Physician Compare National (NPI:1972814895)

HEALTHCARE PROVIDER: JONES SAM JOHN D.O.

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

Individual Professional Information
NPI	1972814895
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9335454800
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20151002001249
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	JOHN
	Individual professional last name
Provider First Name	JONES
	Individual professional first name
Provider Middle Name	SAM
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NOVA SOUTHEASTERN COLLEGE OF OSTEO MEDICINE
	Individual professional's medical school
Graduation Year	2010
	Individual professional's medical school graduation year
Primary Specialty	NEPHROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	7351 W OAKLAND PARK BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 105
	Group Practice or individual's line 2 address
City	LAUDERHILL
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	333197107
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100228
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WESTSIDE REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100167
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PLANTATION GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y