Individual provider Active NPI

Bethany Fry, CRNP

  • Family Nurse Practitioner
  • Columbia, MD
National Provider Identifier
1538430327
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R175641 Issued in MD
Practice address
5900 Waterloo Rd
Suite 110
Columbia, MD 21045-2639
Phone
(443) 451-1614
Fax
(443) 451-1619
NPI assigned
Jan 25, 2012
Last updated
Feb 27, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R175641 MD Primary

Addresses

Primary practice location

5900 Waterloo Rd
Suite 110
Columbia, MD 21045-2639

Mailing address

5900 Waterloo Rd
Suite 110
Columbia, MD 21045-2639
Phone (443) 451-1614

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R175641MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trusted Doctors LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 2

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": "1327449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1538430327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 WATERLOO RD",
            "address_2": "SUITE 110",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452639",
            "telephone_number": "443-451-1614",
            "fax_number": "443-451-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 WATERLOO RD",
            "address_2": "SUITE 110",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452639",
            "telephone_number": "443-451-1614",
            "fax_number": "443-451-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "BETHANY",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-25",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R175641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; 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.