Ellen Grace Tebos, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2019047894 Issued in MI

Practice address

550 W Western Ave Apt 307
Muskegon, MI 49440-1086

Phone

(616) 914-9657

NPI assigned

Dec 11, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County Line Primary CareGroup PAC ID 0547691289, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County Line Primary Care

  • Rural Health Clinic/Center
  • Jackson, KY
  • NPI 1609378132
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1720626641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W WESTERN AVE APT 307",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494401086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W WESTERN AVE APT 307",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494401086",
            "telephone_number": "616-914-9657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEBOS",
        "first_name": "ELLEN",
        "middle_name": "GRACE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-11",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "2019047894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah K Taylor, NP
• Lynn Marie Taylor, COTA
• Paul Taylor, MD
• Preston Taylor, PHARMD, BCPS
• Sandra Taylor
• Dirk Teeter
• Katie Elizabeth Teichmer, LLMSW
• Scott Teichmer
• Tiffany K Temple
• Steven John Tenelshof, MD

• Family Nurse Practitioner in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.