Susan R Fernandez PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

9740 Issued in NV

Legal business name

SUSAN R FERNANDEZ PC

Practice address

6843 W Tropicana Ave
Suite 100
Las Vegas, NV 89103-4922

Phone

(702) 818-3303

Fax

(702) 263-0195

NPI assigned

Feb 11, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Susan R Fernandez, MD

Title

President

Phone

(702) 263-1908

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Horizon Ridge Pediatrics Doing business as

Tax ID family

Horizon Ridge Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Susan R Fernandez PC

  • Pediatrics Physician
  • Henderson, NV
  • NPI 1346374238
  NPD tax ID

Locations

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

{
    "created_epoch": "1423612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423699200000",
    "number": "1508257676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 W. HORIZON RIDGE PWKY",
            "address_2": "SUITE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89052",
            "telephone_number": "702-263-1908",
            "fax_number": "702-263-0195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6843 W TROPICANA AVE",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891034922",
            "telephone_number": "702-818-3303",
            "fax_number": "702-263-0195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN R FERNANDEZ PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-11",
        "last_updated": "2015-02-12",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-263-1908",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "9740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003102477",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Horizon Ridge Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Asia Suriyachottakul Bouddhara
• Raquel Surry
• Raveendra Babu Suryadevara, M.D
• Tejeswi Suryadevara, MBBS
• Susan Hoffert PT Professional Corp
• Susan Reisinger, MD Prof. Corp.
• La Donna Susberry
• Meghan Susser
• Alys Chantell Susskind
• Ernest M. Sussman, MD

• Pediatrics Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Pediatrics Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; 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.