Georgia Kelly Gross, BS, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-19-99351 Issued in IN

Practice address

11922 Fairway Lakes Dr Ste 2
Fort Myers, FL 33913-8384

Phone

(239) 219-3409

NPI assigned

Oct 2, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

Locations

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.

• Umbrella Spectrum LLC

  • Behavior Analyst
  • Fort Myers, FL
  • NPI 1831774439
  NPD

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1275130361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11922 FAIRWAY LAKES DR STE 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138384",
            "telephone_number": "239-219-3409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11922 FAIRWAY LAKES DR STE 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138384",
            "telephone_number": "239-219-3409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "GEORGIA",
        "middle_name": "KELLY",
        "credential": "BS, RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-02",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IN",
            "license": "RBT-19-99351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert M. Grohowski, M.D.
• Camellia Jane Groover, PHARMD
• Amy Rachele Grose, BSP, MSCMHC, RMHCI
• Jodi M Grosflam, M.D.
• Andrew Michael Gross, M.D.
• Jeremi Eleanor Grosser, MS, CCC-SLP
• Jessica Groton, D.O.
• Benjamin Clarence Groves, MD
• Grow and Joy Behavior Services LLC
• Growth 4 Kids, LLC

• Behavior Technician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; 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.