Tiesha Gresham, REGISTERED NURSE

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

1-109186 Issued in AL

Practice address

500 Gene Reed Rd Ste 103
Birmingham, AL 35215-8260

Phone

(205) 407-5718

Fax

(205) 407-5802

NPI assigned

Oct 19, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Lyfelines Certification and Staffing, L.L.C.

  • Clinical Medical Laboratory
  • Birmingham, AL
  • NPI 1538822218
  NPD Authorized official

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1295498970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GENE REED RD STE 103",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352158260",
            "telephone_number": "205-407-5718",
            "fax_number": "205-407-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GENE REED RD STE 103",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352158260",
            "telephone_number": "205-407-5718",
            "fax_number": "205-407-5802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESHAM",
        "first_name": "TIESHA",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "AL",
            "license": "1-109186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgresham@lyfelinescertificationandstaffing.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "500 Gene Reed Rd Ste 103",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352158260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gremmels Chiropractic Center, Inc.
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• Natalia Beatriz Grenett, PA-C
• Miles E Gresham, M.D.
• Mark Allan Greve, MD
• Callie Grey
• Greystone Back Pain Center, LLC
• Greystone Counseling and Consulting, LLC
• Greystone Dermatology

• Administrator Registered Nurse in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Administrator Registered Nurse in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.