Individual provider Active NPI

Audelia Eben, DO

  • Student in an Organized Health Care Education/Training Program
  • Kirksville, MO
National Provider Identifier
1942905583
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1316 Country Club Dr
Kirksville, MO 63501-5362
Phone
(660) 627-7546
NPI assigned
Apr 3, 2023
Last updated
Sep 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

1316 Country Club Dr
Kirksville, MO 63501-5362

Mailing address

1316 Country Club Dr
Kirksville, MO 63501-5362

Other names 1

  • Audelia Eben Professional name

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)
Not enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Cleaver Dermatology PC CurrentSince Sep 29, 2024 Accepting new patients
Lloyd J. Cleaver, D.O., L.L.C. CurrentSince Sep 29, 2024 Accepting new patients

Locations

1316 Country Club Dr
Kirksville, MO 63501
Phone (660) 627-7546

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1942905583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 COUNTRY CLUB DR",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635015362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 COUNTRY CLUB DR",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635015362",
            "telephone_number": "660-627-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBEN",
        "first_name": "AUDELIA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDELIA",
            "last_name": "EBEN",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Kirksville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.