Physician Compare National (NPI:1245247543)

HEALTHCARE PROVIDER: JAMES DEREE SMITH 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	1245247543
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8921001116
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120229000496
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SMITH
	Individual professional last name
Provider First Name	JAMES
	Individual professional first name
Provider Middle Name	D
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1972
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	5453 REYNOLDS ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 422
	Group Practice or individual's line 2 address
City	SAVANNAH
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	314055430
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9123555593
	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	110024
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CANDLER HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	110036
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MEMORIAL UNIVERSITY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	110043
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ST JOSEPH'S HOSPITAL - SAVANNAH
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y