Active NPI
Judy Ann Fryover, NP
- Family Nurse Practitioner
- Portland, MI
National Provider Identifier
1750574950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 470
- Practice address
- 427 W Grand River Ave
Portland, MI 48875-1122 - Phone
- (517) 647-4867
- Fax
- (517) 647-4867
- NPI assigned
- Aug 21, 2007
- Last updated
- Aug 21, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 470 | MI | Primary |
Addresses
Primary practice location
427 W Grand River Ave
Portland, MI 48875-1122
Mailing address
427 W Grand River Ave
Portland, MI 48875-1122
Phone (517) 647-4867
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 470 | MI | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187654400000",
"number": "1750574950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "427 W GRAND RIVER AVE",
"city": "PORTLAND",
"state": "MI",
"postal_code": "488751122",
"telephone_number": "517-647-4867",
"fax_number": "517-647-4867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "427 W GRAND RIVER AVE",
"city": "PORTLAND",
"state": "MI",
"postal_code": "488751122",
"telephone_number": "517-647-4867",
"fax_number": "517-647-4867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRYOVER",
"first_name": "JUDY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-21",
"last_updated": "2007-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.