Physician Compare National (NPI:1972533487)

HEALTHCARE PROVIDER: KIMBERLY WOOD 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	1972533487
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2567551609
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20071127000837
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WOOD
	Individual professional last name
Provider First Name	KIMBERLY
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2615 E 20TH ST
	Group Practice or individual's line 1 address
City	JOPLIN
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	648041039
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	260137
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	FREEMAN HEALTH SYSTEM-FREEMAN WEST
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	260001
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MERCY HOSPITAL JOPLIN
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	030071
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	FORT DEFIANCE INDIAN HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	261331
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	FREEMAN NEOSHO HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y