Immanuel Family Clinic PLLC
NPI 1265072490ActiveOrganization· Nurse Practitioner, Family· Carrollton, TX
Nurse Practitioner, Family in Carrollton, Texas, registered in NPPES in January 2020. The authorized official on file is Sutha M. Fernando, FNP, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1265072490 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 15, 2020 |
| Last updated in NPPES | Feb 11, 2020 |
| Certified by provider | Feb 11, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TX) |
|---|
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