Active NPI
Michelle Fernandez
- Student in an Organized Health Care Education/Training Program
- Avondale, AZ
National Provider Identifier
1467907618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 86-6004326
- Practice address
- 530 E Riley Dr
Avondale, AZ 85323-2154 - Phone
- (623) 932-7300
- Fax
- (623) 932-7311
- NPI assigned
- Aug 17, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 86-6004326 | AZ | Primary |
Addresses
Primary practice location
530 E Riley Dr
Avondale, AZ 85323-2154
Mailing address
530 E Riley Dr
Avondale, AZ 85323-2154
Phone (623) 932-7300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 594722 | Other | AZ | AHCCCS |
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 |
|---|---|---|---|
| 86-6004326 | AZ | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471392000000",
"number": "1467907618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 E RILEY DR",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853232154",
"telephone_number": "623-932-7300",
"fax_number": "623-932-7311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 E RILEY DR",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853232154",
"telephone_number": "623-932-7300",
"fax_number": "623-932-7311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "MICHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-17",
"last_updated": "2016-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "AZ",
"license": "86-6004326",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS",
"identifier": "594722",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Avondale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.