Jana Ebbert, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

81620 Issued in SC

Practice address

999 Cheraw St
Bennettsville, SC 29512-2420

Phone

(843) 479-2341

Fax

(843) 479-2346

NPI assigned

Mar 8, 2014

Last updated

Mar 6, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Lifesource of North Carolina

  • General Practice Physician
  • Clinton, SC
  • NPI 1972861789

  Multi-Specialty

  NPD
• Lifesource of North Carolina

  • Psychologist
  • Milton, FL
  • NPI 1730648288

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1394236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1417373986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 S WELLS ST",
            "city": "SISTERSVILLE",
            "state": "WV",
            "postal_code": "261751098",
            "telephone_number": "304-652-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 CHERAW ST",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "295122420",
            "telephone_number": "843-479-2341",
            "fax_number": "843-479-2346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17540 E Main St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "MS",
            "postal_code": "393390470",
            "country_code": "US",
            "telephone_number": "662-773-3503",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 N 4th St",
            "address_2": "4th and Willow Street",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170465606",
            "country_code": "US",
            "telephone_number": "717-274-0474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17540 E Main St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "MS",
            "postal_code": "393390470",
            "country_code": "US",
            "telephone_number": "662-773-3503",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "314 S Wells St",
            "address_purpose": "LOCATION",
            "city": "Sistersville",
            "state": "WV",
            "postal_code": "26175",
            "country_code": "US",
            "telephone_number": "304-652-2611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "939 Springdale Dr",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "SC",
            "postal_code": "293257266",
            "country_code": "US",
            "telephone_number": "910-742-9243",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3205 Randall Pkwy Ste 105",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284032565",
            "country_code": "US",
            "telephone_number": "910-742-9243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBBERT",
        "first_name": "JANA",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-08",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "3393",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "25215",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "81620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Bennettsville, SC
• Providers in Bennettsville, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.