Jack Everett Gross, EDD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1738 Issued in NC

Practice address

101 Cabarrus Ave E
Concord, NC 28025-3699

Phone

(888) 849-7379

Fax

(855) 857-7333

NPI assigned

Apr 21, 2011

Last updated

Dec 16, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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)

Enrolled

State licenses

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

{
    "created_epoch": "1303344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1356632582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CABARRUS AVE E",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253699",
            "telephone_number": "888-849-7379",
            "fax_number": "855-857-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CABARRUS AVE E",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253699",
            "telephone_number": "888-849-7379",
            "fax_number": "855-857-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "JACK",
        "middle_name": "EVERETT",
        "name_prefix": "Dr.",
        "credential": "EDD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-21",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "1738",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "13823",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn G. Grimsley
• Yekaterina Grinchak, DC
• Melissa Kern Griswold, MSW
• Kelsey Jordan Groce
• Anna D Gross, LCMHC, NCC
• Robert Eugene Grove II, PA
• Andrea Allison Groves, LMFTA
• Grow & Flourish Therapy, PLLC
• Growing Emerging Minds for Success LLC
• Growing Gracefully Counseling and Consulting, PLLC

• Clinical Psychologist in Concord, NC
• Providers in Concord, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; 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.