Individual provider Active NPI

David Claude Fernandez, M.D.

  • General Practice Physician
  • Northport, AL
National Provider Identifier
1275573222
Registry record updated May 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
00021808 Issued in AL
Practice address
1325 MC Farland Blvd. Ste #209
Northport, AL 35476
Phone
(205) 330-1500
Fax
(205) 330-1505
NPI assigned
Jun 7, 2006
Last updated
May 2, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 00021808 AL
General Practice Physician 208D00000X 00021808 AL Primary

Addresses

Primary practice location

1325 MC Farland Blvd. Ste #209
Northport, AL 35476

Mailing address

1325 MC Farland Blvd. Ste #209
Northport, AL 35476
Phone (205) 330-1500

Other identifiers 3

IdentifierTypeStateIssuer
0133506OtherPRESCRIPTION DRUG PROGRAM
0510447420FEROtherALBLUE CROSS BLUE SHIELD
167267200OtherUS DEPT OF LABOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20100211000317 AL Practitioner - Internal MedicinePractitioner - General Practice 5294878336 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00021808ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medcenter Demopolis, LLC CurrentSince Aug 1, 2011 Accepting new patients

Locations

705 US Highway 80 W
Demopolis, AL 36732
Phone (205) 333-1993

3909 McFarland Blvd
Northport, AL 35476
Phone (205) 330-1707

5005 Oscar Baxter Dr
Tuscaloosa, AL 35405
Phone (205) 333-4654

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398988800000",
    "number": "1275573222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 MC FARLAND BLVD. STE #209",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "35476",
            "telephone_number": "205-330-1500",
            "fax_number": "205-330-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 MC FARLAND BLVD. STE #209",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "35476",
            "telephone_number": "205-330-1500",
            "fax_number": "205-330-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "DAVID",
        "middle_name": "CLAUDE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2014-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "00021808",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AL",
            "license": "00021808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESCRIPTION DRUG PROGRAM",
            "identifier": "0133506",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0510447420FER",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "167267200",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, AL

Sources for this page

Verify at the official NPI Registry.