NPIMap

Organization Active NPI

J Mark Gresham MD PC

  • Obstetrics & Gynecology Physician
  • Waynesboro, GA
National Provider Identifier
1952574550
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
039358 Issued in GA
Legal business name
J MARK GRESHAM MD PC
Practice address
301 Jones Ave
Waynesboro, GA 30830-1510
Phone
(706) 437-0770
Fax
(706) 437-0540
NPI assigned
Apr 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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

Authorized official

Name
Dr. Jones Mark Gresham, M.D.NPI 1326026618
Title
Owner
Phone
(706) 437-0770

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
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 039358 GA Primary

Addresses

Primary practice location

301 Jones Ave
Waynesboro, GA 30830-1510

Mailing address

301 Jones Ave
P O Box 328
Waynesboro, GA 30830-1510
Phone (706) 437-0770

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1952574550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 JONES AVE",
            "address_2": "P O BOX 328",
            "city": "WAYNESBORO",
            "state": "GA",
            "postal_code": "308301510",
            "telephone_number": "706-437-0770",
            "fax_number": "706-437-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 JONES AVE",
            "city": "WAYNESBORO",
            "state": "GA",
            "postal_code": "308301510",
            "telephone_number": "706-437-0770",
            "fax_number": "706-437-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J MARK GRESHAM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-04",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "GRESHAM",
        "authorized_official_first_name": "JONES",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-437-0770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "039358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.