Individual provider Active NPI

Lubov Fry, ARNP

  • Nurse Practitioner
  • Coldwater, MI
National Provider Identifier
1194714824
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704319901 Issued in MI
Practice address
892 E Chicago St Ste C
Coldwater, MI 49036-2063
Phone
(517) 278-2301
Fax
(517) 278-2784
NPI assigned
Oct 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704319901 MI Primary

Addresses

Primary practice location

892 E Chicago St Ste C
Coldwater, MI 49036-2063

Mailing address

718 E Channel Dr
Coldwater, MI 49036-9425
Phone (954) 336-1824

Other practice location 1

777 Glades Rd
Florida Atlantic University, Student Health
Boca Raton, FL 33431-6424
Phone (561) 297-3512

Other practice location 2

777 Glades Rd
Florida Atlantic University, Student Health
Boca Raton, FL 33431-6424
Phone (561) 297-3512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MI2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20041026001162 FL Practitioner - Nurse Practitioner 2163483744 Reassigns benefits to 4 organizations
I20160822001249 MI Practitioner - Nurse Practitioner 2163483744 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nautilus Health Care Group LLCGroup PAC ID 5991604852, 51 clinicians
Florida Kidney Physicians LLCGroup PAC ID 4385925650, 167 clinicians

Practice addresses (Care Compare)

200 Ave F NE
Winter Haven, FL 33881-4131
Phone (863) 297-1787

670 Glades Rd
Suite 110
Boca Raton, FL 33431-6462
Phone (561) 368-0235

Hospital & facility affiliations

  • Winter Haven Hospital Hospital, Winter Haven, FL, CCN 100052
  • Orlando Health Hospital, Orlando, FL, CCN 100006
  • Bartow Regional Medical Center Hospital, Bartow, FL, CCN 100121

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704319901MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healogics Specialty Physicians of Michigan, PLLC CurrentSince Apr 1, 2021 Accepting new patients
Advanced Wound Care, LLC CurrentSince Jul 1, 2024 Accepting new patients
Florida Kidney Physicians, LLC CurrentSince Sep 12, 2022 Accepting new patients
Florida Kidney Physicians , LLC CurrentSince Sep 12, 2022 Accepting new patients
Nautilus Health Care Group, LLC CurrentSince May 8, 2023 Accepting new patients
Nautilus Health Care Group LLC Nurse Practitioner Current Accepting new patients
Elemental Living Inc Nurse Practitioner CurrentSince Mar 1, 2025 Accepting new patients
Mobile Medical Industries Inc Past Accepting new patients
Inphynet Contracting Services LLC Nurse Practitioner Past Accepting new patients
Advanced Wound Systems LLC Past Accepting new patients
Bestpractices, Inc. Past Accepting new patients

Locations

2000 Osprey Blvd
Ste 202
Bartow, FL 33830
Phone (863) 531-8436

1905 Clint Moore Rd
Ste 212
Boca Raton, FL 33496
Phone (561) 208-2121

670 Glades Rd
Ste 110
Boca Raton, FL 33431
Phone (561) 289-9467

301 Almeria Ave
Ste 240
Coral Gables, FL 33134
Phone (239) 842-6320

151 E Redstone Ave
Crestview, FL 32539
Phone (850) 629-8515

201 E Sample Rd
Deerfield Beach, FL 33064
Phone (954) 786-6400

1150 N 35th Ave
Ste 620
Hollywood, FL 33021
Phone (954) 612-8173

5220 Belfort Rd
Ste 130
Jacksonville, FL 32256
Phone (904) 446-3686

1500 Lee Blvd
Lehigh Acres, FL 33936
Phone (239) 368-4410

19056 NE 29th Ave
Miami, FL 33180
Phone (305) 354-4558

7339 Stonerock Cir
Orlando, FL 32819
Phone (321) 842-7308

2912 17th St
Saint Cloud, FL 34769
Phone (407) 892-2388

2203 N Lois Ave
Ste 814
Tampa, FL 33607
Phone (813) 505-5060

12662 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 910-8708

1120 Pinellas Bayway S
Ste 200
Tierra Verde, FL 33715
Phone (727) 867-5480

200 Avenue F NE
Winter Haven, FL 33881
Phone (863) 292-4652

320 E Warwick Dr
Alma, MI 48801
Phone (989) 463-4971

370 E Chicago St
Ste 700
Coldwater, MI 49036
Phone (517) 279-5099

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4

Organizations & group practices 12

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 3

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": "1129334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1194714824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 E CHANNEL DR",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490369425",
            "telephone_number": "954-336-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "892 E CHICAGO ST STE C",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490362063",
            "telephone_number": "517-278-2301",
            "fax_number": "517-278-2784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 Glades Rd",
            "address_2": "Florida Atlantic University, Student Health",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334316424",
            "country_code": "US",
            "telephone_number": "561-297-3512",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "777 Glades Rd",
            "address_2": "Florida Atlantic University, Student Health",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334316424",
            "country_code": "US",
            "telephone_number": "561-297-3512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRY",
        "first_name": "LUBOV",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704319901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coldwater, MI

Sources for this page

Verify at the official NPI Registry.