Physician Compare National (NPI:1306853098)

HEALTHCARE PROVIDER: JAY P SPORTSMAN DC

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

Individual Professional Information
NPI	1306853098
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7810949138
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050215000807
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SPORTSMAN
	Individual professional last name
Provider First Name	JAY
	Individual professional first name
Provider Middle Name	P
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	DC
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	CLEVELAND CHIROPRACTIC COLLEGE - KANSAS CITY
	Individual professional's medical school
Graduation Year	2002
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2909 NE BROOKTREE LANE
	Group Practice or individual's line 1 address
Line 2 Street Address	SPORTSMAN CHIROPRACTIC
	Group Practice or individual's line 2 address
City	GLADSTONE
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	64119
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8164551414
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M