Physician Compare National (NPI:1598811127)

HEALTHCARE PROVIDER: JENNIFER RUCCI 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	1598811127
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2062589682
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190521002498
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RUCCI
	Individual professional last name
Provider First Name	JENNIFER
	Individual professional first name
Provider Middle Name	MARIE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	EASTERN VIRGINIA MEDICAL SCHOOL
	Individual professional's medical school
Graduation Year	2005
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	EVENTUS WHOLEHEALTH PLLC
	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	6002169539
	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	144
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1703 LAUREL ST
	Group Practice or individual's line 1 address
City	COLUMBIA
	Group Practice or individual's city
State	SC
	Group Practice or individual's state
Zip Code	292012660
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8557432247
	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	340032
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GASTON MEMORIAL HOSPITAL, INC.
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	340145
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CAROLINAS HEALTHCARE SYSTEM LINCOLN
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	340001
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	CAROLINAS MEDICAL CENTER-NORTHEAST
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	M