Stephen W Fry, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

28164 Issued in TN

Practice address

10461 Wallace Alley St
Kingsport, TN 37663-3936

Phone

(423) 279-1400

Fax

(423) 279-1410

NPI assigned

Aug 10, 2005

Last updated

Oct 1, 2015By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Gastroenterology

Education

Ohio State University College of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tri-Cities Gastroenterology LLCGroup PAC ID 1658354865, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017
• Franklin Woods Community Hospital Hospital, Johnson City, TN, CCN 440184
• Sycamore Shoals Hospital Hospital, Elizabethton, TN, CCN 440018

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tri-Cities Gastroenterology LLC

  • Gastroenterology Physician
  • Kingsport, TN
  • NPI 1083639918
  Medicare reassignment Care Compare group NPD
• Tri-Cities Endoscopy Center PC

  dba The Center for Digestive Wellness

  • Ambulatory Surgical Clinic/Center
  • Kingsport, TN
  • NPI 1063437994
  NPD (past)

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

• Mountain States Health Alliance

  dba Franklin Woods Community Hospital

  • General Acute Care Hospital
  • Johnson City, TN
  • NPI 1114033628
  Care Compare affiliation
• Mountain States Health Alliance

  dba Sycamore Shoals Hospital

  • General Acute Care Hospital
  • Elizabethton, TN
  • NPI 1891801734
  Care Compare affiliation
• Wellmont Health System

  dba Holston Valley Medical Center

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1487690400
  Care Compare affiliation

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1750382982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10461 WALLACE ALLEY ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633936",
            "telephone_number": "423-279-1400",
            "fax_number": "423-279-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10461 WALLACE ALLEY ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633936",
            "telephone_number": "423-279-1400",
            "fax_number": "423-279-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "STEPHEN",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "28164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3801747",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frontier Health (Frontier Industries Kingsport)
• Frontier Health (Traces)
• Frontier Health (Midland Center)
• Frontier Health (Frontier Health Link House)
• Frontline Wellness Center PLLC
• Jorge Federico Fuchs, MA SPF
• Amy Leigh Fugate, FNP
• Kelly Fugate, FNP-C
• Delores Ann Fullen, BA
• Ashley Michelle Fuller, APRN, FNP-BC

• Gastroenterology Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Gastroenterology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; 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.
• 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.