Physician Compare National (NPI:1639478407)

HEALTHCARE PROVIDER: ADRIANNE J ROSS D.P.M.

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

Individual Professional Information
NPI	1639478407
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9234389651
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20121022000102
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ROSS
	Individual professional last name
Provider First Name	ADRIANNE
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1815 HWY 138 SE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 600
	Group Practice or individual's line 2 address
City	CONYERS
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	300132011
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	110091
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PIEDMONT ROCKDALE HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	110226
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	DEKALB MEDICAL CENTER AT HILLANDALE
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y