Jacqueline Fry, CPC-I

Primary specialty

Rehabilitation CounselorTaxonomy code 225C00000X

Practice address

2740 S Jones Blvd
Las Vegas, NV 89146

Phone

(702) 248-8866

NPI assigned

Feb 10, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Fundamental Behavioral Services LLC

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1699158600
  Medicare reassignment NPD

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

{
    "created_epoch": "1486684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1801334701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465398",
            "telephone_number": "702-248-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89146",
            "telephone_number": "702-248-8866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2740 S Jones Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "89146",
            "country_code": "US",
            "telephone_number": "702-248-8866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRY",
        "first_name": "JACQUELINE",
        "credential": "CPC-I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-10",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NV",
            "license": "CI0396",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mayra Frutos, MFT
• Amber Marie Fry
• Carolyn Fry
• Cathy Marie Fry
• Colton Jerome Fry
• Robert Fry
• Tamara Fry
• Hannah Fryar
• Frye NP, PLLC
• Andrew Jonathan Frye, M.D.

• Rehabilitation Counselor in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Rehabilitation Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.