Active NPI
Robert Jackson Gresham
- Massage Therapist
- Naples, FL
National Provider Identifier
1033545868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA42334
- Practice address
- 2500 Tamiami TRL N
Ste 222
Naples, FL 34103-4470 - Phone
- (239) 649-8001
- NPI assigned
- Sep 25, 2013
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA42334 | FL | Primary |
Addresses
Primary practice location
2500 Tamiami TRL N
Ste 222
Naples, FL 34103-4470
Mailing address
2500 Tamiami TRL N
Ste 222
Naples, FL 34103-4470
Phone (239) 649-8001
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA42334 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380067200000",
"number": "1033545868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 TAMIAMI TRL N",
"address_2": "STE 222",
"city": "NAPLES",
"state": "FL",
"postal_code": "341034470",
"telephone_number": "239-649-8001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 TAMIAMI TRL N",
"address_2": "STE 222",
"city": "NAPLES",
"state": "FL",
"postal_code": "341034470",
"telephone_number": "239-649-8001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRESHAM",
"first_name": "ROBERT",
"middle_name": "JACKSON",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-25",
"last_updated": "2013-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA42334",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naples, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.