Individual provider Active NPI

Tracy L Fry, APRN, FNP-C

  • Family Nurse Practitioner
  • Grove, OK
National Provider Identifier
1174070205
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0128239 Issued in OK
Practice address
1121 Neo Loop
Grove, OK 74344-6046
Phone
(877) 783-4441
NPI assigned
Sep 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A005462 AR
Family Nurse Practitioner 363LF0000X 5377388091 KS
Family Nurse Practitioner 363LF0000X 2017044184 MO
Family Nurse Practitioner 363LF0000X R0128239 OK Primary

Addresses

Primary practice location

1121 Neo Loop
Grove, OK 74344-6046

Mailing address

61980 E 225 Rd
Wyandotte, OK 74370-2917
Phone (913) 660-8742

Other practice location 1

3333 McIntosh Cir Ste 4
Joplin, MO 64804
Phone (417) 347-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, OK, AR3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180605002454 MO Practitioner - Nurse Practitioner 9537065933 Reassigns benefits to 1 organization
I20210422000332 OK Practitioner - Nurse Practitioner 9537065933 Reassigns benefits to 2 organizations
I20240123000285 AR Practitioner - Nurse Practitioner 9537065933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians

Practice addresses (Care Compare)

1121 Neo Loop
Mercy Clinic Orthopedics Grove
Grove, OK 74344-6046
Phone (877) 783-4441

202 E 50TH St
MC Family Medicine 50TH Street
Joplin, MO 64804-4527
Phone (417) 556-3400

Hospital & facility affiliations

  • Integris Grove Hospital Hospital, Grove, OK, CCN 370113
  • Mercy Hospital Joplin Hospital, Joplin, MO, CCN 260001
  • Saint Francis Hospital Vinita, Inc Hospital, Vinita, OK, CCN 370237

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A005462ARMDFamily Nurse Practitioner
5377388091KSMDFamily Nurse Practitioner
2017044184MOMDFamily Nurse Practitioner
R0128239OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis House Nwa, Inc CurrentSince Apr 26, 2024 Accepting new patients
St Francis House Nwa, Inc CurrentSince Apr 26, 2024 Accepting new patients
Mercy Clinic Joplin LLC CurrentSince Sep 1, 2025 Accepting new patients
St Francis House Nwa, Inc CurrentSince Jun 2, 2024 Accepting new patients
Integris Grove Hospital Past Accepting new patients

Locations

451 S Holly St
Siloam Springs, AR 72761
Phone (479) 524-3141

614 E Emma Ave
Ste 300
Springdale, AR 72764
Phone (479) 751-4898

11155 Tucker Rd
Pleasanton, KS 66075
Phone (913) 347-8110

202 E 50th St
Joplin, MO 64804
Phone (417) 556-3400

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

1121 Neo Loop
Grove, OK 74344
Phone (877) 783-4441

10 S Treaty Rd
Miami, OK 74354
Phone (918) 238-2410

Interoperability endpoints

  • Direct secure messaging: tfry237440@direct.integrisok.com

Organizations & group practices 5

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 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": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1174070205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61980 E 225 RD",
            "city": "WYANDOTTE",
            "state": "OK",
            "postal_code": "743702917",
            "telephone_number": "913-660-8742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 NEO LOOP",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743446046",
            "telephone_number": "877-783-4441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 McIntosh Cir Ste 4",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "64804",
            "country_code": "US",
            "telephone_number": "417-347-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRY",
        "first_name": "TRACY",
        "middle_name": "L",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005462",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "5377388091",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017044184",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0128239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grove, OK

Sources for this page

Verify at the official NPI Registry.