Nicola J Cherry MD LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD21778 Issued in OR

Legal business name

NICOLA J CHERRY MD LLC

Practice address

2580 Daggett Ave
Klamath Falls, OR 97601-1127

Phone

(541) 884-1224

NPI assigned

Jul 7, 2006

Organization subpart

No

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

Authorized official

Name

Nicola J Cherry, M.D.NPI 1508812207

Title

Owner

Phone

(541) 884-1224

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Childrens Clinic of Klamath Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicola J Cherry, M.D.

  • Pediatrics Physician
  • Klamath Falls, OR
  • NPI 1508812207

  OR, Pediatrics

  Medicare reassignment NPD Authorized official
• Ann Elisabeth Kellogg, D.O.

  • Hospitalist Physician
  • Bend, OR
  • NPI 1619291127

  OR

  Medicare reassignment NPD
• Joanne M Wallis, PNP

  • Primary Care Nurse Practitioner
  • Vancouver, WA
  • NPI 1932370756

  OR

  Medicare reassignment NPD
• Logan Bruttig, DO

  • Emergency Medicine Physician
  • Klamath Falls, OR
  • NPI 1568020246
  NPD (past)
• Damon Lerma, MD

  • Family Medicine Physician
  • Klamath Falls, OR
  • NPI 1407598568
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250812800000",
    "number": "1760415525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1359",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976010075",
            "telephone_number": "541-882-1540",
            "fax_number": "541-882-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011127",
            "telephone_number": "541-884-1224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLA J CHERRY MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2009-08-21",
        "status": "A",
        "authorized_official_last_name": "CHERRY",
        "authorized_official_first_name": "NICOLA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-884-1224",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD21778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288475",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Childrens Clinic of Klamath",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Candace Newbold, FNP-BC
• China Rae Newman, MD
• Jennifer Newton, RD
• Anthony Vinhthong Nguyen
• Jane Nicholson
• Trava Nieves
• Nightingale Home Healthcare of Oregon, Inc.
• Lucia Nino
• Nisha Jackson PC
• Grant Niskanen, MD

• Pediatrics Physician in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.