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: August 02, 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
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

Secondary Practice Location 1

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

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

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.

What insurance does William Etheridge accept?

Health plans from Blue Cross and Blue Shield of NC, CareSource, Oscar Health Plan of North Carolina, Inc, Providence Health Plan and UnitedHealthcare 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 2 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.