MR. JACK P FRY (DPT) – Physical Therapist, NPI 1447510524

MR. JACK P FRY (DPT) is a healthcare provider. based in Evanston, Wyoming. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 2428 (AK). The NPI Number for MR. JACK P FRY (DPT) is 1447510524

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
MR. JACK P FRY (DPT)
NPI
1447510524
Phone
(435) 230-4307
Address
113 MOUNTAIN VILLAGE DR APT D
Enumeration Date
22 May 2012
Last Update Date
22 May 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9077460722
Graduation Year
2012 (14 years ago)
PAC ID
1254597792
Group Practice PAC ID
9739156936
Professional Enrollment ID
I20120727000036
Address ID
AK996456378PA642XXSTXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

461 PHYSICAL THERAPIST IN PRIVATE PRACTICE in AK

Provider Addresses for MR. JACK P FRY (DPT)

  • 113 MOUNTAIN VILLAGE DR APT D

    EVANSTON, WY 829302157

    Phone: (435) 230-4307

    Type: Mailing

  • 157 LEWIS ST

    NORTH POLE, AK 997057699

    Phone: (907) 488-4978

    Fax: (907) 488-4976

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-07-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120727000036IPhysical Therapist In Private PracticeAKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes1,513104$0
97140Therapy procedure using manual technique, each 15 minutes46380$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes29347$0
97113Therapy procedure using water pool to exercises, each 15 minutes14517$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care13427$0
View full utilization report →

Insurance plans in this area (ZIP 82930)

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Provider's Procedures

MR. JACK P FRY (DPT) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYAK97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes66233

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9739156936View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeWI
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeAK
Physical Therapist In Private PracticeAK

Reviews

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Frequently asked questions

Can I cross-check MR. JACK P FRY (DPT) using NPI 1447510524?
NPI 1447510524 belongs to MR. JACK P FRY (DPT); compare other details if you need extra assurance.
Is MR. JACK P FRY (DPT) still an active registrant?
MR. JACK P FRY (DPT) carries an active NPI according to the public dataset.
What expertise is attributed to MR. JACK P FRY (DPT)?
MR. JACK P FRY (DPT)'s specialty line reads Physical Therapist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MR. JACK P FRY (DPT)?
Travel planning: use Evanston, Wyoming as the reference point for MR. JACK P FRY (DPT), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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