Physician Compare National (NPI:1861439069)

HEALTHCARE PROVIDER: PEYTON THOMPSON MD

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

Individual Professional Information
NPI	1861439069
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7012928237
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20060531000189
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	THOMPSON
	Individual professional last name
Provider First Name	PEYTON
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	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	BAYLOR COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1972
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	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
Secondary Specialty 2	PSYCHIATRY
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	EMERGENCY MEDICINE, PSYCHIATRY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	FALLEN TREE CORP
	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	4688745326
	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	11416 RUNNEL RIDGE RD
	Group Practice or individual's line 1 address
City	MANOR
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	786533874
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5127600666
	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	451393
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450011
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CHI ST JOSEPH HEALTH
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	M