Physician Compare National (NPI:1396791455)

HEALTHCARE PROVIDER: RANDALL BRIAN RIGDON 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	1396791455
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8224119300
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080115000272
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RIGDON
	Individual professional last name
Provider First Name	RANDALL
	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	1995
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	270 N SYKES CREEK PKWY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 202
	Group Practice or individual's line 2 address
City	MERRITT ISLAND
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	329533492
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100177
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CAPE CANAVERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100092
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	WUESTHOFF MEDICAL CENTER ROCKLEDGE
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	100315
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	VIERA HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	100028
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	PARRISH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y