Ebe Healthcare, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

2517093 Issued in OH

Legal business name

EBE HEALTHCARE, LLC

Practice address

467 Waterbury CT
Gahanna, OH 43230-5313

Phone

(614) 414-0057

Fax

(614) 414-0052

NPI assigned

Aug 16, 2006

Organization subpart

No

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

Authorized official

Name

Nick Robert King

Title

Ceo

Phone

(614) 501-7802

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Home health agency certification: CCN 368075

Legal name

EBE HEALTHCARE, LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 13, 2004

Last certification

Mar 1, 2018

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

May 10, 2004 in OH

Enrollment address

467 Waterbury CT
Gahanna, OH 43230-5313

Listed as

Ebe Healthcare, LLCCCN 368075

Ownership

Proprietary

Certified

Oct 13, 2004

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478217600000",
    "number": "1821101601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 WATERBURY CT",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432305313",
            "telephone_number": "614-414-0057",
            "fax_number": "614-414-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "467 WATERBURY CT",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432305313",
            "telephone_number": "614-414-0057",
            "fax_number": "614-414-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBE HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2016-11-04",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "NICK",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "614-501-7802"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": "2517093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2517093",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn Renee Dupee, FNP-C
• Marie Josiane Dusabe
• Dwelling Place Counseling LLC
• George M Dyriw, PT, DPT, OCS, SCS
• Nicholas Jayme Eastman, MD
• Sasha Eby, DMD
• Echo Hospice of Ohio, LLC
• Melissa L. Edelmayer, MSW, LISW-S, LICDC
• Barbara Edison, LPN
• Edmiston Counseling LLC

• Home Health Agency in Gahanna, OH
• Providers in Gahanna, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.