Ebg Health Care II, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

031678 Issued in MO

Legal business name

EBG HEALTH CARE II, INC.

Doing business as

St. Louis Avenue Nursing Center

Practice address

2900 N Prairie Ave
Saint Louis, MO 63107-2302

Phone

(314) 652-6111

Fax

(314) 652-1575

NPI assigned

Apr 12, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Carol L Gourley

Title

Chief Financial Officer

Phone

(417) 869-5522

Specialties & licenses 1

Addresses

Other names 1

• St. Louis Avenue Nursing Center Doing business as

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558585240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 E TRAFFICWAY ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658023174",
            "telephone_number": "417-869-5522",
            "fax_number": "417-831-7729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N PRAIRIE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631072302",
            "telephone_number": "314-652-6111",
            "fax_number": "314-652-1575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBG HEALTH CARE II, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOURLEY",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "417-869-5522",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "031678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Louis Avenue Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Trina G Ebersole, MD
• Alan A Ebert, CRNA
• Jamison Ebert, AGNP
• David Patrick Ebertz, MD
• Ebg Health Care I, Inc. (Garrison Care Center)
• Mohsen Sobhi Ebrahim, D.M.D.
• Brendan Thomas Eby, MD
• Charles S Eby, MD
• Jason Eccker, LCSW
• Mara Ada Eccles, MD

• Skilled Nursing Facility in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Skilled Nursing Facility in Missouri

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.