Physician Compare National (NPI:1588631659)

HEALTHCARE PROVIDER: RODNEY ALBERT MARCOM D.O.

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

Individual Professional Information
NPI	1588631659
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1355351248
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20060421000017
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MARCOM
	Individual professional last name
Provider First Name	RODNEY
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	DO
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	KANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED
	Individual professional's medical school
Graduation Year	1967
	Individual professional's medical school graduation year
Primary Specialty	OSTEOPATHIC MANIPULATIVE MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	12276 SAN JOSE BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 210
	Group Practice or individual's line 2 address
City	JACKSONVILLE
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	322238631
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100040
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST VINCENT'S MEDICAL CENTER RIVERSIDE
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100088
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BAPTIST MEDICAL CENTER JACKSONVILLE
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y