Physician Compare National (NPI:1508142506)

HEALTHCARE PROVIDER: IHUOMA J OTTIH APN-C

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

Individual Professional Information
NPI	1508142506
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2466628177
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20111230000260
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	OTTIH
	Individual professional last name
Provider First Name	IHUOMA
	Individual professional first name
Provider Middle Name	JANE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1134 S BLACK HORSE PIKE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 322
	Group Practice or individual's line 2 address
City	BLACKWOOD
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	080122703
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	310011
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CAPE REGIONAL MEDICAL CENTER INC
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y