Richard Gary Fried, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038005386 Issued in IL

Practice address

1715 5TH Ave
Moline, IL 61265-7911

Phone

(309) 762-1050

Fax

(309) 762-1064

NPI assigned

Jun 30, 2005

Reactivated

Mar 24, 2006

Last updated

Oct 23, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 IL

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Tiffany Zimmerman DC PC

  • Chiropractor
  • Moline, IL
  • NPI 1306085428
  NPD (past)

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1710984174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 5TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612657911",
            "telephone_number": "309-762-1050",
            "fax_number": "309-762-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 5TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612657911",
            "telephone_number": "309-762-1050",
            "fax_number": "309-762-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIED",
        "first_name": "RICHARD",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038005386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038005386",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhonda L Freed, MD
• Kyle Edwin Freeman, D.C.
• Morgan Mercedes Deanne Frei, QMHP, LSWM
• Amanda C French, PHARMD
• Fresenius Medical Care Quad Cities, LLC (Fresenius Medical Care Moline)
• Tamarra A Friedrichsen, AU.D.
• Front Lines Wellness QC LLC
• Ronald Dean Frus, MD
• Haley Funk
• Andrew Furgason, LCPC

• Chiropractor in Moline, IL
• Providers in Moline, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.