Fry Eye Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

FRY EYE SURGERY CENTER, LLC

Practice address

411 Campus Drive
Garden City, KS 67846-6124

Phone

(620) 276-7699

Fax

(620) 276-7704

NPI assigned

Jul 24, 2006

Last updated

Aug 10, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. William S Clifford, M.D.NPI 1114941226

Title

Authorized Official/Owner

Phone

(620) 275-7248

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Listed as

Fry Eye Surgery Center LLCCCN 17C0001034

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Fry Eye Associates PA

  • Ophthalmology Physician
  • Garden City, KS
  • NPI 1124049499

  Member Of

  NPD member

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William S Clifford, M.D.

  • Ophthalmology Physician
  • Garden City, KS
  • NPI 1114941226
  NPD (past) Authorized official
• Travis Kimple, MD

  • Ophthalmology Physician
  • Garden City, KS
  • NPI 1114450566
  NPD

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439164800000",
    "number": "1528080876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 CAMPUS DRIVE",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678466124",
            "telephone_number": "620-276-7699",
            "fax_number": "620-276-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 CAMPUS DRIVE",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678466124",
            "telephone_number": "620-276-7699",
            "fax_number": "620-276-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRY EYE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2015-08-10",
        "status": "A",
        "authorized_official_last_name": "CLIFFORD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/OWNER",
        "authorized_official_telephone_number": "620-275-7248",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "94510021",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100750170A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100305010A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Marie Fisher I, LBSW
• Fresenius Medical Care Garden City, LLC (Fresenius Medical Care Garden City)
• Christopher Friedly
• Frontline at Home, LLC
• Fry Eye Associates PA
• Eric L Fry, MD
• Jena L Fry, PA-C
• Albert H Gaines, MD
• Audrey Nicole Galicia, DNP, APRN, FNP-C
• Elizabeth Gant, ARNP

• Ambulatory Surgical Clinic/Center in Garden City, KS
• Providers in Garden City, KS by specialty
• Ambulatory Surgical Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.