Individual provider Active NPI

Joel Daniel Fryfogle, CRNA

  • Certified Registered Nurse Anesthetist
  • Mobile, AL
National Provider Identifier
1760012496
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3-000001 Issued in AL
Practice address
1700 Center St
Mobile, AL 36604-3301
Phone
(251) 415-1000
NPI assigned
Jan 22, 2020
Last updated
Jan 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 3-000001 AL Primary

Addresses

Primary practice location

1700 Center St
Mobile, AL 36604-3301

Mailing address

278 Ernest Pipkins Rd
Lucedale, MS 39452-8614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200331003793 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 8426487117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
USA Health Anesthesia Billing Services LLCGroup PAC ID 1153659123, 160 clinicians

Practice addresses (Care Compare)

2451 Fillingim St
Mobile, AL 36617-2238
Phone (251) 471-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3-000001ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
USA Health Anesthesia Billing Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2020 Accepting new patients

Locations

1700 Center St
Mobile, AL 36604
Phone (251) 415-1000

2451 Fillingim St
Mobile, AL 36617
Phone (251) 434-3711

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1760012496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 ERNEST PIPKINS RD",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394528614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 CENTER ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366043301",
            "telephone_number": "251-415-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYFOGLE",
        "first_name": "JOEL",
        "middle_name": "DANIEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-22",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "3-000001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.