Physician Compare National (NPI:1851669048)

HEALTHCARE PROVIDER: SARA EVERMAN PA-C

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

Individual Professional Information
NPI	1851669048
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7214195114
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120223000474
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	EVERMAN
	Individual professional last name
Provider First Name	SARA
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	PHYSICIAN ASSISTANT
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	TRI-STATE DIGESTIVE DISEASE ASSOC PSC.
	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	9830163609
	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	617 23RD ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 11
	Group Practice or individual's line 2 address
City	ASHLAND
	Group Practice or individual's city
State	KY
	Group Practice or individual's state
Zip Code	411012845
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6063243188
	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	180009
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	KING'S DAUGHTERS' MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	360361
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	KINGS DAUGHTERS MEDICAL CENTER OHIO
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y