Individual provider Active NPI

Fernanda Raquel Marchan Hernandez, SA-C

  • Surgical Assistant
  • Clayton, NC
National Provider Identifier
1922843036
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
24-334 Issued in WI
Practice address
11 Thunder Hill CT
Clayton, NC 27520-6254
Phone
(763) 346-5702
NPI assigned
Jun 28, 2024
Last updated
Jun 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 24-334 WI Primary

Addresses

Primary practice location

11 Thunder Hill CT
Clayton, NC 27520-6254

Mailing address

11 Thunder Hill CT
Clayton, NC 27520-6254
Phone (763) 346-5702

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

LicenseStateTypeSpecialty
24-334WIMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1922843036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 THUNDER HILL CT",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275206254",
            "telephone_number": "763-346-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 THUNDER HILL CT",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275206254",
            "telephone_number": "763-346-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCHAN HERNANDEZ",
        "first_name": "FERNANDA",
        "middle_name": "RAQUEL",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "WI",
            "license": "24-334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.