Individual provider Active NPI

Brendon Joseph Gros, MD

  • Emergency Medicine Physician
  • Birmingham, AL
National Provider Identifier
1245818756
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD.45017 Issued in AL
Practice address
625 19TH St S
Birmingham, AL 35233-1900
Phone
(205) 975-7387
NPI assigned
Mar 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X MD.45017 AL Primary

Addresses

Primary practice location

625 19TH St S
Birmingham, AL 35233-1900

Mailing address

625 19TH St S
Birmingham, AL 35233-1900
Phone (205) 975-7387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, LA2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231103001323 AL Practitioner - Emergency Medicine 4880093046 Reassigns benefits to 1 organization
I20240424001202 LA Practitioner - Emergency Medicine 4880093046 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lafourche Parish Hospital Service District No.1 CurrentSince Mar 5, 2024 Accepting new patients
Paragon Contracting Services LLC Emergency Medicine CurrentSince Sep 25, 2023 Accepting new patients
Lafourche Parish Hospital Service District No.1 Emergency Medicine CurrentSince Mar 5, 2024 Accepting new patients
Physician Practice Partners Emergency Medicine CurrentSince Jul 15, 2024 Accepting new patients
Lafourche Parish Hospital Service District No.1 Past Accepting new patients

Locations

810 Saint Vincents Dr
Birmingham, AL 35205
Phone (205) 930-2456

2030 Lay Dam Rd
Clanton, AL 35045
Phone (205) 258-4400

150 Gilbreath Dr
Oneonta, AL 35121
Phone (205) 274-3000

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

200 W 134th Pl
Cut Off, LA 70345
Phone (985) 325-9300

8120 Main St
Ste 203
Houma, LA 70360
Phone (985) 868-9960

8166 Main St
Houma, LA 70360
Phone (800) 456-9121

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1245818756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900",
            "telephone_number": "205-975-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900",
            "telephone_number": "205-975-7387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROS",
        "first_name": "BRENDON",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "MD.45017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.