Individual provider Active NPI

Deborah D. Eberhart, P.A.

  • Medical Physician Assistant
  • Rockmart, GA
National Provider Identifier
1164437638
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
000696 Issued in GA
Practice address
1008 N Piedmont Ave
Rockmart, GA 30153-2526
Phone
(770) 684-7846
Fax
(770) 684-8294
NPI assigned
Jul 30, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 000696 GA Primary

Addresses

Primary practice location

1008 N Piedmont Ave
Rockmart, GA 30153-2526

Mailing address

420 E 2ND Ave
Suite 103
Rome, GA 30161-3224
Phone (706) 509-3278

Other identifiers 1

IdentifierTypeStateIssuer
00067064CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
696GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd Healthcare Management Inc Past Accepting new patients
Floyd Healthcare Management, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1164437638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E 2ND AVE",
            "address_2": "SUITE 103",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613224",
            "telephone_number": "706-509-3278",
            "fax_number": "706-509-4608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 N PIEDMONT AVE",
            "city": "ROCKMART",
            "state": "GA",
            "postal_code": "301532526",
            "telephone_number": "770-684-7846",
            "fax_number": "770-684-8294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERHART",
        "first_name": "DEBORAH",
        "middle_name": "D.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "000696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00067064C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockmart, GA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.