Individual provider Active NPI

Jennifer L Fryman, FNPC

  • Family Nurse Practitioner
  • Cheyenne, WY
National Provider Identifier
1417020900
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19840.0839 Issued in WY
Practice address
1331 Prairie Ave
Ste 1
Cheyenne, WY 82009-4867
Phone
(307) 632-0728
Fax
(307) 632-5268
NPI assigned
Nov 15, 2006
Last updated
Feb 3, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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 19840.0839 WY Primary

Addresses

Primary practice location

1331 Prairie Ave
Ste 1
Cheyenne, WY 82009-4867

Mailing address

1331 Prairie Ave
Ste 1
Cheyenne, WY 82009-4867
Phone (307) 632-0728

Other identifiers 2

IdentifierTypeStateIssuer
124193100MedicaidWY
DN1175OtherRAILROAD MEDICARE - PALMETTO GBA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20061121000580 WY Practitioner - Nurse Practitioner 3779581004 Reassigns benefits to 1 organization
I20201123002684 NM Practitioner - Nurse Practitioner 3779581004

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Babson and Associates Primary Care PCGroup PAC ID 0345223343, 6 clinicians

Practice addresses (Care Compare)

1331 Prairie Ave
Suite 1
Cheyenne, WY 82009-4867
Phone (307) 632-0728

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19840.0839WYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain West Surgical Specialists LLC CurrentSince Mar 1, 2024 Accepting new patients

Locations

4003 Rawlins St
Cheyenne, WY 82001
Phone (307) 323-2679

Interoperability endpoints

  • FHIR API: https://soap.crmcwy.org/fhirproxy/api/FHIR/R4
  • Direct secure messaging: jennifer.fryman.1@27166.direct.athenahealth.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 4

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422921600000",
    "number": "1417020900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 PRAIRIE AVE",
            "address_2": "STE 1",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094867",
            "telephone_number": "307-632-0728",
            "fax_number": "307-632-5268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 PRAIRIE AVE",
            "address_2": "STE 1",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094867",
            "telephone_number": "307-632-0728",
            "fax_number": "307-632-5268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYMAN",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "FNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2015-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "19840.0839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124193100",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE - PALMETTO GBA",
            "identifier": "DN1175",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.