Jean Ebersole

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61615826 Issued in WA

Practice address

1020 Anderson Dr Ste 203
Aberdeen, WA 98520-1055

Phone

(360) 533-6063

NPI assigned

Jan 8, 2025

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 TX

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Quinault Indian NationGroup PAC ID 4385164839, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grays Harbor Community Hospital Hospital, Aberdeen, WA, CCN 500031

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jean.ebersole.1@32702.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 and National Provider Directory roles.

• Quinault Indian Nation

  dba Quinault Community Health

  • Family Medicine Physician
  • Aberdeen, WA
  • NPI 1952131757

  TX

  Medicare reassignment Care Compare group NPD
• Fisher Family Medicine, PS

  • Clinic/Center
  • Aberdeen, WA
  • NPI 1679229223
  NPD
• Herdel Medical Services

  • Family Medicine Physician
  • Aberdeen, WA
  • NPI 1861756777
  NPD
• Juliette Erickson MD PS

  dba Juliette K Erickson MD

  • Family Medicine Physician
  • Aberdeen, WA
  • NPI 1710026448
  NPD

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

• Grays Harbor Community Hospital

  • General Acute Care Hospital
  • Aberdeen, WA
  • NPI 1154378859
  Care Compare affiliation

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

{
    "created_epoch": "1736294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1366252736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 WATER ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985208040",
            "telephone_number": "717-271-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 ANDERSON DR STE 203",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985201055",
            "telephone_number": "360-533-6063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERSOLE",
        "first_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-08",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61615826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Dunn, LPN
• Jack W Dutro, PH.D.
• Michele Dwyer, RN
• Annabel Louise Eaton-Forsythe
• Courtney Renee Eaton
• Lauren Echols, OTD, OTR/L
• Jeri-Lyn Beth Eddy, LMT
• Ehrmantrout & Obenchain, PLLC (Olympic Oral Surgery)
• Bethany J Elbon
• Emergency Physicians of Grays Harbor (David Jester, DO)

• Family Nurse Practitioner in Aberdeen, WA
• Providers in Aberdeen, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.