Physician Compare National (NPI:1548670086)

HEALTHCARE PROVIDER: ADRIANNE MOODY

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

Individual Professional Information
NPI	1548670086
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9335492172
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20181025000548
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MOODY
	Individual professional last name
Provider First Name	ADRIANNE
	Individual professional first 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	2016
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1360 S 740
	Group Practice or individual's line 1 address
City	OREM
	Group Practice or individual's city
State	UT
	Group Practice or individual's state
Zip Code	840978081
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8018502156
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y