Physician Compare National (NPI:1639314164)

HEALTHCARE PROVIDER: DOUGLAS MACARTHUR SMITH JR. APRN-CNP

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

Individual Professional Information
NPI	1639314164
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9234268145
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100602000053
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SMITH
	Individual professional last name
Provider First Name	DOUGLAS
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ADENA 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	1153456579
	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	295
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	4455 STATE ROUTE 159
	Group Practice or individual's line 1 address
City	CHILLICOTHE
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	456018620
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7407798620
	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	360159
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ADENA REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	361304
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	GREENFIELD AREA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	361334
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ADENA PIKE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y