Claude Randall Fridley

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA 3018 Issued in FL

Practice address

4419 Tram Rd
Panama City, FL 32404-2559

Phone

(850) 747-5825

NPI assigned

Jul 19, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Randy Fridley Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Fridley Roemer HCS, Inc.

  • Clinic/Center
  • Panama City, FL
  • NPI 1205807914
  NPD (past)

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

{
    "created_epoch": "1216425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216425600000",
    "number": "1720243702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "644 FLORIDA AVE",
            "address_2": "UNIT E",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324016354",
            "telephone_number": "850-896-0569",
            "fax_number": "850-522-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 TRAM RD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324042559",
            "telephone_number": "850-747-5825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIDLEY",
        "first_name": "CLAUDE",
        "middle_name": "RANDALL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-19",
        "last_updated": "2008-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA 3018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDY",
            "last_name": "FRIDLEY",
            "prefix": "MR.",
            "credential": "PHYSICIAN ASSISTANT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mary Ellen French, NP-C
• Timothy Gerard French Jr., DMD
• Kathrine Mary Frewin, LCSW
• Robert Allen Frick, DO,DPM,MPH,PT
• Fridley Roemer HCS, Inc.
• Christine A Frohlich, CRNA
• Stephanie Rae Frost
• Justin Frye
• FSL-Panama City, LLC
• Douglas Fujawa, DDS, MS

• Medical Physician Assistant in Panama City, FL
• Providers in Panama City, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2008; 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.