Active NPI
Amie Maria Gresham
- Athletic Trainer
- Hobart, IN
National Provider Identifier
1710667787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36003782A
- Practice address
- 262 Hillcrest Ave
Hobart, IN 46342-3587 - Phone
- (219) 741-3647
- NPI assigned
- Jul 24, 2023
- Last updated
- Jul 24, 2023
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 36003782A | IN | Primary |
Addresses
Primary practice location
262 Hillcrest Ave
Hobart, IN 46342-3587
Mailing address
262 Hillcrest Ave
Hobart, IN 46342-3587
Phone (219) 741-3647
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 |
|---|---|---|---|
| 36003782A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690156800000",
"number": "1710667787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "262 HILLCREST AVE",
"city": "HOBART",
"state": "IN",
"postal_code": "463423587",
"telephone_number": "219-741-3647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "262 HILLCREST AVE",
"city": "HOBART",
"state": "IN",
"postal_code": "463423587",
"telephone_number": "219-741-3647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRESHAM",
"first_name": "AMIE",
"middle_name": "MARIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-24",
"last_updated": "2023-07-24",
"certification_date": "2022-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36003782A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hobart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.