Individual provider Active NPI

Dawn Elizabeth Gresko, PMH-CNS

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Middleburg Heights, OH
National Provider Identifier
1972845188
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
APRN.CNS.13865 Issued in OH
Practice address
18660 Bagley Rd Ste 404
Middleburg Heights, OH 44130-3483
Phone
(404) 234-8746
Fax
(440) 234-8746
NPI assigned
Mar 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X APRN.CNS.13865 OH Primary

Addresses

Primary practice location

18660 Bagley Rd Ste 404
Middleburg Heights, OH 44130-3483

Mailing address

18660 Bagley Rd Ste 404
Middleburg Heights, OH 44130-3483
Phone (330) 690-9311

Other identifiers 1

IdentifierTypeStateIssuer
3025372MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140717000825 OH Practitioner - Certified Clinical Nurse Specialist (CNS) 8123244779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florence Kimbo MD LLCGroup PAC ID 4183850423, 13 clinicians

Practice addresses (Care Compare)

7530 Lucerne Dr
Suite 110
Middleburg Heights, OH 44130-6557
Phone (440) 234-8746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
APRN.CNS.13865OHMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ddunaway1228554@direct.ccf.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1972845188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18660 BAGLEY RD STE 404",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303483",
            "telephone_number": "330-690-9311",
            "fax_number": "216-450-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18660 BAGLEY RD STE 404",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303483",
            "telephone_number": "404-234-8746",
            "fax_number": "440-234-8746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESKO",
        "first_name": "DAWN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PMH-CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-26",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "OH",
            "license": "APRN.CNS.13865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3025372",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg Heights, OH

Sources for this page

Verify at the official NPI Registry.