Individual provider Active NPI

Jodie Lynn Fryman, OTR

  • Specialist
  • Shorewood, IL
National Provider Identifier
1174709554
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
857 Center CT Unit D
Shorewood, IL 60404-8520
Phone
(815) 730-1818
Fax
(815) 730-0808
NPI assigned
Jan 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X IL Primary

Addresses

Primary practice location

857 Center CT Unit D
Shorewood, IL 60404-8520

Mailing address

857 Center CT Unit D
Shorewood, IL 60404-8520
Phone (815) 730-1818

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

LicenseStateTypeSpecialty
056008149ILMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200355200000",
    "number": "1174709554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "857 CENTER CT UNIT D",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604048520",
            "telephone_number": "815-730-1818",
            "fax_number": "815-730-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 CENTER CT UNIT D",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604048520",
            "telephone_number": "815-730-1818",
            "fax_number": "815-730-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYMAN",
        "first_name": "JODIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-15",
        "last_updated": "2008-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shorewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; 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.