Bradley Alan Cherry, D.D.S., M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN17470 Issued in FL

Practice address

109 Nature Walk Parkway
Suite 106
St. Augustine, FL 32092

Phone

(904) 230-6399

NPI assigned

Oct 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 13, 2015 through Feb 13, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942399852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4604 SW 45TH LN",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084948",
            "telephone_number": "352-246-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 NATURE WALK PARKWAY",
            "address_2": "SUITE 106",
            "city": "ST. AUGUSTINE",
            "state": "FL",
            "postal_code": "32092",
            "telephone_number": "904-230-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERRY",
        "first_name": "BRADLEY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN17470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa A Chase, PT
• Erica Chatila
• Sharon Cheatle, OTR
• Tanjeet Cheema
• Subhadra Chereddy, MBBS
• Chesapeake Hyperbaric LC
• Courtney Chesek, LPN
• Kayla Chesser-Murray, APRN
• Leh-Ha Lucia Chew, DDS
• Children's Home Society of Florida

• Oral and Maxillofacial Surgery (Dentist) in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.