Physician Compare National (NPI:1891917662)

HEALTHCARE PROVIDER:

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

Individual Professional Information
NPI	1891917662
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5294825428
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20071212000208
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	REDMON
	Individual professional last name
Provider First Name	SHEILA
	Individual professional first name
Provider Middle Name	J
	Individual professional middle 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	2003
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3600 SW BURLINGAME RD
	Group Practice or individual's line 1 address
Line 2 Street Address	3A GOOD GRIEF COUNSELING
	Group Practice or individual's line 2 address
City	TOPEKA
	Group Practice or individual's city
State	KS
	Group Practice or individual's state
Zip Code	666112053
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7856331629
	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