| Bon Secours Medical Group Greenville Specialty Care Llc | |
|
1 Saint Francis Dr Greenville SC 29601-3955 | |
| (864) 603-6099 | |
| Not Available |
| Full Name | Bon Secours Medical Group Greenville Specialty Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 Saint Francis Dr, Greenville, South Carolina |
| Authorized Official Name and Position | Wilbur Gay (CFO) |
| Authorized Official Contact | 8645617672 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bon Secours Medical Group Greenville Specialty Care Llc 1701 Mercy Health Pl Cincinnati OH 45237-6147 Ph: () - | Bon Secours Medical Group Greenville Specialty Care Llc 1 Saint Francis Dr Greenville SC 29601-3955 Ph: (864) 603-6099 |
| NPI Number | 1821679580 |
|---|---|
| Provider Enumeration Date | 04/15/2021 |
| Last Update Date | 03/13/2024 |
| Certification Date | 03/13/2024 |
| Medicare PECOS PAC ID | 1850779976 |
|---|---|
| Medicare Enrollment ID | O20220602000070 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821679580 | NPI | - | NPPES |
| Provider Name | Jason A Hood |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407880354 PECOS PAC ID: 5698689495 Enrollment ID: I20031117000294 |
| Provider Name | Ahmad Idris |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1841386323 PECOS PAC ID: 1951208495 Enrollment ID: I20031215000211 |
| Provider Name | Michael A Towler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770674400 PECOS PAC ID: 6901792217 Enrollment ID: I20040224000960 |
| Provider Name | Thomas C Mann |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255422168 PECOS PAC ID: 5698661767 Enrollment ID: I20040225000701 |
| Provider Name | Lori L Weinstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598866220 PECOS PAC ID: 9931192622 Enrollment ID: I20040407000992 |
| Provider Name | David Alan Circle |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427011931 PECOS PAC ID: 1759376064 Enrollment ID: I20040416000747 |
| Provider Name | Arthur Thomas Siachos |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1598757171 PECOS PAC ID: 2769471226 Enrollment ID: I20040510000891 |
| Provider Name | Silas Emmett Lucas |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1982661492 PECOS PAC ID: 8729078670 Enrollment ID: I20040513001117 |
| Provider Name | Christopher Hamilton Smith |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831181486 PECOS PAC ID: 6305837642 Enrollment ID: I20040524001092 |
| Provider Name | Mark R Jackson |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1033177530 PECOS PAC ID: 6204817109 Enrollment ID: I20040526001360 |
| Provider Name | Stephanie A Berlet-dach |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376539585 PECOS PAC ID: 8426032871 Enrollment ID: I20040615000395 |
| Provider Name | Rebecca Anne Keith |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417979709 PECOS PAC ID: 6103802996 Enrollment ID: I20040624000512 |
| Provider Name | Kyle Ernest Watford |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1225000573 PECOS PAC ID: 4385622166 Enrollment ID: I20040708001206 |
| Provider Name | Robert E Elvington |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679587232 PECOS PAC ID: 2264410794 Enrollment ID: I20040712000506 |
| Provider Name | Amy Robbins Cantillion |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1659320695 PECOS PAC ID: 6709865363 Enrollment ID: I20040716000590 |
| Provider Name | Barbara A Moran-faile |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396737995 PECOS PAC ID: 8426038449 Enrollment ID: I20040721001000 |
| Provider Name | Hugh M Dennis |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1346331295 PECOS PAC ID: 2961473806 Enrollment ID: I20040804000144 |
| Provider Name | Timothy H Williams |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1801987763 PECOS PAC ID: 6901877943 Enrollment ID: I20040804000218 |
| Provider Name | Tracy King Fasolino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427006170 PECOS PAC ID: 9133190911 Enrollment ID: I20040804001266 |
| Provider Name | David G Anderson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447200514 PECOS PAC ID: 9436122009 Enrollment ID: I20040817000160 |
| Provider Name | Toni Denise Hogan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467488437 PECOS PAC ID: 3779551676 Enrollment ID: I20040920000165 |
| Provider Name | Renu Bhatia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093817058 PECOS PAC ID: 4486622164 Enrollment ID: I20040921000279 |
| Provider Name | Jeff A Benjamin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821057779 PECOS PAC ID: 3678533858 Enrollment ID: I20041012001350 |
| Provider Name | Courtney Gnau Garbade |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1609850460 PECOS PAC ID: 7719948009 Enrollment ID: I20041020000699 |
| Provider Name | Todd Robert Lantz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114913324 PECOS PAC ID: 8921062779 Enrollment ID: I20041112000262 |
| Provider Name | Glenn Martin French |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972599173 PECOS PAC ID: 2365406113 Enrollment ID: I20041112000282 |
| Provider Name | Lynwood Breeden Hollis |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1649237793 PECOS PAC ID: 4082663638 Enrollment ID: I20050120000761 |
| Provider Name | John E Cebe |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1972595536 PECOS PAC ID: 0840237178 Enrollment ID: I20050408000408 |
| Provider Name | David Griffin |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1508823618 PECOS PAC ID: 0042100117 Enrollment ID: I20050426000780 |
| Provider Name | Ralph E Lattimore |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790886018 PECOS PAC ID: 0749229649 Enrollment ID: I20050429000584 |
| Provider Name | Harvey A Sikes |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922109248 PECOS PAC ID: 2163462425 Enrollment ID: I20050505000570 |
| Provider Name | Vanessa A Mazzoli |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437250768 PECOS PAC ID: 2769422021 Enrollment ID: I20050505000600 |
| Provider Name | Gregory San |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679565279 PECOS PAC ID: 2163464181 Enrollment ID: I20050531000569 |
| Provider Name | Chyrel E Stoner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225122211 PECOS PAC ID: 5698710325 Enrollment ID: I20050623000220 |
| Provider Name | Jon M Bittrick |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134111727 PECOS PAC ID: 3779528120 Enrollment ID: I20050627000068 |
| Provider Name | Sharon E Kofoed |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417058645 PECOS PAC ID: 0547205908 Enrollment ID: I20050627000113 |
| Provider Name | Ned D Freeman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1578555173 PECOS PAC ID: 3779519723 Enrollment ID: I20050712000450 |
| Provider Name | Mark A Casebolt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881633402 PECOS PAC ID: 9234033838 Enrollment ID: I20050808000840 |
| Provider Name | Kim Waldenmaier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851373021 PECOS PAC ID: 7719917012 Enrollment ID: I20050816001159 |
| Provider Name | Tracie D Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053381319 PECOS PAC ID: 4183654122 Enrollment ID: I20050818000715 |
| Provider Name | Charles Vincent Mullen |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1447358478 PECOS PAC ID: 9234161043 Enrollment ID: I20050901000065 |
| Provider Name | Ahmad M Boota |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1083715940 PECOS PAC ID: 2062444805 Enrollment ID: I20050901000338 |
| Provider Name | Cindy M Steeves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083708077 PECOS PAC ID: 7719906767 Enrollment ID: I20051118000221 |
| Provider Name | Lucretia P Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134220932 PECOS PAC ID: 4183644685 Enrollment ID: I20051129000783 |
| Provider Name | Edward Perry Heidtman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659472991 PECOS PAC ID: 1658391032 Enrollment ID: I20051130000344 |
| Provider Name | Shannon D Johnson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063513307 PECOS PAC ID: 1456371830 Enrollment ID: I20051130000358 |
| Provider Name | Michele Durham |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619935566 PECOS PAC ID: 9739102740 Enrollment ID: I20060105000143 |
| Provider Name | Samy R Iskandar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275563520 PECOS PAC ID: 5991728834 Enrollment ID: I20060106000328 |
| Provider Name | John Howard Nordeen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1568403244 PECOS PAC ID: 7911921341 Enrollment ID: I20060124000623 |
| Provider Name | Christopher D Vanpelt |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1801833470 PECOS PAC ID: 4981615176 Enrollment ID: I20060602000082 |
| Provider Name | Mark Allen Grabarczyk |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134168941 PECOS PAC ID: 8527951292 Enrollment ID: I20060607000037 |
| Provider Name | Nasir Jalil Awan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1831141894 PECOS PAC ID: 4284647819 Enrollment ID: I20060726000088 |
| Provider Name | Jennifer Martin |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1083642045 PECOS PAC ID: 4981617495 Enrollment ID: I20060731000354 |
| Provider Name | Howland E Crosswell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811943871 PECOS PAC ID: 7911900907 Enrollment ID: I20060811000207 |
| Provider Name | James Kyle Horton |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1750321998 PECOS PAC ID: 9638172471 Enrollment ID: I20060816000221 |
| Provider Name | Stephen R Ridgeway |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1184682239 PECOS PAC ID: 3173527249 Enrollment ID: I20060831000511 |
| Provider Name | Muthamma Machimada |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1699725986 PECOS PAC ID: 3779587860 Enrollment ID: I20060901000183 |
| Provider Name | Michael Edwin Tollison |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1669439766 PECOS PAC ID: 2466456231 Enrollment ID: I20060908000482 |
| Provider Name | Christopher H Kavolus |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1427015155 PECOS PAC ID: 7719981588 Enrollment ID: I20060908000497 |
| Provider Name | James E Jennings |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396702452 PECOS PAC ID: 4981608759 Enrollment ID: I20060908000503 |
| Provider Name | Michael John Ludkowski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477563880 PECOS PAC ID: 0244296796 Enrollment ID: I20060925000248 |
| Provider Name | Sherman Kevin Basong |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639187487 PECOS PAC ID: 2961407747 Enrollment ID: I20060929000253 |
| Provider Name | Richard G Leland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184659880 PECOS PAC ID: 5698772358 Enrollment ID: I20061023000397 |
| Provider Name | Toni P Griffin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1740355494 PECOS PAC ID: 7315948957 Enrollment ID: I20070124000429 |
| Provider Name | Lynn A Curry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285714956 PECOS PAC ID: 0042313355 Enrollment ID: I20070307000086 |
| Provider Name | Michael M Zhadkevich |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1598724882 PECOS PAC ID: 4082718176 Enrollment ID: I20070329000358 |
| Provider Name | Andrew R Bullock |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1194936385 PECOS PAC ID: 3678674850 Enrollment ID: I20070719000056 |
| Provider Name | Amy Donald Cox |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649478561 PECOS PAC ID: 6901997345 Enrollment ID: I20070814000420 |
| Provider Name | Daniel M Jacques |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1699750075 PECOS PAC ID: 4981797818 Enrollment ID: I20070907000452 |
| Provider Name | Phillip C Greig |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851491633 PECOS PAC ID: 4688650690 Enrollment ID: I20071003000247 |
| Provider Name | Brandi K Alt |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699895409 PECOS PAC ID: 7315033016 Enrollment ID: I20071010000738 |
| Provider Name | Earl Christopher Troup |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1326085903 PECOS PAC ID: 9931298759 Enrollment ID: I20071203000013 |
| Provider Name | Michael L Ruppenthal |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1437131232 PECOS PAC ID: 7113980764 Enrollment ID: I20071210000456 |
| Provider Name | Meng Zhou Wang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023088002 PECOS PAC ID: 3971686049 Enrollment ID: I20080212000723 |
| Provider Name | Katarina S Harris |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1003963141 PECOS PAC ID: 8426152042 Enrollment ID: I20080501000439 |
| Provider Name | Matthew G Nessmith |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265490684 PECOS PAC ID: 7810909355 Enrollment ID: I20080514000590 |
| Provider Name | Brad M Simpson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699767277 PECOS PAC ID: 1951470095 Enrollment ID: I20080515000535 |
| Provider Name | John W Womack |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1366579666 PECOS PAC ID: 8921105073 Enrollment ID: I20080723000641 |
| Provider Name | Melissa R Richardson |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1639199201 PECOS PAC ID: 3678647492 Enrollment ID: I20080728000699 |
| Provider Name | Cory Rafe White |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1700973765 PECOS PAC ID: 0840365722 Enrollment ID: I20080813000167 |
| Provider Name | Samuel P Sterrett |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1356460281 PECOS PAC ID: 0749373546 Enrollment ID: I20080814000600 |
| Provider Name | Ezzat El Bayoumi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1962440149 PECOS PAC ID: 1456429729 Enrollment ID: I20081014000516 |
| Provider Name | Lynn M Owens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457321747 PECOS PAC ID: 7315000346 Enrollment ID: I20090116000246 |
| Provider Name | Ashley R Sneed |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1326005729 PECOS PAC ID: 2062577422 Enrollment ID: I20090218000432 |
| Provider Name | Kevin M Phillips |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649381294 PECOS PAC ID: 8527117803 Enrollment ID: I20090515000124 |
| Provider Name | Edward Burrus |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780656595 PECOS PAC ID: 7416008859 Enrollment ID: I20090625000303 |
| Provider Name | Bing Yi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245452366 PECOS PAC ID: 0941352926 Enrollment ID: I20090722000537 |
| Provider Name | Colin R Stephenson |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1194776641 PECOS PAC ID: 7517012214 Enrollment ID: I20090902000072 |
| Provider Name | Kathryn Azelia Hale |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427271261 PECOS PAC ID: 6608922950 Enrollment ID: I20090929000102 |
| Provider Name | Michael P Fox |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912937269 PECOS PAC ID: 3274670062 Enrollment ID: I20091028000011 |
| Provider Name | Alan G Posta |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1841388675 PECOS PAC ID: 3678563814 Enrollment ID: I20100215000030 |
| Provider Name | Jennifer L Huggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568799211 PECOS PAC ID: 3274677000 Enrollment ID: I20100217000776 |
| Provider Name | Karen A Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851398747 PECOS PAC ID: 3577605633 Enrollment ID: I20100726000172 |
| Provider Name | Amy E Roemmich |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720313893 PECOS PAC ID: 9335263334 Enrollment ID: I20100827000310 |
| Provider Name | Edward A Stewart |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013094234 PECOS PAC ID: 5395860712 Enrollment ID: I20100908001083 |
| Provider Name | Erin Michelle Beasley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336398601 PECOS PAC ID: 9335333921 Enrollment ID: I20101027001104 |
| Provider Name | Christina Deluca Schwering |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881893469 PECOS PAC ID: 3870788714 Enrollment ID: I20101117000614 |
| Provider Name | Louis Frederick Knoepp |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1881600963 PECOS PAC ID: 7810028271 Enrollment ID: I20101119000735 |
| Provider Name | James R Monroe |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1225067556 PECOS PAC ID: 9335242908 Enrollment ID: I20101229000347 |
| Provider Name | Thomas E Hamilton |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1053349555 PECOS PAC ID: 1153424726 Enrollment ID: I20110104000112 |
| Provider Name | Amber C Fowler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780814327 PECOS PAC ID: 5698964955 Enrollment ID: I20110118001131 |
| Provider Name | Judith L Botcher-hoover |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992792857 PECOS PAC ID: 8820993066 Enrollment ID: I20110228000290 |
| Provider Name | Michael Naldo Bucci |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1568470904 PECOS PAC ID: 2365356417 Enrollment ID: I20110309000806 |
| Provider Name | Randall M Royal |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053515791 PECOS PAC ID: 8921281957 Enrollment ID: I20110329000195 |
| Provider Name | Travis Greer |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1083811384 PECOS PAC ID: 3577749647 Enrollment ID: I20110525000763 |
| Provider Name | Brian Marshall Thompson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821024993 PECOS PAC ID: 3577468594 Enrollment ID: I20110707000229 |
| Provider Name | Marta Carvalhal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255635322 PECOS PAC ID: 2466630769 Enrollment ID: I20110708000233 |
| Provider Name | Joseph M Hartzog |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003912163 PECOS PAC ID: 3678533015 Enrollment ID: I20110816000425 |
| Provider Name | Rajinder Parmar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1891791570 PECOS PAC ID: 9032100953 Enrollment ID: I20110914000205 |
| Provider Name | Kathleen V Woschkolup |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003013616 PECOS PAC ID: 5496926149 Enrollment ID: I20110929000139 |
| Provider Name | Amanda Kornegay Marullo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548548167 PECOS PAC ID: 2264604701 Enrollment ID: I20111005000941 |
| Provider Name | Leigh C Stinnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942597471 PECOS PAC ID: 3173795622 Enrollment ID: I20111006000120 |
| Provider Name | Lillian M Nicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558641670 PECOS PAC ID: 3678746336 Enrollment ID: I20111026000111 |
| Provider Name | Angela Kay Plumer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1548311772 PECOS PAC ID: 5890690317 Enrollment ID: I20111116000014 |
| Provider Name | Stephen Howard Dyar |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1497883565 PECOS PAC ID: 2668528811 Enrollment ID: I20120727000659 |
| Provider Name | Xuezhong Yang |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1598922650 PECOS PAC ID: 9931355310 Enrollment ID: I20120820000367 |
| Provider Name | Jacqueline A Odum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407867989 PECOS PAC ID: 8729037916 Enrollment ID: I20120828000716 |
| Provider Name | Benjamin S Koch |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1356375414 PECOS PAC ID: 3678743309 Enrollment ID: I20120829000373 |
| Provider Name | Fernando Navarro |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164479325 PECOS PAC ID: 9931107109 Enrollment ID: I20120907000505 |
| Provider Name | Shawn K Mathias |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1417163064 PECOS PAC ID: 9234389099 Enrollment ID: I20121101000500 |
| Provider Name | William Carson Felkel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821309998 PECOS PAC ID: 8628221090 Enrollment ID: I20130115000198 |
| Provider Name | Kelley F Shippey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245431105 PECOS PAC ID: 0345302949 Enrollment ID: I20130207000148 |
| Provider Name | Jeffrey J Senfield |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1871727073 PECOS PAC ID: 6204076037 Enrollment ID: I20130628000006 |
| Provider Name | Erin J Dickert |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609041292 PECOS PAC ID: 4183758568 Enrollment ID: I20130702000011 |
| Provider Name | Melissa Allison Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639518343 PECOS PAC ID: 7810139953 Enrollment ID: I20130820000306 |
| Provider Name | John S Minasi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386920593 PECOS PAC ID: 4284890369 Enrollment ID: I20130905000127 |
| Provider Name | William Todd Whitehouse |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104121847 PECOS PAC ID: 4284878331 Enrollment ID: I20130911000853 |
| Provider Name | Amanda R Ryan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306080080 PECOS PAC ID: 9739313016 Enrollment ID: I20130930000553 |
| Provider Name | Dana G Laird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184059651 PECOS PAC ID: 5698901809 Enrollment ID: I20131118001460 |
| Provider Name | Irum M Idrees |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1568786630 PECOS PAC ID: 4789811019 Enrollment ID: I20131212000905 |
| Provider Name | Fahd Quddus |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1952530677 PECOS PAC ID: 5799819553 Enrollment ID: I20140115000437 |
| Provider Name | James A Merriam |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386871093 PECOS PAC ID: 4385872167 Enrollment ID: I20140124001918 |
| Provider Name | Brandi Dean Giles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386084978 PECOS PAC ID: 6608005160 Enrollment ID: I20140131001940 |
| Provider Name | Taylor J Rowe |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1659797306 PECOS PAC ID: 1153554878 Enrollment ID: I20140505001306 |
| Provider Name | Robert D Siegel |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1518901545 PECOS PAC ID: 0446289086 Enrollment ID: I20140605000580 |
| Provider Name | Julia G Payne |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1194987743 PECOS PAC ID: 2163663824 Enrollment ID: I20140729002681 |
| Provider Name | Kimberly A Frommel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235436809 PECOS PAC ID: 2567689714 Enrollment ID: I20140812000260 |
| Provider Name | Hans T Carlson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1003050154 PECOS PAC ID: 4082841333 Enrollment ID: I20140815002386 |
| Provider Name | Celeste B Beaudoin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639481690 PECOS PAC ID: 5991923781 Enrollment ID: I20140819002252 |
| Provider Name | Wael Aljishi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316105489 PECOS PAC ID: 3274773239 Enrollment ID: I20140922002823 |
| Provider Name | Jennifer L Ashley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184038853 PECOS PAC ID: 9133349665 Enrollment ID: I20141006001585 |
| Provider Name | David Williams |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1962609347 PECOS PAC ID: 3375764418 Enrollment ID: I20141015000366 |
| Provider Name | Jaime E Elliotte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780028456 PECOS PAC ID: 8820219587 Enrollment ID: I20141021002598 |
| Provider Name | Stacie M Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902206147 PECOS PAC ID: 7911129176 Enrollment ID: I20141104001423 |
| Provider Name | Tyra Lynn Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174920847 PECOS PAC ID: 6204150881 Enrollment ID: I20150130002397 |
| Provider Name | Kendra Noelle Head |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437540911 PECOS PAC ID: 6406894401 Enrollment ID: I20150422000550 |
| Provider Name | Dylan Jerome Watson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689802225 PECOS PAC ID: 6507015930 Enrollment ID: I20150810001279 |
| Provider Name | Amanda Calchary |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1750763710 PECOS PAC ID: 9335292267 Enrollment ID: I20150922002264 |
| Provider Name | Matthew B Sellers |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1528225356 PECOS PAC ID: 6507040706 Enrollment ID: I20150926000169 |
| Provider Name | Alexis W Lockyer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093720906 PECOS PAC ID: 7214150168 Enrollment ID: I20151005002937 |
| Provider Name | Lorrie Oldham |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295789790 PECOS PAC ID: 2567473846 Enrollment ID: I20151013001235 |
| Provider Name | William Godfrey Wheeler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558623892 PECOS PAC ID: 4587886460 Enrollment ID: I20151104001059 |
| Provider Name | Danielle N Andrews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245557768 PECOS PAC ID: 3577873405 Enrollment ID: I20151105001197 |
| Provider Name | Brandy D Macdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063897585 PECOS PAC ID: 1355651910 Enrollment ID: I20151110003123 |
| Provider Name | Mary E Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568830461 PECOS PAC ID: 9638471022 Enrollment ID: I20151230002760 |
| Provider Name | Hilary K Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275907602 PECOS PAC ID: 7416100854 Enrollment ID: I20160203000374 |
| Provider Name | Jason Jonathan Crumpler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417397902 PECOS PAC ID: 9638390222 Enrollment ID: I20160330002125 |
| Provider Name | Sharif S Khan |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1184683435 PECOS PAC ID: 5193766251 Enrollment ID: I20160413000508 |
| Provider Name | Ahmad Md Ismail |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1104911650 PECOS PAC ID: 0941356646 Enrollment ID: I20160527000328 |
| Provider Name | Stelina D Jennings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679928428 PECOS PAC ID: 6608167317 Enrollment ID: I20160627001569 |
| Provider Name | Scott Thomas Watson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1881914430 PECOS PAC ID: 5698924025 Enrollment ID: I20160725001634 |
| Provider Name | Lesley B. Pickell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023370905 PECOS PAC ID: 9739337379 Enrollment ID: I20160817002692 |
| Provider Name | Ashley B Wence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922456839 PECOS PAC ID: 6800182270 Enrollment ID: I20160912000374 |
| Provider Name | Jennifer L Standard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942758594 PECOS PAC ID: 4688953375 Enrollment ID: I20161121001946 |
| Provider Name | Lacey P Burke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992247456 PECOS PAC ID: 2264715887 Enrollment ID: I20170206001722 |
| Provider Name | George R Belton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639536311 PECOS PAC ID: 3971880220 Enrollment ID: I20170515002158 |
| Provider Name | Veeral M Oza |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275769580 PECOS PAC ID: 2668612003 Enrollment ID: I20170816001376 |
| Provider Name | Lindsey E Wasson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386167757 PECOS PAC ID: 2163797978 Enrollment ID: I20171004002336 |
| Provider Name | Dat Thanh Ta |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194049049 PECOS PAC ID: 5193961712 Enrollment ID: I20171009003385 |
| Provider Name | Ross Michael Germani |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1992916704 PECOS PAC ID: 3870639115 Enrollment ID: I20171024000505 |
| Provider Name | Celia Janette Ridley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174817167 PECOS PAC ID: 8426206095 Enrollment ID: I20171103002814 |
| Provider Name | Joanna A Grabska |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1144546557 PECOS PAC ID: 8325304793 Enrollment ID: I20171117002310 |
| Provider Name | Jessica Lynn Benes |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568496461 PECOS PAC ID: 1951669779 Enrollment ID: I20171227000539 |
| Provider Name | William Carson Felkel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821309998 PECOS PAC ID: 8628221090 Enrollment ID: I20180102002475 |
| Provider Name | Michael Mcinnis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811402910 PECOS PAC ID: 3779843115 Enrollment ID: I20180205000873 |
| Provider Name | Daniel Robert Green |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1790929230 PECOS PAC ID: 2466673769 Enrollment ID: I20180220003084 |
| Provider Name | John A Porter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487636999 PECOS PAC ID: 5799750048 Enrollment ID: I20180501002112 |
| Provider Name | Stephanie Bank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225458961 PECOS PAC ID: 3173841533 Enrollment ID: I20180521001738 |
| Provider Name | Paul Lapenna |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952711483 PECOS PAC ID: 5092930115 Enrollment ID: I20180725000156 |
| Provider Name | John Garren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346738168 PECOS PAC ID: 1759639453 Enrollment ID: I20180810002411 |
| Provider Name | Adam R Mathes |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1497016778 PECOS PAC ID: 4587914767 Enrollment ID: I20180910001199 |
| Provider Name | Christy R Sine |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1013112614 PECOS PAC ID: 9830339001 Enrollment ID: I20180910001481 |
| Provider Name | Alexandria G Bridges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326415019 PECOS PAC ID: 6305147687 Enrollment ID: I20180910001767 |
| Provider Name | Philip Fontenot |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1790121424 PECOS PAC ID: 7810293370 Enrollment ID: I20180925002184 |
| Provider Name | Rebecca C Rinko |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528379054 PECOS PAC ID: 6709108368 Enrollment ID: I20181019001461 |
| Provider Name | Daniel Wayne Bozarth |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205891025 PECOS PAC ID: 3375571102 Enrollment ID: I20181105000754 |
| Provider Name | Aaron King |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1538454426 PECOS PAC ID: 7214230606 Enrollment ID: I20181204000137 |
| Provider Name | Celeste Marie Sitton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558845321 PECOS PAC ID: 6800130295 Enrollment ID: I20181212001970 |
| Provider Name | Lynnette K Beyerle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194206540 PECOS PAC ID: 7012252331 Enrollment ID: I20181214000580 |
| Provider Name | Jessica Gonzalez Hernandez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1962792580 PECOS PAC ID: 9133418718 Enrollment ID: I20181214000689 |
| Provider Name | Kate M Mcclellan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366927204 PECOS PAC ID: 2466798145 Enrollment ID: I20190117000903 |
| Provider Name | Kurt Alexander Yusi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1700152543 PECOS PAC ID: 8426341181 Enrollment ID: I20190205001437 |
| Provider Name | Fiesky A Nunez |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1770840928 PECOS PAC ID: 2264700798 Enrollment ID: I20190215001141 |
| Provider Name | Megan Roben Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679057772 PECOS PAC ID: 3173863339 Enrollment ID: I20190326000658 |
| Provider Name | Jessica Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992278394 PECOS PAC ID: 3678814993 Enrollment ID: I20190412001914 |
| Provider Name | Katie Elizabeth Roux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538625751 PECOS PAC ID: 9133461247 Enrollment ID: I20190419000496 |
| Provider Name | Sarah Burre Loudermilk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770049009 PECOS PAC ID: 3678814506 Enrollment ID: I20190422000510 |
| Provider Name | James Patrick Davidson |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1811224801 PECOS PAC ID: 3476817081 Enrollment ID: I20190702002607 |
| Provider Name | Jared Williams Atkinson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629424114 PECOS PAC ID: 4587955893 Enrollment ID: I20190703000287 |
| Provider Name | Kristin Kay Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396034278 PECOS PAC ID: 4789861121 Enrollment ID: I20190806000701 |
| Provider Name | Sara Pope Ruiz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578891420 PECOS PAC ID: 4981977469 Enrollment ID: I20190814003725 |
| Provider Name | Daniel Dawson Atkinson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679983811 PECOS PAC ID: 2466778931 Enrollment ID: I20190822000086 |
| Provider Name | Elias Joseph Arbid |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1578561528 PECOS PAC ID: 0042391112 Enrollment ID: I20190829003836 |
| Provider Name | Cody S Freeman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659719862 PECOS PAC ID: 5991028664 Enrollment ID: I20190910001884 |
| Provider Name | Archana Srinivas |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1063705432 PECOS PAC ID: 5496043689 Enrollment ID: I20191021001697 |
| Provider Name | Thomas Robert Dyar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679563852 PECOS PAC ID: 7214015858 Enrollment ID: I20191028001769 |
| Provider Name | Patrick J Hurley |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1417215906 PECOS PAC ID: 8527378538 Enrollment ID: I20191028002559 |
| Provider Name | Lori Michelle Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972152403 PECOS PAC ID: 0840622924 Enrollment ID: I20191111001749 |
| Provider Name | Lindsey Stevenson Coutu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720634702 PECOS PAC ID: 9335571959 Enrollment ID: I20191119002183 |
| Provider Name | Stephanie K Van Camp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467000794 PECOS PAC ID: 3476988841 Enrollment ID: I20200113000599 |
| Provider Name | Kelly Brier San Miguel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245626233 PECOS PAC ID: 3072829415 Enrollment ID: I20200115003196 |
| Provider Name | Dianne Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174906416 PECOS PAC ID: 0143537795 Enrollment ID: I20200123002572 |
| Provider Name | Jane Seabrook Lucas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043858624 PECOS PAC ID: 9537597638 Enrollment ID: I20200324003115 |
| Provider Name | Anita S Leis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457486151 PECOS PAC ID: 9234323973 Enrollment ID: I20200511001427 |
| Provider Name | Mary Batson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861014631 PECOS PAC ID: 8325460660 Enrollment ID: I20200616000115 |
| Provider Name | Noel P Curcio |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1053322172 PECOS PAC ID: 7214948199 Enrollment ID: I20200708001117 |
| Provider Name | Barbara Wall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497370589 PECOS PAC ID: 4587087580 Enrollment ID: I20200709001576 |
| Provider Name | Stacy R Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053947820 PECOS PAC ID: 2365865037 Enrollment ID: I20200714001410 |
| Provider Name | Danielle Boyce Saldana |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508244344 PECOS PAC ID: 9032424841 Enrollment ID: I20200727001753 |
| Provider Name | Michael Sims |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1508278243 PECOS PAC ID: 6507085586 Enrollment ID: I20200818000008 |
| Provider Name | Andrew Heffernan |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1851788749 PECOS PAC ID: 5799095535 Enrollment ID: I20200819001852 |
| Provider Name | Michael Courtney Windham |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861697740 PECOS PAC ID: 2668668393 Enrollment ID: I20200911000988 |
| Provider Name | Jacob Hessey |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588082176 PECOS PAC ID: 0547693699 Enrollment ID: I20200911001364 |
| Provider Name | Barry-stephen Joseph Romeo |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1801277132 PECOS PAC ID: 1355760281 Enrollment ID: I20200928000203 |
| Provider Name | Jonathan Notelle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982061701 PECOS PAC ID: 6204134166 Enrollment ID: I20200928001599 |
| Provider Name | Zachary Dowdy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1982970646 PECOS PAC ID: 1951612142 Enrollment ID: I20201002001478 |
| Provider Name | Kenneth Merck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740898337 PECOS PAC ID: 5193135440 Enrollment ID: I20201028000591 |
| Provider Name | William Lowrance |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1922155878 PECOS PAC ID: 9133391881 Enrollment ID: I20210128000359 |
| Provider Name | Stacey Wilson Sharp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609498849 PECOS PAC ID: 9931514528 Enrollment ID: I20210211002672 |
| Provider Name | Peter Rattner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710203765 PECOS PAC ID: 4486887007 Enrollment ID: I20210309000572 |
| Provider Name | Jami Trenor |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013320761 PECOS PAC ID: 1355750068 Enrollment ID: I20210511000198 |
| Provider Name | Megan Friend |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1447541719 PECOS PAC ID: 1254624570 Enrollment ID: I20210517000445 |
| Provider Name | Jennifer Province |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003437617 PECOS PAC ID: 6901226091 Enrollment ID: I20210622000450 |
| Provider Name | Lisa Renfrow-betker |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1235129123 PECOS PAC ID: 9830145598 Enrollment ID: I20210716002365 |
| Provider Name | Abigael Lynn Dishler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952834491 PECOS PAC ID: 9335415199 Enrollment ID: I20210719000016 |
| Provider Name | Heather P Hoy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730613639 PECOS PAC ID: 4385911478 Enrollment ID: I20210810002606 |
| Provider Name | Alan William Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912040072 PECOS PAC ID: 1658776521 Enrollment ID: I20210817000243 |
| Provider Name | Laura Elaine Anastasia Cook |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699298067 PECOS PAC ID: 1456772904 Enrollment ID: I20210826000146 |
| Provider Name | Andrew G De Nazareth |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861690802 PECOS PAC ID: 3577708635 Enrollment ID: I20210907000137 |
| Provider Name | Amanda Leigh Ridenhour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558540518 PECOS PAC ID: 7618930512 Enrollment ID: I20210909000389 |
| Provider Name | Krystal Nicole Yankowski |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1760916621 PECOS PAC ID: 3870991946 Enrollment ID: I20211006001074 |
| Provider Name | Lee Blackmon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417489774 PECOS PAC ID: 8123392339 Enrollment ID: I20211007000768 |
| Provider Name | Rhody F. Fawaz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1902891625 PECOS PAC ID: 8426190471 Enrollment ID: I20211122002603 |
| Provider Name | Travis Gawler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1780355958 PECOS PAC ID: 3577952035 Enrollment ID: I20211123000465 |
| Provider Name | Dana N Hodges |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1114256971 PECOS PAC ID: 9436549961 Enrollment ID: I20211124000405 |
| Provider Name | Taylor Miller |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265030266 PECOS PAC ID: 3678963097 Enrollment ID: I20211129001911 |
| Provider Name | Colleen Joy Reinovsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477158764 PECOS PAC ID: 6002207149 Enrollment ID: I20211227001097 |
| Provider Name | Diane J Barus |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1851053516 PECOS PAC ID: 8921499872 Enrollment ID: I20220103001176 |
| Provider Name | Tam T Huynh |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1235177098 PECOS PAC ID: 7517971989 Enrollment ID: I20220224000306 |
| Provider Name | Carrie Lichtenstein |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1508248139 PECOS PAC ID: 6406131234 Enrollment ID: I20220307001809 |
| Provider Name | James Eugene Fogartie |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1053359836 PECOS PAC ID: 9234027558 Enrollment ID: I20220314000560 |
| Provider Name | Karin Leanne Small |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659395267 PECOS PAC ID: 7618974189 Enrollment ID: I20220318002263 |
| Provider Name | Justin Claude Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164180535 PECOS PAC ID: 9032504295 Enrollment ID: I20220324002759 |
| Provider Name | Michael Castelvecchi |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467112763 PECOS PAC ID: 2961898994 Enrollment ID: I20220331000557 |
| Provider Name | Richard Cochran |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1013996586 PECOS PAC ID: 8921042870 Enrollment ID: I20220606000757 |
| Provider Name | Zeeshan Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962780536 PECOS PAC ID: 2163730193 Enrollment ID: I20220802000932 |
| Provider Name | Elise W Adams |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1366180093 PECOS PAC ID: 3971985383 Enrollment ID: I20220802001797 |
| Provider Name | Furkan Ubeydullah Ertem |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1487018065 PECOS PAC ID: 5597051847 Enrollment ID: I20220809002711 |
| Provider Name | Joshua Yokel |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1578030623 PECOS PAC ID: 1456788389 Enrollment ID: I20220810000064 |
| Provider Name | Wendy E Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164454328 PECOS PAC ID: 9537162649 Enrollment ID: I20220818001754 |
| Provider Name | Richard Carter |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982813283 PECOS PAC ID: 3779723036 Enrollment ID: I20220823000525 |
| Provider Name | Amy Marie Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942822010 PECOS PAC ID: 5395120786 Enrollment ID: I20220921002533 |
| Provider Name | Andrew Roudebush |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376540559 PECOS PAC ID: 7517967847 Enrollment ID: I20220921003795 |
| Provider Name | Jeffrey Thomas Johnston |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1679969729 PECOS PAC ID: 2860877172 Enrollment ID: I20220921003808 |
| Provider Name | Andrea Jean Burch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235725961 PECOS PAC ID: 9739555830 Enrollment ID: I20221014000168 |
| Provider Name | Matthew Graham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043287220 PECOS PAC ID: 3476448606 Enrollment ID: I20221025000551 |
| Provider Name | Jessica Volfson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841925229 PECOS PAC ID: 0446627889 Enrollment ID: I20221027002758 |
| Provider Name | Jason Cundiff |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497926323 PECOS PAC ID: 6608930656 Enrollment ID: I20221110003181 |
| Provider Name | Katherine Crow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518688621 PECOS PAC ID: 0749659852 Enrollment ID: I20221213000798 |
| Provider Name | Justin Plant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740633056 PECOS PAC ID: 9931451846 Enrollment ID: I20230125003412 |
| Provider Name | Lawanda Little |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023570181 PECOS PAC ID: 5496129207 Enrollment ID: I20230317001650 |
| Provider Name | Meghan Pillow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003487737 PECOS PAC ID: 6204200678 Enrollment ID: I20230327000598 |
| Provider Name | Felicia Humphrey |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1144511833 PECOS PAC ID: 6709005960 Enrollment ID: I20230419002742 |
| Provider Name | Angela Stout Threeths |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164965430 PECOS PAC ID: 0547547614 Enrollment ID: I20230425000925 |
| Provider Name | Laroysha Shawntae Ulmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598430647 PECOS PAC ID: 5799140810 Enrollment ID: I20230425001531 |
| Provider Name | Chelsea O'brien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245942002 PECOS PAC ID: 0345605408 Enrollment ID: I20230425002906 |
| Provider Name | Anna Chappell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366170292 PECOS PAC ID: 9335504315 Enrollment ID: I20230426001204 |
| Provider Name | Faith D Daggs |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821082280 PECOS PAC ID: 8921912049 Enrollment ID: I20230505000804 |
| Provider Name | Rebecca Holt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619696994 PECOS PAC ID: 2163889577 Enrollment ID: I20230530002955 |
| Provider Name | Laura Marcela Alonso-price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013626852 PECOS PAC ID: 6002273265 Enrollment ID: I20230601003077 |
| Provider Name | Benjamin Zwain |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306307103 PECOS PAC ID: 1658732540 Enrollment ID: I20230725000911 |
| Provider Name | Jonathan Hanson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689101511 PECOS PAC ID: 2365718822 Enrollment ID: I20230816003552 |
| Provider Name | Dylan Solise |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376994210 PECOS PAC ID: 6204121254 Enrollment ID: I20230905001075 |
| Provider Name | Dmitri Kovalev |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730675117 PECOS PAC ID: 2567825847 Enrollment ID: I20230905001318 |
| Provider Name | Caroline Merritt Gillespie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629796156 PECOS PAC ID: 4183088321 Enrollment ID: I20230906004388 |
| Provider Name | Lindsay Gregory Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174232946 PECOS PAC ID: 9638533540 Enrollment ID: I20230911004285 |
| Provider Name | Amber Mitchell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275767675 PECOS PAC ID: 4587883251 Enrollment ID: I20230927000625 |
| Provider Name | James Whaley |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1952831927 PECOS PAC ID: 0840560272 Enrollment ID: I20230928003802 |
| Provider Name | Jerec Warren Ricci |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619324902 PECOS PAC ID: 0042598997 Enrollment ID: I20231009001274 |
| Provider Name | Portia Schmidt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821442385 PECOS PAC ID: 5799075016 Enrollment ID: I20231127002160 |
| Provider Name | Luis Dibos |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1679577639 PECOS PAC ID: 7618032269 Enrollment ID: I20231205000357 |
| Provider Name | Andrea Maria Soliman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508358789 PECOS PAC ID: 2365797081 Enrollment ID: I20231215001594 |
| Provider Name | Srinivasa Sridhar |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1134112592 PECOS PAC ID: 6406048354 Enrollment ID: I20231222000260 |
| Provider Name | James M Sanders |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235398231 PECOS PAC ID: 7315117199 Enrollment ID: I20231227000286 |
| Provider Name | Ross Sage |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1417253428 PECOS PAC ID: 1658503412 Enrollment ID: I20240209002642 |
| Provider Name | Alexandra Muranova |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083276323 PECOS PAC ID: 6709113129 Enrollment ID: I20240314001033 |
| Provider Name | Brian Berberian |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861422586 PECOS PAC ID: 4486686490 Enrollment ID: I20240325000975 |
| Provider Name | Tagore Sunkara |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1306158134 PECOS PAC ID: 8729202734 Enrollment ID: I20240409000324 |
| Provider Name | John Pinski |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1073962122 PECOS PAC ID: 8325331721 Enrollment ID: I20240416000198 |
| Provider Name | Jordan Rene Coe |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700640067 PECOS PAC ID: 8628417839 Enrollment ID: I20240422001141 |
| Provider Name | Gina Carmen-feliz Masters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699814137 PECOS PAC ID: 7416398797 Enrollment ID: I20240517000797 |
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