Physician Compare National (NPI:1396897252)

HEALTHCARE PROVIDER: GERALD ALLEN JOHNSON DC

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

Individual Professional Information
NPI	1396897252
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9830352632
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120515000056
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	JOHNSON
	Individual professional last name
Provider First Name	GERALD
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LIFE CHIROPRACTIC COLLEGE
	Individual professional's medical school
Graduation Year	1989
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	8103 HWY 72 W
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE E
	Group Practice or individual's line 2 address
City	MADISON
	Group Practice or individual's city
State	AL
	Group Practice or individual's state
Zip Code	357589529
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2568377781
	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	010039
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HUNTSVILLE HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	M