CHERI ENNIS (NPI# 1578584025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578584025 |
| Entity Type | Individual |
| Full Name | CHERI ENNIS |
| Credential | PA-C |
| Practice Address |
1145 S Utica Ave Ste 460 Tulsa OK 74104-4041 |
| Mailing Address |
1145 S Utica Ave Ste 460 Tulsa OK 74104-4041 |
| Practice Telephone | 9185795749 |
| Practice Fax Number | 9185795762 |
| Mailing Telephone | 9185795749 |
| Mailing Fax Number | 9185795762 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2019-06-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA883 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1145 S UTICA AVE STE 460 |
| City | TULSA |
| State | OK |
| Zip Code | 74104-4041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356376883 | Maak Attiya Dareshani | Internal Medicine | 1145 S Utica Ave Ste 460, Tulsa, OK 74104-4041 | 2006-07-12 |
| 1588273569 | Steven Wingfield | Nurse Practitioner | 1145 S Utica Ave Ste 460, Tulsa, OK 74104-4041 | 2020-07-27 |
| 1164069530 | Jennifer Marie Smith-woosley | Nurse Practitioner | 1145 S Utica Ave Ste 460, Tulsa, OK 74104-4041 | 2019-12-04 |
| 1194361451 | Nada Shahab | Physician Assistant | 1145 S Utica Ave Ste 460, Tulsa, OK 74104-4041 | 2019-11-21 |
| 1104384379 | Wendy Alexander | Nurse Practitioner | 1145 S Utica Ave Ste 460, Tulsa, OK 74104-4041 | 2019-03-06 |
| 1659840213 | Crystal Lynn Jensen | Nurse Practitioner | 1145 S Utica Ave Ste 460, Tulsa, OK 74104-4041 | 2018-11-13 |
| 1740767029 | Suma Thomas | Nurse Practitioner | 1145 S Utica Ave Ste 460, Tulsa, OK 74104-4041 | 2018-07-19 |
| 1265925382 | Rebecca Shaffer | Physician Assistant | 1145 S Utica Ave Ste 460, Tulsa, OK 74104-4041 | 2018-06-13 |
| 1609364314 | Velisa Davis | Nurse Practitioner | 1145 S Utica Ave Ste 460, Tulsa, OK 74104-4041 | 2018-04-27 |
| 1598264004 | Anjuli Shrestha | Physician Assistant | 1145 S Utica Ave Ste 460, Tulsa, OK 74104 | 2018-02-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982253811 | Ultimate Health and Pain Management | Pain Medicine | 1844 East 15th Street, Tulsa, OK 74104 | 2019-09-04 |
| 1225691223 | David Murray | Student in an Organized Health Care Education/Training Program | 2100 S Wheeling Ave, Tulsa, OK 74104 | 2019-04-16 |
| 1083115828 | Susan Fortner | Counselor | 1328 S. Delaware Pl, Tulsa, OK 74104 | 2018-02-27 |
| 1033636915 | Mark Brizendine | Dietitian, Registered | Hillcrest Medical Center 1120 S. Utica Ave, Tulsa, OK 74104 | 2017-08-23 |
| 1295259067 | Demi Reyd Cook | Nurse Practitioner | 1717 A South Utica, Tulsa, OK 74104 | 2017-08-02 |
| 1851827059 | Oklahoma Cvs Pharmacy | Durable Medical Equipment & Medical Supplies | 1701 E 15th Street, Tulsa, OK 74104 | 2017-05-08 |
| 1801334982 | Jamie Lynne Miller | Internal Medicine | 2000 S. Wheeling Avenue Ste 510, Tulsa, OK 74104 | 2017-02-08 |
| 1578913430 | Donna Durant-macon | Registered Nurse | 315 South Utica, Tulsa, OK 74104 | 2016-06-21 |
| 1669833851 | Mbc Dental | Dentist | 401 S. Utica Ave, #a, Tulsa, OK 74104 | 2016-03-15 |
| 1518332170 | Neuro Dynamics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 22 S Lewis, Tulsa, OK 74104 | 2015-12-08 |
| Find all providers in zip 74104 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073154647 | Haley Nicole Beaird | Physician Assistant | 8907 E 93rd St, Tulsa, OK 74133-5634 | 2019-10-03 |
| 1790155562 | Caldwell Medical Group of North Tulsa LLC | Physician Assistant | 8014 S 101st East Ave, Tulsa, OK 74133-4579 | 2015-10-05 |
| 1609298330 | Marci Love Deck | Physician Assistant | 2000 S Wheeling Ave Ste 1000, Tulsa, OK 74104-5648 | 2014-01-15 |
| 1619216272 | Nicole Lisette Mancinelli | Physician Assistant | 2424 E. 21st Street, Suite 320, Tulsa, OK 74114 | 2013-02-01 |
| 1184959389 | Erin Nicole Jones | Physician Assistant | 11212 E 48th St., Oklahoma Oncology, Tulsa, OK 74146-5806 | 2009-10-06 |
| 1194901793 | Annamae Kay | Physician Assistant | 1919 South Wheeling Ave, Ste 304, Tulsa, OK 74104 | 2008-01-14 |
| 1265632129 | Oklahoma Occupational Health Center | Physician Assistant | 5640 S Memorial Dr, Tulsa, OK 74145-9001 | 2007-07-19 |
| 1962535831 | Njanja Margaret Ruenji | Physician Assistant | Morton Comprehensive Health Services, 1334 N. Lasing Ave, Tulsa, OK 74106-5907 | 2007-03-13 |
| 1740355460 | Jeri Clark Goen | Physician Assistant | 3807 S Peoria Ave, Suite G and H, Tulsa, OK 74105-3145 | 2006-11-21 |
| 1790879237 | Steven Paul Henry | Physician Assistant | 10506 South Memorial Drive, Tulsa, OK 74133 | 2006-10-02 |
| Find all providers in TULSA | ||||
Please comment or provide details below to improve the information on CHERI ENNIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.