Nora C Gough-davis (NPI# 1740410661, PAC ID# 0749322345) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1740410661 |
| PAC ID by PECOS | 0749322345 |
| Professional Enrollment ID | I20100120000411 |
| Full Name | Nora C Gough-davis |
| Organization Legal Name | SHAW FAMILY MEDICAL, LLC |
| Address |
189 N Main St Gough's Family Medical Clinic Drew MS 38737-3146 |
| Phone Number | 6627456638 |
| Gender | F |
| Graduation Year | 2009 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 3072769843 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250093 | BOLIVAR MEDICAL CENTER |
| 251318 | NORTH SUNFLOWER MEDICAL CENTER CAH |
| 250042 | NORTHWEST MISSISSIPPI MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 189 N Main St, Gough's Family Medical Clinic, Drew, MS 38737-3146 | 6627456638 | SHAW FAMILY MEDICAL, LLC |
| 112 W Peeler Ave, Shaw, MS 38773-8710 | 6627543301 | SHAW FAMILY MEDICAL, LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_047_overall | Care Plan | 65% | |
| MIPS_EC_333_overall | Adult Sinusitis: Computerized Tomography (CT) for Acute Sinusitis (Overuse) (100%: worst, 0% best) | 0% |
| Organization Legal Name | SHAW FAMILY MEDICAL, LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Williemary Bolden | Nurse Practitioner | Shaw Family Medical, LLC | 112 W Peeler Ave, Shaw, MS 38773-8710 |
| Street Address |
189 N MAIN ST GOUGH'S FAMILY MEDICAL CLINIC |
| City | DREW |
| State | MS |
| Zip | 38737-3146 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Monica J Chun | Obstetrics/gynecology | Concord Hospital, Inc. | 189 N Main St, Concord Hospital Obstetrics and Gynecology, Concord, NH 03301-5046 |
| Christina E Langlois | Physician Assistant | Concord Hospital, Inc. | 189 N Main St, Concord Hospital Obstetrics and Gynecology, Concord, NH 03301-5046 |
| Richard Salchunas | Obstetrics/gynecology | Concord Hospital, Inc. | 189 N Main St, Concord Hospital Obstetrics and Gynecology, Concord, NH 03301-5046 |
| Michele L Domiano | Optometry | 189 N Main St, Old Forge, PA 18518-1755 | |
| Courtney B Jones | Obstetrics/gynecology | Concord Hospital, Inc. | 189 N Main St, Concord Hospital Obstetrics and Gynecology, Concord, NH 03301-5046 |
| Kristina A Wihbey | Obstetrics/gynecology | Concord Hospital, Inc. | 189 N Main St, Concord Hospital Obstetrics and Gynecology, Concord, NH 03301-5046 |
| Heidi Hallonquist | Obstetrics/gynecology | Concord Hospital, Inc. | 189 N Main St, Concord Hospital Obstetrics and Gynecology, Concord, NH 03301-5046 |
| Nancy J Balbick | Clinical Social Worker | 189 N Main St, Warsaw, NY 14569-1151 | |
| Andrea M Dionne | Obstetrics/gynecology | Concord Hospital, Inc. | 189 N Main St, Concord Hospital Obstetrics and Gynecology, Concord, NH 03301-5046 |
| Jessi Lynn Osborne | Physician Assistant | Concord Hospital, Inc. | 189 N Main St, Concord Hospital Obstetrics and Gynecology, Concord, NH 03301-5046 |
| Find all physicians in the same address | |||
| City | DREW |
| Zip Code | 38737 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | DREW + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Nora C Gough-davis.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.