DR. KELLEY LARSON ETHERIDGE APRN/CRNA
NPI 1821574310
Nurse Anesthetist, Certified Registered in Glastonbury, CT
About Dr. Kelley Larson Etheridge Aprn/crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KELLEY LARSON ETHERIDGE APRN/CRNA (NPI 1821574310) is an individual nurse anesthetist, certified registered in Glastonbury, Connecticut, licensed in Connecticut (7675) and active in the NPI registry since July 2018. She is enrolled in Medicare PECOS, maintains a secondary practice location in Hartford, and is a graduate of Other (2018).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
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
Dr. Kelley Larson Etheridge Aprn/crna 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.
Medicare Billing Reassignments
3Medicare enrollment records show Kelley Etheridge reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Hartford, CT 06105
- Reassigned Medicare billing, Connecticut enrollment
- 302 clinicians in this Medicare group
Middletown, CT 06457
- Reassigned Medicare billing, Connecticut enrollment
- 88 clinicians in this Medicare group
Shelton, CT 06484
- Reassigned Medicare billing, Connecticut enrollment
- 727 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 06033 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 9
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
GLASTONBURY, CT 06033
GLASTONBURY, CT 06033
GLASTONBURY, CT 06033
GLASTONBURY, CT 06033
GLASTONBURY, CT 06033
GLASTONBURY, CT 06033
GLASTONBURY, CT 06033
GLASTONBURY, CT 06033
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 Kelley Etheridge's NPI number?
The NPI number for Kelley Etheridge is 1821574310. It was assigned to this individual provider in the NPPES registry on July 17, 2018.
Where is Kelley Etheridge located?
Kelley Etheridge practices at 195 Eastern Blvd, Glastonbury, CT 06033. The listed phone number is (860) 667-9542.
What is Kelley Etheridge's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Kelley Etheridge enrolled in Medicare?
Yes. Kelley 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 Kelley Etheridge's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelley Etheridge reassigns Medicare benefits to 3 organizations: Woodland Anesthesia Associates PC (Hartford, CT), Anesthesiologists Of Middletown, P.C. (Middletown, CT) and Integrated Anesthesia Associates LLC (Shelton, CT). 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 Kelley Etheridge's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kelley Etheridge was last updated on April 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Dr. Kelley Larson Etheridge, APRN/CRNA · NPI 1821574310
Nurse Anesthetist, Certified Registered physician in Glastonbury, Connecticut. Individual provider, active in the CMS NPPES registry since July 17, 2018.
## Identity
- **NPI:** 1821574310 (Entity type: Individual)
- **Enumerated:** July 17, 2018
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 7675 (Connecticut)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 195 EASTERN BLVD, Glastonbury, CT 06033-4312
- **Phone:** (860) 667-9542
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Woodland Anesthesia Associates PC (NPI 1437109824, Hartford, CT); Anesthesiologists Of Middletown, P.C. (NPI 1851317135, Middletown, CT); Integrated Anesthesia Associates LLC (NPI 1881636397, Shelton, CT) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** April 16, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1821574310) · Data from the CMS NPPES public registry.