Active NPI
Adam Fry
- Behavior Analyst
- Tacoma, WA
National Provider Identifier
1780075697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- CG 60351091
- Practice address
- 9740 S Tacoma Way
Tacoma, WA 98499-4456 - Phone
- (253) 682-0353
- Fax
- (253) 682-0301
- NPI assigned
- Feb 13, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | CG 60351091 | WA | Primary |
Addresses
Primary practice location
9740 S Tacoma Way
Tacoma, WA 98499-4456
Mailing address
9740 S Tacoma Way
Tacoma, WA 98499-4456
Phone (253) 682-0353
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CG 60351091 | WA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kitsap Mental Health Services | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Bremerton, WA
- NPI 1033268008
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423785600000",
"number": "1780075697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9740 S TACOMA WAY",
"city": "TACOMA",
"state": "WA",
"postal_code": "984994456",
"telephone_number": "253-682-0353",
"fax_number": "253-682-0301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9740 S TACOMA WAY",
"city": "TACOMA",
"state": "WA",
"postal_code": "984994456",
"telephone_number": "253-682-0353",
"fax_number": "253-682-0301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRY",
"first_name": "ADAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-02-13",
"last_updated": "2015-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "WA",
"license": "CG 60351091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.