Individual provider Active NPI

Jonathan Gross

  • Physician Assistant
  • Hickory, NC
National Provider Identifier
1649705278
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-07197 Issued in NC
Practice address
3169 12TH Ave SE
Hickory, NC 28602-9666
Phone
(704) 325-3202
NPI assigned
Apr 20, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 00107197 NC
Physician Assistant 363A00000X 0010-07197 NC Primary

Addresses

Primary practice location

3169 12TH Ave SE
Hickory, NC 28602-9666

Mailing address

430 9TH St NW
Hickory, NC 28601-3524
Phone (919) 616-5775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170714000255 NC Practitioner - Physician Assistant 2264702885 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catawba Valley Medical Group IncGroup PAC ID 6305007279, 133 clinicians

Practice addresses (Care Compare)

1771 Tate Blvd SE
Suite 204
Hickory, NC 28602-4250
Phone (828) 732-5200

50 Macedonia Church Rd a
Taylorsville, NC 28681-8414
Phone (828) 732-5300

Hospital & facility affiliations

  • Catawba Valley Medical Center Hospital, Hickory, NC, CCN 340143

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-07197NCMDPhysician Assistant
00107197NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Valley Medical Group Inc CurrentSince Jan 24, 2022 Accepting new patients
Catawba Valley Medical Group,Inc CurrentSince Jan 24, 2022 Accepting new patients
Catawba Valley Medical Group, Inc Past Accepting new patients

Locations

200 Rosenwald School St
Catawba, NC 28609
Phone (828) 241-2377

1771 Tate Blvd SE
Ste 204
Hickory, NC 28602
Phone (828) 322-9105

810 Fairgrove Church Rd
Hickory, NC 28602
Phone (704) 326-3000

125 Hospital Ave NW
Ste 200C
Lenoir, NC 28645
Phone (828) 732-7500

50 Macedonia Church Rd
#A
Taylorsville, NC 28681
Phone (828) 732-5300

Interoperability endpoints

  • Direct secure messaging: jonathan.gross@cvmg.eclinicaldirectplus.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1649705278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 9TH ST NW",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013524",
            "telephone_number": "919-616-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3169 12TH AVE SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286029666",
            "telephone_number": "704-325-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "JONATHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-20",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "00107197",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.