Physician Compare National (NPI:1083076145)

HEALTHCARE PROVIDER: SLADE THOMPSON 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	1083076145
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4082985536
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20191015000563
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	THOMPSON
	Individual professional last name
Provider First Name	SLADE
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2016
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	NEWBERRY EMERGENCY PHYSICIANS PLLC
	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	1254656168
	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	15
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	200 STONECREST BLVD
	Group Practice or individual's line 1 address
City	SMYRNA
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	371676810
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6157682303
	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	440227
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TRISTAR STONECREST MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y