| Mercy Virtual | |
|
15740 S Outer 40 Rd Chesterfield MO 63017-2004 | |
| (636) 237-4200 | |
| Not Available |
| Full Name | Mercy Virtual |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 15740 S Outer 40 Rd, Chesterfield, Missouri |
| Authorized Official Name and Position | John Gavin Helton (PRESIDENT) |
| Authorized Official Contact | 6362374102 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Virtual 15740 S Outer 40 Rd Chesterfield MO 63017-2004 Ph: () - | Mercy Virtual 15740 S Outer 40 Rd Chesterfield MO 63017-2004 Ph: (636) 237-4200 |
| NPI Number | 1063965093 |
|---|---|
| Provider Enumeration Date | 07/26/2016 |
| Last Update Date | 01/29/2021 |
| Certification Date | 01/29/2021 |
| Medicare PECOS PAC ID | 6901188572 |
|---|---|
| Medicare Enrollment ID | O20170117001888 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063965093 | NPI | - | NPPES |
| Provider Name | Kyeong P Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770511271 PECOS PAC ID: 8820900970 Enrollment ID: I20031105000644 |
| Provider Name | Brian S Ullery |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962420653 PECOS PAC ID: 4284531765 Enrollment ID: I20031213000022 |
| Provider Name | Edward W Ferguson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205947041 PECOS PAC ID: 4587563523 Enrollment ID: I20040108000177 |
| Provider Name | Michael Scott Plisco |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1861432049 PECOS PAC ID: 7911895503 Enrollment ID: I20040305000729 |
| Provider Name | William R Logan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750311395 PECOS PAC ID: 4789575085 Enrollment ID: I20040324000993 |
| Provider Name | Kelly Ludwig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992720361 PECOS PAC ID: 2365439437 Enrollment ID: I20040429000783 |
| Provider Name | Laishang P Zhang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235143942 PECOS PAC ID: 7719974682 Enrollment ID: I20040430000804 |
| Provider Name | Krista D Woelfel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881632990 PECOS PAC ID: 8123006962 Enrollment ID: I20040709000078 |
| Provider Name | Paul Rei Pfeiffer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821024803 PECOS PAC ID: 4880666080 Enrollment ID: I20040809000923 |
| Provider Name | Farid Ghassan Sadaka |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1144337411 PECOS PAC ID: 1759342819 Enrollment ID: I20041021000826 |
| Provider Name | John C Vandover |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376583393 PECOS PAC ID: 5597708362 Enrollment ID: I20050603000095 |
| Provider Name | Michael Jay Cox |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154334860 PECOS PAC ID: 9830126945 Enrollment ID: I20050720000725 |
| Provider Name | Steven Trottier |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1699832923 PECOS PAC ID: 6305875675 Enrollment ID: I20050808000039 |
| Provider Name | Joan Shaffer |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1568429801 PECOS PAC ID: 3476582743 Enrollment ID: I20050808000056 |
| Provider Name | Robert Scott Duff |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265475727 PECOS PAC ID: 2365472164 Enrollment ID: I20050820000106 |
| Provider Name | Malik I Ahmed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770557985 PECOS PAC ID: 5294752648 Enrollment ID: I20051026000073 |
| Provider Name | Wegdan Andrews |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972511723 PECOS PAC ID: 6709821267 Enrollment ID: I20060217000622 |
| Provider Name | Leanne Watson-ficken |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164451373 PECOS PAC ID: 9638182470 Enrollment ID: I20060724000134 |
| Provider Name | Sohail Khan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1689602930 PECOS PAC ID: 7618980921 Enrollment ID: I20060802000428 |
| Provider Name | Anup Katyal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104858265 PECOS PAC ID: 4385649359 Enrollment ID: I20060926000037 |
| Provider Name | Ashok V Palagiri |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790899151 PECOS PAC ID: 8224036736 Enrollment ID: I20061117000002 |
| Provider Name | John F Fuller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093754574 PECOS PAC ID: 3476655929 Enrollment ID: I20070301000270 |
| Provider Name | Alicia Busso |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386679751 PECOS PAC ID: 6103824917 Enrollment ID: I20070629000524 |
| Provider Name | Neal S Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093933285 PECOS PAC ID: 6709986714 Enrollment ID: I20070705000124 |
| Provider Name | Carter Page Fenton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922199546 PECOS PAC ID: 9234221698 Enrollment ID: I20070815000660 |
| Provider Name | Anna M Conti |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275731267 PECOS PAC ID: 0446342299 Enrollment ID: I20070823000910 |
| Provider Name | Kyle S John |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518031699 PECOS PAC ID: 1557458825 Enrollment ID: I20071102000310 |
| Provider Name | Dawn M Roemer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093995466 PECOS PAC ID: 3274622246 Enrollment ID: I20071129000302 |
| Provider Name | Christopher M Schlanger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215959655 PECOS PAC ID: 2769563238 Enrollment ID: I20080123000091 |
| Provider Name | Phu D Vu |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295718294 PECOS PAC ID: 7315928462 Enrollment ID: I20080313000609 |
| Provider Name | Matthew Stewart Wilson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649392796 PECOS PAC ID: 9830277573 Enrollment ID: I20080422000525 |
| Provider Name | Margaret Marcrander |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972555332 PECOS PAC ID: 0345348637 Enrollment ID: I20080509000145 |
| Provider Name | Karen L Austin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649398926 PECOS PAC ID: 3274606033 Enrollment ID: I20080728000067 |
| Provider Name | Sangita Aradhyula |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1356551915 PECOS PAC ID: 8022182435 Enrollment ID: I20080804000135 |
| Provider Name | Brian Weisenberg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093831042 PECOS PAC ID: 2062572753 Enrollment ID: I20081126000066 |
| Provider Name | Peter W Warner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093756017 PECOS PAC ID: 9133217599 Enrollment ID: I20090105000091 |
| Provider Name | Justin D Moody |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1639370489 PECOS PAC ID: 0941386700 Enrollment ID: I20090501000126 |
| Provider Name | Renee J Zesch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457586919 PECOS PAC ID: 2264583178 Enrollment ID: I20090706000083 |
| Provider Name | Laura D Smith |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1801843230 PECOS PAC ID: 5991840076 Enrollment ID: I20100301000119 |
| Provider Name | Eduardo Luis Garcia-ferrer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619917101 PECOS PAC ID: 8820128077 Enrollment ID: I20100614000814 |
| Provider Name | William B Suk |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053428201 PECOS PAC ID: 6002811247 Enrollment ID: I20100717000134 |
| Provider Name | Justin Huynh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902096613 PECOS PAC ID: 4183758089 Enrollment ID: I20100813000758 |
| Provider Name | Katherine Lynne Garland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568634533 PECOS PAC ID: 0941334684 Enrollment ID: I20100817000159 |
| Provider Name | Wilman Rene Ortega Perez |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1720174246 PECOS PAC ID: 7810049939 Enrollment ID: I20100927001076 |
| Provider Name | Muhammad Javed |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1275741340 PECOS PAC ID: 6305962309 Enrollment ID: I20100928000352 |
| Provider Name | Heidi L Gioia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427142579 PECOS PAC ID: 3173704285 Enrollment ID: I20110223000230 |
| Provider Name | Timothy J Brinker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114181948 PECOS PAC ID: 0749467439 Enrollment ID: I20110606000678 |
| Provider Name | Tomoko R Sampson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346446622 PECOS PAC ID: 5799962999 Enrollment ID: I20110615000131 |
| Provider Name | Sameer Kirtane |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871755777 PECOS PAC ID: 7517145725 Enrollment ID: I20110616000649 |
| Provider Name | Adeel I Khan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1790993863 PECOS PAC ID: 7911191929 Enrollment ID: I20110725000511 |
| Provider Name | Zerihun A Bunaye |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1962668848 PECOS PAC ID: 5890963466 Enrollment ID: I20110726000588 |
| Provider Name | Maryellen Bowman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407938954 PECOS PAC ID: 8325216997 Enrollment ID: I20110726000607 |
| Provider Name | Wei Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952569642 PECOS PAC ID: 0143393637 Enrollment ID: I20110815000641 |
| Provider Name | Venkata Kenguva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497911374 PECOS PAC ID: 1456523612 Enrollment ID: I20111012000030 |
| Provider Name | Rachel A Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255615951 PECOS PAC ID: 3274709977 Enrollment ID: I20111230000173 |
| Provider Name | Christopher Cundiff |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689908105 PECOS PAC ID: 5496890550 Enrollment ID: I20120105000553 |
| Provider Name | Michelle Goetz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740591494 PECOS PAC ID: 3577721406 Enrollment ID: I20120223000841 |
| Provider Name | Jennifer L Quisenberry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598032062 PECOS PAC ID: 0547429359 Enrollment ID: I20120315000016 |
| Provider Name | Maripat Gatter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649374208 PECOS PAC ID: 9638171184 Enrollment ID: I20120316000494 |
| Provider Name | Lindsey C Duesterhaus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063783967 PECOS PAC ID: 7012178262 Enrollment ID: I20120413000693 |
| Provider Name | Nichole Marie Maclellan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043584634 PECOS PAC ID: 8426211152 Enrollment ID: I20120516000683 |
| Provider Name | Soophia Khan Naydenov |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1558562900 PECOS PAC ID: 5597911768 Enrollment ID: I20120804000030 |
| Provider Name | Dustin Ricky Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558591198 PECOS PAC ID: 0042466765 Enrollment ID: I20120813000710 |
| Provider Name | David A Rempe |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1285742171 PECOS PAC ID: 4082809157 Enrollment ID: I20120829000367 |
| Provider Name | Sarah Md Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417120577 PECOS PAC ID: 7517115819 Enrollment ID: I20120911000633 |
| Provider Name | Amanda N Breedlove |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235486952 PECOS PAC ID: 6305096629 Enrollment ID: I20121023000440 |
| Provider Name | Joseph Anthony Pantelis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700097128 PECOS PAC ID: 9032200688 Enrollment ID: I20121101000502 |
| Provider Name | Kristen M Cundiff |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487988093 PECOS PAC ID: 4284875204 Enrollment ID: I20130801000880 |
| Provider Name | Jacqueline Rickard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336235928 PECOS PAC ID: 0244330629 Enrollment ID: I20130815000886 |
| Provider Name | Pooja Sharma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578728218 PECOS PAC ID: 3870736242 Enrollment ID: I20130904000466 |
| Provider Name | Sabrina N Padgett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568777365 PECOS PAC ID: 3072757509 Enrollment ID: I20130923000536 |
| Provider Name | Vinaya R Sermadevi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114243235 PECOS PAC ID: 4688703416 Enrollment ID: I20131001000543 |
| Provider Name | Jonathan Schonert |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225358518 PECOS PAC ID: 8820249428 Enrollment ID: I20131007000380 |
| Provider Name | Erin S Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912232786 PECOS PAC ID: 5193952141 Enrollment ID: I20131218001064 |
| Provider Name | Melissa L Rodgers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932322559 PECOS PAC ID: 6800024597 Enrollment ID: I20131231000665 |
| Provider Name | Ashwani Kumar Joshi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609051630 PECOS PAC ID: 0042358715 Enrollment ID: I20140214001492 |
| Provider Name | Chakradhar Venkata Krishna Venkata |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1285846576 PECOS PAC ID: 1153494216 Enrollment ID: I20140225001176 |
| Provider Name | Michelle Leigh Mcleod |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598195273 PECOS PAC ID: 0345470456 Enrollment ID: I20140310001880 |
| Provider Name | Sarah R Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083044879 PECOS PAC ID: 1052541166 Enrollment ID: I20140310001972 |
| Provider Name | Erica Robinson Mitchell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629366521 PECOS PAC ID: 1557586724 Enrollment ID: I20140701001731 |
| Provider Name | Paula F Oldeg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568438687 PECOS PAC ID: 5991696536 Enrollment ID: I20140702001723 |
| Provider Name | Enquan Gao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295051548 PECOS PAC ID: 0446475198 Enrollment ID: I20140714000586 |
| Provider Name | Thomas Horn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841516598 PECOS PAC ID: 2264695501 Enrollment ID: I20140722002256 |
| Provider Name | Shawna Jo Surman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790106011 PECOS PAC ID: 8022235860 Enrollment ID: I20140819000292 |
| Provider Name | Jason A Shanker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932488962 PECOS PAC ID: 1951560044 Enrollment ID: I20141103000339 |
| Provider Name | Laura E. Marchi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366850554 PECOS PAC ID: 4183946965 Enrollment ID: I20141205000502 |
| Provider Name | Anne Bannister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245621093 PECOS PAC ID: 8123345428 Enrollment ID: I20150325002480 |
| Provider Name | Christie C Pickrell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992063994 PECOS PAC ID: 8325262843 Enrollment ID: I20150421001869 |
| Provider Name | Kimberly H Harsy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437555653 PECOS PAC ID: 7113247651 Enrollment ID: I20150522001371 |
| Provider Name | Kirsten Dunn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356617443 PECOS PAC ID: 6709106057 Enrollment ID: I20150730011242 |
| Provider Name | Stephanie Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275918856 PECOS PAC ID: 9032425046 Enrollment ID: I20150904000641 |
| Provider Name | Timothy Walton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669423976 PECOS PAC ID: 4880903384 Enrollment ID: I20151023001661 |
| Provider Name | Steven Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619960655 PECOS PAC ID: 3072407527 Enrollment ID: I20151105001451 |
| Provider Name | Stephanie Denise Crouch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972976181 PECOS PAC ID: 7214237387 Enrollment ID: I20151120001246 |
| Provider Name | Walter L Mickey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306109384 PECOS PAC ID: 9032426911 Enrollment ID: I20160105000160 |
| Provider Name | George R Shuert |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376716985 PECOS PAC ID: 4688706393 Enrollment ID: I20160126001604 |
| Provider Name | Jesse C Lavin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134567084 PECOS PAC ID: 0941521660 Enrollment ID: I20160406000210 |
| Provider Name | She'tongela S Crutcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134581861 PECOS PAC ID: 0446558563 Enrollment ID: I20160525001152 |
| Provider Name | Barry K Stoll |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750677928 PECOS PAC ID: 0840418760 Enrollment ID: I20160609001857 |
| Provider Name | Javad C Vaziri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528354727 PECOS PAC ID: 3971731365 Enrollment ID: I20160610001421 |
| Provider Name | Tatheer Zohra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457614430 PECOS PAC ID: 5890936033 Enrollment ID: I20160712000138 |
| Provider Name | Eric J Shelley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477999167 PECOS PAC ID: 7315181245 Enrollment ID: I20160804000810 |
| Provider Name | Nanette Randle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780016584 PECOS PAC ID: 8921232653 Enrollment ID: I20160812000680 |
| Provider Name | Gayle L Heady |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538597414 PECOS PAC ID: 2466748389 Enrollment ID: I20160901000533 |
| Provider Name | Jennifer L Seib |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346796562 PECOS PAC ID: 4082992037 Enrollment ID: I20161026003038 |
| Provider Name | Stephanie Dusek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841749967 PECOS PAC ID: 9133407554 Enrollment ID: I20161104001433 |
| Provider Name | Rachel Landgraf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215487863 PECOS PAC ID: 9234418625 Enrollment ID: I20161107001661 |
| Provider Name | Manisha Shrestha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871035766 PECOS PAC ID: 7719267913 Enrollment ID: I20161205002080 |
| Provider Name | Anne Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043760259 PECOS PAC ID: 3476833047 Enrollment ID: I20161219000323 |
| Provider Name | Andrea L Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265815583 PECOS PAC ID: 9931480159 Enrollment ID: I20161230001524 |
| Provider Name | Falak Bhatt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588928535 PECOS PAC ID: 1951622760 Enrollment ID: I20170301000326 |
| Provider Name | Stephanie D Nellesen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003362021 PECOS PAC ID: 6901182310 Enrollment ID: I20170420000870 |
| Provider Name | Mary R Yu |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861807026 PECOS PAC ID: 9335369743 Enrollment ID: I20170519000257 |
| Provider Name | Katie L Palubiak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609308584 PECOS PAC ID: 6103193537 Enrollment ID: I20170606001367 |
| Provider Name | Margaret Mueller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295889244 PECOS PAC ID: 4688579659 Enrollment ID: I20170707001679 |
| Provider Name | Amanda L Melliere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588194427 PECOS PAC ID: 7012287147 Enrollment ID: I20170724001692 |
| Provider Name | Alison Curfman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023306578 PECOS PAC ID: 2961772660 Enrollment ID: I20170727002055 |
| Provider Name | Laura R Thompson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023310737 PECOS PAC ID: 2264605252 Enrollment ID: I20170801001825 |
| Provider Name | Mary L Ehlman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235579012 PECOS PAC ID: 2668690272 Enrollment ID: I20170829002498 |
| Provider Name | Spencer Coffey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689075244 PECOS PAC ID: 2961624416 Enrollment ID: I20171130000134 |
| Provider Name | Temitope Shodunke |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1144517707 PECOS PAC ID: 1052543436 Enrollment ID: I20171205002656 |
| Provider Name | Alla Al-habib |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588900096 PECOS PAC ID: 1355627068 Enrollment ID: I20180419001803 |
| Provider Name | Samantha Nicole Lillico |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093225815 PECOS PAC ID: 6002171162 Enrollment ID: I20180521002622 |
| Provider Name | Brian Snyders |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962797126 PECOS PAC ID: 3577856327 Enrollment ID: I20180612001531 |
| Provider Name | Armin Krvavac |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1134482490 PECOS PAC ID: 2769617877 Enrollment ID: I20180714000102 |
| Provider Name | Mara Kathleen Trautman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922543958 PECOS PAC ID: 5294017463 Enrollment ID: I20180725003522 |
| Provider Name | Joanna I Ramiro |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1376898536 PECOS PAC ID: 3678876406 Enrollment ID: I20180913001194 |
| Provider Name | Dava M Mcgougan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841611746 PECOS PAC ID: 1850641713 Enrollment ID: I20180913003125 |
| Provider Name | Nicolette Prosser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194204388 PECOS PAC ID: 0840541660 Enrollment ID: I20180918002301 |
| Provider Name | Amy Louise Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477030161 PECOS PAC ID: 6002167350 Enrollment ID: I20180925003186 |
| Provider Name | Meghan Lambert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780138891 PECOS PAC ID: 6204123508 Enrollment ID: I20181114000967 |
| Provider Name | James Mark Spaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811472822 PECOS PAC ID: 2365786076 Enrollment ID: I20181206003600 |
| Provider Name | Hasan Saleh El-fahmawi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497221196 PECOS PAC ID: 4486998101 Enrollment ID: I20181207000292 |
| Provider Name | Kelly Pantazo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306326855 PECOS PAC ID: 4587909619 Enrollment ID: I20181218003254 |
| Provider Name | Kathleen Heath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578041703 PECOS PAC ID: 0042557043 Enrollment ID: I20190129003256 |
| Provider Name | Melanie Elaine Janssen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336614775 PECOS PAC ID: 4385981380 Enrollment ID: I20190129003434 |
| Provider Name | Whitney Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902108517 PECOS PAC ID: 5991936270 Enrollment ID: I20190129003506 |
| Provider Name | Katherine Antoinette Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790259844 PECOS PAC ID: 6901143866 Enrollment ID: I20190130002047 |
| Provider Name | Elizabeth Ann Neudecker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891186854 PECOS PAC ID: 6204155906 Enrollment ID: I20190201001372 |
| Provider Name | Melissa Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487122784 PECOS PAC ID: 3870830748 Enrollment ID: I20190211000574 |
| Provider Name | Emily Specker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912430315 PECOS PAC ID: 6305105859 Enrollment ID: I20190221000254 |
| Provider Name | Rebekah Holobaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194295642 PECOS PAC ID: 1557609468 Enrollment ID: I20190305001054 |
| Provider Name | Sarah Walters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699260521 PECOS PAC ID: 2668711771 Enrollment ID: I20190307002866 |
| Provider Name | Margaret Mary Wynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306306865 PECOS PAC ID: 1658612163 Enrollment ID: I20190410002336 |
| Provider Name | Kaitlyn Greenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790297729 PECOS PAC ID: 0446518070 Enrollment ID: I20190417002015 |
| Provider Name | Meaghan Boland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790225894 PECOS PAC ID: 9830430966 Enrollment ID: I20190417002440 |
| Provider Name | Meghan Fusz Rodden |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407054257 PECOS PAC ID: 8022260991 Enrollment ID: I20190509000076 |
| Provider Name | Lacey Ann Stevenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497319560 PECOS PAC ID: 9234462102 Enrollment ID: I20190607000936 |
| Provider Name | Advait Sanjiv Mahulikar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1417377383 PECOS PAC ID: 6305148354 Enrollment ID: I20190701000477 |
| Provider Name | Rada Helen Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508397910 PECOS PAC ID: 7517292311 Enrollment ID: I20190716003738 |
| Provider Name | Mohamed M Alwan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538542634 PECOS PAC ID: 8820390297 Enrollment ID: I20190731002227 |
| Provider Name | Johnson Wong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861846909 PECOS PAC ID: 2466780770 Enrollment ID: I20190824000654 |
| Provider Name | Melody Kay Willis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336604370 PECOS PAC ID: 3375871510 Enrollment ID: I20190826001874 |
| Provider Name | Matrecha Ann Yates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891211553 PECOS PAC ID: 6608104591 Enrollment ID: I20190830001313 |
| Provider Name | Kathryn Shemwell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700263506 PECOS PAC ID: 0749582542 Enrollment ID: I20191007000249 |
| Provider Name | Tammy Lebrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508324351 PECOS PAC ID: 6002147402 Enrollment ID: I20191016002832 |
| Provider Name | Pangaa Buniya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336690288 PECOS PAC ID: 1951687177 Enrollment ID: I20191022001050 |
| Provider Name | Victoria Lynn Alstadt-johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073071585 PECOS PAC ID: 7911235106 Enrollment ID: I20200103002075 |
| Provider Name | Shannon Deann Dobsch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821634247 PECOS PAC ID: 5496181471 Enrollment ID: I20200211001752 |
| Provider Name | Ameenah Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912556556 PECOS PAC ID: 2567890288 Enrollment ID: I20200311002477 |
| Provider Name | Bamidele Ganiyu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073155933 PECOS PAC ID: 1153759394 Enrollment ID: I20200320002762 |
| Provider Name | Elissa Ash |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609804053 PECOS PAC ID: 8921029745 Enrollment ID: I20200430000328 |
| Provider Name | Milind V Gurjar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972538205 PECOS PAC ID: 2163435611 Enrollment ID: I20200511000659 |
| Provider Name | Lauren Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306489083 PECOS PAC ID: 4880015452 Enrollment ID: I20200608000710 |
| Provider Name | Michelle Patrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265994438 PECOS PAC ID: 4688900830 Enrollment ID: I20200608001812 |
| Provider Name | Yelizaveta Makhatadze |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891744876 PECOS PAC ID: 0941214696 Enrollment ID: I20200612000901 |
| Provider Name | Mary Elizabeth Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275060907 PECOS PAC ID: 4981026200 Enrollment ID: I20200615002469 |
| Provider Name | Jeffrey S Calvin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750764866 PECOS PAC ID: 3173825551 Enrollment ID: I20200804002733 |
| Provider Name | Kimberly Wahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194295063 PECOS PAC ID: 1355689589 Enrollment ID: I20200814002061 |
| Provider Name | Senthil Aruchamy |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1386873883 PECOS PAC ID: 5496903254 Enrollment ID: I20200825003576 |
| Provider Name | Christian Hoffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467062646 PECOS PAC ID: 6800213331 Enrollment ID: I20200831000113 |
| Provider Name | Fang Bai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639564776 PECOS PAC ID: 3577872878 Enrollment ID: I20200909000395 |
| Provider Name | Corey Weicht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992315857 PECOS PAC ID: 5799103941 Enrollment ID: I20200921000728 |
| Provider Name | Melinda D Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720345085 PECOS PAC ID: 5597073114 Enrollment ID: I20200924002362 |
| Provider Name | Amanda Bertholomey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871103093 PECOS PAC ID: 3678983566 Enrollment ID: I20201104001509 |
| Provider Name | Adrienne Rebecca Arnone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871945196 PECOS PAC ID: 0446527667 Enrollment ID: I20201125002253 |
| Provider Name | Lindsay White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538762737 PECOS PAC ID: 3577979236 Enrollment ID: I20210304002081 |
| Provider Name | Sujan Teegala Reddy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790170223 PECOS PAC ID: 6507280195 Enrollment ID: I20210528000538 |
| Provider Name | Belma Mahmutovic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447839436 PECOS PAC ID: 3274933262 Enrollment ID: I20210614000400 |
| Provider Name | Yasser Kabbani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982050142 PECOS PAC ID: 5698066736 Enrollment ID: I20210721003110 |
| Provider Name | Maggie Marie Koenig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497324230 PECOS PAC ID: 4284037433 Enrollment ID: I20210726001413 |
| Provider Name | Jordan Nichole Leifield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700455631 PECOS PAC ID: 7810393121 Enrollment ID: I20210913002154 |
| Provider Name | Lingxiao Lu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083135909 PECOS PAC ID: 2365715638 Enrollment ID: I20210913003003 |
| Provider Name | Nida Jamal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1457701104 PECOS PAC ID: 1355637117 Enrollment ID: I20210915000667 |
| Provider Name | Ashley Danuser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609449586 PECOS PAC ID: 1355730037 Enrollment ID: I20211118001497 |
| Provider Name | Navpreet Rawala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518518398 PECOS PAC ID: 8123450871 Enrollment ID: I20211202000764 |
| Provider Name | Charles Jonah Mccloskey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972267656 PECOS PAC ID: 9335539352 Enrollment ID: I20211207000933 |
| Provider Name | Kristin Lee Vorachack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992460778 PECOS PAC ID: 9335539006 Enrollment ID: I20211213000892 |
| Provider Name | Samara Marie Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285389304 PECOS PAC ID: 1153717020 Enrollment ID: I20220331002074 |
| Provider Name | Nikki Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831346204 PECOS PAC ID: 5294803508 Enrollment ID: I20220413000243 |
| Provider Name | Amanda Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952797383 PECOS PAC ID: 9537478011 Enrollment ID: I20220413001554 |
| Provider Name | Shannon Suzanne Grayek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124764477 PECOS PAC ID: 8527440957 Enrollment ID: I20220802002721 |
| Provider Name | Suan Rachels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194459016 PECOS PAC ID: 6204204928 Enrollment ID: I20221130000356 |
| Provider Name | Shakita L Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356963094 PECOS PAC ID: 1355711847 Enrollment ID: I20221227001157 |
| Provider Name | Vismay J Thakkar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912301508 PECOS PAC ID: 7113148370 Enrollment ID: I20230411002971 |
| Provider Name | Mostafa Jafari |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891255725 PECOS PAC ID: 2961861802 Enrollment ID: I20230710002851 |
| Provider Name | Kelley Cassens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942993894 PECOS PAC ID: 6901267111 Enrollment ID: I20230804000543 |
| Provider Name | Jessica Dawn Weseman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871270009 PECOS PAC ID: 6709249956 Enrollment ID: I20230906000377 |
| Provider Name | Abigail Rose Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861103137 PECOS PAC ID: 0749644318 Enrollment ID: I20230914003197 |
| Provider Name | Sylvia Ogilvie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407638349 PECOS PAC ID: 4183070089 Enrollment ID: I20231030001380 |
| Provider Name | Tye' Gc Strong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518537711 PECOS PAC ID: 2466800818 Enrollment ID: I20231127001561 |
| Provider Name | Jessie Grewal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902198583 PECOS PAC ID: 1254560642 Enrollment ID: I20240525000382 |
| Provider Name | Sameera Azad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487831061 PECOS PAC ID: 0345432233 Enrollment ID: I20240613002731 |
Brenda Lee Casey, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 Four Seasons Shopping Ctr, Suite 103b, Chesterfield, MO 63017 Phone: 636-484-2733 Fax: 314-392-9558 | |
Total Health And Productivity Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 232 S Woods Mill Rd, Chesterfield, MO 63017 Phone: 636-236-9578 | |
Chesterfield Counseling Associates, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 15455 Conway Rd Ste 117, Chesterfield, MO 63017 Phone: 636-675-7566 | |
Beyond Vision Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 140 Long Rd Ste 123, Chesterfield, MO 63005 Phone: 818-308-4388 Fax: 855-954-4533 | |
Child Neurology Associates, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 226 S Woods Mill Rd, Suite 46w, Chesterfield, MO 63017 Phone: 314-275-7070 Fax: 314-275-2666 | |
Neurodiagnostics, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 224 S Woods Mill Rd, Suite 550s, Chesterfield, MO 63017 Phone: 314-434-3414 |