Golden Isles Neurology, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

#036152 Issued in GA

Legal business name

GOLDEN ISLES NEUROLOGY, PC

Practice address

3226-C Hampton Avenue
Brunswick, GA 31520-4254

Phone

(912) 261-0044

Fax

(912) 261-0226

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Enrique J Fernandez, MD

Title

President

Phone

(912) 261-0044

Specialties & licenses 2

Addresses

Other identifiers 3

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303430400000",
    "number": "1164589065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3226-C HAMPTON AVENUE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204254",
            "telephone_number": "912-261-0044",
            "fax_number": "912-261-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3226-C HAMPTON AVENUE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204254",
            "telephone_number": "912-261-0044",
            "fax_number": "912-261-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN ISLES NEUROLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2011-04-22",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "ENRIQUE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-261-0044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "036152",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "#036152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "#000518647J",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000518647J",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC3356",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Golden Isles Pediatrics Inc
• Golden Isles Prosthetics & Avery Watson Strickland Sole MBR

• Specialist in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2011; 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.