Individual provider Active NPI

Theresa M Gross, STNA

  • Home Health Aide
  • Bowling Green, OH
National Provider Identifier
1215362579
Registry record updated Sep 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
401061410310 Issued in OH
Practice address
9 Mackenzie CT
Bowling Green, OH 43402-4543
Phone
(567) 395-3162
NPI assigned
Sep 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X 401061410310 OH Primary

Addresses

Primary practice location

9 Mackenzie CT
Bowling Green, OH 43402-4543

Mailing address

9 Mackenzie CT
Bowling Green, OH 43402-4543
Phone (567) 395-3162

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

State licenses

LicenseStateTypeSpecialty
401061410310OHMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1215362579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 MACKENZIE CT",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434024543",
            "telephone_number": "567-395-3162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MACKENZIE CT",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434024543",
            "telephone_number": "567-395-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "THERESA",
        "middle_name": "M",
        "credential": "STNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "OH",
            "license": "401061410310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.