Individual provider Active NPI

Amy M Fry, M.D.

  • Obstetrics & Gynecology Physician
  • Bentonville, AR
National Provider Identifier
1821170481
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
01062670 Issued in IN
Practice address
2900 Medical Center Pkwy Ste 240a
Bentonville, AR 72712-3204
Phone
(795) 533-3340
Fax
(479) 553-1964
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 01062670 IN Primary

Addresses

Primary practice location

2900 Medical Center Pkwy Ste 240a
Bentonville, AR 72712-3204

Mailing address

1200 SE 28TH St
2
Bentonville, AR 72712-3881
Phone (479) 271-0005

Other identifiers 1

IdentifierTypeStateIssuer
178153001MedicaidAR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amy.fry.1@2229.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090711000004 AR Practitioner - Obstetrics/Gynecology 8426154766 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Arkansas College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Women'S Specialty Group, PLLCGroup PAC ID 4880137959, 3 clinicians

Practice addresses (Care Compare)

2900 Medical Ctr Pkwy
Suite 380
Bentonville, AR 72712-3305
Phone (479) 553-3340

Merit-based Incentive Payment System (MIPS)

Final score
87.5 of 100Reported as apm
Quality
69.34
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01062670INMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Benton County Physician Services LLC CurrentSince Jul 30, 2019 Accepting new patients
Women'S Specialty Group, PLLC Obstetrics & Gynecology CurrentSince Jun 3, 2024 Accepting new patients
Lifespring Women'S Healthcare PA Obstetrics & Gynecology CurrentSince Jul 1, 2009 Accepting new patients
Newman, M.D. Plastic Surgery, P.a. Past Accepting new patients

Locations

2900 Medical Center Pkwy
Ste 240A
Bentonville, AR 72712
Phone (479) 553-2215

2900 Medical Center Pkwy
Ste 380
Bentonville, AR 72712
Phone (479) 553-3340

1200 SE 28th St
Ste 2
Bentonville, AR 72712
Phone (479) 271-0005

101 Sun Meadow Dr
Centerton, AR 72719
Phone (479) 273-1426

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GAHCDA
  • Direct secure messaging: amy.fry.1@30995.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1821170481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SE 28TH ST",
            "address_2": "2",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123881",
            "telephone_number": "479-271-0005",
            "fax_number": "479-273-1427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 MEDICAL CENTER PKWY STE 240A",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123204",
            "telephone_number": "795-533-3340",
            "fax_number": "479-553-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "AMY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01062670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178153001",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy.fry.1@2229.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "2900 Medical Center Pkwy Ste 240A",
            "city": "Bentonville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727123204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.