Physician Compare National (NPI:1104917061)

HEALTHCARE PROVIDER: LANA SHARON BEAVERS 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	1104917061
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2466510581
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20081018000074
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BEAVERS
	Individual professional last name
Provider First Name	LANA
	Individual professional first name
Provider Middle Name	S
	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 TENNESSEE, HSC, COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1973
	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
Line 1 Street Address	885 UNION ST
	Group Practice or individual's line 1 address
Line 2 Street Address	A
	Group Practice or individual's line 2 address
City	SHELBYVILLE
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	371602607
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9316848469
	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	440137
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TENNOVA HEALTHCARE-SHELBYVILLE
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y