Physician Compare National (NPI:1770045536)

HEALTHCARE PROVIDER: JAMES BRUCE WHITE II FNP

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

Individual Professional Information
NPI	1770045536
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3678816188
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190525000051
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WHITE
	Individual professional last name
Provider First Name	JAMES
	Individual professional first 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	OTHER
	Individual professional's medical school
Graduation Year	2019
	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	HARLAN MEDICAL 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	8628206034
	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	5
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1307 HARLAN DR
	Group Practice or individual's line 1 address
City	BELLEVUE
	Group Practice or individual's city
State	NE
	Group Practice or individual's state
Zip Code	680053699
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4022918701
	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	160028
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CHI HEALTH MERCY COUNCIL BLUFFS
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y