Physician Compare National (NPI:1669439097)

HEALTHCARE PROVIDER: KATHLEEN M EUBANKS-MENG D.O.

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

Individual Professional Information
NPI	1669439097
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2567415300
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050222000262
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	EUBANKS-MENG
	Individual professional last name
Provider First Name	KATHLEEN
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
	Individual professional's medical school
Graduation Year	2000
	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
Organization Legal Name	CLAY PLATTE FAMILY MEDICINE CLINIC
	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	3173424231
	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	20
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3601 NE RALPH POWELL RD C
	Group Practice or individual's line 1 address
City	LEES SUMMIT
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	640642316
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8162855053
	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	260095
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CENTERPOINT MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	260216
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SAINT LUKE'S EAST HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	260190
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	LEE'S SUMMIT MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	260193
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	ST MARYS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y