Individual provider Active NPI

Janae Fry, DO

  • Emergency Medicine Physician
  • Orange Park, FL
National Provider Identifier
1073072930
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS18569 Issued in FL
Practice address
2001 Kingsley Ave
Orange Park, FL 32073-5156
Phone
(904) 639-2000
Fax
(904) 639-2015
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X OS18569 FL Primary

Addresses

Primary practice location

2001 Kingsley Ave
Orange Park, FL 32073-5156

Mailing address

2001 Kingsley Ave
Orange Park, FL 32073-5156
Phone (904) 639-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20220810003473 FL Practitioner - Emergency Medicine 0244613123 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Liberty Univ College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Emergency Services LLCGroup PAC ID 8628153087, 401 clinicians

Practice addresses (Care Compare)

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 276-8500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Single Specialty CurrentSince Jun 21, 2023 Accepting new patients
Paragon Emergency Services LLC Single Specialty CurrentSince Aug 1, 2022 Accepting new patients
Cep America, LLC Single Specialty Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jun 21, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

9820 Hutchinson Park Dr
Jacksonville, FL 32225
Phone (904) 450-6740

8083 Parramore Rd
Jacksonville, FL 32244
Phone (904) 450-6760

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

615 N Bonita Ave
Panama City, FL 32401
Phone (850) 747-2020

1451 El Camino Real
The Villages, FL 32159
Phone (352) 751-8000

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1073072930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735156",
            "telephone_number": "904-639-2000",
            "fax_number": "904-639-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735156",
            "telephone_number": "904-639-2000",
            "fax_number": "904-639-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "JANAE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS18569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.