Individual provider Active NPI

Ethan Fry, DO

  • Clinical Cardiac Electrophysiology Physician
  • Temple, TX
National Provider Identifier
1245769124
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
02008513A Issued in IN
Practice address
2401 S 31St St
Temple, TX 76508-0001
Phone
(254) 724-2111
NPI assigned
Jun 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X 02008513A IN Primary

Addresses

Primary practice location

2401 S 31St St
Temple, TX 76508-0001

Mailing address

2401 S 31St St
Temple, TX 76508-0001
Phone (254) 724-2111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250909001237 IN Practitioner - Cardiac Electrophysiology 0345514139 Reassigns benefits to 2 organizations
I20250910002292 KY Practitioner - Cardiac Electrophysiology 0345514139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Electrophysiology
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Specialty Physicians, IncGroup PAC ID 0244595205, shared by 3 NPIs, 228 clinicians
Deaconess Hospital, Inc.Group PAC ID 9032021431, 410 clinicians

Practice addresses (Care Compare)

1305 N Elm St
Henderson, KY 42420-2783
Phone (812) 490-4550

4011 Gateway Blvd
Newburgh, IN 47630-8947
Phone (812) 450-2239

4209 Gateway Blvd
Newburgh, IN 47630-8900
Phone (812) 842-0907

Hospital & facility affiliations

  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082
  • Deaconess Henderson Hospital Hospital, Henderson, KY, CCN 180056
  • Gibson General Hospital Hospital, Princeton, IN, CCN 151319
  • Memorial Hospital and Health Care Center Hospital, Jasper, IN, CCN 150115
  • Ferrell Hospital Community Foundations Hospital, Eldorado, IL, CCN 141324

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Hospital, Inc Clinical Cardiac Electrophysiology CurrentSince Nov 3, 2025 Accepting new patients
Deaconess Hospital Inc CurrentSince Nov 3, 2025 Accepting new patients
Deaconess Specialty Physicians, Inc Clinical Cardiac Electrophysiology Current Accepting new patients
Deaconess Specialty Physicians, Inc Clinical Cardiac Electrophysiology Current Accepting new patients
Deaconess Specialty Physicians, Inc Clinical Cardiac Electrophysiology CurrentSince Aug 1, 2025 Accepting new patients
Deaconess Specialty Physicians Inc CurrentSince Aug 1, 2025 Accepting new patients
Deaconess Specialty Physicians, Inc CurrentSince Aug 4, 2025 Accepting new patients
Deaconess Hospital, Inc Clinical Cardiac Electrophysiology Past Accepting new patients

Locations

350 W Columbia St
Ste 310
Evansville, IN 47710
Phone (812) 425-2646

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

440 Scott Rolen Dr
Jasper, IN 47546
Phone (812) 481-1655

4011 Gateway Blvd
Newburgh, IN 47630
Phone (812) 450-2240

4209 Gateway Blvd
Newburgh, IN 47630
Phone (812) 426-9855

1305 N Elm St
Henderson, KY 42420
Phone (270) 827-7100

2200 E Parrish Ave
Bldg A
Owensboro, KY 42303
Phone (270) 228-2811

2200 E Parrish Ave
Owensboro, KY 42303
Phone (270) 691-0059

Interoperability endpoints

  • Direct secure messaging: efry33493@ukhcdirect.org

Organizations & group practices 8

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 11

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": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1245769124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "254-724-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "ETHAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-05",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "IN",
            "license": "02008513A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.