Raven Ebanez, APRN-CNP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

59770 Issued in ID

Practice address

44 N 1St E
Preston, ID 83263-1326

Phone

(208) 852-2900

Fax

(208) 852-3511

NPI assigned

Mar 8, 2024

Last updated

May 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Franklin County Medical CenterGroup PAC ID 8820909104, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Franklin County Medical Center Hospital, Preston, ID, CCN 131322

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: raven.ebanez.1@17373.direct.athenahealth.com

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.

• Franklin County Medical Center

  dba FCMC Specialty Clinic

  • Critical Access Hospital
  • Preston, ID
  • NPI 1548355811

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Franklin County Medical Center

  dba Franklin County Medical Center Home Health and Hospice

  • Home Health Agency
  • Preston, ID
  • NPI 1437927431
  NPD
• Franklin County Medical Center

  dba FCMC Medical Clinic

  • Rural Health Clinic/Center
  • Preston, ID
  • NPI 1144663543
  NPD (past)

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

• Franklin County Medical Center

  dba FCMC Specialty Clinic

  • Critical Access Hospital
  • Preston, ID
  • NPI 1548355811
  Care Compare affiliation

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

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1265290837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 N 1ST E",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "832631326",
            "telephone_number": "208-852-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 N 1ST E",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "832631326",
            "telephone_number": "208-852-2900",
            "fax_number": "208-852-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBANEZ",
        "first_name": "RAVEN",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "59770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Crowther, RDN
• Corby M Dixon
• Dr. Jason B. Welker, D.C. P.C.
• Alyssa Dyer, LMSW
• Michael David Earley, DC
• Eye Care for You LLC
• Eye Care for You, P.C.
• Eyecare Specialties of Idaho PC
• Fellows Chiropractic LLC
• Cami Fellows

• Family Medicine Physician in Preston, ID
• Providers in Preston, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.