Jessica Lynn Ebner, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

116547 Issued in OK

Practice address

1902 E Gore Blvd
Lawton, OK 73501-6102

Phone

(860) 480-6231

NPI assigned

Feb 25, 2020

Last updated

Feb 25, 2020By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Xgto Urgent Medical of Lawton, LLC

  dba WellFast Urgent Care Center East

  • Urgent Care Clinic/Center
  • Lawton, OK
  • NPI 1891027371
  Medicare reassignment NPD

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1497389738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 HAPPY HOLLOW LN",
            "city": "ELGIN",
            "state": "OK",
            "postal_code": "735382142",
            "telephone_number": "860-480-6231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 E GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735016102",
            "telephone_number": "860-480-6231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "249 Happy Hollow Ln",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "OK",
            "postal_code": "735382142",
            "country_code": "US",
            "telephone_number": "860-480-6231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBNER",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-25",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "116547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle East
• Eastside Clinic Pharmacy (Eastside Pharmacy)
• Eastside Clinic Pharmacy (Eastside Pharmacy LTC)
• Rachel Eberhardt
• Shayla Ebisch-Beavers, RBT
• Valarie Jean Eck, DPH
• Sena Ann Eckiwaudah
• Verlecia Eddy
• Marlene Michelle Edior-Garcia, ARNP
• Shicole Monique Edison, M.S.

• Family Nurse Practitioner in Lawton, OK
• Providers in Lawton, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; 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.