nw, Rome, GA 30165-1416 2019-11-12
1659934321 Tara Simonson Physician Assistant 310 W 10th St Ne, Rome, GA 30165-2639 2019-04-18
1255805180 Amanda Lynn Preteroti Physician Assistant 504 Redmond Rd Nw, Rome, GA 30165-1416 2019-01-14
1528535036 Jaskirt Kaur Chahal Physician Assistant 1617 N James St, Rome, NY 13440-2852 2018-11-01
1205311131 Austin James Malcom Physician Assistant 550 Redmond Rd Nw, Rome, GA 30165-1416 2018-09-26
1215439286 Swaraj Suhas Hublikar Physician Assistant 1825 Martha Berry Blvd Nw, Rome, GA 30165-1625 2018-03-06
1245740828 Ashley Marie Gaulin Physician Assistant 1825 Martha Berry Blvd Nw, Rome, GA 30165-1625 2017-10-09
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Competitor

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City ROME
Zip Code 30165

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Dataset Information

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.

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