Individual provider Active NPI

Brette Nicole Fryfogle, FNP-BC

  • Family Nurse Practitioner
  • Midland, MI
National Provider Identifier
1124621826
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704312646 Issued in MI
Practice address
2660 W Sugnet Road
Midland, MI 48670-9475
Phone
(989) 488-5470
Fax
(989) 488-5475
NPI assigned
Nov 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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 4704312646 MI Primary

Addresses

Primary practice location

2660 W Sugnet Road
Midland, MI 48670-9475

Mailing address

2660 W Sugnet Rd
Midland, MI 48640-2647
Phone (989) 600-5735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20210503000705 MI Practitioner - Nurse Practitioner 0143639294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

2660 W Sugnet Rd
Mymichigan Pulmonology and Critical C
Midland, MI 48640-2647
Phone (989) 488-5450

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Midland CurrentSince Apr 30, 2021 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Apr 30, 2021 Accepting new patients

Locations

602 Beech St
Ste 2200
Clare, MI 48617
Phone (989) 488-5470

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

2660 W Sugnet Rd
Midland, MI 48640
Phone (989) 488-5010

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

2660 W Sugnet Rd
#C
Midland, MI 48640
Phone (989) 488-5450

Interoperability endpoints

  • Direct secure messaging: bfryfogle114569@mymichiganhealth.midirect.net

Organizations & group practices 2

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 8

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": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1124621826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 W SUGNET RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402647",
            "telephone_number": "989-600-5735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 W SUGNET ROAD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486709475",
            "telephone_number": "989-488-5470",
            "fax_number": "989-488-5475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYFOGLE",
        "first_name": "BRETTE",
        "middle_name": "NICOLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-17",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704312646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.