Physician Compare National (NPI:1629137880)

HEALTHCARE PROVIDER: DR. NICHOLAS CHARLES ANTHONY

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

Individual Professional Information
NPI	1629137880
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1658400106
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160302002320
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ANTHONY
	Individual professional last name
Provider First Name	NICHOLAS
	Individual professional first name
Provider Middle Name	C
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1973
	Individual professional's medical school graduation year
Primary Specialty	PSYCHOLOGIST, CLINICAL
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	905 HIGHLAND BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 4500
	Group Practice or individual's line 2 address
City	BOZEMAN
	Group Practice or individual's city
State	MT
	Group Practice or individual's state
Zip Code	597156903
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y