Active NPI
Martha S Fernandez
- Case Management Agency
- Mesquite, TX
National Provider Identifier
1376792408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Agency
- License
- 30-0503572
- Practice address
- 4701 Samuell Blvd Apt 105
Mesquite, TX 75149-1057 - Phone
- (972) 977-7436
- NPI assigned
- Sep 12, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | |||
| Case Management Agency | 251B00000X | 30-0503572 | TX | Primary |
Addresses
Primary practice location
4701 Samuell Blvd Apt 105
Mesquite, TX 75149-1057
Mailing address
4701 Samuell Blvd Apt 105
Mesquite, TX 75149-1057
Phone (972) 977-7436
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30-0503572 | TX | MD | Case Management Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221177600000",
"number": "1376792408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4701 SAMUELL BLVD APT 105",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751491057",
"telephone_number": "972-977-7436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4701 SAMUELL BLVD APT 105",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751491057",
"telephone_number": "972-977-7436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "MARTHA",
"middle_name": "S",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-12",
"last_updated": "2008-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "TX",
"license": "30-0503572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mesquite, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.