NPIMap

Individual provider Active NPI

Kristi Nicole Fry, APRN

  • Family Nurse Practitioner
  • Altus, OK
National Provider Identifier
1295230209
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
89095 Issued in OK
Practice address
205 S Park LN
Altus, OK 73521-5755
Phone
(580) 379-6650
Fax
(580) 379-6659
NPI assigned
Mar 30, 2018
Last updated
Aug 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 89095 OK Primary

Addresses

Primary practice location

205 S Park LN
Altus, OK 73521-5755

Mailing address

PO Box 8190
Altus, OK 73522-8190
Phone (580) 379-6650

Other identifiers 1

IdentifierTypeStateIssuer
200767360AMedicaidOK

Other names 1

  • Ms. Kristi Nicole Coakley Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address KristiFry@direct.jcmh.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180615000174 OK Practitioner - Nurse Practitioner 0648525659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 S Hudson St
Altus, OK 73521-4215
Phone (580) 688-2800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shortgrass Community Health Center, Inc Current Accepting new patients

Locations

400 E Sycamore St
Hollis, OK 73550
Phone (580) 688-2800

Interoperability endpoints

  • Direct secure messaging: carolsherman@direct.jcmh.com
  • Direct secure messaging: kristifry@direct.jcmh.com
  • Direct secure messaging: kristifry@schc.secure.relimedsolutions.com

Organizations & group practices 2

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 7

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": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1295230209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8190",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735228190",
            "telephone_number": "580-379-6650",
            "fax_number": "580-379-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S PARK LN",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735215755",
            "telephone_number": "580-379-6650",
            "fax_number": "580-379-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "KRISTI",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-30",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "89095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200767360A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KristiFry@direct.jcmh.com",
            "affiliation": "N",
            "address_1": "205 S Park Ln",
            "city": "Altus",
            "state": "OK",
            "country_code": "US",
            "postal_code": "735215755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTI",
            "last_name": "COAKLEY",
            "middle_name": "NICOLE",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Altus, OK

Sources for this page

Verify at the official NPI Registry.