Individual provider Active NPI

Berline Claris Frye, CNP

  • Adult Health Nurse Practitioner
  • Independence, OH
National Provider Identifier
1811403629
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
022176 Issued in OH
Practice address
6161 Oak Tree Blvd Ste 200
Independence, OH 44131-2581
Phone
(800) 642-4168
NPI assigned
Dec 17, 2017
Last updated
May 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 022176 OH Primary
Gerontology Nurse Practitioner 363LG0600X 022176 OH

Addresses

Primary practice location

6161 Oak Tree Blvd Ste 200
Independence, OH 44131-2581

Mailing address

200 Oceangate Ste 100
Long Beach, CA 90802-4317
Phone (888) 665-4621

Other names 1

  • Mrs. Berline C Frye Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180208002983 OH Practitioner - Nurse Practitioner 7911267042 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
022176OHMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA CurrentSince Nov 25, 2022 Accepting new patients
Mycare Clinic LLC PastSince Feb 5, 2018 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

4449 Easton Way
Fl 2
Columbus, OH 43219
Phone (614) 565-8197

Organizations & group practices 2

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": "1513468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1811403629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "888-665-4621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 OAK TREE BLVD STE 200",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312581",
            "telephone_number": "800-642-4168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYE",
        "first_name": "BERLINE",
        "middle_name": "CLARIS",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-17",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "022176",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "022176",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BERLINE",
            "last_name": "FRYE",
            "middle_name": "C",
            "prefix": "MRS.",
            "credential": "MSN CNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Independence, OH

Sources for this page

Verify at the official NPI Registry.