Individual
JARED GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 MOSAIC CT STE 200, SAINT JOSEPH, MO 64506-0015
(816) 271-4022
(816) 271-4020
Mailing address
101 MOSAIC CT STE 200, SAINT JOSEPH, MO 64506-0015
(816) 271-4022
(816) 271-4020
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2022029081
MO
207Q00000X
Family Medicine Physician
7126
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200113068
—
MO
05
—
30004832220001
—
KS
Enumeration date
04/11/2019
Last updated
04/06/2026
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