Physician Compare National (NPI:1972085140)

HEALTHCARE PROVIDER: REGINA M BOWIE FNP

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

Individual Professional Information
NPI	1972085140
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7214280320
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20181018002731
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BOWIE
	Individual professional last name
Provider First Name	REGINA
	Individual professional first name
Provider Middle Name	MARIE
	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	2018
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	PHYSICAL AND FUNCTIONAL MEDICINE INCORPORATED
	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	8224325519
	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	335 BRIGHTON AVE
	Group Practice or individual's line 1 address
City	PORTLAND
	Group Practice or individual's city
State	ME
	Group Practice or individual's state
Zip Code	041022363
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2077754000
	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	200009
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MAINE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	200019
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SOUTHERN MAINE HEALTH CARE
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y