Mary Ellen Ebersole

Primary specialty

SpecialistTaxonomy code 174400000X

License

E01074 Issued in MD

Practice address

10632 Little Patuxent Pkwy Ste 441
Columbia, MD 21044-6260

Phone

(410) 720-4245

NPI assigned

Aug 3, 2022

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1730816471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11038 MONTGOMERY RD",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207052816",
            "telephone_number": "301-704-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10632 LITTLE PATUXENT PKWY STE 441",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210446260",
            "telephone_number": "410-720-4245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9811 Mallard Dr Ste 215",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MD",
            "postal_code": "207083199",
            "country_code": "US",
            "telephone_number": "301-498-6279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBERSOLE",
        "first_name": "MARY ELLEN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "E01074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Eason, LCSWC
• Eating Disorders Center of Columbia Maryland
• Amy Lynn Eaton Bustillos, RN
• Stacy Eberling, RDH
• Abigail Lyn Eberman
• Rose Egbe Eboule, HHA
• David Echeverria
• Yadira Echeverria, R,N.
• Ashley Ecker
• Elizabeth Ann Edelen, RN

• Specialist in Columbia, MD
• Providers in Columbia, MD by specialty
• Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.