Physician Compare National (NPI:1023086402)

HEALTHCARE PROVIDER: DORIS U THEUNE MS RN CS

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

Individual Professional Information
NPI	1023086402
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7517151517
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101103001211
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	THEUNE
	Individual professional last name
Provider First Name	DORIS
	Individual professional first name
Provider Middle Name	UHLIG
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF COLORADO SCHOOL OF MEDICINE, DENVER
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	SHEBOYGAN PHYSICIANS GROUP S.C.
	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	0648435214
	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	16
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1280 PINE HAVEN LN
	Group Practice or individual's line 1 address
City	SHEBOYGAN FALLS
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	530853001
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9204672400
	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	520044
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST NICHOLAS HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y