Individual provider Active NPI

Constance Louise Fry, MD

  • Ophthalmology Physician
  • Memphis, TN
National Provider Identifier
1306804273
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
68123 Issued in TN
Practice address
930 Madison Ave Ste 200
Memphis, TN 38103-3452
Phone
(901) 448-6650
Fax
(901) 302-2486
NPI assigned
May 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X J2567 TX
Ophthalmology Physician 207W00000X 68123 TN Primary
Ophthalmology Physician 207W00000X MD.020017 LA

Addresses

Primary practice location

930 Madison Ave Ste 200
Memphis, TN 38103-3452

Mailing address

1068 Cresthaven Rd Ste 300
Memphis, TN 38119-0809
Phone (901) 866-8864

Other practice location 1

1068 Cresthaven Rd Ste 400
Memphis, TN 38119-0845
Phone (901) 448-6650

Other practice location 2

401 E Tickle St
Dyersburg, TN 38024-3119
Phone (731) 286-2801

Other practice location 3

668 Skyline Dr
Jackson, TN 38301-3951
Phone (901) 448-6650

Other practice location 4

207 Stonebridge Blvd
Jackson, TN 38305-2075
Phone (731) 661-6340

Other identifiers 6

IdentifierTypeStateIssuer
182388203MedicaidTX
306939001MedicaidAR
182388204OtherTXCSHCN
Q085226MedicaidTN
200006375MedicaidMS
200133851MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, TN2 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
I20061121000735 TX Practitioner - Ophthalmology 1456359694 Reassigns benefits to 1 organization
I20230824001063 TN Practitioner - Ophthalmology 1456359694 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Tulane University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Medical Group IncGroup PAC ID 3173435369, 98 clinicians

Practice addresses (Care Compare)

930 Madison Ave
Suite 200
Memphis, TN 38103-3410
Phone (901) 448-6650

Hospital & facility affiliations

  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
  • Regional One Health Hospital, Memphis, TN, CCN 440152
  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048

Merit-based Incentive Payment System (MIPS)

Final score
88.15 of 100Reported as group
Quality
59.97
Promoting interoperability
100
Improvement activities
40
Cost
80.93

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.020017LAMDOphthalmology Physician
68123TNMDOphthalmology Physician
J2567TXMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at San Antonio Ophthalmology CurrentSince Apr 20, 2009 Accepting new patients
Ut Medical Group, Inc. Ophthalmology CurrentSince Sep 1, 2023 Accepting new patients
Ut Medical Group Inc Ophthalmology CurrentSince Sep 1, 2023 Accepting new patients
St Jude Children'S Research Hospital, Inc. CurrentSince Nov 13, 2023 Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Apr 20, 2009 Accepting new patients

Locations

401 E Tickle St
Dyersburg, TN 38024
Phone (731) 286-2801

668 Skyline Dr
Jackson, TN 38301
Phone (731) 424-1414

207 Stonebridge Blvd
Jackson, TN 38305
Phone (731) 661-6340

1068 Cresthaven Rd
Ste 300
Memphis, TN 38119
Phone (901) 683-0024

1068 Cresthaven Rd
Ste 400
Memphis, TN 38119
Phone (901) 448-6650

930 Madison Ave
Ste 200
Memphis, TN 38103
Phone (901) 448-6650

262 Danny Thomas Pl
Memphis, TN 38105
Phone (888) 226-4343

1407 Union Ave
Ste 700
Memphis, TN 38104
Phone (901) 866-8360

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

8300 Floyd Curl Dr
Fl 6
San Antonio, TX 78229
Phone (210) 450-9400

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

7703 Floyd Curl Dr
#7977
San Antonio, TX 78229
Phone (210) 292-0400

Interoperability endpoints

  • Direct secure messaging: cfry24061@mlh.direct-ci.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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1306804273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 CRESTHAVEN RD STE 300",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190809",
            "telephone_number": "901-866-8864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 MADISON AVE STE 200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033452",
            "telephone_number": "901-448-6650",
            "fax_number": "901-302-2486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1068 Cresthaven Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381190845",
            "country_code": "US",
            "telephone_number": "901-448-6650",
            "fax_number": "901-302-2486",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 E Tickle St",
            "address_purpose": "LOCATION",
            "city": "Dyersburg",
            "state": "TN",
            "postal_code": "380243119",
            "country_code": "US",
            "telephone_number": "731-286-2801",
            "fax_number": "731-286-0058",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "668 Skyline Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383013951",
            "country_code": "US",
            "telephone_number": "901-448-6650",
            "fax_number": "901-302-2486",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "207 Stonebridge Blvd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383052075",
            "country_code": "US",
            "telephone_number": "731-661-6340",
            "fax_number": "731-661-6363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRY",
        "first_name": "CONSTANCE",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "J2567",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "68123",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "MD.020017",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182388203",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306939001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "182388204",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q085226",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200006375",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200133851",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.