Nancy Wolak Gross, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

671651 Issued in NY

Practice address

11043 River Rd
Pavilion, NY 14525-9607

Phone

(585) 721-2484

NPI assigned

Aug 20, 2013

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1215360714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11043 RIVER RD",
            "address_2": "PO BOX 428",
            "city": "PAVILION",
            "state": "NY",
            "postal_code": "145259607",
            "telephone_number": "585-721-2484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11043 RIVER RD",
            "city": "PAVILION",
            "state": "NY",
            "postal_code": "145259607",
            "telephone_number": "585-721-2484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLAK GROSS",
        "first_name": "NANCY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "671651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Lobello
• Pavilion Central School
• Pavilion Central School
• Danyle G Raines, COTA
• Jody Lynne Vonsanden

• All providers in Pavilion, NY
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.

Verify at the official NPI Registry.