Jody Fry, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34004934A Issued in IN

Practice address

5230 S Western Ave
Marion, IN 46953-5778

Phone

(765) 674-2208

Fax

(765) 674-3273

NPI assigned

Mar 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grant-Blackford Mental Health, Inc.

  • Community/Behavioral Health Agency
  • Marion, IN
  • NPI 1407848500
  Medicare reassignment
• Grant-Blackford Mental Health, Inc.

  • Community/Behavioral Health Agency
  • Marion, IN
  • NPI 1437983103
  NPD

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699805689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5230 S WESTERN AVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469535778",
            "telephone_number": "765-674-2208",
            "fax_number": "765-674-3273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 S WESTERN AVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469535778",
            "telephone_number": "765-674-2208",
            "fax_number": "765-674-3273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "JODY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004934A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000361580",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fresenius Medical Care Fort Wayne, LLC
• Gary A Frick, DO
• Aryanna Friend
• Shelby D Fritz, M.A. CF-SLP
• Ashlyn Leigh Fry
• Kelsi Fulda, FNP-C
• James O. Fuller, PH. D., LMHC
• Jeffrey S Fuller, NP
• Taylor Marie Gaillard
• Phillip Vincent Galeon

• Clinical Social Worker in Marion, IN
• Providers in Marion, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.