Katherine Graham Fernandez, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

103556 Issued in NC

Practice address

15825 Ballantyne Medical PL
Suite 240
Charlotte, NC 28277-4652

Phone

(704) 544-5245

Fax

(704) 544-5250

NPI assigned

Mar 19, 2007

Last updated

Aug 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1649394412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15825 BALLANTYNE MEDICAL PL",
            "address_2": "SUITE 240",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774652",
            "telephone_number": "704-544-5245",
            "fax_number": "704-544-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15825 BALLANTYNE MEDICAL PL",
            "address_2": "SUITE 240",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774652",
            "telephone_number": "704-544-5245",
            "fax_number": "704-544-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "KATHERINE",
        "middle_name": "GRAHAM",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "103556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0532PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Janina Fernandez-Osborne, PA-C
• Alejandro Fernandez-Tatum, MD
• Gladys Fernandez
• Isabella Fernandez
• Janiya Fernandez
• Liz Michelle Fernandez
• Rosa Fernandez, ACAGNP-BC
• Stacy Lee Fernandez, FNP
• Walter Fernandez, RN
• Wigsaury M Fernandez

• Surgical Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Surgical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; 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.