Individual provider Active NPI

Cheryl P Athearn, PA

  • Physician Assistant
  • Alexandria, VA
National Provider Identifier
1366401705
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9107831 Issued in FL
Practice address
4320 Seminary Rd
Alexandria Hospital
Alexandria, VA 22304
Phone
(703) 504-3066
Fax
(703) 504-3866
NPI assigned
Mar 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10775 MN
Physician Assistant 363A00000X PA9107831 FL Primary

Addresses

Primary practice location

4320 Seminary Rd
Alexandria Hospital
Alexandria, VA 22304

Mailing address

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 254-1804

Other identifiers 1

IdentifierTypeStateIssuer
P00339583OtherMDRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20140806001460 FL Practitioner - Physician Assistant 4880613280 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9107831FLMDPhysician Assistant
10775MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Jan 11, 2023 Accepting new patients
FL-I Medical Services LLC Physician Assistant CurrentSince Oct 1, 2016 Accepting new patients
Pensacola Emergency Physicians, LLC CurrentSince Jun 1, 2014 Accepting new patients
Cep America LLC CurrentSince Jan 11, 2023 Accepting new patients
FL-I Medical Services LLC Physician Assistant CurrentSince Oct 1, 2016 Accepting new patients
Bestpractices, Inc. Past Accepting new patients
Vale of Paradise Emergency Physicians, LLC Past Accepting new patients
Emergency Medicine Associates Past Accepting new patients
Emergency Medicine Associates P.a., P.C. Past Accepting new patients
Ecc Addiction & Toxicology Services LLC Past Accepting new patients
Bestpractices, Inc. Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

996 Airport Rd
Destin, FL 32541
Phone (615) 338-1250

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

2190 Highway 85 N
Niceville, FL 32578
Phone (850) 678-4131

123 Baptist Way
Pensacola, FL 32503
Phone (850) 434-4011

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1366401705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 SEMINARY RD",
            "address_2": "ALEXANDRIA HOSPITAL",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "22304",
            "telephone_number": "703-504-3066",
            "fax_number": "703-504-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATHEARN",
        "first_name": "CHERYL",
        "middle_name": "P",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10775",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00339583",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.