Agustin Fernandez, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

N5678 Issued in AR

Practice address

3401 Springhill Dr
Ste 400
North Little Rock, AR 72117-2924

Phone

(501) 945-3343

Fax

(501) 945-0770

NPI assigned

Jun 8, 2006

Sex

Male

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 10

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Gastro Clinics of Arkansas, PLLC

  • Specialist
  • North Little Rock, AR
  • NPI 1972944064
  Medicare reassignment NPD
• Arkansas Gastroenterology

  • Specialist
  • North Little Rock, AR
  • NPI 1952358657
  NPD

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282262400000",
    "number": "1124069752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 SPRINGHILL DR",
            "address_2": "STE 400",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172924",
            "telephone_number": "501-945-3343",
            "fax_number": "501-945-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 SPRINGHILL DR",
            "address_2": "STE 400",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172924",
            "telephone_number": "501-945-3343",
            "fax_number": "501-945-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "AGUSTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AR",
            "license": "N5678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTHCARE",
            "identifier": "4205587",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC RAILROAD MEDICARE",
            "identifier": "100005435",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BLUE CROSS BLUE SHIELD",
            "identifier": "51650",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ADVANTAGE",
            "identifier": "51650",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105232001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE ADVANTAGE",
            "identifier": "51650",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST SOURCE",
            "identifier": "51650",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "11415000000",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "7106445040014",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "710644504005",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ja'Kiya Kristeria Farris
• Melinda Jo Felkins, RDH
• Traynesha Makiya Renee Fells
• Jack T Fendley, M.D.
• Joshua Ferguson, PT. DPT. MSOP, LPO
• Lytonya Ferrell
• Finders Keepers Disability Service Inc
• Deandra Finley
• First Step Arkansas, LLC
• Cory Fischer, PT

• Specialist in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Specialist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.