Organization Active NPI

Promise Health Medical Institute

  • Family Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1861338980
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
PROMISE HEALTH MEDICAL INSTITUTE
Practice address
4280 Memorial Dr Ste D
Decatur, GA 30032-1216
Phone
(404) 941-9270
NPI assigned
Apr 29, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Authorized official

Name
Dr. Ebonee Gresham, DNP FNPNPI 1508279837
Title
Director
Phone
(404) 941-9270

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

4280 Memorial Dr Ste D
Decatur, GA 30032-1216

Mailing address

4280 Memorial Dr Ste D
Decatur, GA 30032-1216
Phone (404) 941-9270

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2311077Promise Health Medical Institute4280 Memorial Drive, Suite D, Decatur, GA 30032Certificate of waiverSep 16, 2026

National Provider Directory

National Provider Directory

Locations

4280 Memorial Dr
Ste D
Decatur, GA 30032
Phone (404) 941-9270

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1777420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777420800000",
    "number": "1861338980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4280 MEMORIAL DR STE D",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300321216",
            "telephone_number": "404-941-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 MEMORIAL DR STE D",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300321216",
            "telephone_number": "404-941-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMISE HEALTH MEDICAL INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-29",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A",
        "authorized_official_last_name": "GRESHAM",
        "authorized_official_first_name": "EBONEE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "404-941-9270",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.