Individual provider Active NPI

Tiffany Danielle Fry

  • Nurse Practitioner
  • Coshocton, OH
National Provider Identifier
1578200671
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.0031351 Issued in OH
Practice address
440 Browns LN
Coshocton, OH 43812-2044
Phone
(740) 891-9000
NPI assigned
May 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.0031351 OH Primary

Addresses

Primary practice location

440 Browns LN
Coshocton, OH 43812-2044

Mailing address

440 Browns LN
Coshocton, OH 43812-2044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20220630002690 OH Practitioner - Nurse Practitioner 1355721721 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Primary Care Physicians, LLCGroup PAC ID 5294992293, 45 clinicians

Practice addresses (Care Compare)

23599 Airport Rd
Suite a
Coshocton, OH 43812-9276
Phone (740) 722-9510

Hospital & facility affiliations

  • Genesis Hospital Hospital, Zanesville, OH, CCN 360039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0031351OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Muskingum Valley Health Centers CurrentSince Jun 6, 2022 Accepting new patients
Genesis Primary Care Physicians LLC CurrentSince Apr 25, 2025 Accepting new patients
Muskingum Valley Health Centers CurrentSince Jun 6, 2022 Accepting new patients
Muskingum Valley Health Centers Past Accepting new patients

Locations

1330 Clark St
Cambridge, OH 43725
Phone (740) 421-9530

440 Browns Ln
Coshocton, OH 43812
Phone (740) 295-3331

23599 Airport Rd
Ste A
Coshocton, OH 43812
Phone (740) 722-9510

406 S 15th St
Coshocton, OH 43812
Phone (740) 295-3331

410 Main St
Ste A
Coshocton, OH 43812
Phone (740) 722-9520

859 N Main St
Malta, OH 43758
Phone (740) 962-6111

33 S 5th St
Zanesville, OH 43701
Phone (407) 891-9000

716 Adair Ave
Zanesville, OH 43701
Phone (740) 454-5239

1210 Ashland Ave
Zanesville, OH 43701
Phone (740) 452-1905

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 and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1578200671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 BROWNS LN",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438122044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 BROWNS LN",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438122044",
            "telephone_number": "740-891-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "TIFFANY",
        "middle_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-19",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0031351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coshocton, OH

Sources for this page

Verify at the official NPI Registry.