Lori Nicole Ebenkamp, APRN, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP139365 Issued in TX

Practice address

1915 Mayfield Road #115
Arlington, TX 76014-2605

Phone

(682) 276-6700

NPI assigned

Dec 3, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Rainbow Children'S Clinic Mayfield, PA

  • Pediatrics Physician
  • Arlington, TX
  • NPI 1598144768
  NPD (past)
• Rainbow Children'S Clinic, P.a.

  • Pediatrics Physician
  • Arlington, TX
  • NPI 1174828289
  NPD (past)

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1497225478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 E MAYFIELD RD STE 115",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760142605",
            "telephone_number": "682-276-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 MAYFIELD ROAD #115",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760142605",
            "telephone_number": "682-276-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBENKAMP",
        "first_name": "LORI",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "APRN, CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-03",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "747314",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP139365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RX AUTHORIZATION",
            "identifier": "28150",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "AP139365",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "747314",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Park Pharmacy Inc
• Patricia Kyndall Easterling
• Joe Aaron Eastham, L.M.F.T, L.P.C.
• Eastland Memorial Hospital District
• Malena Eaves, ATC, LAT
• Yvonne Mokou Ebot
• Rael Okoth Eckenroed, FNP-C
• Jan J Eckhart, NP
• Eddie Ette
• Sanna Eddie, LPC

• Pediatric Nurse Practitioner in Arlington, TX
• Providers in Arlington, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.