Active NPI
I. Cletus M. Fernando, M.D.
- Obstetrics & Gynecology Physician
- Elyria, OH
National Provider Identifier
1427015494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 35-042834
- Practice address
- 630 E River St
Elyria, OH 44035-5902 - Phone
- (440) 329-7500
- NPI assigned
- Apr 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 35-042834 | OH | Primary |
Addresses
Primary practice location
630 E River St
Elyria, OH 44035-5902
Mailing address
630 E River St
Elyria, OH 44035-5902
Phone (440) 329-7500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0547706 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35-042834 | OH | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244505600000",
"number": "1427015494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 E RIVER ST",
"city": "ELYRIA",
"state": "OH",
"postal_code": "440355902",
"telephone_number": "440-329-7500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 E RIVER ST",
"city": "ELYRIA",
"state": "OH",
"postal_code": "440355902",
"telephone_number": "440-329-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDO",
"first_name": "I. CLETUS",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-26",
"last_updated": "2009-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "OH",
"license": "35-042834",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0547706",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elyria, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.