Physician Compare National (NPI:1386840239)

HEALTHCARE PROVIDER: AMY ELIZABETH MATTOX 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	1386840239
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4385768274
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100830000401
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MATTOX
	Individual professional last name
Provider First Name	AMY
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	FAMILY PHYSICIANS OF GREELEY LLP
	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	0143115691
	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	29
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	6801 W 20TH ST
	Group Practice or individual's line 1 address
Line 2 Street Address	UNIT 101
	Group Practice or individual's line 2 address
City	GREELEY
	Group Practice or individual's city
State	CO
	Group Practice or individual's state
Zip Code	806349640
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9703788000
	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	060001
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NORTH COLORADO MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	060131
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	060119
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MEDICAL CENTER OF THE ROCKIES
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y