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DR. KIMBERLY LYNN MERCER ETHEREDGE D.C.
NPI 1912094392
Chiropractor in Oakland Park, FL

Active since October 06, 2006Accepts Medicare Assignment
4711 N DIXIE HWY STE A, OAKLAND PARK, FL 33334(954) 491-8127(954) 491-2388 Get Directions Write a Review

NPPES record last updated: March 24, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Kimberly Lynn Mercer Etheredge D.c. NPPES

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

DR. KIMBERLY LYNN MERCER ETHEREDGE D.C. (NPI 1912094392) is an individual chiropractor in Oakland Park, Florida, licensed in Florida (CH8053) and active in the NPI registry since October 2006. She is a graduate of Life Chiropractic College (1995).

NPPES Registry Identity

NPI1912094392
Entity TypeIndividualFemale
Primary Taxonomy111N00000X
Provider Legal NameDR. KIMBERLY LYNN MERCER ETHEREDGECredential: D.C.
Location Address4711 N DIXIE HWY STE AOakland Park, FL 33334-3916
Mailing Address4711 N Dixie Hwy Ste AOakland Park, FL 33334-3916 · (954) 491-8127 · Fax (954) 491-2388
Phone(954) 491-8127
Fax(954) 491-2388
Sole ProprietorYes
Medical School CMSLife Chiropractic CollegeGraduated 1995
Enumeration DateOctober 6, 2006
Last NPPES UpdateMarch 24, 2008
✔ NPI 1912094392 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in FL · CH8053
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
4711 N DIXIE HWY STE A, Oakland Park, FL 33334
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Other Names 1

Professional Name (2)Dr. Kimberly Lynn Etheredge D.c.

Other Identifiers 1

Medicare ID-Type Unspecified60795FL

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. Kimberly Lynn Mercer Etheredge D.c. 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 ID941306070
PECOS Enrollment IDI20070505000102

Medicare Billing Reassignment

Medicare enrollment records show Kimberly Mercer Etheredge reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

John C Theeck Dc PA
221 mi
Chiropractor
1950 LAUREL MANOR DR, SUITE 204
The Villages, FL 32162
  • Reassigned Medicare billing, Florida enrollment
  • Medicare enrollment name: John C Theeck D.C., P.A.
  • 7 clinicians in this Medicare group
NPI 1033430921 (352) 259-0024

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 2

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

NORTH RIDGE CHIROPRACTIC INC
Chiropractor
4711 N DIXIE HWY STE A
OAKLAND PARK, FL 33334
Broward County (954) 491-8127
KIMBERLEY HINTON
Massage Therapist
4711 N DIXIE HWY STE A
OAKLAND PARK, FL 33334
Broward County (954) 798-4646

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 Kimberly Mercer Etheredge's NPI number?

The NPI number for Kimberly Mercer Etheredge is 1912094392. It was assigned to this individual provider in the NPPES registry on October 6, 2006. The provider is also known as Dr. Kimberly Lynn Etheredge D.C..

Where is Kimberly Mercer Etheredge located?

Kimberly Mercer Etheredge practices at 4711 N Dixie Hwy Ste A, Oakland Park, FL 33334. The listed phone number is (954) 491-8127.

What is Kimberly Mercer Etheredge's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Kimberly Mercer Etheredge enrolled in Medicare?

Yes. Kimberly Mercer Etheredge 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 organization bills Medicare for Kimberly Mercer Etheredge's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Mercer Etheredge reassigns Medicare benefits to John C Theeck Dc PA (The Villages, FL). 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 Kimberly Mercer Etheredge'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 Kimberly Mercer Etheredge was last updated on March 24, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.