Physician Compare National (NPI:1649692732)

HEALTHCARE PROVIDER: JORDAN WARNSHOLZ PA

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

Individual Professional Information
NPI	1649692732
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1658599600
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160519000917
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WARNSHOLZ
	Individual professional last name
Provider First Name	JORDAN
	Individual professional first 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	2013
	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	MEMORIAL MEDICAL CENTER OF WEST MICHIGAN
	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	3678543659
	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	51
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	7 N ATKINSON DR
	Group Practice or individual's line 1 address
City	LUDINGTON
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	494311953
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2318452270
	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	230303
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MUNSON HEALTHCARE MANISTEE HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	230081
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MUNSON HEALTHCARE CADILLAC HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	230097
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MUNSON MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	230110
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	SPECTRUM HEALTH LUDINGTON HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y