Active NPI
Rafael M Nunez, M.D.
- Pediatrics Physician
- Fort Stewart, GA
National Provider Identifier
1700067998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD-14510
- Practice address
- 1061 Harmon Ave
Fort Stewart, GA 31314-5641 - Phone
- (912) 435-6965
- NPI assigned
- Nov 16, 2007
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | MD-14510 | HI | |
| Family Medicine Physician | 207Q00000X | MD-14510 | HI | |
| General Practice Physician | 208D00000X | MD-14510 | HI | |
| Pediatrics Physician | 208000000X | MD-14510 | HI | Primary |
Addresses
Primary practice location
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Mailing address
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone (912) 435-6965
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 |
|---|---|---|---|
| MD-14510 | HI | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS PHS Naihs Fort Defiance Hospital | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba PHS Fort Defiance Indian Hospital
- General Acute Care Hospital
- Fort Defiance, AZ
- NPI 1700962131
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695340800000",
"number": "1700067998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1061 HARMON AVE",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "313145641",
"telephone_number": "912-435-6965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1061 HARMON AVE",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "313145641",
"telephone_number": "912-435-6965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUNEZ",
"first_name": "RAFAEL",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-16",
"last_updated": "2023-09-22",
"certification_date": "2023-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "HI",
"license": "MD-14510",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "HI",
"license": "MD-14510",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "HI",
"license": "MD-14510",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "HI",
"license": "MD-14510",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Stewart, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.