Larry Gross

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

134002 Issued in OH

Practice address

18880 Road 115
Cecil, OH 45821-9426

Phone

(419) 439-2973

NPI assigned

Aug 18, 2011

Last updated

Aug 18, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1265712533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18880 ROAD 115",
            "city": "CECIL",
            "state": "OH",
            "postal_code": "458219426",
            "telephone_number": "419-439-2973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18880 ROAD 115",
            "city": "CECIL",
            "state": "OH",
            "postal_code": "458219426",
            "telephone_number": "419-439-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "LARRY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-18",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "134002",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IN",
            "license": "27066143A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy A Betzer
• Seth Bidlack, OT
• Jaclyn Carr
• Jama Cline, RN
• Kandise Violet Fisher
• Anita L Mack

• Licensed Practical Nurse in Cecil, OH
• Providers in Cecil, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.