Mindi Marie Fry, CRNP
Individual provider Active NPI Nurse Practitioner · Fredericksburg, VA
NPI 1447560669 · NPPES record last updated May 5, 2020
Key facts
- NPI
- 1447560669
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 0024177908 (VA)
- Practice address
- 1201 Sam Perry Blvd Ste 280
Fredericksburg, VA 22401-8400 - Phone
- (540) 361-2922
- NPI assigned
- Oct 21, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mary Washington Healthcare Providers LLC
Mary Washington Hospital Inc
Practice addresses (Care Compare)
1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-5610
1201 B Sam Perry Blvd
Suite 280
Fredericksburg, VA 22401-8457
Phone (540) 741-5502
Hospital & facility affiliations
- Mary Washington Hospital
- Stafford Hospital, LLC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200306001258 | VA | Practitioner - Nurse Practitioner | 0143409052 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0001221226 | VA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Washington Hospital, Inc. | Current |
Accepting new patients | |
| Mary Washington Healthcare Physicians | Current | Accepting new patients | |
| Pathology Associates of Fredericksburg PTR | Current | Accepting new patients | |
| Mary Washington Hospital Inc. | Current |
Accepting new patients | |
| Mary Washington Healthcare Providers LLC | Current |
Accepting new patients | |
| Moffitt Heart and Vascular Group Inc. | Past | Accepting new patients |
Locations
1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100
1201 Sam Perry Blvd
Ste 220
Fredericksburg, VA 22401
Phone (540) 361-2922
1201 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-7000
1201 Sam Perry Blvd
Ste 280
Fredericksburg, VA 22401
Phone (540) 361-2922
125 Hospital Center Blvd
Ste 221
Stafford, VA 22554
Phone (540) 741-5501
Interoperability endpoints
- mfry60946@marywashingtonhealthcare.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | SP010900 | PA | |
| Registered Nurse | 163W00000X | 0001221226 | VA | |
| Nurse Practitioner | 363L00000X | 0024177908 | VA | Yes |
Addresses
Primary practice location
1201 Sam Perry Blvd Ste 280
Fredericksburg, VA 22401-8400
Mailing address
1201 Sam Perry Blvd Ste 280
Fredericksburg, VA 22401-8400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103129038 | Medicaid | PA |
Other providers in Fredericksburg, VA
- Erika Frick
- Angela Rose Friend
- Barbara Frimpong
- Amber Froney
- Karen Frostick
- Connie W Fu
- Delia Fulcher
- Andrea M Fulena
- Full Armor Supportive Care, LLC
- Ryan Fulton Stewart
All providers in Fredericksburg, VA · Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 5, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.