Individual provider Active NPI

Ebony N. Raymond, D.O.

  • Internal Medicine Physician
  • Plano, TX
National Provider Identifier
1609230812
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
S1243 Issued in TX
Practice address
3105 W 15TH St Ste E
Plano, TX 75075
Phone
(469) 597-7281
NPI assigned
Apr 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X S1243 TX
Internal Medicine Physician 207R00000X S1243 TX Primary
General Practice Physician 208D00000X S1243 TX

Addresses

Primary practice location

3105 W 15TH St Ste E
Plano, TX 75075

Mailing address

P.O. Box 961205
Fort Worth, TX 76161-1205
Phone (177) 408-4008

Other practice location 1

3105 W 15th St Ste E
Plano, TX 75075
Phone (214) 471-0953

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190822002634 TX Practitioner - Internal Medicine 1759678295 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
William Carey University College of Osteopathic Medicine, 2016
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

112 S Covington St
Hillsboro, TX 76445-3214

14850 Montfort Dr
Suite 181 LB 11
Dallas, TX 75254-7077

14850 Montfort Dr 181 LB
Suite 11
Dallas, TX 75254-7077

15 Grumman Rd W
Suite 1400
Bethpage, NY 11714-5029

17195 Silver Pkwy
Suite 133
Fenton, MI 48430-3426

2821 Lackland Rd
Suite 300
Fort Worth, TX 76116-4178

4500 S Garnett Rd
Suite 919
Tulsa, OK 74146-5214

4535 Dressier Rd NW
Canton, OH 44718-2545

5410 Maryland Way
Suite 300
Brentwood, TN 37027-5339

5575 DTC Pkwy
Suite 225
Greenwood Village, CO 80111-3073

78 Regency Pkwy
Mansfield, TX 76063-7816

8655 Brookhollow Blvd
Apt 5106
Frisco, TX 75034-0119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Hni Physician Services of Texas, Inc Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Dec 10, 2020 Accepting new patients
Usacs Integrated Acute Care Services of Texas, PLLC Internal Medicine CurrentSince Aug 8, 2023 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Cogent Healthcare of Texas, PA Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Concord Medical Group PLLC CurrentSince Dec 10, 2020 Accepting new patients

Locations

1501 S Coulter St
Amarillo, TX 79106
Phone (800) 354-1150

3501 Mills Ave
Austin, TX 78731
Phone (512) 324-1017

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

260 Cully Dr
Kerrville, TX 78028
Phone (830) 258-7323

10700 McPherson Rd
Laredo, TX 78045
Phone (956) 523-2190

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1609230812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 961205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761611205",
            "telephone_number": "177-408-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 W 15TH ST STE E",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75075",
            "telephone_number": "469-597-7281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3105 W 15th St Ste E",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "75075",
            "country_code": "US",
            "telephone_number": "214-471-0953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAYMOND",
        "first_name": "EBONY",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "S1243",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S1243",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "S1243",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.