Cherry Street Surgery Center, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

0046 Issued in OK

Legal business name

CHERRY STREET SURGERY CENTER, LLC

Practice address

1844 E 15TH St
Tulsa, OK 74104-4611

Phone

(918) 749-7177

NPI assigned

Dec 21, 2006

Last updated

Oct 7, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark L Mathers, D.O.NPI 1124150032

Title

Medical Director

Phone

(918) 749-7177

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Listed as

Cherry Street Surgery Center LLCCCN 37C0001033

Medicare certification status

ActiveFrom the Provider of Services file

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark L Mathers, D.O.

  • Plastic Surgery Physician
  • Tulsa, OK
  • NPI 1124150032
  Authorized official Same address or phone
• Brian Thomas Torgerson, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Tulsa, OK
  • NPI 1194928283
  NPD
• Adam Joseph Wallace, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Tulsa, OK
  • NPI 1518129733
  NPD

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223337600000",
    "number": "1902960198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1844 E 15TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044611",
            "telephone_number": "918-749-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1844 E 15TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044611",
            "telephone_number": "918-749-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERRY STREET SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2008-10-07",
        "status": "A",
        "authorized_official_last_name": "MATHERS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "918-749-7177",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OK",
            "license": "0046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dustin Cheney, D.O.
• Sherry Ann Chennault, M.S., LPC
• Rebecca Cherms
• Cherry Street MRI Inc
• Cherry Street Pain Clinic LLC
• Andrea Nicole Cherry, NP-C
• Cass Cherry, D.O.
• Cheryl Cherry
• Courtney Dawn Cherry
• Larry D Cherry, DO

• Clinic/Center in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.