Active NPI
Richard A Ebbert, PA
- Physician Assistant
- Ashtabula, OH
National Provider Identifier
1851435580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50000092
- Practice address
- 2422 Lake Ave
Ashtabula, OH 44004-4985 - Phone
- (440) 998-3376
- Fax
- (440) 997-5751
- NPI assigned
- Feb 16, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50000092 | OH | Primary |
Addresses
Primary practice location
2422 Lake Ave
Ashtabula, OH 44004-4985
Mailing address
14381 Ford Rd
Madison, OH 44057-9562
Phone (440) 298-3714
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Hospital System, Inc | Past | Accepting new patients | |
| Lake Hospital System, Inc | Past | Accepting new patients |
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.
-
- Urgent Care Clinic/Center
- Madison, OH
- NPI 1134189376
-
- Urgent Care Clinic/Center
- Chardon, OH
- NPI 1689634966
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194307200000",
"number": "1851435580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14381 FORD RD",
"city": "MADISON",
"state": "OH",
"postal_code": "440579562",
"telephone_number": "440-298-3714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2422 LAKE AVE",
"city": "ASHTABULA",
"state": "OH",
"postal_code": "440044985",
"telephone_number": "440-998-3376",
"fax_number": "440-997-5751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBBERT",
"first_name": "RICHARD",
"middle_name": "A",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-16",
"last_updated": "2007-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50000092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ashtabula, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.