Active NPI
Michele Fry
- Speech-Language Pathologist
- Independence, MO
National Provider Identifier
1104473875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2000143599
- Practice address
- 201 N Forest Ave
Independence, MO 64050-2696 - Phone
- (715) 220-9280
- NPI assigned
- Aug 19, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2000143599 | MO | Primary |
Addresses
Primary practice location
201 N Forest Ave
Independence, MO 64050-2696
Mailing address
7732 Brook Lane Ave
Kansas City, MO 64139-1295
Phone (715) 220-8783
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 |
|---|---|---|---|
| 2000143599 | MO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566172800000",
"number": "1104473875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7732 BROOK LANE AVE",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641391295",
"telephone_number": "715-220-8783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 N FOREST AVE",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640502696",
"telephone_number": "715-220-9280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRY",
"first_name": "MICHELE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-19",
"last_updated": "2019-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "2000143599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Independence, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.