Individual provider Active NPI

Earl George Gross, M.D.

  • Dermatopathology Physician
  • Morehead City, NC
National Provider Identifier
1073667077
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
99-00855 Issued in NC
Practice address
3610 Medical Park Court
Morehead City, NC 28557
Phone
(252) 808-3376
Fax
(252) 808-2095
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X 99-00855 NC Primary

Addresses

Primary practice location

3610 Medical Park Court
Morehead City, NC 28557

Mailing address

PO Box 1151
Morehead City, NC 28557-1151
Phone (252) 222-4533

Other identifiers 2

IdentifierTypeStateIssuer
1235YOtherNCBLUE CROSS OF NC
891235YMedicaidNC

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
99-00855NCMDDermatopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carteret Medical Group LLC CurrentSince Aug 23, 2021 Accepting new patients

Locations

3610 Medical Park Ct
Morehead City, NC 28557
Phone (252) 222-5790

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15484/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073667077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1151",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285571151",
            "telephone_number": "252-222-4533",
            "fax_number": "252-808-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 MEDICAL PARK COURT",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "28557",
            "telephone_number": "252-808-3376",
            "fax_number": "252-808-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "EARL",
        "middle_name": "GEORGE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "NC",
            "license": "99-00855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF NC",
            "identifier": "1235Y",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891235Y",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.