Physician Compare National (NPI:1255361846)

HEALTHCARE PROVIDER: WILLIAM J LIVESAY JR. D.O.

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

Individual Professional Information
NPI	1255361846
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3971588088
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080609000296
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LIVESAY
	Individual professional last name
Provider First Name	WILLIAM
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE
	Individual professional's medical school
Graduation Year	1999
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL MEDICINE AND REHABILITATION
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	180 WINGO WAY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 308
	Group Practice or individual's line 2 address
City	MT PLEASANT
	Group Practice or individual's city
State	SC
	Group Practice or individual's state
Zip Code	294641812
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	420087
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ROPER HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	420004
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MUSC MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	420065
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	BON SECOURS-ST FRANCIS XAVIER HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y