Physician Compare National (NPI:1013204734)

HEALTHCARE PROVIDER: JOANNA MARIE ADKINS BAILEY M.D.

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

Individual Professional Information
NPI	1013204734
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3173743671
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20141006000700
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BAILEY
	Individual professional last name
Provider First Name	JOANNA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2011
	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
Organization Legal Name	TUG RIVER HEALTH ASSOCIATION, INC.
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	7214820547
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	9
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	512 MOUNTAINEER HWY
	Group Practice or individual's line 1 address
Line 2 Street Address	RM 1344
	Group Practice or individual's line 2 address
City	BRADSHAW
	Group Practice or individual's city
State	WV
	Group Practice or individual's state
Zip Code	24817
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3049677682
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	510046
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PRINCETON COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	510086
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	WELCH COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y