DR. JOHN MACK FRY (NPI# 1871512236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871512236 |
| Entity Type | Individual |
| Full Name | DR. JOHN MACK FRY |
| Credential | D.O. |
| Practice Address |
2750 S Campbell Ave Springfield MO 65807-3506 |
| Mailing Address |
3800 S National Ave #540 Springfield MO 65807-5209 |
| Practice Telephone | 4172692281 |
| Practice Fax Number | 4172692292 |
| Mailing Telephone | 4172696262 |
| Mailing Fax Number | 4172694349 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2007-11-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 30097 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS MO | 25461 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962945873 | John Fry | Registered Nurse | 209 Redington Way, Irmo, SC 29063-8014 | 2016-11-25 |
| 1700021003 | John Rudolph Fry | Ophthalmology | 3 Frith Dr, Asheville, NC 28803-3108 | 2008-12-16 |
| 1841233806 | John Samuel Fry | Chiropractor | 4600a Route 152, Lavalette, WV 25535-9702 | 2006-06-14 |
| 1689804932 | John S. Fry | Psychologist | 1300 Bristol St N, Suite 100, Newport Beach, CA 92660-2951 | 2009-07-21 |
| 1427240829 | John Michael Fry | Counselor | 543 Taylor Ave, Columbus, OH 43203-1278 | 2007-08-10 |
| 1760541056 | John A Fry | Internal Medicine | 500 Gypsy Ln, Youngstown, OH 44504-1315 | 2006-12-06 |
| 1992744544 | John Reed Fry | Dentist | 2530 Perry Ave, Suite 200, Bremerton, WA 98310-5219 | 2006-06-06 |
| Street Address |
2750 S CAMPBELL AVE |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65807-3506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538197850 | Lester E. Cox Medical Centers | Family Medicine | 2750 S Campbell Ave, Springfield, MO 65807-3506 | 2006-06-28 |
| 1124543483 | Tatyana B Lehman | Nurse Practitioner | 2750 S Campbell Ave, Springfield, MO 65807-3506 | 2017-08-08 |
| 1093266470 | Monica Freeman | Registered Nurse | 2750 S Campbell Ave, Springfield, MO 65807 | 2016-10-20 |
| 1417204025 | Melanie R. Smith | Nurse Practitioner | 2750 S Campbell Ave, Springfield, MO 65807-3506 | 2012-08-14 |
| 1447324660 | Lester E Cox Medical Centers | Family Medicine | 2750 S Campbell Ave, Springfield, MO 65807-3506 | 2006-11-20 |
| 1356433601 | Phillip L Monroe | Family Medicine | 2750 S Campbell Ave, Springfield, MO 65807-3506 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396390241 | Karley Kassandra Murphy | Counselor | 3734 South Ave #c, Springfield, MO 65807 | 2019-08-07 |
| 1396203626 | Auvia L Logan | Dietitian, Registered | 3322 S. Campbell Ave. Suite Cc, Springfield, MO 65807 | 2019-03-05 |
| 1598250961 | Kathryn Barber | Nurse Practitioner | 3800 S National Ave Ste 700, Springfield, MO 65807 | 2018-06-27 |
| 1447764899 | Missouri Midwifery Service | Clinic/Center | 3840 South Avenue, Springfield, MO 65807 | 2017-11-21 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1740663335 | Sarah E Kirk | Physical Therapist | 3545 S. National Ave, Springfield, MO 65807 | 2015-07-01 |
| 1750713335 | Amanda Ward | Nurse Practitioner | 2150 W Republic Rd Ste 112, Springfield, MO 65807 | 2013-08-06 |
| 1932531126 | Eugenia R Cortez | Counselor | 2124 Chesterfield Blvd., Springfield, MO 65807 | 2013-07-30 |
| 1962742866 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3045 W Republic St, Springfield, MO 65807 | 2013-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| Find all providers in zip 65807 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841802592 | Community Health and Wellness Services, Inc. | Family Medicine | 312 Memorial Park Dr, Springfield, PA 19064-1714 | 2020-08-22 |
| 1649815796 | 180 Health Lifestyle Wellness Centers | Family Medicine | 1936 S Glenstone Ave, Springfield, MO 65804-2305 | 2019-11-13 |
| 1790337988 | Aminat Ogun | Family Medicine | 520 N 4th St # 62702, Springfield, IL 62702-5238 | 2019-07-09 |
| 1770076622 | Thomas John Schumann | Family Medicine | 1260 E. Woodlawn Ave, Suite 200, Springfield, PA 19064-3988 | 2018-06-14 |
| 1134648959 | Patricia Derges | Family Medicine | 3259 E Sunshine St Ste Aa, Springfield, MO 65804-2114 | 2017-09-12 |
| 1740704667 | Mercy Management of Sepa | Family Medicine | 1001 Baltimore Pike Ste 109, Springfield, PA 19064-2852 | 2017-08-02 |
| 1083134902 | Trevor Conner | Family Medicine | 1423 N Jefferson Ave, B100, Springfield, MO 65802 | 2017-06-21 |
| 1790215853 | Vincent Marchese | Family Medicine | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2017-06-12 |
| 1184152100 | Canaan Arceneaux | Family Medicine | 1001 Baltimore Pike Ste 106, Springfield, PA 19064-2800 | 2017-06-03 |
| 1063943587 | Cody Stark Rogers | Family Medicine | 1423 N Jefferson Ave # A100, Springfield, MO 65802-1988 | 2017-03-26 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65807 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.