Cherry Hill Clinic, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CHERRY HILL CLINIC, LLC

Doing business as

Cherry Hill Clinic

Practice address

1160 E High Point LN
Columbia, MO 65203-9335

Phone

(352) 226-7603

NPI assigned

Sep 20, 2017

Organization subpart

No

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

Authorized official

Name

Ellen Dukate

Title

Credentialing Specialist

Phone

(904) 515-2625

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cherry Hill Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

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

• Sheena Jose, MD

  • Family Medicine Physician
  • Columbia, MO
  • NPI 1710055389
  Medicare reassignment NPD

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505865600000",
    "number": "1780193920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 E HIGH POINT LN",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652039335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 E HIGH POINT LN",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652039335",
            "telephone_number": "352-226-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERRY HILL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2017-09-20",
        "status": "A",
        "authorized_official_last_name": "DUKATE",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "904-515-2625"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "2011003501",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cherry Hill Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sherly Cherian
• Cole Cheripka
• Nadezhda Chernookaya, ACCNS-AG
• Shawn Cherri
• Melinda L Cherrington
• Cherry Hill Dental Associates Inc
• Nathan Douglas Chesshir, CRNA
• Jennifer Cheung, DO
• Steven Shing Yan Cheung, M.D.
• Michael R Chicoine, MD

• Family Medicine Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; 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.