JEAN EBERSOLE – Family Nurse Practitioner, NPI 1366252736

JEAN EBERSOLE is a healthcare provider. based in Aberdeen, Washington. specializing in NURSE PRACTITIONER. They hold a License No. AP61615826 (WA). The NPI Number for JEAN EBERSOLE is 1366252736

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
JEAN EBERSOLE
NPI
1366252736
Phone
(717) 271-4823
Address
722 WATER ST
Enumeration Date
8 January 2025
Last Update Date
8 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3605336063
Graduation Year
2024 (2 years ago)
PAC ID
3678099108
Group Practice PAC ID
4385164839
Professional Enrollment ID
I20250428004258
Address ID
WA985201055AB1020XDRXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

6,261 NURSE PRACTITIONER in WA

Provider Addresses for JEAN EBERSOLE

  • 722 WATER ST

    ABERDEEN, WA 985208040

    Phone: (717) 271-4823

    Type: Mailing

  • 1020 ANDERSON DR STE 203

    ABERDEEN, WA 985201055

    Phone: (360) 533-6063

    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: 2025-04-28

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
I20250428004258INurse PractitionerTXTBD

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 98520)

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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: 4385164839View full group profile
NameSpecialtyState
Family PracticeWA
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerWA
Mental Health CounselorCO
Nurse PractitionerWA

Reviews

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Frequently asked questions

Does JEAN EBERSOLE have a public NPI I can cite?
Public records show JEAN EBERSOLE under NPI 1366252736.
Should I treat JEAN EBERSOLE as an active provider?
Patients and plans typically see JEAN EBERSOLE as active in the national extract.
Which specialty label fits JEAN EBERSOLE?
NPPES ties JEAN EBERSOLE to Family Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit JEAN EBERSOLE in Aberdeen, Washington?
For routing, start with Aberdeen, Washington for JEAN EBERSOLE, then verify phone and hours locally.
Can I export JEAN EBERSOLE's record?
You can download the official NPPES record; we summarize key fields for readability.

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