Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1063674661 Individual Practitioner Male Practitioner

Dr. Jonathan Etheridge , MD

Emergency Medicine • Lamar, MO

Professional Overview & Biography Verified Profile Summary

Dr. Jonathan Etheridge, MD is a registered healthcare professional specializing in Emergency Medicine in Lamar, MO. Practice services are available at 29 NW 1ST LN under active NPI credentials.

Frequently performed procedures and clinical services include emergency department visit for life threatening or functioning severity, emergency department visit with moderate level of medical decision making, critical care, first. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

29 Nw 1st Ln

Lamar, MO 647598105

Telephone 4176815100
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Emergency Medicine in Lamar, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 23.5 Yrs
Regional Practice Density
4 Specialists

Practicing in Lamar, MO (1467 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
78.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2018)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity
72 71 $892.44 $168.11
99284 Emergency department visit with moderate level of medical decision making
19 19 $523.05 $115.17
99291 Critical care, first 30-74 minutes
12 12 $814.00 $203.49

Medical Specialties & State Licenses

CMS Verified: 2026-04-30
Emergency Medicine Primary Specialty

NUCC Taxonomy Code: 207P00000X

State License MO 2012003246

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1063674661 (MO)
Commercial Insurance / Payer ID Tricare
440552485 (MO)
Commercial Insurance / Payer ID Rr Mcr
P01119720 (MO)

Secondary Practice Locations

525 Branson Landing Blvd

Branson, MO 656162052

Phone: 4178752627

1235 E Cherokee St

Springfield, MO 658042203

Phone: 4178202115

1000 E Hwy 60

Monett, MO 657088258

Phone: 4173541269

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Dr. John Willis , MD

Emergency Medicine

NPI 1215958012

Doctor of Medicine (M.D.)

NPI 1295269348

Doctor of Medicine (M.D.)

Dr. Jeremy Sturgell , MD

Emergency Medicine

NPI 1376741173

Doctor of Medicine (M.D.)

Dr. Stephen Tines , MD

Radiology - Diagnostic Radiology

NPI 1457371072

Doctor of Medicine (M.D.)

Dr. Charles Fielder , MD

Radiology - Diagnostic Radiology

NPI 1740200369

Doctor of Medicine (M.D.)

Kevin Deao , CRNA

Nurse Anesthetist, Certified Registered

NPI 1891107652

Certified Registered Nurse Anesthetist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location July 15, 2021

Registered at 29 NW 1ST LN, LAMAR, MO 647598105 (Tel: 4176815100)

📍
Updated Business Mailing Address July 15, 2021

Registered at 29 NW 1ST LN, LAMAR, MO 647598105 (Tel: 4176815100)

NPI Profile Active October 02, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location October 02, 2014

Registered at 1235 E CHEROKEE ST, SPRINGFIELD, MO 658042203 (Tel: 4178202115)

📍
Updated Business Mailing Address October 02, 2014

Registered at PO BOX 505164, SAINT LOUIS, MO 631505164 (Tel: 4178294620)

👤
Provider Name / Credentials Updated October 02, 2014

Recorded as JONATHAN ETHERIDGE, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 02, 2014

Emergency Medicine (License #2012003246 in MO)

🟢
Initial NPI Registration & Enumeration June 26, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1063674661
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 26, 2008
Last Update: April 30, 2026
Sole Proprietor: No

Mailing Address

29 Nw 1st Ln

Lamar, MO 647598105

Phone: 4176815100

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.