| Emergency Medicine Physicians Of Mecklenburg County, Pllc | |
|
10628 Park Rd Charlotte NC 28210-8407 | |
| (330) 493-4443 | |
| Not Available |
| Full Name | Emergency Medicine Physicians Of Mecklenburg County, Pllc |
|---|---|
| Speciality | Emergency Medicine |
| Location | 10628 Park Rd, Charlotte, North Carolina |
| Authorized Official Name and Position | Steven Eisenberg (SECRETARY) |
| Authorized Official Contact | 3304934443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emergency Medicine Physicians Of Mecklenburg County, Pllc 4535 Dressler Rd Nw Canton OH 44718-2545 Ph: (330) 493-4443 | Emergency Medicine Physicians Of Mecklenburg County, Pllc 10628 Park Rd Charlotte NC 28210-8407 Ph: (330) 493-4443 |
| NPI Number | 1912232182 |
|---|---|
| Provider Enumeration Date | 10/06/2009 |
| Last Update Date | 01/09/2023 |
| Certification Date | 01/09/2023 |
| Medicare PECOS PAC ID | 3870635584 |
|---|---|
| Medicare Enrollment ID | O20100119000374 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912232182 | NPI | - | NPPES |
| Provider Name | Melissa Jeanne Maxwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770519837 PECOS PAC ID: 7810895463 Enrollment ID: I20031222000179 |
| Provider Name | Timothy J Hall |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144200429 PECOS PAC ID: 4385557180 Enrollment ID: I20040115001053 |
| Provider Name | Catherine Perry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629062252 PECOS PAC ID: 7618862772 Enrollment ID: I20040217001145 |
| Provider Name | Noralea Elizabeth Meiki Rose |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316902794 PECOS PAC ID: 6002702925 Enrollment ID: I20040226000339 |
| Provider Name | Edna Ekuban-gordon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033143466 PECOS PAC ID: 2062405970 Enrollment ID: I20040406001507 |
| Provider Name | Daniel Christian Minior |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427151737 PECOS PAC ID: 8123098597 Enrollment ID: I20040731000165 |
| Provider Name | Garrick B Mullis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427006865 PECOS PAC ID: 8628049996 Enrollment ID: I20040802001379 |
| Provider Name | Daniel Jeffrey Rashid |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619993979 PECOS PAC ID: 7719941160 Enrollment ID: I20050719000287 |
| Provider Name | Karen B Bentley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1275670010 PECOS PAC ID: 7315970167 Enrollment ID: I20050913000919 |
| Provider Name | Louis J Leblanc |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679652457 PECOS PAC ID: 5597748293 Enrollment ID: I20050919000116 |
| Provider Name | Robert E Driver |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184795031 PECOS PAC ID: 3274434261 Enrollment ID: I20050926000357 |
| Provider Name | Merci G Madar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205877008 PECOS PAC ID: 5597651752 Enrollment ID: I20051108000358 |
| Provider Name | Daniel W Bradford |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851350326 PECOS PAC ID: 3173543725 Enrollment ID: I20051129000327 |
| Provider Name | Kevin Oconnor |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063418101 PECOS PAC ID: 2062485923 Enrollment ID: I20060321000587 |
| Provider Name | Jayne Kendall |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851440234 PECOS PAC ID: 2961434188 Enrollment ID: I20060502000831 |
| Provider Name | Jason E Bolden |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033157318 PECOS PAC ID: 5597776617 Enrollment ID: I20060605000109 |
| Provider Name | Sapana P Adhikari |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902870694 PECOS PAC ID: 6204870413 Enrollment ID: I20060801000233 |
| Provider Name | Arthur A Olyai |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629024948 PECOS PAC ID: 8325041171 Enrollment ID: I20060816000257 |
| Provider Name | Nadine A Lettman-carswell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558397778 PECOS PAC ID: 1759384357 Enrollment ID: I20060822000184 |
| Provider Name | Celia M Aguilar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508885211 PECOS PAC ID: 4183658099 Enrollment ID: I20061002000484 |
| Provider Name | David S Lancaster |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780790188 PECOS PAC ID: 9133162431 Enrollment ID: I20061102000376 |
| Provider Name | Julie Elder Manly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871526475 PECOS PAC ID: 3072512375 Enrollment ID: I20061214000440 |
| Provider Name | Randall H Adolph |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881686871 PECOS PAC ID: 0547214025 Enrollment ID: I20070124000414 |
| Provider Name | David Matthew Sullivan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003840497 PECOS PAC ID: 6507867728 Enrollment ID: I20070130000549 |
| Provider Name | Patrick G Lynch |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306854351 PECOS PAC ID: 2163420662 Enrollment ID: I20070730000928 |
| Provider Name | Kevin J Corrigan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841385531 PECOS PAC ID: 3779581798 Enrollment ID: I20070803000051 |
| Provider Name | Joseph B Dore |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881615300 PECOS PAC ID: 2163510884 Enrollment ID: I20071114000176 |
| Provider Name | Doris L Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891914644 PECOS PAC ID: 2365526787 Enrollment ID: I20080225000328 |
| Provider Name | Ming Qi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821128125 PECOS PAC ID: 9436228137 Enrollment ID: I20080521000489 |
| Provider Name | Gregory L Geers |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174795058 PECOS PAC ID: 2567536543 Enrollment ID: I20080808000692 |
| Provider Name | Vicente Jose Hill |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578527636 PECOS PAC ID: 8820183965 Enrollment ID: I20081008000727 |
| Provider Name | Douglas Holt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144337049 PECOS PAC ID: 4183782949 Enrollment ID: I20081022000621 |
| Provider Name | David Michael Davis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063559615 PECOS PAC ID: 1951464643 Enrollment ID: I20090106000780 |
| Provider Name | Donovan Thompson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982620985 PECOS PAC ID: 3476695081 Enrollment ID: I20100120000509 |
| Provider Name | Carter L Starr |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720046972 PECOS PAC ID: 7214998699 Enrollment ID: I20100315000098 |
| Provider Name | Craig I Schranz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225016496 PECOS PAC ID: 5597793745 Enrollment ID: I20100329000628 |
| Provider Name | Niles Anthony Rains |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790934578 PECOS PAC ID: 0042349730 Enrollment ID: I20100518000380 |
| Provider Name | Ian O. Cole |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003037359 PECOS PAC ID: 6709915457 Enrollment ID: I20100519000178 |
| Provider Name | Eileen B Hitcho |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245442466 PECOS PAC ID: 7810026879 Enrollment ID: I20100601000214 |
| Provider Name | Sean A Rowe |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093972531 PECOS PAC ID: 9638200884 Enrollment ID: I20100701000566 |
| Provider Name | Kenneth J Gilrain |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710168521 PECOS PAC ID: 4789716374 Enrollment ID: I20100716000745 |
| Provider Name | Yalonda Herndon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215154331 PECOS PAC ID: 3072645126 Enrollment ID: I20100726000101 |
| Provider Name | Melissa L Furphy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982820981 PECOS PAC ID: 8729111059 Enrollment ID: I20100806000048 |
| Provider Name | Ian R Welsh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629284559 PECOS PAC ID: 0345306676 Enrollment ID: I20100824000546 |
| Provider Name | Eslie Rolland Phillips |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558324707 PECOS PAC ID: 4789870668 Enrollment ID: I20101118000744 |
| Provider Name | Arthur W Henderson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538459987 PECOS PAC ID: 3971789876 Enrollment ID: I20110510000596 |
| Provider Name | Christopher Kirt Kessler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821250697 PECOS PAC ID: 5890989768 Enrollment ID: I20110606000003 |
| Provider Name | Brantley Busbee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831358829 PECOS PAC ID: 2769652031 Enrollment ID: I20110823000909 |
| Provider Name | Carmella F D'incognito |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891993119 PECOS PAC ID: 3577733476 Enrollment ID: I20110901000517 |
| Provider Name | Sherri M Bissell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548546724 PECOS PAC ID: 4385818376 Enrollment ID: I20111201000606 |
| Provider Name | Gail A Bayliss |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639117724 PECOS PAC ID: 9931176302 Enrollment ID: I20120321000752 |
| Provider Name | Anthony Lee Fox |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669608709 PECOS PAC ID: 7315109618 Enrollment ID: I20120503000001 |
| Provider Name | Gina E Voci |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326218702 PECOS PAC ID: 7517003056 Enrollment ID: I20120510000320 |
| Provider Name | Swarup Misra |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396905121 PECOS PAC ID: 1355505140 Enrollment ID: I20120606000662 |
| Provider Name | Megan M Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386910693 PECOS PAC ID: 0244494037 Enrollment ID: I20120606000681 |
| Provider Name | Brock Hampton Helms |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780812511 PECOS PAC ID: 8325202062 Enrollment ID: I20120611000101 |
| Provider Name | Breckon Daniel Pav |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033431358 PECOS PAC ID: 7810151438 Enrollment ID: I20120612000311 |
| Provider Name | Caleb C Gerhart |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629231212 PECOS PAC ID: 2769506971 Enrollment ID: I20120627000118 |
| Provider Name | Rachel K Smitek |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770810558 PECOS PAC ID: 8729244934 Enrollment ID: I20120716000238 |
| Provider Name | Micheal Saad |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366600991 PECOS PAC ID: 6608032941 Enrollment ID: I20120731000760 |
| Provider Name | Christopher Scott Bewley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184683294 PECOS PAC ID: 3173792314 Enrollment ID: I20120821000482 |
| Provider Name | Kathryn M Walters |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750515219 PECOS PAC ID: 6204083868 Enrollment ID: I20120904000573 |
| Provider Name | Kirk A Campbell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659500775 PECOS PAC ID: 4587800529 Enrollment ID: I20130418000312 |
| Provider Name | Derek Harmon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265768873 PECOS PAC ID: 8123278694 Enrollment ID: I20130529000193 |
| Provider Name | Stephen F Kroh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447489570 PECOS PAC ID: 4789824269 Enrollment ID: I20130703000590 |
| Provider Name | Lauren E Corbley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457512220 PECOS PAC ID: 8325289929 Enrollment ID: I20130724000517 |
| Provider Name | Benjamin M Morel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154647394 PECOS PAC ID: 3274775648 Enrollment ID: I20130814000544 |
| Provider Name | Jaclyn L Davis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346566551 PECOS PAC ID: 9032352034 Enrollment ID: I20130823000211 |
| Provider Name | Jamie Lorraine Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962664789 PECOS PAC ID: 6901044379 Enrollment ID: I20131010001317 |
| Provider Name | Darshan B Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366670457 PECOS PAC ID: 4082848643 Enrollment ID: I20131015000104 |
| Provider Name | Sarah Leggett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922378967 PECOS PAC ID: 7113153602 Enrollment ID: I20131111000488 |
| Provider Name | Mark Alter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730263617 PECOS PAC ID: 5991855330 Enrollment ID: I20131119000714 |
| Provider Name | Rhonda R Lampen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760412621 PECOS PAC ID: 2163477308 Enrollment ID: I20131125000194 |
| Provider Name | Mara Lauren Levitt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932411949 PECOS PAC ID: 3678714979 Enrollment ID: I20131217000870 |
| Provider Name | Adam D Cooley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699099028 PECOS PAC ID: 1254579642 Enrollment ID: I20140911000236 |
| Provider Name | Margaret G Hauck |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043501968 PECOS PAC ID: 1850510553 Enrollment ID: I20140911000659 |
| Provider Name | Bryan J Kopke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477878858 PECOS PAC ID: 1153557525 Enrollment ID: I20141023002276 |
| Provider Name | Sonali S Kopke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346551793 PECOS PAC ID: 9436398922 Enrollment ID: I20141106001301 |
| Provider Name | Michael Louis Juliano |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790741601 PECOS PAC ID: 1759471683 Enrollment ID: I20141216001273 |
| Provider Name | Daniel Allen Johnson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417148974 PECOS PAC ID: 9537324819 Enrollment ID: I20150204002038 |
| Provider Name | Bronwyn L Young |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578723144 PECOS PAC ID: 1557687159 Enrollment ID: I20150225001441 |
| Provider Name | Barbara Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760747992 PECOS PAC ID: 4082930375 Enrollment ID: I20150304000689 |
| Provider Name | Andrea M Kurtz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396136339 PECOS PAC ID: 9133446669 Enrollment ID: I20150323000631 |
| Provider Name | Orion J Colfer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972611937 PECOS PAC ID: 3577539998 Enrollment ID: I20150421000131 |
| Provider Name | Scott G Schmidt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578820171 PECOS PAC ID: 6800019977 Enrollment ID: I20150602002937 |
| Provider Name | Matthew J Chovaz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821354796 PECOS PAC ID: 8921319005 Enrollment ID: I20150616001166 |
| Provider Name | Natacha L Jean-louis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205198975 PECOS PAC ID: 5698081412 Enrollment ID: I20150825002960 |
| Provider Name | Idan Cudykier |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831455229 PECOS PAC ID: 4880901685 Enrollment ID: I20150910002221 |
| Provider Name | Tracy L Kane |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669728739 PECOS PAC ID: 3870801160 Enrollment ID: I20151006003206 |
| Provider Name | Mark A Smiley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1275890477 PECOS PAC ID: 1052620812 Enrollment ID: I20151016001342 |
| Provider Name | Kimberly B Stover |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740544345 PECOS PAC ID: 9335458900 Enrollment ID: I20151021002408 |
| Provider Name | Lauren C Knobeloch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285070359 PECOS PAC ID: 3971742446 Enrollment ID: I20151208000833 |
| Provider Name | Dustin Huerta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518339902 PECOS PAC ID: 7618279001 Enrollment ID: I20151230002821 |
| Provider Name | Jeffrey David Johnson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376574988 PECOS PAC ID: 4981682267 Enrollment ID: I20160209000950 |
| Provider Name | Bryan C Carney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285987248 PECOS PAC ID: 6103048327 Enrollment ID: I20160623001850 |
| Provider Name | Mark A Gonzales |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699038570 PECOS PAC ID: 1052626769 Enrollment ID: I20160725001836 |
| Provider Name | Sean Oliver Cavanaugh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003179151 PECOS PAC ID: 8527297035 Enrollment ID: I20160817003056 |
| Provider Name | Adam Ray Rodriguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366738569 PECOS PAC ID: 8820315294 Enrollment ID: I20160907000638 |
| Provider Name | Raymond J Biersbach |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083903595 PECOS PAC ID: 8022233022 Enrollment ID: I20160919001206 |
| Provider Name | Lori Lovett Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003269606 PECOS PAC ID: 2668760349 Enrollment ID: I20161012001689 |
| Provider Name | Jessica Rodriguez Gillman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275829475 PECOS PAC ID: 6305125584 Enrollment ID: I20161110001085 |
| Provider Name | Scott Lund |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720534647 PECOS PAC ID: 3274812268 Enrollment ID: I20161115001349 |
| Provider Name | Andrew N Bullaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376096669 PECOS PAC ID: 7416236187 Enrollment ID: I20161121001426 |
| Provider Name | Kerri Whitley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972050888 PECOS PAC ID: 6103106265 Enrollment ID: I20161206002439 |
| Provider Name | Elton J Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679526784 PECOS PAC ID: 1759487614 Enrollment ID: I20170209001787 |
| Provider Name | John W Burger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205958220 PECOS PAC ID: 2668506817 Enrollment ID: I20170328000039 |
| Provider Name | Vicky Chodha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366884751 PECOS PAC ID: 3577853522 Enrollment ID: I20170418002139 |
| Provider Name | Krista M Parker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861810517 PECOS PAC ID: 0446472005 Enrollment ID: I20170710001403 |
| Provider Name | Matthew Hodapp |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942629878 PECOS PAC ID: 0941502553 Enrollment ID: I20170808000146 |
| Provider Name | Catherine Marie Waggy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326453739 PECOS PAC ID: 8123390051 Enrollment ID: I20170828000781 |
| Provider Name | Poonam Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831488196 PECOS PAC ID: 0143479311 Enrollment ID: I20170829001530 |
| Provider Name | Stephanie Kaszycki Stemple |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801214432 PECOS PAC ID: 8628341476 Enrollment ID: I20170830002252 |
| Provider Name | Carty E Beck |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982880720 PECOS PAC ID: 8921151895 Enrollment ID: I20171023001247 |
| Provider Name | Charles T Randazzo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770846909 PECOS PAC ID: 2163733965 Enrollment ID: I20171024003675 |
| Provider Name | Tiffany D Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053556399 PECOS PAC ID: 6608161427 Enrollment ID: I20180405001571 |
| Provider Name | James A. Wilson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609827112 PECOS PAC ID: 6608779905 Enrollment ID: I20180411000559 |
| Provider Name | Rachel P Giller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235554353 PECOS PAC ID: 3072895069 Enrollment ID: I20180601001263 |
| Provider Name | Kayla L Garcia |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396124483 PECOS PAC ID: 4486944766 Enrollment ID: I20180725001802 |
| Provider Name | Michael K Brown |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902292998 PECOS PAC ID: 0648584532 Enrollment ID: I20180825000047 |
| Provider Name | Brian James Cohagan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548641780 PECOS PAC ID: 5294028833 Enrollment ID: I20180828004086 |
| Provider Name | Robin Dong |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790135762 PECOS PAC ID: 7719271790 Enrollment ID: I20181002003884 |
| Provider Name | Anna Watkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245627264 PECOS PAC ID: 2860746120 Enrollment ID: I20181126003494 |
| Provider Name | Taylor M Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659824902 PECOS PAC ID: 1153665245 Enrollment ID: I20181129003291 |
| Provider Name | Kimberly L Spain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104312396 PECOS PAC ID: 0547505893 Enrollment ID: I20181214002028 |
| Provider Name | Nicole M Wilson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003234857 PECOS PAC ID: 0042432601 Enrollment ID: I20190219002112 |
| Provider Name | Zachary Hamilton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174976195 PECOS PAC ID: 1557657152 Enrollment ID: I20190611001757 |
| Provider Name | Michael W Bryant |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437505583 PECOS PAC ID: 2769735810 Enrollment ID: I20190815002286 |
| Provider Name | Reece E Wilson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285020834 PECOS PAC ID: 0244520849 Enrollment ID: I20190820003766 |
| Provider Name | Hannah C Koaches-mahony |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184017881 PECOS PAC ID: 4688987340 Enrollment ID: I20190917003004 |
| Provider Name | Devina Mohan Sundaresan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952729089 PECOS PAC ID: 1153623350 Enrollment ID: I20190919002287 |
| Provider Name | Iman Tamimi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124478680 PECOS PAC ID: 3870873458 Enrollment ID: I20190923002798 |
| Provider Name | Harshit Dua |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871945485 PECOS PAC ID: 0547553414 Enrollment ID: I20191008003559 |
| Provider Name | Hamdi Battah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639649585 PECOS PAC ID: 9335470871 Enrollment ID: I20191014002527 |
| Provider Name | Trupti T R Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023341427 PECOS PAC ID: 2769625292 Enrollment ID: I20191121000237 |
| Provider Name | Philip I Hall |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790166197 PECOS PAC ID: 4880926476 Enrollment ID: I20200602000073 |
| Provider Name | Owen D Ortmayer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710336920 PECOS PAC ID: 8123449949 Enrollment ID: I20200603002664 |
| Provider Name | Hope Christopher Page |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811541519 PECOS PAC ID: 0840622890 Enrollment ID: I20200611000659 |
| Provider Name | Ellen Menocal |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104183615 PECOS PAC ID: 8325329477 Enrollment ID: I20200616002407 |
| Provider Name | Justin Ryan Lukasik |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881053726 PECOS PAC ID: 1850685116 Enrollment ID: I20200709001207 |
| Provider Name | Cortlyn W Brown |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992168314 PECOS PAC ID: 7517206097 Enrollment ID: I20200720001048 |
| Provider Name | Neel A Andharia |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174055719 PECOS PAC ID: 5890032361 Enrollment ID: I20200911002074 |
| Provider Name | Xavious Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326579806 PECOS PAC ID: 9234557570 Enrollment ID: I20200917002421 |
| Provider Name | Rosa Gigliotti |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184005829 PECOS PAC ID: 3476846940 Enrollment ID: I20200928001442 |
| Provider Name | Lauren P Grushkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174148357 PECOS PAC ID: 5597184788 Enrollment ID: I20201008000811 |
| Provider Name | Rachel Lea Pretko |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093240764 PECOS PAC ID: 7113359241 Enrollment ID: I20201008001609 |
| Provider Name | James E Butler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104118918 PECOS PAC ID: 5799067237 Enrollment ID: I20201125001633 |
| Provider Name | David M Hanrahan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033347125 PECOS PAC ID: 2163835398 Enrollment ID: I20210112001763 |
| Provider Name | Matthew D Carpinello |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790059194 PECOS PAC ID: 2466888904 Enrollment ID: I20210412000173 |
| Provider Name | Elise Marie Klesick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073975215 PECOS PAC ID: 1951666312 Enrollment ID: I20210608000236 |
| Provider Name | Sarah E Kuhlmann |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538430707 PECOS PAC ID: 6901052455 Enrollment ID: I20210609000839 |
| Provider Name | Vincent Schieffer Linberg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033592654 PECOS PAC ID: 1456655968 Enrollment ID: I20210616002226 |
| Provider Name | Gary P Mikhjian |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407351851 PECOS PAC ID: 4587910484 Enrollment ID: I20210616003255 |
| Provider Name | Bernard Jones |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336634328 PECOS PAC ID: 7911308598 Enrollment ID: I20210702002012 |
| Provider Name | Sam Austin Bores |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831509157 PECOS PAC ID: 4486879590 Enrollment ID: I20210714000708 |
| Provider Name | Kathryn Baglini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790134534 PECOS PAC ID: 2567755713 Enrollment ID: I20210924002414 |
| Provider Name | Barbara Mato |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447802640 PECOS PAC ID: 6406185776 Enrollment ID: I20211119002505 |
| Provider Name | Benjamin John Kyung Myers |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659861441 PECOS PAC ID: 4688925704 Enrollment ID: I20220104002158 |
| Provider Name | Praneeta Bremjit |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316205388 PECOS PAC ID: 8426363656 Enrollment ID: I20220118001776 |
| Provider Name | Joanna Lindquist-lane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760145502 PECOS PAC ID: 4082006135 Enrollment ID: I20220121001235 |
| Provider Name | Bruno Perossa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346657889 PECOS PAC ID: 5092934513 Enrollment ID: I20220222001071 |
| Provider Name | Christopher B Zernial |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770926149 PECOS PAC ID: 1254631971 Enrollment ID: I20220330001426 |
| Provider Name | Matthew Riley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871052761 PECOS PAC ID: 3971920794 Enrollment ID: I20220601002960 |
| Provider Name | Nicholas E Cowell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235632001 PECOS PAC ID: 7315294360 Enrollment ID: I20220607002734 |
| Provider Name | Alex Tansey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548765365 PECOS PAC ID: 2365851847 Enrollment ID: I20220708001738 |
| Provider Name | Brock S Clark |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336600170 PECOS PAC ID: 2163805052 Enrollment ID: I20220809003905 |
| Provider Name | Andrew M Nicholas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912468422 PECOS PAC ID: 5991188773 Enrollment ID: I20220810003869 |
| Provider Name | Bridget A Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053841577 PECOS PAC ID: 7810260304 Enrollment ID: I20220811003676 |
| Provider Name | Barry K. S. G. Kang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366860397 PECOS PAC ID: 6901109065 Enrollment ID: I20220812000969 |
| Provider Name | Michael Ambrose |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548829542 PECOS PAC ID: 9335479831 Enrollment ID: I20220825000027 |
| Provider Name | Omoyemen O Blue |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518428200 PECOS PAC ID: 2163806183 Enrollment ID: I20220825000224 |
| Provider Name | Muryum Hassan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942797972 PECOS PAC ID: 9133503170 Enrollment ID: I20220825001150 |
| Provider Name | Kodjovi Kodjo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780100958 PECOS PAC ID: 7517203177 Enrollment ID: I20220912000739 |
| Provider Name | Karen Severson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689787426 PECOS PAC ID: 0840364030 Enrollment ID: I20220913000064 |
| Provider Name | Stella Ekaette Bassey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821070475 PECOS PAC ID: 8123000387 Enrollment ID: I20220919003002 |
| Provider Name | Endra Sookoor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386933158 PECOS PAC ID: 3577868934 Enrollment ID: I20221013003147 |
| Provider Name | Alice Mckinzie |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720025075 PECOS PAC ID: 7012261167 Enrollment ID: I20221229000367 |
| Provider Name | Amy M Sprague |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629030598 PECOS PAC ID: 6204882673 Enrollment ID: I20230208002350 |
| Provider Name | James Truesdale Russell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477915882 PECOS PAC ID: 3870918774 Enrollment ID: I20230323001463 |
| Provider Name | Kezia A Nixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194053595 PECOS PAC ID: 8224169560 Enrollment ID: I20230330000738 |
| Provider Name | Melanie Galloway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114637154 PECOS PAC ID: 6800269762 Enrollment ID: I20230407001430 |
| Provider Name | Monifa S Seawell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689834285 PECOS PAC ID: 7911154562 Enrollment ID: I20230410000217 |
| Provider Name | Rheanisha Burrell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972928133 PECOS PAC ID: 0941627608 Enrollment ID: I20230411000296 |
| Provider Name | Joseph Divincenzo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740201425 PECOS PAC ID: 3577475649 Enrollment ID: I20230411000468 |
| Provider Name | Traci Gremillion |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316341993 PECOS PAC ID: 4789055633 Enrollment ID: I20230411002792 |
| Provider Name | Britney Colandreo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447909049 PECOS PAC ID: 3971975897 Enrollment ID: I20230412001186 |
| Provider Name | Sabrina Hammond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790301075 PECOS PAC ID: 4880012988 Enrollment ID: I20230412002132 |
| Provider Name | Marcie Leigh Perkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164940318 PECOS PAC ID: 5991061418 Enrollment ID: I20230412002185 |
| Provider Name | Meghan Komaromi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922343664 PECOS PAC ID: 8729233473 Enrollment ID: I20230412002274 |
| Provider Name | Jessica Scales |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760108864 PECOS PAC ID: 9739550625 Enrollment ID: I20230412002333 |
| Provider Name | Ian Vann-campbell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841769437 PECOS PAC ID: 9032582069 Enrollment ID: I20230412003140 |
| Provider Name | India Red Crawford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902141997 PECOS PAC ID: 4789964248 Enrollment ID: I20230412003165 |
| Provider Name | Brenda Sue Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699484162 PECOS PAC ID: 0345615373 Enrollment ID: I20230413001045 |
| Provider Name | Amanda Neeleman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164884847 PECOS PAC ID: 5890163455 Enrollment ID: I20230413002023 |
| Provider Name | Ian P Huff |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053619080 PECOS PAC ID: 4880930841 Enrollment ID: I20230512000077 |
| Provider Name | Annisha Dunaway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316564065 PECOS PAC ID: 1951718451 Enrollment ID: I20230523000858 |
| Provider Name | Orise Carey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184902272 PECOS PAC ID: 6800252453 Enrollment ID: I20230524000498 |
| Provider Name | Suzanne Garber |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104110428 PECOS PAC ID: 2668697483 Enrollment ID: I20230531003559 |
| Provider Name | Catherine E Wasson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295234953 PECOS PAC ID: 9830572767 Enrollment ID: I20230614003939 |
| Provider Name | Johanna Torres-santiago |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659710721 PECOS PAC ID: 6204101744 Enrollment ID: I20230614004128 |
| Provider Name | Haseeb Mohammad Khatri |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548886815 PECOS PAC ID: 1254754310 Enrollment ID: I20230802003348 |
| Provider Name | Amandeep Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033747613 PECOS PAC ID: 6305208067 Enrollment ID: I20230811000850 |
| Provider Name | Ana Maria Barragan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881221844 PECOS PAC ID: 6204267198 Enrollment ID: I20230814000179 |
| Provider Name | Thomas A Rayner |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1194008979 PECOS PAC ID: 0941533574 Enrollment ID: I20230815002875 |
| Provider Name | Brian R Samuels |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215434170 PECOS PAC ID: 9830505643 Enrollment ID: I20230816001975 |
| Provider Name | Shane Robert Davis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134655673 PECOS PAC ID: 2961772702 Enrollment ID: I20230816003529 |
| Provider Name | Mikayla M Leombruno |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568084598 PECOS PAC ID: 8426471939 Enrollment ID: I20230817000027 |
| Provider Name | Richard Kelly Grenn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689201071 PECOS PAC ID: 6305268004 Enrollment ID: I20230817000433 |
| Provider Name | Naimah M Dease |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912521709 PECOS PAC ID: 1759707516 Enrollment ID: I20230817001960 |
| Provider Name | William Z Poston |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497370308 PECOS PAC ID: 7517345408 Enrollment ID: I20230831004571 |
| Provider Name | Joshua H Shurley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972128031 PECOS PAC ID: 6507282472 Enrollment ID: I20230901002695 |
| Provider Name | Amira Faour |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740702943 PECOS PAC ID: 3476966946 Enrollment ID: I20230908001770 |
| Provider Name | Juliana Damilola Adedoyin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235758053 PECOS PAC ID: 0244651859 Enrollment ID: I20230912003852 |
| Provider Name | Sabin Karki |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639780604 PECOS PAC ID: 5890112866 Enrollment ID: I20230920000150 |
| Provider Name | Zachary John Gibson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447871710 PECOS PAC ID: 6305264250 Enrollment ID: I20231010003554 |
| Provider Name | Cameron Culver |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1922390558 PECOS PAC ID: 5698998748 Enrollment ID: I20231017003902 |
| Provider Name | Nina Livia Shander |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457971038 PECOS PAC ID: 9335560952 Enrollment ID: I20231030003101 |
| Provider Name | Laura J Cordonnier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992266993 PECOS PAC ID: 1658727482 Enrollment ID: I20231030003175 |
| Provider Name | Christopher T Hassinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831799477 PECOS PAC ID: 1355397852 Enrollment ID: I20231114001850 |
| Provider Name | Gregory Alan Melish |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295198679 PECOS PAC ID: 4789964792 Enrollment ID: I20231115000588 |
| Provider Name | Pamela Brearey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316576903 PECOS PAC ID: 2961860119 Enrollment ID: I20240530001537 |
Barbara Kaplan Mhdl Incorporated Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 East Woodlawn Road, Suite 136, Charlotte, NC 28217 Phone: 704-527-2108 Fax: 704-527-2108 | |
Carolina Care One, Llc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3601 Beaux St, Charlotte, NC 28208 Phone: 704-299-2616 | |
Myers Park Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2435 Umar Ct, Charlotte, NC 28215 Phone: 704-566-0245 | |
Monarch Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1211 Robinhood Cir, Charlotte, NC 28227 Phone: 704-563-8894 | |
Primary Care Solutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5601 Executive Center Dr Ste 200, Charlotte, NC 28212 Phone: 704-537-1022 Fax: 704-569-0822 | |
Carawell Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3315 Springbank Ln Ste 302, Charlotte, NC 28226 Phone: 704-288-0314 Fax: 704-288-0310 | |
Healing Pathways Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1931 J N Pease Pl Ste 201, Charlotte, NC 28262 Phone: 980-237-2709 Fax: 704-817-9154 |