Active NPI
Emily Ann Ebert, M.D., M.P.H.
- Family Medicine Physician
- Colton, CA
National Provider Identifier
1730194127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A45022
- Practice address
- Arrowhead Regional Medical Center
400 N. Pepper Ave
Colton, CA 92324-1819 - Phone
- (909) 580-6240
- Fax
- (909) 580-6308
- NPI assigned
- Jul 31, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A45022 | CA | Primary |
Addresses
Primary practice location
Arrowhead Regional Medical Center
400 N. Pepper Ave
Colton, CA 92324-1819
Mailing address
P.O. Box 5157
San Bernardino, CA 92412-5157
Phone (909) 580-6240
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A450220 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A45022 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730194127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 5157",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924125157",
"telephone_number": "909-580-6240",
"fax_number": "909-580-6308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ARROWHEAD REGIONAL MEDICAL CENTER",
"address_2": "400 N. PEPPER AVE",
"city": "COLTON",
"state": "CA",
"postal_code": "923241819",
"telephone_number": "909-580-6240",
"fax_number": "909-580-6308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBERT",
"first_name": "EMILY",
"middle_name": "ANN",
"credential": "M.D., M.P.H.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A45022",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A450220",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Colton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.