Physician Compare National (NPI:1225334840)

HEALTHCARE PROVIDER: SHARMILA PARVATHANENI 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	1225334840
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6204050370
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140610002471
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PARVATHANENI
	Individual professional last name
Provider First Name	SHARMILA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2001
	Individual professional's medical school graduation year
Primary Specialty	NEPHROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	2901 N STOCKTON HILL RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE B
	Group Practice or individual's line 2 address
City	KINGMAN
	Group Practice or individual's city
State	AZ
	Group Practice or individual's state
Zip Code	864014121
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	030055
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	KINGMAN REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	290003
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SUNRISE HOSPITAL AND MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y