Physician Compare National (NPI:1669007944)

HEALTHCARE PROVIDER: KAREN ELIZABETH CHANDLER NP

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

Individual Professional Information
NPI	1669007944
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7911328026
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200527003358
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHANDLER
	Individual professional last name
Provider First Name	KAREN
	Individual professional first name
Provider Middle Name	ELIZABETH
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2019
	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	ASCENSION MEDICAL GROUP PROMED
	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	7315856077
	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	329
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	24466 RED ARROW HWY
	Group Practice or individual's line 1 address
City	MATTAWAN
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	490719804
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2696684180
	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	230117
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BORGESS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y