| Broadlawns Medical Center | |
|
1801 Hickman Rd Des Moines IA 50314-1505 | |
| (515) 282-2200 | |
| (515) 282-7823 |
| Full Name | Broadlawns Medical Center |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 1801 Hickman Rd, Des Moines, Iowa |
| Authorized Official Name and Position | Vincent J Mandracchia (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 5152822562 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Broadlawns Medical Center 1801 Hickman Rd Des Moines IA 50314-1505 Ph: (515) 282-2200 | Broadlawns Medical Center 1801 Hickman Rd Des Moines IA 50314-1505 Ph: (515) 282-2200 |
| NPI Number | 1467447508 |
|---|---|
| Provider Enumeration Date | 09/14/2005 |
| Last Update Date | 05/13/2015 |
| Medicare PECOS PAC ID | 3678466166 |
|---|---|
| Medicare Enrollment ID | O20040206000913 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467447508 | NPI | - | NPPES |
| 0236471 | Medicaid | IA | |
| 28545 | Other | IA | WELLMARK PROF CLINIC |
| 6S101 | Other | IA | WELLMARK INST PSYCH |
| 0265959 | Medicaid | IA | |
| 100020 | Other | IA | AMERICAN PYSCH SYSTMES |
| 60101 | Other | IA | WELLMARK INSTITUTIONAL |
| 0432567 | Medicaid | IA | |
| 26595 | Other | IA | WELLMARK PROF ED |
| 29705 | Other | IA | CONVENTRY HEALTHCARE |
| 0601013 | Medicaid | IA | |
| 132198 | Other | IA | VALUE OPTIONS |
| 20023 | Other | IA | TRICARE |
| 2601013 | Other | IA | HOSPITAL IOWA CARE NUMBER |
| 6230290 | Other | IA | AETNA |
| 0427476 | Medicaid | IA | |
| A5031401 | Other | IA | JOHN DEERE, UHC RIVER VAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 770032H (Iowa) | Secondary |
| 282N00000X | General Acute Care Hospital | 770032H (Iowa) | Primary |
| Provider Name | Michael M Mccubbin |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1790708451 PECOS PAC ID: 9436053485 Enrollment ID: I20031125000412 |
| Provider Name | Gregory C Mckernan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558341628 PECOS PAC ID: 8628973906 Enrollment ID: I20031201000143 |
| Provider Name | Martin E Vanzee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568535607 PECOS PAC ID: 0042116535 Enrollment ID: I20031208000202 |
| Provider Name | Sameer A Yaseen |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1063415164 PECOS PAC ID: 4385540731 Enrollment ID: I20031208001004 |
| Provider Name | Ryan Bakke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225030406 PECOS PAC ID: 7315832003 Enrollment ID: I20040220000516 |
| Provider Name | Jason D Stecker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255376331 PECOS PAC ID: 6901792324 Enrollment ID: I20040224000321 |
| Provider Name | Thomas E Benzoni |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245231448 PECOS PAC ID: 0648167924 Enrollment ID: I20040302000309 |
| Provider Name | Michael J Foggia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417972084 PECOS PAC ID: 6608766522 Enrollment ID: I20040316000869 |
| Provider Name | William L Ingram |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013996636 PECOS PAC ID: 2567454549 Enrollment ID: I20040331000629 |
| Provider Name | Monique P Root |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184623860 PECOS PAC ID: 4082608104 Enrollment ID: I20040412001598 |
| Provider Name | Nicholas Joseph Galioto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417942673 PECOS PAC ID: 5294721569 Enrollment ID: I20040422000360 |
| Provider Name | Larry A Severidt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902891021 PECOS PAC ID: 9931195260 Enrollment ID: I20040422000753 |
| Provider Name | John Michael Tentinger |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801881933 PECOS PAC ID: 1052307204 Enrollment ID: I20040422001013 |
| Provider Name | Randy N Maigaard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558356642 PECOS PAC ID: 7911993811 Enrollment ID: I20040426000001 |
| Provider Name | David S Kermode |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255303400 PECOS PAC ID: 4981691458 Enrollment ID: I20040427001049 |
| Provider Name | Manmohan Singh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205821337 PECOS PAC ID: 5294722682 Enrollment ID: I20040428000249 |
| Provider Name | Vincent J Mandracchia |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1174518260 PECOS PAC ID: 5991792277 Enrollment ID: I20040428001037 |
| Provider Name | Michael C Fraizer |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1780666826 PECOS PAC ID: 2769470624 Enrollment ID: I20040501000112 |
| Provider Name | Mark M Belz |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1427012061 PECOS PAC ID: 8426046160 Enrollment ID: I20040503001016 |
| Provider Name | Abdul Chughtai |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1619959855 PECOS PAC ID: 4981692639 Enrollment ID: I20040503001093 |
| Provider Name | Holly B Healey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780679951 PECOS PAC ID: 9436147014 Enrollment ID: I20040503001342 |
| Provider Name | Timothy P Olson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457330474 PECOS PAC ID: 5092704080 Enrollment ID: I20040506000721 |
| Provider Name | Mark Berry |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1336121938 PECOS PAC ID: 9739179623 Enrollment ID: I20040513000674 |
| Provider Name | Matthew R Brown |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1841283496 PECOS PAC ID: 1951391861 Enrollment ID: I20040513000878 |
| Provider Name | Hayley L Harvey |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1811982077 PECOS PAC ID: 5799775573 Enrollment ID: I20040513001354 |
| Provider Name | Sanjiv K Dahal |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1376506121 PECOS PAC ID: 3870583479 Enrollment ID: I20040515000185 |
| Provider Name | Craig Alan Shadur |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1851354674 PECOS PAC ID: 7810806791 Enrollment ID: I20040515000261 |
| Provider Name | Robert D Conner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447363700 PECOS PAC ID: 2769472224 Enrollment ID: I20040517000130 |
| Provider Name | Katherine M Fanter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1629060546 PECOS PAC ID: 4082605589 Enrollment ID: I20040522000322 |
| Provider Name | Eugene J Cherny |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1376679357 PECOS PAC ID: 0244222529 Enrollment ID: I20040528000843 |
| Provider Name | Kathleen S Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073500690 PECOS PAC ID: 4082695598 Enrollment ID: I20040602001598 |
| Provider Name | Larry K Lindell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871588061 PECOS PAC ID: 8224010889 Enrollment ID: I20040607000501 |
| Provider Name | Neeraja Kakade |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659443547 PECOS PAC ID: 4284618133 Enrollment ID: I20040617000145 |
| Provider Name | Tracy A Dickel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780677161 PECOS PAC ID: 1355326802 Enrollment ID: I20040621000479 |
| Provider Name | Jerry Arthur Hancock |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679512818 PECOS PAC ID: 8426035148 Enrollment ID: I20040701000293 |
| Provider Name | Lawrence J Rissman |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1891780904 PECOS PAC ID: 2365420429 Enrollment ID: I20040713001515 |
| Provider Name | Mindy K Gingery |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124026042 PECOS PAC ID: 9931188042 Enrollment ID: I20040714000275 |
| Provider Name | Sue Ann Gingerich |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699779546 PECOS PAC ID: 4284611872 Enrollment ID: I20040715000356 |
| Provider Name | Barbara M Arends |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144216177 PECOS PAC ID: 9032198692 Enrollment ID: I20040716000624 |
| Provider Name | Jennifer L Foster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083600902 PECOS PAC ID: 7911986351 Enrollment ID: I20040719000435 |
| Provider Name | Alan D Hilgerson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255326427 PECOS PAC ID: 9931189602 Enrollment ID: I20040722001147 |
| Provider Name | Paul W Baumert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063408326 PECOS PAC ID: 7113997479 Enrollment ID: I20040727000001 |
| Provider Name | Ernest Manuel Perea |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033171004 PECOS PAC ID: 7416928932 Enrollment ID: I20040805001165 |
| Provider Name | Todd E Schissel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1790758753 PECOS PAC ID: 3971575770 Enrollment ID: I20040811001111 |
| Provider Name | Chad J Torstenson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871688630 PECOS PAC ID: 9931182532 Enrollment ID: I20041112001187 |
| Provider Name | Shawn R Johnson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881689636 PECOS PAC ID: 5799742714 Enrollment ID: I20041210000978 |
| Provider Name | Ronald Mchose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689645368 PECOS PAC ID: 4688632805 Enrollment ID: I20041220001011 |
| Provider Name | Stephen M Quinlan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1588626212 PECOS PAC ID: 7315995586 Enrollment ID: I20050105000391 |
| Provider Name | Mark W Purtle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356315477 PECOS PAC ID: 1951353838 Enrollment ID: I20050218000615 |
| Provider Name | Nicole L Roetman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679560296 PECOS PAC ID: 2961469903 Enrollment ID: I20050222000593 |
| Provider Name | Charles V Wadle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699794941 PECOS PAC ID: 7719971613 Enrollment ID: I20050312000059 |
| Provider Name | Avina Kolareth |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1578676532 PECOS PAC ID: 4688615933 Enrollment ID: I20050517000379 |
| Provider Name | Brahmananda P Makkapati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033157557 PECOS PAC ID: 5496797508 Enrollment ID: I20050531000421 |
| Provider Name | James Francis Lawler |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1922087329 PECOS PAC ID: 4789655242 Enrollment ID: I20050720001163 |
| Provider Name | Jeffrey M Hartung |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902884976 PECOS PAC ID: 8022047067 Enrollment ID: I20050810000061 |
| Provider Name | Anna G Sagebiel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841279502 PECOS PAC ID: 3678502622 Enrollment ID: I20050810000146 |
| Provider Name | Ellie L Bishop |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629057377 PECOS PAC ID: 9830128891 Enrollment ID: I20050810000173 |
| Provider Name | Theron Jameson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1932101466 PECOS PAC ID: 8729017819 Enrollment ID: I20050811000609 |
| Provider Name | Robert L Bender |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1740254218 PECOS PAC ID: 0244262566 Enrollment ID: I20050908000103 |
| Provider Name | William J Wickemeyer |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1184606915 PECOS PAC ID: 8921916107 Enrollment ID: I20050926001290 |
| Provider Name | Gautam Kakade |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992777049 PECOS PAC ID: 7113952847 Enrollment ID: I20051001000035 |
| Provider Name | Bernie J Saks |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255301313 PECOS PAC ID: 3274560065 Enrollment ID: I20051011001168 |
| Provider Name | Jason B Wittmer |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1487630489 PECOS PAC ID: 7517982176 Enrollment ID: I20051012000798 |
| Provider Name | Bryan L Folkers |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1952327728 PECOS PAC ID: 7012933112 Enrollment ID: I20051018000911 |
| Provider Name | Joan M Millea |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1659368272 PECOS PAC ID: 2668499690 Enrollment ID: I20051028000964 |
| Provider Name | Ernesto Vazquez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588645899 PECOS PAC ID: 1052364478 Enrollment ID: I20060202000534 |
| Provider Name | Robert S Rossi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1518918317 PECOS PAC ID: 0840244430 Enrollment ID: I20060313000255 |
| Provider Name | Lizabeth M Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578548293 PECOS PAC ID: 9830107150 Enrollment ID: I20060329000096 |
| Provider Name | William J Yost |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841277910 PECOS PAC ID: 0840209383 Enrollment ID: I20060412000115 |
| Provider Name | Yulia Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437182706 PECOS PAC ID: 7012913528 Enrollment ID: I20061005000498 |
| Provider Name | Benjy Olsen |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1205889417 PECOS PAC ID: 5496759995 Enrollment ID: I20061009000072 |
| Provider Name | Allan P Latcham |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1932194040 PECOS PAC ID: 5496755183 Enrollment ID: I20070103000077 |
| Provider Name | Erik A Pedersen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073558268 PECOS PAC ID: 4981673191 Enrollment ID: I20070117000144 |
| Provider Name | Bettina J Keppy |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699889345 PECOS PAC ID: 7618979261 Enrollment ID: I20070209000525 |
| Provider Name | Wendy M Hansen-penman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801998372 PECOS PAC ID: 0143322073 Enrollment ID: I20070223000560 |
| Provider Name | Matthew W Andres |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1891720678 PECOS PAC ID: 4981706769 Enrollment ID: I20070226000216 |
| Provider Name | Kathleen K Hansen |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1679684922 PECOS PAC ID: 2264535269 Enrollment ID: I20070313000079 |
| Provider Name | Matthew R Spitzenberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902912520 PECOS PAC ID: 7416050414 Enrollment ID: I20070313000109 |
| Provider Name | Daniel J Miller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447273743 PECOS PAC ID: 0244333045 Enrollment ID: I20070315000496 |
| Provider Name | Michael M Baldwin |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1508974684 PECOS PAC ID: 5597869032 Enrollment ID: I20070322000535 |
| Provider Name | Larry J Heller |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1356432421 PECOS PAC ID: 1850294927 Enrollment ID: I20070322000576 |
| Provider Name | Renee R Ellerbroek |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1962510099 PECOS PAC ID: 3779687710 Enrollment ID: I20070330000157 |
| Provider Name | Larry W Anderson |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1891803979 PECOS PAC ID: 3173627023 Enrollment ID: I20070402000546 |
| Provider Name | Becky J Davis-kramer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629066287 PECOS PAC ID: 0244335651 Enrollment ID: I20070413000150 |
| Provider Name | Robert M Nathanson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740268911 PECOS PAC ID: 8224134382 Enrollment ID: I20070507000186 |
| Provider Name | Wendy A Zadeh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194703074 PECOS PAC ID: 7517065667 Enrollment ID: I20070613000354 |
| Provider Name | James Bradley Poole |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184683161 PECOS PAC ID: 9931165404 Enrollment ID: I20070614000323 |
| Provider Name | Carla Louise Aldrich |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1659589828 PECOS PAC ID: 5092816926 Enrollment ID: I20070723000525 |
| Provider Name | Stephanie L Courson Pothoven |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1033230560 PECOS PAC ID: 8224139803 Enrollment ID: I20070726000449 |
| Provider Name | Mark A Kellerman |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1891780995 PECOS PAC ID: 7517068851 Enrollment ID: I20070731000134 |
| Provider Name | Ketan Arvind Dhadphale |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851400121 PECOS PAC ID: 6507967874 Enrollment ID: I20070731000305 |
| Provider Name | John C Bardole |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1841283447 PECOS PAC ID: 5193826469 Enrollment ID: I20070731000339 |
| Provider Name | Mary L Lamar |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134326952 PECOS PAC ID: 7012008022 Enrollment ID: I20070806000508 |
| Provider Name | Francesca Turner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801805304 PECOS PAC ID: 9133127798 Enrollment ID: I20070808000486 |
| Provider Name | Bruce Baron |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801965280 PECOS PAC ID: 7810919834 Enrollment ID: I20070808000498 |
| Provider Name | Christopher S Martin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1568665529 PECOS PAC ID: 5890887731 Enrollment ID: I20070822001411 |
| Provider Name | Udaya M Kabadi |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1770567786 PECOS PAC ID: 3577656032 Enrollment ID: I20070829000867 |
| Provider Name | Jared J Abbott |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1073598512 PECOS PAC ID: 6507837150 Enrollment ID: I20070904000534 |
| Provider Name | Kelly B Kinney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114007283 PECOS PAC ID: 7810081106 Enrollment ID: I20070918000037 |
| Provider Name | Melvin T Bobo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063617355 PECOS PAC ID: 9537253828 Enrollment ID: I20070918000048 |
| Provider Name | Christina Goebel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760469589 PECOS PAC ID: 6305830043 Enrollment ID: I20070924000730 |
| Provider Name | Patricia J Hayes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114007341 PECOS PAC ID: 3870688500 Enrollment ID: I20070926000894 |
| Provider Name | Drew Dennison Lewis |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1225019110 PECOS PAC ID: 3072608363 Enrollment ID: I20071002000185 |
| Provider Name | Enrico L Martin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1942229562 PECOS PAC ID: 7214999051 Enrollment ID: I20071108000215 |
| Provider Name | Thomas M Wernimont |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003030628 PECOS PAC ID: 3072601962 Enrollment ID: I20071109000329 |
| Provider Name | Lance M Vangundy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942290028 PECOS PAC ID: 9032208277 Enrollment ID: I20071211000330 |
| Provider Name | Daniel S Wientzen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952417248 PECOS PAC ID: 7517041981 Enrollment ID: I20080222000585 |
| Provider Name | Tami D Denotter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891976338 PECOS PAC ID: 4486725736 Enrollment ID: I20080614000102 |
| Provider Name | Kyle A Krehbiel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487617403 PECOS PAC ID: 2567411747 Enrollment ID: I20080618000066 |
| Provider Name | Dean C Gute |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225144975 PECOS PAC ID: 1759452493 Enrollment ID: I20080624000258 |
| Provider Name | David S Sosnouski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114009743 PECOS PAC ID: 5092887844 Enrollment ID: I20080710000527 |
| Provider Name | Douglas R Lake |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194808394 PECOS PAC ID: 1456457407 Enrollment ID: I20080726000071 |
| Provider Name | Timothy A Gerdis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679679831 PECOS PAC ID: 8022184431 Enrollment ID: I20080909000601 |
| Provider Name | Susan K Latcham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437306818 PECOS PAC ID: 8921017518 Enrollment ID: I20080910000238 |
| Provider Name | Aneesa Afroze |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1457378242 PECOS PAC ID: 1254412414 Enrollment ID: I20080915000172 |
| Provider Name | Joshwa Leon Tromblee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154529535 PECOS PAC ID: 7517034184 Enrollment ID: I20080923000735 |
| Provider Name | Kay A Frye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487631388 PECOS PAC ID: 2163599549 Enrollment ID: I20080926000441 |
| Provider Name | Deanna B Boesen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104034552 PECOS PAC ID: 5991872160 Enrollment ID: I20080930000585 |
| Provider Name | Gardar Sigurdsson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1043310881 PECOS PAC ID: 2961570882 Enrollment ID: I20081006000374 |
| Provider Name | Aaron S Hahn |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1003064643 PECOS PAC ID: 5294803011 Enrollment ID: I20081007000494 |
| Provider Name | Carolyn S Pease |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1073705760 PECOS PAC ID: 9133297864 Enrollment ID: I20081008000605 |
| Provider Name | Melissa A Rademacher |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407856651 PECOS PAC ID: 7719979772 Enrollment ID: I20081023000759 |
| Provider Name | Kathleen M Laurin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689650657 PECOS PAC ID: 1850459496 Enrollment ID: I20081025000069 |
| Provider Name | Dawn Marie O'regan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255397865 PECOS PAC ID: 7214097039 Enrollment ID: I20081124000098 |
| Provider Name | Richard H Marcus |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023090057 PECOS PAC ID: 6800957895 Enrollment ID: I20081209000670 |
| Provider Name | Leah A Bethel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710183637 PECOS PAC ID: 9830250596 Enrollment ID: I20081212000627 |
| Provider Name | Shakuntala V Advani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861473316 PECOS PAC ID: 4082778006 Enrollment ID: I20090205000269 |
| Provider Name | Shannon M Remington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720202732 PECOS PAC ID: 6002807914 Enrollment ID: I20090205000690 |
| Provider Name | Yogesh A Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265510465 PECOS PAC ID: 0547325961 Enrollment ID: I20090219000293 |
| Provider Name | Robert R Powell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558506402 PECOS PAC ID: 1759447592 Enrollment ID: I20090304000084 |
| Provider Name | Ruby C Cureg |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225147333 PECOS PAC ID: 0244397396 Enrollment ID: I20090318000022 |
| Provider Name | Mark D Mcgaughey |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1083696744 PECOS PAC ID: 5597812891 Enrollment ID: I20090402000090 |
| Provider Name | Joseph E Nobis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336178334 PECOS PAC ID: 2365531704 Enrollment ID: I20090408000532 |
| Provider Name | Tamara S Chance |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427051135 PECOS PAC ID: 6406898980 Enrollment ID: I20090529000481 |
| Provider Name | Philip Bear |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1821070400 PECOS PAC ID: 6608959093 Enrollment ID: I20090602000373 |
| Provider Name | Douglas R Pick |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1215066741 PECOS PAC ID: 8022169242 Enrollment ID: I20090630000212 |
| Provider Name | Sara L Hawk |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1659536613 PECOS PAC ID: 6406907336 Enrollment ID: I20090706000320 |
| Provider Name | Brian L Gallagher |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1336358324 PECOS PAC ID: 4789736695 Enrollment ID: I20090723000106 |
| Provider Name | Ryan T Schulte |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1669598942 PECOS PAC ID: 0446304737 Enrollment ID: I20090820000874 |
| Provider Name | Christos M Kassiotis |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1760623144 PECOS PAC ID: 1254486483 Enrollment ID: I20090911000169 |
| Provider Name | Mica M Murdoch |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1962639906 PECOS PAC ID: 6406902295 Enrollment ID: I20090921000109 |
| Provider Name | Randy L Anderson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912115288 PECOS PAC ID: 4082760624 Enrollment ID: I20090923000055 |
| Provider Name | Marnix A Verhofste |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1821070657 PECOS PAC ID: 2062558232 Enrollment ID: I20091002000020 |
| Provider Name | William J Waldron |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073500633 PECOS PAC ID: 3870536956 Enrollment ID: I20091005000067 |
| Provider Name | Randolph R Rough |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1376525196 PECOS PAC ID: 1850437849 Enrollment ID: I20091005000718 |
| Provider Name | Joel From |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568444248 PECOS PAC ID: 2062558976 Enrollment ID: I20091007000356 |
| Provider Name | Mark S Bissing |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1881676120 PECOS PAC ID: 2264578186 Enrollment ID: I20091007000429 |
| Provider Name | Margaret H Verhey |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1578545307 PECOS PAC ID: 1557407350 Enrollment ID: I20091008000357 |
| Provider Name | Mark A Tannenbaum |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1033191861 PECOS PAC ID: 9537205331 Enrollment ID: I20091008000373 |
| Provider Name | Thomas S Hopkins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922144088 PECOS PAC ID: 9436297983 Enrollment ID: I20091104000060 |
| Provider Name | Chance M Coppola |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437144680 PECOS PAC ID: 4284772765 Enrollment ID: I20091104000334 |
| Provider Name | Christopher R Matson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538368170 PECOS PAC ID: 3173663945 Enrollment ID: I20091230000033 |
| Provider Name | William A Fellows |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972590370 PECOS PAC ID: 3870634777 Enrollment ID: I20100113000641 |
| Provider Name | Adnan Iqbal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376652206 PECOS PAC ID: 5890837611 Enrollment ID: I20100116000150 |
| Provider Name | Jeffrey R Brady |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467465716 PECOS PAC ID: 3577605286 Enrollment ID: I20100119000327 |
| Provider Name | Ryan P Coppola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528053345 PECOS PAC ID: 3375685993 Enrollment ID: I20100120000608 |
| Provider Name | Richard L Glowacki |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1679567663 PECOS PAC ID: 7214079573 Enrollment ID: I20100125000471 |
| Provider Name | Ravi K Vemuri |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1154307536 PECOS PAC ID: 0345250999 Enrollment ID: I20100129000201 |
| Provider Name | Kristi Blomberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750392809 PECOS PAC ID: 0244373074 Enrollment ID: I20100202000763 |
| Provider Name | Lisa A Klock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891707832 PECOS PAC ID: 9234272071 Enrollment ID: I20100202000777 |
| Provider Name | Curtis L Hoegh |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609854413 PECOS PAC ID: 7911040514 Enrollment ID: I20100204000472 |
| Provider Name | Suhas D Bhat |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1952512014 PECOS PAC ID: 5092842237 Enrollment ID: I20100421000020 |
| Provider Name | Sreedhar Somisetty |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1184697385 PECOS PAC ID: 8729116637 Enrollment ID: I20100514000036 |
| Provider Name | Ramona A Thompson |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1043363070 PECOS PAC ID: 1850429556 Enrollment ID: I20100517000180 |
| Provider Name | Carole Ann Frier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730151374 PECOS PAC ID: 1658263165 Enrollment ID: I20100517000460 |
| Provider Name | Robert R Shreck |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1588628101 PECOS PAC ID: 7214011683 Enrollment ID: I20100518000821 |
| Provider Name | Bradley S Lair |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1174584072 PECOS PAC ID: 6305920778 Enrollment ID: I20100608000720 |
| Provider Name | Thomas R Buroker |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1982665337 PECOS PAC ID: 8426941048 Enrollment ID: I20100624000394 |
| Provider Name | Megan Nicole Depoorter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497919468 PECOS PAC ID: 1951433945 Enrollment ID: I20100708001074 |
| Provider Name | James M Cummings |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134114952 PECOS PAC ID: 6002949617 Enrollment ID: I20100803001064 |
| Provider Name | Kaaren R Olesen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1013983881 PECOS PAC ID: 9830235183 Enrollment ID: I20100810000926 |
| Provider Name | Mark L Hilliard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336147339 PECOS PAC ID: 4183758006 Enrollment ID: I20100813001010 |
| Provider Name | Jason Thomas Dewilde |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982696043 PECOS PAC ID: 6608900527 Enrollment ID: I20100813001043 |
| Provider Name | Christopher F Blodi |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1689642290 PECOS PAC ID: 9032241724 Enrollment ID: I20100817000168 |
| Provider Name | Adam M Bell |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1144430117 PECOS PAC ID: 7618001165 Enrollment ID: I20100819000044 |
| Provider Name | Celeste E P Miller |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1255306932 PECOS PAC ID: 6305960071 Enrollment ID: I20100901000854 |
| Provider Name | Ivan R Delgado Ramos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982675559 PECOS PAC ID: 9739203340 Enrollment ID: I20100903000462 |
| Provider Name | Clinton D Crowder |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1457404477 PECOS PAC ID: 2860564820 Enrollment ID: I20100903000517 |
| Provider Name | John A Haggstrom |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710923826 PECOS PAC ID: 9638265713 Enrollment ID: I20100921000862 |
| Provider Name | Amy Bingaman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750359147 PECOS PAC ID: 2365568656 Enrollment ID: I20100923000992 |
| Provider Name | Donald H Junge |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255326435 PECOS PAC ID: 2860686763 Enrollment ID: I20101104001104 |
| Provider Name | Mathew W Severidt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215191523 PECOS PAC ID: 6204021041 Enrollment ID: I20101105001297 |
| Provider Name | Emily Catherine Haines |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215198932 PECOS PAC ID: 7214123983 Enrollment ID: I20101119000609 |
| Provider Name | Douglas Lee Hanson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235124074 PECOS PAC ID: 8921296583 Enrollment ID: I20101223000143 |
| Provider Name | Joyce A Mischel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962706168 PECOS PAC ID: 9739368010 Enrollment ID: I20110119001232 |
| Provider Name | Kelly M Stewart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316189806 PECOS PAC ID: 0446430680 Enrollment ID: I20110205000073 |
| Provider Name | Benjamin W Ross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013177484 PECOS PAC ID: 5698955136 Enrollment ID: I20110215001015 |
| Provider Name | Edward G Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023244076 PECOS PAC ID: 4082899430 Enrollment ID: I20110428000133 |
| Provider Name | Aaron M From |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1255319596 PECOS PAC ID: 2062443369 Enrollment ID: I20110622000736 |
| Provider Name | Jacob E Sramek |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1255657680 PECOS PAC ID: 6103004163 Enrollment ID: I20110623000043 |
| Provider Name | Matthew P Mccormick |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1922121953 PECOS PAC ID: 3779761150 Enrollment ID: I20110707000509 |
| Provider Name | Grant T Goldsberry |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235228685 PECOS PAC ID: 9032398730 Enrollment ID: I20110712000217 |
| Provider Name | Kanwaljit Kaur Chouhan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1033384086 PECOS PAC ID: 0143498469 Enrollment ID: I20110712000497 |
| Provider Name | Sandra Scholten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790937308 PECOS PAC ID: 4880755784 Enrollment ID: I20110817000844 |
| Provider Name | Jennie P Shipley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780865394 PECOS PAC ID: 4587834957 Enrollment ID: I20110823000769 |
| Provider Name | Jesse D Westrum |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1093001091 PECOS PAC ID: 9133391261 Enrollment ID: I20111013000161 |
| Provider Name | Rebecca R Bollin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972758126 PECOS PAC ID: 1456525393 Enrollment ID: I20111110000834 |
| Provider Name | Timothy P Mayfield |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811094089 PECOS PAC ID: 5597880658 Enrollment ID: I20111121000102 |
| Provider Name | Julie A Schuck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134402373 PECOS PAC ID: 3375717440 Enrollment ID: I20111130000061 |
| Provider Name | Dana E Rich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336424795 PECOS PAC ID: 6608041678 Enrollment ID: I20111202000759 |
| Provider Name | Stephen Ambrose Barnes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609197573 PECOS PAC ID: 1850566092 Enrollment ID: I20111216000067 |
| Provider Name | Ronnie Hawkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558353474 PECOS PAC ID: 5597757484 Enrollment ID: I20111227000402 |
| Provider Name | Lorie Montag |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1114953205 PECOS PAC ID: 6204885262 Enrollment ID: I20120116000122 |
| Provider Name | Elizabeth N Cain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326327438 PECOS PAC ID: 9830366137 Enrollment ID: I20120126000473 |
| Provider Name | Sara Lockner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215213707 PECOS PAC ID: 6507023645 Enrollment ID: I20120201000679 |
| Provider Name | Heath W Paulsen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639454697 PECOS PAC ID: 7416967781 Enrollment ID: I20120229000795 |
| Provider Name | Ashley M. Mccurry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750602140 PECOS PAC ID: 5799947883 Enrollment ID: I20120508000106 |
| Provider Name | Jillian J Grund |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063735439 PECOS PAC ID: 3971766304 Enrollment ID: I20120523000256 |
| Provider Name | Jeffrey T Malik |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1376577908 PECOS PAC ID: 5092848069 Enrollment ID: I20120530000433 |
| Provider Name | Janice A Landy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275507022 PECOS PAC ID: 7618007238 Enrollment ID: I20120820000622 |
| Provider Name | James E Philson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184882102 PECOS PAC ID: 8426228107 Enrollment ID: I20120921000548 |
| Provider Name | David S Cornelder |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174759740 PECOS PAC ID: 8820248032 Enrollment ID: I20121024000792 |
| Provider Name | Steven A Neville |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1053691378 PECOS PAC ID: 9133370265 Enrollment ID: I20121119000114 |
| Provider Name | Glenn A Tuckman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821091620 PECOS PAC ID: 3173411527 Enrollment ID: I20121203000049 |
| Provider Name | Kendall Reed |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1619082443 PECOS PAC ID: 5698928448 Enrollment ID: I20130104000084 |
| Provider Name | Melissa A Snyder |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073836607 PECOS PAC ID: 0143473900 Enrollment ID: I20130104000202 |
| Provider Name | Dana L Danley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366437519 PECOS PAC ID: 4587819180 Enrollment ID: I20130305000634 |
| Provider Name | David C King |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1841365277 PECOS PAC ID: 3577708627 Enrollment ID: I20130321000077 |
| Provider Name | Wendy S Street |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659618130 PECOS PAC ID: 3678718053 Enrollment ID: I20130408000340 |
| Provider Name | Meredith D Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801131461 PECOS PAC ID: 7416193859 Enrollment ID: I20130409000614 |
| Provider Name | Meghna Krishnan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376781914 PECOS PAC ID: 5092848630 Enrollment ID: I20130410000077 |
| Provider Name | Lindsey A Christianson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780979666 PECOS PAC ID: 7214174853 Enrollment ID: I20130520000103 |
| Provider Name | Ryan M Brimeyer |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1245435379 PECOS PAC ID: 5294973483 Enrollment ID: I20130529000829 |
| Provider Name | Eric C Donels |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629362785 PECOS PAC ID: 1850532409 Enrollment ID: I20130725000044 |
| Provider Name | Jason P Kruse |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851685911 PECOS PAC ID: 3173764610 Enrollment ID: I20130726000256 |
| Provider Name | Casey M Rice |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1417110404 PECOS PAC ID: 4789825902 Enrollment ID: I20130730000539 |
| Provider Name | Tiffani L Milless |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1912172776 PECOS PAC ID: 4981845930 Enrollment ID: I20130802000441 |
| Provider Name | William E Wortman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912293598 PECOS PAC ID: 5193967644 Enrollment ID: I20130813000067 |
| Provider Name | Kevin Krishna Birusingh |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1497915300 PECOS PAC ID: 2567605215 Enrollment ID: I20130827000873 |
| Provider Name | Lauren Nystrom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598996472 PECOS PAC ID: 5799929998 Enrollment ID: I20130909000705 |
| Provider Name | Logan Vidal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306133210 PECOS PAC ID: 9931343886 Enrollment ID: I20130917000087 |
| Provider Name | Jill L Duffy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396186581 PECOS PAC ID: 6103060991 Enrollment ID: I20130917000670 |
| Provider Name | Debra K Neuharth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417941188 PECOS PAC ID: 2860627890 Enrollment ID: I20131029001977 |
| Provider Name | Ronald P Belin |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1104139161 PECOS PAC ID: 6507092632 Enrollment ID: I20131120001216 |
| Provider Name | Shaun S Quam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376804229 PECOS PAC ID: 8123256807 Enrollment ID: I20140103000234 |
| Provider Name | Timothy D Rankin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1538114368 PECOS PAC ID: 1254324940 Enrollment ID: I20140107000510 |
| Provider Name | Malori J Khalil |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1629374590 PECOS PAC ID: 9931338449 Enrollment ID: I20140203001522 |
| Provider Name | Judith I Nemmers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386877199 PECOS PAC ID: 0648409045 Enrollment ID: I20140205001293 |
| Provider Name | Sarah A Pike |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790107183 PECOS PAC ID: 1254561434 Enrollment ID: I20140310000599 |
| Provider Name | Vuong Anh Nayima |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174817134 PECOS PAC ID: 8224271846 Enrollment ID: I20140311001166 |
| Provider Name | Ashley Lynne Mathes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417241621 PECOS PAC ID: 4880825462 Enrollment ID: I20140324002184 |
| Provider Name | Donald L Harker |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1508179615 PECOS PAC ID: 3577733468 Enrollment ID: I20140325000300 |
| Provider Name | Joseph P Mitros |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1487853479 PECOS PAC ID: 6507006970 Enrollment ID: I20140326001210 |
| Provider Name | Joseph P Eaton |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1700049194 PECOS PAC ID: 7618108010 Enrollment ID: I20140328000550 |
| Provider Name | Rachael Chrstine Parker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356788129 PECOS PAC ID: 8426280991 Enrollment ID: I20140415002289 |
| Provider Name | Gloria A Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508289620 PECOS PAC ID: 2860624251 Enrollment ID: I20140417001536 |
| Provider Name | Michelle M Ewest |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215223847 PECOS PAC ID: 3173766953 Enrollment ID: I20140430001068 |
| Provider Name | Heidi Bradley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972913978 PECOS PAC ID: 3072746338 Enrollment ID: I20140513000177 |
| Provider Name | Timothy M Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164854279 PECOS PAC ID: 5193948123 Enrollment ID: I20140521000083 |
| Provider Name | Joshua B Cook |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1447485966 PECOS PAC ID: 0143444737 Enrollment ID: I20140623001231 |
| Provider Name | Ashley A Mcclain |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1659669760 PECOS PAC ID: 9739306689 Enrollment ID: I20140816000085 |
| Provider Name | Dijana Dugalic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851791230 PECOS PAC ID: 1557581733 Enrollment ID: I20141010001093 |
| Provider Name | Kindra L Perry |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508273178 PECOS PAC ID: 5395966337 Enrollment ID: I20141016001351 |
| Provider Name | Kevin J Furness |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124389697 PECOS PAC ID: 9537380993 Enrollment ID: I20141028001839 |
| Provider Name | Christa Mcenerney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831536788 PECOS PAC ID: 9931322039 Enrollment ID: I20141029001867 |
| Provider Name | Nicholas Patrick Masyga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033556972 PECOS PAC ID: 9436380011 Enrollment ID: I20141222001380 |
| Provider Name | Heidi Bowden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790183341 PECOS PAC ID: 0143546192 Enrollment ID: I20150310001067 |
| Provider Name | Jason Joseph Miiller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699069138 PECOS PAC ID: 7810117702 Enrollment ID: I20150314000221 |
| Provider Name | Lora A Keipper |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801225339 PECOS PAC ID: 0446478465 Enrollment ID: I20150520000938 |
| Provider Name | Ahmar Mannan Butt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275871485 PECOS PAC ID: 7911135348 Enrollment ID: I20150604002388 |
| Provider Name | Megan D Bradley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649658014 PECOS PAC ID: 4284955766 Enrollment ID: I20150609002250 |
| Provider Name | Anubha Mutneja |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1811208267 PECOS PAC ID: 4880915214 Enrollment ID: I20150610000913 |
| Provider Name | Caitlin B Halverson |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1548588395 PECOS PAC ID: 0648417865 Enrollment ID: I20150710001068 |
| Provider Name | Christy E Benson |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1265726913 PECOS PAC ID: 5597997569 Enrollment ID: I20150728003119 |
| Provider Name | Audra L Ramsey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972731388 PECOS PAC ID: 2567603897 Enrollment ID: I20150805009059 |
| Provider Name | Amanda S Olberding |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164835138 PECOS PAC ID: 6103041819 Enrollment ID: I20150821014695 |
| Provider Name | Sabrina Leigh Taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275948986 PECOS PAC ID: 3375768088 Enrollment ID: I20150910000978 |
| Provider Name | Stephanie Perkins Mahan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174937494 PECOS PAC ID: 0244455962 Enrollment ID: I20150910002794 |
| Provider Name | Christine M Young |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104173921 PECOS PAC ID: 6305154519 Enrollment ID: I20151007001424 |
| Provider Name | Donovan T Price |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912106410 PECOS PAC ID: 8426245168 Enrollment ID: I20151109002010 |
| Provider Name | Jackie L Shipley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477926434 PECOS PAC ID: 4082915202 Enrollment ID: I20151214000415 |
| Provider Name | John H Pymm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336552306 PECOS PAC ID: 0345465068 Enrollment ID: I20151214000617 |
| Provider Name | Damon A Demars |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063826758 PECOS PAC ID: 5193941078 Enrollment ID: I20151216001341 |
| Provider Name | Teresa M Bear |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972929784 PECOS PAC ID: 6709019664 Enrollment ID: I20151223000282 |
| Provider Name | Travis J Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306250279 PECOS PAC ID: 9436451523 Enrollment ID: I20160106001880 |
| Provider Name | Tara L Brockman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619380680 PECOS PAC ID: 9931324787 Enrollment ID: I20160115001237 |
| Provider Name | Michael J Mcloughlin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467890376 PECOS PAC ID: 4284877812 Enrollment ID: I20160126001587 |
| Provider Name | Ryan E Laughlin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881008100 PECOS PAC ID: 7719102599 Enrollment ID: I20160129001337 |
| Provider Name | Melissa D Larsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992103386 PECOS PAC ID: 3971800848 Enrollment ID: I20160322000139 |
| Provider Name | Angela A Knoblauch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063826766 PECOS PAC ID: 2365482429 Enrollment ID: I20160608002263 |
| Provider Name | Blake Hines |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1467893131 PECOS PAC ID: 7315239944 Enrollment ID: I20160630000472 |
| Provider Name | Michael J Clegg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518189174 PECOS PAC ID: 2163646233 Enrollment ID: I20160708001514 |
| Provider Name | Eric Dreibelbeis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518371210 PECOS PAC ID: 2264650878 Enrollment ID: I20160714000229 |
| Provider Name | Courtney N Thayer |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1467816520 PECOS PAC ID: 9133412695 Enrollment ID: I20160721002004 |
| Provider Name | Christopher M Eernisse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558742726 PECOS PAC ID: 1759693211 Enrollment ID: I20160816001584 |
| Provider Name | Megan M Norris |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245466424 PECOS PAC ID: 1456508563 Enrollment ID: I20160907002622 |
| Provider Name | Marc Luckett |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881667608 PECOS PAC ID: 4587602966 Enrollment ID: I20160909001578 |
| Provider Name | Andrea Bloch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487790705 PECOS PAC ID: 7618997883 Enrollment ID: I20160912001175 |
| Provider Name | Duane S Abbott |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417362666 PECOS PAC ID: 6709002033 Enrollment ID: I20160930000140 |
| Provider Name | Michelle R Davids |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215215637 PECOS PAC ID: 2466768924 Enrollment ID: I20161003002243 |
| Provider Name | Judith M Kisicki |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306819925 PECOS PAC ID: 4789821083 Enrollment ID: I20161017000789 |
| Provider Name | Usha H Chhatlani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669891719 PECOS PAC ID: 6103042056 Enrollment ID: I20161025000366 |
| Provider Name | Shannon M Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134675937 PECOS PAC ID: 8325327570 Enrollment ID: I20161111000415 |
| Provider Name | William J Schmitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053792887 PECOS PAC ID: 8426361916 Enrollment ID: I20161212001170 |
| Provider Name | Emily Stanford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811445034 PECOS PAC ID: 6608157177 Enrollment ID: I20161222000132 |
| Provider Name | Jennifer J Drew |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285183624 PECOS PAC ID: 3678854148 Enrollment ID: I20161222000235 |
| Provider Name | Blaine B Westemeyer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184005357 PECOS PAC ID: 7012229578 Enrollment ID: I20170124000152 |
| Provider Name | Steven West |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1295806131 PECOS PAC ID: 4880976984 Enrollment ID: I20170125002652 |
| Provider Name | Cory Wiederin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1457803983 PECOS PAC ID: 7517249592 Enrollment ID: I20170127000505 |
| Provider Name | Naima Adeel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356755045 PECOS PAC ID: 0840573457 Enrollment ID: I20170206001121 |
| Provider Name | James B Law |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700299609 PECOS PAC ID: 1456576206 Enrollment ID: I20170220000152 |
| Provider Name | Lacey R Cheeseman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851831499 PECOS PAC ID: 6608151196 Enrollment ID: I20170324000447 |
| Provider Name | James M Maixner |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1992746762 PECOS PAC ID: 1951623461 Enrollment ID: I20170405001775 |
| Provider Name | Jenna Beth Kawase Eshcol |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891175527 PECOS PAC ID: 0547575821 Enrollment ID: I20170515001068 |
| Provider Name | Morgan E Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710419726 PECOS PAC ID: 1456628288 Enrollment ID: I20170530001075 |
| Provider Name | Rima I El-herte |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1164787412 PECOS PAC ID: 3476790957 Enrollment ID: I20170602000356 |
| Provider Name | Kari L Ward |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1730176371 PECOS PAC ID: 4082982699 Enrollment ID: I20170622000348 |
| Provider Name | Irfan K Moinuddin |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1033163449 PECOS PAC ID: 4789665720 Enrollment ID: I20170717000608 |
| Provider Name | Mccabe Clayton Kenny |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1164721338 PECOS PAC ID: 7810217767 Enrollment ID: I20170718002047 |
| Provider Name | Benjamin W Howard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710391503 PECOS PAC ID: 9931325545 Enrollment ID: I20170804003138 |
| Provider Name | Juliane M Winters |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1114448388 PECOS PAC ID: 1658642822 Enrollment ID: I20170807000582 |
| Provider Name | Susan L Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871021543 PECOS PAC ID: 7517238652 Enrollment ID: I20170808000190 |
| Provider Name | Rachel Mack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700308426 PECOS PAC ID: 5092086868 Enrollment ID: I20170814000476 |
| Provider Name | Jennifer L Thompson |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1215224589 PECOS PAC ID: 2163643321 Enrollment ID: I20170823000246 |
| Provider Name | Seth W Meyers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477930766 PECOS PAC ID: 7214201169 Enrollment ID: I20170915003147 |
| Provider Name | David L Fahey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467833632 PECOS PAC ID: 6406168954 Enrollment ID: I20170918000232 |
| Provider Name | Raviv Ramdial |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497016273 PECOS PAC ID: 1557595485 Enrollment ID: I20170919002340 |
| Provider Name | Rebecca J Schleuger-valadao |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1265722250 PECOS PAC ID: 2769756303 Enrollment ID: I20170921000562 |
| Provider Name | Teresa M Dolphin-shaw |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073870226 PECOS PAC ID: 4789807850 Enrollment ID: I20170921000763 |
| Provider Name | Kelsey Marie Randel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073963278 PECOS PAC ID: 2365734761 Enrollment ID: I20170921000880 |
| Provider Name | Audra L Poterucha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033569223 PECOS PAC ID: 2567754955 Enrollment ID: I20170921001597 |
| Provider Name | Emily Ann Mcintosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861901621 PECOS PAC ID: 3375818586 Enrollment ID: I20171013000549 |
| Provider Name | Sarah B Ling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689087595 PECOS PAC ID: 1052536778 Enrollment ID: I20171019001713 |
| Provider Name | Rachel D Filzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144588476 PECOS PAC ID: 7416103957 Enrollment ID: I20171115001940 |
| Provider Name | Andrew J Mcmurray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225488414 PECOS PAC ID: 5799077194 Enrollment ID: I20171201001509 |
| Provider Name | Barbara Jo Christie Kroening |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275760761 PECOS PAC ID: 6103185459 Enrollment ID: I20180115000240 |
| Provider Name | Elizabeth J Dupic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780033639 PECOS PAC ID: 0648562967 Enrollment ID: I20180521001022 |
| Provider Name | Alexandrea M Jacob |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144679788 PECOS PAC ID: 7012209414 Enrollment ID: I20180521001123 |
| Provider Name | Matthew J Kruse |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922389451 PECOS PAC ID: 4082864038 Enrollment ID: I20180606000335 |
| Provider Name | Alexander M Harvin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295097970 PECOS PAC ID: 5496044612 Enrollment ID: I20180615001376 |
| Provider Name | John J Evans |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1093079709 PECOS PAC ID: 4880956283 Enrollment ID: I20180702003344 |
| Provider Name | Brian F Lothrop |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1700230638 PECOS PAC ID: 1658662796 Enrollment ID: I20180706000616 |
| Provider Name | Leah M Kramer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639662273 PECOS PAC ID: 4880940733 Enrollment ID: I20180706000925 |
| Provider Name | Jessica D Streeter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811488471 PECOS PAC ID: 7810243789 Enrollment ID: I20180706001477 |
| Provider Name | Trevor T Wild |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1881969111 PECOS PAC ID: 9830419845 Enrollment ID: I20180718002372 |
| Provider Name | Jessica L Bottenfield-biehn |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1588999114 PECOS PAC ID: 1759638828 Enrollment ID: I20180719003599 |
| Provider Name | Emily Anzmann |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1518341254 PECOS PAC ID: 0840549416 Enrollment ID: I20180815003712 |
| Provider Name | Timothy J Tasler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104311505 PECOS PAC ID: 0244589406 Enrollment ID: I20180821002177 |
| Provider Name | Joseph P Lafeve |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972815314 PECOS PAC ID: 9133317134 Enrollment ID: I20180913000071 |
| Provider Name | Nichole L O'brien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902384118 PECOS PAC ID: 5991055808 Enrollment ID: I20180913001095 |
| Provider Name | Corey R Weaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922586361 PECOS PAC ID: 1759631674 Enrollment ID: I20180913001714 |
| Provider Name | Sara B Kilborn |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1528260650 PECOS PAC ID: 8628229671 Enrollment ID: I20180919001259 |
| Provider Name | Arani D Nanavati |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1538415575 PECOS PAC ID: 5092946426 Enrollment ID: I20181003002101 |
| Provider Name | Nathan P Neuberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922459494 PECOS PAC ID: 6002186343 Enrollment ID: I20181009001582 |
| Provider Name | Elizabeth K Dolfie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578582730 PECOS PAC ID: 6800966128 Enrollment ID: I20181011001284 |
| Provider Name | William M Pruett |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1487005542 PECOS PAC ID: 9931492121 Enrollment ID: I20181015001266 |
| Provider Name | Dhivya Sundaramurthy |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1790073328 PECOS PAC ID: 1052555471 Enrollment ID: I20181109001755 |
| Provider Name | Olga V Tenney |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558745968 PECOS PAC ID: 1759663743 Enrollment ID: I20181113003166 |
| Provider Name | Danielle K Ballard-green |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285162461 PECOS PAC ID: 5092069674 Enrollment ID: I20181117000425 |
| Provider Name | Lindsey Kurdi Wood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902336266 PECOS PAC ID: 9638449952 Enrollment ID: I20181126002109 |
| Provider Name | Patricia L Ferlitsch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093287930 PECOS PAC ID: 0446596688 Enrollment ID: I20190109002513 |
| Provider Name | Kiel A Morris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700318037 PECOS PAC ID: 3173893351 Enrollment ID: I20190122001138 |
| Provider Name | Benjamin Lashar Hoch |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1700884665 PECOS PAC ID: 5597656421 Enrollment ID: I20190320002590 |
| Provider Name | Kara Larsen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417216276 PECOS PAC ID: 8820214752 Enrollment ID: I20190328000248 |
| Provider Name | Dylan J Lowe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588194831 PECOS PAC ID: 6709156052 Enrollment ID: I20190328001473 |
| Provider Name | Molly R Horton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295204832 PECOS PAC ID: 8426399718 Enrollment ID: I20190415002563 |
| Provider Name | Erin L Richmond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487004180 PECOS PAC ID: 6709128796 Enrollment ID: I20190423000575 |
| Provider Name | Ashlesha Sharma |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902068083 PECOS PAC ID: 8325326929 Enrollment ID: I20190430001755 |
| Provider Name | John M Mcgarity |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538591896 PECOS PAC ID: 4880983071 Enrollment ID: I20190618002341 |
| Provider Name | Francis Dinh |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1174077101 PECOS PAC ID: 2466788328 Enrollment ID: I20190730002961 |
| Provider Name | Nicole D Mcclavy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053963900 PECOS PAC ID: 9335477132 Enrollment ID: I20190816002755 |
| Provider Name | Kelly J Weiss Kreps |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053504670 PECOS PAC ID: 8820327737 Enrollment ID: I20190830002646 |
| Provider Name | Abby J Stroeh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255823951 PECOS PAC ID: 8426306499 Enrollment ID: I20191104002507 |
| Provider Name | Johanna Grenko |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366099699 PECOS PAC ID: 3678905536 Enrollment ID: I20191114000556 |
| Provider Name | Hannah C Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194217893 PECOS PAC ID: 1658628045 Enrollment ID: I20191114001114 |
| Provider Name | Kathryn S Linkenmeyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912498981 PECOS PAC ID: 9931457470 Enrollment ID: I20191120002756 |
| Provider Name | Rebecca S Lundquist |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770566739 PECOS PAC ID: 1355300682 Enrollment ID: I20191126003027 |
| Provider Name | Michael Be |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730671470 PECOS PAC ID: 7719237643 Enrollment ID: I20200110002002 |
| Provider Name | Jonathan J Wadle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467946061 PECOS PAC ID: 7416204664 Enrollment ID: I20200225001056 |
| Provider Name | Nathan M Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881044089 PECOS PAC ID: 4880986280 Enrollment ID: I20200407003365 |
| Provider Name | Elizabeth A Fitzgerald |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770136848 PECOS PAC ID: 5395174510 Enrollment ID: I20200408004097 |
| Provider Name | Kirk H Mueller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285610337 PECOS PAC ID: 6406984988 Enrollment ID: I20200408004127 |
| Provider Name | Jared L Rietveld |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205328531 PECOS PAC ID: 9335497866 Enrollment ID: I20200422000739 |
| Provider Name | Francis J Thornton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770545949 PECOS PAC ID: 3678569027 Enrollment ID: I20200608002642 |
| Provider Name | Michael Rozenfeld |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891937454 PECOS PAC ID: 6305137043 Enrollment ID: I20200622001023 |
| Provider Name | Luke Bolek |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508992470 PECOS PAC ID: 8022102904 Enrollment ID: I20200622002907 |
| Provider Name | Benjamin T Bjerke |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1639496292 PECOS PAC ID: 9537470174 Enrollment ID: I20200707000229 |
| Provider Name | Jisun Lee |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1982187027 PECOS PAC ID: 3274959648 Enrollment ID: I20200814002538 |
| Provider Name | Vaishali S Lafita |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053583633 PECOS PAC ID: 3476626847 Enrollment ID: I20200821000950 |
| Provider Name | Dana V Andersen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073139358 PECOS PAC ID: 9638598790 Enrollment ID: I20200923002554 |
| Provider Name | Jennifer Melly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356956916 PECOS PAC ID: 7113346982 Enrollment ID: I20200928002120 |
| Provider Name | Dhrumil Suryakant Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275027047 PECOS PAC ID: 7618396839 Enrollment ID: I20201007001203 |
| Provider Name | Sean R Trammel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619535093 PECOS PAC ID: 8426383985 Enrollment ID: I20201008002401 |
| Provider Name | Daniel J Schnadt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508423344 PECOS PAC ID: 1254666712 Enrollment ID: I20201016002513 |
| Provider Name | Sarah Hiemer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801405832 PECOS PAC ID: 3476973215 Enrollment ID: I20201017000042 |
| Provider Name | Preston S Sereg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215428115 PECOS PAC ID: 0547517922 Enrollment ID: I20201019000783 |
| Provider Name | Nadia Hashemi-toroghi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811500747 PECOS PAC ID: 4688094378 Enrollment ID: I20201019002451 |
| Provider Name | Matthew A Mckinney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790342434 PECOS PAC ID: 7517292071 Enrollment ID: I20201020001016 |
| Provider Name | Kyle Lemasters |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396239034 PECOS PAC ID: 2860812443 Enrollment ID: I20201020003849 |
| Provider Name | Jack R O'brien |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215594312 PECOS PAC ID: 5890020358 Enrollment ID: I20201020003934 |
| Provider Name | Eric W Wood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689168882 PECOS PAC ID: 5991053423 Enrollment ID: I20201023000092 |
| Provider Name | Sue A Mckernan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437766995 PECOS PAC ID: 8628488509 Enrollment ID: I20201104000792 |
| Provider Name | Richard Semelka |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003998717 PECOS PAC ID: 8729118898 Enrollment ID: I20201116002831 |
| Provider Name | Samuel Dumontier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033603717 PECOS PAC ID: 0345597720 Enrollment ID: I20201209000815 |
| Provider Name | Giovanni E Lorenz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114196185 PECOS PAC ID: 7719258904 Enrollment ID: I20201222001178 |
| Provider Name | Sarah Bradbury |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1215164165 PECOS PAC ID: 6901219997 Enrollment ID: I20210112002719 |
| Provider Name | Krista Beckert |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1487919809 PECOS PAC ID: 2163836107 Enrollment ID: I20210202002219 |
| Provider Name | Matthew Bravard |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1891849196 PECOS PAC ID: 1052725090 Enrollment ID: I20210202002286 |
| Provider Name | Jena Velasquez |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730509001 PECOS PAC ID: 3870907819 Enrollment ID: I20210202002292 |
| Provider Name | Bradley B Waller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609433796 PECOS PAC ID: 0143555615 Enrollment ID: I20210305001903 |
| Provider Name | Alyson Kay Seamer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588277404 PECOS PAC ID: 2567879596 Enrollment ID: I20210318001236 |
| Provider Name | Tamara Halbersma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548859374 PECOS PAC ID: 2961819305 Enrollment ID: I20210331000391 |
| Provider Name | Anthony Tabish |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679066013 PECOS PAC ID: 8820343577 Enrollment ID: I20210331000429 |
| Provider Name | Timothy J Kable |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164916854 PECOS PAC ID: 8628325107 Enrollment ID: I20210401001961 |
| Provider Name | Brandon P Barnhart |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760067839 PECOS PAC ID: 0547678542 Enrollment ID: I20210412001441 |
| Provider Name | Tricia M Mittra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851959258 PECOS PAC ID: 2062747538 Enrollment ID: I20210419000094 |
| Provider Name | Rebecca L Sabates |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093209793 PECOS PAC ID: 8123376167 Enrollment ID: I20210519000949 |
| Provider Name | Leslie H Pyle |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1568950970 PECOS PAC ID: 3779839667 Enrollment ID: I20210720000595 |
| Provider Name | Ryan Dornbier |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1609294305 PECOS PAC ID: 2365743226 Enrollment ID: I20210731000247 |
| Provider Name | Jacob Jipp |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1164886644 PECOS PAC ID: 6103188404 Enrollment ID: I20210802000068 |
| Provider Name | Ivy Melgarejo |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1518349992 PECOS PAC ID: 1557610680 Enrollment ID: I20210827002502 |
| Provider Name | Joseph John Doerer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962722819 PECOS PAC ID: 0648560375 Enrollment ID: I20210903001234 |
| Provider Name | Manik Veer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023423969 PECOS PAC ID: 0648558841 Enrollment ID: I20210907000541 |
| Provider Name | Ashland R Stice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184296394 PECOS PAC ID: 3971900325 Enrollment ID: I20210928000486 |
| Provider Name | Marcy Michelle Covert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992464325 PECOS PAC ID: 0840682324 Enrollment ID: I20220112002157 |
| Provider Name | Ashley G Parker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376119271 PECOS PAC ID: 3577959691 Enrollment ID: I20220329002510 |
| Provider Name | Kristin L Schomburg |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1083246136 PECOS PAC ID: 2567890015 Enrollment ID: I20220613000641 |
| Provider Name | Nandita Chawla |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437216264 PECOS PAC ID: 3577740455 Enrollment ID: I20220613001623 |
| Provider Name | Michael John Winters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528681392 PECOS PAC ID: 6002239746 Enrollment ID: I20220613002534 |
| Provider Name | Kyle Freeman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568826865 PECOS PAC ID: 7315213386 Enrollment ID: I20220614001029 |
| Provider Name | Tyler Mccurdy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902267198 PECOS PAC ID: 8123398930 Enrollment ID: I20220615001877 |
| Provider Name | Kyle Yi |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1730641234 PECOS PAC ID: 1254713076 Enrollment ID: I20220726003161 |
| Provider Name | Tyler M Folkerts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215551411 PECOS PAC ID: 1759704489 Enrollment ID: I20220727001449 |
| Provider Name | Jordan Mcpheron |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073937389 PECOS PAC ID: 1759764921 Enrollment ID: I20220822000183 |
| Provider Name | Andrew Mills |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407072150 PECOS PAC ID: 7810060514 Enrollment ID: I20220822000392 |
| Provider Name | Brianna Hamilton |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962164301 PECOS PAC ID: 3678965829 Enrollment ID: I20220908002147 |
| Provider Name | Ammar Taha |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992032577 PECOS PAC ID: 1850538968 Enrollment ID: I20220908003031 |
| Provider Name | Christopher James Atkinson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093013260 PECOS PAC ID: 5294021887 Enrollment ID: I20220928002035 |
| Provider Name | Spencer J Aldridge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407479355 PECOS PAC ID: 5991128639 Enrollment ID: I20220929003474 |
| Provider Name | Brooke E Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932768959 PECOS PAC ID: 6305171638 Enrollment ID: I20221004003741 |
| Provider Name | Seth A Anderson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528210879 PECOS PAC ID: 9133367998 Enrollment ID: I20221012001003 |
| Provider Name | Walter O Mogeni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548885791 PECOS PAC ID: 7517380256 Enrollment ID: I20221017000719 |
| Provider Name | Adrianna D Mitchell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811512064 PECOS PAC ID: 2961825617 Enrollment ID: I20221110000221 |
| Provider Name | Barbara Petersen-fox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598125544 PECOS PAC ID: 7719355361 Enrollment ID: I20221201002561 |
| Provider Name | Kristin M Bell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962146241 PECOS PAC ID: 0446629109 Enrollment ID: I20221220001108 |
| Provider Name | Geoffrey A Jung |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811511504 PECOS PAC ID: 1658794383 Enrollment ID: I20221220002301 |
| Provider Name | Tara Kane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982885414 PECOS PAC ID: 3779663661 Enrollment ID: I20230224001203 |
| Provider Name | Timothy M Jay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144843087 PECOS PAC ID: 1052733672 Enrollment ID: I20230309000179 |
| Provider Name | Rahul N Sawlani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790096592 PECOS PAC ID: 1456645431 Enrollment ID: I20230414002134 |
| Provider Name | Gbenga Adeyemi Shogbesan |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1588169171 PECOS PAC ID: 5193105963 Enrollment ID: I20230703002025 |
| Provider Name | Erin S Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760188676 PECOS PAC ID: 4981064623 Enrollment ID: I20230713001565 |
| Provider Name | Andrew W Osiason |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053396929 PECOS PAC ID: 6709783269 Enrollment ID: I20230717001177 |
| Provider Name | Savannah A Marker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194392829 PECOS PAC ID: 0244631968 Enrollment ID: I20230801001673 |
| Provider Name | Katherine A Dvorak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750904686 PECOS PAC ID: 4183047822 Enrollment ID: I20230928000556 |
| Provider Name | Eddie Scott |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336762079 PECOS PAC ID: 0547615031 Enrollment ID: I20231019000230 |
| Provider Name | Joel Thomas Naberhaus |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1255076543 PECOS PAC ID: 1153779012 Enrollment ID: I20231204000306 |
| Provider Name | Matthew Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396173746 PECOS PAC ID: 3173750221 Enrollment ID: I20231221003208 |
| Provider Name | Douglas Waldman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1902801871 PECOS PAC ID: 3173546603 Enrollment ID: I20240123000568 |
| Provider Name | Lewis M Braster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538805437 PECOS PAC ID: 5597147009 Enrollment ID: I20240125001165 |
| Provider Name | Sarah E Wyler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437773314 PECOS PAC ID: 0547683088 Enrollment ID: I20240229000423 |
| Provider Name | Tamela Visalden |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972913721 PECOS PAC ID: 4880039882 Enrollment ID: I20240229002522 |
| Provider Name | Kiara Nichelle Festing-smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477014025 PECOS PAC ID: 2668701228 Enrollment ID: I20240306000244 |
| Provider Name | Beth Besecker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699895581 PECOS PAC ID: 7719087659 Enrollment ID: I20240318000294 |
| Provider Name | Erin Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689330813 PECOS PAC ID: 9830537554 Enrollment ID: I20240401001516 |
Mercy Ruan Neurology Clinic Central Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1111 6th Ave, East Tower Suite A100, Des Moines, IA 50314 Phone: 515-358-0011 Fax: 515-358-0099 | |
Multicultural Institute Of Therapeutic Excellence Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4313 University Ave, Des Moines, IA 50311 Phone: 515-802-2487 | |
Beyond Wellness Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 699 Walnut St Ste 400, Des Moines, IA 50309 Phone: 855-380-6136 | |
Guided Journeys Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2601 E 40th St, Des Moines, IA 50317 Phone: 515-218-7220 | |
Unitypoint Health - Des Moines Iowa Methodist Medical Center Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 700 E University Ave, Des Moines, IA 50316 Phone: 515-263-5612 | |
The Healing Space Counseling Center, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3810 1/2 Douglas Ave, Des Moines, IA 50310 Phone: 515-423-2333 | |
Openloop Healthcare Partners Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 317 6th Ave Ste 400, Des Moines, IA 50309 Phone: 515-216-0962 |