Active NPI
Nichole Gross, ATC
- Athletic Trainer
- Chanhassen, MN
National Provider Identifier
1730503384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2081
- Practice address
- 7907 Powers Blvd
Chanhassen, MN 55317-9502 - Phone
- (952) 906-7880
- NPI assigned
- Feb 18, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2081 | MN | Primary |
| Athletic Trainer | 2255A2300X | 0400 | SD |
Addresses
Primary practice location
7907 Powers Blvd
Chanhassen, MN 55317-9502
Mailing address
7907 Powers Blvd
Chanhassen, MN 55317-9502
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2081 | MN | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392681600000",
"number": "1730503384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7907 POWERS BLVD",
"city": "CHANHASSEN",
"state": "MN",
"postal_code": "553179502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7907 POWERS BLVD",
"city": "CHANHASSEN",
"state": "MN",
"postal_code": "553179502",
"telephone_number": "952-906-7880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSS",
"first_name": "NICHOLE",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-02-18",
"last_updated": "2014-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MN",
"license": "2081",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "SD",
"license": "0400",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chanhassen, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.