Individual provider Active NPI

Daniel C Fry, DC

  • Chiropractor
  • San Juan Capistrano, CA
National Provider Identifier
1669577995
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC17397 Issued in CA
Practice address
27131 Calle Arroyo
Suite 1702
San Juan Capistrano, CA 92675-2700
Phone
(949) 830-3539
Fax
(949) 489-3749
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC17397 CA Primary

Addresses

Primary practice location

27131 Calle Arroyo
Suite 1702
San Juan Capistrano, CA 92675-2700

Mailing address

27131 Calle Arroyo
Suite 1702
San Juan Capistrano, CA 92675-2700
Phone (949) 830-3539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090122000237 CA Practitioner - Chiropractic 5597829473 Practice locations: San Juan Capistrano, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

31501 Rancho Viejo Rd
Suite 102
San Juan Capistrano, CA 92675-1870
Phone (949) 830-3539

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC17397CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1669577995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27131 CALLE ARROYO",
            "address_2": "SUITE 1702",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926752700",
            "telephone_number": "949-830-3539",
            "fax_number": "949-489-3749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27131 CALLE ARROYO",
            "address_2": "SUITE 1702",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926752700",
            "telephone_number": "949-830-3539",
            "fax_number": "949-489-3749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "DANIEL",
        "middle_name": "C",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC17397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan Capistrano, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.