Great Lakes Rehab, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

35 071295 Issued in OH

Legal business name

GREAT LAKES REHAB, LLC

Doing business as

Eric T. Gross, M.D.

Practice address

6674 Tippecanoe Rd
Suite # 1
Canfield, OH 44406-9149

Phone

(330) 533-0919

Fax

(330) 533-1732

NPI assigned

Mar 21, 2006

Last updated

Dec 17, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Eric T Gross, M.D.NPI 1598946022

Title

President

Phone

(330) 533-0919

Specialties & licenses 1

Addresses

Other names 1

• Eric T. Gross, M.D. Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eric T Gross, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Canfield, OH
  • NPI 1598946022
  Authorized official Same address or phone

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197849600000",
    "number": "1154380822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6674 TIPPECANOE RD",
            "address_2": "SUITE # 1",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069149",
            "telephone_number": "330-533-0919",
            "fax_number": "330-533-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6674 TIPPECANOE RD",
            "address_2": "SUITE # 1",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069149",
            "telephone_number": "330-533-0919",
            "fax_number": "330-533-1732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2007-12-17",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-533-0919",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "35 071295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eric T. Gross, M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Annmarie Kathleen Ginnis
• Alexis Marie Girgus, BSW LSW
• Mary Gomez, PHARMD
• Cynthia M Goodall, LPN
• John James Graham, M.D.
• Gregory S. Zinni MD LLC
• Gregory S. Zinni, M.D., Inc. (Canfield Family Healthcare, Inc.)
• Rylee Gresley
• Eric T Gross, M.D.
• Cynthia Habuda

• Physical Medicine & Rehabilitation Physician in Canfield, OH
• Providers in Canfield, OH by specialty
• Physical Medicine & Rehabilitation Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.