Physician Compare National (NPI:1548796493)

HEALTHCARE PROVIDER: CHELSEA VAN ROOY NP

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

Individual Professional Information
NPI	1548796493
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4789951757
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170522002884
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	VAN ROOY
	Individual professional last name
Provider First Name	CHELSEA
	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	2017
	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
Organization Legal Name	KENTUCKY PHS 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	8325228414
	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	5
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	4965 US HWY 42
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 1000
	Group Practice or individual's line 2 address
City	LOUISVILLE
	Group Practice or individual's city
State	KY
	Group Practice or individual's state
Zip Code	402226375
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3379919276
	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	180104
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BAPTIST HEALTH PADUCAH
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	180093
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BAPTIST HEALTH MADISONVILLE
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y