Physician Compare National (NPI:1013108661)

HEALTHCARE PROVIDER: ALEXIS ANN ECKARD MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1013108661
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6406924497
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120228000428
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ECKARD
	Individual professional last name
Provider First Name	ALEXIS
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2004
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	185 HOSPITAL RD J
	Group Practice or individual's line 1 address
City	WINCHESTER
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	373982404
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	010085
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	DECATUR MORGAN HOSPITAL - DECATUR CAMPUS
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	440058
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SOUTHERN TENNESSEE REGIONAL HLTH SYSTEM WINCHESTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	M