Individual provider Active NPI

Eugonda Fryman, APRN

  • Family Nurse Practitioner
  • Mount Olivet, KY
National Provider Identifier
1083020853
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3008733 Issued in KY
Practice address
45 McDowell St
Mount Olivet, KY 41064
Phone
(606) 698-6160
Fax
(335) 812-4228
NPI assigned
Jul 1, 2014
Last updated
Aug 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3008733 KY Primary

Addresses

Primary practice location

45 McDowell St
Mount Olivet, KY 41064

Mailing address

PO Box 550
Vanceburg, KY 41179-0550
Phone (606) 796-3029

Other identifiers 3

IdentifierTypeStateIssuer
3008733OtherKYAPRN #
K182520, K182521OtherMEDICARE
7100327520MedicaidKY

Other names 1

  • Eugonda Jolly Other name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20150202000512 KY Practitioner - Nurse Practitioner 4486979077 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harrison Memorial HospitalGroup PAC ID 8628961018, 21 clinicians
Harrison Memorial HospitalGroup PAC ID 4284784067, 60 clinicians

Practice addresses (Care Compare)

1210 Kentucky Hwy 36E
Cynthiana, KY 41031-7490

1210 Ky Hwy 36 E
Cynthiana, KY 41031-7490
Phone (859) 234-2300

432 16TH St
Ashland, KY 41101-7693
Phone (859) 509-5636

439 E Pleasant St
Cynthiana, KY 41031-1827
Phone (859) 234-4494

525 Tucker Dr
Maysville, KY 41056-9182
Phone (859) 509-5636

927 Kenton Station Dr
Maysville, KY 41056-9617
Phone (606) 759-5331

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3008733KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis County Primary Care Center, Inc. CurrentSince Jun 20, 2022 Accepting new patients
Harrison Memorial Hospital Family CurrentSince Dec 14, 2014 Accepting new patients
Medycus Staffing PLLC CurrentSince Oct 4, 2024 Accepting new patients
Lewis County Primary Care Center, Inc. CurrentSince Jun 20, 2022 Accepting new patients
Harrison Memorial Hospital CurrentSince Dec 14, 2014 Accepting new patients
Harrison Memorial Hospital Inc Family CurrentSince Dec 14, 2014 Accepting new patients

Locations

432 16th St
Ashland, KY 41101
Phone (859) 509-5636

254 E Main St
Carlisle, KY 40311
Phone (859) 289-6311

1210 KY Highway 36 E
Cynthiana, KY 41031
Phone (859) 234-2300

1210 KY Highway 36 E
Ste G3
Cynthiana, KY 41031
Phone (859) 234-9222

439 E Pleasant St
Cynthiana, KY 41031
Phone (859) 234-4494

805 US Highway 27 S
Cynthiana, KY 41031
Phone (859) 234-2020

809 US Highway 27 S
Ste 107
Cynthiana, KY 41031
Phone (859) 234-2300

1102 W Shelby St
Falmouth, KY 41040
Phone (859) 654-3232

Interoperability endpoints

  • Direct secure messaging: eugonda.fryman.1@13661.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1083020853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "VANCEBURG",
            "state": "KY",
            "postal_code": "411790550",
            "telephone_number": "606-796-3029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MCDOWELL ST",
            "city": "MOUNT OLIVET",
            "state": "KY",
            "postal_code": "41064",
            "telephone_number": "606-698-6160",
            "fax_number": "335-812-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYMAN",
        "first_name": "EUGONDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-01",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3008733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN #",
            "identifier": "3008733",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K182520, K182521",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100327520",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EUGONDA",
            "last_name": "JOLLY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mount Olivet, KY

Sources for this page

Verify at the official NPI Registry.