Individual provider Active NPI

Celso T Ebeo, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Johnson City, TN
National Provider Identifier
1104812734
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
41941 Issued in TN
Practice address
310 N State of Franklin Rd Ste 303
Johnson City, TN 37604-6051
Phone
(423) 926-8181
Fax
(423) 926-4421
NPI assigned
Sep 20, 2005
Last updated
Jun 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 41941 TN Primary
Pulmonary Disease Physician 207RP1001X 41941 TN
Sleep Medicine (Internal Medicine) Physician 207RS0012X 41941 TN

Addresses

Primary practice location

310 N State of Franklin Rd Ste 303
Johnson City, TN 37604-6051

Mailing address

310 N State of Franklin Rd Ste 303
Johnson City, TN 37604-6051
Phone (423) 926-8181

Other identifiers 5

IdentifierTypeStateIssuer
64070527MedicaidKY
1104812734MedicaidVA
1841829000MedicaidWV
3000405MedicaidTN
010036186MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20070822000366 TN Practitioner - Pulmonary DiseasePractitioner - Sleep Medicine 4789631870 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Sleep Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of Franklin Healthcare Associates, PLLCGroup PAC ID 2466346291, 258 clinicians

Practice addresses (Care Compare)

310 N State of Franklin Rd
Suite 303
Johnson City, TN 37604-6051
Phone (423) 926-8181

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Franklin Healthcare Associates PLLC Internal Medicine CurrentSince Aug 9, 2024 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Nov 2, 2011 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Nov 2, 2011 Accepting new patients
Pulmonary Associates of East Tennessee, P.C. Pulmonary Disease CurrentSince Jul 16, 2007 Accepting new patients

Locations

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

2 Professional Park Dr
Ste 15
Johnson City, TN 37604
Phone (423) 232-4867

310 N State of Franklin Rd
Ste 303
Johnson City, TN 37604
Phone (423) 926-8181

313 Princeton Rd
Ste 3
Johnson City, TN 37601
Phone (423) 282-4819

4 Limited Centre St
Ste 103
Johnson City, TN 37604
Phone (423) 794-5890

400 N State of Franklin Rd
Rm 2746
Johnson City, TN 37604
Phone (423) 431-2727

444 Clinchfield St
Ste 201
Kingsport, TN 37660
Phone (423) 230-2100

Interoperability endpoints

  • Direct secure messaging: celsoebeo@paetn.allscriptsdirect.net
  • Direct secure messaging: celsoebeo@sofha.allscriptsdirect.net
  • FHIR API: https://api.platform.athenahealth.com/24871/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1104812734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N STATE OF FRANKLIN RD STE 303",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046051",
            "telephone_number": "423-926-8181",
            "fax_number": "423-926-4421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N STATE OF FRANKLIN RD STE 303",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046051",
            "telephone_number": "423-926-8181",
            "fax_number": "423-926-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBEO",
        "first_name": "CELSO",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TN",
            "license": "41941",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TN",
            "license": "41941",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "TN",
            "license": "41941",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64070527",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104812734",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841829000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3000405",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010036186",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.