Amanda Mary Fry, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

G177603 Issued in IA

Practice address

7555 Hickman Rd
Urbandale, IA 50322-4620

Phone

(515) 225-7201

Fax

(515) 225-9213

NPI assigned

Feb 14, 2024

Last updated

Apr 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primary Health Care IncGroup PAC ID 8426966755, 72 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Primary Health Care, Inc.

  dba Primary Health Care-Bery Engebretsen Clinic

  • Federally Qualified Health Center (FQHC)
  • Des Moines, IA
  • NPI 1588692487
  Medicare reassignment Care Compare group NPD
• Primary Health Care, Inc.

  dba Primary Health Care at East High School

  • Federally Qualified Health Center (FQHC)
  • Des Moines, IA
  • NPI 1497522262
  NPD

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

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1063277671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 UNIVERSITY AVE STE 200",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142355",
            "telephone_number": "515-248-1447",
            "fax_number": "515-248-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7555 HICKMAN RD",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503224620",
            "telephone_number": "515-225-7201",
            "fax_number": "515-225-9213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "AMANDA",
        "middle_name": "MARY",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G177603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Foundations Therapy and Consulting LLC
• Landi Fox, BCBA
• Allison Freel, D.P.T.
• Ebitari O Fregene, DNP
• McKenzie Friedman
• Kay A Frye, ARNP
• Jeanne Marie Fung, OTR/L
• Erik D Furst, PHARMD
• William Jacob Gallaher, DDS
• Holly Jane Gardner, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in Urbandale, IA
• Providers in Urbandale, IA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; 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.