Individual provider Active NPI

Raquel Fernandez-Earns, PH.D.

  • School Psychologist
  • Sault Sainte Marie, MI
National Provider Identifier
1912905704
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
6301012547 Issued in MI
Practice address
315 Armory PL
Sault Sainte Marie, MI 49783-2005
Phone
(906) 632-3373
NPI assigned
Jul 14, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301012547 MI
School Psychologist 103TS0200X 6301012547 MI Primary

Addresses

Primary practice location

315 Armory PL
Sault Sainte Marie, MI 49783-2005

Mailing address

P.O. Box 883 315 Armory Place
Sault Sainte Marie, MI 49783

Other identifiers 2

IdentifierTypeStateIssuer
38337OtherMIUPPER PENINSULA HEALTH PL
0A71030OtherMIBLUE CROSS BLUE SHIELD

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301012547MIMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Upper Peninsula Intermediate School District 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.

NPI Registry JSON

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1912905704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 883 315 ARMORY PLACE",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "49783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 ARMORY PL",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497832005",
            "telephone_number": "906-632-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ-EARNS",
        "first_name": "RAQUEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-14",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301012547",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "MI",
            "license": "6301012547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPPER PENINSULA HEALTH PL",
            "identifier": "38337",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0A71030",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sault Sainte Marie, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; 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.