NPIMap

Organization Active NPI

E Kent Frye MD SC

  • Urology Physician
  • Streator, IL
National Provider Identifier
1871726414
Registry record updated Feb 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
036081908 Issued in IL
Legal business name
E KENT FRYE MD SC
Practice address
104 W 6TH St Ste 206
Streator, IL 61364-2864
Phone
(815) 672-7289
Fax
(815) 672-2891
NPI assigned
Aug 31, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2010

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

Authorized official

Name
Angie Houch
Title
Manager PFS
Phone
(815) 673-4603

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X 036081908 IL Primary

Addresses

Primary practice location

104 W 6TH St Ste 206
Streator, IL 61364-2864

Mailing address

908 Percy CT
Bourbonnais, IL 60914-1884

Other identifiers 1

IdentifierTypeStateIssuer
1952392557OtherILNPI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266192000000",
    "number": "1871726414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 PERCY CT",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 6TH ST STE 206",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642864",
            "telephone_number": "815-672-7289",
            "fax_number": "815-672-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E KENT FRYE MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-31",
        "last_updated": "2010-02-15",
        "status": "A",
        "authorized_official_last_name": "HOUCH",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "MANAGER PFS",
        "authorized_official_telephone_number": "815-673-4603"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "IL",
            "license": "036081908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1952392557",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Streator, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.