Chere Ann O'Grady, P.A-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17605 Issued in CA

Practice address

12550 Hesperia Rd Ste 100
Victorville, CA 92395-5873

Phone

(760) 241-6666

Fax

(760) 247-7575

NPI assigned

Jun 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1619912482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W CENTER STREET PROMENADE STE 300",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053960",
            "telephone_number": "714-449-4841",
            "fax_number": "714-937-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12550 HESPERIA RD STE 100",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955873",
            "telephone_number": "760-241-6666",
            "fax_number": "760-247-7575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18300 Highway 18",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "92307",
            "country_code": "US",
            "telephone_number": "760-242-2311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18300 Highway 18",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "92307",
            "country_code": "US",
            "telephone_number": "760-242-2311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'GRADY",
        "first_name": "CHERE",
        "middle_name": "ANN",
        "credential": "P.A-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ijeoma Obiageli Nwokenna, B.PHARM
• Charles Nwufo, MFTI
• Brian Nyamwange, PHARMD
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• Erica Renita O'Connor
• Karen Lynne O'Rear II
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• Oak & Vale Care Inc.
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• Joseph S Obadahun, LICENSEE

• Physician Assistant in Victorville, CA
• Providers in Victorville, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.