Individual provider Active NPI

Cherriee Milynn Deshong, WHNP

  • Women's Health Nurse Practitioner
  • Goodyear, AZ
National Provider Identifier
1093298283
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
AP11764 Issued in AZ
Practice address
13471 W Cornerstone Blvd
Goodyear, AZ 85395-2713
Phone
(480) 964-2273
NPI assigned
Sep 13, 2018
Last updated
Jun 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X AP11764 AZ Primary

Addresses

Primary practice location

13471 W Cornerstone Blvd
Goodyear, AZ 85395-2713

Mailing address

3033 N Central Ave Ste 145
Phoenix, AZ 85012-2808
Phone (623) 583-3001

Other identifiers 1

IdentifierTypeStateIssuer
428718MedicaidAZ

Other names 1

  • Cherriee Glasscock Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20181204003579 AZ Practitioner - Nurse Practitioner 2961746706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adelante Healthcare, IncGroup PAC ID 4688588643, 132 clinicians

Practice addresses (Care Compare)

13471 W Cornerstone Blvd
Goodyear, AZ 85395-2713
Phone (877) 809-5092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP11764AZMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adelante Healthcare, Inc. Current Accepting new patients
Adelante Healthcare, Inc CurrentSince Apr 6, 2024 Accepting new patients
Adelante Healthcare, Inc. CurrentSince Apr 6, 2024 Accepting new patients
Adelante Healthcare, Inc. Past Accepting new patients

Locations

13471 W Cornerstone Blvd
Goodyear, AZ 85395
Phone (844) 551-6691

1705 W Main St
Mesa, AZ 85201
Phone (480) 845-6769

3033 N Central Ave
Ste 145
Phoenix, AZ 85012

9610 N Metro Pkwy W
Phoenix, AZ 85051
Phone (602) 618-0002

15317 W Bell Rd
Ste 100
Surprise, AZ 85374

15351 W Bell Rd
Surprise, AZ 85374

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1093298283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 N CENTRAL AVE STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122808",
            "telephone_number": "623-583-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13471 W CORNERSTONE BLVD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952713",
            "telephone_number": "480-964-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHONG",
        "first_name": "CHERRIEE",
        "middle_name": "MILYNN",
        "name_prefix": "Mrs.",
        "credential": "WHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AZ",
            "license": "AP11764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428718",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERRIEE",
            "last_name": "GLASSCOCK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.