Susan Fernandes

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

S2579 Issued in TX

Practice address

620 S Grove St Ste 105
Marshall, TX 75670-5295

Phone

(903) 935-9441

Fax

(903) 938-1246

NPI assigned

Apr 5, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Houston Community Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
  • NPI 1093780280
  NPD (past)

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

{
    "created_epoch": "1428192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1104211275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1326",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "756711326",
            "telephone_number": "903-927-3782",
            "fax_number": "903-927-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S GROVE ST STE 105",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "756705295",
            "telephone_number": "903-935-9441",
            "fax_number": "903-938-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDES",
        "first_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-05",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S2579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "S2579",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yoalnda Cherie Escobedo
• Essential Counseling and Resources, LLC
• Everi Woman'S Health Care, P.a.
• James A. Facello, D.O.
• Melinda Fenton, APRN, PMHNP-BC
• Ivonne Flores, RN
• Tameka Rasha Floyd
• Sharelle Fontenot, LVN
• Ashley Frazier
• Fresh Air Oxygen and Medical Supply

• Pediatrics Physician in Marshall, TX
• Providers in Marshall, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.