Mrs Leslie Ann Ethridge, CRNP, FNP in Dothan, AL

Mrs Leslie Ann Ethridge, CRNP, FNP is a medicare enrolled "Nurse Practitioner - Family" in Dothan, Alabama. Her current practice location is 1450 Ross Clark Cir Ste 400, Dothan, Alabama. You can reach out to her office (for appointments etc.) via phone at (334) 305-0400.

Mrs Leslie Ann Ethridge is licensed to practice in Alabama (license number 1-155435) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1639804560.

Contact Information

	Mrs Leslie Ann Ethridge, CRNP, FNP
	1450 Ross Clark Cir Ste 400, Dothan, AL 36301-4770
	(334) 305-0400
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Leslie Ann Ethridge
Gender	Female
Speciality	Nurse Practitioner - Family
Location	1450 Ross Clark Cir Ste 400, Dothan, Alabama
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1639804560
Provider Enumeration Date: 07/25/2022
Last Update Date: 08/31/2023

Medicare PECOS Information:

PECOS PAC ID: 7618343476
Enrollment ID: I20221019000806

Medical Identifiers

Medical identifiers for Mrs Leslie Ann Ethridge such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1639804560	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	1-155435 (Alabama)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Leslie Ann Ethridge allows following entities to bill medicare on her behalf.

Entity Name	Professional Medical Associates Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1063476836 PECOS PAC ID: 3375574106 Enrollment ID: O20050822001085

Entity Name	Pulmonary Associates, Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1912987785 PECOS PAC ID: 8022031475 Enrollment ID: O20060111000817

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Leslie Ann Ethridge is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Leslie Ann Ethridge, CRNP, FNP 1450 Ross Clark Cir Ste 400, Dothan, AL 36301-4770 Ph: (334) 305-0400	Mrs Leslie Ann Ethridge, CRNP, FNP 1450 Ross Clark Cir Ste 400, Dothan, AL 36301-4770 Ph: (334) 305-0400

Reviews and Comments

Nurse Practitioner Nurses in Dothan, AL

Julia Jones Holloway, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1812 E Main St, Dothan, AL 36301 Phone: 334-792-5184 Fax: 334-792-5190
Heather Young, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 480 Honeysuckle Rd, Dothan, AL 36305 Phone: 334-836-1212
Jenna Oates, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 287 Healthwest Dr, Dothan, AL 36303 Phone: 334-792-9500
Mrs. Samantha Poole Carter, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4300 W Main St Ste 15, Dothan, AL 36305 Phone: 334-944-7056 Fax: 334-944-7063
Elizabeth Ann Mcfarland, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 207 Haven Dr, Dothan, AL 36301 Phone: 334-793-3319 Fax: 334-793-2291
Amanda B Imming, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1901 Melba Drive, Dothan, AL 36301 Phone: 334-794-6611 Fax: 334-794-6614
Vickie D Sconyers, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4300 West Main St, Womens Healthcare Of Dothan Pc Ste 31, Dothan, AL 36305 Phone: 334-793-6511 Fax: 334-677-5642

Mrs Leslie Ann Ethridge, CRNP, FNP - Medicare Nurse Practitioner in Dothan, AL