DR. JONATHAN DREW GROSS (NPI# 1174880959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174880959 |
| Entity Type | Individual |
| Full Name | DR. JONATHAN DREW GROSS |
| Credential | PSY.D. |
| Practice Address |
9310 Old Kings Rd S Suite 102 Jacksonville FL 32257-6152 |
| Practice Telephone | 9044375176 |
| Practice Fax Number | 9044383175 |
| Mailing Telephone | 9044375176 |
| Mailing Fax Number | 9044383175 |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2013-09-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | PSY003602 | GA | Behavioral Health & Social Service Providers |
| Y | 103G00000X | Clinical Neuropsychologist | PY 8505 | FL | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PY 8505 | FL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649705278 | Jonathan Gross | Physician Assistant | 3169 12th Ave Se, Hickory, NC 28602-9666 | 2017-04-20 |
| 1912419557 | Jonathan Steven Gross | Case Manager/Care Coordinator | 274 Sutton Rd, Cincinnati, OH 45230-3521 | 2017-11-03 |
| 1457593881 | Jonathan Michael Gross | Internal Medicine | 444 Nw Elks Dr, Corvallis, OR 97330-3745 | 2009-03-31 |
| 1194920751 | Jonathan Seth Gross | Radiology | 560 1st Ave, He 221, New York, NY 10016-6402 | 2007-06-15 |
| 1316960552 | Jonathan Gross | Specialist | 3333 Hylan Blvd, Staten Island, NY 10306 | 2006-07-26 |
| Street Address |
9310 OLD KINGS RD S SUITE 102 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32257-6152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407867237 | Jeffrey B. Schultz | Dentist | 9310 Old Kings Rd S, Bldg. 601, Jacksonville, FL 32257-6152 | 2006-08-10 |
| 1265807127 | Dr. Zain Barnouti LLC | Podiatrist | 9310 Old Kings Rd S, Suite 1201, Jacksonville, FL 32257-6152 | 2015-12-03 |
| 1043680648 | Jax Sleep Solutions LLC | Dentist | 9310 Old Kings Rd S, Suite 601, Jacksonville, FL 32257-6152 | 2015-09-25 |
| 1518012913 | William J Namen II Dpm Pa | Podiatrist | 9310 Old Kings Rd S, Suite 1201, Jacksonville, FL 32257-6152 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740835842 | Majdoline Kasera | Pharmacist | 11250-4 Old St Augustine Rd, Jacksonville, FL 32257 | 2019-08-06 |
| 1386203859 | Jetaime Y Lewis | Physical Therapist | 9765 San Jose Blvd Ste 6, Jacksonville, FL 32257 | 2019-06-10 |
| 1437622107 | Michelle Espanol Garcia | Nurse Practitioner | 9957 Moorings Dr Ste 204, Jacksonville, FL 32257 | 2019-01-05 |
| 1982172995 | Pacifica Augustine Road LLC | Alzheimer Center (Dementia Center) | 10660 Old Augustine Road, Jacksonville, FL 32257 | 2018-11-07 |
| 1659860492 | Andrea Leigh Miller | Social Worker | 10416 Spotted Fawn Lane, Jacksonville, FL 32257 | 2018-05-08 |
| 1376049965 | Stephanie Lynne Jordon | Nurse Practitioner | 9765 San Jose Blvd Ste 102, Jacksonville, FL 32257 | 2018-04-02 |
| 1205335619 | Annetta Aileen Brown | Respite Care | 4901 Sunbeam Rd Apt 1016, Jacksonville, FL 32257 | 2018-02-12 |
| 1841714888 | Freda Stevens | Counselor | 9521 Shellie Road Unit 13, Jacksonville, FL 32257 | 2017-08-01 |
| 1659821353 | Jennifer Lavoro | Acupuncturist | 11259 Thomaston Pl, Jacksonville, FL 32257 | 2016-10-06 |
| 1225488232 | Avenues Dental LLC | Dentist | 6144 Gazebo Park Place South, Ste 210, Jacksonville, FL 32257 | 2016-06-21 |
| Find all providers in zip 32257 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447604806 | Rujvi Kamat | Clinical Neuropsychologist | 1235 San Marco Blvd Fl 4, Jacksonville, FL 32207-8554 | 2016-04-21 |
| 1750744405 | Andrew J Ruffett Phd LLC | Clinical Neuropsychologist | 11869 Curlew Way, Jacksonville, FL 32223-1939 | 2016-03-31 |
| 1629499819 | Bay Area Psychology Associates | Clinical Neuropsychologist | 302 Woodberry Pl, Jacksonville, NC 28540-4264 | 2013-12-14 |
| 1356778898 | Behavioral Health of North Florida Pllc | Clinical Neuropsychologist | 3733 University Blvd W Ste 214, Jacksonville, FL 32217-2128 | 2013-09-30 |
| 1093939498 | Christopher Rackley | Clinical Neuropsychologist | 1660 Prudential Dr Ste 210, Jacksonville, FL 32207-8185 | 2007-04-13 |
| 1336256353 | Elizabeth Tannahill Glen Keymer | Clinical Neuropsychologist | 751 Oak St Ste 120, Jacksonville, FL 32204-3359 | 2006-08-24 |
| 1215989991 | David S Sabsevitz | Clinical Neuropsychologist | 4500 San Pablo Rd S Dept Of, Jacksonville, FL 32224-1865 | 2006-05-17 |
| 1902880537 | Andrew J Ruffett | Clinical Neuropsychologist | 3617 Crown Point Rd, Ste 6, Jacksonville, FL 32257-9010 | 2005-12-06 |
| 1255331237 | Randi Most | Clinical Neuropsychologist | 13400 Sutton Park Dr S, Suite 1504, Jacksonville, FL 32224-0236 | 2005-07-30 |
| 1619973997 | Nicole Annette Hagedorn | Clinical Neuropsychologist | 2680 Henderson Dr Ste 5, Jacksonville, NC 28546-5297 | 2005-06-22 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32257 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.