Courtney Fry

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057005872 Issued in IL

Practice address

821 W Highway 50 Ste 150
O Fallon, IL 62269-1828

Phone

(618) 726-0370

NPI assigned

Jan 21, 2025

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• SSM Select Rehab St. Louis, LLC

  • Rehabilitation Practitioner
  • Breese, IL
  • NPI 1740166347
  NPD (past)
• SSM Select Rehab St Louis LLC

  • Rehabilitation Hospital
  • Richmond Heights, MO
  • NPI 1659511988
  NPD (past)

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

{
    "created_epoch": "1737417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1912719790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 PARDEE RD",
            "city": "GODFREY",
            "state": "IL",
            "postal_code": "620352556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 W HIGHWAY 50 STE 150",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691828",
            "telephone_number": "618-726-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MO",
            "license": "2022015131",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057005872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Alexandra Frick
• Vicki Fricke, PHD, RBT
• Alec John Friedman
• John M Frisbie, MAMH
• Kylie Jean Fritz
• Brittni Amber Futrell
• Maria Galanos
• Aristides J. Garces, M.D.
• Maria Monica Paz Garcia
• Candice Cherie Gaston

• Occupational Therapy Assistant in O Fallon, IL
• Providers in O Fallon, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.