Active NPI
Nicole Fry, LAT, ATC
- Athletic Trainer
- Tampa, FL
National Provider Identifier
1295233609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AL4960
- Practice address
- 17410 Commerce Park Blvd
Tampa, FL 33647-3500 - Phone
- (813) 558-1185
- NPI assigned
- Jan 31, 2018
- Last updated
- Jan 31, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AL4960 | FL | Primary |
Addresses
Primary practice location
17410 Commerce Park Blvd
Tampa, FL 33647-3500
Mailing address
8749 Orange Leaf CT
Temple Terrace, FL 33637-5036
Phone (970) 846-7807
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL4960 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517356800000",
"number": "1295233609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8749 ORANGE LEAF CT",
"city": "TEMPLE TERRACE",
"state": "FL",
"postal_code": "336375036",
"telephone_number": "970-846-7807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17410 COMMERCE PARK BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336473500",
"telephone_number": "813-558-1185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRY",
"first_name": "NICOLE",
"name_prefix": "Miss",
"credential": "LAT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-31",
"last_updated": "2018-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL4960",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.