Individual provider Active NPI

Enrique J. Fernandez, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Brunswick, GA
National Provider Identifier
1912978065
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
036152 Issued in GA
Practice address
2500 Starling St Ste 501
Brunswick, GA 31520-4270
Phone
(912) 466-4050
Fax
(912) 466-5553
NPI assigned
Jan 27, 2006
Last updated
Dec 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 036152 GA Primary

Addresses

Primary practice location

2500 Starling St Ste 501
Brunswick, GA 31520-4270

Mailing address

2500 Starling St Ste 501
Brunswick, GA 31520-4270
Phone (912) 466-4050

Other identifiers 2

IdentifierTypeStateIssuer
#000518647JMedicaidGA
000518647JMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20041229000015 GA Practitioner - Neurology 2264490077 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooperative Healthcare Services IncGroup PAC ID 9830093640, 235 clinicians

Practice addresses (Care Compare)

2415 Parkwood Dr
Brunswick, GA 31520-4722
Phone (912) 466-4079

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
John D Archbold Memorial Hospital Inc CurrentSince Jul 18, 2010 Accepting new patients
Cooperative Healthcare Services Inc CurrentSince Nov 1, 2013 Accepting new patients
John D. Archbold Memorial Hospital, Inc. CurrentSince Jul 18, 2010 Accepting new patients
Neurological Associates of the South, LLC PastSince Apr 24, 2006 Accepting new patients
The Pediatric Center LLC Past Accepting new patients
Consultants in Pain Medicine, LLC Past Accepting new patients

Locations

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

2500 Starling St
Ste 501
Brunswick, GA 31520
Phone (912) 262-9998

704 S Broad St
Thomasville, GA 31792
Phone (229) 226-8880

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

920 Cairo Rd
Thomasville, GA 31792
Phone (229) 228-8800

Interoperability endpoints

  • Direct secure messaging: efernan@secure.sghsmessaging.org

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1912978065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 STARLING ST STE 501",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204270",
            "telephone_number": "912-466-4050",
            "fax_number": "912-466-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 STARLING ST STE 501",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204270",
            "telephone_number": "912-466-4050",
            "fax_number": "912-466-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "ENRIQUE",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "GA",
            "license": "036152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "#000518647J",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000518647J",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.