Individual provider Active NPI

Andrew Joseph Ebner, MD

  • Child & Adolescent Psychiatry Physician
  • Atlanta, GA
National Provider Identifier
1073001871
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
91998 Issued in GA
Practice address
1605 Chantilly Dr NE
Atlanta, GA 30324-3267
Phone
(404) 785-7878
NPI assigned
Apr 26, 2018
Last updated
Sep 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 91998 GA Primary

Addresses

Primary practice location

1605 Chantilly Dr NE
Atlanta, GA 30324-3267

Mailing address

1575 Northeast Expy NE
Brookhaven, GA 30329-2317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240219001843 GA Practitioner - Psychiatry 9638428758 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Current Accepting new patients
Emory Medical Care Foundation Inc Child & Adolescent Psychiatry CurrentSince Feb 7, 2024 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Feb 7, 2024 Accepting new patients

Locations

12 Executive Park Dr NE
Ste 331
Atlanta, GA 30329
Phone (404) 727-5157

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1073001871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 NORTHEAST EXPY NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 CHANTILLY DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303243267",
            "telephone_number": "404-785-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBNER",
        "first_name": "ANDREW",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-26",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "GA",
            "license": "91998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.