Individual provider Active NPI

Cherie Darlene Ertha, M.D.

  • Family Medicine Physician
  • Plymouth, NH
National Provider Identifier
1629090600
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
80607 Issued in MA
Practice address
103 Boulder Point Dr
Plymouth, NH 03264-3168
Phone
(603) 536-1881
NPI assigned
Jul 25, 2006
Last updated
Jan 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 28155 WV
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 80607 MA
Family Medicine Physician 207Q00000X 80607 MA Primary

Addresses

Primary practice location

103 Boulder Point Dr
Plymouth, NH 03264-3168

Mailing address

16 Hospital Rd
Plymouth, NH 03264-1126
Phone (603) 238-6447

Other practice location 1

3 E Benjamin Dr
New Martinsville, WV 26155-2705
Phone (304) 455-8000

Other identifiers 3

IdentifierTypeStateIssuer
J31270OtherMABLUE CROSS & BLUE SHIELD
080607OtherMATUFTS HEALTH PLAN
3142418MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, TX, WV3 enrollments
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.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20060330000494 MA Practitioner - Emergency MedicinePractitioner - Family Practice 7315955457 Reassigns benefits to 2 organizations
I20180404000855 TX Practitioner - Emergency Medicine 7315955457 Reassigns benefits to 1 organization
I20180619001188 WV Practitioner - Emergency Medicine 7315955457 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Feb 21, 2018 Accepting new patients
Lakes/National Emergency Physicians Inc Emergency Medicine CurrentSince Mar 15, 2018 Accepting new patients
LGH Medical Group, Inc. Family Medicine CurrentSince Apr 1, 2025 Accepting new patients
Beckley Emergency Physicians LLC Emergency Medicine CurrentSince Jan 6, 2020 Accepting new patients
Cherokee Nation CurrentSince Feb 21, 2018 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
LGH Professional Services LLC Past Accepting new patients
Steward Medical Group, Inc. Past Accepting new patients

Locations

575 Beech St
Holyoke, MA 01040
Phone (413) 534-2570

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

600 Clark Rd
Tewksbury, MA 01876
Phone (978) 452-3453

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

306 Stanaford Rd
Beckley, WV 25801
Phone (304) 255-3373

Interoperability endpoints

  • Direct secure messaging: certha135146@tuftsmedicine.direct-ci.com
  • Direct secure messaging: cherie.ertha@778128272654340.direct.elationemr.com

Organizations & group practices 9

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1629090600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 HOSPITAL RD",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "032641126",
            "telephone_number": "603-238-6447",
            "fax_number": "603-536-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 BOULDER POINT DR",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "032643168",
            "telephone_number": "603-536-1881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 E Benjamin Dr",
            "address_purpose": "LOCATION",
            "city": "New Martinsville",
            "state": "WV",
            "postal_code": "261552705",
            "country_code": "US",
            "telephone_number": "304-455-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERTHA",
        "first_name": "CHERIE",
        "middle_name": "DARLENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2023-01-25",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "28155",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MA",
            "license": "80607",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "80607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "J31270",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "080607",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3142418",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, NH

Sources for this page

Verify at the official NPI Registry.