Physician Compare National (NPI:1851488241)

HEALTHCARE PROVIDER: JORDAN TROTTER BROOKS 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	1851488241
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6204930514
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070327000035
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BROOKS
	Individual professional last name
Provider First Name	JORDAN
	Individual professional first name
Provider Middle Name	T.
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	OD
	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	SOUTHERN COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2006
	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	8890 SALROSE LN
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 203
	Group Practice or individual's line 2 address
City	FORT MYERS
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	339122085
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y