Active NPI
Samantha Gresham
- Occupational Therapist
- Detroit, MI
National Provider Identifier
1861994964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201009549
- Practice address
- 2799 W Grand Blvd
Detroit, MI 48202-2608 - Phone
- (313) 916-2600
- NPI assigned
- Mar 5, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5201009549 | MI | Primary |
Addresses
Primary practice location
2799 W Grand Blvd
Detroit, MI 48202-2608
Mailing address
2799 W Grand Blvd
Detroit, MI 48202-2608
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sgresham420429@direct.hfhs.org | Direct |
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 |
|---|---|---|---|
| 5201009549 | MI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616112000000",
"number": "1861994964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022608",
"telephone_number": "313-916-2600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRESHAM",
"first_name": "SAMANTHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-05",
"last_updated": "2021-03-19",
"certification_date": "2021-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201009549",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sgresham420429@direct.hfhs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2799 W Grand Blvd",
"city": "Detroit",
"state": "MI",
"country_code": "US",
"postal_code": "482022608",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.