Physician Compare National (NPI:1144664681)

HEALTHCARE PROVIDER: CLAIRE A GROSS 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	1144664681
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0345545190
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20181102002040
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GROSS
	Individual professional last name
Provider First Name	CLAIRE
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2013
	Individual professional's medical school graduation year
Primary Specialty	SPORTS MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PHYSICAL MEDICINE AND REHABILITATION
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PHYSICAL MEDICINE AND REHABILITATION
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	INTERMOUNTAIN HEALTHCARE SERVICES, INC
	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	1850209420
	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	2283
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1157 N 300
	Group Practice or individual's line 1 address
City	PROVO
	Group Practice or individual's city
State	UT
	Group Practice or individual's state
Zip Code	846046124
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8013571200
	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	460023
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	AMERICAN FORK HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y