| Dayton Children's Specialty Physicians, Inc. | |
|
1 Childrens Plz Dayton OH 45404-1815 | |
| (937) 641-4000 | |
| (937) 641-4500 |
| Full Name | Dayton Children's Specialty Physicians, Inc. |
|---|---|
| Speciality | Pediatrics |
| Location | 1 Childrens Plz, Dayton, Ohio |
| Authorized Official Name and Position | Chris Bergman (C.F.O.) |
| Authorized Official Contact | 9376413338 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dayton Children's Specialty Physicians, Inc. Po Box 933432 Cleveland OH 44193-0039 Ph: (937) 641-5072 | Dayton Children's Specialty Physicians, Inc. 1 Childrens Plz Dayton OH 45404-1815 Ph: (937) 641-4000 |
| NPI Number | 1225192610 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 01/12/2024 |
| Medicare PECOS PAC ID | 5496916124 |
|---|---|
| Medicare Enrollment ID | O20181024001690 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225192610 | NPI | - | NPPES |
| H557370 | Other | MEDICARE | |
| 0888633 | Medicaid | OH |
| Provider Name | Janet Wasylyshen-velasco |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467444240 PECOS PAC ID: 8527965292 Enrollment ID: I20031219000058 |
| Provider Name | Hari M Polenakovik |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902966690 PECOS PAC ID: 3375444946 Enrollment ID: I20040116000267 |
| Provider Name | Oliver S Soldes |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750365250 PECOS PAC ID: 6204720311 Enrollment ID: I20040510000101 |
| Provider Name | Adam Gary Mezoff |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710943758 PECOS PAC ID: 3870405509 Enrollment ID: I20040603001236 |
| Provider Name | Nora L Vish |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083641526 PECOS PAC ID: 8426033564 Enrollment ID: I20040622001123 |
| Provider Name | Rogelio Virgilio Amisola |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336106111 PECOS PAC ID: 2860460144 Enrollment ID: I20040923000960 |
| Provider Name | Corey James Ellis |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1376509323 PECOS PAC ID: 2062472996 Enrollment ID: I20041014001270 |
| Provider Name | Shilpa Gangad Sangvai |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437147543 PECOS PAC ID: 0840268082 Enrollment ID: I20041201000238 |
| Provider Name | Kimberly S Sparks |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1649279530 PECOS PAC ID: 7719943851 Enrollment ID: I20041209000596 |
| Provider Name | James Ray Ebert |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568428316 PECOS PAC ID: 9032160858 Enrollment ID: I20050209000111 |
| Provider Name | Richard P Golden |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1437159571 PECOS PAC ID: 1254383300 Enrollment ID: I20050216000797 |
| Provider Name | Lakshmi Gali Vemuru |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821102500 PECOS PAC ID: 8729033527 Enrollment ID: I20050315000266 |
| Provider Name | Josette Damato |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669468559 PECOS PAC ID: 6305884768 Enrollment ID: I20050418000785 |
| Provider Name | David N Dhanraj |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104994797 PECOS PAC ID: 2264474501 Enrollment ID: I20050526000023 |
| Provider Name | Mary Lou K Mcgregor |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1487654422 PECOS PAC ID: 0042255390 Enrollment ID: I20050627001018 |
| Provider Name | Sasi Kalathoor |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588637573 PECOS PAC ID: 6406834712 Enrollment ID: I20050706000502 |
| Provider Name | Jonathan D Thackeray |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437151453 PECOS PAC ID: 2062448046 Enrollment ID: I20050711000921 |
| Provider Name | Edward J Walz |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1255304267 PECOS PAC ID: 1557316197 Enrollment ID: I20050920000872 |
| Provider Name | Gary A Mueller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043276009 PECOS PAC ID: 9032130919 Enrollment ID: I20051208000002 |
| Provider Name | Patrick O Sobande |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801846191 PECOS PAC ID: 2264447457 Enrollment ID: I20060208000836 |
| Provider Name | Melanie Jennifer Burja |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265412811 PECOS PAC ID: 9830104967 Enrollment ID: I20060210000522 |
| Provider Name | Margaret F Hemmen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386601466 PECOS PAC ID: 1658380605 Enrollment ID: I20060419000403 |
| Provider Name | Bonnie Louise Golich |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912970096 PECOS PAC ID: 7810909900 Enrollment ID: I20060607000154 |
| Provider Name | Claire Nicole Mcdowell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124030689 PECOS PAC ID: 9638174022 Enrollment ID: I20060918000274 |
| Provider Name | Lisa Ziemnik |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689696437 PECOS PAC ID: 8729083753 Enrollment ID: I20060926000588 |
| Provider Name | Mark Smith |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497745285 PECOS PAC ID: 6800892688 Enrollment ID: I20061019000007 |
| Provider Name | Karen M Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174616486 PECOS PAC ID: 8729085311 Enrollment ID: I20061024000192 |
| Provider Name | Marc Anthony Raslich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619917705 PECOS PAC ID: 9436158516 Enrollment ID: I20061219000371 |
| Provider Name | Vipul Kumar Garg |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750444725 PECOS PAC ID: 9537169933 Enrollment ID: I20070109000456 |
| Provider Name | Craig F Shank |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1346300258 PECOS PAC ID: 8224130554 Enrollment ID: I20070216000454 |
| Provider Name | David L Rogers |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1326076647 PECOS PAC ID: 7113930918 Enrollment ID: I20070523000289 |
| Provider Name | Kristina J Kirk |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093929275 PECOS PAC ID: 6507965951 Enrollment ID: I20070626000155 |
| Provider Name | Emily Cramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811017015 PECOS PAC ID: 2163522772 Enrollment ID: I20070712000015 |
| Provider Name | Salim N Mancho |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1790989168 PECOS PAC ID: 4587764782 Enrollment ID: I20070717000040 |
| Provider Name | Merrilee I Cox |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730272329 PECOS PAC ID: 6800987736 Enrollment ID: I20070807000816 |
| Provider Name | Yelena Nicholson |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1568652212 PECOS PAC ID: 7113010224 Enrollment ID: I20070906000131 |
| Provider Name | Sherman J Alter |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1871559914 PECOS PAC ID: 6800977927 Enrollment ID: I20080115000525 |
| Provider Name | Carmen R Sekulic |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1376720474 PECOS PAC ID: 1254416027 Enrollment ID: I20080305000006 |
| Provider Name | Angela C Bush |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508047762 PECOS PAC ID: 6608951256 Enrollment ID: I20080307000047 |
| Provider Name | Venkata R Jayanthi |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1447346317 PECOS PAC ID: 7517044563 Enrollment ID: I20080402000016 |
| Provider Name | John C Duby |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740205046 PECOS PAC ID: 8527147545 Enrollment ID: I20080502000005 |
| Provider Name | Jeffery T Boyd |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1710194865 PECOS PAC ID: 6204909484 Enrollment ID: I20080721000818 |
| Provider Name | Samuel K Dzodzomenyo |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1407857063 PECOS PAC ID: 3476628868 Enrollment ID: I20080819000982 |
| Provider Name | Maria Pilar Hanson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689850307 PECOS PAC ID: 7618043431 Enrollment ID: I20080902000496 |
| Provider Name | Pramodha Muniyappa |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1427220276 PECOS PAC ID: 3476617218 Enrollment ID: I20090123000030 |
| Provider Name | Karen J Leeds |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1376782664 PECOS PAC ID: 5890844914 Enrollment ID: I20090520000520 |
| Provider Name | Kristen J Paddon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679636567 PECOS PAC ID: 0345399051 Enrollment ID: I20090528000274 |
| Provider Name | Richard Strait |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962547935 PECOS PAC ID: 3375696594 Enrollment ID: I20090805000114 |
| Provider Name | Emily K Boone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134296692 PECOS PAC ID: 5395881486 Enrollment ID: I20091002000368 |
| Provider Name | Samantha Sandlin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497979637 PECOS PAC ID: 1052457652 Enrollment ID: I20091013000415 |
| Provider Name | Julie M Lange |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1356422133 PECOS PAC ID: 9436229994 Enrollment ID: I20100211000137 |
| Provider Name | Christopher B Gordon |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1891875563 PECOS PAC ID: 3870637218 Enrollment ID: I20100223000305 |
| Provider Name | Sasha Lynn Roneker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285963033 PECOS PAC ID: 8325183957 Enrollment ID: I20100305000857 |
| Provider Name | Michael C Albert |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1508807793 PECOS PAC ID: 7618964453 Enrollment ID: I20100330000477 |
| Provider Name | James T Lehner |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1487695722 PECOS PAC ID: 8224164165 Enrollment ID: I20100330000539 |
| Provider Name | Ravindhra G Elluru |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1356361968 PECOS PAC ID: 8123157575 Enrollment ID: I20100525000023 |
| Provider Name | Melissa D King |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598980294 PECOS PAC ID: 4789714643 Enrollment ID: I20100621000094 |
| Provider Name | Jennifer De Vries |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1891768974 PECOS PAC ID: 3375598915 Enrollment ID: I20100622000197 |
| Provider Name | Shawn A Robinson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780865865 PECOS PAC ID: 8729112065 Enrollment ID: I20100823000269 |
| Provider Name | Erica L Taylor |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750509816 PECOS PAC ID: 7113042979 Enrollment ID: I20100916000746 |
| Provider Name | Jeremy Todd Larson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386638344 PECOS PAC ID: 4486846854 Enrollment ID: I20101005000300 |
| Provider Name | Kambiz Kamian |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1891004339 PECOS PAC ID: 2668665571 Enrollment ID: I20101025000275 |
| Provider Name | Sandra Wright |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346443330 PECOS PAC ID: 0143413948 Enrollment ID: I20101026000021 |
| Provider Name | Ann Marie Nie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508173980 PECOS PAC ID: 7214121110 Enrollment ID: I20101104001114 |
| Provider Name | Chandler L Parker |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1104015262 PECOS PAC ID: 4789772849 Enrollment ID: I20101112000259 |
| Provider Name | Marvin E Miller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447216403 PECOS PAC ID: 8921280702 Enrollment ID: I20110316000008 |
| Provider Name | Shehzad Saeed |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346350212 PECOS PAC ID: 5294791687 Enrollment ID: I20110512000728 |
| Provider Name | Smita Mehta |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255313342 PECOS PAC ID: 3779471057 Enrollment ID: I20110923000118 |
| Provider Name | Lindsey C Weisbecker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821319880 PECOS PAC ID: 2264606060 Enrollment ID: I20111112000003 |
| Provider Name | Marissa N Emerson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962771576 PECOS PAC ID: 8123286085 Enrollment ID: I20120223000117 |
| Provider Name | Del Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1013969229 PECOS PAC ID: 8820902109 Enrollment ID: I20120224000211 |
| Provider Name | Jessie A Mcmullen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1952687600 PECOS PAC ID: 0648439661 Enrollment ID: I20120312000450 |
| Provider Name | John P Crow |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992803993 PECOS PAC ID: 4789843384 Enrollment ID: I20120316000186 |
| Provider Name | Jason T Daume |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1801935796 PECOS PAC ID: 9638272172 Enrollment ID: I20120323000198 |
| Provider Name | Cheryl Kuck |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386607810 PECOS PAC ID: 0941462873 Enrollment ID: I20120510000144 |
| Provider Name | Tammy M Kaiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881965259 PECOS PAC ID: 3678737723 Enrollment ID: I20120621000138 |
| Provider Name | Michelle A Potts |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1407071830 PECOS PAC ID: 0446415350 Enrollment ID: I20120627000253 |
| Provider Name | Christopher J Bugnitz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144461062 PECOS PAC ID: 8628233350 Enrollment ID: I20120703000372 |
| Provider Name | James M Lee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073711974 PECOS PAC ID: 3375709397 Enrollment ID: I20120719000208 |
| Provider Name | Catherine O Jordan |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1932356540 PECOS PAC ID: 3375709207 Enrollment ID: I20120723000245 |
| Provider Name | Ottelee C Waite |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609121334 PECOS PAC ID: 8820246622 Enrollment ID: I20120920000383 |
| Provider Name | Catherine E Mcdaniel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1710130224 PECOS PAC ID: 4284782954 Enrollment ID: I20121004000729 |
| Provider Name | Lionel M Chow |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1568619500 PECOS PAC ID: 4385894930 Enrollment ID: I20121017000527 |
| Provider Name | Lauren Giometti Imhoff |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417279753 PECOS PAC ID: 2860521556 Enrollment ID: I20121024000336 |
| Provider Name | Vanessa Lynn Douglas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336499854 PECOS PAC ID: 9537312202 Enrollment ID: I20130104000412 |
| Provider Name | Hani A Alnajjar |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1134312028 PECOS PAC ID: 6901050095 Enrollment ID: I20130124000393 |
| Provider Name | Rachel Elizabeth Sidwell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063642643 PECOS PAC ID: 6305039314 Enrollment ID: I20130221000350 |
| Provider Name | Rodolfo Louis Canos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982946844 PECOS PAC ID: 4082852629 Enrollment ID: I20130521000488 |
| Provider Name | Sally Ann Mills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386934040 PECOS PAC ID: 6608010848 Enrollment ID: I20130910000428 |
| Provider Name | Anne Kim Mackow |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1790767036 PECOS PAC ID: 2769626746 Enrollment ID: I20130912000384 |
| Provider Name | Jordan M Wright |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1437352424 PECOS PAC ID: 4284868944 Enrollment ID: I20131011000532 |
| Provider Name | David Martineau |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1306095518 PECOS PAC ID: 6709055239 Enrollment ID: I20131202000700 |
| Provider Name | Jennifer Jenay Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376971721 PECOS PAC ID: 5698901213 Enrollment ID: I20131203001848 |
| Provider Name | Angela J Younts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528495074 PECOS PAC ID: 3173754900 Enrollment ID: I20140320001065 |
| Provider Name | Jennifer L Lakeberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295168409 PECOS PAC ID: 5799908075 Enrollment ID: I20140514002090 |
| Provider Name | Ryan A Mills |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1861629958 PECOS PAC ID: 9032337548 Enrollment ID: I20140825002758 |
| Provider Name | Carrie Wisler |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1396185302 PECOS PAC ID: 3870712557 Enrollment ID: I20140910002573 |
| Provider Name | Clare Herlihy |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407081573 PECOS PAC ID: 1557509742 Enrollment ID: I20141017001348 |
| Provider Name | Ann E Burke |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225094287 PECOS PAC ID: 1850513128 Enrollment ID: I20141121000592 |
| Provider Name | Nicole Cruz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255643110 PECOS PAC ID: 5597087197 Enrollment ID: I20141210001715 |
| Provider Name | Kristen M Roth |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770972804 PECOS PAC ID: 8426373317 Enrollment ID: I20150218000496 |
| Provider Name | David W Morris |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1598995052 PECOS PAC ID: 6507179959 Enrollment ID: I20150714003166 |
| Provider Name | Ufuoma A Onyemachi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508122805 PECOS PAC ID: 7113155904 Enrollment ID: I20150812007228 |
| Provider Name | Daniel A Evans |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558422162 PECOS PAC ID: 1052639333 Enrollment ID: I20150821014365 |
| Provider Name | Kent A Depue |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023236452 PECOS PAC ID: 4880912161 Enrollment ID: I20150821014822 |
| Provider Name | Dale G Evans |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700947314 PECOS PAC ID: 9234457516 Enrollment ID: I20150824000675 |
| Provider Name | Dana L Drazner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770641821 PECOS PAC ID: 5799003075 Enrollment ID: I20150824001104 |
| Provider Name | Kelly Sandberg |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1922269133 PECOS PAC ID: 1850609157 Enrollment ID: I20151007000495 |
| Provider Name | Thomas R Krzmarzick |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457419517 PECOS PAC ID: 4688992969 Enrollment ID: I20151016001312 |
| Provider Name | Margaret R Soulen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952598666 PECOS PAC ID: 3779892534 Enrollment ID: I20151016001387 |
| Provider Name | Laura P Lindsay |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518128529 PECOS PAC ID: 6305082249 Enrollment ID: I20151016001711 |
| Provider Name | Susan K Henry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447311071 PECOS PAC ID: 7911216791 Enrollment ID: I20151016001927 |
| Provider Name | Amit Vohra |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1093720849 PECOS PAC ID: 4981913522 Enrollment ID: I20151021001029 |
| Provider Name | Barbara L Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669461323 PECOS PAC ID: 9234448887 Enrollment ID: I20151021001556 |
| Provider Name | Lisa Kay H Clarke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417397530 PECOS PAC ID: 5597074849 Enrollment ID: I20151027002926 |
| Provider Name | Marian M Del Vecchio |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487856175 PECOS PAC ID: 3375739550 Enrollment ID: I20151103002919 |
| Provider Name | Saundra D Zerbe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013170778 PECOS PAC ID: 2466762232 Enrollment ID: I20151106000120 |
| Provider Name | April Anne Bunn |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841420742 PECOS PAC ID: 3678883063 Enrollment ID: I20151116001210 |
| Provider Name | Kristen O Spisak |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1780837377 PECOS PAC ID: 4981860574 Enrollment ID: I20151123002901 |
| Provider Name | Jennifer M Dillard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1205210705 PECOS PAC ID: 8426358300 Enrollment ID: I20151125000729 |
| Provider Name | Hassan Dbouk |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790807675 PECOS PAC ID: 7416022975 Enrollment ID: I20160510000870 |
| Provider Name | Meagan Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770980823 PECOS PAC ID: 1951620798 Enrollment ID: I20160706001570 |
| Provider Name | William B Aitchison |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1144411349 PECOS PAC ID: 7810046521 Enrollment ID: I20160729001272 |
| Provider Name | Angela K Via |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316394372 PECOS PAC ID: 8628363397 Enrollment ID: I20160818002580 |
| Provider Name | Kimberly R Joo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346511367 PECOS PAC ID: 2264727809 Enrollment ID: I20160822002956 |
| Provider Name | Cheriya Akizimana |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992173041 PECOS PAC ID: 8527353838 Enrollment ID: I20160825002457 |
| Provider Name | Randy Earl Eisenhut |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174580948 PECOS PAC ID: 4284847021 Enrollment ID: I20160829000339 |
| Provider Name | Jennifer J Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982001053 PECOS PAC ID: 9931494994 Enrollment ID: I20160830001003 |
| Provider Name | Katherine M Demasie |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487802112 PECOS PAC ID: 2163571902 Enrollment ID: I20160906001357 |
| Provider Name | Sean P Antosh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1093099707 PECOS PAC ID: 0941596621 Enrollment ID: I20160906002192 |
| Provider Name | Tamara Brockman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639224140 PECOS PAC ID: 0345536983 Enrollment ID: I20160908001508 |
| Provider Name | Audrey J Landefeld |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184030975 PECOS PAC ID: 3072809391 Enrollment ID: I20160912002146 |
| Provider Name | Michael Bates |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1689602708 PECOS PAC ID: 4789757246 Enrollment ID: I20161003002729 |
| Provider Name | Amanda Way |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1821384025 PECOS PAC ID: 5597066522 Enrollment ID: I20161115001939 |
| Provider Name | Donald H Nguyen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1467520429 PECOS PAC ID: 0648559500 Enrollment ID: I20161116001813 |
| Provider Name | Christine L Bowles-mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962944082 PECOS PAC ID: 3577842020 Enrollment ID: I20161128001198 |
| Provider Name | Brenda Kay Young |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1740491034 PECOS PAC ID: 6103964291 Enrollment ID: I20161214001522 |
| Provider Name | Emily-ann E Arnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457713935 PECOS PAC ID: 6800178864 Enrollment ID: I20170126002413 |
| Provider Name | Miriam L Lader |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528473337 PECOS PAC ID: 3779867346 Enrollment ID: I20170227000682 |
| Provider Name | Luke Mccoy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376982959 PECOS PAC ID: 0345543757 Enrollment ID: I20170306002716 |
| Provider Name | Osama M. Sheth |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457586992 PECOS PAC ID: 6305960089 Enrollment ID: I20170418001114 |
| Provider Name | Mellissa E Mahabee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235391954 PECOS PAC ID: 5294021689 Enrollment ID: I20170425000715 |
| Provider Name | Christopher T Brown |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124315585 PECOS PAC ID: 4183991334 Enrollment ID: I20170518002751 |
| Provider Name | Alaina Dunkelberger |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1437690542 PECOS PAC ID: 9537437371 Enrollment ID: I20170619002787 |
| Provider Name | Keyna A Austin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881135218 PECOS PAC ID: 2264700889 Enrollment ID: I20170622000697 |
| Provider Name | Onyinyechi Ukwuoma |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891105714 PECOS PAC ID: 1759661218 Enrollment ID: I20170809001121 |
| Provider Name | Emily Catherine Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700317187 PECOS PAC ID: 1456622265 Enrollment ID: I20170811001220 |
| Provider Name | Leslie Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508388083 PECOS PAC ID: 7517239346 Enrollment ID: I20170814003296 |
| Provider Name | Joseph E Ross |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1639175649 PECOS PAC ID: 9638443799 Enrollment ID: I20170928000708 |
| Provider Name | Mukund Dole |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1093824922 PECOS PAC ID: 7810262854 Enrollment ID: I20171002001807 |
| Provider Name | Gogi Kumar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548362825 PECOS PAC ID: 9537434576 Enrollment ID: I20171002001857 |
| Provider Name | John Karl Lachica De Dios |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093019291 PECOS PAC ID: 1759605488 Enrollment ID: I20171019002680 |
| Provider Name | Amanda B Myers |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053395467 PECOS PAC ID: 2264621937 Enrollment ID: I20171020000877 |
| Provider Name | Jill V Narron |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1114921657 PECOS PAC ID: 9638445067 Enrollment ID: I20171030001520 |
| Provider Name | Tahira G Adelekan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801968599 PECOS PAC ID: 5092817775 Enrollment ID: I20171101002578 |
| Provider Name | Kathleen M Matic |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639566607 PECOS PAC ID: 2163788480 Enrollment ID: I20171102000342 |
| Provider Name | Lubabatu Abdurrahman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437156973 PECOS PAC ID: 9032493721 Enrollment ID: I20171128002271 |
| Provider Name | Michael Ralston |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1801890793 PECOS PAC ID: 8426316894 Enrollment ID: I20171213002219 |
| Provider Name | Lora Scott |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1841489994 PECOS PAC ID: 8325306277 Enrollment ID: I20171222000158 |
| Provider Name | Shafee Salloum |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508129560 PECOS PAC ID: 0446567705 Enrollment ID: I20180131003316 |
| Provider Name | Stephen Wolf |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1235447939 PECOS PAC ID: 7810258282 Enrollment ID: I20180227001270 |
| Provider Name | Erin Kathleen Dahlinghaus |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285891275 PECOS PAC ID: 1456499250 Enrollment ID: I20180309000741 |
| Provider Name | Kate Marie Lambert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366850448 PECOS PAC ID: 2163784968 Enrollment ID: I20180314001258 |
| Provider Name | Korey Lee Vecchione |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407240450 PECOS PAC ID: 0143521138 Enrollment ID: I20180423001558 |
| Provider Name | Shaun Vincent Spielman |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1962631283 PECOS PAC ID: 6901059062 Enrollment ID: I20180516002729 |
| Provider Name | Stacy P Ferguson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1285052308 PECOS PAC ID: 2769747716 Enrollment ID: I20180523000777 |
| Provider Name | Jennifer M Hilgeman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215391206 PECOS PAC ID: 4587929021 Enrollment ID: I20180604000839 |
| Provider Name | Daniel J Urschel |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1174752661 PECOS PAC ID: 7416275466 Enrollment ID: I20180604002313 |
| Provider Name | Stephanie Anne Morrison |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568656478 PECOS PAC ID: 3971821067 Enrollment ID: I20180604002525 |
| Provider Name | Leah Raguindin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053356048 PECOS PAC ID: 7618162983 Enrollment ID: I20180606002046 |
| Provider Name | Shernaz A Wadia |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366768806 PECOS PAC ID: 2466631361 Enrollment ID: I20180606002276 |
| Provider Name | Meghan Brooke Theurer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790137875 PECOS PAC ID: 2961757919 Enrollment ID: I20180615002025 |
| Provider Name | John M Pascoe |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750347712 PECOS PAC ID: 9133475593 Enrollment ID: I20180627003417 |
| Provider Name | Jennifer Ann Mackey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679081574 PECOS PAC ID: 3577815331 Enrollment ID: I20181008000236 |
| Provider Name | Joseph Anthony Iocono |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528024890 PECOS PAC ID: 3577743954 Enrollment ID: I20181029002227 |
| Provider Name | Jon Lieth Woltmann |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1821388752 PECOS PAC ID: 3577817410 Enrollment ID: I20181113002106 |
| Provider Name | Paul R Breyer |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1649343351 PECOS PAC ID: 7911281696 Enrollment ID: I20181114003482 |
| Provider Name | Claire F Beimesch |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1598976532 PECOS PAC ID: 9830256684 Enrollment ID: I20181126002053 |
| Provider Name | Arturo Aranda |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700183282 PECOS PAC ID: 5799913208 Enrollment ID: I20181128001031 |
| Provider Name | Deborah Mowery |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1336338615 PECOS PAC ID: 4385809409 Enrollment ID: I20181207001744 |
| Provider Name | Mahesh Chikkannaiah |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114203262 PECOS PAC ID: 2264776798 Enrollment ID: I20181210002310 |
| Provider Name | Sara N Adducchio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972937852 PECOS PAC ID: 9931485091 Enrollment ID: I20181213002103 |
| Provider Name | Elizabeth A Medaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124455241 PECOS PAC ID: 0042596173 Enrollment ID: I20181217001720 |
| Provider Name | Laura Danielle Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508301524 PECOS PAC ID: 6709121809 Enrollment ID: I20181218002168 |
| Provider Name | Abiodun Aderogba Omoloja |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1811932767 PECOS PAC ID: 5294070173 Enrollment ID: I20181220002551 |
| Provider Name | Stacy Lynn Meyer |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1902068224 PECOS PAC ID: 2365787165 Enrollment ID: I20181226001274 |
| Provider Name | Pradeep Padmanabhan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588654735 PECOS PAC ID: 0648251637 Enrollment ID: I20190104002841 |
| Provider Name | Shahid Nadeem |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417111964 PECOS PAC ID: 1153547567 Enrollment ID: I20190108004089 |
| Provider Name | Bryce Lawrence Willen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013337716 PECOS PAC ID: 2365754918 Enrollment ID: I20190115001977 |
| Provider Name | Shelly Rustagi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1962762161 PECOS PAC ID: 6406167584 Enrollment ID: I20190117002451 |
| Provider Name | Irma Liezl Reyes |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356617765 PECOS PAC ID: 6709122310 Enrollment ID: I20190117002534 |
| Provider Name | Mark E Minor |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1689930737 PECOS PAC ID: 4486955127 Enrollment ID: I20190117002657 |
| Provider Name | Kallol Kumar Set |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972996130 PECOS PAC ID: 2567764251 Enrollment ID: I20190122002076 |
| Provider Name | Elizabeth Marie Knecht |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1376801647 PECOS PAC ID: 9931446382 Enrollment ID: I20190123003988 |
| Provider Name | Robert Lober |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1457512162 PECOS PAC ID: 2668690132 Enrollment ID: I20190125002126 |
| Provider Name | Krishnamallika Mutyala |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1528299880 PECOS PAC ID: 5395991699 Enrollment ID: I20190129003574 |
| Provider Name | Tina Nelle Krysiak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316906126 PECOS PAC ID: 9234148131 Enrollment ID: I20190131003387 |
| Provider Name | Amy Marie Jeffers |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174759377 PECOS PAC ID: 2264698117 Enrollment ID: I20190225002217 |
| Provider Name | Connie Chin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770858870 PECOS PAC ID: 8224395413 Enrollment ID: I20190228002489 |
| Provider Name | Bonnie Lynn Albertini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215484894 PECOS PAC ID: 3971842303 Enrollment ID: I20190301002435 |
| Provider Name | Hemanth S Lingadevaru |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1003018425 PECOS PAC ID: 9234427139 Enrollment ID: I20190304001724 |
| Provider Name | Vipul V Patel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1255416392 PECOS PAC ID: 6608162748 Enrollment ID: I20190304002249 |
| Provider Name | Rasika Venkatrman |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1639301054 PECOS PAC ID: 2062708647 Enrollment ID: I20190304002487 |
| Provider Name | Jessica D Whitlock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942633763 PECOS PAC ID: 5991077638 Enrollment ID: I20190305002011 |
| Provider Name | Mohammad Salah Agha |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467607291 PECOS PAC ID: 3678747417 Enrollment ID: I20190307001320 |
| Provider Name | Hillary Voss |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679988422 PECOS PAC ID: 6406195445 Enrollment ID: I20190308001154 |
| Provider Name | Michael G Vish |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1104842863 PECOS PAC ID: 8325044233 Enrollment ID: I20190325002565 |
| Provider Name | Zenar Yohannes |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033504618 PECOS PAC ID: 8224379078 Enrollment ID: I20190404002310 |
| Provider Name | Sarah Rose Steward |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1821291576 PECOS PAC ID: 7618194812 Enrollment ID: I20190409002837 |
| Provider Name | Hila L. Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366772303 PECOS PAC ID: 2365783784 Enrollment ID: I20190412001601 |
| Provider Name | Elizabeth A Mitchell |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174822670 PECOS PAC ID: 3577865542 Enrollment ID: I20190423001180 |
| Provider Name | Hilliary E Inger |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1912324245 PECOS PAC ID: 4587882816 Enrollment ID: I20190612001600 |
| Provider Name | Katherine Alexandra Battisti |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427318724 PECOS PAC ID: 3678881364 Enrollment ID: I20190812003509 |
| Provider Name | Sarah M Ferrigno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376061077 PECOS PAC ID: 6507193422 Enrollment ID: I20190814003004 |
| Provider Name | Jessie Marie Vadnais |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891289674 PECOS PAC ID: 0749510386 Enrollment ID: I20190925001905 |
| Provider Name | Anne Christine Mchugh |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1326331034 PECOS PAC ID: 9234377953 Enrollment ID: I20191001000556 |
| Provider Name | Wendla Alderman Sensing |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720474059 PECOS PAC ID: 5991036097 Enrollment ID: I20191003001452 |
| Provider Name | Rajkumar Laxminarayan Agarwal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568795425 PECOS PAC ID: 1850513243 Enrollment ID: I20191004003108 |
| Provider Name | Roshani Rajkumar Agarwal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437453644 PECOS PAC ID: 6608016647 Enrollment ID: I20191011002141 |
| Provider Name | Dustin E Fleck |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1619298106 PECOS PAC ID: 2365759701 Enrollment ID: I20191021001273 |
| Provider Name | Beth Bourquin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144732579 PECOS PAC ID: 2264791557 Enrollment ID: I20191022003010 |
| Provider Name | Eric T Whitney |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164849022 PECOS PAC ID: 0840591608 Enrollment ID: I20191029003480 |
| Provider Name | Elizabeth A. Bacon |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1205816303 PECOS PAC ID: 3274658489 Enrollment ID: I20191104000890 |
| Provider Name | Ajay Goenka |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669726097 PECOS PAC ID: 8022440296 Enrollment ID: I20191111000833 |
| Provider Name | Shobhan Vachhrajani |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1972056554 PECOS PAC ID: 0749576379 Enrollment ID: I20191113002273 |
| Provider Name | Susan Pena Almazan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1164501573 PECOS PAC ID: 3870925779 Enrollment ID: I20191114002102 |
| Provider Name | Debra M O'donnell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215902952 PECOS PAC ID: 5890709117 Enrollment ID: I20191114002986 |
| Provider Name | Lucinda M Brown |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1497027031 PECOS PAC ID: 2163854951 Enrollment ID: I20191115002929 |
| Provider Name | Craig D Boreman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588659015 PECOS PAC ID: 4183869712 Enrollment ID: I20191119003230 |
| Provider Name | Anastazia Marie Agin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245527514 PECOS PAC ID: 8628400140 Enrollment ID: I20191120003235 |
| Provider Name | Beth Anna Sullivan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1093002453 PECOS PAC ID: 8022441369 Enrollment ID: I20191127001490 |
| Provider Name | Agnes Doeyo Asiedu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417368515 PECOS PAC ID: 1456785559 Enrollment ID: I20191226000474 |
| Provider Name | Dhritiman R Gurkha |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316342082 PECOS PAC ID: 6406286491 Enrollment ID: I20200414003622 |
| Provider Name | Heather Dyer |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1568411932 PECOS PAC ID: 1557402419 Enrollment ID: I20200417003370 |
| Provider Name | Justin T Huntington |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760709018 PECOS PAC ID: 6507007044 Enrollment ID: I20200423000809 |
| Provider Name | Paige Altom Triplett |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629419338 PECOS PAC ID: 9032540638 Enrollment ID: I20200514003215 |
| Provider Name | Eileen Frances Kasten |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437194149 PECOS PAC ID: 7618308149 Enrollment ID: I20200515001589 |
| Provider Name | Kelly Liker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689817256 PECOS PAC ID: 1658592753 Enrollment ID: I20200515002101 |
| Provider Name | Dina Maria Thurman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336132810 PECOS PAC ID: 2264863612 Enrollment ID: I20200519001187 |
| Provider Name | Lisa Marie Sowar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790154508 PECOS PAC ID: 1456782754 Enrollment ID: I20200520000851 |
| Provider Name | Leora Langdon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093861007 PECOS PAC ID: 5597196881 Enrollment ID: I20200521001070 |
| Provider Name | Stephanie J Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568610566 PECOS PAC ID: 4082900626 Enrollment ID: I20200522002633 |
| Provider Name | Brandon Kibby |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1144271149 PECOS PAC ID: 1052316999 Enrollment ID: I20200526002301 |
| Provider Name | Ramakrishna Mutyala |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1013194802 PECOS PAC ID: 8729112495 Enrollment ID: I20200526002366 |
| Provider Name | Alisha E Moreno |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1588026132 PECOS PAC ID: 8628499886 Enrollment ID: I20200527000812 |
| Provider Name | Elizabeth Ann Yarger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699024091 PECOS PAC ID: 6800217985 Enrollment ID: I20200527001916 |
| Provider Name | Sarah C Gehring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457785347 PECOS PAC ID: 3072899129 Enrollment ID: I20200529000690 |
| Provider Name | Courtney Alexis Schweickart |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558999193 PECOS PAC ID: 3173945441 Enrollment ID: I20200616001411 |
| Provider Name | Kimberly Victoria Newkirk |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1174151880 PECOS PAC ID: 8426470600 Enrollment ID: I20200616002050 |
| Provider Name | Colleen Clare Begley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871940247 PECOS PAC ID: 6406137074 Enrollment ID: I20200616002146 |
| Provider Name | Krista Mcneice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104312081 PECOS PAC ID: 4082036579 Enrollment ID: I20200630001799 |
| Provider Name | Hayley L Hammersand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235749805 PECOS PAC ID: 7315364734 Enrollment ID: I20200831003290 |
| Provider Name | Hersh Varma |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1194110122 PECOS PAC ID: 9133438302 Enrollment ID: I20201110001221 |
| Provider Name | Mekam Tochukwu Okoye |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609266774 PECOS PAC ID: 6002227360 Enrollment ID: I20201118001578 |
| Provider Name | Amanda Michelle Lipsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194332791 PECOS PAC ID: 6901218171 Enrollment ID: I20201211000282 |
| Provider Name | Hilary Lynne Fortkamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780210096 PECOS PAC ID: 8628481017 Enrollment ID: I20201231001752 |
| Provider Name | Harsh Kothari |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1538574371 PECOS PAC ID: 6305117946 Enrollment ID: I20210201001687 |
| Provider Name | April M Denlinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659976876 PECOS PAC ID: 6002220191 Enrollment ID: I20210201002653 |
| Provider Name | James M Klatte |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1801116579 PECOS PAC ID: 6901034008 Enrollment ID: I20210217003041 |
| Provider Name | Ankur Patel |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1114105129 PECOS PAC ID: 6305098153 Enrollment ID: I20210218001263 |
| Provider Name | Dustin Michael Bergman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477143949 PECOS PAC ID: 1052726361 Enrollment ID: I20210218003071 |
| Provider Name | Daniel K Robie |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1326143512 PECOS PAC ID: 9032134267 Enrollment ID: I20210219000728 |
| Provider Name | Ahmad Al Dughiem |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1538537865 PECOS PAC ID: 5294086237 Enrollment ID: I20210219002515 |
| Provider Name | Amy E Kosanovich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477926772 PECOS PAC ID: 8921394560 Enrollment ID: I20210224000361 |
| Provider Name | Carolina Cuba-gutierrez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942579735 PECOS PAC ID: 4486800653 Enrollment ID: I20210226001763 |
| Provider Name | Zachary Madson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861827339 PECOS PAC ID: 5294073664 Enrollment ID: I20210301000140 |
| Provider Name | Michelle M Barnes |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1366539470 PECOS PAC ID: 2466549241 Enrollment ID: I20210302000817 |
| Provider Name | Angela Marie Butts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184756736 PECOS PAC ID: 6800202508 Enrollment ID: I20210303003265 |
| Provider Name | Rachael Anne Courtney |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1255566352 PECOS PAC ID: 2163838863 Enrollment ID: I20210303003294 |
| Provider Name | Kelsi N Gerdeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023609617 PECOS PAC ID: 8527474998 Enrollment ID: I20210309002892 |
| Provider Name | Kelsey A Kapolka |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841645017 PECOS PAC ID: 3274949516 Enrollment ID: I20210310002105 |
| Provider Name | Julia Sondergard |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497140362 PECOS PAC ID: 4587966882 Enrollment ID: I20210310002786 |
| Provider Name | Michael Edward Kallile |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1851616890 PECOS PAC ID: 5799191995 Enrollment ID: I20210315000203 |
| Provider Name | Sara F Guerrero-duby |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003808007 PECOS PAC ID: 6800202011 Enrollment ID: I20210315000957 |
| Provider Name | Moira C Pfeifer |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1366439119 PECOS PAC ID: 6800203811 Enrollment ID: I20210318000386 |
| Provider Name | Samantha Joan Carpenter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790373777 PECOS PAC ID: 3870900707 Enrollment ID: I20210322000659 |
| Provider Name | Mousumee Shah |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1780021451 PECOS PAC ID: 9335436799 Enrollment ID: I20210322001676 |
| Provider Name | Brooke A Crum |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518491745 PECOS PAC ID: 0042627762 Enrollment ID: I20210325000471 |
| Provider Name | Edward Caston Rowse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770198046 PECOS PAC ID: 2264849413 Enrollment ID: I20210406000462 |
| Provider Name | Sara Maureen Conley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780741496 PECOS PAC ID: 3870900921 Enrollment ID: I20210407002971 |
| Provider Name | Erica M Bautista |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508243494 PECOS PAC ID: 7719395730 Enrollment ID: I20210412002334 |
| Provider Name | Maria C Rivera-amisola |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952407645 PECOS PAC ID: 4789588070 Enrollment ID: I20210413001484 |
| Provider Name | Danya Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609405224 PECOS PAC ID: 1658794938 Enrollment ID: I20210415002285 |
| Provider Name | Brianne L Fitzgerald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457885899 PECOS PAC ID: 9133537772 Enrollment ID: I20210420000415 |
| Provider Name | Jubin Mathews |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1467714592 PECOS PAC ID: 7810306826 Enrollment ID: I20210504000738 |
| Provider Name | Jasa Talarico |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255771390 PECOS PAC ID: 9436568474 Enrollment ID: I20210504002304 |
| Provider Name | Sean M Bingham |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1427348457 PECOS PAC ID: 9234438425 Enrollment ID: I20210514002258 |
| Provider Name | Kileen Jerricha Fernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891397170 PECOS PAC ID: 0547669665 Enrollment ID: I20210521002234 |
| Provider Name | Stephanie A Lake |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255865952 PECOS PAC ID: 5991104440 Enrollment ID: I20210603000656 |
| Provider Name | Meghan M Couch |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508433947 PECOS PAC ID: 9537561600 Enrollment ID: I20210712003241 |
| Provider Name | Kim R Koster |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1750347050 PECOS PAC ID: 1658312087 Enrollment ID: I20210723003306 |
| Provider Name | Allison Moss Greening |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1700059144 PECOS PAC ID: 4082858410 Enrollment ID: I20210818002832 |
| Provider Name | Courtney E Rowland |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851884134 PECOS PAC ID: 1456604537 Enrollment ID: I20210819001412 |
| Provider Name | Sarah R Walton |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1316965882 PECOS PAC ID: 4688704422 Enrollment ID: I20210819003297 |
| Provider Name | Barynia F Backeljauw |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1558725705 PECOS PAC ID: 8325444284 Enrollment ID: I20210901002439 |
| Provider Name | Jennifer E Lapin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245627223 PECOS PAC ID: 4183922503 Enrollment ID: I20210910000414 |
| Provider Name | Elisabeth K Wynne |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1801159926 PECOS PAC ID: 6305179599 Enrollment ID: I20210913002944 |
| Provider Name | Laura Ann Sullivan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801391313 PECOS PAC ID: 5193071629 Enrollment ID: I20210924001378 |
| Provider Name | Matthew E Kuestner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487776852 PECOS PAC ID: 6507021003 Enrollment ID: I20211014002909 |
| Provider Name | Jason Roy Toews |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760864441 PECOS PAC ID: 6507264967 Enrollment ID: I20211015000380 |
| Provider Name | Ann Lafuze Daniel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1194707133 PECOS PAC ID: 3779589031 Enrollment ID: I20211018000574 |
| Provider Name | Emily Elizabeth Hendrickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487892964 PECOS PAC ID: 1850789074 Enrollment ID: I20211020002924 |
| Provider Name | Chelsea Ea Ferree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588231369 PECOS PAC ID: 9830587674 Enrollment ID: I20211027000889 |
| Provider Name | Rachel Marie Burd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578225785 PECOS PAC ID: 2365831104 Enrollment ID: I20211116001697 |
| Provider Name | Amber Dawson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588282164 PECOS PAC ID: 1850715699 Enrollment ID: I20211116003131 |
| Provider Name | Mollie Anne Vandam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699433169 PECOS PAC ID: 6901297423 Enrollment ID: I20211216002653 |
| Provider Name | Jenna C Korsog |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679147920 PECOS PAC ID: 6406249903 Enrollment ID: I20220204001708 |
| Provider Name | Jatandra Morton |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1861836702 PECOS PAC ID: 6204180904 Enrollment ID: I20220224003117 |
| Provider Name | Jennifer Lynne Adkins |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073590386 PECOS PAC ID: 6608158332 Enrollment ID: I20220322003099 |
| Provider Name | Jillian L Hazlett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518614775 PECOS PAC ID: 7618363136 Enrollment ID: I20220411001144 |
| Provider Name | Kevin D Maupin |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1598779811 PECOS PAC ID: 4284652538 Enrollment ID: I20220418002548 |
| Provider Name | Madison Towler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225604531 PECOS PAC ID: 2769869205 Enrollment ID: I20220523000387 |
| Provider Name | Scott Joseph Rapp |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1346402948 PECOS PAC ID: 5395985113 Enrollment ID: I20220526000571 |
| Provider Name | Michelle R Smith |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1114308640 PECOS PAC ID: 4385956861 Enrollment ID: I20220622002417 |
| Provider Name | Jennifer Nicole Mills |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215598719 PECOS PAC ID: 8022498955 Enrollment ID: I20220708002046 |
| Provider Name | Molly Joan Osterhage Tilly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932662145 PECOS PAC ID: 5890022602 Enrollment ID: I20220708002632 |
| Provider Name | Chantal K Barbot |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1801255674 PECOS PAC ID: 1052600087 Enrollment ID: I20220708003526 |
| Provider Name | John F Gillis |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1083970628 PECOS PAC ID: 8729411475 Enrollment ID: I20220711000383 |
| Provider Name | Grant Joseph Turek |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114380516 PECOS PAC ID: 6305227810 Enrollment ID: I20220714003478 |
| Provider Name | Jennifer Ann Tendler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700231115 PECOS PAC ID: 1759762156 Enrollment ID: I20220716000277 |
| Provider Name | Louis Duy Canh Le |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396956116 PECOS PAC ID: 5890003123 Enrollment ID: I20220728003588 |
| Provider Name | Brian Peter Weimerskirch |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1871888453 PECOS PAC ID: 4486080892 Enrollment ID: I20220809001941 |
| Provider Name | April Ann Mathews |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1629462809 PECOS PAC ID: 8729461694 Enrollment ID: I20220810003317 |
| Provider Name | Nicholas Daniel Gajewski |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1619330503 PECOS PAC ID: 7113279340 Enrollment ID: I20220812000772 |
| Provider Name | Khalid Safi |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1336371442 PECOS PAC ID: 3779872239 Enrollment ID: I20220812002240 |
| Provider Name | Michael Ryan Kessel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710201256 PECOS PAC ID: 7315321056 Enrollment ID: I20220830003135 |
| Provider Name | Caleb James Botta |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336778901 PECOS PAC ID: 8022493840 Enrollment ID: I20220915000288 |
| Provider Name | Brian Leigh Forster |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407396328 PECOS PAC ID: 3678990264 Enrollment ID: I20220915002458 |
| Provider Name | Tanya Paul |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003369331 PECOS PAC ID: 0749665123 Enrollment ID: I20220921001976 |
| Provider Name | Courtney Paige Goode |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235893439 PECOS PAC ID: 0345626560 Enrollment ID: I20220926001678 |
| Provider Name | Lia Marie Ratliff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952058000 PECOS PAC ID: 9335515972 Enrollment ID: I20221021001889 |
| Provider Name | Erica Leigh Lucas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528789963 PECOS PAC ID: 6406223403 Enrollment ID: I20221103003280 |
| Provider Name | Meghan V Burkley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1043500291 PECOS PAC ID: 5092001198 Enrollment ID: I20221116002707 |
| Provider Name | Carol R Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598481715 PECOS PAC ID: 5193193381 Enrollment ID: I20221118001605 |
| Provider Name | Autumn Diane Hurm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427015270 PECOS PAC ID: 1355525452 Enrollment ID: I20221129001875 |
| Provider Name | Matthew J Roesch |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457715500 PECOS PAC ID: 4082907530 Enrollment ID: I20221219000752 |
| Provider Name | Kayla Danae Goodwin Bryan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407023294 PECOS PAC ID: 2062729783 Enrollment ID: I20221228002968 |
| Provider Name | Debra Ann Jacobs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255693107 PECOS PAC ID: 5698145019 Enrollment ID: I20221229002427 |
| Provider Name | Kevan Oneill |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1528329372 PECOS PAC ID: 1254652605 Enrollment ID: I20230127001778 |
| Provider Name | Luxme Hariharan |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1386962868 PECOS PAC ID: 4880837392 Enrollment ID: I20230131003487 |
| Provider Name | Janelle Fairchild Pool |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477615029 PECOS PAC ID: 3678945896 Enrollment ID: I20230215002244 |
| Provider Name | Dania Al-hamad |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1659628022 PECOS PAC ID: 1557657830 Enrollment ID: I20230222002798 |
| Provider Name | Lindsay Michele Cary |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598172827 PECOS PAC ID: 9436425006 Enrollment ID: I20230227002435 |
| Provider Name | Courtney L Mcintosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356054498 PECOS PAC ID: 1759754344 Enrollment ID: I20230301002018 |
| Provider Name | Shelby N Layman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063121010 PECOS PAC ID: 7719350222 Enrollment ID: I20230303001500 |
| Provider Name | Michelle Halton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760022743 PECOS PAC ID: 9739566852 Enrollment ID: I20230320001505 |
| Provider Name | Ashima Goyal Gurkha |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861913030 PECOS PAC ID: 2264890854 Enrollment ID: I20230613003347 |
| Provider Name | Jonathan Michael Elliott |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992265748 PECOS PAC ID: 9133456551 Enrollment ID: I20230614002285 |
| Provider Name | Christine Deeths |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811008097 PECOS PAC ID: 6305010992 Enrollment ID: I20230616001894 |
| Provider Name | Lubna S Mehyar |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1659648806 PECOS PAC ID: 5799089470 Enrollment ID: I20230707001894 |
| Provider Name | Amanda B Gutwein |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538694302 PECOS PAC ID: 2163892332 Enrollment ID: I20230708000286 |
| Provider Name | Kimberlyn Jeanne Chandler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780369611 PECOS PAC ID: 0345609202 Enrollment ID: I20230710003573 |
| Provider Name | Thomas Tanner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982059671 PECOS PAC ID: 0446516959 Enrollment ID: I20230712001955 |
| Provider Name | Kara Bethany Pappas |
|---|---|
| Provider Type | Practitioner - Medical Genetics And Genomics |
| Provider Identifiers | NPI Number: 1417396136 PECOS PAC ID: 0244535821 Enrollment ID: I20230712002491 |
| Provider Name | Katherine Cothern |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255795787 PECOS PAC ID: 0345576971 Enrollment ID: I20230725003332 |
| Provider Name | David Charles Conti |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1487117446 PECOS PAC ID: 2769843937 Enrollment ID: I20230803003169 |
| Provider Name | Rebekah Elizabeth Baron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619654951 PECOS PAC ID: 1456714500 Enrollment ID: I20230823000915 |
| Provider Name | Carla Bridges |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1134506827 PECOS PAC ID: 0547546061 Enrollment ID: I20230905002724 |
| Provider Name | Leanne M Buschmeier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932795788 PECOS PAC ID: 9032563762 Enrollment ID: I20230928001140 |
| Provider Name | Debra Ellen Bockhorn |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285699272 PECOS PAC ID: 4587875729 Enrollment ID: I20230928001594 |
| Provider Name | Germaine Neh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821651316 PECOS PAC ID: 9830544683 Enrollment ID: I20231013001346 |
| Provider Name | Elizabeth Rose Shisler Dawson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609337484 PECOS PAC ID: 9537493481 Enrollment ID: I20231013002492 |
| Provider Name | Tiffany Lynn Wissman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811208259 PECOS PAC ID: 4486009149 Enrollment ID: I20231016002446 |
| Provider Name | Stephanie Janelle Quincy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710300868 PECOS PAC ID: 6709231475 Enrollment ID: I20231016002497 |
| Provider Name | Mark Ronald Rohaus |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316301971 PECOS PAC ID: 8820324353 Enrollment ID: I20231017000234 |
| Provider Name | Christopher Lynn Harper |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174028716 PECOS PAC ID: 6901251529 Enrollment ID: I20231017000444 |
| Provider Name | Linda Ebelechukwu Odenigbo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083679161 PECOS PAC ID: 0941411177 Enrollment ID: I20231017001818 |
| Provider Name | Divya S Thomas |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700399623 PECOS PAC ID: 4082069646 Enrollment ID: I20231017002286 |
| Provider Name | Matthew William Byers |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083886998 PECOS PAC ID: 4789039348 Enrollment ID: I20231017002413 |
| Provider Name | John Walter Thomas |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710943485 PECOS PAC ID: 6507211166 Enrollment ID: I20231017002452 |
| Provider Name | Kathleen Patricia Bernice Gibbs |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669593604 PECOS PAC ID: 6002261674 Enrollment ID: I20231017002704 |
| Provider Name | Erin Leigh Perkey Nienaber |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700028362 PECOS PAC ID: 2163877739 Enrollment ID: I20231017002797 |
| Provider Name | Kathleen A Gutman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639134992 PECOS PAC ID: 9739392580 Enrollment ID: I20231018000478 |
| Provider Name | Alonzo Patterson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609830447 PECOS PAC ID: 1759737240 Enrollment ID: I20231019000484 |
| Provider Name | Katherine Muse |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275996670 PECOS PAC ID: 9436505708 Enrollment ID: I20231023001099 |
| Provider Name | Karmyn Schneider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578344305 PECOS PAC ID: 8123475530 Enrollment ID: I20231107001689 |
| Provider Name | Alana Christine Tunnacliffe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619652906 PECOS PAC ID: 8426408279 Enrollment ID: I20231220002194 |
| Provider Name | Kelsey Simpson Tincher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104692789 PECOS PAC ID: 2264882943 Enrollment ID: I20231220003494 |
| Provider Name | Preston Keiffer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902426935 PECOS PAC ID: 4789034349 Enrollment ID: I20231221002798 |
| Provider Name | Holli N Kroger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003685694 PECOS PAC ID: 3274978309 Enrollment ID: I20240228004492 |
| Provider Name | Jennifer Michele Feldman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114003332 PECOS PAC ID: 8426493008 Enrollment ID: I20240305003387 |
| Provider Name | Ashley Nicole Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811602436 PECOS PAC ID: 1254777816 Enrollment ID: I20240306002192 |
| Provider Name | Jennifer Marie Conlon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023194248 PECOS PAC ID: 1153767579 Enrollment ID: I20240307003564 |
| Provider Name | Erica Potts |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508487331 PECOS PAC ID: 2567887243 Enrollment ID: I20240308003500 |
| Provider Name | Shalini Aggarwal Ryan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760568984 PECOS PAC ID: 3971495953 Enrollment ID: I20240313000245 |
| Provider Name | Elizabeth Amorkor Darkwa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265655856 PECOS PAC ID: 9931545928 Enrollment ID: I20240313000685 |
| Provider Name | Sara Marie Diskin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023464369 PECOS PAC ID: 8527404516 Enrollment ID: I20240313000908 |
| Provider Name | Rayma Keshavaram |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144596149 PECOS PAC ID: 7012218639 Enrollment ID: I20240314003696 |
| Provider Name | John Michael Rahe |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588740708 PECOS PAC ID: 3971949777 Enrollment ID: I20240315000513 |
| Provider Name | David Lloyd Roer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396821518 PECOS PAC ID: 8224474937 Enrollment ID: I20240315001328 |
| Provider Name | Debra Ann Rill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295862001 PECOS PAC ID: 9234576117 Enrollment ID: I20240327002520 |
| Provider Name | Grace Elizabeth Nitting |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972164556 PECOS PAC ID: 4385081264 Enrollment ID: I20240327002692 |
| Provider Name | Timothy Truong Phamduy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033572680 PECOS PAC ID: 0547549651 Enrollment ID: I20240402003252 |
Coleman Management Group Vandalia, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8605 N Dixie Dr, Dayton, OH 45414 Phone: 937-264-1600 | |
Peter J Shempp Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3550 Far Hills Ave, Dayton, OH 45429 Phone: 937-298-0908 Fax: 937-298-3318 | |
Robert T. Jensen D.d.s., M.s., Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7100 Corporate Way, Dayton, OH 45459 Phone: 937-435-1555 | |
Aggarwal Dental Center Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2640 Salem Ave, Dayton, OH 45406 Phone: 937-276-9788 | |
Family Orthodontics Of Ohio Jim Shealy Dds Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4440 Linden Ave, Dayton, OH 45432 Phone: 937-252-8651 | |
Alan D Janoff Dds & Dennis D Baum Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1203 Salem Ave, Dayton, OH 45406 Phone: 937-275-7448 Fax: 937-275-0018 | |
Byron G Epley Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 709 Xenia Ave, Dayton, OH 45410 Phone: 937-253-8958 Fax: 937-253-8958 |