Physician Compare National (NPI:1588768857)

HEALTHCARE PROVIDER: WILLIE CARL MC CLAIREN JR. MD

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

Individual Professional Information
NPI	1588768857
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3870527336
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050923000371
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MCCLAIREN
	Individual professional last name
Provider First Name	WILLIE
	Individual professional first name
Provider Middle Name	C
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	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	PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1985
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	MERCY CLINICS INC
	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	7911810882
	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	396
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1111 6TH AVE E TOWER
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	DES MOINES
	Group Practice or individual's city
State	IA
	Group Practice or individual's state
Zip Code	503142610
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	160083
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MERCY MEDICAL CENTER-DES MOINES
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	160082
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	IOWA METHODIST MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	160030
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MARY GREELEY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	160032
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	SKIFF MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y