Physician Compare National (NPI:1174919617)

HEALTHCARE PROVIDER: LAUREN LEWIS COOPER

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

Individual Professional Information
NPI	1174919617
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0648591743
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180910001633
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	COOPER
	Individual professional last name
Provider First Name	LAUREN
	Individual professional first name
Provider Middle Name	LEWIS
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT
	Individual professional's medical school
Graduation Year	2015
	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	SUMNER PHYSICIAN PRACTICES LLC
	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	8820283260
	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	40
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	225 BIG STATION CAMP BLVD
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	GALLATIN
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	370668466
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	441307
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	RIVERVIEW REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y