MARANDA BROOKE ETHEREDGE AGACNP-BC
NPI 1871470682
Nurse Practitioner in Dallas, TX

Q: What is Maranda Etheredge's NPI number?

The NPI number for Maranda Etheredge is 1871470682. It was assigned to this individual provider in the NPPES registry on August 21, 2025.

Q: What is Maranda Etheredge's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Maranda Etheredge was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since August 21, 2025PECOS EnrolledAccepts Medicare Assignment

2710 SWISS AVE, DALLAS, TX 75204(214) 821-1599 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Maranda Brooke Etheredge Agacnp-bc NPPES

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

MARANDA BROOKE ETHEREDGE AGACNP-BC (NPI 1871470682) is an individual nurse practitioner in Dallas, Texas, licensed in Texas (1212740) and active in the NPI registry since August 2025. She is enrolled in Medicare PECOS, is affiliated with Baylor University Medical Center, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1871470682

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMARANDA BROOKE ETHEREDGECredential: AGACNP-BC

Location Address2710 SWISS AVEDallas, TX 75204-5900

Mailing Address3610 Gillespie St Apt 6Dallas, TX 75219-4979 · (918) 845-6053

Phone(214) 821-1599

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateAugust 21, 2025

Last NPPES UpdateSeptember 11, 2025

NPPES CertifiedSeptember 11, 2025

✔ NPI 1871470682 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in TX · 1212740

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Maranda Brooke Etheredge Agacnp-bc 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 ID3072009448

PECOS Enrollment IDI20260106001847

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baylor University Medical Center

Acute Care Hospitals · Dallas, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number450021

Location3500 Gaston AveDallas, TX 75246 · Dallas County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75204 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.19 typical visit price

range $57.18 – $172.86

Typical copayment $22.04 (range $14.29 – $43.21)

Most-billed visit code 99203

Established Patient

$100.80 typical visit price

range $18.48 – $141.20

Typical copayment $25.20 (range $4.62 – $35.30)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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