Physician Compare National (NPI:1902880362)

HEALTHCARE PROVIDER: COURTNEY SHANDS III 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	1902880362
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1850288341
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110104000799
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SHANDS
	Individual professional last name
Provider First Name	COURTNEY
	Individual professional first name
Provider Name Suffix Text	III
	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.

Medical School Information
Medical School Name	VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1982
	Individual professional's medical school graduation year
Primary Specialty	UROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	UROLOGY OF ST. LOUIS, INC
	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	6204723786
	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	43
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1215 FRANCISCAN DR
	Group Practice or individual's line 1 address
City	LITCHFIELD
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	620561778
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3145676071
	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	141350
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST FRANCIS HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	260108
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MISSOURI BAPTIST MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	141332
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	HILLSBORO AREA HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y