Physician Compare National (NPI:1396184420)

HEALTHCARE PROVIDER: NATHAN BLAKE NORRIS 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	1396184420
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3072837756
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200310000059
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	NORRIS
	Individual professional last name
Provider First Name	NATHAN
	Individual professional first name
Provider Middle Name	B
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
	Individual professional's medical school
Graduation Year	2013
	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	ASHLAND DISTRICT HOSPITAL
	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	6800849324
	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	4
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	625 KENTUCKY ST
	Group Practice or individual's line 1 address
City	ASHLAND
	Group Practice or individual's city
State	KS
	Group Practice or individual's state
Zip Code	678313199
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6206352241
	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	171304
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ASHLAND HEALTH CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	171340
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HERINGTON MUNICIPAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	170068
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SOUTHWEST MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y