Phillip Edward Fry Jr., DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

DO.OP.70134164 Issued in WA

Practice address

34800 Bob Wilson Dr
San Diego, CA 92134-1010

Phone

(619) 532-6400

NPI assigned

Apr 12, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Phillip Edward Fry Other name

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Las Cruces HB Medical Services LLCGroup PAC ID 8123473600, 157 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eastern New Mexico Medical Center Hospital, Roswell, NM, CCN 320006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Las Cruces HB Medical Services LLC

  • Emergency Medicine Physician
  • Las Cruces, NM
  • NPI 1598446171
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Roswell Hospital Corporation

  • General Acute Care Hospital
  • Roswell, NM
  • NPI 1447221742
  Care Compare affiliation

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1003270331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 EVERGLADE CT",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882013485",
            "telephone_number": "575-420-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341010",
            "telephone_number": "619-532-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "PHILLIP",
        "middle_name": "EDWARD",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-12",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A17583",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "DO.OP.70134164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHILLIP",
            "last_name": "FRY",
            "middle_name": "EDWARD",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Elizabeth M Fry, ASW 26470
• Emory Allen Fry, MD
• Liane Fry
• Lindsay Fry, ND
• Micah Fry, MD
• Eva Marie Frye
• Maggie Frye
• Jonathan Fryer
• Myshayla Fryer
• Howard Frymire

• Emergency Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.