Physician Compare National (NPI:1669578902)

HEALTHCARE PROVIDER: CHARLES CORNELIUS EGBERT MD

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

Individual Professional Information
NPI	1669578902
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5294745956
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20060426000512
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	EGBERT
	Individual professional last name
Provider First Name	CHARLES
	Individual professional first name
Provider Gender	M
	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	UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1992
	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	SOUTHWESTERN VERMONT MEDICAL CENTER INC
	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	0143138446
	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	112
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	5957 MAIN ST
	Group Practice or individual's line 1 address
City	MANCHESTER CENTER
	Group Practice or individual's city
State	VT
	Group Practice or individual's state
Zip Code	052558913
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8023624440
	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	470012
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SOUTHWESTERN VERMONT MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y