MRS. AUDREY DALE ETHRIDGE PMHNP-BC, MSN
NPI 1982484416
Nurse Practitioner - Psychiatric/Mental Health in Tupelo, MS

Active since October 02, 2023PECOS EnrolledAccepts Medicare Assignment
777 HOLLY HILL DR, TUPELO, MS 38801(662) 432-1221(888) 836-0702 Get Directions Write a Review

NPPES record last updated: January 30, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mrs. Audrey Dale Ethridge Pmhnp-bc, Msn NPPES

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

MRS. AUDREY DALE ETHRIDGE PMHNP-BC, MSN (NPI 1982484416) is an individual psychiatric/mental health provider in Tupelo, Mississippi, licensed in Mariana Islands (2023001592) and active in the NPI registry since October 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1982484416
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMRS. AUDREY DALE ETHRIDGECredential: PMHNP-BC, MSN
Location Address777 HOLLY HILL DRTupelo, MS 38801-2340
Mailing Address777 Holly Hill DrTupelo, MS 38801-2340 · (662) 432-1221 · Fax (888) 836-1221
Fax(888) 836-0702
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateOctober 2, 2023
Last NPPES UpdateJanuary 30, 2024
NPPES CertifiedJanuary 30, 2024
NPI 1982484416 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License Licensed in MP · 2023001592
777 HOLLY HILL DR, Tupelo, MS 38801

Accepted 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

Mrs. Audrey Dale Ethridge Pmhnp-bc, Msn 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 ID5597203307
PECOS Enrollment IDI20240812002247
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38801 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
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
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

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

Psychiatry & Neurology (Psychiatry)
777 HOLLY HILL DR
TUPELO, MS 38801

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1982484416, enumerated as an "individual" on October 02, 2023.

The provider is located at 777 HOLLY HILL DR TUPELO, MS 38801 and the phone number is (662) 432-1221.

Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.

The provider might be accepting Accepts: Oscar Health Plan, Inc. and UnitedHealthcare. Please consult your insurance carrier or call the provider to verify.