Jessie Enrique Gross, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA 13618 Issued in CA

Practice address

220 Hovey Rd FL 1047
Pensacola, FL 32508-1047

Phone

(619) 339-2536

NPI assigned

Jan 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1437204948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 HOVEY RD FL 1047",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325081047",
            "telephone_number": "619-339-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 HOVEY RD FL 1047",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325081047",
            "telephone_number": "619-339-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "JESSIE",
        "middle_name": "ENRIQUE",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA 13618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "13618",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessie.e.gross.mil@mail.com",
            "affiliation": "N",
            "endpointDescription": "Military Command",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "220 Hovey Rd Fl 1047",
            "city": "Pensacola",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325081047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elliot Groff, DO
• Jason Gronert, MD
• Kevin N Groom, PHD
• Pashia D Groom, PHD
• Caitlin Reichle Gross, MS.CCC-SLP
• William Elsworth Gross, MD
• Skyelar Grosvenor, RBT
• Kevin Dale Groves, M.D.
• Maynilla Grudowski, LMT
• Cori Gruschow

• Medical Physician Assistant in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; 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.