East Paris Surgical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

416834 Issued in MI

Legal business name

EAST PARIS SURGICAL CENTER, LLC

Practice address

1000 E Paris Ave SE
Suite LL01
Grand Rapids, MI 49546-3680

Phone

(616) 464-3430

Fax

(616) 464-3440

NPI assigned

Feb 10, 2006

Organization subpart

No

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

Authorized official

Name

Kathy J Mosley, BS

Title

Facility Administrator

Phone

(616) 949-2001

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Listed as

East Paris Surgical Center LLCCCN 23C0001053

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David D Verdier, M.D.

  • Ophthalmology Physician
  • Grand Rapids, MI
  • NPI 1588637433
  NPD
• Kyle McKey

  • Cornea and External Diseases Specialist Physician
  • Grand Rapids, MI
  • NPI 1205360062
  NPD (past)

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194798959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E PARIS AVE SE",
            "address_2": "SUITE LL01",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463680",
            "telephone_number": "616-464-3430",
            "fax_number": "616-464-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E PARIS AVE SE",
            "address_2": "SUITE LL01",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463680",
            "telephone_number": "616-464-3430",
            "fax_number": "616-464-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST PARIS SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOSLEY",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "FACILITY ADMINISTRATOR",
        "authorized_official_telephone_number": "616-949-2001",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MI",
            "license": "416834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Marie Eason, LMSW
• East Beltline Imaging PLC
• East Paris Dental Professionals PLC
• East Paris Internal Medicine Associates P.C
• East Paris Pharmacy Inc.
• Luke Eastburg, MD
• Mark Connar Eastburg, PH.D.
• Jessica Easterbrook, PA-C
• Eastern Clinic PLLC
• Eastern Dental PLC

• Ambulatory Surgical Clinic/Center in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Ambulatory Surgical Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.