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SHANTALE ETHERIDGE
NPI 1801338538
Counselor - Professional in Killeen, TX

Active since November 11, 2016PECOS Enrolled
6000 BRUSHY CREEK DR, KILLEEN, TX 76549(254) 519-8803(254) 519-8805 Get Directions Write a Review

NPPES record last updated: August 27, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 27, 2026, Jun 18, 2024, Nov 11, 2016 (3 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 Texas (79090) 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 Address6000 BRUSHY CREEK DRKilleen, TX 76549-2001
Mailing Address2403 W Stan Schlueter Loop Unit 690125Killeen, TX 76549-0206 · (254) 499-2905
Phone(254) 519-8803
Fax(254) 519-8805
Sole ProprietorYes
Medical School CMSOtherGraduated 2004
Enumeration DateNovember 11, 2016
Last NPPES UpdateAugust 27, 20263 updates tracked since enumeration
NPPES CertifiedAugust 27, 2026
✔ 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 TX · 79090
6000 BRUSHY CREEK DR, Killeen, TX 76549
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

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

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.

Medicare Billing Reassignment

Medicare enrollment records show Shantale Etheridge reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Metroplex Clinic Physicians, Inc.
2.7 mi
Urology
2207 S CLEAR CREEK RD, STE 204
Killeen, TX 76549
  • Reassigned Medicare billing, Texas enrollment
  • 25 clinicians in this Medicare group
NPI 1891730396 (254) 519-8419

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 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 6000 Brushy Creek Dr, Killeen, TX 76549. The listed phone number is (254) 519-8803.

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.

Which organization bills Medicare for Shantale Etheridge's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shantale Etheridge reassigns Medicare benefits to Metroplex Clinic Physicians, Inc. (Killeen, TX). The 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 Shantale Etheridge's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shantale Etheridge accept?

Health plans from Blue Cross and Blue Shield of Texas 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 August 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.