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Physician Compare National (NPI:1780881011)

HEALTHCARE PROVIDER: JONATHAN MICHAEL JOHNSON MD

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

Individual Professional Information

NPI 1780881011
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 2264564640
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20161004002364
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name JOHNSON
Individual professional last name
Provider First Name JONATHAN
Individual professional first name
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 2002
Individual professional's medical school graduation year
Primary Specialty NEUROLOGY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name AMERICAN NEUROMONITORING 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 8022019710
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 25
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 137 E WILSON ST
Group Practice or individual's line 1 address
Line 2 Street Address UNIT 711
Group Practice or individual's line 2 address
City MADISON
Group Practice or individual's city
State WI
Group Practice or individual's state
Zip Code 537034080
Group Practice or individual's zip code (9 digits when available)
Phone Number 8884642466
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 230038
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 SPECTRUM HEALTH-BUTTERWORTH CAMPUS
Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2 340115
Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2 FIRSTHEALTH MOORE REGIONAL HOSPITAL
Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3 100291
Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3 STEWARD MELBOURNE HOSPITAL
Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4 360085
Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4 OHIO STATE UNIVERSITY STATE HEALTH SYSTEM
Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5 100019
Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5 HOLMES REGIONAL MEDICAL CENTER
Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment Y

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