Active NPI
John Gross
- Physical Therapist
- Folsom, CA
National Provider Identifier
1821562398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 294810
- Practice address
- 330 Montrose Dr
Folsom, CA 95630-2720 - Phone
- (916) 351-9151
- NPI assigned
- Jan 17, 2019
- Last updated
- Jan 17, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 294810 | CA | Primary |
Addresses
Primary practice location
330 Montrose Dr
Folsom, CA 95630-2720
Mailing address
3000 Goffs Falls Rd Ste 101
Manchester, NH 03103-6109
Phone (800) 995-2673
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 294810 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547683200000",
"number": "1821562398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 GOFFS FALLS RD STE 101",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031036109",
"telephone_number": "800-995-2673",
"fax_number": "888-979-6551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 MONTROSE DR",
"city": "FOLSOM",
"state": "CA",
"postal_code": "956302720",
"telephone_number": "916-351-9151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSS",
"first_name": "JOHN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-01-17",
"last_updated": "2019-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "294810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Folsom, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.