Jonathan Fried, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

01035321 Issued in IN

Practice address

2605 N Lebanon St
Lebanon, IN 46052-1476

Phone

(765) 448-8000

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Southside Emergency Associates

  • Personal Emergency Response Attendant
  • Indianapolis, IN
  • NPI 1053366922
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585440000000",
    "number": "1154338309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5545",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479035545",
            "telephone_number": "765-448-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521476",
            "telephone_number": "765-448-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIED",
        "first_name": "JONATHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2020-03-29",
        "certification_date": "2020-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01035321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000594100",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100342860",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Desiree Fort
• Emily Kaufman Frank, MD
• Dianna Frederick
• Leah J Freeland, LMHC
• Geffry E French, DDS
• Julie Dawn Friend, MD
• Alisha A Fuino, MSW, LCSW, APHSW-C
• Karamaneh Ann Galbert, MA
• John E Garber, M.D.
• Mariah K Garland, AGNP-C

• Emergency Medicine Physician in Lebanon, IN
• Providers in Lebanon, IN by specialty
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.