Individual provider Active NPI

Juan H Fernandez, M.D.

  • Specialist
  • Greensboro, NC
National Provider Identifier
1033222435
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
33037 Issued in NC
Practice address
719 Green Valley Rd
Suite 305
Greensboro, NC 27408
Phone
(336) 275-5391
Fax
(336) 275-4702
NPI assigned
Aug 17, 2006
Last updated
Sep 25, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 33037 NC Primary

Addresses

Primary practice location

719 Green Valley Rd
Suite 305
Greensboro, NC 27408

Mailing address

719 Green Valley Rd
Suite 305
Greensboro, NC 27408-7014
Phone (336) 275-5391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090713000560 NC Practitioner - Obstetrics/Gynecology 0648322271

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33037NCMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1033222435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 GREEN VALLEY RD",
            "address_2": "SUITE 305",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087014",
            "telephone_number": "336-275-5391",
            "fax_number": "336-275-4702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 GREEN VALLEY RD",
            "address_2": "SUITE 305",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27408",
            "telephone_number": "336-275-5391",
            "fax_number": "336-275-4702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "JUAN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "33037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.