Physician Compare National (NPI:1831123686)

HEALTHCARE PROVIDER:

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

Individual Professional Information
NPI	1831123686
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1355302118
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100614000647
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TRIMBLE
	Individual professional last name
Provider First Name	GERALD
	Individual professional first name
Provider Middle Name	EDWARD
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF SOUTH FLORIDA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	INTERVENTIONAL PAIN MANAGEMENT
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	WEST FLORIDA PAIN MANAGEMENT PA
	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	9638130495
	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	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	603 7TH ST S
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 320
	Group Practice or individual's line 2 address
City	SAINT PETERSBURG
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	337014731
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7275537313
	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	440040
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PERRY COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100032
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BAYFRONT HEALTH - ST PETERSBURG
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y