Travis Ryan Gross

Primary specialty

PharmacistTaxonomy code 183500000X

License

033.0134102 Issued in VT

Practice address

901 Lower PLN
Bradford, VT 05033

Phone

(802) 222-9292

NPI assigned

Nov 12, 2015

Last updated

Aug 19, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• KPH Healthcare Services, Inc.

  dba Kinney Drugs #56

  • Community/Retail Pharmacy
  • Bradford, VT
  • NPI 1225145402
  NPD (past)
• KPH Healthcare Services, Inc.

  dba Kinney Drugs #153

  • Community/Retail Pharmacy
  • Brattleboro, VT
  • NPI 1407747157
  NPD (past)

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

{
    "created_epoch": "1447286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1225401219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 LOWER PLN",
            "city": "BRADFORD",
            "state": "VT",
            "postal_code": "050338924",
            "telephone_number": "802-222-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 LOWER PLN",
            "city": "BRADFORD",
            "state": "VT",
            "postal_code": "05033",
            "telephone_number": "802-222-9292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21655 Redwood Ln",
            "address_2": "unit A",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "NY",
            "postal_code": "136016399",
            "country_code": "US",
            "telephone_number": "516-724-3520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSS",
        "first_name": "TRAVIS",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-12",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "061088",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VT",
            "license": "033.0134102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Florentine, BA
• Nancy Ryan Foote, ARNP
• Katherine Frank
• Alex Gagnon, BA
• Michelle Grabowski, MA
• Lauren A Harlow, DH
• Mark Steven Harris, MD
• Demetra S Hazatones, LADC, LCMHC
• Abigail Reiber Henderson, CPNP-PC
• Taylor Hollis, BA

• Pharmacist in Bradford, VT
• Providers in Bradford, VT by specialty
• Pharmacist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; 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.