MARY ETTA JAMES GRESHAM R.D.L.D. NPI 1316057862

NPI Information

  • NPI: 1316057862
  • Provider Name: MARY ETTA JAMES GRESHAM, R.D.L.D.
  • Classification: Dietitian, Registered - 133VN1005X
  • Specialization: Nutrition, Renal
  • Entity Type: Individual
  • Address: 5330 CAYUGA CT
    LITHONIA, GA
    ZIP 30038
  • Phone: (404) 578-6525

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NPI Details

Mary Etta James Gresham, R.D.L.D. is a nutrition and renal dietitian registered in Lithonia, GA. The provider is an individual who is a Board Certified Specialist in Renal Nutrition and works directly with adult and/or pediatric patients with acute kidney injury, chronic kidney disease (CKD) stages 1-5, or receiving renal replacement therapies (dialysis/transplant) in a variety of settings, OR works indirectly in management, education, or research practice linked specifically to renal nutrition. The specialist in renal/nephrology nutrition is responsible for nutrition assessment, diagnosis, intervention, monitoring, and evaluation. Mary Etta James Gresham, R.D.L.D. NPI is 1316057862. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5330 CAYUGA CT
LITHONIA, GA
ZIP 30038-106
Phone: (404) 578-6525

The enumeration date for this NPI number is 8/30/2006 and was last updated on 7/31/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1133VN1005XDietitian, RegisteredNutrition, RenalLD000377GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
171BBBTTMEDICARE PINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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