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Physician Compare National (NPI:1437193323)

HEALTHCARE PROVIDER: JOHN M CARL III 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 1437193323
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 1456355825
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20060828000365
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name CARL
Individual professional last name
Provider First Name JOHN
Individual professional first name
Provider Middle Name M
Individual professional middle name
Provider Name Suffix Text III
The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender M
The provider's gender if the provider is a person.
Provider Credential Text MD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information

Medical School Name JC EDWARDS SCHOOL OF MEDICINE, MARSHALL UNIVERSITY
Individual professional's medical school
Graduation Year 1993
Individual professional's medical school graduation year
Primary Specialty GENERAL SURGERY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name MARTHA JEFFERSON MEDICAL GROUP 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 5991889081
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 163
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 500 MARTHA JEFFERSON DR
Group Practice or individual's line 1 address
Line 2 Street Address FL 5
Group Practice or individual's line 2 address
City CHARLOTTESVILLE
Group Practice or individual's city
State VA
Group Practice or individual's state
Zip Code 229114668
Group Practice or individual's zip code (9 digits when available)
Phone Number 4346545260
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 490077
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 SENTARA MARTHA JEFFERSON HOSPITAL
Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment Y

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