Jaistemmi Fernandez List

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

166988.MEDS-IV Issued in OH

Practice address

5275 N Abbe Rd
Sheffield Village, OH 44035-1451

Phone

(440) 934-9158

NPI assigned

Dec 21, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1671580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1194437152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 N JAMES RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432191834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5275 N ABBE RD",
            "city": "SHEFFIELD VILLAGE",
            "state": "OH",
            "postal_code": "440351451",
            "telephone_number": "440-934-9158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ LIST",
        "first_name": "JAISTEMMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-21",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "166988.MEDS-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Evans
• Evergreen Pain Management & Rehabilitation LTD
• Everside Health, LLC
• Mourad Fanous
• Brittany Fenderson
• Martina Marie Ferraro, DO
• Jacqueline Finefrock, PA-C
• Kimberly Fish, PA-C
• Gerald W Formoso
• Nora Jillian Frankeny, CNM

• Licensed Practical Nurse in Sheffield Village, OH
• Providers in Sheffield Village, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; 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.