Physician Compare National (NPI:1346660883)

HEALTHCARE PROVIDER: JEREMY DAY MD

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

Individual Professional Information
NPI	1346660883
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8527330166
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200729002480
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DAY
	Individual professional last name
Provider First Name	JEREMY
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2014
	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	HOSPITALIST
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	HOSPITALIST
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	JACKSONVILLE HOSPITAL LLC
	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	4284996638
	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	9
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	203 NACOGDOCHES ST
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	JACKSONVILLE
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	757662444
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9035415396
	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	450194
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	EAST TEXAS MEDICAL CENTER JACKSONVILLE
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	230239
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CHIPPEWA COUNTY WAR MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y