John Timothy Ebert, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

31114 Issued in KY

Practice address

105B West 18TH Street
Hopkinsville, KY 42240

Phone

(270) 889-0567

Fax

(270) 889-9048

NPI assigned

Jan 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1114071255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1313",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "42241",
            "telephone_number": "270-889-0567",
            "fax_number": "270-889-9048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105B WEST 18TH STREET",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "42240",
            "telephone_number": "270-889-0567",
            "fax_number": "270-889-9048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERT",
        "first_name": "JOHN",
        "middle_name": "TIMOTHY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "31114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64311145",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000054212",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dva Renal Healthcare Inc (Hopkinsville Dialysis)
• Donna B Dyer, DPH
• Lauren Kyle Eaker, MSN, AGPCNP-BC
• Cody Earl
• Holden East
• Mark Anthony Edmonds
• Mark Joseph Edmunds, D.P.M.
• Lydia Edwards
• Ryneka Edwards
• Jonathan Joseph Eisenhauer, PTA

• Neurology Physician in Hopkinsville, KY
• Providers in Hopkinsville, KY by specialty
• Neurology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.