Physician Compare National (NPI:1902284417)

HEALTHCARE PROVIDER: HEATHER CORINNE JEKOT GRIFFITH 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	1902284417
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1759641210
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190506000753
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GRIFFITH
	Individual professional last name
Provider First Name	HEATHER
	Individual professional first name
Provider Middle Name	CORINNE JEKOT
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2015
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	PECOS COUNTY MEMORIAL HOSPITAL
	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	0446160733
	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	6
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	387 W I H
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	FORT STOCKTON
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	797352700
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	451389
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PECOS COUNTY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450132
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MEDICAL CENTER HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y