| Mercy Medical Center | |
|
1301 15th Ave W Williston ND 58801-3821 | |
| (701) 774-7401 | |
| (701) 774-7479 |
| Full Name | Mercy Medical Center |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1301 15th Ave W, Williston, North Dakota |
| Authorized Official Name and Position | Kerry S. Monson (VP FINANCE CFO) |
| Authorized Official Contact | 7017747401 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Medical Center 1301 15th Ave W Williston ND 58801-3821 Ph: (701) 774-7401 | Mercy Medical Center 1301 15th Ave W Williston ND 58801-3821 Ph: (701) 774-7401 |
| NPI Number | 1801928593 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 06/23/2008 |
| Medicare PECOS PAC ID | 7416851381 |
|---|---|
| Medicare Enrollment ID | O20031230000336 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801928593 | NPI | - | NPPES |
| 11684 | Medicaid | ND | |
| 711002 | Other | ND | BLUE SHIELD OF ND |
| Provider Name | Karen Rinehart |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1124197728 PECOS PAC ID: 7416860465 Enrollment ID: I20031106000773 |
| Provider Name | John W Steely |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801837349 PECOS PAC ID: 1254243355 Enrollment ID: I20031205000413 |
| Provider Name | Kory Albert |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1326148859 PECOS PAC ID: 2264339803 Enrollment ID: I20031212000776 |
| Provider Name | Luann M Cederstrom |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184712515 PECOS PAC ID: 4880597947 Enrollment ID: I20040128000360 |
| Provider Name | David N Skurdal |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1265450316 PECOS PAC ID: 4688577919 Enrollment ID: I20040202000581 |
| Provider Name | Debra J Lukenbill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265456370 PECOS PAC ID: 5294622569 Enrollment ID: I20040302000284 |
| Provider Name | Sheldon L Swenson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104830298 PECOS PAC ID: 2769372408 Enrollment ID: I20040317000778 |
| Provider Name | Ann M Cadwalader |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922196351 PECOS PAC ID: 6305737131 Enrollment ID: I20040322001690 |
| Provider Name | Jeffrey E Magnuson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457330409 PECOS PAC ID: 7618881301 Enrollment ID: I20040804001463 |
| Provider Name | Christopher L Tillotson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295714954 PECOS PAC ID: 1658285366 Enrollment ID: I20040804001793 |
| Provider Name | Curtis C Krueger |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1952341026 PECOS PAC ID: 3274501192 Enrollment ID: I20040920000269 |
| Provider Name | Ravindra P Joshi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477551422 PECOS PAC ID: 6608835194 Enrollment ID: I20041112001126 |
| Provider Name | Shanon Mark Sell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609895879 PECOS PAC ID: 5597721357 Enrollment ID: I20041203000667 |
| Provider Name | Kevin Edelman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558316620 PECOS PAC ID: 8224940481 Enrollment ID: I20050615000338 |
| Provider Name | David A Billings |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588752919 PECOS PAC ID: 2365472883 Enrollment ID: I20050815000884 |
| Provider Name | Wayne L Anderson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053417840 PECOS PAC ID: 0345267167 Enrollment ID: I20051031000502 |
| Provider Name | Debra Jean Davis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538246152 PECOS PAC ID: 6901839927 Enrollment ID: I20051220000138 |
| Provider Name | Robert G Kemp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114951431 PECOS PAC ID: 2365452661 Enrollment ID: I20060502000212 |
| Provider Name | Thompson T Kamba |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548279003 PECOS PAC ID: 8123062478 Enrollment ID: I20061106000471 |
| Provider Name | Bruce S Pugatch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700862232 PECOS PAC ID: 8224028600 Enrollment ID: I20070213000358 |
| Provider Name | Arthur J Raymond |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568438893 PECOS PAC ID: 9234111451 Enrollment ID: I20070508000410 |
| Provider Name | Jane A Grorud |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386664696 PECOS PAC ID: 4880791755 Enrollment ID: I20070530000170 |
| Provider Name | James M Mylrea |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528052594 PECOS PAC ID: 9830118694 Enrollment ID: I20070914000107 |
| Provider Name | Geoffrey Bodeau |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770534372 PECOS PAC ID: 6709798960 Enrollment ID: I20070918000638 |
| Provider Name | Paul R Rust |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700833720 PECOS PAC ID: 7719899913 Enrollment ID: I20070918000659 |
| Provider Name | Thomas J Ibach |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538116595 PECOS PAC ID: 6800708074 Enrollment ID: I20070920000385 |
| Provider Name | David J Mills |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407915226 PECOS PAC ID: 2668566787 Enrollment ID: I20070920000419 |
| Provider Name | Stephen Hite |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619914645 PECOS PAC ID: 2365354537 Enrollment ID: I20070924000778 |
| Provider Name | Jon P Kane |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528005535 PECOS PAC ID: 9931001443 Enrollment ID: I20070928000507 |
| Provider Name | Brent Ronald Bullis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831140441 PECOS PAC ID: 8123921715 Enrollment ID: I20071001000701 |
| Provider Name | Thomas C Matson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639117435 PECOS PAC ID: 9436148004 Enrollment ID: I20071001000726 |
| Provider Name | Stanley D Kurisko |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992758833 PECOS PAC ID: 0446162630 Enrollment ID: I20071002000637 |
| Provider Name | Scott D Sidney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366490062 PECOS PAC ID: 3375556673 Enrollment ID: I20071008000238 |
| Provider Name | David Javier Lopez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275629719 PECOS PAC ID: 0648241232 Enrollment ID: I20071009000104 |
| Provider Name | Douglass Hassell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760497150 PECOS PAC ID: 9638175458 Enrollment ID: I20071011000440 |
| Provider Name | Norman Arslanlar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851350110 PECOS PAC ID: 3173427960 Enrollment ID: I20071022000595 |
| Provider Name | Karla Myhra Bloom |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700831690 PECOS PAC ID: 2961314166 Enrollment ID: I20080122000332 |
| Provider Name | Joanne A Bakken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790865673 PECOS PAC ID: 8921182494 Enrollment ID: I20080221000424 |
| Provider Name | Robin Parker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235109703 PECOS PAC ID: 4587616784 Enrollment ID: I20080428000299 |
| Provider Name | Trudi Parker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851364210 PECOS PAC ID: 5395742068 Enrollment ID: I20080519000699 |
| Provider Name | Justin A Shafer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366659278 PECOS PAC ID: 3678643574 Enrollment ID: I20080604000335 |
| Provider Name | Mark W Doyscher |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538184569 PECOS PAC ID: 2163323320 Enrollment ID: I20080617000792 |
| Provider Name | James F Split |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1811925282 PECOS PAC ID: 3971565730 Enrollment ID: I20081113000273 |
| Provider Name | Tom Larson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598793226 PECOS PAC ID: 5294738407 Enrollment ID: I20081229000024 |
| Provider Name | John G Nelson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952481723 PECOS PAC ID: 4385708544 Enrollment ID: I20090203000169 |
| Provider Name | Lakesha S Smith |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1780867283 PECOS PAC ID: 2163592270 Enrollment ID: I20090205000728 |
| Provider Name | Frederick K Ness |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306864665 PECOS PAC ID: 1153382288 Enrollment ID: I20090526000328 |
| Provider Name | Sara B Veldman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578755740 PECOS PAC ID: 0042386559 Enrollment ID: I20090708000313 |
| Provider Name | William C Small |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992793673 PECOS PAC ID: 8628016854 Enrollment ID: I20090727000148 |
| Provider Name | John P Mccarthy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780638064 PECOS PAC ID: 7012975477 Enrollment ID: I20090811000468 |
| Provider Name | Robert A Yost |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194849166 PECOS PAC ID: 0941300610 Enrollment ID: I20090814000028 |
| Provider Name | Subbarao Inampudi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225082829 PECOS PAC ID: 0941112106 Enrollment ID: I20090818000193 |
| Provider Name | Deborah G Longley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740269794 PECOS PAC ID: 2264346956 Enrollment ID: I20091103000153 |
| Provider Name | Salem Shahin |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1578529392 PECOS PAC ID: 9739220088 Enrollment ID: I20100108000186 |
| Provider Name | Karen L Johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073841227 PECOS PAC ID: 2264575281 Enrollment ID: I20100129000532 |
| Provider Name | Cory R Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598783631 PECOS PAC ID: 9436286929 Enrollment ID: I20100414000416 |
| Provider Name | Shawn E Brooking |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1154403749 PECOS PAC ID: 5193753770 Enrollment ID: I20100903000851 |
| Provider Name | Madhu S Reddy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639389133 PECOS PAC ID: 1052472420 Enrollment ID: I20110131000867 |
| Provider Name | Lonna Potter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1538312590 PECOS PAC ID: 7810058195 Enrollment ID: I20110415000188 |
| Provider Name | Michael Macuga |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750351748 PECOS PAC ID: 7517988918 Enrollment ID: I20110520000208 |
| Provider Name | Anson S Li |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1326064015 PECOS PAC ID: 4789611252 Enrollment ID: I20110609000039 |
| Provider Name | David Keene |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659532844 PECOS PAC ID: 6002081411 Enrollment ID: I20111214000331 |
| Provider Name | Cherise A Norby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669750469 PECOS PAC ID: 4981870458 Enrollment ID: I20120104000744 |
| Provider Name | Roxanne R Keene |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1184661118 PECOS PAC ID: 8729027065 Enrollment ID: I20120104000786 |
| Provider Name | Leszek J Jaszczak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467528455 PECOS PAC ID: 1456243922 Enrollment ID: I20120131000574 |
| Provider Name | Richard L Larson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063512895 PECOS PAC ID: 7214110428 Enrollment ID: I20120210000601 |
| Provider Name | Samuel Forsyth Andelin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619132834 PECOS PAC ID: 7315003381 Enrollment ID: I20120405000725 |
| Provider Name | Kristi J Johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336496579 PECOS PAC ID: 7113183468 Enrollment ID: I20120731000795 |
| Provider Name | Christine Hoglund |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1184600926 PECOS PAC ID: 7416120654 Enrollment ID: I20120815000066 |
| Provider Name | Austin J Mccoy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508092933 PECOS PAC ID: 6406003466 Enrollment ID: I20120827000180 |
| Provider Name | Randal Henry Noyes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912979345 PECOS PAC ID: 8123000502 Enrollment ID: I20121003000822 |
| Provider Name | Josser E Delgado |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942257944 PECOS PAC ID: 2860679412 Enrollment ID: I20121025000677 |
| Provider Name | Yasha Kayan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306056130 PECOS PAC ID: 1254463854 Enrollment ID: I20121025000688 |
| Provider Name | Nathan J Groebner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043310188 PECOS PAC ID: 5193727675 Enrollment ID: I20121116000116 |
| Provider Name | John M Nobrega |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336188671 PECOS PAC ID: 2769394964 Enrollment ID: I20130213000312 |
| Provider Name | Alan L Mannheimer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679717789 PECOS PAC ID: 8921081522 Enrollment ID: I20130215000128 |
| Provider Name | Paul B Andelin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457413858 PECOS PAC ID: 1254384894 Enrollment ID: I20130612000411 |
| Provider Name | Leah M Brewster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598104119 PECOS PAC ID: 6507008703 Enrollment ID: I20130819000559 |
| Provider Name | Ryan K Hegge |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669634184 PECOS PAC ID: 4082857941 Enrollment ID: I20130826000745 |
| Provider Name | Bjorn Ingemar Engstrom |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255599403 PECOS PAC ID: 0345480687 Enrollment ID: I20130903000697 |
| Provider Name | Sheila K Ponzio |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992742381 PECOS PAC ID: 7719145473 Enrollment ID: I20130905000042 |
| Provider Name | Menelik Mulu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144526740 PECOS PAC ID: 0547404311 Enrollment ID: I20130917000389 |
| Provider Name | Michael E Grant |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1003027582 PECOS PAC ID: 9638224470 Enrollment ID: I20140409001601 |
| Provider Name | Jason L Keszler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881831436 PECOS PAC ID: 7810033149 Enrollment ID: I20140410000354 |
| Provider Name | Jordan Lee Bales |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760691927 PECOS PAC ID: 0840358875 Enrollment ID: I20140416000984 |
| Provider Name | Cody Chathams |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528485141 PECOS PAC ID: 0143444893 Enrollment ID: I20140619000526 |
| Provider Name | Carol A Gilmore |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508836586 PECOS PAC ID: 0941395826 Enrollment ID: I20140715001093 |
| Provider Name | Theresa A Hegge |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1124280649 PECOS PAC ID: 3577702570 Enrollment ID: I20140721002013 |
| Provider Name | Nancy R Carlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447667399 PECOS PAC ID: 2264659382 Enrollment ID: I20140814000510 |
| Provider Name | Frances K Lawson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851334387 PECOS PAC ID: 3274520796 Enrollment ID: I20140825002204 |
| Provider Name | Rylan Brantl |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013178326 PECOS PAC ID: 0648595983 Enrollment ID: I20150209002090 |
| Provider Name | Fareed Z Kadum |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760495840 PECOS PAC ID: 4688677149 Enrollment ID: I20150303000000 |
| Provider Name | John M Clair |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427232354 PECOS PAC ID: 7113073594 Enrollment ID: I20150320000976 |
| Provider Name | Ifeanyichukwu N Nwobodo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497922074 PECOS PAC ID: 2163669458 Enrollment ID: I20150331001413 |
| Provider Name | Andrew S Malin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1538377916 PECOS PAC ID: 4688851066 Enrollment ID: I20150609000801 |
| Provider Name | Michael B Kennis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215291083 PECOS PAC ID: 6901045343 Enrollment ID: I20150729010231 |
| Provider Name | Stacie Bondy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982089272 PECOS PAC ID: 2668789413 Enrollment ID: I20150911000724 |
| Provider Name | Cathie S Henneberry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053398909 PECOS PAC ID: 9830083161 Enrollment ID: I20150930003229 |
| Provider Name | Tessa Marburger |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942476825 PECOS PAC ID: 6103095989 Enrollment ID: I20151009000987 |
| Provider Name | Stephanie A Easton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083964928 PECOS PAC ID: 5890930044 Enrollment ID: I20151023002221 |
| Provider Name | Nancy Grover |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1679984314 PECOS PAC ID: 2062712490 Enrollment ID: I20151207003022 |
| Provider Name | Jaimee M Homan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831515261 PECOS PAC ID: 1153552484 Enrollment ID: I20160201002980 |
| Provider Name | Peter W Levasseur |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093729519 PECOS PAC ID: 7719932466 Enrollment ID: I20160328000672 |
| Provider Name | Peerawut Deeprasertkul |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1144466111 PECOS PAC ID: 7618261918 Enrollment ID: I20160809003217 |
| Provider Name | Ashley Lemere |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1154647816 PECOS PAC ID: 1052607504 Enrollment ID: I20160908002161 |
| Provider Name | Lynn Nyquist |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457315970 PECOS PAC ID: 5193840049 Enrollment ID: I20161025002986 |
| Provider Name | Maged S Botros |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982651824 PECOS PAC ID: 1951294289 Enrollment ID: I20161205001774 |
| Provider Name | Larry Johann William Skeete |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508854407 PECOS PAC ID: 4981684313 Enrollment ID: I20161223000447 |
| Provider Name | Robin Kenning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700215225 PECOS PAC ID: 8628290814 Enrollment ID: I20161227002014 |
| Provider Name | Ion S Chuang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821034448 PECOS PAC ID: 2860488319 Enrollment ID: I20170518001553 |
| Provider Name | Agnieszka Olga Solberg |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1063478170 PECOS PAC ID: 1951463868 Enrollment ID: I20170713003310 |
| Provider Name | Tiah Rigby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669901591 PECOS PAC ID: 0941572275 Enrollment ID: I20170822002683 |
| Provider Name | Joseph M Klick |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073516266 PECOS PAC ID: 4587611660 Enrollment ID: I20170825002493 |
| Provider Name | Jarmon C Comeaux |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578721478 PECOS PAC ID: 7214165950 Enrollment ID: I20170831001106 |
| Provider Name | Peter Sandroni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154737419 PECOS PAC ID: 7911123773 Enrollment ID: I20170914004329 |
| Provider Name | Kevin Curtis Sullivan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1750523775 PECOS PAC ID: 7618242389 Enrollment ID: I20171005001017 |
| Provider Name | Joseph H Stonehocker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437660198 PECOS PAC ID: 4183980113 Enrollment ID: I20171108001204 |
| Provider Name | Ruby A Valencia |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1104271345 PECOS PAC ID: 2163717836 Enrollment ID: I20180309000792 |
| Provider Name | Camille A Settelmeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437637501 PECOS PAC ID: 8224380159 Enrollment ID: I20181004000673 |
| Provider Name | Shiquan Liu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104182757 PECOS PAC ID: 1850664210 Enrollment ID: I20181108002157 |
| Provider Name | Kyle L Bohling |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497862692 PECOS PAC ID: 7719891761 Enrollment ID: I20181219002710 |
| Provider Name | Thomas W Welch |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477545242 PECOS PAC ID: 6002802717 Enrollment ID: I20190102002445 |
| Provider Name | April D Haugrose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376099424 PECOS PAC ID: 4880981349 Enrollment ID: I20190305000557 |
| Provider Name | Brennen D Smith |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376753277 PECOS PAC ID: 0749467280 Enrollment ID: I20190305001489 |
| Provider Name | Amanda R Zuck |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285972737 PECOS PAC ID: 5092955807 Enrollment ID: I20190306000544 |
| Provider Name | Jill M Paulsen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1093988537 PECOS PAC ID: 1456430586 Enrollment ID: I20190306000661 |
| Provider Name | Rajiv Narula |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881081412 PECOS PAC ID: 9032418454 Enrollment ID: I20190306002524 |
| Provider Name | Anton Mandrov |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639599863 PECOS PAC ID: 3173863800 Enrollment ID: I20190315002584 |
| Provider Name | Altressa Drummond |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891722849 PECOS PAC ID: 5496717456 Enrollment ID: I20190320001484 |
| Provider Name | Bianca K Chun |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1649534470 PECOS PAC ID: 5890928550 Enrollment ID: I20190626002076 |
| Provider Name | Michael Ryan Johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336419969 PECOS PAC ID: 1557522687 Enrollment ID: I20190627003324 |
| Provider Name | Jeremy John Stringer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1366719460 PECOS PAC ID: 7810243896 Enrollment ID: I20190711003293 |
| Provider Name | Peter C Glassbrenner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1811335391 PECOS PAC ID: 4385885078 Enrollment ID: I20190711003425 |
| Provider Name | Nana Oforiwaa Boateng-holland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093219685 PECOS PAC ID: 8123354792 Enrollment ID: I20190719002949 |
| Provider Name | William J Arban |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174565188 PECOS PAC ID: 6901819721 Enrollment ID: I20190722002671 |
| Provider Name | Abimbola Odusanya |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689660151 PECOS PAC ID: 3274516463 Enrollment ID: I20190909003214 |
| Provider Name | Greg A Brown |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1043280530 PECOS PAC ID: 6608778774 Enrollment ID: I20191106001505 |
| Provider Name | Jill M. Meyers |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588815039 PECOS PAC ID: 7012286040 Enrollment ID: I20191205001508 |
| Provider Name | Jorge Ballesteros |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1174550925 PECOS PAC ID: 6305811944 Enrollment ID: I20191212001116 |
| Provider Name | Chelsea N Smith |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1396394904 PECOS PAC ID: 8921432907 Enrollment ID: I20191227001731 |
| Provider Name | Heather R Hass |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1700420288 PECOS PAC ID: 1254765126 Enrollment ID: I20191231000995 |
| Provider Name | Russell D Japikse |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780027268 PECOS PAC ID: 4183848385 Enrollment ID: I20200129002046 |
| Provider Name | Kurt A Kaczander |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1275572554 PECOS PAC ID: 8921003328 Enrollment ID: I20200131000736 |
| Provider Name | Elle D Perkins |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083064380 PECOS PAC ID: 5193056489 Enrollment ID: I20200131000977 |
| Provider Name | Dwight C Reynolds |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447483474 PECOS PAC ID: 8729301445 Enrollment ID: I20200131001038 |
| Provider Name | Kirk Wg Brown |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447440276 PECOS PAC ID: 8729162862 Enrollment ID: I20200226002418 |
| Provider Name | Tamara A Howard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255368007 PECOS PAC ID: 1557308673 Enrollment ID: I20200228002310 |
| Provider Name | Mason Ben Kates |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033168364 PECOS PAC ID: 7618012279 Enrollment ID: I20200302000160 |
| Provider Name | Peter C Fuller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528446093 PECOS PAC ID: 3870897374 Enrollment ID: I20200402001359 |
| Provider Name | Daniel L Pendleton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366555708 PECOS PAC ID: 4981689726 Enrollment ID: I20200402003292 |
| Provider Name | John Keitz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912092818 PECOS PAC ID: 7618077751 Enrollment ID: I20200403000206 |
| Provider Name | Donald Bennett |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558569533 PECOS PAC ID: 0345390605 Enrollment ID: I20200421001442 |
| Provider Name | Alison Killelea |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942461678 PECOS PAC ID: 1759537392 Enrollment ID: I20200421002871 |
| Provider Name | Melissa C Jarboe |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053674762 PECOS PAC ID: 6103110564 Enrollment ID: I20200421002878 |
| Provider Name | Ana Maria Ibrado |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851376529 PECOS PAC ID: 6204727936 Enrollment ID: I20200422001907 |
| Provider Name | Brian D James |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376905570 PECOS PAC ID: 6507159621 Enrollment ID: I20200422002088 |
| Provider Name | Anna Elizabeth Wolf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740822584 PECOS PAC ID: 3870914161 Enrollment ID: I20200521001565 |
| Provider Name | Andrew Mccoy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780883025 PECOS PAC ID: 2961646195 Enrollment ID: I20200611002870 |
| Provider Name | Amy Yeh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215376421 PECOS PAC ID: 7517191927 Enrollment ID: I20200630002113 |
| Provider Name | Steven C Salcido |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053843771 PECOS PAC ID: 6901173632 Enrollment ID: I20200728001131 |
| Provider Name | Ines Teuma Nguimfack |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154776268 PECOS PAC ID: 6507102944 Enrollment ID: I20200828000826 |
| Provider Name | Veronica Bonales |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205999190 PECOS PAC ID: 5799973699 Enrollment ID: I20200910002290 |
| Provider Name | Pamela Kim Moore |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700851391 PECOS PAC ID: 1153414347 Enrollment ID: I20200915002930 |
| Provider Name | Bridget Freeman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649346032 PECOS PAC ID: 4486729159 Enrollment ID: I20200916003047 |
| Provider Name | Curtis Binder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104875004 PECOS PAC ID: 6709897176 Enrollment ID: I20201023002699 |
| Provider Name | Andrew Tyler Miller |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083022198 PECOS PAC ID: 3870824527 Enrollment ID: I20201023002738 |
| Provider Name | Brandon J Massin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205060951 PECOS PAC ID: 8921241712 Enrollment ID: I20201027001574 |
| Provider Name | Erik Egsieker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205898806 PECOS PAC ID: 3173553807 Enrollment ID: I20201109001099 |
| Provider Name | Sarah Fryberger |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366548935 PECOS PAC ID: 7517993140 Enrollment ID: I20201109001366 |
| Provider Name | David Allen Gross |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164478327 PECOS PAC ID: 0648182816 Enrollment ID: I20201116002552 |
| Provider Name | Scott S Nielsen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902824238 PECOS PAC ID: 0143217034 Enrollment ID: I20201211000975 |
| Provider Name | Jefri A Williams |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1770533622 PECOS PAC ID: 9234132440 Enrollment ID: I20210319001247 |
| Provider Name | Arthur David Kaminski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306906151 PECOS PAC ID: 4587560032 Enrollment ID: I20210615002770 |
| Provider Name | Janet Isaacs |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386662393 PECOS PAC ID: 2062411838 Enrollment ID: I20210615002925 |
| Provider Name | Brian K Kradel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1356370852 PECOS PAC ID: 7517864382 Enrollment ID: I20210615002927 |
| Provider Name | Marc C Johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689866592 PECOS PAC ID: 6305737263 Enrollment ID: I20210615003290 |
| Provider Name | Pirthvi R Giyanwani |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578058251 PECOS PAC ID: 2163822917 Enrollment ID: I20210615003310 |
| Provider Name | Scarlett B Hinson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992789366 PECOS PAC ID: 8022052463 Enrollment ID: I20210616001791 |
| Provider Name | Candice Queen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033655907 PECOS PAC ID: 4688942964 Enrollment ID: I20210908003251 |
| Provider Name | Laurie M Duff |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356559280 PECOS PAC ID: 6800947193 Enrollment ID: I20210909001955 |
| Provider Name | Ryan Dreikorn |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1932462611 PECOS PAC ID: 9032360458 Enrollment ID: I20210916002196 |
| Provider Name | Peter H Olson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1063494664 PECOS PAC ID: 3870569841 Enrollment ID: I20211001002252 |
| Provider Name | Afaq Sharieff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952887192 PECOS PAC ID: 5092064410 Enrollment ID: I20211115001437 |
| Provider Name | Holden A Mccall |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1891362901 PECOS PAC ID: 3870983034 Enrollment ID: I20211201002167 |
| Provider Name | Gregory W Rennirt |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1871517664 PECOS PAC ID: 8325146350 Enrollment ID: I20211203000296 |
| Provider Name | Steven Peter Dondlinger |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720441959 PECOS PAC ID: 4082010905 Enrollment ID: I20220516000565 |
| Provider Name | Dirk Bahoravitch |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184083826 PECOS PAC ID: 0941595441 Enrollment ID: I20220711003393 |
| Provider Name | Karli Janae Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356071534 PECOS PAC ID: 7416338769 Enrollment ID: I20220718001338 |
| Provider Name | Airron Richardson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881869451 PECOS PAC ID: 0446321293 Enrollment ID: I20220728000606 |
| Provider Name | Lina M Ricketts |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508527755 PECOS PAC ID: 3375937816 Enrollment ID: I20220728000747 |
| Provider Name | Cassie Joy Rothe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780314021 PECOS PAC ID: 9234513789 Enrollment ID: I20220831003611 |
| Provider Name | James Shaotsung Peng |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780871780 PECOS PAC ID: 8224196605 Enrollment ID: I20220901001475 |
| Provider Name | Amy Skeel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407410988 PECOS PAC ID: 6406267947 Enrollment ID: I20220930002560 |
| Provider Name | Lisa Miller |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689660276 PECOS PAC ID: 5395758049 Enrollment ID: I20221020002285 |
| Provider Name | Joshua Teich |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508387663 PECOS PAC ID: 4981954401 Enrollment ID: I20221110002540 |
| Provider Name | Shanda Harstad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376276766 PECOS PAC ID: 4587032966 Enrollment ID: I20221115002972 |
| Provider Name | Temitope Mary Falade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194446187 PECOS PAC ID: 8022473958 Enrollment ID: I20230428001551 |
| Provider Name | Michael Samuels |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083936413 PECOS PAC ID: 7315180981 Enrollment ID: I20230503002202 |
| Provider Name | Deena Wise |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982683488 PECOS PAC ID: 7517031115 Enrollment ID: I20230517003118 |
| Provider Name | David Feiger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518461987 PECOS PAC ID: 8325392772 Enrollment ID: I20230606002554 |
| Provider Name | Amarjot Mann |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306464888 PECOS PAC ID: 9830512474 Enrollment ID: I20230606003171 |
| Provider Name | Erin Teresa Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518659705 PECOS PAC ID: 1557722725 Enrollment ID: I20230803003296 |
| Provider Name | Alissa Marie Larsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528751872 PECOS PAC ID: 1456713320 Enrollment ID: I20230810000417 |
| Provider Name | Gregory Zandrow |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528629276 PECOS PAC ID: 8325374622 Enrollment ID: I20230907001428 |
| Provider Name | Michael Jones |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639189053 PECOS PAC ID: 1658393509 Enrollment ID: I20230907004032 |
| Provider Name | London Herbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730873829 PECOS PAC ID: 5890140677 Enrollment ID: I20231013002701 |
| Provider Name | Cathy R Xu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609078831 PECOS PAC ID: 7012192305 Enrollment ID: I20231025003144 |
| Provider Name | Jewel Grant |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427251461 PECOS PAC ID: 5496841470 Enrollment ID: I20231113003031 |
| Provider Name | Brittany Kay Albers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841558210 PECOS PAC ID: 6406099720 Enrollment ID: I20240124004067 |
| Provider Name | Douglas Paul Caldwell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982682209 PECOS PAC ID: 9537052659 Enrollment ID: I20240124004680 |
| Provider Name | Michael James Annen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326275520 PECOS PAC ID: 0648604009 Enrollment ID: I20240125000922 |
| Provider Name | Kathan Atul Amin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801139142 PECOS PAC ID: 1456586023 Enrollment ID: I20240125001762 |
| Provider Name | Vinit B Amin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881919272 PECOS PAC ID: 3173813680 Enrollment ID: I20240125003727 |
| Provider Name | Willis Chung |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659357804 PECOS PAC ID: 0244222727 Enrollment ID: I20240125003853 |
| Provider Name | Alexander Copelan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932469673 PECOS PAC ID: 8325279839 Enrollment ID: I20240125004146 |
| Provider Name | Paul Alexander Farris |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154426997 PECOS PAC ID: 2062511983 Enrollment ID: I20240125004248 |
| Provider Name | Thomas Gebhard |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649444167 PECOS PAC ID: 5395984637 Enrollment ID: I20240125004466 |
| Provider Name | Karolyn Ivanovic |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457337867 PECOS PAC ID: 2264460799 Enrollment ID: I20240125004613 |
| Provider Name | Daniel Mark Golding |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528058070 PECOS PAC ID: 1951456888 Enrollment ID: I20240126000132 |
| Provider Name | Kayleen Jahangir |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609214576 PECOS PAC ID: 8224330212 Enrollment ID: I20240126000815 |
| Provider Name | Brent James King |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336520931 PECOS PAC ID: 7416255419 Enrollment ID: I20240126000872 |
| Provider Name | David Durand |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235418997 PECOS PAC ID: 3577842285 Enrollment ID: I20240126000970 |
| Provider Name | Patrick Whitney Hanks |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114911906 PECOS PAC ID: 2264423573 Enrollment ID: I20240126001062 |
| Provider Name | Samuel John Hauck |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356609937 PECOS PAC ID: 8426355629 Enrollment ID: I20240126001239 |
| Provider Name | Jimmy Huynh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174977987 PECOS PAC ID: 3678850971 Enrollment ID: I20240126001303 |
| Provider Name | Brenda Joy Sokotoff |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912347493 PECOS PAC ID: 3678790565 Enrollment ID: I20240126001405 |
| Provider Name | Patrick Belson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861421331 PECOS PAC ID: 6507809662 Enrollment ID: I20240126001746 |
| Provider Name | Jillian Ann Karow |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609131887 PECOS PAC ID: 9537479126 Enrollment ID: I20240126002114 |
| Provider Name | Ryan Kuhnlein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285081513 PECOS PAC ID: 1355634718 Enrollment ID: I20240126002183 |
| Provider Name | William Andrew Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710412556 PECOS PAC ID: 3476890054 Enrollment ID: I20240126003294 |
| Provider Name | Phillip Lee Rathousky |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558743393 PECOS PAC ID: 7810206091 Enrollment ID: I20240126003321 |
| Provider Name | David Jacob Lerner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396061636 PECOS PAC ID: 5890014492 Enrollment ID: I20240126003479 |
| Provider Name | Charles Pappas |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932286523 PECOS PAC ID: 8729002514 Enrollment ID: I20240126003775 |
| Provider Name | Peter Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881673374 PECOS PAC ID: 2860420239 Enrollment ID: I20240129003141 |
| Provider Name | Matthew Joseph Sondag |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427347004 PECOS PAC ID: 2769786615 Enrollment ID: I20240129003303 |
| Provider Name | Joseph Michael Uricchio |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083077275 PECOS PAC ID: 4880989094 Enrollment ID: I20240129003560 |
| Provider Name | David Morrell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629022801 PECOS PAC ID: 8729970223 Enrollment ID: I20240129003568 |
| Provider Name | Alexander Yowei Sheu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083024830 PECOS PAC ID: 8921227554 Enrollment ID: I20240129003749 |
| Provider Name | Sopo Lin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982961892 PECOS PAC ID: 1759664253 Enrollment ID: I20240129004035 |
| Provider Name | Russell Meyer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124260138 PECOS PAC ID: 4082680400 Enrollment ID: I20240129004073 |
| Provider Name | Tam Minh Vu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942543517 PECOS PAC ID: 4880912906 Enrollment ID: I20240129004236 |
| Provider Name | Kim Mckenna |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427410661 PECOS PAC ID: 2163793498 Enrollment ID: I20240130000470 |
| Provider Name | Huy Tran |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770571457 PECOS PAC ID: 4981797768 Enrollment ID: I20240130003442 |
| Provider Name | Lindsay Stratchko |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265876866 PECOS PAC ID: 0345463030 Enrollment ID: I20240131002040 |
| Provider Name | Reed Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255312286 PECOS PAC ID: 5698063782 Enrollment ID: I20240131003314 |
| Provider Name | Jeannette Gasal Spilde |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437182169 PECOS PAC ID: 4486557949 Enrollment ID: I20240212000237 |
| Provider Name | Zalak Tulsibhai Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164926721 PECOS PAC ID: 7315290616 Enrollment ID: I20240419001006 |
| Provider Name | Benjamin Faustich |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699092916 PECOS PAC ID: 8123246451 Enrollment ID: I20240423001922 |
| Provider Name | Alekhya Yechoor |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285139287 PECOS PAC ID: 9739436296 Enrollment ID: I20240430000957 |
| Provider Name | David Thompson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265895494 PECOS PAC ID: 0244522019 Enrollment ID: I20240507002067 |
| Provider Name | Charles Davis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568959120 PECOS PAC ID: 5395071799 Enrollment ID: I20240507002309 |
| Provider Name | Alexandra Helena Besser |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427584374 PECOS PAC ID: 3678931730 Enrollment ID: I20240507002550 |
| Provider Name | Justin Bauer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538691373 PECOS PAC ID: 0648659862 Enrollment ID: I20240516002949 |
| Provider Name | Lauryn Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285488858 PECOS PAC ID: 9133661341 Enrollment ID: I20240603004176 |
| Provider Name | Thomas Chung Tong Hon Shum |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306401708 PECOS PAC ID: 4981044054 Enrollment ID: I20240609000077 |
Clinical Consulting P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 322 Main St, Suite 104, Williston, ND 58801 Phone: 701-651-6951 | |
Rachelle Eldred Professional Counseling Services, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 511 2nd St W Ste B, Williston, ND 58801 Phone: 701-580-4623 | |
Healing Hearts Therapy, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 511 2nd St W, Williston, ND 58801 Phone: 701-570-1317 | |
Dakota Family Solutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 322 Main St, Williston, ND 58801 Phone: 701-774-8215 | |
Opportunity Foundation Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 8th St E, Williston, ND 58801 Phone: 701-774-8593 Fax: 701-572-8871 | |
Bakken Behavioral Health Associates Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 511 2nd St W Ste B, Williston, ND 58801 Phone: 701-770-7768 | |
Summit Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 14th St W Ste 290, Williston, ND 58801 Phone: 701-334-6242 Fax: 701-712-3299 |