Individual provider Active NPI

Robin R Fry, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1720508492
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP016240 Issued in PA
Practice address
900 Walnut St
Philadelphia, PA 19107-5509
Phone
(251) 955-2243
NPI assigned
Jun 23, 2017
Last updated
Jan 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP016240 PA Primary
Neurology Physician 2084N0400X SP016240 PA

Addresses

Primary practice location

900 Walnut St
Philadelphia, PA 19107-5509

Mailing address

204 Stratford Ave
Haddon Township, NJ 08108-2328
Phone (856) 981-4530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171016000328 PA Practitioner - Nurse Practitioner 4880969070 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

900 Walnut St 2ND Floor
Jeff Hosp for Neuro
Philadelphia, PA 19107-5191
Phone (215) 955-1234

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP016240PAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc CurrentSince Jan 1, 2023 Accepting new patients
Jefferson University Physicians CurrentSince Aug 19, 2017 Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Jan 1, 2023 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

2301 S Broad St
Philadelphia, PA 19148
Phone (215) 952-9000

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

900 Walnut St
Fl 2
Philadelphia, PA 19107
Phone (215) 955-1234

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1720508492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 STRATFORD AVE",
            "city": "HADDON TOWNSHIP",
            "state": "NJ",
            "postal_code": "081082328",
            "telephone_number": "856-981-4530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WALNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075509",
            "telephone_number": "251-955-2243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "ROBIN",
        "middle_name": "R",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-23",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP016240",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "SP016240",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.