Active NPI
Dana Ebb, DO
- Sports Medicine (Family Medicine) Physician
- Tupelo, MS
National Provider Identifier
1609508167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- License
- 34179
- Practice address
- 499 Gloster Creek VLG Ste G1
Tupelo, MS 38801-4751 - Phone
- (662) 377-2663
- Fax
- (662) 377-6706
- NPI assigned
- Jun 24, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician | 207QS0010X | DO4260 | AL | |
| Family Medicine Physician | 207Q00000X | DO4260 | AL | |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 34179 | MS | Primary |
Addresses
Primary practice location
499 Gloster Creek VLG Ste G1
Tupelo, MS 38801-4751
Mailing address
499 Gloster Creek VLG Ste G1
Tupelo, MS 38801-4751
Phone (662) 377-2663
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL, MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250821003972 | AL | Practitioner - Family Practice | 8325420813 | Reassigns benefits to 1 organization |
| I20260519003084 | MS | Practitioner - Sports Medicine | 8325420813 |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Pikeville, Kentucky College of Osteopathic Med, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Capstone Health Services Foundation PC
Practice addresses (Care Compare)
850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7457
Phone (205) 348-1770
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO4260 | AL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Capstone Health Services Foundation PC | Current | Accepting new patients | |
| Capstone Health Services Foundation PC | Family Medicine | Current | Accepting new patients |
Locations
850 Peter Bryce Blvd
Tuscaloosa, AL 35401
Interoperability endpoints
- dana.huttondo.p1@direct.umc.nextgenshare.com
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Tuscaloosa, AL
- NPI 1740397751
AL, Family Medicine
-
- Neurology Physician
- Tuscaloosa, AL
- NPI 1255212353
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786492800000",
"number": "1609508167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "499 GLOSTER CREEK VLG STE G1",
"city": "TUPELO",
"state": "MS",
"postal_code": "388014751",
"telephone_number": "662-377-2663",
"fax_number": "662-377-6706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "499 GLOSTER CREEK VLG STE G1",
"city": "TUPELO",
"state": "MS",
"postal_code": "388014751",
"telephone_number": "662-377-2663",
"fax_number": "662-377-6706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBB",
"first_name": "DANA",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-24",
"last_updated": "2026-08-12",
"certification_date": "2026-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "AL",
"license": "DO4260",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AL",
"license": "DO4260",
"primary": false
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "MS",
"license": "34179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.