Active NPI
William Kristofer Fridley, DC
- Sports Physician Chiropractor
- Austin, TX
National Provider Identifier
1053818005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 13738
- Practice address
- 410 Pressler St
Austin, TX 78703-5100 - Phone
- (512) 266-1000
- Fax
- (512) 266-1000
- NPI assigned
- Apr 6, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 13738 | TX | Primary |
Addresses
Primary practice location
410 Pressler St
Austin, TX 78703-5100
Mailing address
6800 Burnet Rd Ste 2
Austin, TX 78757-2853
Phone (512) 266-1000
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13738 | TX | MD | Sports Physician Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kimberly Mullen DC PLLC | Sports Physician | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522972800000",
"number": "1053818005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 BURNET RD STE 2",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787572853",
"telephone_number": "512-266-1000",
"fax_number": "512-266-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 PRESSLER ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787035100",
"telephone_number": "512-266-1000",
"fax_number": "512-266-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIDLEY",
"first_name": "WILLIAM",
"middle_name": "KRISTOFER",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-06",
"last_updated": "2018-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "TX",
"license": "13738",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.