Individual provider Active NPI

Joshua Gary Bross, DC, MS, CSCS

  • Chiropractor
  • Columbia, MD
National Provider Identifier
1225287766
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
03553 Issued in MD
Practice address
6325 Woodside CT
Suite 225
Columbia, MD 21046-1017
Phone
(443) 718-9432
NPI assigned
Sep 9, 2008
Last updated
Sep 30, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 30942 CA
Chiropractor 111N00000X 03553 MD Primary

Addresses

Primary practice location

6325 Woodside CT
Suite 225
Columbia, MD 21046-1017

Mailing address

10716 Symphony Way
Columbia, MD 21044-4924
Phone (310) 488-0303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160927000434 MD Practitioner - Chiropractic 3375830904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Chiropractic and Sport, LLCGroup PAC ID 2466749098, 2 clinicians

Practice addresses (Care Compare)

10630 Little Patuxent Pkwy
Suite 329
Columbia, MD 21044-3204
Phone (443) 718-9432

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
30942CAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Chiropractic & Sport, LLC Chiropractor CurrentSince May 30, 2016 Accepting new patients

Locations

10630 Little Patuxent Pkwy
Ste 329
Columbia, MD 21044
Phone (443) 718-9432

6325 Woodside Ct
Ste 225
Columbia, MD 21046
Phone (443) 718-9432

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285804800000",
    "number": "1225287766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10716 SYMPHONY WAY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210444924",
            "telephone_number": "310-488-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6325 WOODSIDE CT",
            "address_2": "SUITE 225",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461017",
            "telephone_number": "443-718-9432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSS",
        "first_name": "JOSHUA",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "DC, MS, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-09",
        "last_updated": "2010-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "30942",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "03553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.