Individual provider Active NPI

John R. Ebensberger, MD

  • Emergency Medicine Physician
  • Greene, IA
National Provider Identifier
1073594339
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
21584 Issued in IA
Practice address
11779 Jay Ave
Greene, IA 50636-9023
Phone
(641) 823-4679
NPI assigned
Nov 14, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 21584 IA Primary

Addresses

Primary practice location

11779 Jay Ave
Greene, IA 50636-9023

Mailing address

11779 Jay Ave
Greene, IA 50636-9023
Phone (641) 823-4679

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20040805001140 IA Practitioner - Family Practice 7810968336 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21584IAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd County Memorial Hospital Commission Current Accepting new patients
Floyd County Memorial Hospital Commission Emergency Medicine CurrentSince Sep 1, 2025 Accepting new patients
Floyd County Memorial Hospital Commission CurrentSince Sep 1, 2025 Accepting new patients

Locations

800 11th St
Charles City, IA 50616
Phone (641) 228-6830

901 Montgomery St
Decorah, IA 52101
Phone (319) 382-2911

312 9th St SW
Waverly, IA 50677
Phone (319) 352-4120

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": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1073594339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11779 JAY AVE",
            "city": "GREENE",
            "state": "IA",
            "postal_code": "506369023",
            "telephone_number": "641-823-4679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11779 JAY AVE",
            "city": "GREENE",
            "state": "IA",
            "postal_code": "506369023",
            "telephone_number": "641-823-4679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBENSBERGER",
        "first_name": "JOHN",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "21584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greene, IA

Sources for this page

Verify at the official NPI Registry.