Jay Grayson Fernando, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

9901172 Issued in NC

Practice address

7615 Colony Rd
Ste 115
Charlotte, NC 28226-5017

Phone

(704) 626-6812

Fax

(704) 626-6824

NPI assigned

May 25, 2006

Last updated

Jun 20, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Anuvia Prevention & Recovery, Center, Inc.

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1093756819

  Multi-Specialty

  Medicare reassignment NPD
• Carolina Physicians Group, PC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1538199567
  Authorized official Same address or phone
• Rock Hill Treatment Specialists, Inc

  • Methadone Clinic
  • Rock Hill, SC
  • NPI 1629553607
  NPD
• Anuvia Prevention and Recovery Center, Inc

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1154706307
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1750337325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7615 COLONY RD",
            "address_2": "STE 115",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282265017",
            "telephone_number": "704-626-6812",
            "fax_number": "704-626-6824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7615 COLONY RD",
            "address_2": "STE 115",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282265017",
            "telephone_number": "704-626-6812",
            "fax_number": "704-626-6824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Billingsley Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282111002",
            "country_code": "US",
            "telephone_number": "704-376-7447",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "429 Billingsley Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282111007",
            "country_code": "US",
            "telephone_number": "704-445-6900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDO",
        "first_name": "JAY",
        "middle_name": "GRAYSON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NC",
            "license": "9901172",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9901172",
            "primary": true
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NC",
            "license": "9901172",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "9901172",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891235U",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Liz Michelle Fernandez
• Rosa Fernandez, ACAGNP-BC
• Stacy Lee Fernandez, FNP
• Walter Fernandez, RN
• Wigsaury M Fernandez
• Nichole Ann Fernez
• Andrea White Ferrage, FNP-C
• Amy G Ferrara, CRNA
• Emele Danean Ferrara, D.D.S.
• Linda Ferrara, CRNA

• Internal Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.