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WILLIAM THOMAS GORDON ETHERIDGE
NPI 1205466885
Counselor - Mental Health in Raleigh, NC

Active since January 22, 2020PECOS EnrolledAccepts Medicare Assignment
THRIVEWORKS, 8406 SIX FORKS RD SUITE 104, RALEIGH, NC 27615(919) 642-4857 Get Directions Write a Review

NPPES record last updated: September 15, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About William Thomas Gordon Etheridge NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLIAM THOMAS GORDON ETHERIDGE (NPI 1205466885) is an individual mental health provider in Raleigh, North Carolina, licensed in North Carolina (15542) and active in the NPI registry since January 2020. He is enrolled in Medicare PECOS, maintains a secondary practice location in Durham, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1205466885
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameWILLIAM THOMAS GORDON ETHERIDGE
Location AddressTHRIVEWORKS, 8406 SIX FORKS RD SUITE 104Raleigh, NC 27615
Mailing Address122 Masondale AveDurham, NC 27707-3152 · (919) 308-7306
Phone(919) 642-4857
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateJanuary 22, 2020
Last NPPES UpdateSeptember 15, 2023
NPPES CertifiedSeptember 14, 2023
✔ NPI 1205466885 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NC · 15542
THRIVEWORKS, Raleigh, NC 27615
Open in Google Maps ↗

Secondary Practice Location 1

Location 1122 Masondale AveDurham, NC 27707-3152 · Phone (919) 308-7306

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

William Thomas Gordon Etheridge is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4082064977
PECOS Enrollment IDI20231218003890
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show William Etheridge reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Thriveworks Clinical - North Carolina PC
0.7 mi
Mental Health
8406 SIX FORKS RD STE 104
Raleigh, NC 27615
  • Reassigned Medicare billing, North Carolina enrollment
  • 188 clinicians in this Medicare group
NPI 1003303082 (919) 424-6045
Grow Healthcare Group PA
704 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, North Carolina enrollment
  • 712 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is William Etheridge's NPI number?

The NPI number for William Etheridge is 1205466885. It was assigned to this individual provider in the NPPES registry on January 22, 2020.

Where is William Etheridge located?

William Etheridge practices at Thriveworks 8406 Six Forks Rd Suite 104, Raleigh, NC 27615. The listed phone number is (919) 642-4857.

What is William Etheridge's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is William Etheridge enrolled in Medicare?

Yes. William Etheridge is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for William Etheridge's services?

According to the CMS Revalidation Reassignment List (October 2026 release), William Etheridge reassigns Medicare benefits to 2 organizations: Thriveworks Clinical - North Carolina PC (Raleigh, NC) and Grow Healthcare Group PA (Miami, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for William Etheridge's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does William Etheridge accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and Blue Cross and Blue Shield of NC and 4 other insurers list William Etheridge as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for William Etheridge was last updated on September 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.