Physician Compare National (NPI:1700311529)

HEALTHCARE PROVIDER: DAVID RUNANA

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

Individual Professional Information
NPI	1700311529
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1658645718
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170928000621
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RUNANA
	Individual professional last name
Provider First Name	DAVID
	Individual professional first name
Provider Middle Name	MARWA
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	INDIANA UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2017
	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	IN CHARGE MEDICAL PROFESSIONALS LLC
	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	9436474178
	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	11
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	8060 KNUE RD
	Group Practice or individual's line 1 address
City	INDIANAPOLIS
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	462501976
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3178138900
	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	150048
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	REID HOSPITAL & HEALTH CARE SERVICES
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	150113
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y