Active NPI
Keishia Gresham
- Licensed Practical Nurse
- Plymouth Meeting, PA
National Provider Identifier
1891915682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN252843L
- Practice address
- 2250 Hickory Rd
Suite 240
Plymouth Meeting, PA 19462-1047 - Phone
- (610) 834-1122
- Fax
- (610) 834-7525
- NPI assigned
- Apr 26, 2007
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN252843L | PA | Primary |
Addresses
Primary practice location
2250 Hickory Rd
Suite 240
Plymouth Meeting, PA 19462-1047
Mailing address
603 Swift St
Norristown, PA 19401-5157
Phone (610) 278-0355
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 |
|---|---|---|---|
| PN252843L | PA | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891915682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "603 SWIFT ST",
"city": "NORRISTOWN",
"state": "PA",
"postal_code": "194015157",
"telephone_number": "610-278-0355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2250 HICKORY RD",
"address_2": "SUITE 240",
"city": "PLYMOUTH MEETING",
"state": "PA",
"postal_code": "194621047",
"telephone_number": "610-834-1122",
"fax_number": "610-834-7525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRESHAM",
"first_name": "KEISHIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "PA",
"license": "PN252843L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth Meeting, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.