MR. STEVEN DOUGLAS ETHEREDGE (NPI# 1972125250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972125250 |
| Entity Type | Individual |
| Full Name | MR. STEVEN DOUGLAS ETHEREDGE |
| Credential | NREMT |
| Practice Address |
1188 Constitution Blvd Rock Hill SC 29732-3006 |
| Mailing Address |
101 Fleetwood Rd York SC 29745-9008 |
| Practice Telephone | 8888260911 |
| Mailing Telephone | 8034314685 |
| Enumeration Date | 2020-05-10 |
| Last Update Date | 2020-05-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 146N00000X | Emergency Medical Technician, Basic | P071901 | NC | Emergency Medical Service Providers |
| Y | 146N00000X | Emergency Medical Technician, Basic | SC031616 | SC | Emergency Medical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | SCDHEC | SC031616 | 01 |
| NC | NC OEMS | P071901 | 01 |
| Street Address |
1188 CONSTITUTION BLVD |
| City | ROCK HILL |
| State | SC |
| Zip Code | 29732-3006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023659471 | Jessie M. Armstrong | Counselor | 199 S Herlong Avenue, Rock Hill, SC 29732 | 2019-10-07 |
| 1215407861 | Alicia Johnson | Occupational Therapist | 2025 Ebenezer Rd Suite H, Rock Hill, SC 29732 | 2018-11-27 |
| 1346716909 | Leslie Marie Metzler | Nurse Practitioner | 125 Amendment Ave, Rock Hill, SC 29732 | 2018-10-22 |
| 1356824668 | Laurie E Grove | Counselor | 508 Bethel Street, Clover, SC 29732 | 2018-09-12 |
| 1366924441 | Chinyere Gill-smith | Occupational Therapist | 2390 127 Murrah Drive, Rock Hill, SC 29732 | 2018-09-05 |
| 1053825513 | Community Medicine Foundation Inc | Clinic/Center | 205 Piedmont Blvd. Suite 100, Catawba Community Mental Health Services York Adult Ser, Rock Hill, SC 29732 | 2017-11-20 |
| 1952824906 | Miriam George-norman | Occupational Therapist | 831 Mcdow Drive, Rock Hill, SC 29732 | 2017-07-21 |
| 1255854550 | Courtney Costa | Counselor | 199 S. Herlong Avenue, Rock Hill, NC 29732 | 2017-07-19 |
| 1861913022 | Drs Misiek, Farrell, Farrell, Nale, Cook, Kapitan, Mohamed & Franco Pa | Oral & Maxillofacial Surgery | 1761 Ebenezer Road, Rock Hill, SC 29732 | 2017-06-28 |
| 1396275806 | Chrysalis Autism Center, Inc | Assistant Behavior Analyst | 1547 Cherry Rd, Rock Hill, SC 29732 | 2017-06-16 |
| Find all providers in zip 29732 | ||||
| Taxonomy Code | 146N00000X |
| Grouping | Emergency Medical Service Providers |
| Classification | Emergency Medical Technician, Basic |
| A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. |
| Notes: Sources: Tabers Medical Dictionary and Florida EMS Clearing House. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902348782 | John Cook | Emergency Medical Technician, Basic | 1273 Ebenezer Rd, Rock Hill, SC 29732-2353 | 2016-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053970772 | James T Miller Jr. | Emergency Medical Technician, Basic | 3738 Maple St, Loris, SC 29569-2320 | 2019-06-06 |
| 1811493802 | Matthew Joseph Bailey | Emergency Medical Technician, Basic | 3203 Highway 52, Moncks Corner, SC 29461-5055 | 2018-03-30 |
| 1982120176 | City of Beaufort | Emergency Medical Technician, Basic | 135 Ribaut Rd, Beaufort, SC 29902-4449 | 2017-08-18 |
| 1679094643 | James D Pearson | Emergency Medical Technician, Basic | 9b Willow Drive, Sumter, SC 29150 | 2017-06-29 |
| 1457888273 | Matthew Drescher | Emergency Medical Technician, Basic | 732 Ravenglass Dr, Fort Mill, SC 29715-7326 | 2017-05-11 |
| 1790131704 | Keowee Fire Tax District | Emergency Medical Technician, Basic | 115 Maintenance Rd, Salem, SC 29676 | 2016-05-09 |
| 1083019053 | Stephanie Baker | Emergency Medical Technician, Basic | 80 Woodwind Dr, Spartanburg, SC 29302-4519 | 2014-11-03 |
| 1306248141 | Boiling Springs Fire District | Emergency Medical Technician, Basic | 5020 Pelham Rd, Greenville, SC 29615-5717 | 2014-09-24 |
| 1851706899 | James Woods | Emergency Medical Technician, Basic | 2538 Highway 301 S, Suite C, Dillon, SC 29536-8217 | 2014-06-29 |
| 1962785121 | Wendell D Glenn | Emergency Medical Technician, Basic | 346 Coleman Rd, Clinton, SC 29325-6936 | 2011-09-23 |
| Find all providers with the same taxonomy | ||||
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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.