Individual provider Active NPI

Melissa Fryer, CCC-SLP

  • Speech-Language Pathologist
  • Milwaukie, OR
National Provider Identifier
1689866071
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
12786 Issued in OR
Practice address
11222 SE Main St
Milwaukie, OR 97269
Phone
(503) 683-3675
NPI assigned
Aug 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 12786 OR Primary

Addresses

Primary practice location

11222 SE Main St
Milwaukie, OR 97269

Mailing address

11222 SE Main St
PO Box 22946
Milwaukie, OR 97269
Phone (503) 683-3675

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160715001682 OR Practitioner - Qualified Speech Language Pathologist 9234421967 Reassigns benefits to 1 organization
Practice locations: Milwaukie, OR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12786ORMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific University CurrentSince Oct 1, 2017 Accepting new patients
Pacific University CurrentSince Oct 1, 2017 Accepting new patients
Pacific University Current Accepting new patients

Locations

2043 College Way
Forest Grove, OR 97116
Phone (503) 352-2020

222 SE 8th Ave
#212
Hillsboro, OR 97123
Phone 5033522400 ext. 8060

1411 SW Morrison St
Ste 310
Portland, OR 97205

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1689866071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11222 SE MAIN ST",
            "address_2": "PO BOX 22946",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "97269",
            "telephone_number": "503-683-3675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11222 SE MAIN ST",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "97269",
            "telephone_number": "503-683-3675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYER",
        "first_name": "MELISSA",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-09",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "12786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.