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Physician Compare National (NPI:1114131778)

HEALTHCARE PROVIDER: JOHN A SHARMA MD, MSC, MBA, FAAFP

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

Individual Professional Information

NPI 1114131778
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 2062559735
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20091029000058
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name SHARMA
Individual professional last name
Provider First Name JOHN
Individual professional first name
Provider Middle Name A
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2005
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

Organization Legal Name CRAWFORD HOSPITAL DISTRICT
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 7719898071
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 38
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 1101 N ALLEN ST
Group Practice or individual's line 1 address
Line 2 Street Address CMH RURAL HEALTH
Group Practice or individual's line 2 address
City ROBINSON
Group Practice or individual's city
State IL
Group Practice or individual's state
Zip Code 624541168
Group Practice or individual's zip code (9 digits when available)
Phone Number 6185443699
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 141343
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 CRAWFORD MEMORIAL HOSPITAL
Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment Y

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