Individual provider Active NPI

Jennifer Fernandez-Vasquez, MD

  • Family Medicine Physician
  • Fort Gordon, GA
National Provider Identifier
1508480294
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101274351 Issued in VA
Practice address
300 East Hospital Road
Fort Gordon, GA 30905-5650
Phone
(706) 787-5811
NPI assigned
May 29, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101274351 VA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

300 East Hospital Road
Fort Gordon, GA 30905-5650

Mailing address

300 East Hospital Road
Fort Gordon, GA 30905-5650

Other names 1

  • Dr. Jennifer Arana-Vasquez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220317001597 VA Order and Referring Only - Family PracticePractitioner - Family Practice 2567857162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101274351VAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1508480294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 EAST HOSPITAL ROAD",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 EAST HOSPITAL ROAD",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055650",
            "telephone_number": "706-787-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ-VASQUEZ",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101274351",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ARANA-VASQUEZ",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Gordon, GA

Sources for this page

Verify at the official NPI Registry.