| Cherokee Health Systems | |
|
6350 W Andrew Johnson Hwy Talbott TN 37877-8605 | |
| (423) 587-7337 | |
| (423) 586-0614 |
| Full Name | Cherokee Health Systems |
|---|---|
| Speciality | Clinic/Center |
| Location | 6350 W Andrew Johnson Hwy, Talbott, Tennessee |
| Authorized Official Name and Position | Jeffrey W Howard (CFO) |
| Authorized Official Contact | 4235877337 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cherokee Health Systems 6350 W Andrew Johnson Hwy Talbott TN 37877-8605 Ph: (800) 355-3565 | Cherokee Health Systems 6350 W Andrew Johnson Hwy Talbott TN 37877-8605 Ph: (423) 587-7337 |
| NPI Number | 1134128820 |
|---|---|
| Provider Enumeration Date | 07/15/2005 |
| Last Update Date | 09/30/2020 |
| Certification Date | 09/30/2020 |
| Medicare PECOS PAC ID | 3577474295 |
|---|---|
| Medicare Enrollment ID | O20031119000769 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134128820 | NPI | - | NPPES |
| 44-1902 | Medicaid | TN | |
| 3686393 | Medicaid | TN |
| Provider Name | Gregory J Perry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972501187 PECOS PAC ID: 5092618512 Enrollment ID: I20040130000706 |
| Provider Name | William Allan Richards |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639178684 PECOS PAC ID: 0749173391 Enrollment ID: I20040206000059 |
| Provider Name | Andrew H Demick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932107125 PECOS PAC ID: 4688567241 Enrollment ID: I20040210001120 |
| Provider Name | Kristin K Mahoney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316946585 PECOS PAC ID: 7810889474 Enrollment ID: I20040327000319 |
| Provider Name | Guy L Smoak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649238791 PECOS PAC ID: 3971597899 Enrollment ID: I20040413001365 |
| Provider Name | Treena W Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417906827 PECOS PAC ID: 0648255653 Enrollment ID: I20040623000713 |
| Provider Name | Tim Larson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962487157 PECOS PAC ID: 8527953801 Enrollment ID: I20040727001221 |
| Provider Name | Michael R Caudle |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114984010 PECOS PAC ID: 1658341417 Enrollment ID: I20040728001636 |
| Provider Name | Febe I Wallace |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811974512 PECOS PAC ID: 7315906443 Enrollment ID: I20041005000934 |
| Provider Name | Lawrence L Bushkell |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1376501544 PECOS PAC ID: 7719947365 Enrollment ID: I20041018000667 |
| Provider Name | Tina Rosling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851347439 PECOS PAC ID: 4981666997 Enrollment ID: I20041102000494 |
| Provider Name | James D Yates |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487655098 PECOS PAC ID: 6800845298 Enrollment ID: I20050112000655 |
| Provider Name | John C Scott |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1992706782 PECOS PAC ID: 5496704892 Enrollment ID: I20050112000794 |
| Provider Name | Parinda Khatri |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831199595 PECOS PAC ID: 1355392622 Enrollment ID: I20050203000397 |
| Provider Name | Laura G Porter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720087901 PECOS PAC ID: 5294788931 Enrollment ID: I20050223000077 |
| Provider Name | Hal M Moncier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609875814 PECOS PAC ID: 3274586383 Enrollment ID: I20050301000827 |
| Provider Name | Rachel W Hovis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629026950 PECOS PAC ID: 1850329707 Enrollment ID: I20050801001101 |
| Provider Name | Katheryn E Lagrange |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134127350 PECOS PAC ID: 4587687132 Enrollment ID: I20060110000125 |
| Provider Name | Jewel Mcmillen Birdwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841298049 PECOS PAC ID: 1658380324 Enrollment ID: I20060410000122 |
| Provider Name | Janice T Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083657373 PECOS PAC ID: 0749290104 Enrollment ID: I20060428000496 |
| Provider Name | Sarah J Levan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720152911 PECOS PAC ID: 2365443934 Enrollment ID: I20070124000683 |
| Provider Name | Angela Warden |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912905118 PECOS PAC ID: 1951403443 Enrollment ID: I20070301000612 |
| Provider Name | Brian A Bonnyman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871505685 PECOS PAC ID: 5799881546 Enrollment ID: I20070510000627 |
| Provider Name | Allison J East |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578642385 PECOS PAC ID: 7214035203 Enrollment ID: I20070615000375 |
| Provider Name | Jody Fletcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770616708 PECOS PAC ID: 9931208477 Enrollment ID: I20070623000055 |
| Provider Name | Matthew B Reese |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790783918 PECOS PAC ID: 3274624911 Enrollment ID: I20070809000177 |
| Provider Name | Jessica Allin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699749952 PECOS PAC ID: 9436246857 Enrollment ID: I20071101000561 |
| Provider Name | Kathy E Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154500676 PECOS PAC ID: 2769566678 Enrollment ID: I20080229000428 |
| Provider Name | Misty D Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750550026 PECOS PAC ID: 4587749817 Enrollment ID: I20080311000580 |
| Provider Name | Annita J Rowland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205005212 PECOS PAC ID: 9032297528 Enrollment ID: I20080424000133 |
| Provider Name | Naoko Kinoshita |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861681769 PECOS PAC ID: 9931278322 Enrollment ID: I20080527000819 |
| Provider Name | Carol D Lucas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851446926 PECOS PAC ID: 2264509181 Enrollment ID: I20080918000446 |
| Provider Name | Lori J Elmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306874052 PECOS PAC ID: 5294893566 Enrollment ID: I20081015000658 |
| Provider Name | Patricia A Kyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568660777 PECOS PAC ID: 6204987605 Enrollment ID: I20090624000723 |
| Provider Name | Suzanne E Bailey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952349227 PECOS PAC ID: 2163578980 Enrollment ID: I20090921000397 |
| Provider Name | Walter W Schoutko |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639145840 PECOS PAC ID: 6103963442 Enrollment ID: I20091020000082 |
| Provider Name | Kimberly R Rivers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982837126 PECOS PAC ID: 3274674775 Enrollment ID: I20100106000267 |
| Provider Name | Bobbie B Ramsey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245481357 PECOS PAC ID: 3870636533 Enrollment ID: I20100203000113 |
| Provider Name | Matthew V Gent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104148626 PECOS PAC ID: 8921137589 Enrollment ID: I20100520000533 |
| Provider Name | Tracy D Schultz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982643649 PECOS PAC ID: 1456347194 Enrollment ID: I20100608000756 |
| Provider Name | Stacy H Gunnoe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356664338 PECOS PAC ID: 5092846865 Enrollment ID: I20100623000888 |
| Provider Name | Ron O Debord |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851614564 PECOS PAC ID: 1759414238 Enrollment ID: I20100804000621 |
| Provider Name | Bradley P Carter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801845821 PECOS PAC ID: 3375667108 Enrollment ID: I20100901000193 |
| Provider Name | Katherine L Mullins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750589347 PECOS PAC ID: 6901090976 Enrollment ID: I20101103000949 |
| Provider Name | Julie R Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336368307 PECOS PAC ID: 2769662097 Enrollment ID: I20110203000692 |
| Provider Name | Susan R Goble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811212962 PECOS PAC ID: 1759562879 Enrollment ID: I20110223000314 |
| Provider Name | Jason K Caldwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427188523 PECOS PAC ID: 0840337820 Enrollment ID: I20110309000226 |
| Provider Name | Robert R Mindrup |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598098527 PECOS PAC ID: 1254517790 Enrollment ID: I20110517000467 |
| Provider Name | Deborah G Allen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942237474 PECOS PAC ID: 3274706601 Enrollment ID: I20111101000231 |
| Provider Name | Cindy D Perry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235137464 PECOS PAC ID: 4486827631 Enrollment ID: I20111103000143 |
| Provider Name | Amir Hussaini |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235137415 PECOS PAC ID: 2567635725 Enrollment ID: I20111103000174 |
| Provider Name | Edwin F Hochnedel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356343909 PECOS PAC ID: 0244406908 Enrollment ID: I20111229000544 |
| Provider Name | Robert Humphreys |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356401129 PECOS PAC ID: 7315033057 Enrollment ID: I20120319000282 |
| Provider Name | Heather N Browder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104962422 PECOS PAC ID: 0941460125 Enrollment ID: I20120326000513 |
| Provider Name | Suzanne M Winzenburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427192004 PECOS PAC ID: 2860653649 Enrollment ID: I20120423000522 |
| Provider Name | Lori R Hestand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326377177 PECOS PAC ID: 1254597669 Enrollment ID: I20120730000016 |
| Provider Name | Sara L Propst |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720250426 PECOS PAC ID: 7618126616 Enrollment ID: I20121008000540 |
| Provider Name | Jennifer A Hardy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962751339 PECOS PAC ID: 5991955288 Enrollment ID: I20121023000108 |
| Provider Name | Jean E Cobb |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831403146 PECOS PAC ID: 8921252446 Enrollment ID: I20130211000380 |
| Provider Name | Matthew T Beason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437490737 PECOS PAC ID: 4385880046 Enrollment ID: I20130424001069 |
| Provider Name | Emilie M Ball |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487994265 PECOS PAC ID: 7012154099 Enrollment ID: I20130510000357 |
| Provider Name | Jennifer C Cupp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306289715 PECOS PAC ID: 5799923041 Enrollment ID: I20130529000290 |
| Provider Name | Haley S Richardson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891052916 PECOS PAC ID: 6709027592 Enrollment ID: I20130719000557 |
| Provider Name | Robert J Bartucci |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912054990 PECOS PAC ID: 5092717553 Enrollment ID: I20130724000202 |
| Provider Name | Leigh Ann L Breckenridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477800092 PECOS PAC ID: 7911149562 Enrollment ID: I20130809000480 |
| Provider Name | Amber M Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396184222 PECOS PAC ID: 7214179670 Enrollment ID: I20130814000481 |
| Provider Name | Jacqui Renee Schollenberger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629400148 PECOS PAC ID: 4486897824 Enrollment ID: I20130904000099 |
| Provider Name | Uzma Karim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124258314 PECOS PAC ID: 3971739186 Enrollment ID: I20131118001401 |
| Provider Name | Jeffrey D Bull |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235421637 PECOS PAC ID: 7214163906 Enrollment ID: I20131203000419 |
| Provider Name | Mark Allen Mcgrail |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063488831 PECOS PAC ID: 9931336476 Enrollment ID: I20131209000723 |
| Provider Name | Stacy Wason-fawver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194143347 PECOS PAC ID: 2466672142 Enrollment ID: I20140930002729 |
| Provider Name | Eboni C Winford |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902221708 PECOS PAC ID: 8224352364 Enrollment ID: I20150121001280 |
| Provider Name | Kelly C Cooper |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1356509368 PECOS PAC ID: 6901124601 Enrollment ID: I20150408002868 |
| Provider Name | Anna M Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679966329 PECOS PAC ID: 9133448004 Enrollment ID: I20150428001482 |
| Provider Name | Lawana J Green |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1144221086 PECOS PAC ID: 6608184940 Enrollment ID: I20151006001406 |
| Provider Name | Ruth F Kamrass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376923565 PECOS PAC ID: 6204145345 Enrollment ID: I20151012001989 |
| Provider Name | Kathleen D Saneford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386030492 PECOS PAC ID: 7810206372 Enrollment ID: I20151022002860 |
| Provider Name | Rachel A Taubenheim |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932534328 PECOS PAC ID: 6305156415 Enrollment ID: I20151102001615 |
| Provider Name | Brianna N Cooke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851761183 PECOS PAC ID: 5799095568 Enrollment ID: I20151106000282 |
| Provider Name | Joy Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275903585 PECOS PAC ID: 3375853849 Enrollment ID: I20151112002320 |
| Provider Name | Michelle P Black |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588037055 PECOS PAC ID: 5193025757 Enrollment ID: I20151203001903 |
| Provider Name | Brittney Burns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073978375 PECOS PAC ID: 9830493287 Enrollment ID: I20160205001145 |
| Provider Name | Robert D Brindle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902113558 PECOS PAC ID: 8527363795 Enrollment ID: I20160225001663 |
| Provider Name | Mary J Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144353186 PECOS PAC ID: 5496051393 Enrollment ID: I20160302001373 |
| Provider Name | Alexandra J Fort |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245699222 PECOS PAC ID: 0446556443 Enrollment ID: I20160316001500 |
| Provider Name | Tiffany N Barnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952704850 PECOS PAC ID: 5496053613 Enrollment ID: I20160420002368 |
| Provider Name | Janice S Ledford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790140648 PECOS PAC ID: 8729377908 Enrollment ID: I20160511000577 |
| Provider Name | Brittany Mccafferty |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134365398 PECOS PAC ID: 5294027033 Enrollment ID: I20160714001098 |
| Provider Name | Amineh Abbas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659501161 PECOS PAC ID: 9638463870 Enrollment ID: I20160810001262 |
| Provider Name | Christina L Sanks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407208747 PECOS PAC ID: 8628363900 Enrollment ID: I20160825001395 |
| Provider Name | Sarah E Oxendine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629524533 PECOS PAC ID: 6002102381 Enrollment ID: I20160913001503 |
| Provider Name | Sachin S Jogal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831140672 PECOS PAC ID: 0941277537 Enrollment ID: I20161011001844 |
| Provider Name | Danielle Ranae King |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093941809 PECOS PAC ID: 7214232057 Enrollment ID: I20161128001768 |
| Provider Name | Michelle R Whitelaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164973541 PECOS PAC ID: 0749562890 Enrollment ID: I20170125000460 |
| Provider Name | Hilary A Parker |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1720480106 PECOS PAC ID: 0941582944 Enrollment ID: I20170127001009 |
| Provider Name | Jennifer L Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699219923 PECOS PAC ID: 2769769082 Enrollment ID: I20170515000902 |
| Provider Name | Terri Lee Moran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790237816 PECOS PAC ID: 6002183464 Enrollment ID: I20170606002732 |
| Provider Name | Wesley Shane Singleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528596459 PECOS PAC ID: 7416229208 Enrollment ID: I20170814001518 |
| Provider Name | Brittany Lucas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225569031 PECOS PAC ID: 3678845831 Enrollment ID: I20170823000670 |
| Provider Name | Angela Liske |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346400520 PECOS PAC ID: 7214209816 Enrollment ID: I20170908000784 |
| Provider Name | Kristy M Bolt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881117521 PECOS PAC ID: 4385917574 Enrollment ID: I20170911001339 |
| Provider Name | Sarah H Hawkins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528452844 PECOS PAC ID: 9739445131 Enrollment ID: I20171116002690 |
| Provider Name | Elizabeth M Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497265227 PECOS PAC ID: 4981961000 Enrollment ID: I20171128002433 |
| Provider Name | Maggie Holland |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922489228 PECOS PAC ID: 2466710223 Enrollment ID: I20171227002429 |
| Provider Name | Ariel Stakely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689195927 PECOS PAC ID: 9133488539 Enrollment ID: I20180110001362 |
| Provider Name | Laura Contri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023510625 PECOS PAC ID: 0749544088 Enrollment ID: I20180514001026 |
| Provider Name | Shannon R Bodiford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972037000 PECOS PAC ID: 3274898572 Enrollment ID: I20180606003199 |
| Provider Name | Thitiporn Whaley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295187789 PECOS PAC ID: 5395090559 Enrollment ID: I20180612003161 |
| Provider Name | Caytlin Cardwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114429800 PECOS PAC ID: 6002161635 Enrollment ID: I20180621002167 |
| Provider Name | Jacqueline A Bonsu |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023490844 PECOS PAC ID: 7214284090 Enrollment ID: I20180725001180 |
| Provider Name | Adair Allen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720087216 PECOS PAC ID: 6608123260 Enrollment ID: I20180727002033 |
| Provider Name | Tony Wayne Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609142611 PECOS PAC ID: 6608024799 Enrollment ID: I20180815002474 |
| Provider Name | Aldridge S Westrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316457179 PECOS PAC ID: 9931461084 Enrollment ID: I20180821001463 |
| Provider Name | Ballina H Griffy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558871814 PECOS PAC ID: 1658620729 Enrollment ID: I20180822002656 |
| Provider Name | Crystal D Lane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245732874 PECOS PAC ID: 4688923758 Enrollment ID: I20180822002982 |
| Provider Name | Wendy Houseright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992286678 PECOS PAC ID: 7214288174 Enrollment ID: I20180917001520 |
| Provider Name | Kathryn Heckle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376024844 PECOS PAC ID: 1759632367 Enrollment ID: I20180920002212 |
| Provider Name | Clayton D Humphrey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104289057 PECOS PAC ID: 1759677222 Enrollment ID: I20180920002582 |
| Provider Name | Teresa G Hassard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497908701 PECOS PAC ID: 5193866630 Enrollment ID: I20181001001768 |
| Provider Name | Emily Hensley Barnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134605124 PECOS PAC ID: 9830441492 Enrollment ID: I20181009002169 |
| Provider Name | Laurie Potter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720566565 PECOS PAC ID: 8325390693 Enrollment ID: I20181015002740 |
| Provider Name | Jacqueline Dotson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104309681 PECOS PAC ID: 6901158294 Enrollment ID: I20181015003592 |
| Provider Name | Elizabeth Noble Ergen |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1821350521 PECOS PAC ID: 7911200498 Enrollment ID: I20181022000110 |
| Provider Name | Amanda Thore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659856656 PECOS PAC ID: 4082968763 Enrollment ID: I20181115001621 |
| Provider Name | Jasma Leah Mcdonald |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1598212516 PECOS PAC ID: 1052607223 Enrollment ID: I20181115001703 |
| Provider Name | Daniel W. Mills |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093190316 PECOS PAC ID: 3274877485 Enrollment ID: I20181128003263 |
| Provider Name | Kevin R Myers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720517485 PECOS PAC ID: 1254675853 Enrollment ID: I20181210001008 |
| Provider Name | Cherie A Long |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760759138 PECOS PAC ID: 3072859909 Enrollment ID: I20190114000895 |
| Provider Name | Meijuan Zheng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356877435 PECOS PAC ID: 2668711755 Enrollment ID: I20190307001814 |
| Provider Name | Cynthia D Mantooth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649742149 PECOS PAC ID: 7315287398 Enrollment ID: I20190329001238 |
| Provider Name | Crystal K Buchanan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659839611 PECOS PAC ID: 2567705452 Enrollment ID: I20190516000665 |
| Provider Name | Lauren R Hankins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245792092 PECOS PAC ID: 7416281837 Enrollment ID: I20190618003685 |
| Provider Name | Rebecca Nicholson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871053736 PECOS PAC ID: 7214261486 Enrollment ID: I20190620003373 |
| Provider Name | Nicole Rebecca Lamb |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770079287 PECOS PAC ID: 3274867759 Enrollment ID: I20190703001469 |
| Provider Name | Curtis R Markham |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1124216387 PECOS PAC ID: 9335477165 Enrollment ID: I20190819000497 |
| Provider Name | Kelley Randolph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942863915 PECOS PAC ID: 0941539670 Enrollment ID: I20190905002674 |
| Provider Name | Chelsea L Foust |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861952467 PECOS PAC ID: 2062741309 Enrollment ID: I20190911001499 |
| Provider Name | Ariel R Long |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548657281 PECOS PAC ID: 6305167156 Enrollment ID: I20190923003390 |
| Provider Name | Tara E Lundy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477115749 PECOS PAC ID: 6002146297 Enrollment ID: I20191002000429 |
| Provider Name | Ewelina Freudenberger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205488202 PECOS PAC ID: 5294067914 Enrollment ID: I20191030002052 |
| Provider Name | Michelle Lawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548733348 PECOS PAC ID: 3577995794 Enrollment ID: I20191108001809 |
| Provider Name | Michelle Lawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548733348 PECOS PAC ID: 3577995794 Enrollment ID: I20191108001894 |
| Provider Name | Jessica Schwerin Danner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174921381 PECOS PAC ID: 4789018037 Enrollment ID: I20191219002754 |
| Provider Name | Katherine Anne Legare |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407273550 PECOS PAC ID: 3678827474 Enrollment ID: I20200113001881 |
| Provider Name | Tiffany A Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952946337 PECOS PAC ID: 8820424989 Enrollment ID: I20200207002223 |
| Provider Name | Theresa Caniff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407210172 PECOS PAC ID: 4385905090 Enrollment ID: I20200220002857 |
| Provider Name | Lindsay Heath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487910485 PECOS PAC ID: 5092142166 Enrollment ID: I20200302001681 |
| Provider Name | Alexander L Nourse |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609300136 PECOS PAC ID: 5991055063 Enrollment ID: I20200319002894 |
| Provider Name | Kristin Rae Mckamey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811527609 PECOS PAC ID: 3173952843 Enrollment ID: I20200331002533 |
| Provider Name | Sarah Lord |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013569201 PECOS PAC ID: 6608205992 Enrollment ID: I20200408001422 |
| Provider Name | Michael W Hughes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598764565 PECOS PAC ID: 6901847227 Enrollment ID: I20200424001139 |
| Provider Name | Donald L Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154979359 PECOS PAC ID: 1355774456 Enrollment ID: I20200501000431 |
| Provider Name | Anne K Brouha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922117084 PECOS PAC ID: 1850341454 Enrollment ID: I20200504002836 |
| Provider Name | Donna E Kirk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366066342 PECOS PAC ID: 5597189670 Enrollment ID: I20200722001540 |
| Provider Name | Nicole C O'hartz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194933762 PECOS PAC ID: 5193995611 Enrollment ID: I20200729004010 |
| Provider Name | Katherine E Whittington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023597945 PECOS PAC ID: 3678817723 Enrollment ID: I20200730000380 |
| Provider Name | Laura Brudecki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912437153 PECOS PAC ID: 7315362696 Enrollment ID: I20200804000216 |
| Provider Name | Kimberly A West |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578199196 PECOS PAC ID: 5890112718 Enrollment ID: I20200824002260 |
| Provider Name | Anicka K Kolarik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689103525 PECOS PAC ID: 8527318898 Enrollment ID: I20200916002681 |
| Provider Name | Katherine A Silva |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023540192 PECOS PAC ID: 2466870613 Enrollment ID: I20200921000617 |
| Provider Name | Emily L Woodrum |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770052417 PECOS PAC ID: 3577981695 Enrollment ID: I20200922000531 |
| Provider Name | Yolanda Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356863021 PECOS PAC ID: 8224457270 Enrollment ID: I20200924002931 |
| Provider Name | Callie M Lugo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528599503 PECOS PAC ID: 0749553063 Enrollment ID: I20200925001666 |
| Provider Name | Arieal Felix |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699201681 PECOS PAC ID: 3072947902 Enrollment ID: I20201020001481 |
| Provider Name | Roger M Nooe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881209864 PECOS PAC ID: 4789955386 Enrollment ID: I20201022003583 |
| Provider Name | Ty A Taubenheim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902404080 PECOS PAC ID: 7719399401 Enrollment ID: I20201222002769 |
| Provider Name | Crystal L Larrimore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225663651 PECOS PAC ID: 6507278181 Enrollment ID: I20201226000028 |
| Provider Name | Keisha M Shervington |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659782076 PECOS PAC ID: 0749693943 Enrollment ID: I20210107001347 |
| Provider Name | Casey L Dawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023644374 PECOS PAC ID: 6901210269 Enrollment ID: I20210127001711 |
| Provider Name | Tina Hurley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013523653 PECOS PAC ID: 7719392216 Enrollment ID: I20210216000350 |
| Provider Name | Ashley M Breazeale |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477045854 PECOS PAC ID: 5395151146 Enrollment ID: I20210303000860 |
| Provider Name | Emily Elizabeth Wasson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346874609 PECOS PAC ID: 7719316934 Enrollment ID: I20210422001546 |
| Provider Name | Colleen Michelle Clark Laing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912525049 PECOS PAC ID: 3476952292 Enrollment ID: I20210527003029 |
| Provider Name | Rebecca Sue Roland |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528346673 PECOS PAC ID: 3870704281 Enrollment ID: I20210709001975 |
| Provider Name | Amy E Gentry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417527672 PECOS PAC ID: 6507260072 Enrollment ID: I20210805000079 |
| Provider Name | Abigail R Tungett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003345513 PECOS PAC ID: 6901201821 Enrollment ID: I20210816002133 |
| Provider Name | Manasa Enja |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326400599 PECOS PAC ID: 6507150802 Enrollment ID: I20210818001164 |
| Provider Name | Mary Margaret Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083387112 PECOS PAC ID: 1557768637 Enrollment ID: I20210916003279 |
| Provider Name | Robin E Rhodea |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225508724 PECOS PAC ID: 2365849379 Enrollment ID: I20210917001137 |
| Provider Name | Michael D Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588272611 PECOS PAC ID: 6002213022 Enrollment ID: I20210917001481 |
| Provider Name | Shelby P Buffin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003307232 PECOS PAC ID: 0547667263 Enrollment ID: I20210923000727 |
| Provider Name | Anna Moreno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124497680 PECOS PAC ID: 2062800246 Enrollment ID: I20211020000850 |
| Provider Name | Leigh Scotten Tatum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285159830 PECOS PAC ID: 2769871995 Enrollment ID: I20211110000108 |
| Provider Name | Gina M Marqua |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467827097 PECOS PAC ID: 4688976640 Enrollment ID: I20211208000366 |
| Provider Name | Jacob A Lay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477216281 PECOS PAC ID: 6507256351 Enrollment ID: I20211209001500 |
| Provider Name | Chantia Fears-perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114685922 PECOS PAC ID: 2567854839 Enrollment ID: I20220118001920 |
| Provider Name | Hannah E Raines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023774379 PECOS PAC ID: 2264824465 Enrollment ID: I20220120001912 |
| Provider Name | Krystal J Rall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033790167 PECOS PAC ID: 6204228414 Enrollment ID: I20220120002221 |
| Provider Name | Sarah Elizabeth Eriksen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053671115 PECOS PAC ID: 2769630797 Enrollment ID: I20220209002607 |
| Provider Name | Gail G Reilly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235114539 PECOS PAC ID: 8224311865 Enrollment ID: I20220211000330 |
| Provider Name | Laura A Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215935499 PECOS PAC ID: 9133404189 Enrollment ID: I20220321001574 |
| Provider Name | Zachary P Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467988980 PECOS PAC ID: 0446647242 Enrollment ID: I20220426001504 |
| Provider Name | Jacqueline Blackburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326578725 PECOS PAC ID: 0840565172 Enrollment ID: I20220620000646 |
| Provider Name | Mary E Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962843409 PECOS PAC ID: 5597144212 Enrollment ID: I20220627000049 |
| Provider Name | Theresa Marie Whittler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740660893 PECOS PAC ID: 8729394168 Enrollment ID: I20220907001824 |
| Provider Name | Claudia Baskind |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508214362 PECOS PAC ID: 3072935832 Enrollment ID: I20221001000022 |
| Provider Name | Hannah B Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033751383 PECOS PAC ID: 4183059215 Enrollment ID: I20221005001709 |
| Provider Name | Hillary Anne Ebling Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639566243 PECOS PAC ID: 3476874470 Enrollment ID: I20221103003430 |
| Provider Name | Jordan Taylor Bentz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356065148 PECOS PAC ID: 0042687931 Enrollment ID: I20221107000789 |
| Provider Name | William Bruce Allen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326047408 PECOS PAC ID: 9739556499 Enrollment ID: I20221109001348 |
| Provider Name | Courtney Bramblett Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780292938 PECOS PAC ID: 9133596893 Enrollment ID: I20221109001616 |
| Provider Name | Andrew Carter Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326046509 PECOS PAC ID: 9032588314 Enrollment ID: I20221208000562 |
| Provider Name | Abigale Bethanie Cheatham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538898952 PECOS PAC ID: 3971972845 Enrollment ID: I20221215002176 |
| Provider Name | John Andrew Neece |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568463552 PECOS PAC ID: 9436520467 Enrollment ID: I20230130000978 |
| Provider Name | Jessica Danielle Brasel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235844077 PECOS PAC ID: 3678947256 Enrollment ID: I20230322001062 |
| Provider Name | Brennan Joseph Downey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245887215 PECOS PAC ID: 9032574991 Enrollment ID: I20230427001662 |
| Provider Name | Ioana Iacob |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1194100826 PECOS PAC ID: 7416246384 Enrollment ID: I20230427003082 |
| Provider Name | Michael Alan Heald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467496042 PECOS PAC ID: 8426416645 Enrollment ID: I20230621001098 |
| Provider Name | Tiffany Monique Gordon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902421944 PECOS PAC ID: 2365805678 Enrollment ID: I20230901002428 |
| Provider Name | Allan Gary Akin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629698626 PECOS PAC ID: 4880003979 Enrollment ID: I20230925001873 |
| Provider Name | Margaret Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912534744 PECOS PAC ID: 9234558859 Enrollment ID: I20230925002313 |
| Provider Name | Patrick Joseph Mcnicholas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073124228 PECOS PAC ID: 9032564166 Enrollment ID: I20231010002757 |
| Provider Name | Thomas Austin Witt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760010185 PECOS PAC ID: 0345695904 Enrollment ID: I20231017002305 |
| Provider Name | Brittany Nicole Mcgill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174203103 PECOS PAC ID: 7214383538 Enrollment ID: I20231023003159 |
| Provider Name | Palmer Gleason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073390977 PECOS PAC ID: 9436505641 Enrollment ID: I20231024003920 |
| Provider Name | Whitney Leigh Leon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760261226 PECOS PAC ID: 7719334994 Enrollment ID: I20231109000836 |
| Provider Name | Elizabeth Anne Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063982460 PECOS PAC ID: 9537517602 Enrollment ID: I20231129003816 |
| Provider Name | Chloe Lorraine Gonzalez Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366071235 PECOS PAC ID: 1658795455 Enrollment ID: I20231130000811 |
| Provider Name | Meghan Hohn Lacks |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1336692896 PECOS PAC ID: 3072961804 Enrollment ID: I20231204003271 |
| Provider Name | Patrick Michael Mills |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639386667 PECOS PAC ID: 1456700277 Enrollment ID: I20231205003240 |
| Provider Name | Haley Marie Novak |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215545983 PECOS PAC ID: 5193174597 Enrollment ID: I20231211002434 |
| Provider Name | David Alexander Hicks |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1134674948 PECOS PAC ID: 4082063334 Enrollment ID: I20231212000938 |
| Provider Name | Melissa L Wilson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336198647 PECOS PAC ID: 3779934609 Enrollment ID: I20240104003974 |
| Provider Name | Tabitha Sarena Hubbard |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1558861765 PECOS PAC ID: 4587015870 Enrollment ID: I20240111001067 |
| Provider Name | Kendra Renee Dailey |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1720638786 PECOS PAC ID: 9234572207 Enrollment ID: I20240206004186 |
| Provider Name | Rishay Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447688999 PECOS PAC ID: 4284071341 Enrollment ID: I20240325002335 |
| Provider Name | Garrett Bell-gresham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194138560 PECOS PAC ID: 9335417344 Enrollment ID: I20240401000448 |
| Provider Name | Lauren Whitney Hulse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740882471 PECOS PAC ID: 8820439904 Enrollment ID: I20240508000531 |
| Provider Name | John Randolph |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073264115 PECOS PAC ID: 0042652190 Enrollment ID: I20240521003915 |
Ethel M Vicks Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 162 Claire Pl, Talbott, TN 37877 Phone: 423-353-0322 |