Individual provider Active NPI

Daphne L. Fry, ARNP

  • Family Nurse Practitioner
  • Shawnee Mission, KS
National Provider Identifier
1487621264
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
45196 Issued in KS
Practice address
9100 W 74TH St
Shawnee Mission, KS 66204-4004
Phone
(913) 676-2679
NPI assigned
Mar 1, 2006
Last updated
Nov 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 45196 KS Primary
Registered Nurse 163W00000X 1484913081 KS

Addresses

Primary practice location

9100 W 74TH St
Shawnee Mission, KS 66204-4004

Mailing address

PO Box 411895
Kansas City, MO 64141-1895
Phone (913) 632-2230

Other identifiers 4

IdentifierTypeStateIssuer
100405840AMedicaidKS
30316011OtherKSBCBS KC
429070600MedicaidMO
500029863OtherKSRR MEDICARE

Other names 1

  • Daphne L. Threinen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080815000322 KS Practitioner - Nurse Practitioner 2264507839 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Baylor College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4550 W 109TH St
Suite 210
Overland Park, KS 66211-1351
Phone (913) 287-5678

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1484913081KSMDRegistered Nurse
45796KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Hospice of Kansas LLC CurrentSince Nov 6, 2022 Accepting new patients
Care Alternatives of Missouri, LLC CurrentSince Dec 9, 2024 Accepting new patients
Midwest Anesthesia Associates, PA Registered Nurse CurrentSince Jul 30, 2001 Accepting new patients
Care Alternatives of Missouri, LLC CurrentSince Dec 9, 2024 Accepting new patients

Locations

11150 Thompson Ave
Lenexa, KS 66219
Phone (913) 850-7500

4550 W 109th St
Ste 210
Overland Park, KS 66211
Phone (913) 287-5678

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

65 Jackson Dr
Ste 103
Cranford, NJ 07016
Phone (908) 931-9068

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1487621264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411895",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641411895",
            "telephone_number": "913-632-2230",
            "fax_number": "913-632-2297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 W 74TH ST",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662044004",
            "telephone_number": "913-676-2679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "DAPHNE",
        "middle_name": "L.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "45196",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "1484913081",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100405840A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KC",
            "identifier": "30316011",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "429070600",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "500029863",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAPHNE",
            "last_name": "THREINEN",
            "middle_name": "L.",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shawnee Mission, KS

Sources for this page

Verify at the official NPI Registry.