| Columbus Ambulatory Healthcare Services, Inc. | |
|
1800 10th Ave Columbus GA 31901-3624 | |
| (706) 571-1120 | |
| (706) 660-2685 |
| Full Name | Columbus Ambulatory Healthcare Services, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1800 10th Ave, Columbus, Georgia |
| Authorized Official Name and Position | Teirra Walker (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 7064944300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbus Ambulatory Healthcare Services, Inc. Po Box 117337 Atlanta GA 30368-7337 Ph: (770) 801-2500 | Columbus Ambulatory Healthcare Services, Inc. 1800 10th Ave Columbus GA 31901-3624 Ph: (706) 571-1120 |
| NPI Number | 1790733244 |
|---|---|
| Provider Enumeration Date | 05/05/2006 |
| Last Update Date | 10/26/2021 |
| Certification Date | 10/26/2021 |
| Medicare PECOS PAC ID | 1355244385 |
|---|---|
| Medicare Enrollment ID | O20040128000790 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790733244 | NPI | - | NPPES |
| 85001603G | Medicaid | GA |
| Provider Name | Sabrina M Rene |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1710906607 PECOS PAC ID: 5496656043 Enrollment ID: I20040120000359 |
| Provider Name | Steven B Leichter |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1548302201 PECOS PAC ID: 8921995267 Enrollment ID: I20040304000408 |
| Provider Name | Daryl A Ellis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467468355 PECOS PAC ID: 8426043076 Enrollment ID: I20040419000319 |
| Provider Name | Joseph R Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366416166 PECOS PAC ID: 6305823162 Enrollment ID: I20040630000774 |
| Provider Name | Shabbir S Motiwala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306820253 PECOS PAC ID: 2567449176 Enrollment ID: I20040701000918 |
| Provider Name | Curtis M Sorensen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457381089 PECOS PAC ID: 4082693999 Enrollment ID: I20040715000179 |
| Provider Name | Ronson Hughes |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1811917586 PECOS PAC ID: 7113907304 Enrollment ID: I20040720000900 |
| Provider Name | James M Cunningham |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1023084068 PECOS PAC ID: 8426029737 Enrollment ID: I20040802000888 |
| Provider Name | Richard C Gillett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134113277 PECOS PAC ID: 0143280164 Enrollment ID: I20041015000021 |
| Provider Name | Joyce H Hendry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285767566 PECOS PAC ID: 9335105659 Enrollment ID: I20041208000059 |
| Provider Name | Lisa M Plock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528056660 PECOS PAC ID: 8224094545 Enrollment ID: I20041208000077 |
| Provider Name | Jefferson C Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033107164 PECOS PAC ID: 5799741021 Enrollment ID: I20041208000160 |
| Provider Name | Elizabeth M Martin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851405005 PECOS PAC ID: 5294716262 Enrollment ID: I20041208000267 |
| Provider Name | Patrick B Railey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871529032 PECOS PAC ID: 6507815982 Enrollment ID: I20050113000184 |
| Provider Name | Sonie M Clayton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982778221 PECOS PAC ID: 9931158466 Enrollment ID: I20050121000444 |
| Provider Name | Kendall M Handy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316931975 PECOS PAC ID: 1456302959 Enrollment ID: I20050202000168 |
| Provider Name | Michael Eugene Greene |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942232681 PECOS PAC ID: 3274588421 Enrollment ID: I20050322000378 |
| Provider Name | Michael N Steinbook |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1811085616 PECOS PAC ID: 2668428111 Enrollment ID: I20050328000707 |
| Provider Name | Jennifer Lynn Jestel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710002225 PECOS PAC ID: 2466490149 Enrollment ID: I20050422000313 |
| Provider Name | William S Hudson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922064914 PECOS PAC ID: 0941242374 Enrollment ID: I20050802000595 |
| Provider Name | Janine E Burgher-jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811935091 PECOS PAC ID: 3173545910 Enrollment ID: I20051221000506 |
| Provider Name | Gregory A Foster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548289341 PECOS PAC ID: 3072535822 Enrollment ID: I20051221000604 |
| Provider Name | Amber Zafar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518151075 PECOS PAC ID: 0941222616 Enrollment ID: I20051221000824 |
| Provider Name | John R Bucholtz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861411746 PECOS PAC ID: 3173545712 Enrollment ID: I20051227000199 |
| Provider Name | Hollis C Sigman |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1740395953 PECOS PAC ID: 8022011584 Enrollment ID: I20060823000151 |
| Provider Name | Todd S Jarrell |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1215042510 PECOS PAC ID: 3678576139 Enrollment ID: I20060823000164 |
| Provider Name | Sebastian O Hubbuch |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1811994403 PECOS PAC ID: 5698750180 Enrollment ID: I20061205000276 |
| Provider Name | Vibhuti A Ansar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649288382 PECOS PAC ID: 2163422304 Enrollment ID: I20070111000312 |
| Provider Name | Charles S. Mccall |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1316969561 PECOS PAC ID: 4688687668 Enrollment ID: I20070221000141 |
| Provider Name | Don Ken Nakayama |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871590158 PECOS PAC ID: 6103886759 Enrollment ID: I20070723000627 |
| Provider Name | Lezli Braswell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194722876 PECOS PAC ID: 8022102334 Enrollment ID: I20070918000190 |
| Provider Name | Vaibhav V Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386670073 PECOS PAC ID: 2961583349 Enrollment ID: I20080111000505 |
| Provider Name | Vincent M Nicolais |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1205978434 PECOS PAC ID: 0547341471 Enrollment ID: I20080117000277 |
| Provider Name | Rajinder Chhokar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215039714 PECOS PAC ID: 6507879582 Enrollment ID: I20080125000044 |
| Provider Name | Samir H Mewar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013019512 PECOS PAC ID: 0042223026 Enrollment ID: I20080125000059 |
| Provider Name | Rachna A Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154447266 PECOS PAC ID: 3375515174 Enrollment ID: I20080226000070 |
| Provider Name | Walker G Carter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700962644 PECOS PAC ID: 4284710104 Enrollment ID: I20080318000474 |
| Provider Name | Said Elshihabi |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1467477463 PECOS PAC ID: 3577568526 Enrollment ID: I20080327000414 |
| Provider Name | Richard S Hannay |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1801862917 PECOS PAC ID: 5092885566 Enrollment ID: I20080610000601 |
| Provider Name | Marie J Trenga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932173440 PECOS PAC ID: 2769531656 Enrollment ID: I20090526000230 |
| Provider Name | Timothy P Villegas |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942393210 PECOS PAC ID: 6406906262 Enrollment ID: I20090617000076 |
| Provider Name | Robert A Jenks |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588630461 PECOS PAC ID: 3072665801 Enrollment ID: I20090709000036 |
| Provider Name | Edmund M Molnar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1790751816 PECOS PAC ID: 1557413317 Enrollment ID: I20090709000322 |
| Provider Name | Bradley J Battaglia |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619125754 PECOS PAC ID: 7315085909 Enrollment ID: I20091119000438 |
| Provider Name | Jude I Emokpare |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629292198 PECOS PAC ID: 6204976632 Enrollment ID: I20091216000286 |
| Provider Name | Mark Randall Sexton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982678702 PECOS PAC ID: 1052449139 Enrollment ID: I20100511000554 |
| Provider Name | Kenneth L Smith |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457323909 PECOS PAC ID: 2163574815 Enrollment ID: I20100812000837 |
| Provider Name | Cesar Y Figueroa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255386835 PECOS PAC ID: 8527955616 Enrollment ID: I20100816000474 |
| Provider Name | Dennis K Harden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982715538 PECOS PAC ID: 3678766482 Enrollment ID: I20101028001168 |
| Provider Name | Julie Jenell Ward |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1528238193 PECOS PAC ID: 9830384858 Enrollment ID: I20101116000321 |
| Provider Name | Bruce Howard Brennaman |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1578535563 PECOS PAC ID: 9234324898 Enrollment ID: I20101202000561 |
| Provider Name | Kandra Watson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104930874 PECOS PAC ID: 1557454899 Enrollment ID: I20110106000949 |
| Provider Name | Ike A Nwaobi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417112475 PECOS PAC ID: 8224218391 Enrollment ID: I20110207000356 |
| Provider Name | Sharanjeet K Emokpare |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245420777 PECOS PAC ID: 3870773633 Enrollment ID: I20110210000872 |
| Provider Name | Jefferson C Jones |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700063336 PECOS PAC ID: 9931381175 Enrollment ID: I20110310000038 |
| Provider Name | Eric R Manahan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295785194 PECOS PAC ID: 2961397831 Enrollment ID: I20110407000903 |
| Provider Name | Muhammad J Mohyuddin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598965352 PECOS PAC ID: 4789861329 Enrollment ID: I20110607000561 |
| Provider Name | David Flowers |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255385043 PECOS PAC ID: 6305016726 Enrollment ID: I20110823000266 |
| Provider Name | Regina F Ayeni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720375165 PECOS PAC ID: 7517137185 Enrollment ID: I20110909002599 |
| Provider Name | Haley Patterson Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417244450 PECOS PAC ID: 7416129663 Enrollment ID: I20111011000708 |
| Provider Name | Charles Paul Roman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487636577 PECOS PAC ID: 6800826116 Enrollment ID: I20111013000353 |
| Provider Name | Karen Adrienne Stuart |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275627481 PECOS PAC ID: 8022112952 Enrollment ID: I20111227000601 |
| Provider Name | William Robert Lahouse |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841383593 PECOS PAC ID: 6800943150 Enrollment ID: I20120110000558 |
| Provider Name | Otis Edward Tillman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962597385 PECOS PAC ID: 7810044161 Enrollment ID: I20120119000132 |
| Provider Name | Shuconda K Sturdivant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528340056 PECOS PAC ID: 2062670342 Enrollment ID: I20120215000588 |
| Provider Name | Jagdish R Sidhpura |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184617599 PECOS PAC ID: 7517067671 Enrollment ID: I20120322000433 |
| Provider Name | Jagdish H Shukla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992933014 PECOS PAC ID: 5496901308 Enrollment ID: I20120808000907 |
| Provider Name | Gail L Lynch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134162720 PECOS PAC ID: 3274782859 Enrollment ID: I20120926000493 |
| Provider Name | Sheri D Lopez |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255303897 PECOS PAC ID: 5395897193 Enrollment ID: I20130103000209 |
| Provider Name | Benjamin A Dennis |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1417119173 PECOS PAC ID: 1658516612 Enrollment ID: I20130321000314 |
| Provider Name | John Mate-kole |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558374371 PECOS PAC ID: 3577705755 Enrollment ID: I20130819000331 |
| Provider Name | Sandra K Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699731679 PECOS PAC ID: 7012939697 Enrollment ID: I20140225001834 |
| Provider Name | Thomas Getzen Fortson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1588950596 PECOS PAC ID: 5294951810 Enrollment ID: I20140716002359 |
| Provider Name | Barbara Menchan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033100326 PECOS PAC ID: 5597982421 Enrollment ID: I20140815001974 |
| Provider Name | Chasity Renee Reese |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669728697 PECOS PAC ID: 2062632623 Enrollment ID: I20141001002796 |
| Provider Name | Adrienne Crow |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538320668 PECOS PAC ID: 5799935599 Enrollment ID: I20141201001898 |
| Provider Name | Lauren Kubik Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902205057 PECOS PAC ID: 5496077000 Enrollment ID: I20141210002103 |
| Provider Name | Michael Courtney Windham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861697740 PECOS PAC ID: 2668668393 Enrollment ID: I20150331000979 |
| Provider Name | Albert Eaton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740209626 PECOS PAC ID: 8325355233 Enrollment ID: I20150909002319 |
| Provider Name | Homer T Keadle |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1528227972 PECOS PAC ID: 4981850195 Enrollment ID: I20151002002219 |
| Provider Name | Maliha I Jumani |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1093023830 PECOS PAC ID: 4880903194 Enrollment ID: I20151027000793 |
| Provider Name | Deidre Mills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720464225 PECOS PAC ID: 1355642760 Enrollment ID: I20151208003110 |
| Provider Name | Brenda Kay Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326419201 PECOS PAC ID: 3779886395 Enrollment ID: I20160114001642 |
| Provider Name | Jessi L Hale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053662874 PECOS PAC ID: 6204139884 Enrollment ID: I20160115000479 |
| Provider Name | Tara Newman Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093989733 PECOS PAC ID: 1355630625 Enrollment ID: I20160510002481 |
| Provider Name | Anna M Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033573266 PECOS PAC ID: 9032409420 Enrollment ID: I20160525002830 |
| Provider Name | Akram Ibrahim |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1508029802 PECOS PAC ID: 7214229152 Enrollment ID: I20160713000875 |
| Provider Name | Jennifer C Roberts-woodbuy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194080143 PECOS PAC ID: 5890099493 Enrollment ID: I20160811001384 |
| Provider Name | Joao Mc-oneil Plancher |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1700142668 PECOS PAC ID: 9638317837 Enrollment ID: I20160812002179 |
| Provider Name | Geetanjali Kumar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477993004 PECOS PAC ID: 5991012353 Enrollment ID: I20160830002044 |
| Provider Name | David Paulk |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336106475 PECOS PAC ID: 5395041412 Enrollment ID: I20160923000366 |
| Provider Name | Daniel J. Roth |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467541078 PECOS PAC ID: 7911068473 Enrollment ID: I20160927002283 |
| Provider Name | Deliana Peykova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396971875 PECOS PAC ID: 6103104799 Enrollment ID: I20161102001783 |
| Provider Name | Tonya Mitcham Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962476788 PECOS PAC ID: 9830155175 Enrollment ID: I20161122001766 |
| Provider Name | Vincent E Pair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114294188 PECOS PAC ID: 7315113503 Enrollment ID: I20161212000793 |
| Provider Name | Lauren M Villegas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023550423 PECOS PAC ID: 4880976968 Enrollment ID: I20170125001652 |
| Provider Name | Mary Heather Netrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386189280 PECOS PAC ID: 3173807096 Enrollment ID: I20170221001159 |
| Provider Name | N. Bande Mangaliso Virgil |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912155292 PECOS PAC ID: 7618140690 Enrollment ID: I20170227001228 |
| Provider Name | Keldreca Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447797600 PECOS PAC ID: 5799062501 Enrollment ID: I20170504000954 |
| Provider Name | Lakesha High |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699143347 PECOS PAC ID: 8729356142 Enrollment ID: I20170607002282 |
| Provider Name | Jai Surana |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1780817288 PECOS PAC ID: 5294951547 Enrollment ID: I20170807003615 |
| Provider Name | Birenkumar Rajandrakumar Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679900062 PECOS PAC ID: 0547533788 Enrollment ID: I20170908002747 |
| Provider Name | Aymen Bukannan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1700179983 PECOS PAC ID: 3779700091 Enrollment ID: I20170918002329 |
| Provider Name | Robert Crawford |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1033372610 PECOS PAC ID: 4789864133 Enrollment ID: I20171102000843 |
| Provider Name | Stephanie Kay Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134630585 PECOS PAC ID: 4789941063 Enrollment ID: I20171121001399 |
| Provider Name | Ghurulakshmi Moorthy |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1639434814 PECOS PAC ID: 0244545960 Enrollment ID: I20180123001617 |
| Provider Name | Chatora C Tolbert Berry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093225179 PECOS PAC ID: 1850651126 Enrollment ID: I20180206000171 |
| Provider Name | Schvon Bussey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093139693 PECOS PAC ID: 4284994138 Enrollment ID: I20180214001045 |
| Provider Name | Amy Saulsby-smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053711747 PECOS PAC ID: 5890019178 Enrollment ID: I20180609000062 |
| Provider Name | Joshua Samraj |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215047014 PECOS PAC ID: 9335185438 Enrollment ID: I20180726002953 |
| Provider Name | Whitney S Batchelor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649764903 PECOS PAC ID: 3476802786 Enrollment ID: I20180820003625 |
| Provider Name | Jamie Bonner Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447758305 PECOS PAC ID: 7517216351 Enrollment ID: I20180828000545 |
| Provider Name | Srividya Nukala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801081666 PECOS PAC ID: 1850475740 Enrollment ID: I20180905001816 |
| Provider Name | Katherine M Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962998476 PECOS PAC ID: 5799037495 Enrollment ID: I20181008002431 |
| Provider Name | Matthew Alan Bolinger |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1144405747 PECOS PAC ID: 7113098831 Enrollment ID: I20181009002141 |
| Provider Name | Meesha Gwan-nulla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669435707 PECOS PAC ID: 2163482068 Enrollment ID: I20181009003326 |
| Provider Name | Meagan Elizabeth Mahoney |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114281599 PECOS PAC ID: 5193077360 Enrollment ID: I20181016004134 |
| Provider Name | Daniel N Gwan-nulla |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1194725762 PECOS PAC ID: 2961462544 Enrollment ID: I20181026000479 |
| Provider Name | Siraj Abdullah |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1235450685 PECOS PAC ID: 1759509854 Enrollment ID: I20181105001960 |
| Provider Name | Pierre Fequiere |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952575763 PECOS PAC ID: 4981757887 Enrollment ID: I20190115003508 |
| Provider Name | January Aisha Hill |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174757462 PECOS PAC ID: 0345487690 Enrollment ID: I20190211000954 |
| Provider Name | Kristin Neely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629517669 PECOS PAC ID: 6800137498 Enrollment ID: I20190409000600 |
| Provider Name | Nurat Abiola Aro-lambo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336623487 PECOS PAC ID: 8527391432 Enrollment ID: I20190607002562 |
| Provider Name | Gurkeerat Singh |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1194139642 PECOS PAC ID: 7719103746 Enrollment ID: I20190624000523 |
| Provider Name | Matthew Leo Morton |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770903676 PECOS PAC ID: 1951603760 Enrollment ID: I20190808003658 |
| Provider Name | Juliana M Vera Ortiz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992068456 PECOS PAC ID: 7911235213 Enrollment ID: I20190823003590 |
| Provider Name | Abigail B Tate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447800768 PECOS PAC ID: 9537591201 Enrollment ID: I20191118003198 |
| Provider Name | Stacey Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245794387 PECOS PAC ID: 1456786912 Enrollment ID: I20200111000041 |
| Provider Name | Kaleigh S Beauchamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932759263 PECOS PAC ID: 0143655985 Enrollment ID: I20200124000292 |
| Provider Name | Alyssa Morris Francisco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841835634 PECOS PAC ID: 7214363944 Enrollment ID: I20200128003213 |
| Provider Name | Lisa A Dileonardo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346801701 PECOS PAC ID: 7618207598 Enrollment ID: I20200129002474 |
| Provider Name | Brielle Cartwright |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710484969 PECOS PAC ID: 7113252164 Enrollment ID: I20200224000342 |
| Provider Name | Yolanda L Bunkley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841852662 PECOS PAC ID: 5193154771 Enrollment ID: I20200402000640 |
| Provider Name | Suja P Antony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255819447 PECOS PAC ID: 9739518853 Enrollment ID: I20200410000170 |
| Provider Name | Danny Le |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114558723 PECOS PAC ID: 8123458692 Enrollment ID: I20200423003039 |
| Provider Name | Kimberly G Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932748605 PECOS PAC ID: 2668803412 Enrollment ID: I20200511001768 |
| Provider Name | Bailee Blackburn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992246177 PECOS PAC ID: 1557632288 Enrollment ID: I20200709002521 |
| Provider Name | Jerry Walters |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1083058291 PECOS PAC ID: 7012232739 Enrollment ID: I20200710000655 |
| Provider Name | Wendy Blair Chipman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932664612 PECOS PAC ID: 9436573045 Enrollment ID: I20200715002601 |
| Provider Name | Steven Hanrahan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487188587 PECOS PAC ID: 9931442332 Enrollment ID: I20200812001848 |
| Provider Name | Kenneth Jackson Delay |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1699092056 PECOS PAC ID: 5890082945 Enrollment ID: I20200813000299 |
| Provider Name | Charis N Chambers |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114331014 PECOS PAC ID: 3274752282 Enrollment ID: I20200818003069 |
| Provider Name | Richard Newman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831199850 PECOS PAC ID: 2365415957 Enrollment ID: I20200819000714 |
| Provider Name | Jessica Floyd |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386888113 PECOS PAC ID: 3779729868 Enrollment ID: I20200903003026 |
| Provider Name | Patricia Colon-garcia |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427157270 PECOS PAC ID: 0446356216 Enrollment ID: I20200903003664 |
| Provider Name | Mazen Almidani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912936725 PECOS PAC ID: 4587667282 Enrollment ID: I20200904000149 |
| Provider Name | Stanley Garken Lue |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1003017427 PECOS PAC ID: 6204005648 Enrollment ID: I20200904000622 |
| Provider Name | Jason R Sebesto |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861786246 PECOS PAC ID: 0749416238 Enrollment ID: I20200908002053 |
| Provider Name | Mai Won |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871676676 PECOS PAC ID: 2860418175 Enrollment ID: I20200912000081 |
| Provider Name | Neetu Dhadwal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962842492 PECOS PAC ID: 4183852270 Enrollment ID: I20200914000215 |
| Provider Name | Sui Li |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992026371 PECOS PAC ID: 0345554929 Enrollment ID: I20200915000330 |
| Provider Name | Vahid Behravan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871722520 PECOS PAC ID: 6507189123 Enrollment ID: I20200916002388 |
| Provider Name | Murtaza Amir |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508971920 PECOS PAC ID: 4688602915 Enrollment ID: I20200917000495 |
| Provider Name | Lori D Thornton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407464183 PECOS PAC ID: 9638597842 Enrollment ID: I20200918002098 |
| Provider Name | Mark Mitchell Mcdonald |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366837429 PECOS PAC ID: 6709156334 Enrollment ID: I20200919000127 |
| Provider Name | Elizabeth Chang Wendel |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1932594249 PECOS PAC ID: 1254622251 Enrollment ID: I20200922000959 |
| Provider Name | Sandro James Corti |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538503131 PECOS PAC ID: 4789953696 Enrollment ID: I20200922001479 |
| Provider Name | Shubhangi Chumble |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881684074 PECOS PAC ID: 6305844242 Enrollment ID: I20200923001874 |
| Provider Name | Yelena G Vidgop |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336300771 PECOS PAC ID: 0941444095 Enrollment ID: I20200928001489 |
| Provider Name | Mohammed Zaman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215126032 PECOS PAC ID: 4284882895 Enrollment ID: I20200930001506 |
| Provider Name | Michelle Boudreau |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346534864 PECOS PAC ID: 7416182480 Enrollment ID: I20201001002015 |
| Provider Name | Michelle H Payne |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568826253 PECOS PAC ID: 2365861861 Enrollment ID: I20201002000719 |
| Provider Name | Yazan M Suradi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952600223 PECOS PAC ID: 5698055945 Enrollment ID: I20201002000743 |
| Provider Name | Theresa B. Sevilis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407111461 PECOS PAC ID: 6608191911 Enrollment ID: I20201005002077 |
| Provider Name | Raina Gupta |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366698482 PECOS PAC ID: 4385816685 Enrollment ID: I20201005002310 |
| Provider Name | Chut Sombutmai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649320987 PECOS PAC ID: 4284807413 Enrollment ID: I20201009001386 |
| Provider Name | Geetanjali Vajapey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740523935 PECOS PAC ID: 5799087441 Enrollment ID: I20201012000002 |
| Provider Name | Vivian Marie Suarez Gonzalez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801107388 PECOS PAC ID: 7618145830 Enrollment ID: I20201012000528 |
| Provider Name | Harsha Ghatge Nagaraja |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568606259 PECOS PAC ID: 5496983009 Enrollment ID: I20201012002911 |
| Provider Name | Katherine Colleen Riordan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689832107 PECOS PAC ID: 8224174354 Enrollment ID: I20201013003055 |
| Provider Name | Lorianne Elizabeth Avino |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306898762 PECOS PAC ID: 6305859919 Enrollment ID: I20201019001615 |
| Provider Name | Da Monica A Cannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063028793 PECOS PAC ID: 2769892801 Enrollment ID: I20201102000511 |
| Provider Name | Mary Katherine Carpenter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861644809 PECOS PAC ID: 6608286281 Enrollment ID: I20201110003426 |
| Provider Name | Tigist Mehari |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235490426 PECOS PAC ID: 4688955370 Enrollment ID: I20201226000040 |
| Provider Name | Morgan Patrylo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972946002 PECOS PAC ID: 4880948959 Enrollment ID: I20210105002994 |
| Provider Name | Aleksandr Shikhman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578988390 PECOS PAC ID: 1052530144 Enrollment ID: I20210119002956 |
| Provider Name | Mariecken V Fowler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548200116 PECOS PAC ID: 4688602758 Enrollment ID: I20210203001254 |
| Provider Name | Obeidurahman Rehmani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619275963 PECOS PAC ID: 2668605106 Enrollment ID: I20210324000819 |
| Provider Name | Hsiong Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912165374 PECOS PAC ID: 1456548601 Enrollment ID: I20210331000606 |
| Provider Name | Noel P Curcio |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1053322172 PECOS PAC ID: 7214948199 Enrollment ID: I20210402000583 |
| Provider Name | Juanita Jones-harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063927101 PECOS PAC ID: 2466717152 Enrollment ID: I20210408001191 |
| Provider Name | Youssef Salim Anid |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1902891864 PECOS PAC ID: 5597770362 Enrollment ID: I20210419000598 |
| Provider Name | Mohamed S Elfar |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1457514226 PECOS PAC ID: 6002967585 Enrollment ID: I20210503002062 |
| Provider Name | Neil J Patel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295155364 PECOS PAC ID: 5193076578 Enrollment ID: I20210506002241 |
| Provider Name | Joshua Todd Mendelson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265641070 PECOS PAC ID: 8921139023 Enrollment ID: I20210617002328 |
| Provider Name | Nina Grace Bradley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750692422 PECOS PAC ID: 6709025505 Enrollment ID: I20210630001876 |
| Provider Name | Fermina Alia Pirmohamed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508138314 PECOS PAC ID: 9133369754 Enrollment ID: I20210729001921 |
| Provider Name | Samuel Quaynor |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215319710 PECOS PAC ID: 6507175569 Enrollment ID: I20210803003503 |
| Provider Name | Carmen Kagha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902391964 PECOS PAC ID: 7416291620 Enrollment ID: I20210819002447 |
| Provider Name | Manisha Jakkidi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1083098925 PECOS PAC ID: 7911303334 Enrollment ID: I20210910001392 |
| Provider Name | Jenna R Kanter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063737302 PECOS PAC ID: 1850514456 Enrollment ID: I20210915000645 |
| Provider Name | Brian D Wright |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770057788 PECOS PAC ID: 9739419516 Enrollment ID: I20210922003151 |
| Provider Name | Evan G Black |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346260247 PECOS PAC ID: 6103724554 Enrollment ID: I20210923000845 |
| Provider Name | Ricky Chen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063779213 PECOS PAC ID: 6901039734 Enrollment ID: I20211013001234 |
| Provider Name | Darshana Pritesh Amin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407901382 PECOS PAC ID: 4082750468 Enrollment ID: I20211111001051 |
| Provider Name | Benzion Chaim Yitzchok Blech |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538515465 PECOS PAC ID: 9638461056 Enrollment ID: I20211111001526 |
| Provider Name | Philippe Gerard Douyon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306169487 PECOS PAC ID: 3072755396 Enrollment ID: I20211208002491 |
| Provider Name | Morgan Elizabeth Figurelle |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801241260 PECOS PAC ID: 8729373642 Enrollment ID: I20211211000165 |
| Provider Name | Abhi H Kapuria |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730542812 PECOS PAC ID: 8820493935 Enrollment ID: I20211212000000 |
| Provider Name | Yu-hsuan Liao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063868677 PECOS PAC ID: 9133523350 Enrollment ID: I20211213000506 |
| Provider Name | Danielle L Stembridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023689049 PECOS PAC ID: 3072904499 Enrollment ID: I20211220000830 |
| Provider Name | Colby A. Richardson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558724799 PECOS PAC ID: 2567866973 Enrollment ID: I20211229001408 |
| Provider Name | Kristi Patricia Gill |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750514261 PECOS PAC ID: 6406080811 Enrollment ID: I20211229002082 |
| Provider Name | Andrew Novick |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316568728 PECOS PAC ID: 7315335361 Enrollment ID: I20220103001990 |
| Provider Name | Samuel Winter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689739542 PECOS PAC ID: 0042497075 Enrollment ID: I20220104000333 |
| Provider Name | Satinder Kaur Grewal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386085546 PECOS PAC ID: 7618229436 Enrollment ID: I20220106000458 |
| Provider Name | Robert Myers |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700248937 PECOS PAC ID: 7416356324 Enrollment ID: I20220118000061 |
| Provider Name | Guha K Venkatraman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356517593 PECOS PAC ID: 3476721887 Enrollment ID: I20220124001538 |
| Provider Name | Linda Y. Jiang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427476456 PECOS PAC ID: 3678870276 Enrollment ID: I20220127001075 |
| Provider Name | Jewell Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568789212 PECOS PAC ID: 5496140873 Enrollment ID: I20220322000878 |
| Provider Name | Stephanie Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952868341 PECOS PAC ID: 4486067451 Enrollment ID: I20220503002081 |
| Provider Name | Wendi I Kulin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043411333 PECOS PAC ID: 5193857647 Enrollment ID: I20220509001692 |
| Provider Name | Dawn Harbin Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205480969 PECOS PAC ID: 0143609305 Enrollment ID: I20220617000537 |
| Provider Name | Bhanu Gogia |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538683339 PECOS PAC ID: 4981085263 Enrollment ID: I20220718002395 |
| Provider Name | Julia Jane Sieth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376034751 PECOS PAC ID: 3870974975 Enrollment ID: I20220721003783 |
| Provider Name | Yaseen Aleatany |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1326569815 PECOS PAC ID: 6103251129 Enrollment ID: I20220815001725 |
| Provider Name | Mellissa Ward |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891200630 PECOS PAC ID: 9436554037 Enrollment ID: I20220815003452 |
| Provider Name | John Lynch |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043251648 PECOS PAC ID: 0840294773 Enrollment ID: I20220817003421 |
| Provider Name | Albert Kirven Gilbert |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1427581313 PECOS PAC ID: 7517340763 Enrollment ID: I20220819002906 |
| Provider Name | Kenneth Henry Copperwheat |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316393879 PECOS PAC ID: 0749681161 Enrollment ID: I20220901003534 |
| Provider Name | Brandy Mize |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1790148203 PECOS PAC ID: 0244523140 Enrollment ID: I20220907000891 |
| Provider Name | Matthew Alan Barnes |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1285096420 PECOS PAC ID: 4385996941 Enrollment ID: I20220915000003 |
| Provider Name | Steven Gangloff |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952756058 PECOS PAC ID: 4587951637 Enrollment ID: I20220922003208 |
| Provider Name | Anant Shenoy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194998005 PECOS PAC ID: 5991855140 Enrollment ID: I20220927000895 |
| Provider Name | Benjamin C Groves |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396242202 PECOS PAC ID: 7012399033 Enrollment ID: I20220927002120 |
| Provider Name | Nathanael J Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255794525 PECOS PAC ID: 0648560250 Enrollment ID: I20220928003432 |
| Provider Name | Kyle Binder |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841635422 PECOS PAC ID: 8325479116 Enrollment ID: I20221011002399 |
| Provider Name | Sheyar Wala Amin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1720511769 PECOS PAC ID: 7517357783 Enrollment ID: I20221012003643 |
| Provider Name | Clark Cobb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730287426 PECOS PAC ID: 0244559979 Enrollment ID: I20221013001433 |
| Provider Name | Igor Alexandrovich Malenky |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740714054 PECOS PAC ID: 8820361330 Enrollment ID: I20221024000260 |
| Provider Name | Arvind Vasudevan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770503526 PECOS PAC ID: 2860414091 Enrollment ID: I20221024002718 |
| Provider Name | Nicholas Anthony Ressa |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366974867 PECOS PAC ID: 8921370404 Enrollment ID: I20221025000777 |
| Provider Name | Iman Dabiri |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841721628 PECOS PAC ID: 5799058194 Enrollment ID: I20221026001220 |
| Provider Name | Cintasha Redmond |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639437452 PECOS PAC ID: 8628344728 Enrollment ID: I20221027000727 |
| Provider Name | Susie Wang Platt |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447646013 PECOS PAC ID: 4880971845 Enrollment ID: I20221122001329 |
| Provider Name | Srijana Zarkou |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649482340 PECOS PAC ID: 3779617139 Enrollment ID: I20221128002262 |
| Provider Name | Shao-hwa P Wei |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205062361 PECOS PAC ID: 7517278146 Enrollment ID: I20221213001184 |
| Provider Name | Hisham Abdelmonem Ahmed Abdelmotilib |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1417445677 PECOS PAC ID: 3870840747 Enrollment ID: I20230131002677 |
| Provider Name | Praveen Singh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760746531 PECOS PAC ID: 3870805062 Enrollment ID: I20230214003065 |
| Provider Name | Diana Alsbrook |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942798004 PECOS PAC ID: 1759639891 Enrollment ID: I20230320001010 |
| Provider Name | Veronica Ikonge Gichana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477296739 PECOS PAC ID: 2769857960 Enrollment ID: I20230330002791 |
| Provider Name | Brian Birdsong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841750031 PECOS PAC ID: 2264762053 Enrollment ID: I20230404001015 |
| Provider Name | Santa Bartholomew |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316925787 PECOS PAC ID: 6103831557 Enrollment ID: I20230524002426 |
| Provider Name | Courtney Clark Hawkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013618719 PECOS PAC ID: 7416314174 Enrollment ID: I20230612001636 |
| Provider Name | Desiree Barksdale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528752318 PECOS PAC ID: 0244699577 Enrollment ID: I20230705002896 |
| Provider Name | Daniel P Alexander |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1760423784 PECOS PAC ID: 9537178496 Enrollment ID: I20230808001295 |
| Provider Name | Edward Snyder |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083792873 PECOS PAC ID: 6204994296 Enrollment ID: I20230811001366 |
| Provider Name | Leopoldo Maldonado |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831629831 PECOS PAC ID: 6608239025 Enrollment ID: I20230831002644 |
| Provider Name | Christopher Ryan Newey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871751305 PECOS PAC ID: 0941513170 Enrollment ID: I20230831004183 |
| Provider Name | Eptesam Sufiyan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184358079 PECOS PAC ID: 5597128975 Enrollment ID: I20230901000288 |
| Provider Name | Nieka Harris |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1396825618 PECOS PAC ID: 0547408395 Enrollment ID: I20230907000066 |
| Provider Name | Hector E Santiago Belledonne |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1487852919 PECOS PAC ID: 4385885268 Enrollment ID: I20230915000351 |
| Provider Name | Blake Barnes |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467985655 PECOS PAC ID: 5698028165 Enrollment ID: I20230919001929 |
| Provider Name | Stephen Milhollin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265993406 PECOS PAC ID: 1052646981 Enrollment ID: I20230919002921 |
| Provider Name | Irene N. A Aryee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699020651 PECOS PAC ID: 7810202173 Enrollment ID: I20231002003242 |
| Provider Name | Keiko M Tarquinio |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730278201 PECOS PAC ID: 6608944764 Enrollment ID: I20231003000356 |
| Provider Name | Brittany Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346925849 PECOS PAC ID: 8820443195 Enrollment ID: I20231006002692 |
| Provider Name | Michael Clerveus |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1922460963 PECOS PAC ID: 8921497173 Enrollment ID: I20231110000955 |
| Provider Name | Rich Hong Pak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306620299 PECOS PAC ID: 6305295585 Enrollment ID: I20231213001846 |
| Provider Name | Asma Moussaoui |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720424898 PECOS PAC ID: 8426354432 Enrollment ID: I20240117000887 |
| Provider Name | Appaji Rayi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184930133 PECOS PAC ID: 4981915824 Enrollment ID: I20240118002684 |
| Provider Name | Adam Rizvi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841551355 PECOS PAC ID: 1456657451 Enrollment ID: I20240220002682 |
| Provider Name | Laxmi Dhakal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598997348 PECOS PAC ID: 0446490056 Enrollment ID: I20240304001116 |
| Provider Name | Oyebisi Moriliat Kilani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013614668 PECOS PAC ID: 5698111326 Enrollment ID: I20240315002108 |
| Provider Name | Bo Leung |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932635539 PECOS PAC ID: 4688087513 Enrollment ID: I20240320001078 |
| Provider Name | Janetta Kelly |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669666814 PECOS PAC ID: 8921038746 Enrollment ID: I20240321000667 |
| Provider Name | Nashia Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215707989 PECOS PAC ID: 1951748086 Enrollment ID: I20240325001270 |
| Provider Name | Yi Mao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629327986 PECOS PAC ID: 0547538118 Enrollment ID: I20240403000576 |
| Provider Name | Diego Condes Diez Martinez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760802540 PECOS PAC ID: 7214267822 Enrollment ID: I20240408000140 |
| Provider Name | Kalyan Sajja |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346682861 PECOS PAC ID: 1052542347 Enrollment ID: I20240416003205 |
| Provider Name | Ather M Taqui |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154637593 PECOS PAC ID: 0941520126 Enrollment ID: I20240417002076 |
| Provider Name | Shuan Chen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952063976 PECOS PAC ID: 7113367483 Enrollment ID: I20240503000330 |
| Provider Name | Lyle Dennis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598729220 PECOS PAC ID: 6406807395 Enrollment ID: I20240515004271 |
| Provider Name | Sunita Sharma |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1285296392 PECOS PAC ID: 1557703121 Enrollment ID: I20240528003060 |
| Provider Name | Danah Martrece Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801527502 PECOS PAC ID: 8325580459 Enrollment ID: I20240605000334 |
| Provider Name | Roni Sharon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548581275 PECOS PAC ID: 4385863877 Enrollment ID: I20240613001167 |
Lighthouse Professional Services Group, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2102 7th St, Columbus, GA 31906 Phone: 706-392-5008 | |
New Beginnings For Autism Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4335 Braddock Dr, Columbus, GA 31907 Phone: 706-840-1121 | |
Project Rebound Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1170 Brown Ave Ste B, Columbus, GA 31906 Phone: 706-221-4830 | |
Arvind Patel, Md, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 Center St Ste 501, Columbus, GA 31901 Phone: 706-653-1152 | |
Rivertown Psychiatry Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 6003 Veterans Pkwy, Columbus, GA 31909 Phone: 706-223-1933 Fax: 706-223-1934 | |
Epiphany Counseling Guidance And Treatment Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 233 12th St, Columbus, GA 31901 Phone: 678-788-7400 Fax: 678-954-6896 | |
Harmony Counseling Center Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3575 Macon Rd, Suite 18, Columbus, GA 31907 Phone: 706-565-5927 |