Tom J Gresham, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

765 Issued in OK

Practice address

4111 S Darlington Ave
Ste 700
Tulsa, OK 74135-6348

Phone

(918) 743-8943

Fax

(918) 743-9058

NPI assigned

Nov 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pulmonary Care Innovations PLLC

  • Clinic/Center
  • Tulsa, OK
  • NPI 1124598149
  NPD
• Radiological Imaging of Oklahoma, L.L.C.

  • Medical Specialty Clinic/Center
  • Owasso, OK
  • NPI 1588649305
  NPD (past)
• Radiology Consultants of Tulsa Inc

  • Diagnostic Radiology Physician
  • Tulsa, OK
  • NPI 1487641890
  NPD (past)

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1952384232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4939",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741590939",
            "telephone_number": "918-743-8943",
            "fax_number": "918-743-9058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 S DARLINGTON AVE",
            "address_2": "STE 700",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741356348",
            "telephone_number": "918-743-8943",
            "fax_number": "918-743-9058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESHAM",
        "first_name": "TOM",
        "middle_name": "J",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100087830B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Greses
• Anthony Gresham
• Ashley Gresham
• Ashley Gresham
• Kevin Thomas Gresham
• Theresa Lynn Gress, APRN
• Deborah Louise Greubel, ARNP
• Jacob V Greuel, MD
• Kiersten D Greuel
• Harleen Grewal, M.D.

• Physician Assistant in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.