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Physician Compare National (NPI:1851642300)

HEALTHCARE PROVIDER: USREESHA GOURNENI M.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 1851642300
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 4183926496
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20170216000182
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name GOURNENI
Individual professional last name
Provider First Name USREESHA
Individual professional first name
Provider Gender F
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 HOSPITALIST
Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1 EMERGENCY MEDICINE
First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties EMERGENCY MEDICINE
All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information

Organization Legal Name HOLZER CLINIC LLC
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 5890606008
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 237
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 500 BURLINGTON RD
Group Practice or individual's line 1 address
City JACKSON
Group Practice or individual's city
State OH
Group Practice or individual's state
Zip Code 456409360
Group Practice or individual's zip code (9 digits when available)
Phone Number 7403958420
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 360014
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 OHIOHEALTH O'BLENESS HOSPITAL
Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2 360008
Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2 SOUTHERN OHIO MEDICAL CENTER
Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3 360054
Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3 HOLZER MEDICAL CENTER
Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4 360203
Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4 SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER
Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5 361320
Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5 HOLZER MEDICAL CENTER JACKSON
Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment Y

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