Individual provider Active NPI

Kelly Ann Friar, PA-C

  • Physician Assistant
  • Rochester, IN
National Provider Identifier
1275215899
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10004383A Issued in IN
Practice address
1430 E 9TH St
Rochester, IN 46975-8931
Phone
(317) 738-8095
NPI assigned
Aug 3, 2023
Last updated
Feb 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10004383A IN Primary

Addresses

Primary practice location

1430 E 9TH St
Rochester, IN 46975-8931

Mailing address

12386 Diamond Dr
Plymouth, IN 46563-7623
Phone (219) 775-9608

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20240618002133 IN Practitioner - Physician Assistant 7618410762 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Woodlawn HospitalGroup PAC ID 4082506993, 30 clinicians

Practice addresses (Care Compare)

1400 E 9TH St
Rochester, IN 46975-8931

1430 E 9TH St
Rochester, IN 46975-8931

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10004383AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Woodlawn Hospital CurrentSince Jun 3, 2024 Accepting new patients
Woodlawn Hospital CurrentSince Jun 3, 2024 Accepting new patients
Woodlawn Hospital CurrentSince Dec 31, 2025 Accepting new patients
Woodlawn Hospital Past Accepting new patients

Locations

1400 E 9th St
Rochester, IN 46975
Phone (574) 223-2020

1430 E 9th St
Rochester, IN 46975
Phone (574) 223-9393

Interoperability endpoints

  • Direct secure messaging: kfriar673692@direct.parkviewexchange.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1275215899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12386 DIAMOND DR",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465637623",
            "telephone_number": "219-775-9608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 E 9TH ST",
            "city": "ROCHESTER",
            "state": "IN",
            "postal_code": "469758931",
            "telephone_number": "317-738-8095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIAR",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-03",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004383A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, IN

Sources for this page

Verify at the official NPI Registry.