JENNIFER DAWN EBERSOLE (ARNP) – Physician Assistant, NPI 1245283951

JENNIFER DAWN EBERSOLE (ARNP) is a healthcare provider. based in Liberal, Kansas. specializing in NURSE PRACTITIONER. They hold the professional credentials ARNP. They hold a License No. 53-45719-111 (KS). The NPI Number for JENNIFER DAWN EBERSOLE (ARNP) is 1245283951

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER DAWN EBERSOLE (ARNP)
NPI
1245283951
Phone
(620) 236-3125
Address
305 W 15TH ST STE 103
Enumeration Date
17 May 2006
Last Update Date
19 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7018005110
Graduation Year
2005 (21 years ago)
PAC ID
6406983089
Group Practice PAC ID
6901221597
Professional Enrollment ID
I20100430000250
Address ID
KS679012455LI305XXSTXX407
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,551 NURSE PRACTITIONER in KS

Provider Addresses for JENNIFER DAWN EBERSOLE (ARNP)

  • 305 W 15TH ST STE 103

    LIBERAL, KS 679012455

    Phone: (620) 236-3125

    Type: Location

  • 1700 Avenue F

    Dodge City, KS 678014541

    Phone: (620) 225-6621

    Type: Location

  • 202, West la Mesa Drive, Dodge City, Ford County, Kansas, 67801, United States

    DODGE CITY, KS 678012838

    Phone: (620) 225-6821

    Type: Mailing

  • Avenue F, Dodge City, Ford County, Kansas, 67801, United States

    DODGE CITY, KS 678014541

    Phone: (620) 225-6621

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-04-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100430000250INurse PractitionerKSTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 67901)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6901221597View full group profile
NameSpecialtyState
D E R M A T O L O G YND
Nurse PractitionerNC
Nurse PractitionerND
Nurse PractitionerND
Physician AssistantCO

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Frequently asked questions

Does JENNIFER DAWN EBERSOLE (ARNP) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — JENNIFER DAWN EBERSOLE (ARNP) uses 1245283951.
Is JENNIFER DAWN EBERSOLE (ARNP) still practicing?
JENNIFER DAWN EBERSOLE (ARNP) is currently listed as active in the public NPI registry.
What taxonomy line describes JENNIFER DAWN EBERSOLE (ARNP)?
For research purposes, treat JENNIFER DAWN EBERSOLE (ARNP) as Physician Assistant in this dataset. Clinical services aligned with this taxonomy classification.
Where is JENNIFER DAWN EBERSOLE (ARNP) based?
JENNIFER DAWN EBERSOLE (ARNP) is tied to Liberal, Kansas in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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