Active NPI
Cherilyn Carrillo Cabanero, PA-C
- Physician Assistant
- Cordova, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5532
- Practice address
- 57 Germantown CT Ste 100
Cordova, TN 38018-4274 - Phone
- (901) 435-8550
- Fax
- (901) 478-0781
- NPI assigned
- Jan 17, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5532 | TN | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
57 Germantown CT Ste 100
Cordova, TN 38018-4274
Mailing address
1211 Union Ave Ste 330
Memphis, TN 38104-6655
Other practice location 1
3950 New Covington Pike Ste 220
Memphis, TN 38128-2595
Phone (901) 763-0200
Other practice location 2
4240 Bethel Rd Ste 201
Olive Branch, MS 38654-8737
Phone (901) 763-0200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4240 Bethel Rd
Suite 201
Olive Branch, MS 38654-8737
Phone (901) 763-0200
4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone (662) 932-9000
57 Germantown CT
Suite 100
Cordova, TN 38018-4274
Phone (901) 435-8550
7460 Wolf River Blvd
Germantown, TN 38138-1760
Phone (901) 763-0200
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5532 | TN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutherland Cardiology Clinic, P.C. | Current | Accepting new patients | |
| Methodist Healthcare - Olive Branch Hospital | Past | Accepting new patients |
Locations
7460 Wolf River Blvd
Memphis, TN 38138
Phone (901) 516-6792
Interoperability endpoints
- cherilyncabanero@sccpc.allscriptsdirect.net
- ccabanero23946@mlh.direct-ci.com
Organizations & group practices 3
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.
-
- Specialist
- Germantown, TN
- NPI 1740391804
-
- General Acute Care Hospital
- Olive Branch, MS
- NPI 1912341439
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Le Bonheur Children's Hospital
- Children's Hospital
- Memphis, TN
- NPI 1386709871
-
- General Acute Care Hospital
- Memphis, TN
- NPI 1558365890
-
dba Le Bonheur Children's Hospital - Germantown
- Children's Hospital
- Germantown, TN
- NPI 1649654450
-
- General Acute Care Hospital
- Olive Branch, MS
- NPI 1912341439
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704844800000",
"number": "1114632908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1211 UNION AVE STE 330",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381046655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57 GERMANTOWN CT STE 100",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380184274",
"telephone_number": "901-435-8550",
"fax_number": "901-478-0781"
}
],
"practiceLocations": [
{
"address_1": "3950 New Covington Pike Ste 220",
"address_purpose": "LOCATION",
"city": "Memphis",
"state": "TN",
"postal_code": "381282595",
"country_code": "US",
"telephone_number": "901-763-0200",
"fax_number": "901-516-5370",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4240 Bethel Rd Ste 201",
"address_purpose": "LOCATION",
"city": "Olive Branch",
"state": "MS",
"postal_code": "386548737",
"country_code": "US",
"telephone_number": "901-763-0200",
"fax_number": "901-761-4002",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CABANERO",
"first_name": "CHERILYN",
"middle_name": "CARRILLO",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-17",
"last_updated": "2024-01-10",
"certification_date": "2024-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "5532",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cordova, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.