Physician Compare National (NPI:1861575227)

HEALTHCARE PROVIDER: THOMAS JEFFERSON PRIDEMORE JR. D.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	1861575227
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2062309065
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040309000122
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PRIDEMORE
	Individual professional last name
Provider First Name	THOMAS
	Individual professional first name
Provider Middle Name	JEFFERSON
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	DC
	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	PALMER COLLEGE CHIROPRACTIC - DAVENPORT
	Individual professional's medical school
Graduation Year	2002
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	109 S JOHNSON ST
	Group Practice or individual's line 1 address
City	MACOMB
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	614552134
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3093339264
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y