Individual provider Active NPI

Jereme Ryan Gross, PT

  • Physical Therapist
  • Mechanicsburg, PA
National Provider Identifier
1265545453
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT018907 Issued in PA
Practice address
920 Century Dr
Mechanicsburg, PA 17055-8417
Phone
(717) 591-1331
Fax
(717) 591-1332
NPI assigned
Aug 15, 2006
Last updated
Aug 26, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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 PT018907 PA Primary

Addresses

Primary practice location

920 Century Dr
Mechanicsburg, PA 17055-8417

Mailing address

110 N 7TH St
Lemoyne, PA 17043-1501
Phone (717) 731-6094

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071023000465 PA Practitioner - Physical Therapist in Private Practice 1658467584 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Orthopedic & Spine Physical Therapy, Inc. Physical Therapist CurrentSince Nov 23, 2015 Accepting new patients
Conforti Rehabilitation Services, Inc. Physical Therapist CurrentSince Aug 23, 2007 Accepting new patients
FC Select LLC Physical Therapist CurrentSince Jan 6, 2022 Accepting new patients

Locations

4033 Linglestown Rd
Ste 2
Harrisburg, PA 17112
Phone (717) 657-8240

110 N 7th St
Lemoyne, PA 17043
Phone (717) 731-6094

6375 Mercury Dr
Ste 100
Mechanicsburg, PA 17050
Phone (717) 591-3000

920 Century Dr
Mechanicsburg, PA 17055
Phone (717) 697-5800

Organizations & group practices 3

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1265545453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N 7TH ST",
            "city": "LEMOYNE",
            "state": "PA",
            "postal_code": "170431501",
            "telephone_number": "717-731-6094",
            "fax_number": "717-731-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 CENTURY DR",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170558417",
            "telephone_number": "717-591-1331",
            "fax_number": "717-591-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "JEREME",
        "middle_name": "RYAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT018907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.