Mary Fry, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

003035 Issued in MI

Practice address

1215 E Michigan Ave
Lansing, MI 48912-1811

Phone

(517) 364-2223

NPI assigned

Mar 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Medical Observation Services, PLLC

  • Emergency Medicine Physician
  • Lansing, MI
  • NPI 1346503158
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205452800000",
    "number": "1043340938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 634280",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630041",
            "telephone_number": "517-337-0957",
            "fax_number": "517-336-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "517-364-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "MARY",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2008-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "003035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Frisk, OTR/L
• David L Frobish, LPC
• Drew Froh, RN
• Jessica Frost, MD
• Michaela Frost
• Daniel Fryc
• Courtney Fuller
• Ashley Marie Fullerton, TLLP
• Gwendolyn Lee Fulton, PT
• Functional Mobility and Health, LLC

• Physician Assistant in Lansing, MI
• Providers in Lansing, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.