Individual provider Active NPI

Kenneth W Friar, M.D.

  • Internal Medicine Physician
  • Traverse City, MI
National Provider Identifier
1730184847
Registry record updated Sep 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301056539 Issued in MI
Practice address
1105 6TH St
Traverse City, MI 49684-2349
Phone
(231) 947-0673
Fax
(801) 740-2847
NPI assigned
Jun 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301056539 MI Primary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 4301056539 MI

Addresses

Primary practice location

1105 6TH St
Traverse City, MI 49684-2349

Mailing address

PO Box 107
Traverse City, MI 49685-0107
Phone (231) 947-0673

Other identifiers 2

IdentifierTypeStateIssuer
4326594MedicaidMI
KF056539OtherBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060209000302 MI Practitioner - HospitalistPractitioner - Internal Medicine 0143272377 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Wayne State University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1721 S Stephenson Ave
Dickinson County Healthcare System
Iron Mountain, MI 49801-3637
Phone (906) 774-1313

580 W College Ave
Up Health System
Marquette, MI 49855-2736
Phone (906) 228-9440

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Michigan, PLLC Internal Medicine CurrentSince Jun 1, 2019 Accepting new patients
Sound Inpatient Physicians-Michigan, PLLC Internal Medicine Current Accepting new patients
Hospitalist Medicine Physicians of Michigan PLLC Internal Medicine CurrentSince Jun 1, 2019 Accepting new patients
Sound Inpatient Physicians - Michigan, PLLC Internal Medicine CurrentSince Jun 12, 2019 Accepting new patients
Dickinson County Healthcare System Past Accepting new patients

Locations

1501 W Chisholm St
Alpena, MI 49707
Phone (989) 356-7000

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

224 Park Ave
Frankfort, MI 49635
Phone (231) 352-2200

1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

1465 E Parkdale Ave
Manistee, MI 49660
Phone (231) 398-1000

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

Organizations & group practices 5

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.

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": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189728000000",
    "number": "1730184847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 107",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496850107",
            "telephone_number": "231-947-0673",
            "fax_number": "801-740-2847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 6TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842349",
            "telephone_number": "231-947-0673",
            "fax_number": "801-740-2847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIAR",
        "first_name": "KENNETH",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2007-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301056539",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "4301056539",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4326594",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "KF056539",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.