CAMERON KEITH ETHRIDGE (APRN) – Nurse Practitioner, NPI 1902361413
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CAMERON KEITH ETHRIDGE (APRN)
2308B W HIGHWAY 66
STROUD, OK 740796729
Phone: (918) 968-4469
Fax: (918) 987-1622
Type: Location
The Queen's Treasures, 777, North 5th Street, Arlington Heights, Stroudsburg, Monroe County, Pennsylvania, 18360, United States
STROUD, OK 740790777
Phone: (918) 290-9216
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $71.
Total Amount is formed as General ($71) + Research ($0) + Ownership ($0) = $71.
Last reported payment date: 2023-11-17 • Largest payer in this snapshot: Avion Pharmaceuticals ($47).
Total Amount
$71
General + Research + Ownership
Payments
3
Total payment records
General Amount
$71
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Avion Pharmaceuticals | $47 |
| Lundbeck LLC | $24 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-06-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190617000787 | I | Nurse Practitioner | OK | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 232 | 67 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 80 | 40 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 60 | 11 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 45 | 23 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 31 | 22 | $0 |
Insurance plans in this area (ZIP 74079)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OK | |
| Nurse Practitioner | OK | |
| - | OK | |
| General Practice | OK |
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