Physician Compare National (NPI:1811242787)

HEALTHCARE PROVIDER: LEVI CHRISTOPHER MANSFIELD 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	1811242787
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2961654884
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20121128000513
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MANSFIELD
	Individual professional last name
Provider First Name	LEVI
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	SOUTHERN COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2012
	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	5101 HINKLEVILLE RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 490
	Group Practice or individual's line 2 address
City	PADUCAH
	Group Practice or individual's city
State	KY
	Group Practice or individual's state
Zip Code	420019047
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M