ELIZABETH FERNANDES (NPI# 1316057979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316057979 |
| Entity Type | Individual |
| Full Name | ELIZABETH FERNANDES |
| Credential | PA-C |
| Practice Address |
1502 Highway 16 E Jackson GA 30233-5202 |
| Practice Telephone | 6787740430 |
| Practice Fax Number | 7707753410 |
| Mailing Telephone | 6787740430 |
| Mailing Fax Number | 7707753410 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2015-10-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 3319 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | AMERIGROUP | 10033117 | 01 |
| GA | WELLCARE | 319977 | 01 |
| GA | 100002125A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801396098 | Elizabeth Cushing Fernandes | Behavioral Analyst | 436b Station Ave, South Yarmouth, MA 02664-1208 | 2018-02-14 |
| 1851697650 | Elizabeth Fernandes | Social Worker | 399 Silver Street, Middletown, CT 06457-3826 | 2011-01-27 |
| 1043398134 | Elizabeth W. Fernandes | Internal Medicine | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2006-11-02 |
| Street Address |
1502 HIGHWAY 16 E |
| City | JACKSON |
| State | GA |
| Zip Code | 30233-5202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205919263 | Eagles Landing Family Practice, LLC | Family Medicine | 1502 Highway 16 E, Jackson, GA 30233-5202 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366800914 | Georgia Ophthalmologists LLC | Durable Medical Equipment & Medical Supplies | 860 W 3rd St, Jackson, GA 30233 | 2016-02-10 |
| 1306225057 | Young Dreaden | Nurse Practitioner | 2978 Hwy 36w, Jackson, GA 30233 | 2015-05-28 |
| 1609255520 | Neta J Roby | Nurse Practitioner | Hwy 36, Georgia Diagnostic Classification Prison, Jackson, GA 30233 | 2015-05-26 |
| 1033546098 | Henrietta Lindsay | Social Worker | 463-b Ernest Biles Dr, Jackson, GA 30233 | 2013-10-04 |
| 1255776993 | Gareth Gene Walker | Technician | 514 Covinton Street, Jackson, GA 30233 | 2013-05-08 |
| 1730489592 | Mary L. Melton | Licensed Practical Nurse | 463 Ernest Biles Dr., Jackson, GA 30233 | 2010-10-27 |
| 1083864250 | Chastity Moore Brown | Dentist | 1520 Lucky Street, Griffin, GA 30233 | 2008-09-24 |
| 1568661320 | Joseph Fowlkes | Internal Medicine | 2978 Highway 36 W, Jackson, GA 30233 | 2007-07-12 |
| 1942386289 | Butts County Board of Commissioners | Ambulance | 154 Sylvan Drive, Jackson, GA 30233 | 2006-10-30 |
| 1841238300 | Jackson Pharmacy Services | Pharmacy | 22 Mulberry St., Jackson, GA 30233 | 2006-06-04 |
| Find all providers in zip 30233 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942834494 | Emily Amburn | Physician Assistant | 2968 N Highland Ave, Jackson, TN 38305-3409 | 2020-02-24 |
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1972161891 | Allison Taylor | Physician Assistant | 1850 Chadwick Drive, Suite 1427, North Tower, 4 West, Jackson, MS 39204-3404 | 2019-06-05 |
| 1306302328 | Chloe A Goldfarb | Physician Assistant | 21 Shoal Rd, Jackson, NJ 08527-4025 | 2019-02-14 |
| 1447722558 | Casey James Elliott | Physician Assistant | 747 Oakwood St, Jackson, MS 39202-1121 | 2018-12-31 |
| 1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
| 1982194551 | Samantha Lynn Denoville | Physician Assistant | 1 Kensington Ct, Jackson, NJ 08527-1292 | 2018-05-18 |
| 1104320308 | Dalton Glenn Weaver | Physician Assistant | 708 N Highland Ave, Jackson, TN 38301-4829 | 2018-03-21 |
| 1336669258 | Whitney J Peterson | Physician Assistant | 501 Marshall St Ste 301, Jackson, MS 39202-1687 | 2017-06-21 |
| 1922541093 | Jacob Carpenter | Physician Assistant | 2497 N West St, Jackson, MS 39216-4409 | 2016-11-22 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.