Individual provider Active NPI

Jordan Fried

  • Certified Registered Nurse Anesthetist
  • Fort Sam Houston, TX
National Provider Identifier
1679929624
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
169123 Issued in AK
Practice address
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone
(210) 916-7595
NPI assigned
May 9, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 169123 AK Primary

Addresses

Primary practice location

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Mailing address

5955 Zeamer Ave
Jber, AK 99506-3702
Phone (907) 580-1820

Other practice location 1

5955 Zeamer Ave
Anchorage, AK 99506-3702
Phone (907) 580-9068

Other practice location 2

5955 Zeamer Ave
Jber, AK 99506-3702
Phone (907) 580-1820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210324000872 AK Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608283460 Reassigns benefits to 2 organizations
I20260304003818 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608283460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Kansas City, MO 64180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chugach Anesthesia, LLC CurrentSince Apr 1, 2021 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2026 Accepting new patients
Providence Anchorage Anesthesia Medical Group, P.C. CurrentSince Nov 1, 2021 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2026 Accepting new patients
University Hospitals Medical Group Inc PastSince Nov 1, 2021 Accepting new patients
Alaska Spine Center, LLC Past Accepting new patients

Locations

3300 Providence Dr
Ste 207
Anchorage, AK 99508
Phone (907) 279-0555

4100 Lake Otis Pkwy
Ste 212
Anchorage, AK 99508
Phone (907) 550-6100

3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1679929624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVE",
            "city": "JBER",
            "state": "AK",
            "postal_code": "995063702",
            "telephone_number": "907-580-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-7595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5955 Zeamer Ave",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995063702",
            "country_code": "US",
            "telephone_number": "907-580-9068",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5955 Zeamer Ave",
            "address_purpose": "LOCATION",
            "city": "Jber",
            "state": "AK",
            "postal_code": "995063702",
            "country_code": "US",
            "telephone_number": "907-580-1820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRIED",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-09",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AK",
            "license": "169123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; 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.