JOHN STEPHEN EBROM (NPI# 1184636953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184636953 |
| Entity Type | Individual |
| Full Name | JOHN STEPHEN EBROM |
| Credential | MD |
| Practice Address |
200 Jefferson Ave Se Grand Rapids MI 49503 |
| Mailing Address |
Po Box 77000 Dept #77339 Detroit MI 48277-0339 |
| Practice Telephone | 6163646700 |
| Practice Fax Number | 6163644960 |
| Mailing Telephone | 6163646700 |
| Mailing Fax Number | 6163644960 |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2007-08-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0105X |
Pathology Specialization: Clinical Pathology/Laboratory Medicine |
4301044412 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4525177100 | 05 | |
| MI | RR MEDICARE | P00009267 | 01 |
| Street Address |
200 JEFFERSON AVE SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114929353 | Grand River Emergency Medical Group Plc | Emergency Medicine | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2005-06-01 |
| 1073130449 | Jessica Goldsworthy | Pharmacist | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-07-01 |
| 1851918551 | Lacy J Worden | Pharmacist | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-06-29 |
| 1669099560 | Kamah Ellena | Pharmacist | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-06-26 |
| 1629694344 | Yoad Yechiel Porat | Anesthesiology | 200 Jefferson Ave Se, Jefferson Suite 305, Grand Rapids, MI 49503 | 2020-06-18 |
| 1851917587 | Danuka Manupriya Ubayasena | Anesthesiology | 200 Jefferson Ave Se, Jefferson Suite 305, Grand Rapids, MI 49503 | 2020-06-18 |
| 1619593530 | Albert Dongzhou Jiao | Radiology | 200 Jefferson Ave Se, Jefferson Suite 360, Grand Rapids, MI 49503 | 2020-06-17 |
| 1548882046 | Rebecca Tourison | Registered Nurse | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-05-07 |
| 1942821079 | Breanne Nicole Ranucci | Physician Assistant | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-04-29 |
| 1750901757 | Nicholas Patrick Callahan | Registered Nurse | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496195 | Airway Oxygen, Inc. | Durable Medical Equipment & Medical Supplies | Lemmen Holton Cancer Pavilion, 145 Michigan St Ne Ste 3400, Grand Rapids, MI 49503 | 2020-10-27 |
| 1730707282 | Adriana Molina-schmuker | Counselor | 901 Eastern Avenue Ne, Grand Rapids, MI 49503 | 2020-07-10 |
| 1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
| 1124647805 | Jared Host | Speech-Language Pathologist | Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 | 2020-04-13 |
| 1265061378 | Heather Gladfelter | Student in an Organized Health Care Education/Training Program | 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 | 2020-04-02 |
| 1194368647 | Amy Jo Arends | Nurse Practitioner | 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 | 2019-10-28 |
| 1376185199 | Beth Arce | Occupational Therapist | 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 | 2019-10-14 |
| 1295387256 | Althea Ziolkowski | Licensed Practical Nurse | Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 | 2019-07-10 |
| 1790340719 | Heather Anne Fox | Occupational Therapist | Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 | 2019-05-06 |
| 1184182883 | April L Kaiserlian | Social Worker | 983 Spaulding Ave Ne, Ada, MI 49503 | 2019-03-12 |
| Find all providers in zip 49503 | ||||
| Taxonomy Code | 207ZP0105X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Clinical Pathology/Laboratory Medicine |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pathology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316181795 | Stephen John Bloechl | Pathology | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2009-04-28 |
| 1770595563 | Marilyn Estrada Intengan | Pathology | 200 Jefferson Ave Se, Grand Rapids, MI 49503 | 2006-08-12 |
| 1427013994 | Carl Eugene Soechtig | Pathology | 1919 Boston St Se, Grand Rapids, MI 49506-4160 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033748728 | Steve Martin | Pathology | 5575 Conner St Ste A, Detroit, MI 48213-6400 | 2020-04-04 |
| 1083020150 | Maria Vida Villegas Singson | Pathology | 30946 Roselawn Dr, Warren, MI 48088-5948 | 2014-07-09 |
| 1205264579 | Visiting Nurse Services of Michigan | Pathology | 4000 S Saginaw St, Flint, MI 48507-2604 | 2013-10-24 |
| 1982996831 | Yasin K Ahmed | Pathology | 919 Shore Club Dr, Saint Clair Shores, MI 48080-1562 | 2011-05-11 |
| 1215102272 | Aspirus Iron River Hospital & Clinics, Inc. | Pathology | 1400 West Ice Lake Road, Iron River, MI 49935 | 2008-04-29 |
| 1437205200 | Shirley Siew | Pathology | A622 E Fee Hall, East Lansing, MI 48824 | 2007-01-26 |
| 1558443432 | Thomas E Wilson | Pathology | 1500 East Medical Center, 2nd Floor University Hospital Recp Pathology, Ann Arbor, MI 48109-5054 | 2006-10-19 |
| 1790274678 | Heritage Labs, Inc. | Pathology | 2891 E Maple Rd, Troy, MI 48083-6106 | 2018-05-06 |
| 1013424399 | Tox Testing Inc | Pathology | 16100 19 Mile Rd Ste 200, Clinton Township, MI 48038-1148 | 2018-01-08 |
| 1265835110 | Ghassan Allo | Pathology | 2799 W Grand Blvd, Henry Ford Hospital, Dept of Pathology K-6, Detroit, MI 48202-2608 | 2014-10-07 |
| Find all providers with the same taxonomy | ||||
| City | GRAND RAPIDS |
| Zip Code | 49503 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.