Active NPI
Johanna Louise Gross
- Family Nurse Practitioner
- Oak Creek, WI
National Provider Identifier
1750841482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 9156-33
- Practice address
- 7901 S 6TH St
Oak Creek, WI 53154-2010 - Phone
- (414) 346-8000
- NPI assigned
- Mar 20, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 9156-33 | WI | Primary |
Addresses
Primary practice location
7901 S 6TH St
Oak Creek, WI 53154-2010
Mailing address
4963 N 125TH St
Butler, WI 53007-1532
Phone (262) 370-7460
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9156-33 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
7901 S 6TH St
Oak Creek, WI 53154-2010
Phone (414) 346-8000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current | Accepting new patients | |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current | Accepting new patients | |
| The Medical College of Wisconsin, Inc. | Current | Accepting new patients |
Locations
W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060
7901 S 6th St
Oak Creek, WI 53154
Phone (414) 346-8000
1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990
Interoperability endpoints
- jgrossrn12502@direct.froedtert.com
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Menomonee Falls, WI
- NPI 1568787448
-
- Durable Medical Equipment & Medical Supplies
- Wauwatosa, WI
- NPI 1154947224
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553040000000",
"number": "1750841482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4963 N 125TH ST",
"city": "BUTLER",
"state": "WI",
"postal_code": "530071532",
"telephone_number": "262-370-7460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7901 S 6TH ST",
"city": "OAK CREEK",
"state": "WI",
"postal_code": "531542010",
"telephone_number": "414-346-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSS",
"first_name": "JOHANNA",
"middle_name": "LOUISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-20",
"last_updated": "2019-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "9156-33",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9156-33",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Oak Creek, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.