Physician Compare National (NPI:1609077528)

HEALTHCARE PROVIDER: JOY CHIYO DAWN GEPHART P.A.-C.

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

Individual Professional Information
NPI	1609077528
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0547369365
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070620000159
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GEPHART
	Individual professional last name
Provider First Name	JOY
	Individual professional first name
Provider Middle Name	CHIYO DAWN
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	PA
	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	OTHER
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	PHYSICIAN ASSISTANT
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	TUALITY MEDICAL GROUP 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	7416173414
	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	167
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1825 MAPLE ST
	Group Practice or individual's line 1 address
City	FOREST GROVE
	Group Practice or individual's city
State	OR
	Group Practice or individual's state
Zip Code	971161939
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5033572136
	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	380021
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TUALITY COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y