Leroy Fernandez

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

411 S 3Rd St
Raton, NM 87740-4005

Phone

(575) 733-0003

Fax

(575) 733-0004

NPI assigned

Oct 9, 2020

Last updated

Oct 9, 2020By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: kwebb@noesisih.org

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1366040610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94508",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871994508",
            "telephone_number": "505-384-7352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 S 3RD ST",
            "city": "RATON",
            "state": "NM",
            "postal_code": "877404005",
            "telephone_number": "575-733-0003",
            "fax_number": "575-733-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "LEROY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KWEBB@NOESISIH.ORG",
            "affiliation": "N",
            "address_1": "411 S 3rd St",
            "city": "Raton",
            "state": "NM",
            "country_code": "US",
            "postal_code": "877404005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shantell Layce Esquivel, BMS
• David W Fairbanks, MD
• Family Practice Associates of Raton Inc
• Rhonda L Fanelli, BMS
• Jill Anne Fernandez, LCSW
• Robert J Forbeck, OT
• Amy Charlene Ford, NP
• Dwayne Garcia
• Jimmy Garcia, UCC OFFICER
• Sara J Garcia, BMS PROG MAN

• Community Health Worker in Raton, NM
• Providers in Raton, NM by specialty
• Community Health Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.