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EBO MD LLC
NPI 1326503376
Family Medicine in Cape Girardeau, MO

Active since February 04, 2019CLIA 26D2139419 · Waiver
1417 N MOUNT AUBURN RD STE A, CAPE GIRARDEAU, MO 63701(573) 803-2941(573) 803-0815 Get Directions Write a Review

NPPES record last updated: February 4, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ebo Md Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EBO MD LLC (NPI 1326503376) is a healthcare organization registered as a family medicine in Cape Girardeau, Missouri and active in the NPI registry since February 2019. The organization holds a CLIA Waiver certificate valid through November 2, 2027 and lists Genni L Ourth, Manager, as its authorized official.

NPPES Registry Identity

NPI1326503376
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameEBO MD LLC
Location Address1417 N MOUNT AUBURN RD STE ACape Girardeau, MO 63701-2171
Mailing Address1417 N Mount Auburn Rd Ste ACape Girardeau, MO 63701-2171 · (573) 803-2941 · Fax (573) 803-0815
Phone(573) 803-2941
Fax(573) 803-0815
Organization SubpartNo
Authorized OfficialGenni L OurthManager · (573) 803-2941
Enumeration DateFebruary 4, 2019
✔ NPI 1326503376 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1417 N MOUNT AUBURN RD STE A, Cape Girardeau, MO 63701
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2139419

Ebomd, LLC · Cape Girardeau, MO
Active · expires Nov 2, 2027
CLIA Number26D2139419
Laboratory TypePhysician Office
Certificate Effective DateNovember 3, 2025
Certificate Expiration DateNovember 2, 2027
Laboratory DirectorTony Thompson
Laboratory Phone(573) 803-2941
Laboratory LocationEbomd, LLC1417 North Mount Auburn, Cape Girardeau, MO 63701
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SHAHZAIB ANWAR MD
Family Medicine
1417 N MOUNT AUBURN RD STE A
CAPE GIRARDEAU, MO 63701
Cape Girardeau County (573) 803-2941
ILAH ELIZABETH YATES FNP-BC
Family Medicine
1417 N MOUNT AUBURN RD STE A
CAPE GIRARDEAU, MO 63701
Cape Girardeau County (573) 803-2941

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ebo MD LLC's NPI number?

The NPI number for Ebo MD LLC is 1326503376. It was assigned to this organization in the NPPES registry on February 4, 2019.

Where is Ebo MD LLC located?

Ebo MD LLC is located at 1417 N Mount Auburn Rd Ste A, Cape Girardeau, MO 63701. The listed phone number is (573) 803-2941.

What is Ebo MD LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Ebo MD LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2139419) is associated with this NPI, valid through November 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ebo MD LLC was last updated on February 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.