Jackie L Grosklos, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

R9H27 Issued in MO

Practice address

450 N New Ballas Rd
Ste 270 W
Saint Louis, MO 63195-2632

Phone

(314) 991-6969

Fax

(314) 997-6969

NPI assigned

Aug 25, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• Mercy Clinic Cardiovascular and Thoracic Surgery, LLC

  • Vascular Surgery Physician
  • Washington, MO
  • NPI 1528192416
  NPD (past)
• The Heart Health Center, PC

  • Cardiovascular Disease Physician
  • Saint Louis, MO
  • NPI 1801889795
  NPD (past)
• The Heart Health Center, PC

  • Cardiovascular Disease Physician
  • Farmington, MO
  • NPI 1881863009
  NPD (past)

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1245223239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N NEW BALLAS RD",
            "address_2": "STE 270 W",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631952632",
            "telephone_number": "314-991-6969",
            "fax_number": "314-997-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N NEW BALLAS RD",
            "address_2": "STE 270 W",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631952632",
            "telephone_number": "314-991-6969",
            "fax_number": "314-997-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSKLOS",
        "first_name": "JACKIE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-25",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "R9H27",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR GROUP 01",
            "identifier": "CD6536",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROV ID AREA 99",
            "identifier": "002013185",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER ID",
            "identifier": "003012762",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE NUMBER",
            "identifier": "060049013",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ralph William Groom Jr., LCSW, LBA
• Robert J Gropler, MD
• Michelle M Groppe, PTA
• Gretchen Grosch, DO
• Jolene Esther Grosch, PT
• Muhidin Grosonja, PHARMD
• Cathy L Gross, PNP
• Elizabeth Gross
• Gilad A Gross, MD
• Maureen Elizabeth Gross, MD

• Cardiovascular Disease Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Cardiovascular Disease Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; 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.