NPIMap

Ebony Eddy, PA-C

Individual provider Active NPI Physician Assistant · West River, MD

NPI 1144097973 · NPPES record last updated Aug 6, 2026

Key facts

NPI
1144097973
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
C0009500 (MD)
Practice address
134 Owensville Rd
West River, MD 20778-9702
Phone
(410) 867-4700
NPI assigned
Dec 12, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 24

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

Hospital & facility affiliations 4

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

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Three Lower Counties Community Services Inc (74 clinicians)

Practice addresses (Care Compare)

32033 Beaver Run Dr
Salisbury, MD 21804-1773
Phone (410) 749-1015

Hospital & facility affiliations

  • Homecall Home health agency · Easton, MD · CCN 217066
  • Tidalhealth Home Care Home health agency · Salisbury, MD · CCN 217079
  • Adoration Home Health Home health agency · Salisbury, MD · CCN 217111
  • Tidalhealth Peninsula Regional, Inc Hospital · Salisbury, MD · CCN 210019

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20241017003276 MD Practitioner - Physician Assistant 1759813546 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Three Lower Counties Community Services, Inc. Current
since Oct 14, 2024		 Accepting new patients
Three Lower Counties Community Services, Inc. Current
since Oct 14, 2024		 Accepting new patients
Three Lower Counties Community Services Inc Current Accepting new patients

Locations

12145 Elm St
Princess Anne, MD 21853
Phone (410) 651-2204

12137 Elm St
Princess Anne, MD 21853
Phone (410) 651-1000

1665 Woodbrooke Dr
Salisbury, MD 21804
Phone (410) 546-6650

Interoperability endpoints

  • Direct secure messaging: ebony.eddy.1@3167.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0009500 MD Yes

Addresses

Primary practice location

134 Owensville Rd
West River, MD 20778-9702

Mailing address

134 Owensville Rd
West River, MD 20778-9702
Phone (410) 867-4700

Other practice location 1

5408 Southern Maryland Blvd
Lothian, MD 20711-2601
Phone (410) 867-4700

Other practice location 2

6131 Shady Side Rd
Shady Side, MD 20764-9504
Phone (410) 867-4700

Other identifiers

IdentifierTypeStateIssuer
119591300MedicaidMD

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 6, 2026.

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1144097973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 OWENSVILLE RD",
            "city": "WEST RIVER",
            "state": "MD",
            "postal_code": "207789702",
            "telephone_number": "410-867-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 OWENSVILLE RD",
            "city": "WEST RIVER",
            "state": "MD",
            "postal_code": "207789702",
            "telephone_number": "410-867-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5408 Southern Maryland Blvd",
            "address_purpose": "LOCATION",
            "city": "Lothian",
            "state": "MD",
            "postal_code": "207112601",
            "country_code": "US",
            "telephone_number": "410-867-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6131 Shady Side Rd",
            "address_purpose": "LOCATION",
            "city": "Shady Side",
            "state": "MD",
            "postal_code": "207649504",
            "country_code": "US",
            "telephone_number": "410-867-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDDY",
        "first_name": "EBONY",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-12",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0009500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West River, MD

All providers in West River, MD · Physician Assistant in Maryland

Sources for this page

Verify at the official NPI Registry.