Active NPI
Ernesto Jose Fernandez
- Occupational Therapist
- Mooresville, NC
National Provider Identifier
1831680263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 14082
- Practice address
- 105 Conductor LN Apt 720
Mooresville, NC 28115-5419 - Phone
- (304) 673-2320
- NPI assigned
- May 22, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 14082 | NC | Primary |
Addresses
Primary practice location
105 Conductor LN Apt 720
Mooresville, NC 28115-5419
Mailing address
102 Leonard Ave
Newton, NC 28658-9649
Phone (828) 464-8260
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14082 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622764800000",
"number": "1831680263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 LEONARD AVE",
"city": "NEWTON",
"state": "NC",
"postal_code": "286589649",
"telephone_number": "828-464-8260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 CONDUCTOR LN APT 720",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281155419",
"telephone_number": "304-673-2320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "ERNESTO",
"middle_name": "JOSE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-22",
"last_updated": "2021-06-04",
"certification_date": "2021-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "14082",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mooresville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.