Physician Compare National (NPI:1699218636)

HEALTHCARE PROVIDER: NATACHA LAURE NGOZI MANACK 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	1699218636
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0648552182
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170118002227
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MANACK
	Individual professional last name
Provider First Name	LAURE
	Individual professional first name
Provider Middle Name	N
	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	2016
	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	TRINITY KENMARE HOSPITAL
	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	9931018777
	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	4
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	307 1ST AVE NW
	Group Practice or individual's line 1 address
City	KENMARE
	Group Practice or individual's city
State	ND
	Group Practice or individual's state
Zip Code	587467104
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7013854283
	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	351305
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TRINITY KENMARE COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	350006
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	TRINITY HOSPITALS
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y