Individual provider Active NPI

Elizabeth Fryer

  • Family Nurse Practitioner
  • Kailua Kona, HI
National Provider Identifier
1235460965
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-1413 Issued in HI
Practice address
75-5751 Kuakini Hwy 203
Kailua Kona, HI 96740-1705
Phone
(808) 326-5629
NPI assigned
Jan 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP010516 PA
Family Nurse Practitioner 363LF0000X APRN-1413 HI Primary

Addresses

Primary practice location

75-5751 Kuakini Hwy 203
Kailua Kona, HI 96740-1705

Mailing address

75-5751 Kuakini Hwy 203
Kailua Kona, HI 96740-1705
Phone (808) 326-5629

Other identifiers 1

IdentifierTypeStateIssuer
692831MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN-1413HIMDFamily Nurse Practitioner
SP010516PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellbe Senior Medical Group of Pennsylvania PC CurrentSince Jan 22, 2024 Accepting new patients

Locations

225 W Washington St
Ste 1500
Chicago, IL 60606
Phone (312) 776-2422

1001 Liberty Ave
Ste 5
Pittsburgh, PA 15222
Phone (855) 493-5523

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1235460965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5751 KUAKINI HWY 203",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401705",
            "telephone_number": "808-326-5629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5751 KUAKINI HWY 203",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401705",
            "telephone_number": "808-326-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYER",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-20",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP010516",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-1413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "692831",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

Verify at the official NPI Registry.