Physician Compare National (NPI:1326180068)

HEALTHCARE PROVIDER: SHERI JO TALLEY 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	1326180068
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4880765569
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080624000612
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TALLEY
	Individual professional last name
Provider First Name	SHERI
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ORTHOPEDIC SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ORTHOPEDIC SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	CONCORD MEDICAL GROUP PLLC
	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	0446296818
	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	175
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	305 N MCKINNEY ST
	Group Practice or individual's line 1 address
City	SWEENY
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	774802801
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9795481500
	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	451314
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WINKLER COUNTY MEMORIAL HOSPITAL-SWINGBED
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y