Physician Compare National (NPI:1780099358)

HEALTHCARE PROVIDER: DAVID HARRIS 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	1780099358
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1759601297
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20181210000772
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HARRIS
	Individual professional last name
Provider First Name	DAVID
	Individual professional first name
Provider Middle Name	CHRISTOPHER
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2014
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	SOUTHEASTERN EMERGENCY PHYSICIANS 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	2466364997
	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	261
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1500 W POPLAR AVE
	Group Practice or individual's line 1 address
City	COLLIERVILLE
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	380170601
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9018619000
	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	180011
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SAINT JOSEPH LONDON
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	181318
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	THE MEDICAL CENTER AT FRANKLIN
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	180016
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	JEWISH HOSPITAL - SHELBYVILLE
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	180080
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	BAPTIST HEALTH CORBIN
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y