Physician Compare National (NPI:1528062197)

HEALTHCARE PROVIDER: JOHN S BURRELL 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	1528062197
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2769678218
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101123000132
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BURRELL
	Individual professional last name
Provider First Name	JOHN
	Individual professional first name
Provider Middle Name	S.
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1960
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	COMMUNITY HEALTH OF EAST TENNESSEE INC
	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	7618887803
	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	8
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	130 INDEPENDENCE LN
	Group Practice or individual's line 1 address
City	LA FOLLETTE
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	377663073
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4235621705
	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	440033
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LAFOLLETTE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	440034
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	METHODIST MEDICAL CENTER OF OAK RIDGE
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y