Physician Compare National (NPI:1548553456)

HEALTHCARE PROVIDER: JOHN MICHAEL CHIPKO JR. 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	1548553456
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6709137201
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200401001474
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHIPKO
	Individual professional last name
Provider First Name	JOHN
	Individual professional first name
Provider Gender	M
	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	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	CRITICAL CARE (INTENSIVISTS)
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	CRITICAL CARE (INTENSIVISTS)
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	GLENARM ACUTE SURGICAL SPECIALISTS 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	5698050532
	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	10
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2316 E MEYER BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	RESEARCH MEDICAL CENTER
	Group Practice or individual's line 2 address
City	KANSAS CITY
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	641321136
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3178054640
	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	260027
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	RESEARCH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	060065
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	NORTH SUBURBAN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	260175
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	GOLDEN VALLEY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	M