| Chi Saint Joseph Medical Group | |
|
1401 Harrodsburg Rd Lexington KY 40504-3751 | |
| (606) 330-7835 | |
| (606) 330-7825 |
| Full Name | Chi Saint Joseph Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 1401 Harrodsburg Rd, Lexington, Kentucky |
| Authorized Official Name and Position | Carmel Jones (COO) |
| Authorized Official Contact | 8593131713 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chi Saint Joseph Medical Group Po Box 936 London KY 40743-0936 Ph: (606) 330-7835 | Chi Saint Joseph Medical Group 1401 Harrodsburg Rd Lexington KY 40504-3751 Ph: (606) 330-7835 |
| NPI Number | 1104875970 |
|---|---|
| Provider Enumeration Date | 05/09/2006 |
| Last Update Date | 01/25/2023 |
| Certification Date | 01/25/2023 |
| Medicare PECOS PAC ID | 8820993702 |
|---|---|
| Medicare Enrollment ID | O20031204000080 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104875970 | NPI | - | NPPES |
| 000000060604 | Other | KY | ANTHEM GROUP# |
| 200434820A | Medicaid | IN | |
| 7100201000 (FPAS) | Medicaid | KY | |
| 7100200880 (CRNA) | Medicaid | KY | |
| 7100200870 (MD) | Medicaid | KY | |
| 7100200890 (PA) | Medicaid | KY | |
| 7100200840 (LCSW) | Medicaid | KY | |
| 7100294690 (LMFT) | Medicaid | KY | |
| 78904851 (NP) | Medicaid | KY |
| Provider Name | Richard Dinardo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1922047224 PECOS PAC ID: 3678487477 Enrollment ID: I20031117000254 |
| Provider Name | Steve S Lin |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1518979111 PECOS PAC ID: 2668386467 Enrollment ID: I20031117000260 |
| Provider Name | James Rollins |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1346238599 PECOS PAC ID: 4385549625 Enrollment ID: I20031201000459 |
| Provider Name | Henry Vontez Poston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306951934 PECOS PAC ID: 0042119810 Enrollment ID: I20031231000444 |
| Provider Name | Peter H Ko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730145012 PECOS PAC ID: 9830090331 Enrollment ID: I20040116001089 |
| Provider Name | Trina R Mattingly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316993165 PECOS PAC ID: 8022903566 Enrollment ID: I20040216000406 |
| Provider Name | Herbert Long |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801890686 PECOS PAC ID: 4789588492 Enrollment ID: I20040326000157 |
| Provider Name | Aqeel H Mandviwala |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1326016460 PECOS PAC ID: 2264419829 Enrollment ID: I20040701000563 |
| Provider Name | Maria P. Mendoza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710094255 PECOS PAC ID: 6002887676 Enrollment ID: I20040805000748 |
| Provider Name | Robin Kay Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104835859 PECOS PAC ID: 7517935984 Enrollment ID: I20040923000081 |
| Provider Name | Jean Maurice Page |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1407804164 PECOS PAC ID: 5991774846 Enrollment ID: I20040928001037 |
| Provider Name | Patrice Beliveau |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1720036486 PECOS PAC ID: 1355310202 Enrollment ID: I20040928001071 |
| Provider Name | Alam N Khan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629047162 PECOS PAC ID: 2062474646 Enrollment ID: I20041027000712 |
| Provider Name | Oluwole John Abe |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1841269834 PECOS PAC ID: 5294797874 Enrollment ID: I20041027000744 |
| Provider Name | Shelley B Stanko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043232101 PECOS PAC ID: 5890758536 Enrollment ID: I20041104000552 |
| Provider Name | Ray B Terrell |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1447257415 PECOS PAC ID: 2769448166 Enrollment ID: I20041207001158 |
| Provider Name | Timothy D Adkins |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1932203338 PECOS PAC ID: 6002869484 Enrollment ID: I20050309000478 |
| Provider Name | Thomas K Slabaugh |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1174622120 PECOS PAC ID: 8224082516 Enrollment ID: I20050309000761 |
| Provider Name | Neil J Patil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073569471 PECOS PAC ID: 0345296166 Enrollment ID: I20050324000808 |
| Provider Name | Daniell B Hill |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1801980644 PECOS PAC ID: 0749223881 Enrollment ID: I20050609000005 |
| Provider Name | Timothy Jones |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467402925 PECOS PAC ID: 5890731681 Enrollment ID: I20050701000348 |
| Provider Name | Kimberly Cesario |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467401083 PECOS PAC ID: 3779510144 Enrollment ID: I20050719000047 |
| Provider Name | Thomas Collier Thornberry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346280062 PECOS PAC ID: 9335178953 Enrollment ID: I20050809000219 |
| Provider Name | Kristine Y Lain |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821039215 PECOS PAC ID: 2668412255 Enrollment ID: I20050913000467 |
| Provider Name | Nezar M Falluji |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1053427872 PECOS PAC ID: 3678593456 Enrollment ID: I20051123000407 |
| Provider Name | Connie J Pate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669412334 PECOS PAC ID: 7719994524 Enrollment ID: I20060320000014 |
| Provider Name | Nancy V Morris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770543175 PECOS PAC ID: 3779590609 Enrollment ID: I20060405000167 |
| Provider Name | Toufic A Fakhoury |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235234394 PECOS PAC ID: 4385653427 Enrollment ID: I20060418000333 |
| Provider Name | Hussam Hamdalla |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1871527804 PECOS PAC ID: 7012913775 Enrollment ID: I20061020000101 |
| Provider Name | Paula Dix Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457360398 PECOS PAC ID: 7214934520 Enrollment ID: I20061030000510 |
| Provider Name | Robert D Owen |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1003850736 PECOS PAC ID: 3173520384 Enrollment ID: I20061101000267 |
| Provider Name | Fred P Hadley |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1154414548 PECOS PAC ID: 1658324033 Enrollment ID: I20070202000111 |
| Provider Name | James A Mullins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851461685 PECOS PAC ID: 9133225782 Enrollment ID: I20070428000037 |
| Provider Name | Sanjiv Mehta |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1013014133 PECOS PAC ID: 2365548450 Enrollment ID: I20070507000395 |
| Provider Name | Michael Brennan Royalty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083740377 PECOS PAC ID: 3173622784 Enrollment ID: I20070622000274 |
| Provider Name | Robin R House |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003008095 PECOS PAC ID: 3678666054 Enrollment ID: I20070830000131 |
| Provider Name | Teresa Lynn Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669671863 PECOS PAC ID: 2769576099 Enrollment ID: I20070918000371 |
| Provider Name | Anantha L Krishna |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1740203447 PECOS PAC ID: 6305744988 Enrollment ID: I20070919000547 |
| Provider Name | Hamid R Mohammadzadeh |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1053394619 PECOS PAC ID: 7719878016 Enrollment ID: I20071127000336 |
| Provider Name | Tom K Mccormick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952444796 PECOS PAC ID: 2668553520 Enrollment ID: I20080116000698 |
| Provider Name | Suzanne M Morton |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679591903 PECOS PAC ID: 9436229218 Enrollment ID: I20080605000370 |
| Provider Name | Matthew S Miller |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1295791671 PECOS PAC ID: 6002984408 Enrollment ID: I20081013000471 |
| Provider Name | Collin E Ball |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1619166378 PECOS PAC ID: 8022176361 Enrollment ID: I20081015000366 |
| Provider Name | Samy C Elayi |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1760698609 PECOS PAC ID: 5597828137 Enrollment ID: I20090108000424 |
| Provider Name | John R Strifling |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679736375 PECOS PAC ID: 5496800195 Enrollment ID: I20090902000001 |
| Provider Name | William Sutherland |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1790989663 PECOS PAC ID: 3072604073 Enrollment ID: I20090921000410 |
| Provider Name | Molly M Hawley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316179286 PECOS PAC ID: 6103972757 Enrollment ID: I20090923000225 |
| Provider Name | Julianne Z Ewen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275515066 PECOS PAC ID: 3375699788 Enrollment ID: I20090925000229 |
| Provider Name | Lawrence Jedlicka |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508958521 PECOS PAC ID: 2860492238 Enrollment ID: I20090926000063 |
| Provider Name | James D Duncan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598725020 PECOS PAC ID: 6406994268 Enrollment ID: I20091116000356 |
| Provider Name | Joseph F Morris |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1477667269 PECOS PAC ID: 6709974702 Enrollment ID: I20091124000259 |
| Provider Name | Richard A Blake |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699702308 PECOS PAC ID: 5395884225 Enrollment ID: I20091205000009 |
| Provider Name | John M Harris |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083619886 PECOS PAC ID: 6406746163 Enrollment ID: I20091211000071 |
| Provider Name | Farhan Javaid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417966425 PECOS PAC ID: 3274508809 Enrollment ID: I20091215000660 |
| Provider Name | Caresse L Wesley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841462322 PECOS PAC ID: 1153462056 Enrollment ID: I20100113000639 |
| Provider Name | Jessica Pennington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003861162 PECOS PAC ID: 7810998838 Enrollment ID: I20100330000540 |
| Provider Name | Richard C Montgomery |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1326066648 PECOS PAC ID: 5698802734 Enrollment ID: I20100422000250 |
| Provider Name | Larry S Butler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053352500 PECOS PAC ID: 7911891171 Enrollment ID: I20100427000236 |
| Provider Name | Elizabeth S Campbell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053352518 PECOS PAC ID: 4486548641 Enrollment ID: I20100503000323 |
| Provider Name | Anup S Chattha |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1720076672 PECOS PAC ID: 6204740137 Enrollment ID: I20100605000137 |
| Provider Name | Nicole Anne Everman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801059464 PECOS PAC ID: 1052442936 Enrollment ID: I20100622000574 |
| Provider Name | Fred L Hamlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194041897 PECOS PAC ID: 9436281268 Enrollment ID: I20100714000865 |
| Provider Name | Warren F Chumley |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1902853617 PECOS PAC ID: 7416089693 Enrollment ID: I20100723000413 |
| Provider Name | Matthew P Tutt |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1881824860 PECOS PAC ID: 2860526175 Enrollment ID: I20100820001065 |
| Provider Name | Rodrigo S Cavallazzi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851500961 PECOS PAC ID: 9234255654 Enrollment ID: I20100923000101 |
| Provider Name | Cristina Cabral Pauig |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1790916468 PECOS PAC ID: 0941326318 Enrollment ID: I20100923000630 |
| Provider Name | Kyra N Gambrel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083929236 PECOS PAC ID: 5890811814 Enrollment ID: I20100928000715 |
| Provider Name | Melissa J Poynter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093861064 PECOS PAC ID: 1557553526 Enrollment ID: I20101008000383 |
| Provider Name | Eliseo A Colon-carreras |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1982606422 PECOS PAC ID: 6608831086 Enrollment ID: I20101209001046 |
| Provider Name | Lekshmi Seemanthini |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1326229352 PECOS PAC ID: 6103014980 Enrollment ID: I20101221000251 |
| Provider Name | Kathleen R Martin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437243268 PECOS PAC ID: 7618959255 Enrollment ID: I20110216000819 |
| Provider Name | Brett Darrell Akers |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1639162340 PECOS PAC ID: 4183795065 Enrollment ID: I20110404000644 |
| Provider Name | Dasen R Ritchey |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013907237 PECOS PAC ID: 7012962400 Enrollment ID: I20110524000740 |
| Provider Name | Sharat Koul |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1093986614 PECOS PAC ID: 2668506114 Enrollment ID: I20110730000004 |
| Provider Name | Laura J Watson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104089457 PECOS PAC ID: 4587833355 Enrollment ID: I20110811000751 |
| Provider Name | Samer A Kseibi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1851359541 PECOS PAC ID: 5890741870 Enrollment ID: I20110902000513 |
| Provider Name | Joseph Edmund Skurka |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1013152677 PECOS PAC ID: 2567632201 Enrollment ID: I20110907000929 |
| Provider Name | Felicia D Geron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265729990 PECOS PAC ID: 0143491209 Enrollment ID: I20110921000236 |
| Provider Name | Debra F Danzinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578524641 PECOS PAC ID: 1850562604 Enrollment ID: I20110927000736 |
| Provider Name | Amjad A Bukhari |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972896249 PECOS PAC ID: 4082888367 Enrollment ID: I20111123000113 |
| Provider Name | Anthony Joseph Smith |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508959495 PECOS PAC ID: 4789859364 Enrollment ID: I20111209000194 |
| Provider Name | Mary E Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366713828 PECOS PAC ID: 6901060177 Enrollment ID: I20120620000107 |
| Provider Name | Hannah M Hall |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548423957 PECOS PAC ID: 9638325327 Enrollment ID: I20120813000397 |
| Provider Name | Jessica M Fairchild |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851526271 PECOS PAC ID: 1951559236 Enrollment ID: I20120911000397 |
| Provider Name | Amanda E Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952541203 PECOS PAC ID: 9638327737 Enrollment ID: I20120914000345 |
| Provider Name | Teresa W Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619948569 PECOS PAC ID: 6608878756 Enrollment ID: I20121009000130 |
| Provider Name | Jocelyn Elhalawany |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518215326 PECOS PAC ID: 1951550722 Enrollment ID: I20121011000429 |
| Provider Name | Syed Bokhari |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1831382399 PECOS PAC ID: 5395981211 Enrollment ID: I20130422000068 |
| Provider Name | Vidhya Lakshmi Ravi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558696989 PECOS PAC ID: 8426295759 Enrollment ID: I20130506000260 |
| Provider Name | Nagabhushanam R Bollavaram |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1548572704 PECOS PAC ID: 4284876764 Enrollment ID: I20130813000356 |
| Provider Name | Brian C Glover |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710205992 PECOS PAC ID: 2365685963 Enrollment ID: I20130829000728 |
| Provider Name | Roberto Cardarelli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194794701 PECOS PAC ID: 9133192503 Enrollment ID: I20130917000569 |
| Provider Name | Iram Nawaz |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1992967269 PECOS PAC ID: 7012055502 Enrollment ID: I20131003000180 |
| Provider Name | Kimberly Dawn Pruitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174964969 PECOS PAC ID: 3476788423 Enrollment ID: I20131028001614 |
| Provider Name | William Scott Bridges |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063482792 PECOS PAC ID: 6103714316 Enrollment ID: I20131114001159 |
| Provider Name | Sherri Lynn Newton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841624244 PECOS PAC ID: 0042441222 Enrollment ID: I20140401001997 |
| Provider Name | Suzanne B Mcgill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366709511 PECOS PAC ID: 9133351935 Enrollment ID: I20140409002095 |
| Provider Name | Molly Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386080752 PECOS PAC ID: 7012140643 Enrollment ID: I20140505002230 |
| Provider Name | Andrea Noble Irwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508284845 PECOS PAC ID: 5597998070 Enrollment ID: I20140507002294 |
| Provider Name | Micah N Greenwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740692193 PECOS PAC ID: 6507082161 Enrollment ID: I20140717001189 |
| Provider Name | Jessica D Lamb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841604576 PECOS PAC ID: 0941426969 Enrollment ID: I20140729001038 |
| Provider Name | Justin D Johnson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1013179001 PECOS PAC ID: 8820216492 Enrollment ID: I20140822001056 |
| Provider Name | Yousef Darrat |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1114127354 PECOS PAC ID: 5991942187 Enrollment ID: I20141103000631 |
| Provider Name | Rachel M Decoster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871902957 PECOS PAC ID: 3173845369 Enrollment ID: I20141124002465 |
| Provider Name | Paul R Mcclung |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104223718 PECOS PAC ID: 6406170703 Enrollment ID: I20150114002307 |
| Provider Name | Paul Ewald Rober |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1518968619 PECOS PAC ID: 9335331735 Enrollment ID: I20150122001151 |
| Provider Name | Amy Carrillo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780878330 PECOS PAC ID: 5991863862 Enrollment ID: I20150126000286 |
| Provider Name | Russell Crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225427388 PECOS PAC ID: 3779801303 Enrollment ID: I20150410002527 |
| Provider Name | Joanie L Keith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992193270 PECOS PAC ID: 8729392345 Enrollment ID: I20150727001887 |
| Provider Name | June Y Yong |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437150364 PECOS PAC ID: 5193788180 Enrollment ID: I20150814013173 |
| Provider Name | Shawn E Flynn |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427272673 PECOS PAC ID: 0749331817 Enrollment ID: I20150908001630 |
| Provider Name | Carmel Hensley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174918544 PECOS PAC ID: 2264732569 Enrollment ID: I20151118000407 |
| Provider Name | Rhiannon L Black |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528431871 PECOS PAC ID: 4789984469 Enrollment ID: I20151202001243 |
| Provider Name | Christopher A Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649641895 PECOS PAC ID: 3375843758 Enrollment ID: I20151208001871 |
| Provider Name | Megan E Collett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134580145 PECOS PAC ID: 6800186438 Enrollment ID: I20160609001145 |
| Provider Name | Sabrina D Lambert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750749065 PECOS PAC ID: 0446541973 Enrollment ID: I20160614000675 |
| Provider Name | Summer Blair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245683697 PECOS PAC ID: 3870889744 Enrollment ID: I20160901002377 |
| Provider Name | Heather B Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528513892 PECOS PAC ID: 0648567438 Enrollment ID: I20160921002846 |
| Provider Name | Don Morring |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437479797 PECOS PAC ID: 5496978991 Enrollment ID: I20170206002828 |
| Provider Name | Angel Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821534769 PECOS PAC ID: 1456635309 Enrollment ID: I20170221002510 |
| Provider Name | Kelly Taylor |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1881131530 PECOS PAC ID: 3072880640 Enrollment ID: I20170602000313 |
| Provider Name | Kevin Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740270016 PECOS PAC ID: 8820366834 Enrollment ID: I20170615002376 |
| Provider Name | Alberto Zarak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659650034 PECOS PAC ID: 3173893377 Enrollment ID: I20170720002355 |
| Provider Name | Amelia Nicole Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467970715 PECOS PAC ID: 2466719653 Enrollment ID: I20171122002758 |
| Provider Name | Jeeshan Ali Faridi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1134514532 PECOS PAC ID: 0244519387 Enrollment ID: I20171129002475 |
| Provider Name | Sarah Greenwell Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376058883 PECOS PAC ID: 1254699432 Enrollment ID: I20171215001664 |
| Provider Name | Lisa Ann Mallard |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1891847869 PECOS PAC ID: 5496014136 Enrollment ID: I20180125002105 |
| Provider Name | Hillary Morgan Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720591076 PECOS PAC ID: 4183984644 Enrollment ID: I20180201002956 |
| Provider Name | Shannon Michelle Woods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730697517 PECOS PAC ID: 1355602723 Enrollment ID: I20180227001319 |
| Provider Name | Jennifer Schadle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568991941 PECOS PAC ID: 0840552154 Enrollment ID: I20180327000999 |
| Provider Name | Brian P Kelty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124462221 PECOS PAC ID: 3375825441 Enrollment ID: I20180410002352 |
| Provider Name | Jan M Veloso |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1992111850 PECOS PAC ID: 4587933700 Enrollment ID: I20180427002134 |
| Provider Name | David Cody Dugger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063906675 PECOS PAC ID: 5496002008 Enrollment ID: I20180726003270 |
| Provider Name | Hawa J Edriss |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1841546793 PECOS PAC ID: 8224336466 Enrollment ID: I20180809000714 |
| Provider Name | Alexis N Mcanally |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639657018 PECOS PAC ID: 4082963368 Enrollment ID: I20180820002351 |
| Provider Name | Kathryne J Blair |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245675933 PECOS PAC ID: 1153555438 Enrollment ID: I20180821002021 |
| Provider Name | Rachel H Mathis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1922368695 PECOS PAC ID: 3476859869 Enrollment ID: I20180905002858 |
| Provider Name | Nessa S Timoney |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1952696676 PECOS PAC ID: 8325359458 Enrollment ID: I20181001002165 |
| Provider Name | Christopher D Frisch |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1740575984 PECOS PAC ID: 9436308996 Enrollment ID: I20181018002524 |
| Provider Name | Majdi Lagili Al Dliw |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1790041069 PECOS PAC ID: 8820239122 Enrollment ID: I20181207002627 |
| Provider Name | Kristina Paige Cassmeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740757194 PECOS PAC ID: 0941545966 Enrollment ID: I20181219003600 |
| Provider Name | Heather Lynn Darnell Bishop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316431265 PECOS PAC ID: 4587904578 Enrollment ID: I20190329001717 |
| Provider Name | Stacey C Greenwell-osborne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356809768 PECOS PAC ID: 4688917834 Enrollment ID: I20190510000639 |
| Provider Name | Amy E Baker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811377377 PECOS PAC ID: 7911211966 Enrollment ID: I20190802002842 |
| Provider Name | Lauren Etienne Nance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245887652 PECOS PAC ID: 8729318886 Enrollment ID: I20191002003724 |
| Provider Name | Crystal Denise Martin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801059332 PECOS PAC ID: 2567657091 Enrollment ID: I20191230002313 |
| Provider Name | Carla Deanne Gilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669021523 PECOS PAC ID: 5890122212 Enrollment ID: I20200225001811 |
| Provider Name | Alicia Alvarado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720622715 PECOS PAC ID: 6800226507 Enrollment ID: I20200421001110 |
| Provider Name | Tyler B. Holley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992184030 PECOS PAC ID: 2365873817 Enrollment ID: I20200515002456 |
| Provider Name | Ali Elfandi |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1669816336 PECOS PAC ID: 5991059479 Enrollment ID: I20200604001476 |
| Provider Name | Adam Kimball Franson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093036964 PECOS PAC ID: 1052631967 Enrollment ID: I20200615001284 |
| Provider Name | Hazim Bukamur |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1861807489 PECOS PAC ID: 7517186869 Enrollment ID: I20200624003093 |
| Provider Name | Madeline Keyser Fisher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770945115 PECOS PAC ID: 6800167578 Enrollment ID: I20200709003606 |
| Provider Name | Vincent Depalma |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1295155927 PECOS PAC ID: 4183968399 Enrollment ID: I20200803002108 |
| Provider Name | Autumn Gayheart Westmoreland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114544509 PECOS PAC ID: 5496170730 Enrollment ID: I20200804002723 |
| Provider Name | Nicole Ivanchak Goodin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336534437 PECOS PAC ID: 4789000936 Enrollment ID: I20200818002843 |
| Provider Name | Kevin Magone |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1801209069 PECOS PAC ID: 4688988207 Enrollment ID: I20200818002872 |
| Provider Name | Frank P Taddeo |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1164884904 PECOS PAC ID: 3870886013 Enrollment ID: I20200910000794 |
| Provider Name | Ibrahim M Shahoub |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1629410691 PECOS PAC ID: 2860623998 Enrollment ID: I20200922003029 |
| Provider Name | Nellie Goodin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336724376 PECOS PAC ID: 7618384363 Enrollment ID: I20210325001628 |
| Provider Name | Bruce Allen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639210743 PECOS PAC ID: 3779519111 Enrollment ID: I20210426002378 |
| Provider Name | George Mcclellan Dimeling |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1932398161 PECOS PAC ID: 0547575623 Enrollment ID: I20210429002972 |
| Provider Name | Phyo Kyaw |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1316333248 PECOS PAC ID: 1658679899 Enrollment ID: I20210526001516 |
| Provider Name | Bilal Aslam |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1790193100 PECOS PAC ID: 0547574303 Enrollment ID: I20210527002718 |
| Provider Name | Chioma Nwagbara |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1659782530 PECOS PAC ID: 6507177466 Enrollment ID: I20210609001148 |
| Provider Name | Fred Ochieng Odago |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356872238 PECOS PAC ID: 0840690467 Enrollment ID: I20210617002587 |
| Provider Name | Benjamin Thomas Neltner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922531680 PECOS PAC ID: 5395093223 Enrollment ID: I20210625000359 |
| Provider Name | Abdul Siddiqui |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1912331323 PECOS PAC ID: 4486926334 Enrollment ID: I20210721003742 |
| Provider Name | Nikki L Cornett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891362885 PECOS PAC ID: 3779987524 Enrollment ID: I20210802001980 |
| Provider Name | Tara Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225704836 PECOS PAC ID: 0446658553 Enrollment ID: I20211004002304 |
| Provider Name | Torey Arnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558024729 PECOS PAC ID: 3678962354 Enrollment ID: I20211118001292 |
| Provider Name | Seyed Kamran Hejazi Kenari |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1134521669 PECOS PAC ID: 2264755214 Enrollment ID: I20211209002812 |
| Provider Name | Jayla Rebecca Hignite Scalf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184382780 PECOS PAC ID: 7012307739 Enrollment ID: I20211210001884 |
| Provider Name | Derrick H Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780966408 PECOS PAC ID: 8628210499 Enrollment ID: I20220210001720 |
| Provider Name | Hannah Archer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629737721 PECOS PAC ID: 5496149841 Enrollment ID: I20220228002563 |
| Provider Name | Brian Berk |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1952324600 PECOS PAC ID: 2365408838 Enrollment ID: I20220310002876 |
| Provider Name | Lorie Jean Stines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346990421 PECOS PAC ID: 1456747112 Enrollment ID: I20220405001821 |
| Provider Name | Jessica Thomas Mcmaine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093254930 PECOS PAC ID: 3476934597 Enrollment ID: I20220721000854 |
| Provider Name | Jacob Adams Trapp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700313269 PECOS PAC ID: 6800164633 Enrollment ID: I20220801002540 |
| Provider Name | Alexander Hernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144725946 PECOS PAC ID: 9931436284 Enrollment ID: I20220809003042 |
| Provider Name | Eric Scott Schmidt |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1841687555 PECOS PAC ID: 0941592794 Enrollment ID: I20220825003301 |
| Provider Name | Amanda Mistique Vickers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770925794 PECOS PAC ID: 9830419407 Enrollment ID: I20220902000266 |
| Provider Name | Casey Clark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306340286 PECOS PAC ID: 5193052447 Enrollment ID: I20220902002251 |
| Provider Name | Zaiba Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720645799 PECOS PAC ID: 2961886221 Enrollment ID: I20220906001079 |
| Provider Name | David S. Swedler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508196130 PECOS PAC ID: 4385968809 Enrollment ID: I20230208001087 |
| Provider Name | Chukwunweike John Nwosu |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1346651130 PECOS PAC ID: 2264659507 Enrollment ID: I20230512002022 |
| Provider Name | Anthony Ryan Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417655382 PECOS PAC ID: 9436515400 Enrollment ID: I20230517000774 |
| Provider Name | Courtney Ann Beisler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164111480 PECOS PAC ID: 3577929264 Enrollment ID: I20230523001400 |
| Provider Name | Tamara Lynn Andrews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538859111 PECOS PAC ID: 5294192118 Enrollment ID: I20230608002200 |
| Provider Name | Sara Cornelison Ballard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730877713 PECOS PAC ID: 9830559376 Enrollment ID: I20230717000838 |
| Provider Name | Katherine Isabelle Foster |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528599669 PECOS PAC ID: 3870954514 Enrollment ID: I20230727004014 |
| Provider Name | Nova L White |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073141032 PECOS PAC ID: 0749685782 Enrollment ID: I20230728001987 |
| Provider Name | Damir Kusmic |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780039727 PECOS PAC ID: 4880980424 Enrollment ID: I20230803002309 |
| Provider Name | Jarred Connor Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396374575 PECOS PAC ID: 3577983998 Enrollment ID: I20230804001430 |
| Provider Name | Robert Christopher Spears |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1174985592 PECOS PAC ID: 9234404211 Enrollment ID: I20230804002660 |
| Provider Name | Nicholas Capal |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942707468 PECOS PAC ID: 2062777139 Enrollment ID: I20230811001322 |
| Provider Name | Sean Butterbaugh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598226490 PECOS PAC ID: 5890023204 Enrollment ID: I20230821003435 |
| Provider Name | Mohamed Shtiwi Ayan |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1700219193 PECOS PAC ID: 4385936046 Enrollment ID: I20230911004020 |
| Provider Name | Natalie Marie Chelf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386359149 PECOS PAC ID: 2163886953 Enrollment ID: I20230912003775 |
| Provider Name | Kelly Moore |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205331600 PECOS PAC ID: 4880027127 Enrollment ID: I20230914001682 |
| Provider Name | Erika Moffitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750782306 PECOS PAC ID: 1153542162 Enrollment ID: I20230928004096 |
| Provider Name | Kristin Elizabeth Hoover |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1578094348 PECOS PAC ID: 3779996384 Enrollment ID: I20240105003570 |
| Provider Name | Jose Maria Ochoa |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1144548876 PECOS PAC ID: 5193952299 Enrollment ID: I20240124003764 |
| Provider Name | Mark Harold Enker |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1477600260 PECOS PAC ID: 2163562471 Enrollment ID: I20240130000498 |
| Provider Name | Wanda Hale Schubarth |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1801099031 PECOS PAC ID: 8729444930 Enrollment ID: I20240130002584 |
| Provider Name | Terris Laurent White |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1467773978 PECOS PAC ID: 4880974146 Enrollment ID: I20240202001800 |
| Provider Name | Shoaib Ahmad |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1255651477 PECOS PAC ID: 8527208040 Enrollment ID: I20240202003469 |
| Provider Name | Akinyinka Abidem Ajelabi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1841227808 PECOS PAC ID: 8729044789 Enrollment ID: I20240205000901 |
| Provider Name | Salil Kalra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275983744 PECOS PAC ID: 6002109329 Enrollment ID: I20240213001188 |
| Provider Name | Ajit Nandkumar Chary |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1396184214 PECOS PAC ID: 0143453043 Enrollment ID: I20240304002664 |
| Provider Name | Erika Maria Moseson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1790010387 PECOS PAC ID: 9133305337 Enrollment ID: I20240305002080 |
| Provider Name | Kelli Lynn Mcguire |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1154079317 PECOS PAC ID: 7911393004 Enrollment ID: I20240311000798 |
| Provider Name | Darshan R Dhingani |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1053547968 PECOS PAC ID: 3274797196 Enrollment ID: I20240408000335 |
| Provider Name | Gregory Evans |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1073788816 PECOS PAC ID: 6800039355 Enrollment ID: I20240424002289 |
Alexander J. Tikhtman, M.d., P.s.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1517 Nicholasville Rd, Suite 403, Lexington, KY 40503 Phone: 859-276-6168 Fax: 859-276-0850 | |
Verbal Behavior Consulting, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1035 Strader Dr Ste 150, Lexington, KY 40505 Phone: 859-899-9200 Fax: 859-899-9202 | |
Thomas-peeples & Associates, Psc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 Dennis Dr, Lexington, KY 40503 Phone: 859-278-4775 Fax: 859-373-0018 | |
Kvc Behavorial Healthcare Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 Beasley St, Lexington, KY 40509 Phone: 859-254-1035 | |
Momo Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 162 Glenn Pl, Lexington, KY 40505 Phone: 502-509-9436 | |
Andre N. Fernandez Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 Darby Creek Rd, Suite 21, Lexington, KY 40509 Phone: 859-263-9305 Fax: 859-264-1169 | |
Mended Counseling & Trauma Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 824 Euclid Ave Ste A102, Lexington, KY 40502 Phone: 859-338-0006 |