Kimberlee B Gross, M.A., CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

8562 Issued in MN

Practice address

1891 Station Pkwy NW
Andover, MN 55304-3341

Phone

(763) 755-4275

Fax

(763) 755-4261

NPI assigned

Aug 9, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Family Speech & Therapy Services, LLC

  dba Sora Pediatric Therapy

  • Speech-Language Pathologist
  • Andover, MN
  • NPI 1235285966
  Medicare reassignment NPD
• Ace Speech and Language Clinic, LLC

  • Speech-Language Pathologist
  • Saint Paul, MN
  • NPI 1326059536
  NPD (past)

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1164701074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1891 STATION PKWY NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553043341",
            "telephone_number": "763-755-4275",
            "fax_number": "763-755-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1891 STATION PKWY NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553043341",
            "telephone_number": "763-755-4275",
            "fax_number": "763-755-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "KIMBERLEE",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "M.A., CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-09",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "8562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grand St Paul CVS LLC (CVS Pharmacy #17118)
• Grand St Paul CVS LLC (CVS Pharmacy #07110)
• Gratia Counseling & Consulting, LLC
• Rachel Grimm
• Kathryn Eileen Grimsby, MOTR/L
• Group Health, Inc. (HealthPartners)
• Group Health, Inc. (Riverway - Andover Clinic)
• Sophia Guo, PHARMD
• Melanie Gylling, MA, CF-SLP
• Brooke Nicole Halliday, LPCC

• Speech-Language Pathologist in Andover, MN
• Providers in Andover, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.