NPIMap

Individual provider Active NPI

Jay Weston Grosse, M.D.

  • Internal Medicine Physician
  • Clyde, NC
National Provider Identifier
1356568471
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2008-00544 Issued in NC
Practice address
600 Hospital Drive
Suite 9
Clyde, NC 28721-8046
Phone
(828) 452-0331
Fax
(828) 456-8726
NPI assigned
Apr 19, 2007
Last updated
Sep 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2008-00544 NC Primary

Addresses

Primary practice location

600 Hospital Drive
Suite 9
Clyde, NC 28721-8046

Mailing address

600 Hospital Dr Ste 9
Clyde, NC 28721-8046
Phone (828) 452-0331

Other identifiers 2

IdentifierTypeStateIssuer
3823902MedicaidTN
5909453MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080610000143 NC Practitioner - Internal Medicine 8123198645 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio State University College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

262 Leroy George Dr
Clyde, NC 28721-7430

600 Hospital Dr
Suite 9
Clyde, NC 28721-8046
Phone (828) 452-0331

98 Doctors Dr
Sylva, NC 28779-4502

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2008-00544NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Haywood Regional Medical Center LLC CurrentSince Apr 13, 2015 Accepting new patients
DLP Haywood Regional Medical Center LLC CurrentSince Apr 13, 2015 Accepting new patients
DLP Western Carolina Physician Practices LLC Internal Medicine CurrentSince Aug 1, 2014 Accepting new patients
DLP Western Carolina Physician Practices LLC CurrentSince Aug 1, 2014 Accepting new patients
Jackson Madison County General Hospital Internal Medicine Past Accepting new patients
Haywood Women's Medical Center, PA Past Accepting new patients
Prime Doc of Haywood, PA Internal Medicine Past Accepting new patients

Locations

262 Leroy George Dr
Clyde, NC 28721
Phone (828) 452-8210

600 Hospital Dr
Ste 9
Clyde, NC 28721
Phone (828) 452-0331

68 Hospital Rd
Sylva, NC 28779
Phone (828) 586-7351

98 Doctors Dr
Ste 200
Sylva, NC 28779
Phone (828) 586-8971

Interoperability endpoints

  • Direct secure messaging: jay.grosse.1@9865.direct.athenahealth.com

Organizations & group practices 7

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1356568471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HOSPITAL DR STE 9",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287218046",
            "telephone_number": "828-452-0331",
            "fax_number": "828-456-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HOSPITAL DRIVE",
            "address_2": "SUITE 9",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287218046",
            "telephone_number": "828-452-0331",
            "fax_number": "828-456-8726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSE",
        "first_name": "JAY",
        "middle_name": "WESTON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2008-00544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3823902",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5909453",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clyde, NC

Sources for this page

Verify at the official NPI Registry.