Active NPI
Wendy Renee Gross, R.N.
- Clinical Nurse Specialist
- Edina, MN
National Provider Identifier
1104837418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Nurse Specialist
- License
- R1369119
- Practice address
- 7373 France Ave S
Suite 312
Edina, MN 55435-4534 - Phone
- (952) 832-0076
- Fax
- (952) 832-0477
- NPI assigned
- Aug 11, 2006
- 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 |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | R1369119 | MN | Primary |
Addresses
Primary practice location
7373 France Ave S
Suite 312
Edina, MN 55435-4534
Mailing address
6465 Wayzata Blvd
Suite 900
St Louis Park, MN 55426-1728
Phone (952) 512-5600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 73B60RO | Other | BLUE CROSS BLUE SHIELD |
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 |
|---|---|---|---|
| R1369119 | MN | MD | Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184025600000",
"number": "1104837418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6465 WAYZATA BLVD",
"address_2": "SUITE 900",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554261728",
"telephone_number": "952-512-5600",
"fax_number": "952-512-5650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7373 FRANCE AVE S",
"address_2": "SUITE 312",
"city": "EDINA",
"state": "MN",
"postal_code": "554354534",
"telephone_number": "952-832-0076",
"fax_number": "952-832-0477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSS",
"first_name": "WENDY",
"middle_name": "RENEE",
"credential": "R.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-11",
"last_updated": "2007-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "MN",
"license": "R1369119",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "73B60RO",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.