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

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.

Title

Medical Director

Phone

(918) 749-7177

Specialties & licenses 1

Addresses

Other identifiers 2

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 2

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

• 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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100748420A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "731572836-001",
            "state": "OK"
        }
    ],
    "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.