Individual provider Active NPI

Andrew Dalton Gross, D.C.

  • Chiropractor
  • Marlton, NJ
National Provider Identifier
1811314198
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00716000 Issued in NJ
Practice address
525 Route 73 N Ste 117
Marlton, NJ 08053-3422
Phone
(856) 452-1413
NPI assigned
Mar 25, 2014
Last updated
Aug 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00716000 NJ Primary

Addresses

Primary practice location

525 Route 73 N Ste 117
Marlton, NJ 08053-3422

Mailing address

525 Route 73 N Ste 117
Marlton, NJ 08053-3422
Phone (856) 452-1413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220928000108 NJ Practitioner - Chiropractic 8426434572 Practice locations: Marlton, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00716000NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Glen Oaks Health and Spine Center LLC Chiropractor PastSince Apr 27, 2010 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1811314198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 ROUTE 73 N STE 117",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533422",
            "telephone_number": "856-452-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 ROUTE 73 N STE 117",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533422",
            "telephone_number": "856-452-1413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "ANDREW",
        "middle_name": "DALTON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-25",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00716000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.