Individual provider Active NPI

Joseph E Gross III, PA-C

  • Physician Assistant
  • Sewell, NJ
National Provider Identifier
1972718732
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MP00286 Issued in NJ
Practice address
100 Kings Way E
Suite a-3
Sewell, NJ 08080-2237
Phone
(856) 589-3331
Fax
(856) 589-3416
NPI assigned
May 14, 2007
Last updated
Jul 6, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MP00286 NJ Primary

Addresses

Primary practice location

100 Kings Way E
Suite a-3
Sewell, NJ 08080-2237

Mailing address

100 Kings Way E
Suite a-3
Sewell, NJ 08080-2237
Phone (856) 589-3331

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MP00286NJMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1972718732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS WAY E",
            "address_2": "SUITE A-3",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802237",
            "telephone_number": "856-589-3331",
            "fax_number": "856-589-3416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 KINGS WAY E",
            "address_2": "SUITE A-3",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802237",
            "telephone_number": "856-589-3331",
            "fax_number": "856-589-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "JOSEPH",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "MP00286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.