Physician Compare National (NPI:1750677753)

HEALTHCARE PROVIDER: KATIE ROBERTSON MCELVAINE O.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	1750677753
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0941471379
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110915000428
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MCELVAINE
	Individual professional last name
Provider First Name	KATIE
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2939 E BATTLEFIELD ST
	Group Practice or individual's line 1 address
City	SPRINGFIELD
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	658044015
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y