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SHANTALE ETHERIDGE
NPI 1801338538
Counselor - Professional in Killeen, TX

Active since November 11, 2016PECOS Enrolled
2403 W STAN SCHLUETER LOOP UNIT 690125, KILLEEN, TX 76549(254) 499-2905 Get Directions Write a Review

NPPES record last updated: June 18, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 18, 2024, Nov 11, 2016 (2 updates tracked since 2016).

About Shantale Etheridge NPPES

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

SHANTALE ETHERIDGE (NPI 1801338538) is an individual professional provider in Killeen, Texas, licensed in Mississippi (1920) and active in the NPI registry since November 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2004).

NPPES Registry Identity

NPI1801338538
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameSHANTALE ETHERIDGE
Location Address2403 W STAN SCHLUETER LOOP UNIT 690125Killeen, TX 76549-0206
Mailing Address2403 W Stan Schlueter Loop Unit 690125Killeen, TX 76549-0206 · (254) 499-2905
Phone(254) 499-2905
Sole ProprietorYes
Medical School CMSOtherGraduated 2004
Enumeration DateNovember 11, 2016
Last NPPES UpdateJune 18, 20242 updates tracked since enumeration
NPPES CertifiedJune 18, 2024
✔ NPI 1801338538 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MS · 1920
2403 W STAN SCHLUETER LOOP UNIT 690125, Killeen, TX 76549
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas, Moda Health Plan, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shantale Etheridge is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6608363759
PECOS Enrollment IDI20251014001104
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 Shantale Etheridge's NPI number?

The NPI number for Shantale Etheridge is 1801338538. It was assigned to this individual provider in the NPPES registry on November 11, 2016.

Where is Shantale Etheridge located?

Shantale Etheridge practices at 2403 W Stan Schlueter Loop Unit 690125, Killeen, TX 76549. The listed phone number is (254) 499-2905.

What is Shantale Etheridge's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Shantale Etheridge enrolled in Medicare?

Yes. Shantale Etheridge is registered in the Medicare PECOS enrollment system.

What insurance does Shantale Etheridge accept?

Health plans from Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas, Moda Health Plan, Inc. and Providence Health Plan list Shantale 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 Shantale Etheridge was last updated on June 18, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.