MS. KATHERINE GRAHAM FERNANDEZ (NPI# 1649394412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649394412 |
| Entity Type | Individual |
| Full Name | MS. KATHERINE GRAHAM FERNANDEZ |
| Credential | PA-C |
| Practice Address |
15825 Ballantyne Medical Pl Suite 240 Charlotte NC 28277-4652 |
| Practice Telephone | 7045445245 |
| Practice Fax Number | 7045445250 |
| Mailing Telephone | 7045445245 |
| Mailing Fax Number | 7045445250 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2015-04-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
103556 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 0532PA | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114371556 | Katherine Fernandez | Early Intervention Provider Agency | 340 E 105th St Apt 5f, New York, NY 10029-5083 | 2016-04-22 |
| 1174994065 | Katherine Fernandez | Marriage & Family Therapist | 1040 Bayview Dr Ste 110, Fort Lauderdale, FL 33304-2532 | 2015-10-18 |
| 1134573553 | Katherine Fernandez | Pharmacist | 311 S Mountain Ave, Upland, CA 91786-7032 | 2016-04-21 |
| 1194058982 | Katherine Fernandez | Occupational Therapist | 1013 Riverburch Pkwy, Suite 4, Dalton, GA 30721-8887 | 2009-09-10 |
| Street Address |
15825 BALLANTYNE MEDICAL PL SUITE 240 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28277-4652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063429314 | Shaun M Riney | Physical Therapist | 15825 Ballantyne Medical Pl, Suite 120, Charlotte, NC 28277-4652 | 2006-08-01 |
| 1770993388 | Gail Stauffer | Nurse Practitioner | 15825 Ballantyne Medical Pl, Suite 220, Charlotte, NC 28277-4652 | 2014-05-05 |
| 1730407628 | Ashley Dyches Deyoung | Physical Therapist | 15825 Ballantyne Medical Pl, Suite 120, Charlotte, NC 28277-4652 | 2010-05-17 |
| 1649361239 | Jason P Gajdzis | Physician Assistant | 15825 Ballantyne Medical Pl, #100, Charlotte, NC 28277-4652 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255949731 | New Life Peer Support and Coaching LLC | Clinic/Center | 3450 Toringdon Way, Suite 200, Charlotte, NC 28277 | 2020-07-21 |
| 1083256762 | Speak Life Counseling Services, Pllc | Counselor | 16147 Lacaster Hwy, Suite 110, Charlotte, NC 28277 | 2019-10-14 |
| 1275010019 | Jigneshkumar R Mistry | Pharmacist | 11805 Allforth Ln Apt 2105, Charlotte, NC 28277 | 2018-07-24 |
| 1255825410 | Novant Medical Group Inc. | Family Medicine | 15033 Balloncroft Parkway, Suite 200, Charlotte, NC 28277 | 2018-06-20 |
| 1447752316 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 11135 Golf Links Dr, Charlotte, NC 28277 | 2018-03-06 |
| 1932607595 | Charlotte Proactive Md PC | Clinic/Center | 11220 Golf Links Drive North, Charlotte, NC 28277 | 2018-01-30 |
| 1003331521 | Accela Spine and Pain, Pllc | Anesthesiology | 10120 Ivey Chase Lane, Apt 617, Charlotte, NC 28277 | 2017-08-04 |
| 1265961619 | Dominicka Whitaker | Counselor | 12365 Bluestem Ln., Charlotte, NC 28277 | 2017-06-08 |
| 1083143408 | Monika D Hayes | Counselor | 11330 Snapfinger Drive, Charlotte, NC 28277 | 2017-06-08 |
| 1225582984 | Danielle Mcdaniel | Occupational Therapist | 5113 Piper Station Dr Ste 103, Charlotte, NC 28277 | 2016-08-11 |
| Find all providers in zip 28277 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316411713 | Nicole Alyse Zbiciak | Physician Assistant | 325 Hawthorne Ln Ste 300, Charlotte, NC 28204-2536 | 2019-01-18 |
| 1588060412 | Jessica Fowler Michalak | Physician Assistant | 2104 Randolph Rd, Charlotte, NC 28207-1522 | 2014-11-04 |
| 1396154209 | Kayla Lacci | Physician Assistant | 1025 Morehead Medical Dr, Ste 300, Charlotte, NC 28204-2963 | 2014-08-05 |
| 1457794125 | Lauren S Jones | Physician Assistant | 225 Baldwin Ave, Charlotte, NC 28204-3109 | 2013-04-12 |
| 1073879060 | Michael A Marconi | Physician Assistant | 3541 Randolph Road, Suite 210, Charlotte, NC 28211-2886 | 2012-04-04 |
| 1912284266 | Sapnil D Patel | Physician Assistant | 225 Baldwin Ave, Charlotte, NC 28204-3109 | 2011-11-14 |
| 1215222310 | Angela Marie Darket | Physician Assistant | 225 Baldwin Ave, Charlotte, NC 28204-3109 | 2011-06-16 |
| 1164730487 | Kristin Kathleen Teague | Physician Assistant | 200 Hawthorne Ln, Charlotte, NC 28204-2515 | 2010-09-21 |
| 1700110814 | Rachelle M. Eiden | Physician Assistant | 10512 Park Rd, Suite 101, Charlotte, NC 28210-8475 | 2009-09-22 |
| 1588849327 | Orthocarolina | Physician Assistant | 4601 Park Rd, Suite 300, Charlotte, NC 28209-3239 | 2007-12-28 |
| Find all providers in CHARLOTTE | ||||
Please comment or provide details below to improve the information on MS. KATHERINE GRAHAM FERNANDEZ.
| 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.