Physician Compare National (NPI:1043278260)

HEALTHCARE PROVIDER: CHARLES E. STANKARD 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	1043278260
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3375645856
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100320000208
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	STANKARD
	Individual professional last name
Provider First Name	CHARLES
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	NORTH FLORIDA SURGEONS PA
	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	2769381391
	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	109
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1658 ST VINCENTS WAY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 210
	Group Practice or individual's line 2 address
City	MIDDLEBURG
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	320688459
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9042148161
	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	100321
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST VINCENTS MEDICAL CENTER - CLAY COUNTY
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100088
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BAPTIST MEDICAL CENTER JACKSONVILLE
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y