Individual provider Active NPI

Alexis Nicole Ghersi, MD

  • Pediatrics Physician
  • Fort Sam Houston, TX
National Provider Identifier
1407431141
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101276943 Issued in VA
Practice address
3100 Schofield Rd BLDG 1179
Fort Sam Houston, TX 78234-7577
Phone
(210) 916-3160
NPI assigned
Mar 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101276943 VA Primary

Addresses

Primary practice location

3100 Schofield Rd BLDG 1179
Fort Sam Houston, TX 78234-7577

Mailing address

847 E Ashby PL Apt 463
San Antonio, TX 78212-2046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250908000722 VA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0648772772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1407431141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 E ASHBY PL APT 463",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782122046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SCHOFIELD RD BLDG 1179",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782347577",
            "telephone_number": "210-916-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHERSI",
        "first_name": "ALEXIS",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-15",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101276943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.