Individual provider Active NPI

Todd Lee Fridley, D.O.

  • Surgery Physician
  • Hickory, NC
National Provider Identifier
1396040739
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2019-02053 Issued in NC
Practice address
1501 Tate Blvd SE Ste 202
Hickory, NC 28602-1385
Phone
(828) 485-2707
Fax
(828) 485-2708
NPI assigned
Jan 16, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 2019-02053 NC Primary

Addresses

Primary practice location

1501 Tate Blvd SE Ste 202
Hickory, NC 28602-1385

Mailing address

1501 Tate Blvd SE Ste 202
Hickory, NC 28602-1385
Phone (828) 485-2707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190923001042 NC Practitioner - General Surgery 4284871971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catawba Valley Medical Group IncGroup PAC ID 6305007279, 133 clinicians

Practice addresses (Care Compare)

1501 Tate Blvd SE
Suite 202
Hickory, NC 28602-1385
Phone (828) 732-7400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy14
Hernia repair (minimally invasive)15
Upper gastrointestinal (GI) endoscopy for acid reflux15
Removal of skin lesions41
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019-02053NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Valley Medical Group Inc CurrentSince Jul 26, 2024 Accepting new patients
Catawba Valley Medical Group Inc Surgery CurrentSince Jul 26, 2024 Accepting new patients
Catawba Valley Medical Group, Inc Single Specialty Current Accepting new patients

Locations

1501 Tate Blvd SE
Ste 202
Hickory, NC 28602
Phone (828) 485-2707

810 Fairgrove Church Rd
Hickory, NC 28602
Phone (704) 326-3000

50 Macedonia Church Rd
#A
Taylorsville, NC 28681
Phone (828) 732-5300

Interoperability endpoints

  • Direct secure messaging: todd.fridley@cvmg.eclinicaldirectplus.com
  • Direct secure messaging: toddfridley@cscc.allscriptsdirect.net

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.

Hospital & facility affiliations 1

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": "1295136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1396040739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 TATE BLVD SE STE 202",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286021385",
            "telephone_number": "828-485-2707",
            "fax_number": "828-485-2708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 TATE BLVD SE STE 202",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286021385",
            "telephone_number": "828-485-2707",
            "fax_number": "828-485-2708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIDLEY",
        "first_name": "TODD",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-16",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NC",
            "license": "2019-02053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.