Individual provider Active NPI

Justin Maxwell Visitacion Fernan, RRT-ACCS

  • Registered Respiratory Therapist
  • Muskogee, OK
National Provider Identifier
1992653620
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Respiratory TherapistTaxonomy code 227900000X
License
4277 Issued in OK
Practice address
1011 Honor Heights Dr
Muskogee, OK 74401-1318
Phone
(918) 577-3048
NPI assigned
Mar 18, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Respiratory Therapist 227900000X 4277 OK Primary
Emergency Care Registered Respiratory Therapist 2279E0002X 4277 OK
Critical Care Registered Respiratory Therapist 2279C0205X 4277 OK

Addresses

Primary practice location

1011 Honor Heights Dr
Muskogee, OK 74401-1318

Mailing address

3909 N Country Club Cir
Muskogee, OK 74403-2324
Phone (918) 520-5292

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

NPI Registry JSON

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

{
    "created_epoch": "1773792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1992653620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 N COUNTRY CLUB CIR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744032324",
            "telephone_number": "918-520-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 HONOR HEIGHTS DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744011318",
            "telephone_number": "918-577-3048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNAN",
        "first_name": "JUSTIN MAXWELL",
        "middle_name": "VISITACION",
        "credential": "RRT-ACCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-18",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "227900000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered",
            "state": "OK",
            "license": "4277",
            "primary": true
        },
        {
            "code": "2279E0002X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Emergency Care",
            "state": "OK",
            "license": "4277",
            "primary": false
        },
        {
            "code": "2279C0205X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Critical Care",
            "state": "OK",
            "license": "4277",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; 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.