DR. GARY LEE EBERLY (MD) – Emergency Medicine Physician, NPI 1003967639
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
886 EMERGENCY MEDICINE in KY
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Provider Addresses for DR. GARY LEE EBERLY (MD)
650 JOEL DR
FORT CAMPBELL, KY 422235318
Phone: (270) 798-8500
Type: Mailing
19713, 16th Avenue Court East, Spanaway, Pierce County, Washington, 98387, United States
SPANAWAY, WA 983878095
Phone: (253) 846-9419
Type: Mailing
Colonel Florence A Blanchfield Army Community Hospital, 650, Joel Drive, Clarksville, Montgomery County, Tennessee, 42223, United States
FORT CAMPBELL, KY 422235318
Phone: (270) 798-8500
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: 2025-11-25
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20251125004835 | I | Emergency Medicine | TN | TBD |
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.
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 42223)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | OH | |
| Emergency Medicine | FL | |
| Emergency Medicine | TN | |
| Emergency Medicine | TN | |
| Emergency Medicine | TN | |
| Emergency Medicine | KY | |
| - | LA | |
| Family Practice, Emergency Medicine | TN | |
| Nurse Practitioner | KY | |
| Family Practice, Family Practice, Emergency Medicine | TN |
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