Norman M Fernando, MD

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

15894 Issued in AZ

Practice address

6619 N 19TH Ave
Ste B
Phoenix, AZ 85015-1631

Phone

(602) 254-5777

Fax

(602) 253-9771

NPI assigned

Aug 25, 2005

Reactivated

Mar 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1023001963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6619 N 19TH AVE",
            "address_2": "STE B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850151631",
            "telephone_number": "602-254-5777",
            "fax_number": "602-253-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6619 N 19TH AVE",
            "address_2": "STE B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850151631",
            "telephone_number": "602-254-5777",
            "fax_number": "602-253-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDO",
        "first_name": "NORMAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2015-12-01",
        "deactivation_date": "2006-03-27",
        "reactivation_date": "2006-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "AZ",
            "license": "15894",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AZ",
            "license": "15894",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254293",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robin Renae Fernandez, M.ED, LISAC
• Rosa Ileana Fernandez
• Samuel Tamayo Fernandez Jr., DDS
• Barry Fernando, MD
• Coleene Fernando, MD
• Shahan Fernando, M.D.
• Limy Fernandus, FNP-C
• Martin J Feroli, COTA
• Arbita K Ferozepurwalla, LPC
• Joseph Ferral, LPC

• Critical Care Medicine (Internal Medicine) Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Critical Care Medicine (Internal Medicine) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.