Individual provider Active NPI

Laura R Fry, MD

  • Family Medicine Physician
  • Manchester, NH
National Provider Identifier
1255328563
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
NH 9619 Issued in NH
Practice address
145 Hollis St
Manchester, NH 03101-1235
Phone
(603) 626-9500
Fax
(603) 626-0899
NPI assigned
Oct 3, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NH 9619 NH Primary

Addresses

Primary practice location

145 Hollis St
Manchester, NH 03101-1235

Mailing address

145 Hollis St
Manchester, NH 03101-1235
Phone (603) 626-9500

Other identifiers 1

IdentifierTypeStateIssuer
30009334MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040622000717 NH Practitioner - Family Practice 0749265940 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NH 9619NHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amoskeag Health CurrentSince Jan 3, 1996 Accepting new patients
NH Eye Associates PLLC Past Accepting new patients

Locations

1555 Elm St
Manchester, NH 03101
Phone 60366841115269

145 Hollis St
Manchester, NH 03101

Organizations & group practices 3

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": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1255328563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 HOLLIS ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011235",
            "telephone_number": "603-626-9500",
            "fax_number": "603-626-0899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 HOLLIS ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011235",
            "telephone_number": "603-626-9500",
            "fax_number": "603-626-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "LAURA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-03",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "NH 9619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30009334",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.