Na؉ /H ؉ exchanger regulatory factor (NHERF) is an adapter protein that is responsible for organizing a number of cell receptors and channels. NHERF contains two amino-terminal PDZ (postsynaptic density 95/disk-large/zonula occluden-1) domains that bind to the cytoplasmic domains of a number of membrane channels or receptors. The carboxyl terminus of NHERF interacts with the FERM domain (a domain shared by protein 4.1, ezrin, radixin, and moesin) of a family of actin-binding proteins, ezrin-radixin-moesin. NHERF was shown previously to be capable of enhancing the channel activities of cystic fibrosis transmembrane conductance regulator (CFTR). Here we show that binding of the FERM domain of ezrin to NHERF regulates the cooperative binding of NHERF to bring two cytoplasmic tails of CFTR into spatial proximity to each other. We find that ezrin binding activates the second PDZ domain of NHERF to interact with the cytoplasmic tails of CFTR (C-CFTR), so as to form a specific 2:1:1 (C-CFTR) 2 ⅐NHERF⅐ezrin ternary complex. Without ezrin binding, the cytoplasmic tail of CFTR only interacts strongly with the first amino-terminal PDZ domain to form a 1:1 C-CFTR⅐NHERF complex. Immunoprecipitation and immunoblotting confirm the specific interactions of NHERF with the full-length CFTR and with ezrin in vivo. Because of the concentrated distribution of ezrin and NHERF in the apical membrane regions of epithelial cells and the diverse binding partners for the NHERF PDZ domains, the regulation of NHERF by ezrin may be employed as a general mechanism to assemble channels and receptors in the membrane cytoskeleton.Na ϩ /H ϩ exchanger regulator factor (NHERF) 2 is an adaptor protein that is responsible for organizing membrane channels and receptors (1, 2). NHERF was originally identified as an essential cofactor for inhibiting a transmembrane transporter sodium-hydrogen exchanger isoform 3 (NHE3) by the cAMP-dependent protein kinase A in the kidney proximal tubule cells (1). However, subsequent studies find that NHERF is densely distributed in the apical membranes of polarized epithelial cells of several mammalian tissues (2, 3) and that NHERF participates in organizing the trafficking, localization, and membrane targeting of a large number of membrane receptors and channels to which NHERF binds (3)(4)(5)(6)(7)(8)(9)(10)(11)(12).NHERF is a multidomain and multivalent protein that recruits different signaling partners. The amino terminus of NHERF contains two modular PDZ (name derived from the first three proteins that this domain was identified postsynaptic density 95/disk-large/zonula occluden-1) domains, PDZ1 and PDZ2 (see Fig. 1). The NHERF PDZ domains bind to the consensus PDZ-binding motif D(S/T)X(V/I/L) (X denoting any amino acid residue) at the carboxyl termini of a number of membrane channels or receptors (13)(14)(15)(16)(17)(18)(19). The carboxyl terminus of NHERF recognizes the FERM domain (a conserved domain that is shared by protein 4.1, ezrin, radixin, and moesin) of a family of cytoskeletal actin-binding proteins, ez...