Physician Compare National (NPI:1740316959)

HEALTHCARE PROVIDER: JERRY JACKSON CROOK II M.D.

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

Individual Professional Information
NPI	1740316959
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7810097748
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090619000398
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CROOK
	Individual professional last name
Provider First Name	JERRY
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Name Suffix Text	II
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2003
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1940 ALCOA HWY E310
	Group Practice or individual's line 1 address
City	KNOXVILLE
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	379202267
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	440015
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	UNIVERSITY OF TN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y