Individual provider Active NPI

Anna Pearson Gresham, FNP

  • Family Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1194077636
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
842113 Issued in TX
Practice address
3417 Gaston Avenue
Suite 700
Dallas, TX 75246
Phone
(214) 823-4800
Fax
(214) 823-4801
NPI assigned
Oct 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 842113 TX Primary

Addresses

Primary practice location

3417 Gaston Avenue
Suite 700
Dallas, TX 75246

Mailing address

3417 Gaston Ave.
Suite 700
Dallas, TX 75246
Phone (601) 624-2662

Other identifiers 1

IdentifierTypeStateIssuer
3276743-01MedicaidTX

Other names 1

  • Anna Pearson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131111001473 TX Practitioner - Nurse Practitioner 5395971816 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Abksw Preferred Health Partners, PLLCGroup PAC ID 2961710892, 48 clinicians

Practice addresses (Care Compare)

3417 Gaston Ave
Suite 700
Dallas, TX 75246-2031
Phone (241) 823-4800

440 W
635 Suite 405
Irving, TX 75063
Phone (972) 993-5080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Sep 17, 2013 Accepting new patients
Healthtexas Provider Network CurrentSince Sep 17, 2013 Accepting new patients
Abksw Preferred Health Partners, PLLC CurrentSince Oct 1, 2015 Accepting new patients

Locations

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

3417 Gaston Ave
Ste 700
Dallas, TX 75246
Phone (214) 823-4800

440 W Lyndon B Johnson Fwy
Ste 405
Irving, TX 75063
Phone (214) 823-4800

Interoperability endpoints

  • Direct secure messaging: anna.gresham@ntphp.eclinicaldirectplus.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1194077636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 GASTON AVE.",
            "address_2": "SUITE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75246",
            "telephone_number": "601-624-2662",
            "fax_number": "214-823-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 GASTON AVENUE",
            "address_2": "SUITE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75246",
            "telephone_number": "214-823-4800",
            "fax_number": "214-823-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESHAM",
        "first_name": "ANNA",
        "middle_name": "PEARSON",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "842113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3276743-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "PEARSON",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.