SHAWN M FRY


Address: 610 N. Westgate, Jacksonville, IL 62650
Phone: 2172459931

SHAWN M FRY (NPI# 1659467793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1659467793
Entity Type Individual
Full Name SHAWN M FRY
Other Name SHAWN M HEMBROUGH
Credential M.D.
Practice Address 610 N. Westgate
Jacksonville
IL 62650
Mailing Address 1025 S 6th St
Springfield
IL 62703-2403
Practice Telephone 2172459931
Mailing Telephone 2175287541
Enumeration Date 2006-10-05
Last Update Date 2008-12-11
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine 036-108501 IL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IL 036108501 05

Office Location

Street Address 610 N. WESTGATE
City JACKSONVILLE
State IL
Zip Code 62650

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1811391782 Rodney E. Overstreet Hearing Instrument Specialist 1521 W. Walnut, Jacksonville, IL 62650 2014-10-21
1407979818 Jan Ala Speech-Language Pathologist 1111 W Morton, Speechworks, Jacksonville, IL 62650 2007-04-09
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1194895979 Joseph J Kozma Internal Medicine 1440 West Walnut, Jacksonville, IL 62650 2006-11-08
1740350529 Susan Weller Dentist 1614 West Lafayette Avenue, Jackson, IL 62650 2006-11-08
1518050061 Ward Richard Dunseth II Nurse Anesthetist, Certified Registered 1400 W Walnut, Jacksonville, IL 62650 2006-10-02
1205933561 Wells Center Inc Substance Abuse Rehabilitation Facility 1300 Lincoln Avenue, Jacksonville, IL 62650 2006-09-20
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

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1528676186 Sarah Colleen Tapscott Family Medicine 1908 Mill Creek Rd, Jacksonville, FL 32211-5052 2020-07-20
1790303170 Samantha L Scott Family Medicine 516 Pierce Ln, Jacksonville, TX 75766-4546 2020-07-11
1689298689 Meridian Spine and Joint, Inc Family Medicine 9770 Old Baymeadows Rd Ste 139, Jacksonville, FL 32256-7986 2020-06-04
1154942563 Families First Medical Group Family Medicine 12086 Fort Caroline Rd Ste 103, Jacksonville, FL 32225-2688 2020-04-27
1598396392 Pareto Population Health Management Practice Pllc Family Medicine 1697 Kings Rd Ste 1, Jacksonville, FL 32209-6169 2020-01-30
1942862206 Cindy S Wright Do Pllc Family Medicine 12627 San Jose Blvd Ste 902, Jacksonville, FL 32223-8645 2019-07-07
1942868377 Pain Spine & Wellness LLC Family Medicine 9770 Old Baymeadows Rd Ste 141, Jacksonville, FL 32256-7986 2019-05-31
1669035705 Kathy Jo Daniels Family Medicine 10457 Wellington Springs Way, Jacksonville, FL 32221-1175 2019-04-15
1821579103 Tiffany N Major Family Medicine 5194 Johnson Creek Dr, Jacksonville, FL 32218-9308 2018-08-24
1568987360 Main Street Health LLC Family Medicine 2 Shircliff Way Ste 620, Jacksonville, FL 32204-4762 2017-08-14
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Competitor

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City JACKSONVILLE
Zip Code 62650

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Dataset Information

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.

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