Physician Compare National (NPI:1033764360)

HEALTHCARE PROVIDER: KELSEY DANIELLE LANDON PA-C

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

Individual Professional Information
NPI	1033764360
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9032449483
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190926003297
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LANDON
	Individual professional last name
Provider First Name	KELSEY
	Individual professional first name
Provider Middle Name	DANIELLE
	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	2018
	Individual professional's medical school graduation year
Primary Specialty	PHYSICIAN ASSISTANT
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	OKLAHOMA ARTHRITIS CENTER, P.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	0446239743
	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	23
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1701 RENAISSANCE BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 110
	Group Practice or individual's line 2 address
City	EDMOND
	Group Practice or individual's city
State	OK
	Group Practice or individual's state
Zip Code	730133084
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4058444978
	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	370026
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST MARY'S REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	370016
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	INTEGRIS BASS BAPTIST HEALTH CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	370002
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ALLIANCEHEALTH WOODWARD
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y