Samantha Kaye Ethridge (NPI# 1417355819, PAC ID# 4880911478) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1417355819 |
| PAC ID by PECOS | 4880911478 |
| Professional Enrollment ID | I20180911002383 |
| Full Name | Samantha Kaye Ethridge |
| Organization Legal Name | HEART OF TEXAS COMMUNITY HEALTH CENTER INC |
| Address |
1800 Gurley Ln Waco TX 76706-4025 |
| Phone Number | 2543136000 |
| Gender | F |
| Medical School | UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON |
| Graduation Year | 2014 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 1153370242 |
| Number of Group Practice Members | 82 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 450042 | PROVIDENCE HEALTH CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1600 Providence Dr, Waco, TX 76707-2261 | 2543134200 | HEART OF TEXAS COMMUNITY HEALTH CENTER INC |
| 1800 Gurley Ln, Waco, TX 76706-4025 | 2543136000 | HEART OF TEXAS COMMUNITY HEALTH CENTER INC |
| Organization Legal Name | HEART OF TEXAS COMMUNITY HEALTH CENTER INC |
| Physicians | 35 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lauren E Repa | Clinical Social Worker | Heart of Texas Community Health Center Inc | 120 Hillcrest Medical Blvd, Suite 300, Waco, TX 76712-8951 |
| Rachel C Woodfin | Clinical Social Worker | Heart of Texas Community Health Center Inc | 609 Elm St, Elm Avenue Community Clinic, Waco, TX 76704-2516 |
| Leslie Smith | Nurse Practitioner | Heart of Texas Community Health Center Inc | 1800 Gurley Ln, Waco, TX 76706-4025 |
| Katie Carranza | Nurse Practitioner | Heart of Texas Community Health Center Inc | 3400 Bellmead Dr, Waco, TX 76705-3081 |
| Amy Elizabeth Koester | Physician Assistant | Heart of Texas Community Health Center Inc | 500 Johnson Dr, Mc Gregor, TX 76657-1441 |
| Richard James Hecker | Physician Assistant | Heart of Texas Community Health Center Inc | 1226 Washington Ave, Meyer Center Community Clinic, Waco, TX 76701-1127 |
| Megan Abigail Arboleda | Family Medicine | Heart of Texas Community Health Center Inc | 1911 N Martin Luther King Jr Blvd, Martin Luther King Community Clinic, Waco, TX 76704-1438 |
| Susan L Rhodes | Clinical Social Worker | Heart of Texas Community Health Center Inc | 1800 Gurley Ln, Waco, TX 76706-4025 |
| Ashley M Pitts | Clinical Social Worker | Heart of Texas Community Health Center Inc | 1600 Providence Dr, Waco, TX 76707-2261 |
| Carey Lape | Physician Assistant | Heart of Texas Community Health Center Inc | 1600 Providence Dr, Waco, TX 76707-2261 |
| Street Address |
1800 GURLEY LN |
| City | WACO |
| State | TX |
| Zip | 76706-4025 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Leslie Smith | Nurse Practitioner | Heart of Texas Community Health Center Inc | 1800 Gurley Ln, Waco, TX 76706-4025 |
| Susan L Rhodes | Clinical Social Worker | Heart of Texas Community Health Center Inc | 1800 Gurley Ln, Waco, TX 76706-4025 |
| Julia Anne Riley | Nurse Practitioner | Heart of Texas Community Health Center Inc | 1800 Gurley Ln, Waco, TX 76706-4025 |
| Amy V Coker | Nurse Practitioner | Heart of Texas Community Health Center Inc | 1800 Gurley Ln, Waco, TX 76706-4025 |
| Shannon C Mcdermitt | Clinical Social Worker | Heart of Texas Community Health Center Inc | 1800 Gurley Ln, Waco, TX 76706-4025 |
| Starla Johnson | Nurse Practitioner | Heart of Texas Community Health Center Inc | 1800 Gurley Ln, Waco, TX 76706-4025 |
| City | WACO |
| Zip Code | 76706 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | WACO + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Samantha Kaye Ethridge.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.