Physician Compare National (NPI:1487673232)

HEALTHCARE PROVIDER: SARAH ROSE MACK 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	1487673232
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5597727669
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20111117000318
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MACK
	Individual professional last name
Provider First Name	SARAH
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	GEORGIA EMERGENCY DEPARTMENT SERVICES, P.C.
	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	5597751032
	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	63
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	316 N BROAD ST
	Group Practice or individual's line 1 address
City	WINDER
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	306802150
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7708673400
	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	110041
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HABERSHAM COUNTY MEDICAL CTR
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	110191
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PIEDMONT HENRY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	110237
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	110045
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	BARROW REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y