Individual provider Active NPI

Cherry Antoine, NP

  • Acute Care Nurse Practitioner
  • Menifee, CA
National Provider Identifier
1215745187
Registry record updated Mar 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95033399 Issued in CA
Practice address
26689 Dash Dr
Menifee, CA 92585-1333
Phone
(619) 626-5980
NPI assigned
Dec 24, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2100X 95033399 CA Primary

Addresses

Primary practice location

26689 Dash Dr
Menifee, CA 92585-1333

Mailing address

26689 Dash Dr
Menifee, CA 92585-1333
Phone (619) 626-5980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250901000018 CA Practitioner - Nurse Practitioner 5799286613 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medexa Medical Group, CorporationGroup PAC ID 3375060296, 7 clinicians

Practice addresses (Care Compare)

2204 E 4TH St
Suite 106
Santa Ana, CA 92705-3868
Phone (949) 832-1055

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Western Institute of Critical Care Medicine, Inc Single Specialty CurrentSince Dec 1, 2025 Accepting new patients
Medexa Medical Group, Corporation Single Specialty CurrentSince Aug 11, 2025 Accepting new patients
Advanced Foot & Ankle Single Specialty PastSince Aug 11, 2025 Accepting new patients

Locations

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

2204 E 4th St
Ste 107
Santa Ana, CA 92705
Phone (949) 832-1055

2204 E 4th St
Ste 106
Santa Ana, CA 92705
Phone (949) 832-1055

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1734998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741392000000",
    "number": "1215745187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26689 DASH DR",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925851333",
            "telephone_number": "619-626-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26689 DASH DR",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925851333",
            "telephone_number": "619-626-5980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTOINE",
        "first_name": "CHERRY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-24",
        "last_updated": "2025-03-08",
        "certification_date": "2025-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95033399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menifee, CA

Sources for this page

Verify at the official NPI Registry.