Physician Compare National (NPI:1326001975)

HEALTHCARE PROVIDER: SHIRLEY FRED HARTLEY D.P.M.

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

Individual Professional Information
NPI	1326001975
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0446218283
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110120000904
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HARTLEY
	Individual professional last name
Provider First Name	SHIRLEY
	Individual professional first name
Provider Middle Name	FRED
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WILLIAM M. SCHOLL COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	1979
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	S. F. HARTLEY, D.P.M., P.C.
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	3173643236
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	112 W PASADENA BLVD
	Group Practice or individual's line 1 address
City	DEER PARK
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	775364870
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2814795311
	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	670031
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CHI ST LUKE'S PATIENTS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y