Individual provider Active NPI

Melissa Fry, OTR

  • Occupational Therapist
  • Milwaukee, WI
National Provider Identifier
1497202998
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3342-26 Issued in WI
Practice address
2901 West Kinnickinnic Parkway
Suite 500
Milwaukee, WI 53219-1628
Phone
(414) 649-3251
Fax
(414) 649-3245
NPI assigned
Sep 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3342-26 WI Primary

Addresses

Primary practice location

2901 West Kinnickinnic Parkway
Suite 500
Milwaukee, WI 53219-1628

Mailing address

N61W15150 Wigwam Dr
Menomonee Falls, WI 53051-5835
Phone (414) 640-3091

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mfry1461@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200117001637 WI Practitioner - Occupational Therapist in Private Practice 4880029966 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3342-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2020 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2020 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients

Locations

2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215
Phone (414) 384-5111

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

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.

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1497202998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N61W15150 WIGWAM DR",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530515835",
            "telephone_number": "414-640-3091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 WEST KINNICKINNIC PARKWAY",
            "address_2": "SUITE 500",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532191628",
            "telephone_number": "414-649-3251",
            "fax_number": "414-649-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "MELISSA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3342-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfry1461@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2901 West Kinnickinnic Parkway",
            "address_2": "Suite 500",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532191628",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2901 West Kinnickinnic Parkway",
            "address_2": "Suite 500",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532191628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.