Individual provider Active NPI

Debra J Gross, ARNP

  • Nurse Practitioner
  • Olympia, WA
National Provider Identifier
1659663607
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60215083 Issued in WA
Practice address
1620 Cooper Point Rd SW
Olympia, WA 98502-5736
Phone
(360) 486-6710
Fax
(360) 705-0614
NPI assigned
May 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP60215083 WA
Nurse Practitioner 363L00000X AP60215083 WA Primary

Addresses

Primary practice location

1620 Cooper Point Rd SW
Olympia, WA 98502-5736

Mailing address

PO Box 3360
Portland, OR 97208-3360

Other practice location 1

413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (360) 330-8516

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dgross99512@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20110805000373 WA Practitioner - Nurse Practitioner 3274702352 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP60215083WAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Physician Associates PC Nurse Practitioner CurrentSince Jan 1, 2013 Accepting new patients
Providence Health & Services Washington CurrentSince Aug 2, 2016 Accepting new patients
Olympia Emergency Services, PLLC CurrentSince Jun 1, 2018 Accepting new patients
Scheuber Road Emergency Physicians Nurse Practitioner Past Accepting new patients
Olympia Orthopaedic Associates PLLC Past Accepting new patients

Locations

2901 Squalicum Pkwy
Bellingham, WA 98225
Phone (360) 734-5400

914 S Scheuber Rd
Centralia, WA 98531
Phone (360) 330-8516

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

1620 Cooper Point Rd SW
Olympia, WA 98502
Phone (360) 486-6710

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

1018 Capitol Way S
Ste 300
Olympia, WA 98501
Phone (360) 486-6508

3900 Capital Mall Dr SW
Olympia, WA 98502
Phone (360) 704-4743

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

615 Lilly Rd NE
Ste 240
Olympia, WA 98506
Phone (360) 413-3850

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5512/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1659663607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 COOPER POINT RD SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025736",
            "telephone_number": "360-486-6710",
            "fax_number": "360-705-0614"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "413 Lilly Rd NE",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065133",
            "country_code": "US",
            "telephone_number": "360-330-8516",
            "fax_number": "360-330-8684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSS",
        "first_name": "DEBRA",
        "middle_name": "J",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-10",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WA",
            "license": "AP60215083",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60215083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dgross99512@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "413 Lilly Rd NE",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.