Individual provider Active NPI

Adam K Fry, PT DPT

  • Physical Therapist
  • Moody AFB, GA
National Provider Identifier
1013105394
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7834 Issued in AZ
Practice address
3278 Mitchell Blvd
Moody AFB, GA 31699-5003
Phone
(229) 257-6364
NPI assigned
Oct 11, 2007
Last updated
Jul 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7834 AZ Primary

Addresses

Primary practice location

3278 Mitchell Blvd
Moody AFB, GA 31699-5003

Mailing address

3278 Mitchell Blvd
Moody AFB, GA 31699-1500
Phone (229) 257-6364

Other identifiers 1

IdentifierTypeStateIssuer
292981MedicaidAZ

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
7834AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Spooner Phoenix Physical Therapy, Inc. Physical Therapist Past Accepting new patients
KC's Physical Therapy LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1013105394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3278 MITCHELL BLVD",
            "city": "MOODY AFB",
            "state": "GA",
            "postal_code": "316991500",
            "telephone_number": "229-257-6364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3278 MITCHELL BLVD",
            "city": "MOODY AFB",
            "state": "GA",
            "postal_code": "316995003",
            "telephone_number": "229-257-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "ADAM",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PT DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-11",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "7834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292981",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moody AFB, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; 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.