Individual provider Active NPI

Amy E. Gross, P.T.

  • Physical Therapist
  • Canton, GA
National Provider Identifier
1215979794
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT008072 Issued in GA
Practice address
147 Reinhardt College Pkwy
Suite 9
Canton, GA 30114-5641
Phone
(770) 345-3057
Fax
(770) 345-3154
NPI assigned
Jun 11, 2006
Last updated
Nov 30, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT008072 GA Primary

Addresses

Primary practice location

147 Reinhardt College Pkwy
Suite 9
Canton, GA 30114-5641

Mailing address

121 Woodbury LN
Canton, GA 30114-4590
Phone (770) 479-9138

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196380800000",
    "number": "1215979794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 WOODBURY LN",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301144590",
            "telephone_number": "770-479-9138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 REINHARDT COLLEGE PKWY",
            "address_2": "SUITE 9",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145641",
            "telephone_number": "770-345-3057",
            "fax_number": "770-345-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "AMY",
        "middle_name": "E.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2007-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.