Physician Compare National (NPI:1316956055)

HEALTHCARE PROVIDER: EDWARD JOHN LIND II 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	1316956055
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6103860291
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050620000698
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LIND
	Individual professional last name
Provider First Name	EDWARD
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Name Suffix Text	II
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	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	UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
	Individual professional's medical school
Graduation Year	1978
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	SPORTS MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	SPORTS MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1431 S BLUFFVIEW
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 102
	Group Practice or individual's line 2 address
City	WICHITA
	Group Practice or individual's city
State	KS
	Group Practice or individual's state
Zip Code	672183039
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	170123
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WESLEY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y