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Deactivated NPI 1285694430 Deactivated / Inactive NPI Male Practitioner

Dr. J Kendall Ethridge , MD

Orthopaedic Surgery • Waco, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. J Ethridge has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 23, 2006
NPI Deactivation Date October 07, 2019
Total Practice Duration ~13 Years of Practice (2006 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. J Ethridge, MD was a registered Orthopaedic Surgery practicing in Waco, TX. Throughout an active medical career spanning 13 years, Dr. Ethridge provided care at the practice location at 6600 FISH POND RD until profile deactivation on 2019-10-07.

Practice Location & Contact Primary Location

Practice Address

6600 Fish Pond Rd
Suite 201

Waco, TX 767102581

Telephone 2547529638
Fax 2547522201
Associated Practice Facility / Clinic
🏢 Waco Surgical Clinic P A Facility NPI 1598844367

Specialty Benchmarks & Practice Insights

Comparative analytics for Orthopaedic Surgery in Waco, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 24.5 Yrs
State Avg: 25.4 Yrs
Regional Practice Density
13 Specialists

Practicing in Waco, TX (1627 Statewide)

Telehealth Adoption Rate
7.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Orthopaedic Surgery Primary Specialty

NUCC Taxonomy Code: 207X00000X

State License TX F2651

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Practice Associates & Co-Workers

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

9 Associated Practitioners
Dr. Gary Becker , MD

Neuromusculoskeletal Medicine, Sports Medicine

NPI 1023084639

Doctor of Medicine (M.D.)

Dr. Oluwarotimi Adesina , MD

Pediatrics - Sports Medicine

NPI 1164837514

Doctor of Medicine (M.D.)

Dr. Jerry Benham , MD

Orthopaedic Surgery

NPI 1245290972

Doctor of Medicine (M.D.)

Dr. Stephen Sierra , MD

Orthopaedic Surgery - Sports Medicine

NPI 1295228591

Doctor of Medicine (M.D.)

Dr. Chad Conner , MD

Orthopaedic Surgery

NPI 1578767133

Doctor of Medicine (M.D.)

Greg Palm , PA

Physician Assistant - Surgical

NPI 1588056782

Physician Assistant

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated October 07, 2019

Record deactivated on October 07, 2019

NPI Profile Active December 29, 2009

NPI status registered as active in NPPES database

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Updated Practice Location December 29, 2009

Registered at 6600 FISH POND RD, SUITE 201, WACO, TX 767102581 (Tel: 2547529638)

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Updated Business Mailing Address December 29, 2009

Registered at 6600 FISH POND RD, SUITE 201, WACO, TX 767102581 (Tel: 2547529638)

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Provider Name / Credentials Updated December 29, 2009

Recorded as J ETHRIDGE, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 29, 2009

Orthopaedic Surgery (License #F2651 in TX)

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Initial NPI Registration & Enumeration March 23, 2006

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: 1285694430
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 23, 2006
Last Update: December 29, 2009
Deactivation Date: October 07, 2019

Mailing Address

6600 Fish Pond Rd, Suite 201

Waco, TX 767102581

Phone: 2547529638

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.