Individual provider Active NPI

Dana Marie Ebeling, FNP-C, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1114353588
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1046802 Issued in TX
Practice address
18707 Hardy Oak Blvd Ste 105
San Antonio, TX 78258-4792
Phone
(855) 204-2502
Fax
(512) 777-3193
NPI assigned
Sep 17, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1046802 TX
Family Nurse Practitioner 363LF0000X 0024171160 VA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1046802 TX Primary

Addresses

Primary practice location

18707 Hardy Oak Blvd Ste 105
San Antonio, TX 78258-4792

Mailing address

368 Martingale Trail
Bandera, TX 78003
Phone (830) 328-6002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131205000011 VA Practitioner - Nurse Practitioner 4082840673 Reassigns benefits to 1 organization
I20210818000158 TX Practitioner - Nurse Practitioner 4082840673 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Continuity Mental Health PLLCGroup PAC ID 1557899556, 11 clinicians

Practice addresses (Care Compare)

539 W Commerce St
Dallas, TX 75208-1953
Phone (469) 678-8787

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1046802TXMDFamily Nurse Practitioner
0024171160VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Continuity Mental Health, PLLC CurrentSince Nov 7, 2024 Accepting new patients
Kotel Atx PLLC CurrentSince Nov 15, 2021 Accepting new patients
Mellow Medical Inc a Professional Corporation CurrentSince Feb 1, 2023 Accepting new patients
Tele-Physicians, P.C. Past Accepting new patients

Locations

12301 Wilshire Blvd
Ste 512
Los Angeles, CA 90025
Phone (888) 284-2779

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

8235 Santa Monica Blvd
Ste 302
West Hollywood, CA 90046
Phone (310) 892-4284

539 W Commerce St
Dallas, TX 75208
Phone (385) 377-9352

18707 Hardy Oak Blvd
Ste 105
San Antonio, TX 78258
Phone (512) 610-8067

3001 Bee Caves Rd
Ste 220
West Lake Hills, TX 78746

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1114353588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 MARTINGALE TRAIL",
            "city": "BANDERA",
            "state": "TX",
            "postal_code": "78003",
            "telephone_number": "830-328-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18707 HARDY OAK BLVD STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584792",
            "telephone_number": "855-204-2502",
            "fax_number": "512-777-3193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBELING",
        "first_name": "DANA",
        "middle_name": "MARIE",
        "credential": "FNP-C, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1046802",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024171160",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1046802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.