Individual provider Active NPI

Jennifer Lynn Frary, PA-C

  • Physician Assistant
  • Casper, WY
National Provider Identifier
1609862580
Registry record updated Jan 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
91 Issued in WY
Practice address
6500 E 2ND St
Suite 200
Casper, WY 82609-4338
Phone
(307) 577-5100
Fax
(307) 234-1201
NPI assigned
Sep 26, 2005
Last updated
Jan 25, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 91 WY Primary

Addresses

Primary practice location

6500 E 2ND St
Suite 200
Casper, WY 82609-4338

Mailing address

6500 E 2ND St
Suite 200
Casper, WY 82609-4338
Phone (307) 577-5100

Other identifiers 1

IdentifierTypeStateIssuer
315274OtherWYBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20050816000817 WY Practitioner - Physician Assistant 8921038274 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Casper Obstetrical and Gynecological Associates PCGroup PAC ID 3779565270, 6 clinicians

Practice addresses (Care Compare)

1125 E 2ND St
Casper, WY 82601-2903
Phone (307) 234-6988

150 N Melrose St
Casper, WY 82601-2735
Phone (307) 234-6988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
91WYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell County Hospital District, CurrentSince Aug 27, 2018 Accepting new patients
Campbell County Hospital District Current Accepting new patients
Campbell County Hospital District CurrentSince Aug 27, 2018 Accepting new patients

Locations

501 S Burma Ave
Gillette, WY 82716
Phone (307) 682-8811

501 S Burma Ave
Fl 3
Gillette, WY 82716
Phone (307) 688-3636

Interoperability endpoints

  • Direct secure messaging: jfrary@ccmgclinics.gwaydirect.com

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": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201219200000",
    "number": "1609862580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 E 2ND ST",
            "address_2": "SUITE 200",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094338",
            "telephone_number": "307-577-5100",
            "fax_number": "307-234-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 E 2ND ST",
            "address_2": "SUITE 200",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094338",
            "telephone_number": "307-577-5100",
            "fax_number": "307-234-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRARY",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2008-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "91",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "315274",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.