Andrew Jackson Etheridge IV, CCA, CFO, CFM, CPED
NPI 1487246369ActiveIndividual· Anaplastologist· Baltimore, MD
Anaplastologist (CCA, CFO, CFM, CPED) in Baltimore, Maryland, with an NPI issued in February 2021.
Overview
| NPI | 1487246369 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | CCA, CFO, CFM, CPED |
| Sole proprietor | No |
| NPI issued | Feb 11, 2021 |
| Last updated in NPPES | Aug 30, 2022 |
| Certified by provider | Aug 30, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Anaplastologist Primary | 229N00000X | — | — |
| Technician/Technologist, Ocularist | 156FX1700X | — | — |
| Mastectomy Fitter | 224900000X | — | — |
| Pedorthist | 224L00000X | — | — |
| Orthotic Fitter | 225000000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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