Physician Compare National (NPI:1780644476)

HEALTHCARE PROVIDER: JAMES WILLIAM RICHARDS P.A.C.

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

Individual Professional Information
NPI	1780644476
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2961491527
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120209000676
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RICHARDS
	Individual professional last name
Provider First Name	JAMES
	Individual professional first name
Provider Middle Name	W
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	PA
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1999
	Individual professional's medical school graduation year
Primary Specialty	PHYSICIAN ASSISTANT
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	NEURO SURGICAL AND SPINAL SURGERY ASSOCIATES PC
	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	6002718251
	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	17
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	4141 5TH ST
	Group Practice or individual's line 1 address
City	RAPID CITY
	Group Practice or individual's city
State	SD
	Group Practice or individual's state
Zip Code	577016021
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	430091
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BLACK HILLS SURGICAL HOSPITAL LLP
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	351334
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CHI ST ALEXIUS HEALTH WILLISTON
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y