Individual provider Active NPI

Matthew R Fries, M. D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Warner Robins, GA
National Provider Identifier
1851375448
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
052247 Issued in GA
Practice address
1601 Watson Blvd
Warner Robins, GA 31093-3431
Phone
(912) 261-2669
Fax
(912) 261-0561
NPI assigned
Dec 6, 2005
Last updated
Apr 29, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 052247 GA Primary

Addresses

Primary practice location

1601 Watson Blvd
Warner Robins, GA 31093-3431

Mailing address

PO Box 30309
Charleston, SC 29417-0309
Phone (843) 554-9300

Other identifiers 1

IdentifierTypeStateIssuer
000973244AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20100614000493 GA Practitioner - Pathology 0941330278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Texas Southwestern Medical School at Dallas, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1601 Watson Blvd
Warner Robins, GA 31093-3431
Phone (478) 322-5155

801 W Gordon St
Thomaston, GA 30286-3426
Phone (912) 261-2669

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Pathology Associates PC Anatomic Pathology & Clinical Pathology CurrentSince Feb 15, 2010 Accepting new patients
Southeastern Pathology Associates PC Anatomic Pathology & Clinical Pathology CurrentSince Feb 15, 2010 Accepting new patients
Coastal Care Inc Past Accepting new patients

Locations

163 E Tollison St
Baxley, GA 31513
Phone (912) 367-9847

203 Indigo Dr
Brunswick, GA 31525
Phone (912) 279-1900

3215 Shrine Rd
Ste 2
Brunswick, GA 31520
Phone (912) 262-0042

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

616 19th St
Columbus, GA 31901
Phone (706) 494-4262

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

1101 Ocilla Rd
Douglas, GA 31533
Phone (912) 383-5641

163 S Tallahassee St
Hazlehurst, GA 31539
Phone (912) 375-7781

865 S 1st St
Jesup, GA 31545
Phone (912) 427-6811

821 N Cobb St
Milledgeville, GA 31061
Phone (478) 454-3500

898 College St
Monticello, GA 31064
Phone (706) 468-0988

2000 Dan Proctor Dr
Saint Marys, GA 31558
Phone (912) 576-6160

459 Highway 119 S
Springfield, GA 31329
Phone (912) 754-0200

1499 Fair Rd
Statesboro, GA 30458
Phone (912) 486-1000

801 W Gordon St
Thomaston, GA 30286
Phone (706) 647-4371

2810 N Oak St
Valdosta, GA 31602
Phone (229) 259-0019

1 Meadows Pkwy
Vidalia, GA 30474
Phone (912) 535-5429

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

2005 Pioneer St
Ste B
Waycross, GA 31501
Phone (912) 285-8822

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1851375448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30309",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294170309",
            "telephone_number": "843-554-9300",
            "fax_number": "843-566-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WATSON BLVD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933431",
            "telephone_number": "912-261-2669",
            "fax_number": "912-261-0561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIES",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "052247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000973244A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.