NPIMap

Individual provider Active NPI

Douglas Fryar, CRNA

  • Certified Registered Nurse Anesthetist
  • Hamlet, NC
National Provider Identifier
1528060126
Registry record updated Mar 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
030988 Issued in NC
Practice address
1000 W Hamlet Ave
Hamlet, NC 28345-4522
Phone
(910) 205-8245
Fax
(910) 205-8164
NPI assigned
Aug 12, 2005
Last updated
Mar 5, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 030988 NC Primary

Addresses

Primary practice location

1000 W Hamlet Ave
Hamlet, NC 28345-4522

Mailing address

1000 W Hamlet Ave
Hamlet, NC 28345-4522
Phone (910) 205-8245

Other identifiers 3

IdentifierTypeStateIssuer
0065428000MedicaidWV
8939420MedicaidVA
001717376OtherWVMTN STATE BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030988NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Hamlet PPM LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Hamlet Hma PPM LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Mercy Tyler Hospital Past Accepting new patients
Mercy Tyler Health Systems Past Accepting new patients
Hamlet Hma Physician Management, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12291/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267747200000",
    "number": "1528060126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W HAMLET AVE",
            "city": "HAMLET",
            "state": "NC",
            "postal_code": "283454522",
            "telephone_number": "910-205-8245",
            "fax_number": "910-205-8164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W HAMLET AVE",
            "city": "HAMLET",
            "state": "NC",
            "postal_code": "283454522",
            "telephone_number": "910-205-8245",
            "fax_number": "910-205-8164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYAR",
        "first_name": "DOUGLAS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2010-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "030988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0065428000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8939420",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MTN STATE BCBS",
            "identifier": "001717376",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamlet, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.