| Indiana University Health Ball Memorial Physicians, Inc. | |
|
2401 W University Ave Muncie IN 47303-3428 | |
| (765) 747-3111 | |
| Not Available |
| Full Name | Indiana University Health Ball Memorial Physicians, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 2401 W University Ave, Muncie, Indiana |
| Authorized Official Name and Position | Lori Luther (COO) |
| Authorized Official Contact | 3179483525 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Indiana University Health Ball Memorial Physicians, Inc. 1200 W. White River Blvd. Rcs Provider Enrollment Muncie IN 47303-4988 Ph: (765) 254-4009 | Indiana University Health Ball Memorial Physicians, Inc. 2401 W University Ave Muncie IN 47303-3428 Ph: (765) 747-3111 |
| NPI Number | 1235455544 |
|---|---|
| Provider Enumeration Date | 04/12/2010 |
| Last Update Date | 05/15/2019 |
| Medicare PECOS PAC ID | 9537072640 |
|---|---|
| Medicare Enrollment ID | O20031110000505 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235455544 | NPI | - | NPPES |
| 200986050J | Medicaid | IN | |
| DQ6230 | Other | IN | RR MEDICARE |
| Provider Name | Linda L Daniel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912054008 PECOS PAC ID: 3779496161 Enrollment ID: I20031111000577 |
| Provider Name | Regi Joseph |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1861461980 PECOS PAC ID: 2860306818 Enrollment ID: I20031114000291 |
| Provider Name | Jerry W Whetzel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215935705 PECOS PAC ID: 6406760925 Enrollment ID: I20031118000519 |
| Provider Name | Thomas M Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487606083 PECOS PAC ID: 0648174052 Enrollment ID: I20031126000116 |
| Provider Name | Paul D Bojrab |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1538125430 PECOS PAC ID: 7315842184 Enrollment ID: I20031204000645 |
| Provider Name | Stuart W Fraley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1104810316 PECOS PAC ID: 4789580267 Enrollment ID: I20031208000734 |
| Provider Name | Troy A Abbott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689693889 PECOS PAC ID: 4587566773 Enrollment ID: I20040127000566 |
| Provider Name | Wa'el Bakdash |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275552481 PECOS PAC ID: 8426941261 Enrollment ID: I20040205000145 |
| Provider Name | Justina M Girod |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497746895 PECOS PAC ID: 5294620373 Enrollment ID: I20040218000059 |
| Provider Name | Jeffrey L Witt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073523098 PECOS PAC ID: 2961392469 Enrollment ID: I20040318000381 |
| Provider Name | Michael T Stack |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1770585945 PECOS PAC ID: 7214829795 Enrollment ID: I20040329000739 |
| Provider Name | Charles Loyd Carroll |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114927373 PECOS PAC ID: 9638165012 Enrollment ID: I20040421001514 |
| Provider Name | Gregory L Chupp |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003992025 PECOS PAC ID: 8820084882 Enrollment ID: I20040423000855 |
| Provider Name | Stephen R Myron |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801889142 PECOS PAC ID: 8729982434 Enrollment ID: I20040430000938 |
| Provider Name | Thomas J Melham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851495394 PECOS PAC ID: 2264421585 Enrollment ID: I20040511000550 |
| Provider Name | Tipton Lee Sneed |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518949809 PECOS PAC ID: 5294622957 Enrollment ID: I20040604000612 |
| Provider Name | Julius A Silvidi |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1730121385 PECOS PAC ID: 9638152606 Enrollment ID: I20040610000925 |
| Provider Name | Thomas D Stewart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316901200 PECOS PAC ID: 1850374836 Enrollment ID: I20040610000980 |
| Provider Name | Sudarshan K Komanapalli |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1316915911 PECOS PAC ID: 8426949413 Enrollment ID: I20040628000542 |
| Provider Name | Eric Jay Betts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336132679 PECOS PAC ID: 8224014261 Enrollment ID: I20040629000677 |
| Provider Name | Joseph E Spahr |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1659432235 PECOS PAC ID: 7911985445 Enrollment ID: I20040712000490 |
| Provider Name | Robert J Robinson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720063951 PECOS PAC ID: 0840270518 Enrollment ID: I20040722001174 |
| Provider Name | Marvin Roger Mcbride |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730189499 PECOS PAC ID: 4981684685 Enrollment ID: I20040722001293 |
| Provider Name | Michael J Williamson |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1366581209 PECOS PAC ID: 1759353550 Enrollment ID: I20040811001131 |
| Provider Name | Samuel C Kim |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1134129679 PECOS PAC ID: 3577536994 Enrollment ID: I20040814000095 |
| Provider Name | Andrew Offerle |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598785149 PECOS PAC ID: 5193798031 Enrollment ID: I20040818000338 |
| Provider Name | Helen Ann Borgenheimer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386696532 PECOS PAC ID: 3870561277 Enrollment ID: I20040923000256 |
| Provider Name | Kevin W Schreiber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427014976 PECOS PAC ID: 5799753109 Enrollment ID: I20040923000337 |
| Provider Name | William S Kamanda |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1275597650 PECOS PAC ID: 3870562085 Enrollment ID: I20040924000833 |
| Provider Name | Antonio J Navarrete-casas |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1265400683 PECOS PAC ID: 2264491562 Enrollment ID: I20041004000282 |
| Provider Name | Joseph C Dickey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154326411 PECOS PAC ID: 0840259073 Enrollment ID: I20041005000184 |
| Provider Name | Joni E Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679571970 PECOS PAC ID: 3971562497 Enrollment ID: I20041008000700 |
| Provider Name | Brad M Johnston |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114971223 PECOS PAC ID: 0042271389 Enrollment ID: I20041020001085 |
| Provider Name | Joseph B Landwehr |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134106347 PECOS PAC ID: 1850352741 Enrollment ID: I20041025000043 |
| Provider Name | Sindee J Fry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063464121 PECOS PAC ID: 5193787497 Enrollment ID: I20041029000169 |
| Provider Name | Daniel C Lopiccolo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235116443 PECOS PAC ID: 9638132053 Enrollment ID: I20041108000171 |
| Provider Name | Peter M Voss |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750368072 PECOS PAC ID: 7214998103 Enrollment ID: I20041108000300 |
| Provider Name | Patrick A Cleary |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508831538 PECOS PAC ID: 3577476191 Enrollment ID: I20041112001095 |
| Provider Name | William S Cassel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1689640450 PECOS PAC ID: 7214991967 Enrollment ID: I20041112001106 |
| Provider Name | John Eliades |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1801861844 PECOS PAC ID: 3678537321 Enrollment ID: I20041112001112 |
| Provider Name | David M Brown |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043259245 PECOS PAC ID: 7911962725 Enrollment ID: I20041122000222 |
| Provider Name | Jason G Carter |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023108768 PECOS PAC ID: 0648236729 Enrollment ID: I20041209000903 |
| Provider Name | Nancy W Griffith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487758934 PECOS PAC ID: 9335107119 Enrollment ID: I20041227000517 |
| Provider Name | Erin Elizabeth Vinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689697898 PECOS PAC ID: 8628027885 Enrollment ID: I20050114000612 |
| Provider Name | Donald J Mcintire |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316022189 PECOS PAC ID: 9436108420 Enrollment ID: I20050117000532 |
| Provider Name | James Eugene Ong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649289570 PECOS PAC ID: 7810946498 Enrollment ID: I20050120000989 |
| Provider Name | Michael Skulski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801871876 PECOS PAC ID: 8921058108 Enrollment ID: I20050125001105 |
| Provider Name | Mumtaz Jahan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952358079 PECOS PAC ID: 2668370677 Enrollment ID: I20050128000144 |
| Provider Name | Justin K Whitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972533123 PECOS PAC ID: 6305898933 Enrollment ID: I20050211000378 |
| Provider Name | Kent Farnsworth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144296088 PECOS PAC ID: 1254231400 Enrollment ID: I20050228000038 |
| Provider Name | James Estill Wells |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730100405 PECOS PAC ID: 8426005323 Enrollment ID: I20050404000179 |
| Provider Name | Mark A Haggenjos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619935475 PECOS PAC ID: 9739128885 Enrollment ID: I20050427001316 |
| Provider Name | Charles R Routh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437129798 PECOS PAC ID: 2062325665 Enrollment ID: I20050505000874 |
| Provider Name | Dwayne C Adrian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881664589 PECOS PAC ID: 1153361456 Enrollment ID: I20050505000924 |
| Provider Name | Mark A Litz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326013327 PECOS PAC ID: 7911947221 Enrollment ID: I20050505000974 |
| Provider Name | Brian L Lumpkin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710976527 PECOS PAC ID: 1456391606 Enrollment ID: I20050506000134 |
| Provider Name | Shannon D Riegle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801862677 PECOS PAC ID: 0648210807 Enrollment ID: I20050506000217 |
| Provider Name | Helen G Riegle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912973702 PECOS PAC ID: 8628018892 Enrollment ID: I20050506000244 |
| Provider Name | Heidi M Lakanen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942276720 PECOS PAC ID: 2567402738 Enrollment ID: I20050506000282 |
| Provider Name | Danette A Baird |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700838919 PECOS PAC ID: 7911949177 Enrollment ID: I20050526001036 |
| Provider Name | Thomas Carroll |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851343172 PECOS PAC ID: 3173565330 Enrollment ID: I20050526001056 |
| Provider Name | Steve L Rousseau |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306924394 PECOS PAC ID: 2860436730 Enrollment ID: I20050613000763 |
| Provider Name | Steven A Farmer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568549202 PECOS PAC ID: 0749224574 Enrollment ID: I20050613001334 |
| Provider Name | Renu Weiss |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841411824 PECOS PAC ID: 8325084551 Enrollment ID: I20050628001168 |
| Provider Name | Narayan P Neupane |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1285675173 PECOS PAC ID: 8921044298 Enrollment ID: I20050708000175 |
| Provider Name | Lora J Jones Mcclure |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720077332 PECOS PAC ID: 9436186913 Enrollment ID: I20050726001181 |
| Provider Name | Michael Stennis |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1538192836 PECOS PAC ID: 0143259960 Enrollment ID: I20050811000341 |
| Provider Name | Melanie A Schreiner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427150937 PECOS PAC ID: 0648209478 Enrollment ID: I20050811000374 |
| Provider Name | John D Lee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447291786 PECOS PAC ID: 3779513296 Enrollment ID: I20050815000917 |
| Provider Name | Elizabeth M Lauber |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053308551 PECOS PAC ID: 9133023369 Enrollment ID: I20050830000531 |
| Provider Name | Bradley L Hayes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891736419 PECOS PAC ID: 2264326735 Enrollment ID: I20050928001103 |
| Provider Name | Robert B Elliott |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437198686 PECOS PAC ID: 4486689189 Enrollment ID: I20050930000698 |
| Provider Name | Thomas E Kundenreich |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326012915 PECOS PAC ID: 1850316571 Enrollment ID: I20051012000327 |
| Provider Name | Jennifer Renee Bunch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346239407 PECOS PAC ID: 3274558895 Enrollment ID: I20051012000463 |
| Provider Name | Stewart C Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659361673 PECOS PAC ID: 8123043759 Enrollment ID: I20051012000527 |
| Provider Name | Rajeev Mehta |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1114995545 PECOS PAC ID: 1355367335 Enrollment ID: I20051019000367 |
| Provider Name | Brenda Kaye Dearmond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568433746 PECOS PAC ID: 1658399126 Enrollment ID: I20051103000769 |
| Provider Name | Gerald Kevin Greer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700882701 PECOS PAC ID: 8628096542 Enrollment ID: I20051109000030 |
| Provider Name | Elmer A Toliver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053398552 PECOS PAC ID: 7113994690 Enrollment ID: I20051117000687 |
| Provider Name | Betsy K Longnecker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700887601 PECOS PAC ID: 6204856982 Enrollment ID: I20051123000476 |
| Provider Name | Ryan Christian Wallace |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316086291 PECOS PAC ID: 3173543865 Enrollment ID: I20051123000509 |
| Provider Name | Charles T Webster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346222429 PECOS PAC ID: 5799689519 Enrollment ID: I20051128000501 |
| Provider Name | Charles W Brian |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346344975 PECOS PAC ID: 3779560214 Enrollment ID: I20051129000859 |
| Provider Name | Jill D Abram |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447384250 PECOS PAC ID: 9739109034 Enrollment ID: I20051201000451 |
| Provider Name | Tammy Lea Lightner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700854932 PECOS PAC ID: 1052331220 Enrollment ID: I20051202000154 |
| Provider Name | Kendal Renee Baker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598764532 PECOS PAC ID: 6204857519 Enrollment ID: I20051214000817 |
| Provider Name | Oleh Dzera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255348371 PECOS PAC ID: 5991726044 Enrollment ID: I20051216000115 |
| Provider Name | Boaz Ofek |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013075878 PECOS PAC ID: 8426065830 Enrollment ID: I20060309000469 |
| Provider Name | William Walter Pond |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1649260183 PECOS PAC ID: 5991713794 Enrollment ID: I20060404000682 |
| Provider Name | Jan Roman Kornilow |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487653515 PECOS PAC ID: 0244143816 Enrollment ID: I20060413000119 |
| Provider Name | Michael Todd Emmons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417950726 PECOS PAC ID: 2769395839 Enrollment ID: I20061101000361 |
| Provider Name | Jennifer Joy Huisman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942214010 PECOS PAC ID: 5890795462 Enrollment ID: I20070104000215 |
| Provider Name | Tonee A Pieroni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184645541 PECOS PAC ID: 3971504515 Enrollment ID: I20070124000412 |
| Provider Name | Kishin K Dodwani |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1265482988 PECOS PAC ID: 3870529225 Enrollment ID: I20070228000001 |
| Provider Name | Abby L Koons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558352682 PECOS PAC ID: 6103920459 Enrollment ID: I20070327000441 |
| Provider Name | Karen Miller |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1841300084 PECOS PAC ID: 8224133632 Enrollment ID: I20070413000162 |
| Provider Name | Shana K Carmin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760569065 PECOS PAC ID: 1355446089 Enrollment ID: I20070425000057 |
| Provider Name | Paul L Kane |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1831165273 PECOS PAC ID: 6901902956 Enrollment ID: I20070508000231 |
| Provider Name | Michael E Thomas |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497724066 PECOS PAC ID: 2264538255 Enrollment ID: I20070508000628 |
| Provider Name | Camille A Elick Shawver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982796512 PECOS PAC ID: 5991803728 Enrollment ID: I20070601000461 |
| Provider Name | Stephen H Castleman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1154426310 PECOS PAC ID: 8921044496 Enrollment ID: I20070608000094 |
| Provider Name | Mir I Ali |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1568490670 PECOS PAC ID: 7113921941 Enrollment ID: I20070611000078 |
| Provider Name | Ryan M Johnston |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104865419 PECOS PAC ID: 2365540432 Enrollment ID: I20070613000515 |
| Provider Name | Syed Hasan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619909991 PECOS PAC ID: 6800782137 Enrollment ID: I20070619000008 |
| Provider Name | Michael J Moran |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1154380319 PECOS PAC ID: 2567376569 Enrollment ID: I20070619000228 |
| Provider Name | Thomas J Gibson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528110764 PECOS PAC ID: 3375642234 Enrollment ID: I20070619000360 |
| Provider Name | Robert P Suer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902957400 PECOS PAC ID: 5092814954 Enrollment ID: I20070619000374 |
| Provider Name | Bruce M Graham |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1598734659 PECOS PAC ID: 6204740202 Enrollment ID: I20070619000462 |
| Provider Name | Wayne L Gray |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588633663 PECOS PAC ID: 5991619900 Enrollment ID: I20070619000483 |
| Provider Name | Gary R Hazlett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932292737 PECOS PAC ID: 9739288507 Enrollment ID: I20070619000532 |
| Provider Name | Cynthia L Vanderbosch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235120544 PECOS PAC ID: 7517066145 Enrollment ID: I20070622000396 |
| Provider Name | Alicia Rene Yilmaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699888305 PECOS PAC ID: 3779683479 Enrollment ID: I20070711000016 |
| Provider Name | Joseph Charles Muhler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912988056 PECOS PAC ID: 1153300173 Enrollment ID: I20070712000779 |
| Provider Name | Theresa K Hoffman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992786198 PECOS PAC ID: 4082714456 Enrollment ID: I20070713000635 |
| Provider Name | Brandon Scott Dickey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659581098 PECOS PAC ID: 4082707542 Enrollment ID: I20070829000906 |
| Provider Name | Diana L Lackey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942341615 PECOS PAC ID: 6103911441 Enrollment ID: I20071002000688 |
| Provider Name | Andrew Robert Fischer |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1962473553 PECOS PAC ID: 8628020542 Enrollment ID: I20071012000094 |
| Provider Name | Jennifer L Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437351731 PECOS PAC ID: 2163519224 Enrollment ID: I20071106000577 |
| Provider Name | Jennifer E Kinsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114019924 PECOS PAC ID: 3870681968 Enrollment ID: I20071217000828 |
| Provider Name | J. Frank Vormohr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033117726 PECOS PAC ID: 7012805344 Enrollment ID: I20071218000042 |
| Provider Name | Christopher D Gamble |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174725048 PECOS PAC ID: 9436230216 Enrollment ID: I20080117000718 |
| Provider Name | Julie J Jarrett |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558547851 PECOS PAC ID: 1759463474 Enrollment ID: I20080201000502 |
| Provider Name | Eric A Pinkie |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609050715 PECOS PAC ID: 0446336846 Enrollment ID: I20080326000274 |
| Provider Name | Leah D Jamison |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1063494102 PECOS PAC ID: 2062418320 Enrollment ID: I20080410000269 |
| Provider Name | Robin A Fox |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881693893 PECOS PAC ID: 6709799372 Enrollment ID: I20080512000453 |
| Provider Name | Sai G Yarram |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154446250 PECOS PAC ID: 1456423490 Enrollment ID: I20080708000270 |
| Provider Name | Keith Dinklage |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538243498 PECOS PAC ID: 6608940465 Enrollment ID: I20080729000221 |
| Provider Name | Juan C Vargas |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1356502033 PECOS PAC ID: 5395819023 Enrollment ID: I20080729000765 |
| Provider Name | Michael J Burrell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023067816 PECOS PAC ID: 2769395391 Enrollment ID: I20080813000007 |
| Provider Name | Dennis Orr |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376715391 PECOS PAC ID: 9931274818 Enrollment ID: I20080813000166 |
| Provider Name | Patsy S Detamore Brush |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578646212 PECOS PAC ID: 0446326813 Enrollment ID: I20080909000247 |
| Provider Name | Elizabeth A Droege |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851394290 PECOS PAC ID: 7214096544 Enrollment ID: I20081031000352 |
| Provider Name | Chantel S Willmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467466854 PECOS PAC ID: 0244391340 Enrollment ID: I20081208000614 |
| Provider Name | Deon W Vigilance |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1982748661 PECOS PAC ID: 7517029267 Enrollment ID: I20081215000568 |
| Provider Name | Kevin J Luksus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568490555 PECOS PAC ID: 3072675545 Enrollment ID: I20081217000121 |
| Provider Name | Christian B Shue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598967598 PECOS PAC ID: 8628130705 Enrollment ID: I20081224000299 |
| Provider Name | John C Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508880642 PECOS PAC ID: 0547322422 Enrollment ID: I20081231000379 |
| Provider Name | Lisa R Clay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124228010 PECOS PAC ID: 8224194451 Enrollment ID: I20090312000598 |
| Provider Name | Brandy Jo Mcclaughry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083867089 PECOS PAC ID: 1355408733 Enrollment ID: I20090330000682 |
| Provider Name | Scott Alan Hanan |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1588699714 PECOS PAC ID: 8820145618 Enrollment ID: I20090414000307 |
| Provider Name | Hua Luo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659439149 PECOS PAC ID: 2062562283 Enrollment ID: I20090610000297 |
| Provider Name | Enrique F Molina |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497831291 PECOS PAC ID: 2062463722 Enrollment ID: I20090617000437 |
| Provider Name | Anna M Steinbarger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336148352 PECOS PAC ID: 1759433279 Enrollment ID: I20090714000792 |
| Provider Name | Angel Ann-walker Wilson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275781544 PECOS PAC ID: 0840342218 Enrollment ID: I20090715000621 |
| Provider Name | Joel S Corvera |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1861677361 PECOS PAC ID: 8527132976 Enrollment ID: I20090720000320 |
| Provider Name | Rajender Kumar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104050087 PECOS PAC ID: 7719039643 Enrollment ID: I20090723000293 |
| Provider Name | Stephen A Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669411245 PECOS PAC ID: 5799697595 Enrollment ID: I20090813000742 |
| Provider Name | Lisa C Gregory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881826196 PECOS PAC ID: 7719033588 Enrollment ID: I20090921000487 |
| Provider Name | Derrick Thomas Rogers |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1013916345 PECOS PAC ID: 4284600313 Enrollment ID: I20090929000546 |
| Provider Name | Sri Krishna K Vasireddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043462393 PECOS PAC ID: 0648316679 Enrollment ID: I20091006000257 |
| Provider Name | Abdul Subhan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376717744 PECOS PAC ID: 1153468988 Enrollment ID: I20091027000319 |
| Provider Name | Thomas K Kalmbach |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1114011798 PECOS PAC ID: 0547300022 Enrollment ID: I20091214000406 |
| Provider Name | John Hume Fallon |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1326040395 PECOS PAC ID: 6406748136 Enrollment ID: I20091214000697 |
| Provider Name | Eric W Waldo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356501514 PECOS PAC ID: 9830231414 Enrollment ID: I20100120000279 |
| Provider Name | Abhay Singhal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962595850 PECOS PAC ID: 9931241312 Enrollment ID: I20100122000573 |
| Provider Name | Mandelle Dreu Doerstler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851428585 PECOS PAC ID: 5193868883 Enrollment ID: I20100203000324 |
| Provider Name | Jennifer M Bow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144451014 PECOS PAC ID: 4981787876 Enrollment ID: I20100205000705 |
| Provider Name | John Joseph Schier |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1184643512 PECOS PAC ID: 3971639204 Enrollment ID: I20100325001041 |
| Provider Name | Julie Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093707770 PECOS PAC ID: 7911033568 Enrollment ID: I20100407000394 |
| Provider Name | Svetlana Bucchino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932120847 PECOS PAC ID: 5092841528 Enrollment ID: I20100410000006 |
| Provider Name | Bachar Al Khatib |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992726814 PECOS PAC ID: 9436285962 Enrollment ID: I20100410000024 |
| Provider Name | Melvin Christian |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1649457391 PECOS PAC ID: 7214011378 Enrollment ID: I20100419000841 |
| Provider Name | Stephanie J Russ |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629239355 PECOS PAC ID: 3173650066 Enrollment ID: I20100426000115 |
| Provider Name | Michael Gerard Koelsch |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1053336297 PECOS PAC ID: 4981731692 Enrollment ID: I20100428000350 |
| Provider Name | Marcie L Baird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447577275 PECOS PAC ID: 5294865598 Enrollment ID: I20100614000164 |
| Provider Name | Gordon M Hughes |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1003895681 PECOS PAC ID: 8628975513 Enrollment ID: I20100614000356 |
| Provider Name | Rosemarie M Jeffery |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1881662732 PECOS PAC ID: 6305750308 Enrollment ID: I20100614000483 |
| Provider Name | Daryl G Morrical |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1780652123 PECOS PAC ID: 1759295751 Enrollment ID: I20100614000605 |
| Provider Name | Marlowe J Stinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730158882 PECOS PAC ID: 4688763485 Enrollment ID: I20100615000459 |
| Provider Name | James Matthew Neal |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1528037207 PECOS PAC ID: 7315851318 Enrollment ID: I20100616000402 |
| Provider Name | Alice O Bruggeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114020104 PECOS PAC ID: 5597895490 Enrollment ID: I20100618000401 |
| Provider Name | Tracy Kay Heath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881794840 PECOS PAC ID: 3173653086 Enrollment ID: I20100618000468 |
| Provider Name | Nitin Arun Khadilkar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629237078 PECOS PAC ID: 5597897587 Enrollment ID: I20100708001083 |
| Provider Name | William B Fisher |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1053389379 PECOS PAC ID: 4183538192 Enrollment ID: I20100720000935 |
| Provider Name | David E Lentz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285625566 PECOS PAC ID: 8325135056 Enrollment ID: I20100722000816 |
| Provider Name | Luke P Philippsen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1861494627 PECOS PAC ID: 2466542956 Enrollment ID: I20100803001314 |
| Provider Name | Steven J Lansing |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1861518581 PECOS PAC ID: 2163555699 Enrollment ID: I20100804000007 |
| Provider Name | Jonathan Lewis Schmidt |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1699777201 PECOS PAC ID: 9133165418 Enrollment ID: I20100804000456 |
| Provider Name | Mark A King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720079148 PECOS PAC ID: 2769461789 Enrollment ID: I20100806000833 |
| Provider Name | Gregory S Eskew |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1134155278 PECOS PAC ID: 4284767427 Enrollment ID: I20100809000518 |
| Provider Name | Michael E Inman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1700828928 PECOS PAC ID: 1153454392 Enrollment ID: I20100809000563 |
| Provider Name | David L Brand |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1972719755 PECOS PAC ID: 7416081666 Enrollment ID: I20100810000940 |
| Provider Name | Andrew J Crook |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1669412813 PECOS PAC ID: 9931233194 Enrollment ID: I20100810000991 |
| Provider Name | Bracken J Dewitt |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1548201833 PECOS PAC ID: 6608900865 Enrollment ID: I20100810001069 |
| Provider Name | Gerard T Costello |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1902960149 PECOS PAC ID: 1456485341 Enrollment ID: I20100813000612 |
| Provider Name | Sai K Devarapalli |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1548234966 PECOS PAC ID: 4183727183 Enrollment ID: I20100826000898 |
| Provider Name | John F Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386726248 PECOS PAC ID: 2466494299 Enrollment ID: I20100827000583 |
| Provider Name | Gautam Phookan |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1093750978 PECOS PAC ID: 9335264597 Enrollment ID: I20100913000428 |
| Provider Name | Mark A Hall |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1952338923 PECOS PAC ID: 5496947319 Enrollment ID: I20101011001086 |
| Provider Name | Jean Langley Roberts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972702744 PECOS PAC ID: 5991998775 Enrollment ID: I20101025001278 |
| Provider Name | Nathan L Christenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851608178 PECOS PAC ID: 0648464990 Enrollment ID: I20101030000209 |
| Provider Name | Lisa M Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134438286 PECOS PAC ID: 5395931026 Enrollment ID: I20101120000079 |
| Provider Name | Sherry D Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366429698 PECOS PAC ID: 5799971875 Enrollment ID: I20101201000829 |
| Provider Name | Franky Voss |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487631784 PECOS PAC ID: 1557558020 Enrollment ID: I20101209000663 |
| Provider Name | Hal S Dickson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992780894 PECOS PAC ID: 2163619552 Enrollment ID: I20101210000781 |
| Provider Name | Carolyn L Keihn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609186030 PECOS PAC ID: 3274712385 Enrollment ID: I20110121000208 |
| Provider Name | Paul B Stewart |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295739100 PECOS PAC ID: 2264611268 Enrollment ID: I20110125000690 |
| Provider Name | Ashraf H Hanna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720153919 PECOS PAC ID: 3274713656 Enrollment ID: I20110203000079 |
| Provider Name | Herman Burgermeister |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215953492 PECOS PAC ID: 1658552120 Enrollment ID: I20110217000247 |
| Provider Name | Stephen Boyle |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306865142 PECOS PAC ID: 4880640093 Enrollment ID: I20110217000269 |
| Provider Name | Lance K Ottinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306898747 PECOS PAC ID: 0446431639 Enrollment ID: I20110222000026 |
| Provider Name | Angela Jane Crouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306144704 PECOS PAC ID: 7810170685 Enrollment ID: I20110401000012 |
| Provider Name | Mark Saleem |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902009517 PECOS PAC ID: 3678672094 Enrollment ID: I20110405000475 |
| Provider Name | Ryan P Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740378215 PECOS PAC ID: 8628254430 Enrollment ID: I20110512000075 |
| Provider Name | Mark E Nielson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1942407838 PECOS PAC ID: 2668658808 Enrollment ID: I20110524000071 |
| Provider Name | Alyssa A Hunter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285869206 PECOS PAC ID: 4789860818 Enrollment ID: I20110525000336 |
| Provider Name | Arman H Siddiqui |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447484167 PECOS PAC ID: 5698953016 Enrollment ID: I20110706000417 |
| Provider Name | Mariano L Orca |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1932273984 PECOS PAC ID: 2365343803 Enrollment ID: I20110707000005 |
| Provider Name | Emily B Rose |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1699793117 PECOS PAC ID: 1951579267 Enrollment ID: I20110712000378 |
| Provider Name | Lisa L Swingley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609012087 PECOS PAC ID: 9931377389 Enrollment ID: I20110729000402 |
| Provider Name | Muhammad Khalil Aslam |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659384220 PECOS PAC ID: 3971605437 Enrollment ID: I20110809000468 |
| Provider Name | Bhuvaneswari Burugapalli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518127695 PECOS PAC ID: 4981874039 Enrollment ID: I20110826000453 |
| Provider Name | Ali F Iqtidar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780781088 PECOS PAC ID: 0042480089 Enrollment ID: I20110830000190 |
| Provider Name | Mushoba N Njalamimba |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1043406200 PECOS PAC ID: 8224209366 Enrollment ID: I20110921000015 |
| Provider Name | Howard Cooper |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1720021223 PECOS PAC ID: 1759393143 Enrollment ID: I20111017000246 |
| Provider Name | Sonal J Bazeley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1457541971 PECOS PAC ID: 1052405909 Enrollment ID: I20111123000424 |
| Provider Name | John D Wulff |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477530913 PECOS PAC ID: 7719152131 Enrollment ID: I20111214000464 |
| Provider Name | Jeffrey W Barr |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1558349845 PECOS PAC ID: 4880773175 Enrollment ID: I20120110000204 |
| Provider Name | Robert N Reilly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336116334 PECOS PAC ID: 3779750336 Enrollment ID: I20120123000286 |
| Provider Name | Roland W James |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841511524 PECOS PAC ID: 1557538899 Enrollment ID: I20120127000006 |
| Provider Name | Debra A Garner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962494062 PECOS PAC ID: 6800053646 Enrollment ID: I20120206000412 |
| Provider Name | Michael D Atwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790055648 PECOS PAC ID: 5799942363 Enrollment ID: I20120209000321 |
| Provider Name | John Collins |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003830399 PECOS PAC ID: 4789640681 Enrollment ID: I20120210000251 |
| Provider Name | Sandra A Mccabe |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1427093376 PECOS PAC ID: 8325041346 Enrollment ID: I20120216000487 |
| Provider Name | Jason W Kennard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639208747 PECOS PAC ID: 2961665500 Enrollment ID: I20120518000320 |
| Provider Name | Satish R Nandyala |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1619107885 PECOS PAC ID: 5991969917 Enrollment ID: I20120604000076 |
| Provider Name | Degesew A Bezza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487961397 PECOS PAC ID: 5991969602 Enrollment ID: I20120608000469 |
| Provider Name | Meghana G Bhat |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427212398 PECOS PAC ID: 2062676273 Enrollment ID: I20120619000164 |
| Provider Name | Jeffery J Obrian |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437419710 PECOS PAC ID: 5890950539 Enrollment ID: I20120703000395 |
| Provider Name | Amy J Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972866085 PECOS PAC ID: 6103081740 Enrollment ID: I20120703000577 |
| Provider Name | Naeem Raza |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1447214994 PECOS PAC ID: 7517861859 Enrollment ID: I20120709000236 |
| Provider Name | Gail A Clark |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1760718258 PECOS PAC ID: 2769648112 Enrollment ID: I20120730000531 |
| Provider Name | Nkiruka Nnebe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982667069 PECOS PAC ID: 3577597285 Enrollment ID: I20120731000154 |
| Provider Name | Corinna Yu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679734032 PECOS PAC ID: 9830345180 Enrollment ID: I20120802000181 |
| Provider Name | Manish Jain |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1750443297 PECOS PAC ID: 8729180138 Enrollment ID: I20120802000472 |
| Provider Name | Michael Savitt |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1609838184 PECOS PAC ID: 7911944657 Enrollment ID: I20121022000031 |
| Provider Name | Tapan R Mehta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235371030 PECOS PAC ID: 2365692563 Enrollment ID: I20121024000688 |
| Provider Name | Rodney Joe O Yuhico |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902047996 PECOS PAC ID: 8527212760 Enrollment ID: I20130215000537 |
| Provider Name | David J Rizk |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558529198 PECOS PAC ID: 1052451218 Enrollment ID: I20130306000600 |
| Provider Name | Kenneth A Havenstrite |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861736688 PECOS PAC ID: 5597900712 Enrollment ID: I20130318000216 |
| Provider Name | Maria E Faget |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932307527 PECOS PAC ID: 6608011465 Enrollment ID: I20130326000633 |
| Provider Name | Rajiv Sharma |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1770797359 PECOS PAC ID: 5294923272 Enrollment ID: I20130409000592 |
| Provider Name | Luke S Ernstberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821383209 PECOS PAC ID: 2365688686 Enrollment ID: I20130411000182 |
| Provider Name | Allen E Shepherd |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942471628 PECOS PAC ID: 5496992638 Enrollment ID: I20130508000160 |
| Provider Name | Joshua B Brewster |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1700048709 PECOS PAC ID: 7911156179 Enrollment ID: I20130509000251 |
| Provider Name | Mabrey Jen Chamberlin |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1568619955 PECOS PAC ID: 1355588989 Enrollment ID: I20130518000112 |
| Provider Name | Fahd Saeed |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1891972386 PECOS PAC ID: 7113190687 Enrollment ID: I20130719000114 |
| Provider Name | Marina Weinstein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124339262 PECOS PAC ID: 1355584574 Enrollment ID: I20130906000493 |
| Provider Name | Salman A Khan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1922335116 PECOS PAC ID: 8123261344 Enrollment ID: I20130906000557 |
| Provider Name | Sadia Abbasi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740570423 PECOS PAC ID: 2264676261 Enrollment ID: I20130912000575 |
| Provider Name | Mohamed H Morad |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730481870 PECOS PAC ID: 3779723564 Enrollment ID: I20130916000098 |
| Provider Name | Justin B Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235459355 PECOS PAC ID: 3274771464 Enrollment ID: I20130917000018 |
| Provider Name | Vicente Mauricio Gonzaga |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437442555 PECOS PAC ID: 5799929543 Enrollment ID: I20130917000182 |
| Provider Name | Jonathan J Gries |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801116819 PECOS PAC ID: 7911143789 Enrollment ID: I20131002000381 |
| Provider Name | David A Cadogan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235336793 PECOS PAC ID: 9739313669 Enrollment ID: I20131009000733 |
| Provider Name | Som Dutt Tyagi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366698177 PECOS PAC ID: 1254599657 Enrollment ID: I20131014000999 |
| Provider Name | Naasha V Gheyara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245557149 PECOS PAC ID: 1456591809 Enrollment ID: I20131016000393 |
| Provider Name | Roy Abraham |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912214560 PECOS PAC ID: 6204083579 Enrollment ID: I20131023000060 |
| Provider Name | Kendra A Misbach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104268432 PECOS PAC ID: 1850526658 Enrollment ID: I20131104000385 |
| Provider Name | Stacey P Cadogan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295177061 PECOS PAC ID: 2668608787 Enrollment ID: I20131120001000 |
| Provider Name | Theressia Louise Washington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992951347 PECOS PAC ID: 2668667452 Enrollment ID: I20131213001755 |
| Provider Name | Joseph I Indiano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457612053 PECOS PAC ID: 5193961506 Enrollment ID: I20131226001664 |
| Provider Name | Aditya R Boddu |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1497917744 PECOS PAC ID: 3577790245 Enrollment ID: I20131230001637 |
| Provider Name | Martha J Mccart Silvidi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750717955 PECOS PAC ID: 6305074030 Enrollment ID: I20140102000449 |
| Provider Name | Erika A Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376979245 PECOS PAC ID: 6608004221 Enrollment ID: I20140106000347 |
| Provider Name | Unnikrishnan Ponnamma Kunjan Pillai |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1801086640 PECOS PAC ID: 3173772415 Enrollment ID: I20140114000607 |
| Provider Name | Milissa Ann Eley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013283464 PECOS PAC ID: 9537305768 Enrollment ID: I20140214000395 |
| Provider Name | Sheraz Younus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396928552 PECOS PAC ID: 1153550116 Enrollment ID: I20140215000111 |
| Provider Name | Angela E Parsley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487084919 PECOS PAC ID: 7911136833 Enrollment ID: I20140218001077 |
| Provider Name | Michelle Rene Lashorne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972945194 PECOS PAC ID: 5597995084 Enrollment ID: I20140301000047 |
| Provider Name | Nadia P Paul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487937157 PECOS PAC ID: 4284864786 Enrollment ID: I20140303000028 |
| Provider Name | Lizabeth A Van Hooser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467881789 PECOS PAC ID: 8224268636 Enrollment ID: I20140305000139 |
| Provider Name | Adam David Amos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407122666 PECOS PAC ID: 6608012810 Enrollment ID: I20140306000655 |
| Provider Name | Meredith Angner Shepherd |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1093957193 PECOS PAC ID: 5597901785 Enrollment ID: I20140331000600 |
| Provider Name | Frances R Baccus |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1366431454 PECOS PAC ID: 1759371057 Enrollment ID: I20140407000451 |
| Provider Name | Stephanie A Havens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629402946 PECOS PAC ID: 5698908002 Enrollment ID: I20140508001209 |
| Provider Name | George Gad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811144678 PECOS PAC ID: 1658530357 Enrollment ID: I20140508002163 |
| Provider Name | Alan Sonsky |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1083723225 PECOS PAC ID: 0547205106 Enrollment ID: I20140528002141 |
| Provider Name | Elizabeth Ann Morgan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235267410 PECOS PAC ID: 6901048701 Enrollment ID: I20140603001748 |
| Provider Name | Caleb R Overpeck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740576529 PECOS PAC ID: 4789820655 Enrollment ID: I20140623000870 |
| Provider Name | Mohammed Alfaiyumi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1063612687 PECOS PAC ID: 9234362468 Enrollment ID: I20140624000443 |
| Provider Name | Ramesh Prajapati |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245661859 PECOS PAC ID: 7810112372 Enrollment ID: I20140626000411 |
| Provider Name | Arzu Karaman Gonulalan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184903981 PECOS PAC ID: 5597980821 Enrollment ID: I20140630001822 |
| Provider Name | Tracy M Laux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730509605 PECOS PAC ID: 8921223918 Enrollment ID: I20140708000175 |
| Provider Name | Pu Cheng |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063739670 PECOS PAC ID: 2365667185 Enrollment ID: I20140710000571 |
| Provider Name | Jonathan Lee Thomas Munro |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1942438817 PECOS PAC ID: 1052536836 Enrollment ID: I20140711000536 |
| Provider Name | Peter C Jenkins |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083761019 PECOS PAC ID: 4880828730 Enrollment ID: I20140715000344 |
| Provider Name | Abdul Naseer Syed |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962782805 PECOS PAC ID: 0648496612 Enrollment ID: I20140728001901 |
| Provider Name | Jeffrey A Glant |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407149578 PECOS PAC ID: 7315186699 Enrollment ID: I20140729000242 |
| Provider Name | Augusta Uwah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205065471 PECOS PAC ID: 7618194614 Enrollment ID: I20140815000611 |
| Provider Name | Adrian Singson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992096085 PECOS PAC ID: 7214177393 Enrollment ID: I20140909001891 |
| Provider Name | Romana N Malik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487948501 PECOS PAC ID: 1153569025 Enrollment ID: I20140911002048 |
| Provider Name | Ashwin Reddy Madupu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437416310 PECOS PAC ID: 2466671540 Enrollment ID: I20140923000887 |
| Provider Name | Kimberly Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134298276 PECOS PAC ID: 8628298007 Enrollment ID: I20141007001255 |
| Provider Name | Moustafa M Aouthmany |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164419834 PECOS PAC ID: 4688863772 Enrollment ID: I20141111002270 |
| Provider Name | Godson Nnamdi Aronu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104114552 PECOS PAC ID: 2062634405 Enrollment ID: I20141119001165 |
| Provider Name | Travis Donovan Newman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679975676 PECOS PAC ID: 6800118043 Enrollment ID: I20141125001763 |
| Provider Name | Kevin Clemans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689015927 PECOS PAC ID: 5698098606 Enrollment ID: I20141224001156 |
| Provider Name | Kelsey J Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104220086 PECOS PAC ID: 6507180981 Enrollment ID: I20150112001983 |
| Provider Name | Bradley Goldenberg |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477595239 PECOS PAC ID: 8729121280 Enrollment ID: I20150122000172 |
| Provider Name | Mark E Pajeau |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1114131711 PECOS PAC ID: 5092991125 Enrollment ID: I20150126000223 |
| Provider Name | Shea Nichele Aulbach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245489723 PECOS PAC ID: 3870571532 Enrollment ID: I20150210000365 |
| Provider Name | Rizwan Jafri |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1386930667 PECOS PAC ID: 8820314826 Enrollment ID: I20150311000236 |
| Provider Name | Christina Andrew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285026526 PECOS PAC ID: 3375862345 Enrollment ID: I20150427000033 |
| Provider Name | Haibin Wang |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1013112184 PECOS PAC ID: 5092996801 Enrollment ID: I20150501001178 |
| Provider Name | Dennis Daniels |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1265404222 PECOS PAC ID: 5991808628 Enrollment ID: I20150504001857 |
| Provider Name | Pradeesh M George |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992960157 PECOS PAC ID: 5597905430 Enrollment ID: I20150519002582 |
| Provider Name | Abigael V Magadia |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417291782 PECOS PAC ID: 4284955717 Enrollment ID: I20150609000861 |
| Provider Name | Chiaki Nakanishi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659660553 PECOS PAC ID: 0143467431 Enrollment ID: I20150610000492 |
| Provider Name | Deepthi C Kurakula |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1033419882 PECOS PAC ID: 2860626439 Enrollment ID: I20150618002384 |
| Provider Name | Prakash Shankar Bhoopalam |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942208905 PECOS PAC ID: 9739491838 Enrollment ID: I20150702000146 |
| Provider Name | Tamara M Tolson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1811285133 PECOS PAC ID: 6507003092 Enrollment ID: I20150707001895 |
| Provider Name | Thomas Zarchary Boone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699188672 PECOS PAC ID: 3476779364 Enrollment ID: I20150721002600 |
| Provider Name | Ritvika Panghal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396033320 PECOS PAC ID: 1254644917 Enrollment ID: I20150723009002 |
| Provider Name | Lizbeth M Hingst |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548589237 PECOS PAC ID: 3072749530 Enrollment ID: I20150724011442 |
| Provider Name | Rosette Kfoury |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1376873323 PECOS PAC ID: 8325284979 Enrollment ID: I20150727002350 |
| Provider Name | Renee V Green |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1790078012 PECOS PAC ID: 3072597830 Enrollment ID: I20150814012702 |
| Provider Name | Aldrin C Roque |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356608020 PECOS PAC ID: 3971743527 Enrollment ID: I20150821014798 |
| Provider Name | Sara L Sorrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528471539 PECOS PAC ID: 1153541370 Enrollment ID: I20150826000959 |
| Provider Name | Ahmed A Behery |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841556131 PECOS PAC ID: 1355581802 Enrollment ID: I20150915000916 |
| Provider Name | Natalie King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396122735 PECOS PAC ID: 7810204146 Enrollment ID: I20150917002761 |
| Provider Name | Josh C Rainey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780067199 PECOS PAC ID: 2961710116 Enrollment ID: I20151007002914 |
| Provider Name | Sandra Duggan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861869513 PECOS PAC ID: 7315243052 Enrollment ID: I20160307002073 |
| Provider Name | Tiffany L Pierce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386005031 PECOS PAC ID: 1658678131 Enrollment ID: I20160329000051 |
| Provider Name | Paul B Delonnay |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1548490097 PECOS PAC ID: 1456594696 Enrollment ID: I20160414001152 |
| Provider Name | Jennifer D Vanskyock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912365875 PECOS PAC ID: 8325347420 Enrollment ID: I20160425000304 |
| Provider Name | Bryan Anderson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1376813949 PECOS PAC ID: 6204097892 Enrollment ID: I20160506001682 |
| Provider Name | Anna Liza Maglinte |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861735060 PECOS PAC ID: 8123260775 Enrollment ID: I20160510001557 |
| Provider Name | Joseph T Varnau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972916997 PECOS PAC ID: 1557588894 Enrollment ID: I20160510002099 |
| Provider Name | Lauren J Stoffel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063827053 PECOS PAC ID: 2163649930 Enrollment ID: I20160608002527 |
| Provider Name | Heather A Masters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043672660 PECOS PAC ID: 0648560268 Enrollment ID: I20160609001012 |
| Provider Name | Aneel Kumar Bole |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1275822264 PECOS PAC ID: 5395914303 Enrollment ID: I20160616000955 |
| Provider Name | Mary C Martin Hemphill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215010806 PECOS PAC ID: 9335430008 Enrollment ID: I20160628001039 |
| Provider Name | Robin E Witham-curry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700833423 PECOS PAC ID: 9234213307 Enrollment ID: I20160629000848 |
| Provider Name | Morgan J Langhofer |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1952662314 PECOS PAC ID: 7416193834 Enrollment ID: I20160705001756 |
| Provider Name | Nicholas A Pipito |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1700144086 PECOS PAC ID: 3072805787 Enrollment ID: I20160715000971 |
| Provider Name | Kristy L Mount |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235572124 PECOS PAC ID: 7719111079 Enrollment ID: I20160715001735 |
| Provider Name | Kara D Wyatt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245675099 PECOS PAC ID: 3274777214 Enrollment ID: I20160725002024 |
| Provider Name | Andrew M Stevens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679816078 PECOS PAC ID: 6800030057 Enrollment ID: I20160726000231 |
| Provider Name | John E Marx |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720491731 PECOS PAC ID: 2365669710 Enrollment ID: I20160728001914 |
| Provider Name | Stephen A Morse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801234729 PECOS PAC ID: 0446474258 Enrollment ID: I20160803000639 |
| Provider Name | Franklin Cornelius Mikell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568805265 PECOS PAC ID: 9133361322 Enrollment ID: I20160803000768 |
| Provider Name | Kevin L Witt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922441757 PECOS PAC ID: 5991949158 Enrollment ID: I20160815002859 |
| Provider Name | William Cress |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1346240991 PECOS PAC ID: 9739139064 Enrollment ID: I20160822000040 |
| Provider Name | Bryan E. Mcdonnell |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1780682781 PECOS PAC ID: 8022112937 Enrollment ID: I20160823000101 |
| Provider Name | Kathleen Noll |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841236148 PECOS PAC ID: 7719938737 Enrollment ID: I20160829000304 |
| Provider Name | Eric B Lester |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700172608 PECOS PAC ID: 3375838345 Enrollment ID: I20160830001490 |
| Provider Name | Megan E Shetty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639623614 PECOS PAC ID: 0244526408 Enrollment ID: I20160914001825 |
| Provider Name | Hillary B Risk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487007241 PECOS PAC ID: 2466748637 Enrollment ID: I20160914002074 |
| Provider Name | Amir Tirmizi |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1861401507 PECOS PAC ID: 9638141682 Enrollment ID: I20160927000710 |
| Provider Name | Amy L Padgett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619426657 PECOS PAC ID: 6305134081 Enrollment ID: I20161012002072 |
| Provider Name | Chung Ning Tan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619357779 PECOS PAC ID: 1052623394 Enrollment ID: I20161017000359 |
| Provider Name | Lindsey M Moorman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043760523 PECOS PAC ID: 4587952031 Enrollment ID: I20161017000363 |
| Provider Name | Stefanie Rae Warstler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871045781 PECOS PAC ID: 4486933884 Enrollment ID: I20161107002175 |
| Provider Name | Syed Hasan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689089674 PECOS PAC ID: 9931327475 Enrollment ID: I20161115001941 |
| Provider Name | Nora Deenik |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1649534934 PECOS PAC ID: 3476799222 Enrollment ID: I20170110001189 |
| Provider Name | Sai Siva J Mungara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417397423 PECOS PAC ID: 0446532071 Enrollment ID: I20170117000137 |
| Provider Name | Yousuf A Bahrami |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548641525 PECOS PAC ID: 8224341359 Enrollment ID: I20170119002368 |
| Provider Name | Anne E. Hardesty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336694736 PECOS PAC ID: 5395028773 Enrollment ID: I20170209000080 |
| Provider Name | Obiageli Ezewuiro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518128149 PECOS PAC ID: 6406171057 Enrollment ID: I20170210000658 |
| Provider Name | Samerawit A Zeleke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982014296 PECOS PAC ID: 5799901104 Enrollment ID: I20170213000071 |
| Provider Name | Songoli Umeh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1356635163 PECOS PAC ID: 6709194541 Enrollment ID: I20170223000939 |
| Provider Name | Anne M Patch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346788924 PECOS PAC ID: 0648554774 Enrollment ID: I20170308002033 |
| Provider Name | Danielle Dues |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912242504 PECOS PAC ID: 2163706250 Enrollment ID: I20170309002259 |
| Provider Name | Tigist W Adugna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245659739 PECOS PAC ID: 1355568940 Enrollment ID: I20170316000788 |
| Provider Name | Edward W Kubek |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1992906382 PECOS PAC ID: 2961713441 Enrollment ID: I20170322000667 |
| Provider Name | Michael Park |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043659956 PECOS PAC ID: 3274828173 Enrollment ID: I20170511001063 |
| Provider Name | Sashank Kolli |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1205140985 PECOS PAC ID: 6608179221 Enrollment ID: I20170605002966 |
| Provider Name | Joseph L Falin |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1871939561 PECOS PAC ID: 4880837673 Enrollment ID: I20170607002460 |
| Provider Name | Vallikantha Nellaiappan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1548557812 PECOS PAC ID: 8022250042 Enrollment ID: I20170608000778 |
| Provider Name | Muhammad M Haq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659790194 PECOS PAC ID: 6800164260 Enrollment ID: I20170608000975 |
| Provider Name | David L Dycus |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497098867 PECOS PAC ID: 8820366206 Enrollment ID: I20170608001780 |
| Provider Name | Prashant Malviya |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689981565 PECOS PAC ID: 4284947987 Enrollment ID: I20170613000226 |
| Provider Name | Bhavana Siddegowda-bangalore |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1760707988 PECOS PAC ID: 6002110640 Enrollment ID: I20170613001529 |
| Provider Name | Kathryn R Yuhico |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902197957 PECOS PAC ID: 7315187499 Enrollment ID: I20170614000319 |
| Provider Name | Alan J Schmitt |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568729994 PECOS PAC ID: 7618117813 Enrollment ID: I20170620001806 |
| Provider Name | Beth T Webber |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1114293586 PECOS PAC ID: 0749584316 Enrollment ID: I20170620002930 |
| Provider Name | Lacie S Burge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972043305 PECOS PAC ID: 2264700814 Enrollment ID: I20170622002022 |
| Provider Name | Aksana Waskosky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205262052 PECOS PAC ID: 0749550309 Enrollment ID: I20170714001711 |
| Provider Name | Tracy M Hamrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689080798 PECOS PAC ID: 1153691654 Enrollment ID: I20170717000744 |
| Provider Name | Benjamin Grandy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285976571 PECOS PAC ID: 1850531047 Enrollment ID: I20170720001812 |
| Provider Name | Michael Thorpe |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730413717 PECOS PAC ID: 2163735762 Enrollment ID: I20170823000265 |
| Provider Name | Douglas Cifuentes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689677544 PECOS PAC ID: 8224059969 Enrollment ID: I20170830001924 |
| Provider Name | Nicole M Waters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235651647 PECOS PAC ID: 3971876327 Enrollment ID: I20170906002048 |
| Provider Name | Dustin A Buchanan |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1356782056 PECOS PAC ID: 5496028540 Enrollment ID: I20170912001269 |
| Provider Name | Matthew T Sieg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871018119 PECOS PAC ID: 0042584807 Enrollment ID: I20170919000416 |
| Provider Name | Angela L Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649796178 PECOS PAC ID: 6103191721 Enrollment ID: I20171009000986 |
| Provider Name | Darcy L Deisler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699294587 PECOS PAC ID: 3870868342 Enrollment ID: I20171010000105 |
| Provider Name | Ahmed Abdel-maksoud |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1295917086 PECOS PAC ID: 2668545641 Enrollment ID: I20171019001517 |
| Provider Name | Amin H Jiminian Wilmot |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710268412 PECOS PAC ID: 5799931788 Enrollment ID: I20171023002666 |
| Provider Name | Sameh G Abuerreish |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1447246202 PECOS PAC ID: 8527145671 Enrollment ID: I20171102001248 |
| Provider Name | Joseph K Hampton |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164718037 PECOS PAC ID: 7315249232 Enrollment ID: I20171109000619 |
| Provider Name | Brogan E Bahler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750738258 PECOS PAC ID: 5395039861 Enrollment ID: I20171201002695 |
| Provider Name | Nedda Karimi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265895486 PECOS PAC ID: 3476847955 Enrollment ID: I20171208001596 |
| Provider Name | Andi Anderson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1174893598 PECOS PAC ID: 7719148311 Enrollment ID: I20180216000358 |
| Provider Name | Aaron A Jones |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215015706 PECOS PAC ID: 7810948585 Enrollment ID: I20180228000114 |
| Provider Name | Betsy Krause |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003262965 PECOS PAC ID: 8426342908 Enrollment ID: I20180323001081 |
| Provider Name | John Ambrose Mihelcic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134582521 PECOS PAC ID: 7113211699 Enrollment ID: I20180402001397 |
| Provider Name | Leslie Acton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326541780 PECOS PAC ID: 1456614130 Enrollment ID: I20180410002837 |
| Provider Name | Eric S Westergren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073975041 PECOS PAC ID: 8820384696 Enrollment ID: I20180417002140 |
| Provider Name | Karen T Roque |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841687746 PECOS PAC ID: 4981917226 Enrollment ID: I20180420002467 |
| Provider Name | Jordan E Dicken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073019659 PECOS PAC ID: 1951665470 Enrollment ID: I20180510000080 |
| Provider Name | Tonia R Childers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609245133 PECOS PAC ID: 6406110923 Enrollment ID: I20180510000104 |
| Provider Name | Boris M Vitvitskiy |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1831517978 PECOS PAC ID: 1850605536 Enrollment ID: I20180514001827 |
| Provider Name | Monzur Haque |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639436314 PECOS PAC ID: 4183989122 Enrollment ID: I20180523000433 |
| Provider Name | Don Jaffe |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1457352031 PECOS PAC ID: 9830117928 Enrollment ID: I20180530000211 |
| Provider Name | Rachael Fizer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790199578 PECOS PAC ID: 4082839303 Enrollment ID: I20180612000861 |
| Provider Name | Mohammad Adnan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306239918 PECOS PAC ID: 0749578896 Enrollment ID: I20180614001051 |
| Provider Name | Amit Shetty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801283890 PECOS PAC ID: 3870806136 Enrollment ID: I20180618001989 |
| Provider Name | Daniel A Stegelman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477940427 PECOS PAC ID: 9537471081 Enrollment ID: I20180619001960 |
| Provider Name | Elesha Dunbar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326537788 PECOS PAC ID: 0446505226 Enrollment ID: I20180619002277 |
| Provider Name | Mohammad Nawaf Sadeddin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588041313 PECOS PAC ID: 4183924301 Enrollment ID: I20180627002422 |
| Provider Name | Sandra Horvath Dori |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1689666927 PECOS PAC ID: 5092606848 Enrollment ID: I20180727000368 |
| Provider Name | Najmul Hasan Siddiqui |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558527580 PECOS PAC ID: 1052587250 Enrollment ID: I20180803001546 |
| Provider Name | Michael J Gallagher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487065272 PECOS PAC ID: 1052624426 Enrollment ID: I20180813003044 |
| Provider Name | Scott D Cohen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1871699652 PECOS PAC ID: 3577475904 Enrollment ID: I20180815003379 |
| Provider Name | Kerry M Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073092631 PECOS PAC ID: 7315297470 Enrollment ID: I20180911002205 |
| Provider Name | Joseph Francis Vormohr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962815761 PECOS PAC ID: 3375769359 Enrollment ID: I20180917000285 |
| Provider Name | Kari Alyssa Choate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093292450 PECOS PAC ID: 5991056764 Enrollment ID: I20180919000303 |
| Provider Name | Samuel Jacob |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1992931414 PECOS PAC ID: 9032350509 Enrollment ID: I20180919003209 |
| Provider Name | Abdul Rehman Tayyab Tahir |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134515307 PECOS PAC ID: 0648582411 Enrollment ID: I20180926002338 |
| Provider Name | Aisha Davis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023405073 PECOS PAC ID: 3678886991 Enrollment ID: I20181009000482 |
| Provider Name | Derrianne M Monteiro |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073096715 PECOS PAC ID: 8123370418 Enrollment ID: I20181015003400 |
| Provider Name | Raquel Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417431388 PECOS PAC ID: 9436402559 Enrollment ID: I20181018003003 |
| Provider Name | Edna Wong Mckinstry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295997211 PECOS PAC ID: 0547431447 Enrollment ID: I20181023002700 |
| Provider Name | Jessica Knapp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386129120 PECOS PAC ID: 9830442102 Enrollment ID: I20181102001831 |
| Provider Name | Kayla R Heldman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205310588 PECOS PAC ID: 3375896558 Enrollment ID: I20181106000855 |
| Provider Name | Kathryn J Riggin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659865194 PECOS PAC ID: 2163766924 Enrollment ID: I20181205000385 |
| Provider Name | Vishal Viswam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245670611 PECOS PAC ID: 8123320595 Enrollment ID: I20181207002201 |
| Provider Name | Jessica Lynn Roseberry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487129342 PECOS PAC ID: 4486999869 Enrollment ID: I20181213002245 |
| Provider Name | Jonathan Laurence Berkowitz |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1609070671 PECOS PAC ID: 6103095344 Enrollment ID: I20181214000103 |
| Provider Name | Greta R Braun |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619404977 PECOS PAC ID: 3072858083 Enrollment ID: I20181219003291 |
| Provider Name | Elisabeth Marriah Bernal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144790726 PECOS PAC ID: 5092050807 Enrollment ID: I20181226001736 |
| Provider Name | Cassandra Louise Alexander |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972074482 PECOS PAC ID: 4688919145 Enrollment ID: I20190102003119 |
| Provider Name | Bruce Max Rothschild |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1265423024 PECOS PAC ID: 5496651622 Enrollment ID: I20190111000195 |
| Provider Name | Kathy A Baule |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1801863584 PECOS PAC ID: 9537123906 Enrollment ID: I20190111001051 |
| Provider Name | Camilo Santiago |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1124089313 PECOS PAC ID: 8224258272 Enrollment ID: I20190206000584 |
| Provider Name | Clifford Sander Hecht |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922457217 PECOS PAC ID: 1850684242 Enrollment ID: I20190206002931 |
| Provider Name | Stephanie Harrison Hubbard |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679558787 PECOS PAC ID: 6507847423 Enrollment ID: I20190214000332 |
| Provider Name | Grace Borton |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275061699 PECOS PAC ID: 6204174022 Enrollment ID: I20190220001826 |
| Provider Name | Rachel L Hency |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053861500 PECOS PAC ID: 2264710920 Enrollment ID: I20190404001395 |
| Provider Name | Jessieca Lynn Holtzleiter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215493853 PECOS PAC ID: 6709127939 Enrollment ID: I20190416001247 |
| Provider Name | Trenton K Schmale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851827935 PECOS PAC ID: 2163765611 Enrollment ID: I20190523002763 |
| Provider Name | Ravi Savani |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1184067746 PECOS PAC ID: 2062648884 Enrollment ID: I20190607001947 |
| Provider Name | Assad Mukhtar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609259001 PECOS PAC ID: 7315240876 Enrollment ID: I20190614000437 |
| Provider Name | Darcy Lash |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659728244 PECOS PAC ID: 8729379573 Enrollment ID: I20190618000959 |
| Provider Name | Nour Batarseh |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1184023384 PECOS PAC ID: 3971813866 Enrollment ID: I20190618001324 |
| Provider Name | Hamza Ansari |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548524812 PECOS PAC ID: 5890935803 Enrollment ID: I20190624000357 |
| Provider Name | Andrea Dee Coons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295393239 PECOS PAC ID: 6709111925 Enrollment ID: I20190710003219 |
| Provider Name | Mohammed Eid Madmani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1578819777 PECOS PAC ID: 5496998809 Enrollment ID: I20190711002052 |
| Provider Name | Mohammad Sami Bakdash |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104271790 PECOS PAC ID: 8628361037 Enrollment ID: I20190715000718 |
| Provider Name | Ismail Qattash |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1538329982 PECOS PAC ID: 2062579121 Enrollment ID: I20190718003660 |
| Provider Name | Marwan Mounayar |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1689012676 PECOS PAC ID: 2567603103 Enrollment ID: I20190729000100 |
| Provider Name | Fernando Miguel De Lemos Figueira |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992253298 PECOS PAC ID: 9537495239 Enrollment ID: I20190801000708 |
| Provider Name | Amy J Dockrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013569821 PECOS PAC ID: 8729316369 Enrollment ID: I20190821001373 |
| Provider Name | Erik P Keskinen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487006052 PECOS PAC ID: 9032402391 Enrollment ID: I20190822000688 |
| Provider Name | Molly A Kelly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780112870 PECOS PAC ID: 7719215268 Enrollment ID: I20190822001414 |
| Provider Name | Meghan K Kinsel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770019002 PECOS PAC ID: 9830427269 Enrollment ID: I20190823000427 |
| Provider Name | Wendy Ann Vanstone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255568358 PECOS PAC ID: 0244568400 Enrollment ID: I20190826002635 |
| Provider Name | Robyn Renee Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972164630 PECOS PAC ID: 7315275401 Enrollment ID: I20190828000377 |
| Provider Name | Megan Skelding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700330958 PECOS PAC ID: 7012246580 Enrollment ID: I20190909001994 |
| Provider Name | Vikas Kalra |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023270550 PECOS PAC ID: 0143516138 Enrollment ID: I20190911001794 |
| Provider Name | Lori Wanko |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1215270897 PECOS PAC ID: 6800190356 Enrollment ID: I20190926002080 |
| Provider Name | Rana Prathap Mercy Pathrose |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992188395 PECOS PAC ID: 2668776113 Enrollment ID: I20191002002602 |
| Provider Name | Ramiz Musa Saeed Mohammed |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1194278507 PECOS PAC ID: 9032440524 Enrollment ID: I20191015000986 |
| Provider Name | Adesola Awomolo |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1699778894 PECOS PAC ID: 0840260212 Enrollment ID: I20191023000417 |
| Provider Name | Amber D Petty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013568724 PECOS PAC ID: 8022440254 Enrollment ID: I20191108002244 |
| Provider Name | Kodwo Kuntu Orleans Lindsay |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1932216439 PECOS PAC ID: 0345273561 Enrollment ID: I20191118001384 |
| Provider Name | Richard L Williams |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1730158833 PECOS PAC ID: 8426218793 Enrollment ID: I20191213001715 |
| Provider Name | Zafar Zamir |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336123058 PECOS PAC ID: 7113930264 Enrollment ID: I20200106001840 |
| Provider Name | Kasey L Ely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174164503 PECOS PAC ID: 8325472921 Enrollment ID: I20200107000047 |
| Provider Name | Shelby Nicole Laflash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518502541 PECOS PAC ID: 9537594874 Enrollment ID: I20200115001612 |
| Provider Name | George L Kistler |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1710973656 PECOS PAC ID: 1658461009 Enrollment ID: I20200121001379 |
| Provider Name | David Gutman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376507079 PECOS PAC ID: 8921012113 Enrollment ID: I20200211001797 |
| Provider Name | Leo Jp Clark |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1659374007 PECOS PAC ID: 0648166918 Enrollment ID: I20200211002427 |
| Provider Name | Fowad Shahzad |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1568708428 PECOS PAC ID: 1850532532 Enrollment ID: I20200307000046 |
| Provider Name | Nancy W Lo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316197221 PECOS PAC ID: 5799909537 Enrollment ID: I20200329000568 |
| Provider Name | Tonya W Robinson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174605281 PECOS PAC ID: 5092143974 Enrollment ID: I20200330002377 |
| Provider Name | Molly Etling Gilbert |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669979456 PECOS PAC ID: 3072942754 Enrollment ID: I20200331003171 |
| Provider Name | Dakota Gilbert |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023515921 PECOS PAC ID: 0244669943 Enrollment ID: I20200401000331 |
| Provider Name | George N Batty |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1003020413 PECOS PAC ID: 2163675810 Enrollment ID: I20200416000243 |
| Provider Name | Jocelyn Mattoon |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1407350564 PECOS PAC ID: 0749610624 Enrollment ID: I20200416001071 |
| Provider Name | Richard Koepke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891797510 PECOS PAC ID: 1850372004 Enrollment ID: I20200416001562 |
| Provider Name | Madonna L Ferris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609900836 PECOS PAC ID: 9234238213 Enrollment ID: I20200501000607 |
| Provider Name | Ryan N Chauvin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1417158536 PECOS PAC ID: 7315015757 Enrollment ID: I20200521000891 |
| Provider Name | Velmalia D Matthews-smith |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1144257791 PECOS PAC ID: 1850396029 Enrollment ID: I20200521001427 |
| Provider Name | Lisa R Hodge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629448691 PECOS PAC ID: 8123449147 Enrollment ID: I20200529002167 |
| Provider Name | Priya Dharshini Ravindran |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033167333 PECOS PAC ID: 1355371808 Enrollment ID: I20200608000602 |
| Provider Name | Georgios Tzavellas |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1710368659 PECOS PAC ID: 4789005273 Enrollment ID: I20200609003091 |
| Provider Name | Ritika Zijoo |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1144691296 PECOS PAC ID: 2264707025 Enrollment ID: I20200610002090 |
| Provider Name | Md Salahuddin Siddiqui |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1750796611 PECOS PAC ID: 1355620147 Enrollment ID: I20200611000653 |
| Provider Name | Shuchi Talwar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174044473 PECOS PAC ID: 8022383124 Enrollment ID: I20200616002265 |
| Provider Name | Ippei Takagi |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1619144391 PECOS PAC ID: 3779717459 Enrollment ID: I20200616002883 |
| Provider Name | Reneelynn M Dixon |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1356541189 PECOS PAC ID: 4284807744 Enrollment ID: I20200622002698 |
| Provider Name | Fnu Sandhia |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154842813 PECOS PAC ID: 6507288396 Enrollment ID: I20200624002176 |
| Provider Name | Chandra Kathryn Flack |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1295115038 PECOS PAC ID: 2365753647 Enrollment ID: I20200624002376 |
| Provider Name | Mark A Cogen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1730147562 PECOS PAC ID: 4880752286 Enrollment ID: I20200629002981 |
| Provider Name | Joel Michael Phelps |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1881129286 PECOS PAC ID: 7113293390 Enrollment ID: I20200630001637 |
| Provider Name | Stephanie S Kidd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689194813 PECOS PAC ID: 2264708064 Enrollment ID: I20200702001942 |
| Provider Name | Supriya Todkar |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1942683958 PECOS PAC ID: 4688988033 Enrollment ID: I20200727003247 |
| Provider Name | Brittany S Kern |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639583719 PECOS PAC ID: 4385861822 Enrollment ID: I20200804003358 |
| Provider Name | Richard M Watkins |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1770533689 PECOS PAC ID: 4587716071 Enrollment ID: I20200806001564 |
| Provider Name | Lisa Nicole Grooms |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427587906 PECOS PAC ID: 1456776434 Enrollment ID: I20200807001660 |
| Provider Name | Megan Ash |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336678234 PECOS PAC ID: 0244656890 Enrollment ID: I20200813002102 |
| Provider Name | Kimberly Hinman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1336644152 PECOS PAC ID: 4284051988 Enrollment ID: I20200826001789 |
| Provider Name | Jennifer Lee Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043828635 PECOS PAC ID: 7113344797 Enrollment ID: I20200827001361 |
| Provider Name | Adil Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780117176 PECOS PAC ID: 5597003202 Enrollment ID: I20200827001825 |
| Provider Name | Ryan R Bean |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962939165 PECOS PAC ID: 5991073165 Enrollment ID: I20200827002078 |
| Provider Name | Jan M Deguzman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477083848 PECOS PAC ID: 4880964758 Enrollment ID: I20200828001985 |
| Provider Name | Mina S Youssef |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447783683 PECOS PAC ID: 3173893971 Enrollment ID: I20200831000709 |
| Provider Name | Katie M Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346859980 PECOS PAC ID: 7113345026 Enrollment ID: I20200909001964 |
| Provider Name | Sana Afroz |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1356724074 PECOS PAC ID: 0446548440 Enrollment ID: I20200911001468 |
| Provider Name | Nathan S Timm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902301195 PECOS PAC ID: 5698193373 Enrollment ID: I20200911001643 |
| Provider Name | Betty M Ho |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1134168750 PECOS PAC ID: 7416985486 Enrollment ID: I20200911001773 |
| Provider Name | Faisal A Siddiqui |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1902193402 PECOS PAC ID: 5395980155 Enrollment ID: I20200911001777 |
| Provider Name | Martin G Hoffman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1922035617 PECOS PAC ID: 0244398832 Enrollment ID: I20200915003151 |
| Provider Name | Jose Marco R Mendezona |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1407383094 PECOS PAC ID: 6507137882 Enrollment ID: I20200918001317 |
| Provider Name | Samyukta Chava |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1467622779 PECOS PAC ID: 4082784988 Enrollment ID: I20201007002437 |
| Provider Name | Danielle Lynn Brainerd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023617370 PECOS PAC ID: 9638589906 Enrollment ID: I20201028001538 |
| Provider Name | Colin Good |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053816959 PECOS PAC ID: 8921418203 Enrollment ID: I20201028001940 |
| Provider Name | Amy J Laurent |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073670659 PECOS PAC ID: 1951499557 Enrollment ID: I20201028002424 |
| Provider Name | Jessica Lynn Handy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043818396 PECOS PAC ID: 2567873029 Enrollment ID: I20201204001794 |
| Provider Name | Emily A Farkas |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1811197742 PECOS PAC ID: 5890889810 Enrollment ID: I20201210001251 |
| Provider Name | Amy Jane Mullin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619572823 PECOS PAC ID: 5698187383 Enrollment ID: I20201222002505 |
| Provider Name | Jessica Jo Brannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952960908 PECOS PAC ID: 9032522453 Enrollment ID: I20210104000945 |
| Provider Name | Mark Vaughn Larkins |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1740230317 PECOS PAC ID: 3072565175 Enrollment ID: I20210114000745 |
| Provider Name | Omar H Jawaid |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1104289370 PECOS PAC ID: 5799077525 Enrollment ID: I20210114002004 |
| Provider Name | Season Dawn Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851989198 PECOS PAC ID: 2567876279 Enrollment ID: I20210120002300 |
| Provider Name | Sadra Azizi-ghannad |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1639435084 PECOS PAC ID: 0446542872 Enrollment ID: I20210128001078 |
| Provider Name | Amy Christine Roby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477158277 PECOS PAC ID: 3072927037 Enrollment ID: I20210202003120 |
| Provider Name | Meredith K Humiston |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1265034169 PECOS PAC ID: 1759795743 Enrollment ID: I20210203000831 |
| Provider Name | Mustafa Qureshi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578011656 PECOS PAC ID: 0143508937 Enrollment ID: I20210204000697 |
| Provider Name | Vancy Zora |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841752359 PECOS PAC ID: 8527393834 Enrollment ID: I20210218001371 |
| Provider Name | Mark Elliott Lambert |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578548277 PECOS PAC ID: 6103232285 Enrollment ID: I20210316000883 |
| Provider Name | Jennifer Elizabeth Bosley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376131565 PECOS PAC ID: 3870901846 Enrollment ID: I20210413001492 |
| Provider Name | Christa M Lewis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285918433 PECOS PAC ID: 7012149461 Enrollment ID: I20210421001926 |
| Provider Name | Megan Colleen Wathen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407434210 PECOS PAC ID: 1254730435 Enrollment ID: I20210519002363 |
| Provider Name | Beatriz Martinez Quintero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568915841 PECOS PAC ID: 1254627508 Enrollment ID: I20210521000599 |
| Provider Name | Jie Yu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1255748075 PECOS PAC ID: 4880990050 Enrollment ID: I20210604002803 |
| Provider Name | Natasha Dudiki |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1366859142 PECOS PAC ID: 6305138728 Enrollment ID: I20210609000434 |
| Provider Name | Augustine A Ajuogu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326544438 PECOS PAC ID: 3971856691 Enrollment ID: I20210611002302 |
| Provider Name | Vamsi K Kantamaneni |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1306252580 PECOS PAC ID: 9133407711 Enrollment ID: I20210616002667 |
| Provider Name | Haris A Noorani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487142527 PECOS PAC ID: 6901145762 Enrollment ID: I20210729002360 |
| Provider Name | Rory Sandberg |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1184902447 PECOS PAC ID: 4789968165 Enrollment ID: I20210817001351 |
| Provider Name | Urooj Najm |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1912404823 PECOS PAC ID: 6800134511 Enrollment ID: I20210817001911 |
| Provider Name | Archana A Kulkarni |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1427432178 PECOS PAC ID: 1850689431 Enrollment ID: I20210818003723 |
| Provider Name | Nancy Elizabeth Vanderbilt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538832969 PECOS PAC ID: 1052716412 Enrollment ID: I20210823002533 |
| Provider Name | Sarah R Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881129682 PECOS PAC ID: 3476958760 Enrollment ID: I20210825001128 |
| Provider Name | Ana Karolina Viquez Beita |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1972099794 PECOS PAC ID: 8628306974 Enrollment ID: I20210831000242 |
| Provider Name | Jessica Ann Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740953959 PECOS PAC ID: 8628474657 Enrollment ID: I20210831000838 |
| Provider Name | Yashoba R Voss |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639606361 PECOS PAC ID: 7214361500 Enrollment ID: I20210831002507 |
| Provider Name | Roopsi Bring |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750873030 PECOS PAC ID: 2466708789 Enrollment ID: I20210831002646 |
| Provider Name | Anand K Ravi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1497165914 PECOS PAC ID: 4385946581 Enrollment ID: I20210831002731 |
| Provider Name | Cory M Coffey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184237463 PECOS PAC ID: 8527464429 Enrollment ID: I20210901000159 |
| Provider Name | Kathryn R Pointis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427721018 PECOS PAC ID: 6608272521 Enrollment ID: I20210901001039 |
| Provider Name | Amanda Williams |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467984922 PECOS PAC ID: 1850797366 Enrollment ID: I20210909000287 |
| Provider Name | David J Hart |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1235155110 PECOS PAC ID: 3577537729 Enrollment ID: I20210923001353 |
| Provider Name | Derek M Voss |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851824221 PECOS PAC ID: 2264865807 Enrollment ID: I20210923002790 |
| Provider Name | Swetha Parvataneni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174931406 PECOS PAC ID: 0042582116 Enrollment ID: I20210930000599 |
| Provider Name | Charles Lucas Scheel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649809237 PECOS PAC ID: 0244651040 Enrollment ID: I20211119000756 |
| Provider Name | Kendra Sue Hall-franks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164438859 PECOS PAC ID: 4486607736 Enrollment ID: I20211208000365 |
| Provider Name | Charles Austin Curtis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013413806 PECOS PAC ID: 6305247172 Enrollment ID: I20211208000433 |
| Provider Name | George Le |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306374764 PECOS PAC ID: 2466875752 Enrollment ID: I20211216001721 |
| Provider Name | Sarah Ann Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699368720 PECOS PAC ID: 3173914066 Enrollment ID: I20220104001367 |
| Provider Name | Gary Allen Mellick |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1780641506 PECOS PAC ID: 1951389550 Enrollment ID: I20220118001841 |
| Provider Name | Lynette Christine Polston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629730031 PECOS PAC ID: 1254723497 Enrollment ID: I20220119002300 |
| Provider Name | Dylan Torgerson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538620653 PECOS PAC ID: 3779975610 Enrollment ID: I20220126001738 |
| Provider Name | Sundance Zxaine Kemp |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1679233118 PECOS PAC ID: 7315330057 Enrollment ID: I20220202000319 |
| Provider Name | Warren Gregory Lawless |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932661063 PECOS PAC ID: 8123410057 Enrollment ID: I20220202002583 |
| Provider Name | Charles Reilly Hester |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1437819992 PECOS PAC ID: 0042603946 Enrollment ID: I20220216001417 |
| Provider Name | Jacqualine Anthony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033863857 PECOS PAC ID: 8921492836 Enrollment ID: I20220218000436 |
| Provider Name | Lynn R White |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023094778 PECOS PAC ID: 8729103536 Enrollment ID: I20220218001256 |
| Provider Name | Niko J Mccarter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528697489 PECOS PAC ID: 4284028127 Enrollment ID: I20220218001331 |
| Provider Name | Megan M Hollingsworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750042743 PECOS PAC ID: 3971997123 Enrollment ID: I20220303001935 |
| Provider Name | Kevin Michael Doulens |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1447263694 PECOS PAC ID: 7113023334 Enrollment ID: I20220314000650 |
| Provider Name | Maria Gross |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1740945823 PECOS PAC ID: 6800282997 Enrollment ID: I20220329000692 |
| Provider Name | An Bao Nguyen |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1285201590 PECOS PAC ID: 2163819392 Enrollment ID: I20220418002162 |
| Provider Name | Chelsea Faye Kolodziej |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407484264 PECOS PAC ID: 5496146839 Enrollment ID: I20220425000541 |
| Provider Name | Lu Pan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477843449 PECOS PAC ID: 3779862396 Enrollment ID: I20220427000728 |
| Provider Name | Luke Portwood Fife |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053601682 PECOS PAC ID: 5698912335 Enrollment ID: I20220506000321 |
| Provider Name | Johnny S Salameh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053431700 PECOS PAC ID: 1951457894 Enrollment ID: I20220517000590 |
| Provider Name | Kendall Michelle Anders |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1730787698 PECOS PAC ID: 2961889613 Enrollment ID: I20220518001113 |
| Provider Name | Hayder Abbood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922448141 PECOS PAC ID: 2668768649 Enrollment ID: I20220523000626 |
| Provider Name | Sally M Archer-jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588217889 PECOS PAC ID: 7911385075 Enrollment ID: I20220601001264 |
| Provider Name | Nicholas M Wetjen |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1275502726 PECOS PAC ID: 6507779980 Enrollment ID: I20220607002487 |
| Provider Name | Ankit Kumar Bhatia |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1326575416 PECOS PAC ID: 7416356878 Enrollment ID: I20220608000887 |
| Provider Name | Brittney Michelle Vogel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962816991 PECOS PAC ID: 3577964154 Enrollment ID: I20220610001364 |
| Provider Name | Ahmed Munir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154874881 PECOS PAC ID: 6800123258 Enrollment ID: I20220627000127 |
| Provider Name | Vikas Raghove |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1093207466 PECOS PAC ID: 8527305796 Enrollment ID: I20220629000601 |
| Provider Name | Samuel T Werne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811456197 PECOS PAC ID: 0941530547 Enrollment ID: I20220708002358 |
| Provider Name | Allison Elizabeth Goetz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992267991 PECOS PAC ID: 7315327137 Enrollment ID: I20220711000358 |
| Provider Name | Melinda S Hintermeister |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1871579565 PECOS PAC ID: 0446290027 Enrollment ID: I20220713001836 |
| Provider Name | Joseph James Lopez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578908992 PECOS PAC ID: 8123308210 Enrollment ID: I20220714003126 |
| Provider Name | Maria Gabriela Negron Marte |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619407004 PECOS PAC ID: 0042636490 Enrollment ID: I20220719000537 |
| Provider Name | Jordan L Hartung |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1376278143 PECOS PAC ID: 8729460365 Enrollment ID: I20220729000890 |
| Provider Name | Fredy Nehme |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700269537 PECOS PAC ID: 4284948332 Enrollment ID: I20220729001660 |
| Provider Name | Simant Singh Thapa |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1750765541 PECOS PAC ID: 0547551913 Enrollment ID: I20220808001981 |
| Provider Name | Benjamin Simpson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1699207597 PECOS PAC ID: 0941572630 Enrollment ID: I20220809001423 |
| Provider Name | Zubair S Almani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750919908 PECOS PAC ID: 1052733904 Enrollment ID: I20220809001675 |
| Provider Name | Hamza Viquar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295296853 PECOS PAC ID: 5890020101 Enrollment ID: I20220813000770 |
| Provider Name | Dillon James Hensley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952032534 PECOS PAC ID: 5991188237 Enrollment ID: I20220818001530 |
| Provider Name | Tachira Tavarez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952741613 PECOS PAC ID: 7113225327 Enrollment ID: I20220901001107 |
| Provider Name | Jacob John Triplet |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1083073167 PECOS PAC ID: 5496021479 Enrollment ID: I20220907002122 |
| Provider Name | James Anthony Torma |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659303543 PECOS PAC ID: 7315935335 Enrollment ID: I20220913001265 |
| Provider Name | Nilay Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861054926 PECOS PAC ID: 8426383555 Enrollment ID: I20220913002023 |
| Provider Name | Zachary David Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477117125 PECOS PAC ID: 7810222122 Enrollment ID: I20220913002142 |
| Provider Name | Deanna C Gutierrez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457072795 PECOS PAC ID: 5991180143 Enrollment ID: I20220923002068 |
| Provider Name | Ibrahim Ahmad Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386272565 PECOS PAC ID: 4183046030 Enrollment ID: I20220929002387 |
| Provider Name | Debbie B Bailey |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1356327118 PECOS PAC ID: 0547235871 Enrollment ID: I20221007002767 |
| Provider Name | Darcy Nicole Crouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194453282 PECOS PAC ID: 7416333893 Enrollment ID: I20221008000335 |
| Provider Name | Mackenzie Wahl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659959385 PECOS PAC ID: 4688075559 Enrollment ID: I20221014002685 |
| Provider Name | Jill K Denney |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1215901954 PECOS PAC ID: 0345138905 Enrollment ID: I20221027000626 |
| Provider Name | Shaylee R Vice |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154888410 PECOS PAC ID: 2668849423 Enrollment ID: I20221108000674 |
| Provider Name | Angela T. Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609509074 PECOS PAC ID: 7012384555 Enrollment ID: I20221112000226 |
| Provider Name | Jordan Michael Holt |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1699232736 PECOS PAC ID: 6507288420 Enrollment ID: I20221114002583 |
| Provider Name | Salvatore Vitale |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1043215353 PECOS PAC ID: 0345137659 Enrollment ID: I20221128000966 |
| Provider Name | Landon Mcglinchy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881222149 PECOS PAC ID: 2163844010 Enrollment ID: I20221205002116 |
| Provider Name | Joseph A Gillespie |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912223371 PECOS PAC ID: 2163668815 Enrollment ID: I20230128000347 |
| Provider Name | Jennifer Nicole Prescott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053017111 PECOS PAC ID: 8527431071 Enrollment ID: I20230302001933 |
| Provider Name | Chandler S Brobst |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437682564 PECOS PAC ID: 9739458720 Enrollment ID: I20230308003112 |
| Provider Name | Steve Pierre |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1225201528 PECOS PAC ID: 7416195417 Enrollment ID: I20230403002215 |
| Provider Name | Nabeel G El-amir |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1841243698 PECOS PAC ID: 2567359748 Enrollment ID: I20230407000503 |
| Provider Name | Hannah J Perkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376131516 PECOS PAC ID: 4082089313 Enrollment ID: I20230418002451 |
| Provider Name | Christa Ann Yeakle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386343085 PECOS PAC ID: 0547625816 Enrollment ID: I20230421000165 |
| Provider Name | Mansour Almnajam |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265815229 PECOS PAC ID: 2062708605 Enrollment ID: I20230508002090 |
| Provider Name | Manuel G Rivera Maza |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1144601816 PECOS PAC ID: 9638535891 Enrollment ID: I20230515002249 |
| Provider Name | Karim Saleb |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073034583 PECOS PAC ID: 0941572606 Enrollment ID: I20230515002895 |
| Provider Name | Ramzy Taylor Burns |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1871083261 PECOS PAC ID: 0648526780 Enrollment ID: I20230516002440 |
| Provider Name | Rebecca Reed Schwab |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063075760 PECOS PAC ID: 4486987260 Enrollment ID: I20230608000563 |
| Provider Name | Yunus Muneer Shah |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1376595892 PECOS PAC ID: 0840269205 Enrollment ID: I20230613001973 |
| Provider Name | Gregory J Allred |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1225415854 PECOS PAC ID: 6204132749 Enrollment ID: I20230615003375 |
| Provider Name | Yejin No |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609405430 PECOS PAC ID: 5799109203 Enrollment ID: I20230615003781 |
| Provider Name | Hiba I El Fadeel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831695964 PECOS PAC ID: 8224383302 Enrollment ID: I20230622001929 |
| Provider Name | Jessica Ann Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992332712 PECOS PAC ID: 2567884984 Enrollment ID: I20230629001990 |
| Provider Name | Jennifer Lee Wu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1477016236 PECOS PAC ID: 5890154975 Enrollment ID: I20230707001207 |
| Provider Name | Lauren D Gilman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568005072 PECOS PAC ID: 0941634364 Enrollment ID: I20230711003860 |
| Provider Name | Jason M Powell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437656220 PECOS PAC ID: 9931569118 Enrollment ID: I20230719002960 |
| Provider Name | Daniel J Livera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043838543 PECOS PAC ID: 1951725142 Enrollment ID: I20230721001596 |
| Provider Name | Sugat Wagle |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1578919015 PECOS PAC ID: 1759673635 Enrollment ID: I20230724000261 |
| Provider Name | Mark D Bevill |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1487182937 PECOS PAC ID: 4688944689 Enrollment ID: I20230724002011 |
| Provider Name | Dustin J Roberts |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1326018771 PECOS PAC ID: 7911214697 Enrollment ID: I20230731003156 |
| Provider Name | Samion Shabashev |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1922341437 PECOS PAC ID: 0648531715 Enrollment ID: I20230803001995 |
| Provider Name | Carmen L Pisc |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1356324453 PECOS PAC ID: 8325010945 Enrollment ID: I20230804002409 |
| Provider Name | Julie Renee Bogue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225719578 PECOS PAC ID: 3173985876 Enrollment ID: I20230811002443 |
| Provider Name | Karampal Singh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1598117525 PECOS PAC ID: 0244656304 Enrollment ID: I20230817000382 |
| Provider Name | Rachel Brooke Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477250959 PECOS PAC ID: 7416311386 Enrollment ID: I20230911002405 |
| Provider Name | Alan K Kojima |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427461268 PECOS PAC ID: 5799079083 Enrollment ID: I20230912003877 |
| Provider Name | Punam V Raghove |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1750802633 PECOS PAC ID: 8921400862 Enrollment ID: I20230913002965 |
| Provider Name | Sarah K Bandt |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1922261742 PECOS PAC ID: 7315176930 Enrollment ID: I20230915001544 |
| Provider Name | Ahmed Mourtada Mohamed Salih |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093393787 PECOS PAC ID: 1052711678 Enrollment ID: I20231003000670 |
| Provider Name | Taylor Jean Mcpherson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386424471 PECOS PAC ID: 3274988076 Enrollment ID: I20231014000415 |
| Provider Name | Alexis M Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538944293 PECOS PAC ID: 0446606800 Enrollment ID: I20231023000545 |
| Provider Name | Ibrahim Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205414984 PECOS PAC ID: 3375943087 Enrollment ID: I20231027002301 |
| Provider Name | Christi M Wohlt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134908205 PECOS PAC ID: 3274989074 Enrollment ID: I20231031002158 |
| Provider Name | Kaitlynn Licht-freimanis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417736422 PECOS PAC ID: 4183071426 Enrollment ID: I20231108003011 |
| Provider Name | Tellissa A Colglazier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174143119 PECOS PAC ID: 7113374349 Enrollment ID: I20231109002881 |
| Provider Name | Donald A Culley |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1548281397 PECOS PAC ID: 1557327202 Enrollment ID: I20231129001639 |
| Provider Name | Amir Fathi Beirat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609454321 PECOS PAC ID: 5092115709 Enrollment ID: I20231129001711 |
| Provider Name | Michael M Liddy |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1285845552 PECOS PAC ID: 8022288109 Enrollment ID: I20231204001205 |
| Provider Name | Roy N Skousen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1043229354 PECOS PAC ID: 7517935455 Enrollment ID: I20231218000942 |
| Provider Name | Ryan Khanna |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1609267905 PECOS PAC ID: 0749573921 Enrollment ID: I20231218003125 |
| Provider Name | Katelyn White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730661521 PECOS PAC ID: 2163773763 Enrollment ID: I20231220002371 |
| Provider Name | Morgan R Colaianni |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1821650110 PECOS PAC ID: 4385974864 Enrollment ID: I20231221003480 |
| Provider Name | Fatima Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750843611 PECOS PAC ID: 0244566529 Enrollment ID: I20240103002186 |
| Provider Name | Michael Scott Patrick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144947219 PECOS PAC ID: 8022451673 Enrollment ID: I20240210000092 |
| Provider Name | John W Schock |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558817619 PECOS PAC ID: 7517302466 Enrollment ID: I20240229004542 |
| Provider Name | Lemuel G Villanueva |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336107978 PECOS PAC ID: 1153499967 Enrollment ID: I20240307000708 |
| Provider Name | James S Bembry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962468165 PECOS PAC ID: 8325082167 Enrollment ID: I20240409003623 |
Center For Psychological Development, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 526 N Martin Ave, Muncie, IN 47303 Phone: 765-287-1922 | |
Freedom Work Counseling And Consulting Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 114 E Washington St, Muncie, IN 47305 Phone: 765-273-3224 | |
Patrick M. Moore, Acsw, Lcsw, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1945 W Royale Dr, Muncie, IN 47304 Phone: 765-288-7939 Fax: 765-288-7841 | |
Occupational Medicine Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3813 S. Madison Street, Muncie, IN 47302 Phone: 765-751-3300 Fax: 765-751-1115 | |
Family Harmony Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 920 S Ribble Ave, Muncie, IN 47302 Phone: 765-256-1747 | |
Melissa Osner Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1945 W Royale Dr, Muncie, IN 47304 Phone: 765-288-7939 | |
Brave Enough, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3001 N Kent Dr, Muncie, IN 47304 Phone: 765-744-3322 |