Ebsc, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

EBSC, LLC

Practice address

750 East Beltline NE
Grand Rapids, MI 49525-6049

Phone

(616) 940-3600

Fax

(616) 954-0213

NPI assigned

Oct 18, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Kristine Patrice Kilgore, RN BSN

Title

Administratice Director

Phone

(616) 580-6520

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Surgical Care Center of Michigan Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Listed as

Surgical Care Center of MichiganCCN 23C0001020

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel M Miller, MD

  • Ophthalmology Physician
  • Cincinnati, OH
  • NPI 1487681987
  NPD
• James Wachter, O.D.

  • Optometrist
  • Ellisville, MO
  • NPI 1689670697
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609632000000",
    "number": "1700967106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 EAST BELTLINE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256049",
            "telephone_number": "616-940-3600",
            "fax_number": "616-954-0216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 EAST BELTLINE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256049",
            "telephone_number": "616-940-3600",
            "fax_number": "616-954-0213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBSC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2021-01-03",
        "certification_date": "2021-01-03",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_middle_name": "PATRICE",
        "authorized_official_title_or_position": "ADMINISTRATICE DIRECTOR",
        "authorized_official_telephone_number": "616-580-6520",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN BSN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "490001454",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgical Care Center of Michigan",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Surgical Care Center of Michigan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gabrielle Laura Eberly
• Gresha L Eberly
• Kassie Ebert
• Matthew J. Ebright, MD
• John Stephen Ebrom, MD
• Melissa Eccher, LPC, LMHC, IADC, RN
• Allison Eckert
• Kathryn Eckert, LMSW
• Stephanie Eckstein, PA-C
• Ecs Western Michigan PC

• 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 Jan 3, 2021; 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.