Lactancio Fernandes, MD

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

14203 Issued in MS

Practice address

1107 Earl Frye Blvd Ste 3
Amory, MS 38821-5519

Phone

(662) 256-9590

Fax

(662) 256-9599

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Amory Hma Physician Management LLC

  • Family Medicine Physician
  • Amory, MS
  • NPI 1255361978

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1942398409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6418",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395066418",
            "telephone_number": "228-229-7776",
            "fax_number": "601-984-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 EARL FRYE BLVD STE 3",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388215519",
            "telephone_number": "662-256-9590",
            "fax_number": "662-256-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDES",
        "first_name": "LACTANCIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "14203",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MS",
            "license": "14203",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MS",
            "license": "14203",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MS",
            "license": "14203",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01578334",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00821834",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eliza Cares Homecare, LLC
• Emcare Physician Providers, Inc.
• Krisha M Evans
• Family Care Pharmacy, LLC
• Family Medicine Clinic
• Lisa Fleitas, N.P.
• Frederick Winston Flowers, N.P.
• Lewis Richard French, DC
• Ryan O French
• Fugett Health Services LLC

• Critical Care Medicine (Internal Medicine) Physician in Amory, MS
• Providers in Amory, MS by specialty
• Critical Care Medicine (Internal Medicine) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.