Physician Compare National (NPI:1669424651)

HEALTHCARE PROVIDER:

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

Individual Professional Information
NPI	1669424651
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8022204650
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101122001166
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BISHOP
	Individual professional last name
Provider First Name	ROY
	Individual professional first name
Provider Middle Name	L
	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	1989
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	100 INDEPENDENCE CIR
	Group Practice or individual's line 1 address
City	CHICO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	959730258
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5308990130
	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	050030
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	OROVILLE HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050039
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ENLOE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	051317
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ADVENTIST HEALTH CLEARLAKE
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y