Active NPI
Demetria Ann Gross, RN
- Point of Service
- Clinton Township, MI
National Provider Identifier
1063855112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Point of Service
- License
- 4704218611
- Practice address
- 41045 Vista Woods Way
Clinton Township, MI 48038-4536 - Phone
- (586) 291-1411
- NPI assigned
- Apr 9, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Point of Service | 305S00000X | 4704218611 | MI | Primary |
Addresses
Primary practice location
41045 Vista Woods Way
Clinton Township, MI 48038-4536
Mailing address
41045 Vista Woods Way
Clinton Township, MI 48038-4536
Phone (586) 291-1411
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704218611 | MI | MD | Point of Service |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365465600000",
"number": "1063855112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41045 VISTA WOODS WAY",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480384536",
"telephone_number": "586-291-1411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41045 VISTA WOODS WAY",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480384536",
"telephone_number": "586-291-1411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSS",
"first_name": "DEMETRIA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-09",
"last_updated": "2013-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "305S00000X",
"taxonomy_group": "",
"desc": "Point of Service",
"state": "MI",
"license": "4704218611",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.