Active NPI
Kate-Marie Bleecker Ebersole, PA-C
- Physician Assistant
- Somerset, KY
National Provider Identifier
1205356441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 305 Langdon St
Somerset, KY 42503-2750 - Phone
- (606) 679-7441
- NPI assigned
- Jun 20, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
305 Langdon St
Somerset, KY 42503-2750
Mailing address
606 Ford Dr
Ferguson, KY 42533-9526
Phone (828) 508-2864
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY, TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sweetwater Hospital ER Physician Group | Current | Accepting new patients | |
| Sweetwater Hospital Association | Current | Accepting new patients | |
| Sweetwater Hospital Association | Physician Assistant | Past | Accepting new patients |
Locations
304 Church St
Sweetwater, TN 37874
Phone (865) 213-8200
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/sweet-8feb766f
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 and National Provider Directory roles.
-
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- Athens, TN
- NPI 1669414264
-
- Certified Registered Nurse Anesthetist
- Sweetwater, TN
- NPI 1629077532
-
- Rural Health Clinic/Center
- Sweetwater, TN
- NPI 1205659711
-
- Emergency Medicine Physician
- Sweetwater, TN
- NPI 1083613905
-
- Obstetrics & Gynecology Physician
- Sweetwater, TN
- NPI 1558995399
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497916800000",
"number": "1205356441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "606 FORD DR",
"city": "FERGUSON",
"state": "KY",
"postal_code": "425339526",
"telephone_number": "828-508-2864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 LANGDON ST",
"city": "SOMERSET",
"state": "KY",
"postal_code": "425032750",
"telephone_number": "606-679-7441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBERSOLE",
"first_name": "KATE-MARIE",
"middle_name": "BLEECKER",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-20",
"last_updated": "2017-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Somerset, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.