Physician Compare National (NPI:1497726376)

HEALTHCARE PROVIDER: THOMAS E RENFRO 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	1497726376
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1658459805
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080429000233
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RENFRO
	Individual professional last name
Provider First Name	THOMAS
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1988
	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
Organization Legal Name	MOUNTAIN STATES HEALTH ALLIANCE
	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	6002726718
	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	12
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	16431 WISE ST
	Group Practice or individual's line 1 address
City	SAINT PAUL
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	242833537
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2767622300
	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	490001
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NORTON COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	490002
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	RUSSELL COUNTY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	491303
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	DICKENSON COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	490114
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	WELLMONT LONESOME PINE HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	490053
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	JOHNSTON MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1497726376)

HEALTHCARE PROVIDER: THOMAS E RENFRO MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information