Shannon Danielle Fry, is a medicare enrolled "Physical Medicine & Rehabilitation" in Erie, Illinois. Her current practice location is
5789 Cordova Rd, Erie, Illinois. You can reach out to her office (for appointments etc.) via phone at
(863) 221-2351.
Shannon Danielle Fry is licensed to practice in Illinois (license number 209.025648) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1982335022.
Provider's Profile
Full Name | Shannon Danielle Fry |
---|
Gender | Female |
---|
Speciality | Physical Medicine & Rehabilitation |
---|
Location | 5789 Cordova Rd, Erie, Illinois |
---|
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1982335022
- Provider Enumeration Date: 06/20/2022
- Last Update Date: 12/30/2024
Medicare PECOS Information:
- PECOS PAC ID: 1951771013
- Enrollment ID: I20230105002488
Medical Identifiers
Medical identifiers for Shannon Danielle Fry such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1982335022 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163WP0000X | Registered Nurse - Pain Management | 209.025648 (Illinois) | Secondary |
363LF0000X | Nurse Practitioner - Family | A169408 (Iowa) | Secondary |
208100000X | Physical Medicine & Rehabilitation | 209.025648 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Shannon Danielle Fry allows following entities to bill medicare on her behalf.
Entity Name | Mercyone Urgentcare |
---|
Entity Type | Part B Supplier - Clinic/group Practice |
---|
Entity Identifiers | NPI Number: 1447995766 PECOS PAC ID: 6002294907 Enrollment ID: O20220606001558 |
---|
Entity Name | Mercyone Central Iowa Urgent Care |
---|
Entity Type | Part B Supplier - Clinic/group Practice |
---|
Entity Identifiers | NPI Number: 1790422095 PECOS PAC ID: 0749664902 Enrollment ID: O20220907002258 |
---|
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shannon Danielle Fry is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Shannon Danielle Fry, 5789 Cordova Rd, Erie, IL 61250-9740 Ph: (863) 221-2351 | Shannon Danielle Fry, 5789 Cordova Rd, Erie, IL 61250-9740 Ph: (863) 221-2351 |
Reviews and Comments