Dominique Shaney Gresham

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Practice address

17325 Euclid Ave # 2045
Cleveland, OH 44112-1247

Phone

(216) 618-8731

NPI assigned

Sep 25, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1609655265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17325 EUCLID AVE # 2045",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441121247",
            "telephone_number": "216-618-8731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17325 EUCLID AVE # 2045",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441121247",
            "telephone_number": "216-618-8731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESHAM",
        "first_name": "DOMINIQUE",
        "middle_name": "SHANEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Gage Grenfell, PA-C
• Anna Grenier Pawlikowski, LISW
• Natalie Joy Grenier, RN
• Briona Rae Gresham
• Denzel T Gresham
• Jason Gresham
• Jonetta Gresham
• Linda Gresham
• Michael Gressel, M.D.
• David Gretick, LISW-S

• Developmentally Disabled Services Day Training Agency in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Developmentally Disabled Services Day Training Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.