Constance S Fair, PA

Primary specialty

Perioperative Clinical Nurse SpecialistTaxonomy code 364SP2800X

License

MA060918 Issued in PA

Practice address

3900 Woodland Ave
Philadelphia, PA 19104-4551

Phone

(252) 241-9898

NPI assigned

Feb 5, 2009

Last updated

Jun 22, 2021By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1720227309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 WITLEY RD",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190962424",
            "telephone_number": "252-241-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 WOODLAND AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044551",
            "telephone_number": "252-241-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIR",
        "first_name": "CONSTANCE",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-05",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01710",
            "primary": false
        },
        {
            "code": "364SP2800X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Perioperative",
            "state": "PA",
            "license": "MA060918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nina Fainberg, M.D.
• Anna Faini, PMHNP-BC
• Fair Hill Community Physicians (Fair Hill Peds Physicians)
• Fair Hill Community Physicians
• Fair Hill Community Physicians (Fair Hill Pharmacy at Liberty Square)
• Grace Fairbrother
• Brandon Fairless, M.D.
• Alexander Fairman
• Ronald M Fairman, MD
• Fairmount Pharmacy Inc

• Clinical Nurse Specialist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Nurse Specialist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.