Lyndon Bernard Gross, M.D., PH.D

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

License

119343 Issued in MO

Practice address

11330 Olive Blvd
Suite 150
Creve Coeur, MO 63141

Phone

(314) 336-2566

Fax

(314) 948-9011

NPI assigned

Feb 20, 2006

Last updated

Jun 6, 2024By the provider in NPPES

Sex

Male

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2014 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lgross244361@direct.carenet.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ortho Missouri, LLC

  dba OrthoMO, LLC

  • Orthopaedic Surgery Physician
  • Creve Coeur, MO
  • NPI 1447941067
  NPD
• Orthopedic & Sports Medicine Inc

  • Orthopaedic Surgery Physician
  • Saint Louis, MO
  • NPI 1144372491
  NPD (past)
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1215902648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11330 OLIVE BLVD",
            "address_2": "SUITE 150",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-336-2566",
            "fax_number": "314-948-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11330 OLIVE BLVD",
            "address_2": "SUITE 150",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-336-2566",
            "fax_number": "314-948-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "LYNDON",
        "middle_name": "BERNARD",
        "credential": "M.D., PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "MO",
            "license": "119343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dylan Green
• Erin L Greenberg, MSW, LCSW
• Stacey Nentwig Greer, M.ED.
• Lisa Gregory, R.N.
• Gloria Rizkallah Grice, PHARMD
• Grounded Health Chiropractic LLC
• Bernie Gruszka
• Tina J Guarino, APN-BC
• Elizabeth Jane Gurnow, PHARM.D.
• Hannah-Ngoc T Ha, M.D.

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.