Individual provider Active NPI

Mary Lee Cherry, MD

  • Obstetrics & Gynecology Physician
  • Covington, LA
National Provider Identifier
1366492621
Registry record updated Aug 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
020710 Issued in LA
Practice address
204 Highland Park PLZ
Covington, LA 70433-7129
Phone
(985) 809-3883
Fax
(985) 809-3886
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 020710 LA Primary

Addresses

Primary practice location

204 Highland Park PLZ
Covington, LA 70433-7129

Mailing address

204 Highland Park Plaza
Covington, LA 70433-7233
Phone (985) 809-3883

Other identifiers 2

IdentifierTypeStateIssuer
1967874MedicaidLA
020710OtherLASTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Nov 1, 2015 through Nov 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
020710LAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Lee Cherry, MD Apmc Obstetrics & Gynecology Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 2

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217894400000",
    "number": "1366492621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 HIGHLAND PARK PLAZA",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337233",
            "telephone_number": "985-809-3883",
            "fax_number": "985-809-3886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 HIGHLAND PARK PLZ",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337129",
            "telephone_number": "985-809-3883",
            "fax_number": "985-809-3886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERRY",
        "first_name": "MARY",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2008-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "LA",
            "license": "020710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1967874",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "020710",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.