Glen S Frick, M.D., PHD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

10534932-1205 Issued in UT

Practice address

495 E 4500 S
Ste 200
Salt Lake City, UT 84107

Phone

(801) 595-8844

Fax

(801) 506-0188

NPI assigned

Sep 15, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: glen.frick.1@30414.direct.athenahealth.com

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.

• Comfort Care Pediatrics Inc.

  • Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1477733509
  NPD (past)
• Valley Pediatrics PC

  • Pediatrics Physician
  • Warminster, PA
  • NPI 1841383239
  NPD (past)

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1699760629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 E 4500 S",
            "address_2": "STE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84107",
            "telephone_number": "801-595-8844",
            "fax_number": "801-506-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 E 4500 S",
            "address_2": "STE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84107",
            "telephone_number": "801-595-8844",
            "fax_number": "801-506-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRICK",
        "first_name": "GLEN",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "M.D., PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD417392",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "10534932-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10101276",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Diomira Frew
• Leticia Frias, CPSS
• Patrick Francis Frias, MD
• Danielle Friberg, MOT
• Cosimo Fricano
• Joshua Carlon Frick, DMD
• Kathryn Friddle, NNP
• Louisa Danielle Friedman
• Susan Friedman, LCSW
• Olivia Eileen Friedrichs

• Pediatrics Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Pediatrics Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.