Physician Compare National (NPI:1578680815)

HEALTHCARE PROVIDER: SHIRLEY ANN SMITH ADVANCED PRACTICE NU

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

Individual Professional Information
NPI	1578680815
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4082944921
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190919002107
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LEVENSON
	Individual professional last name
Provider First Name	SHIRLEY
	Individual professional first name
Provider Middle Name	ANN
	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	2002
	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	501 N STONE ST
	Group Practice or individual's line 1 address
City	CALDWELL
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	778361134
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	451305
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CHI ST JOSEPH HEALTH BURLESON HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y