Individual provider Active NPI

Dorian Fernandez

  • Registered Nurse
  • Kapolei, HI
National Provider Identifier
1174355374
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN-115340 Issued in HI
Practice address
91-1051 Franklin D Roosevelt Ave
Kapolei, HI 96707-2185
Phone
(808) 458-5065
NPI assigned
Aug 15, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN-115340 HI Primary

Addresses

Primary practice location

91-1051 Franklin D Roosevelt Ave
Kapolei, HI 96707-2185

Mailing address

91-1051 Franklin D Roosevelt Ave
Kapolei, HI 96707-2185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN-115340HIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1174355374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-1051 FRANKLIN D ROOSEVELT AVE",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-1051 FRANKLIN D ROOSEVELT AVE",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072185",
            "telephone_number": "808-458-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "DORIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "HI",
            "license": "RN-115340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapolei, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.