Individual provider Active NPI

Jennifer A Frye, NP

  • Family Nurse Practitioner
  • Newark, IL
National Provider Identifier
1114363470
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.010403 Issued in IL
Practice address
5 N Johnson St
Newark, IL 60541-0002
Phone
(815) 695-5042
NPI assigned
May 14, 2013
Last updated
May 11, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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 209.010403 IL Primary

Addresses

Primary practice location

5 N Johnson St
Newark, IL 60541-0002

Mailing address

150 W High St
Morris, IL 60450-1463
Phone (815) 942-2932

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20131029001018 IL Practitioner - Nurse Practitioner 2567697568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morris HospitalGroup PAC ID 1850372459, 115 clinicians

Practice addresses (Care Compare)

5 N Johnson St
Newark, IL 60541-0002
Phone (815) 695-5042

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.010403ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Morris Hospital Current Accepting new patients
Morris Hospital CurrentSince Jul 8, 2013 Accepting new patients
Morris Hospital CurrentSince Jul 8, 2013 Accepting new patients
Morris Hospital Current Accepting new patients

Locations

389 E Main St
Braidwood, IL 60408
Phone (815) 458-2532

580 Sycamore St
Marseilles, IL 61341
Phone (815) 795-2122

150 W High St
Morris, IL 60450
Phone (815) 942-2129

725 School St
Ste A
Morris, IL 60450

Interoperability endpoints

  • Direct secure messaging: jennifer.frye.1@14307.direct.athenahealth.com
  • Direct secure messaging: jennifer.frye@direct-address.org

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

Hospital & facility affiliations 6

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": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1114363470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W HIGH ST",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501463",
            "telephone_number": "815-942-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 N JOHNSON ST",
            "city": "NEWARK",
            "state": "IL",
            "postal_code": "605410002",
            "telephone_number": "815-695-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYE",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-14",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.010403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, IL

Sources for this page

Verify at the official NPI Registry.