Active NPI
Sabina Gresham
- Nurse's Aide
- Athens, GA
National Provider Identifier
1124366992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 109-R-0323
- Practice address
- 975 Gaines School Rd
Athens, GA 30605-3133 - Phone
- (706) 549-2289
- Fax
- (706) 549-1177
- NPI assigned
- Jan 29, 2013
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 109-R-0323 | GA | Primary |
Addresses
Primary practice location
975 Gaines School Rd
Athens, GA 30605-3133
Mailing address
975 Gaines School Rd
Athens, GA 30605-3133
Phone (706) 549-2289
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 896062924B | Medicaid | GA | |
| 896062924E | Medicaid | GA | |
| 829944758A | Medicaid | GA | |
| 896062924D | Medicaid | GA | |
| 896062924A | Medicaid | GA | |
| 262171341A | Medicaid | GA |
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 |
|---|---|---|---|
| 109-R-0323 | GA | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359417600000",
"number": "1124366992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "975 GAINES SCHOOL RD",
"city": "ATHENS",
"state": "GA",
"postal_code": "306053133",
"telephone_number": "706-549-2289",
"fax_number": "706-549-1177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "975 GAINES SCHOOL RD",
"city": "ATHENS",
"state": "GA",
"postal_code": "306053133",
"telephone_number": "706-549-2289",
"fax_number": "706-549-1177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRESHAM",
"first_name": "SABINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-29",
"last_updated": "2013-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "GA",
"license": "109-R-0323",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "896062924B",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "896062924E",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "829944758A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "896062924D",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "896062924A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "262171341A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Athens, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.