Individual provider Active NPI

Karyn Lynette Molinari-Fryer, D.O.

  • Pediatric Adolescent Medicine Physician
  • Bridgeport, WV
National Provider Identifier
1669669453
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
2090 Issued in WV
Practice address
139 Conference Center Way
Suite 113
Bridgeport, WV 26330
Phone
(304) 599-8000
Fax
(304) 599-8003
NPI assigned
Sep 26, 2007
Last updated
Apr 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 2090 WV Primary

Addresses

Primary practice location

139 Conference Center Way
Suite 113
Bridgeport, WV 26330

Mailing address

1247 Suncrest Town Center
Morgantown, WV 26505
Phone (304) 599-8000

Other identifiers 1

IdentifierTypeStateIssuer
3810010249MedicaidWV

Other names 1

  • Dr. Karyn Lynett Fryer Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211118001053 WV Practitioner - Pediatric Medicine 8426447194 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2090WVMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Nov 1, 2021 Accepting new patients
West Virginia University Medical Corporation CurrentSince Nov 1, 2021 Accepting new patients
Cardinal Pediatrics PLLC Past Accepting new patients

Locations

1377 Locust Ave
Fairmont, WV 26554
Phone (304) 363-3500

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

Organizations & group practices 3

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": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1669669453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1247 SUNCREST TOWN CENTER",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26505",
            "telephone_number": "304-599-8000",
            "fax_number": "304-599-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 CONFERENCE CENTER WAY",
            "address_2": "SUITE 113",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "26330",
            "telephone_number": "304-599-8000",
            "fax_number": "304-599-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINARI-FRYER",
        "first_name": "KARYN",
        "middle_name": "LYNETTE",
        "name_prefix": "Mrs.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "WV",
            "license": "2090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810010249",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARYN",
            "last_name": "FRYER",
            "middle_name": "LYNETT",
            "prefix": "DR.",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.