| Peacehealth Medical Group | |
|
1200 Hilyard St Eugene OR 97401-8122 | |
| (541) 687-6217 | |
| Not Available |
| Full Name | Peacehealth Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 1200 Hilyard St, Eugene, Oregon |
| Authorized Official Name and Position | Lori Kettler (PROVIDER ENROLLMENT LEAD) |
| Authorized Official Contact | 3607291411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peacehealth Medical Group Po Box 24410 Eugene OR 97402-0451 Ph: () - | Peacehealth Medical Group 1200 Hilyard St Eugene OR 97401-8122 Ph: (541) 687-6217 |
| NPI Number | 1447207287 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 04/04/2017 |
| Medicare PECOS PAC ID | 9032023270 |
|---|---|
| Medicare Enrollment ID | O20031113000097 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447207287 | NPI | - | NPPES |
| 071634 | Medicaid | OR |
| Provider Name | Richard A Barnhart |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861471054 PECOS PAC ID: 5193638435 Enrollment ID: I20031111000891 |
| Provider Name | Mohammad H Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295702850 PECOS PAC ID: 5799698965 Enrollment ID: I20031112000640 |
| Provider Name | Jon E Ekstrom |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407871163 PECOS PAC ID: 9133033046 Enrollment ID: I20031114000651 |
| Provider Name | Robert E Gunderman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497787485 PECOS PAC ID: 5890695043 Enrollment ID: I20040113000105 |
| Provider Name | Dawn L Mehlhaff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720149677 PECOS PAC ID: 0648164061 Enrollment ID: I20040209000401 |
| Provider Name | Lisa L Lamoreaux |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1821065624 PECOS PAC ID: 3678568672 Enrollment ID: I20040419000957 |
| Provider Name | Erin P Reilly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285602086 PECOS PAC ID: 4385639277 Enrollment ID: I20040419001598 |
| Provider Name | William Strek |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447228085 PECOS PAC ID: 5597751917 Enrollment ID: I20040421001769 |
| Provider Name | John O Lipkin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235106980 PECOS PAC ID: 2668468018 Enrollment ID: I20040422000119 |
| Provider Name | Urszula W Tajchman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316973464 PECOS PAC ID: 4880679224 Enrollment ID: I20040621001194 |
| Provider Name | Kristi L Seidel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780601617 PECOS PAC ID: 7012993660 Enrollment ID: I20040625000186 |
| Provider Name | Paul R Stauffer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649208422 PECOS PAC ID: 1658359955 Enrollment ID: I20040713000282 |
| Provider Name | Rajeev L Alexander |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1497725808 PECOS PAC ID: 3678553278 Enrollment ID: I20040723000532 |
| Provider Name | Michael J Kraynyak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225005093 PECOS PAC ID: 0345214987 Enrollment ID: I20040820000520 |
| Provider Name | Camille E Leider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972548766 PECOS PAC ID: 9739158346 Enrollment ID: I20040930000378 |
| Provider Name | Jeffrey G Baxter |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1053383893 PECOS PAC ID: 0749240596 Enrollment ID: I20041015000270 |
| Provider Name | Andrew J Kokkino |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1780628719 PECOS PAC ID: 7618933391 Enrollment ID: I20041203000923 |
| Provider Name | Bernardo H Isuani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881630861 PECOS PAC ID: 4880651827 Enrollment ID: I20041211000191 |
| Provider Name | Harry T Adamo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235191412 PECOS PAC ID: 8820046071 Enrollment ID: I20050105000248 |
| Provider Name | Fred P Kinnicutt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427108521 PECOS PAC ID: 0941251987 Enrollment ID: I20050207000718 |
| Provider Name | Angela M Bradley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588633523 PECOS PAC ID: 9436103132 Enrollment ID: I20050305000024 |
| Provider Name | Akshay S Gupta |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326084377 PECOS PAC ID: 1456333152 Enrollment ID: I20050415000819 |
| Provider Name | Andrea L Halliday |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1306829049 PECOS PAC ID: 9234172636 Enrollment ID: I20050608000584 |
| Provider Name | Doherty B Gilchrist |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518942093 PECOS PAC ID: 9638112642 Enrollment ID: I20050609000673 |
| Provider Name | David W Tsai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265478499 PECOS PAC ID: 2567359185 Enrollment ID: I20050615000297 |
| Provider Name | Michael Schiedler |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1164528600 PECOS PAC ID: 3274578232 Enrollment ID: I20050621001004 |
| Provider Name | Stephan G Thiede |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346277399 PECOS PAC ID: 2062494438 Enrollment ID: I20050624000706 |
| Provider Name | James T Akins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366478166 PECOS PAC ID: 0648215145 Enrollment ID: I20050624000738 |
| Provider Name | Steven M Yoder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871561456 PECOS PAC ID: 6507892312 Enrollment ID: I20050713000440 |
| Provider Name | William E Cox |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1992778443 PECOS PAC ID: 1951337583 Enrollment ID: I20050714000391 |
| Provider Name | Carol L Crocker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598964884 PECOS PAC ID: 0345273199 Enrollment ID: I20050913000997 |
| Provider Name | Hsiang-sen R Yeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770698490 PECOS PAC ID: 4587698048 Enrollment ID: I20050923000323 |
| Provider Name | Andrea O Blattler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912013707 PECOS PAC ID: 7315972494 Enrollment ID: I20050927001481 |
| Provider Name | Wendy I Lang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336176643 PECOS PAC ID: 5597784058 Enrollment ID: I20051115000242 |
| Provider Name | Lisa M Adams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447223987 PECOS PAC ID: 9234126897 Enrollment ID: I20051130000228 |
| Provider Name | Joyce M Brackebusch |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1710065271 PECOS PAC ID: 2961424676 Enrollment ID: I20051222000092 |
| Provider Name | Lee Azpiroz |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184622300 PECOS PAC ID: 3577585652 Enrollment ID: I20060104000095 |
| Provider Name | James A Christon |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1619984853 PECOS PAC ID: 7517943798 Enrollment ID: I20060104000153 |
| Provider Name | Julie C Scalisi |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1396773032 PECOS PAC ID: 4486660537 Enrollment ID: I20060227000327 |
| Provider Name | Stewart L Mones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144277559 PECOS PAC ID: 6406872357 Enrollment ID: I20060407000102 |
| Provider Name | Karthik P Mahadevan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1144285263 PECOS PAC ID: 5799749552 Enrollment ID: I20060815000155 |
| Provider Name | Adrienne Nicklin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326036211 PECOS PAC ID: 0941286017 Enrollment ID: I20061003000081 |
| Provider Name | Melissa S Defreest |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407960388 PECOS PAC ID: 1850398884 Enrollment ID: I20061103000280 |
| Provider Name | R Michael Harding |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780616243 PECOS PAC ID: 6709885056 Enrollment ID: I20061213000613 |
| Provider Name | Jill J Chaplin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508803743 PECOS PAC ID: 2567453749 Enrollment ID: I20070122000028 |
| Provider Name | Robert C Barnes |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1689696999 PECOS PAC ID: 6507811999 Enrollment ID: I20070206000494 |
| Provider Name | Jonell Blase |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245391192 PECOS PAC ID: 7113020363 Enrollment ID: I20070308000688 |
| Provider Name | Rosemary J Rifino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346384500 PECOS PAC ID: 1759486186 Enrollment ID: I20070413000276 |
| Provider Name | Katherine A Swem |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1770686131 PECOS PAC ID: 4385611862 Enrollment ID: I20070427000153 |
| Provider Name | Leslie R Pelinka |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275643645 PECOS PAC ID: 3476523432 Enrollment ID: I20070621000325 |
| Provider Name | Lorna J Wong |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245208156 PECOS PAC ID: 3870692452 Enrollment ID: I20070622000007 |
| Provider Name | Katherine K Swank |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568578870 PECOS PAC ID: 7214946342 Enrollment ID: I20070821000345 |
| Provider Name | Victor B Richenstein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205811502 PECOS PAC ID: 1951495357 Enrollment ID: I20070917000089 |
| Provider Name | Jonathan T Sims |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124075122 PECOS PAC ID: 6103839535 Enrollment ID: I20070918000562 |
| Provider Name | Pauline G Davis |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1760689202 PECOS PAC ID: 1658465752 Enrollment ID: I20070920000241 |
| Provider Name | James H Kiley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861694861 PECOS PAC ID: 1456446012 Enrollment ID: I20070927000849 |
| Provider Name | Hans T Notenboom |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427004357 PECOS PAC ID: 8325946502 Enrollment ID: I20071003000098 |
| Provider Name | Julia N.e. Sunkomat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326237488 PECOS PAC ID: 8022107507 Enrollment ID: I20071207000006 |
| Provider Name | Christopher C Hammond |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588679039 PECOS PAC ID: 5991785552 Enrollment ID: I20071211000714 |
| Provider Name | Christopher A Calawa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992803944 PECOS PAC ID: 8022108679 Enrollment ID: I20071219000530 |
| Provider Name | Jeffrey H Mcdonald |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447298716 PECOS PAC ID: 2961435482 Enrollment ID: I20071227000079 |
| Provider Name | Erik J Young |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1558484238 PECOS PAC ID: 2062511389 Enrollment ID: I20080614000060 |
| Provider Name | Lorne E Bigley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922029289 PECOS PAC ID: 5395817480 Enrollment ID: I20080707000468 |
| Provider Name | John P Dohrman |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1508030909 PECOS PAC ID: 5597837609 Enrollment ID: I20080707000656 |
| Provider Name | Marylin A Datzman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386617868 PECOS PAC ID: 5496828808 Enrollment ID: I20080717000759 |
| Provider Name | David J Vanscoy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689722654 PECOS PAC ID: 1658446901 Enrollment ID: I20080820000702 |
| Provider Name | William Frank Foster |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225048325 PECOS PAC ID: 4486547726 Enrollment ID: I20080922000402 |
| Provider Name | Paul E Evans |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1962480871 PECOS PAC ID: 5698791929 Enrollment ID: I20081023000561 |
| Provider Name | Christopher M Massari |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700948973 PECOS PAC ID: 2062439938 Enrollment ID: I20081031000414 |
| Provider Name | Natasa Petrac |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1578508214 PECOS PAC ID: 2769430586 Enrollment ID: I20081106000585 |
| Provider Name | Erin J Couture |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003902867 PECOS PAC ID: 1850453945 Enrollment ID: I20081226000018 |
| Provider Name | Michael D Jay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154575777 PECOS PAC ID: 5890858054 Enrollment ID: I20090114000226 |
| Provider Name | Suzanne T Temple |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932179546 PECOS PAC ID: 2668536491 Enrollment ID: I20090122000697 |
| Provider Name | Jason M Quiring |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609015049 PECOS PAC ID: 4880750645 Enrollment ID: I20090303000012 |
| Provider Name | Christine K Wung |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043408024 PECOS PAC ID: 0840356473 Enrollment ID: I20090306000277 |
| Provider Name | Robert K Pelz |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1235106386 PECOS PAC ID: 8729138664 Enrollment ID: I20090615000349 |
| Provider Name | Sara S Batya |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801084116 PECOS PAC ID: 0446301345 Enrollment ID: I20090707000292 |
| Provider Name | Misty L Carlson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083824031 PECOS PAC ID: 5799830824 Enrollment ID: I20090826000084 |
| Provider Name | Patrick G Tandingan |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1992859623 PECOS PAC ID: 5193871689 Enrollment ID: I20090924000664 |
| Provider Name | Kialing P Perez |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1952501744 PECOS PAC ID: 0446396170 Enrollment ID: I20091008000679 |
| Provider Name | Graham S Kaiser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598731903 PECOS PAC ID: 0143360172 Enrollment ID: I20091222000556 |
| Provider Name | Kenneth N Hanson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710950324 PECOS PAC ID: 0648310672 Enrollment ID: I20091222000589 |
| Provider Name | John P Merrick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154398162 PECOS PAC ID: 8820138878 Enrollment ID: I20091222000698 |
| Provider Name | Peter S Kosek |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1639120801 PECOS PAC ID: 7315939964 Enrollment ID: I20100223000876 |
| Provider Name | Deborah R Fuerth |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255304200 PECOS PAC ID: 1153466289 Enrollment ID: I20100301000726 |
| Provider Name | Michael A Laurie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619944022 PECOS PAC ID: 0042355067 Enrollment ID: I20100302000726 |
| Provider Name | Joan M Jensen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1437125929 PECOS PAC ID: 4981749322 Enrollment ID: I20100309000881 |
| Provider Name | Barry S Jarvis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528034899 PECOS PAC ID: 5991840357 Enrollment ID: I20100310000175 |
| Provider Name | Daniel S Hutton |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1346365871 PECOS PAC ID: 3072665553 Enrollment ID: I20100310000221 |
| Provider Name | Katherine L Beckstrand |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982676730 PECOS PAC ID: 7012052483 Enrollment ID: I20100310000245 |
| Provider Name | Libor Pavlosek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376510420 PECOS PAC ID: 3274668033 Enrollment ID: I20100318000138 |
| Provider Name | William Mark Dukeminier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154394450 PECOS PAC ID: 4789710005 Enrollment ID: I20100325000934 |
| Provider Name | Regina D Mcglothlin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619944071 PECOS PAC ID: 7214063536 Enrollment ID: I20100325000956 |
| Provider Name | Michael A Mirhej |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548237910 PECOS PAC ID: 8123154457 Enrollment ID: I20100325000974 |
| Provider Name | Mark B Lyon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447227434 PECOS PAC ID: 9830225168 Enrollment ID: I20100325000993 |
| Provider Name | John B Holtzapple |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588638852 PECOS PAC ID: 4284760513 Enrollment ID: I20100325000998 |
| Provider Name | John E Dunphy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821061029 PECOS PAC ID: 9133255409 Enrollment ID: I20100326000233 |
| Provider Name | Kathleen T Chinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649249681 PECOS PAC ID: 6305972282 Enrollment ID: I20100330000976 |
| Provider Name | Robert C Brasted |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447223862 PECOS PAC ID: 8820124753 Enrollment ID: I20100331000036 |
| Provider Name | Carolyn M Hartman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194799718 PECOS PAC ID: 7618003443 Enrollment ID: I20100331000081 |
| Provider Name | Christa Danielson |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1982677449 PECOS PAC ID: 0244366078 Enrollment ID: I20100331000094 |
| Provider Name | Geoffrey S Simmons |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295703825 PECOS PAC ID: 3072649870 Enrollment ID: I20100331000786 |
| Provider Name | Jennifer L Difrancesco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821067703 PECOS PAC ID: 9830225507 Enrollment ID: I20100405000364 |
| Provider Name | Klarissa K Beller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104898956 PECOS PAC ID: 1951438175 Enrollment ID: I20100420000801 |
| Provider Name | James Wiley Dickerson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023004512 PECOS PAC ID: 9830130996 Enrollment ID: I20100420000970 |
| Provider Name | Matthew B Walter |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1093722217 PECOS PAC ID: 3870622509 Enrollment ID: I20100518000871 |
| Provider Name | Indulal K Rughani |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1639185242 PECOS PAC ID: 1951430685 Enrollment ID: I20100518000879 |
| Provider Name | Harold E Whiteley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942278817 PECOS PAC ID: 3577692045 Enrollment ID: I20100520000807 |
| Provider Name | Binaya Rimal |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1942229117 PECOS PAC ID: 1153345459 Enrollment ID: I20100521000871 |
| Provider Name | William R Macmaster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164557054 PECOS PAC ID: 4688705130 Enrollment ID: I20100626000383 |
| Provider Name | Christine Foley Kollmorgen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346282852 PECOS PAC ID: 6103822754 Enrollment ID: I20100712000647 |
| Provider Name | David R Dehaas |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417986761 PECOS PAC ID: 5294731840 Enrollment ID: I20100712000701 |
| Provider Name | Thomas H Bascom |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1790714046 PECOS PAC ID: 1759387301 Enrollment ID: I20100713000181 |
| Provider Name | Mark E Snider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639102619 PECOS PAC ID: 2264528413 Enrollment ID: I20100907000852 |
| Provider Name | Winnie W Henderson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235347428 PECOS PAC ID: 3072639012 Enrollment ID: I20100927001108 |
| Provider Name | Elaine J Skalabrin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609966233 PECOS PAC ID: 9436111911 Enrollment ID: I20101021001210 |
| Provider Name | Thea E Petersen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083887087 PECOS PAC ID: 0547454027 Enrollment ID: I20101028000680 |
| Provider Name | Dariusz Z Zawierucha |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1700839107 PECOS PAC ID: 7911908868 Enrollment ID: I20101112000455 |
| Provider Name | Benjamin R Bock |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982753810 PECOS PAC ID: 5799974093 Enrollment ID: I20110118000366 |
| Provider Name | Margaret N Njonjo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427239334 PECOS PAC ID: 8921287590 Enrollment ID: I20110127001215 |
| Provider Name | Juanita P Doerksen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679546162 PECOS PAC ID: 8820278120 Enrollment ID: I20110203000349 |
| Provider Name | Richard A Gross |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891764270 PECOS PAC ID: 6103009766 Enrollment ID: I20110321000413 |
| Provider Name | Heather A Schlessman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417192881 PECOS PAC ID: 4284818147 Enrollment ID: I20110418000739 |
| Provider Name | Kathleen A Brandt |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1649202029 PECOS PAC ID: 8820273121 Enrollment ID: I20110502000564 |
| Provider Name | Daniel A Cusati Oropeza |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134210370 PECOS PAC ID: 3678570710 Enrollment ID: I20110520000248 |
| Provider Name | Serena S Black |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508007675 PECOS PAC ID: 2466620042 Enrollment ID: I20110726000687 |
| Provider Name | Michael A Carnevale |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1164425534 PECOS PAC ID: 6406740646 Enrollment ID: I20110809000446 |
| Provider Name | Haidee D Zamora |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1316188857 PECOS PAC ID: 3971774761 Enrollment ID: I20110928000218 |
| Provider Name | Marika D Wolfe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992966311 PECOS PAC ID: 7517139223 Enrollment ID: I20110930000203 |
| Provider Name | James E Sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467693093 PECOS PAC ID: 8628047172 Enrollment ID: I20111123000665 |
| Provider Name | Kathryn M Kernan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710250329 PECOS PAC ID: 7416118104 Enrollment ID: I20120405000018 |
| Provider Name | Susan L Sanderson |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1417134222 PECOS PAC ID: 0042403719 Enrollment ID: I20120509000048 |
| Provider Name | Corinne A Kuszik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427108885 PECOS PAC ID: 9739093774 Enrollment ID: I20120717000675 |
| Provider Name | Janjan A Reforma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487986469 PECOS PAC ID: 7618133612 Enrollment ID: I20120718000973 |
| Provider Name | Valerie C Coon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407026263 PECOS PAC ID: 5092961219 Enrollment ID: I20120803000291 |
| Provider Name | Brenda M Ormesher |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1922267384 PECOS PAC ID: 3577719574 Enrollment ID: I20120807000575 |
| Provider Name | Loan T Duong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255568515 PECOS PAC ID: 8628231982 Enrollment ID: I20120927000849 |
| Provider Name | Lindsay Erin Bromley |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1659536126 PECOS PAC ID: 3779732433 Enrollment ID: I20121012000618 |
| Provider Name | Kevin A Modeste |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942447032 PECOS PAC ID: 8426208109 Enrollment ID: I20121016000386 |
| Provider Name | Eric N Leong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851475099 PECOS PAC ID: 1557511672 Enrollment ID: I20121026000443 |
| Provider Name | Robbin A Sebastiani |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356539142 PECOS PAC ID: 2860643434 Enrollment ID: I20121107000275 |
| Provider Name | Keely A Petersen-snider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902092547 PECOS PAC ID: 6406009315 Enrollment ID: I20121228000473 |
| Provider Name | John Horton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487690889 PECOS PAC ID: 9133373988 Enrollment ID: I20130204000328 |
| Provider Name | Michelle Davila |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518274414 PECOS PAC ID: 2961647805 Enrollment ID: I20130326000312 |
| Provider Name | Shanna M Bunce |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952414989 PECOS PAC ID: 8628060035 Enrollment ID: I20130515000282 |
| Provider Name | Steven B Smith |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1205824703 PECOS PAC ID: 8729068366 Enrollment ID: I20130619000663 |
| Provider Name | Pallav Pareek |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922232644 PECOS PAC ID: 9537300215 Enrollment ID: I20130723000064 |
| Provider Name | Alexander B Schabel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801978481 PECOS PAC ID: 5698921609 Enrollment ID: I20130808000149 |
| Provider Name | Katsufumi Nishida |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1912118159 PECOS PAC ID: 2264606185 Enrollment ID: I20130820001003 |
| Provider Name | Kierst L Bradley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417272188 PECOS PAC ID: 1052555208 Enrollment ID: I20130910000578 |
| Provider Name | Malgorzata A Zukowska |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427219633 PECOS PAC ID: 6305016411 Enrollment ID: I20130910000656 |
| Provider Name | Hollys J. Nielsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245393131 PECOS PAC ID: 0941306211 Enrollment ID: I20130912000602 |
| Provider Name | Chong Wee Foo |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1588861058 PECOS PAC ID: 7113161662 Enrollment ID: I20130923000833 |
| Provider Name | Kenna M Wood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336460567 PECOS PAC ID: 0345474672 Enrollment ID: I20130927000669 |
| Provider Name | Nathan P Christensen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1952324907 PECOS PAC ID: 0244415917 Enrollment ID: I20131111001287 |
| Provider Name | Jason D Cronin |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1346260379 PECOS PAC ID: 9931103702 Enrollment ID: I20131122001757 |
| Provider Name | Alba Virginia Schultz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801164926 PECOS PAC ID: 3173799392 Enrollment ID: I20131203001548 |
| Provider Name | Dianna L Bordewick |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1790720100 PECOS PAC ID: 6507947942 Enrollment ID: I20140312000583 |
| Provider Name | Jennifer L Saxer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336130103 PECOS PAC ID: 7911080080 Enrollment ID: I20140429000440 |
| Provider Name | Leita Marie Dzubay |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871566000 PECOS PAC ID: 1052535036 Enrollment ID: I20140612002201 |
| Provider Name | Sandra J Wilmot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043635519 PECOS PAC ID: 3678797271 Enrollment ID: I20140623001722 |
| Provider Name | Alan Garcin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063849024 PECOS PAC ID: 8921223223 Enrollment ID: I20140630000687 |
| Provider Name | Rechelle L Asirot |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902118417 PECOS PAC ID: 1153546858 Enrollment ID: I20140714002492 |
| Provider Name | Matthew J Kaiser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720374069 PECOS PAC ID: 6709019631 Enrollment ID: I20140716000165 |
| Provider Name | Elizabeth A Mokrohisky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720195233 PECOS PAC ID: 9133153216 Enrollment ID: I20140905002040 |
| Provider Name | Rensie Chiara R De Vera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477846608 PECOS PAC ID: 6507094364 Enrollment ID: I20140908000565 |
| Provider Name | Hang Pham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831486471 PECOS PAC ID: 7416176912 Enrollment ID: I20140916000865 |
| Provider Name | Nandakumar Srinivasan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1235270927 PECOS PAC ID: 6103950530 Enrollment ID: I20140916001687 |
| Provider Name | Christopher M Love |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043522949 PECOS PAC ID: 2567699531 Enrollment ID: I20140919000321 |
| Provider Name | Neil E Roundy |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1174723720 PECOS PAC ID: 1355596156 Enrollment ID: I20140923002425 |
| Provider Name | Hong T Le |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639453822 PECOS PAC ID: 2567684293 Enrollment ID: I20141113001929 |
| Provider Name | Joshua D Pfeiffer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1962658336 PECOS PAC ID: 7113169590 Enrollment ID: I20141229002075 |
| Provider Name | Diego Muilenburg |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295716926 PECOS PAC ID: 7719034065 Enrollment ID: I20150107000222 |
| Provider Name | Jennifer L Durrant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871844506 PECOS PAC ID: 3870745201 Enrollment ID: I20150219001939 |
| Provider Name | Michael S Racine |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1144287848 PECOS PAC ID: 4183652910 Enrollment ID: I20150220000020 |
| Provider Name | Cathleen M Fritz |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1407254014 PECOS PAC ID: 7517283096 Enrollment ID: I20150226002294 |
| Provider Name | Sean C Mcelligott |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1669785820 PECOS PAC ID: 0547488553 Enrollment ID: I20150311001432 |
| Provider Name | Elizabeth M Spence |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912225574 PECOS PAC ID: 8224358551 Enrollment ID: I20150527002405 |
| Provider Name | Carly L Moe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457428484 PECOS PAC ID: 1658682695 Enrollment ID: I20150617003186 |
| Provider Name | Sarah J Brinkman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528451911 PECOS PAC ID: 7911219985 Enrollment ID: I20150703000028 |
| Provider Name | Clifton J Burt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972824043 PECOS PAC ID: 7517191232 Enrollment ID: I20150707003456 |
| Provider Name | Claudia Kathleen Knight |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639461015 PECOS PAC ID: 7416269998 Enrollment ID: I20150713000825 |
| Provider Name | Jerrell Ingalls |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851517999 PECOS PAC ID: 8123176104 Enrollment ID: I20150713002033 |
| Provider Name | Susan E Mann-sweeney |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366414054 PECOS PAC ID: 4385957596 Enrollment ID: I20150716003045 |
| Provider Name | Stephanie M Nixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790164028 PECOS PAC ID: 1850604752 Enrollment ID: I20150721002923 |
| Provider Name | Nichole Ingalls |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1235357104 PECOS PAC ID: 5890848659 Enrollment ID: I20150728006596 |
| Provider Name | Jing Wei |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093114373 PECOS PAC ID: 0446564884 Enrollment ID: I20150729010441 |
| Provider Name | Ehsan Hazrat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043564586 PECOS PAC ID: 4587979844 Enrollment ID: I20150814013921 |
| Provider Name | Vivekanand Pantangi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508123183 PECOS PAC ID: 9537474739 Enrollment ID: I20150818003541 |
| Provider Name | Cecelia N Jacobson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1528447026 PECOS PAC ID: 5092020925 Enrollment ID: I20150820011260 |
| Provider Name | Andrea L Childress |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710211768 PECOS PAC ID: 0547308165 Enrollment ID: I20150820011704 |
| Provider Name | Janet M Lukehart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285772699 PECOS PAC ID: 4587722558 Enrollment ID: I20150909000471 |
| Provider Name | Micah Lundstedt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124428032 PECOS PAC ID: 3678880804 Enrollment ID: I20150921000387 |
| Provider Name | Lauren Forrester Clancey |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1265809966 PECOS PAC ID: 6709194723 Enrollment ID: I20150924001665 |
| Provider Name | Erik W Young |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891059333 PECOS PAC ID: 8325356785 Enrollment ID: I20151005000960 |
| Provider Name | Andrea Louisell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508232448 PECOS PAC ID: 5193033249 Enrollment ID: I20151009000434 |
| Provider Name | Heidi R Schultz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235291808 PECOS PAC ID: 4082923222 Enrollment ID: I20151029000048 |
| Provider Name | Victoria Rose Smet |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1740653393 PECOS PAC ID: 0244531515 Enrollment ID: I20151211000402 |
| Provider Name | Sean Andrew D Orlino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518198233 PECOS PAC ID: 4587811294 Enrollment ID: I20151211000470 |
| Provider Name | Joseph Krainin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386792307 PECOS PAC ID: 2567557176 Enrollment ID: I20160226000610 |
| Provider Name | Kemble Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205292703 PECOS PAC ID: 5597062398 Enrollment ID: I20160322001731 |
| Provider Name | Michael J Jones |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033475793 PECOS PAC ID: 2163667866 Enrollment ID: I20160408000936 |
| Provider Name | Laura J Christensen |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1093176083 PECOS PAC ID: 5092013797 Enrollment ID: I20160413001403 |
| Provider Name | Michael J Wilder |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982861191 PECOS PAC ID: 1254487341 Enrollment ID: I20160415000374 |
| Provider Name | Orlene Hoskinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396078937 PECOS PAC ID: 1759697980 Enrollment ID: I20160502000991 |
| Provider Name | Maggie T Drake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265899710 PECOS PAC ID: 2163721572 Enrollment ID: I20160505000988 |
| Provider Name | Holly M Shillington |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477878825 PECOS PAC ID: 2264721471 Enrollment ID: I20160511001306 |
| Provider Name | Linda F Mcintyre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437510765 PECOS PAC ID: 9335438019 Enrollment ID: I20160519001077 |
| Provider Name | Stephen D Hubbard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679911432 PECOS PAC ID: 1658696794 Enrollment ID: I20160614002688 |
| Provider Name | Sarah G Keating |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679966634 PECOS PAC ID: 9436440658 Enrollment ID: I20160620000720 |
| Provider Name | Alireza Parsoei |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871871533 PECOS PAC ID: 5193954766 Enrollment ID: I20160622002717 |
| Provider Name | Venugopal Komakula |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1407115181 PECOS PAC ID: 9133435118 Enrollment ID: I20160629000932 |
| Provider Name | Jamie T Rabot |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851527329 PECOS PAC ID: 2163714320 Enrollment ID: I20160707002287 |
| Provider Name | Morgan C Garvin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558676049 PECOS PAC ID: 7911148861 Enrollment ID: I20160707002497 |
| Provider Name | Tiffany Debra Kamrath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942586417 PECOS PAC ID: 3870738297 Enrollment ID: I20160708000227 |
| Provider Name | Katelyn A Clark |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366732729 PECOS PAC ID: 7911143201 Enrollment ID: I20160727000078 |
| Provider Name | Eric A Johnson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881836724 PECOS PAC ID: 4587810080 Enrollment ID: I20160804002517 |
| Provider Name | Anna T Dooley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265710537 PECOS PAC ID: 4981871373 Enrollment ID: I20160819002047 |
| Provider Name | Kenneth Mccarley |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1235230707 PECOS PAC ID: 7911171129 Enrollment ID: I20160908001112 |
| Provider Name | Mailynn A Mitchell-sanchez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205157757 PECOS PAC ID: 5799947081 Enrollment ID: I20160908002928 |
| Provider Name | Marlene E Dietrich |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1124088406 PECOS PAC ID: 8426945635 Enrollment ID: I20161005001706 |
| Provider Name | Leda Mae T Rabot Cura |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154515781 PECOS PAC ID: 0143530840 Enrollment ID: I20161016000003 |
| Provider Name | Raymond C Ray |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1013229293 PECOS PAC ID: 9739369372 Enrollment ID: I20161017000733 |
| Provider Name | Titus B Kosgei |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376099572 PECOS PAC ID: 9931487949 Enrollment ID: I20161026001283 |
| Provider Name | Paul G Bouressa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366414047 PECOS PAC ID: 9032498266 Enrollment ID: I20161110002470 |
| Provider Name | Samantha M Radel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548713399 PECOS PAC ID: 0941589493 Enrollment ID: I20161128001153 |
| Provider Name | Amy V Mann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760517098 PECOS PAC ID: 6507939634 Enrollment ID: I20161130000857 |
| Provider Name | Marion O Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205086253 PECOS PAC ID: 2062541451 Enrollment ID: I20170125002320 |
| Provider Name | Morgan K Shasteen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851707814 PECOS PAC ID: 9436468600 Enrollment ID: I20170220001037 |
| Provider Name | Fay Y Sunada |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790753796 PECOS PAC ID: 1052695434 Enrollment ID: I20170302001689 |
| Provider Name | Bonnie M Mcirvin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487938957 PECOS PAC ID: 0042595860 Enrollment ID: I20170317001649 |
| Provider Name | Colleen Conway-edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770023731 PECOS PAC ID: 8224313960 Enrollment ID: I20170321001481 |
| Provider Name | Courtney L Apker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104363878 PECOS PAC ID: 1951686195 Enrollment ID: I20170330000782 |
| Provider Name | Sarah E Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164574091 PECOS PAC ID: 1759667843 Enrollment ID: I20170403002098 |
| Provider Name | Melody R Stupey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821022419 PECOS PAC ID: 1456364165 Enrollment ID: I20170425003169 |
| Provider Name | Margareth Saldanha |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1235387291 PECOS PAC ID: 0143345827 Enrollment ID: I20170508002069 |
| Provider Name | Priscilla S Park |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518094507 PECOS PAC ID: 8224251905 Enrollment ID: I20170511000868 |
| Provider Name | Logan J Mcghan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689965204 PECOS PAC ID: 7113229865 Enrollment ID: I20170517000006 |
| Provider Name | Nicole Shirvani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295175347 PECOS PAC ID: 7315215522 Enrollment ID: I20170612002686 |
| Provider Name | Amber Vester |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942629126 PECOS PAC ID: 9638447410 Enrollment ID: I20170620001585 |
| Provider Name | Natalia Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033645213 PECOS PAC ID: 7214205962 Enrollment ID: I20170621001362 |
| Provider Name | Tyler D Grissom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700168804 PECOS PAC ID: 2163790833 Enrollment ID: I20170621002049 |
| Provider Name | Sarah Beth Flanders |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154687606 PECOS PAC ID: 6709017080 Enrollment ID: I20170621002768 |
| Provider Name | Miranda D Lanning |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609219989 PECOS PAC ID: 6406126804 Enrollment ID: I20170718001530 |
| Provider Name | Tracy L Schmitz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629143367 PECOS PAC ID: 3678844404 Enrollment ID: I20170811002461 |
| Provider Name | Jason O Keister |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073928438 PECOS PAC ID: 2668699414 Enrollment ID: I20170822003854 |
| Provider Name | Deanna Dahlem |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1386793495 PECOS PAC ID: 3971685165 Enrollment ID: I20170911002310 |
| Provider Name | Janice R Howard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861946188 PECOS PAC ID: 2567736093 Enrollment ID: I20170922001053 |
| Provider Name | Kelly R Quinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639456379 PECOS PAC ID: 8729253398 Enrollment ID: I20171018002428 |
| Provider Name | Heidi Marie Semple |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205355740 PECOS PAC ID: 9032485735 Enrollment ID: I20171025000553 |
| Provider Name | Lisa Braun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770925265 PECOS PAC ID: 4486898988 Enrollment ID: I20171117002741 |
| Provider Name | Rachel A Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104282102 PECOS PAC ID: 6608133871 Enrollment ID: I20171122002085 |
| Provider Name | Kathleen Rubio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629484472 PECOS PAC ID: 4880960012 Enrollment ID: I20171214002920 |
| Provider Name | Tracy T Nguyen |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841592441 PECOS PAC ID: 1153680764 Enrollment ID: I20180104001619 |
| Provider Name | Hannah D Beeching |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467576272 PECOS PAC ID: 8527327030 Enrollment ID: I20180108003177 |
| Provider Name | Kenten D Woolhiser |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669470670 PECOS PAC ID: 6901891266 Enrollment ID: I20180109002454 |
| Provider Name | Angela R Zallen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871737726 PECOS PAC ID: 8820358906 Enrollment ID: I20180209001691 |
| Provider Name | Virginia L Dimitre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972021707 PECOS PAC ID: 4880954767 Enrollment ID: I20180214002756 |
| Provider Name | Ryan Wesneski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306298864 PECOS PAC ID: 2163783648 Enrollment ID: I20180223002373 |
| Provider Name | Katherine Cox |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1366990483 PECOS PAC ID: 9739440728 Enrollment ID: I20180308001656 |
| Provider Name | Valerie Baldwin-thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093713505 PECOS PAC ID: 3072554898 Enrollment ID: I20180315002023 |
| Provider Name | Monique Graves |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679851182 PECOS PAC ID: 6608135678 Enrollment ID: I20180402000862 |
| Provider Name | Ashley O Schmieding |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871972141 PECOS PAC ID: 1951666734 Enrollment ID: I20180525002175 |
| Provider Name | Mark Schuchman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467517300 PECOS PAC ID: 2961683487 Enrollment ID: I20180531002299 |
| Provider Name | Hiroe Toyama |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225041338 PECOS PAC ID: 4284927294 Enrollment ID: I20180711002534 |
| Provider Name | Priyanka Chandrasekhar Iyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427346881 PECOS PAC ID: 4284863564 Enrollment ID: I20180711003436 |
| Provider Name | Finn J Joehnk |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588630073 PECOS PAC ID: 7315294659 Enrollment ID: I20180718001864 |
| Provider Name | Roberto Cruz Barahona |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174860563 PECOS PAC ID: 2668729617 Enrollment ID: I20180720002759 |
| Provider Name | Julien Succar |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1700220811 PECOS PAC ID: 8820345705 Enrollment ID: I20180724001162 |
| Provider Name | Brandy Tolliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306370432 PECOS PAC ID: 1759639107 Enrollment ID: I20180801003416 |
| Provider Name | Iris V Guerrero Urena |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205276367 PECOS PAC ID: 2365790557 Enrollment ID: I20180803001709 |
| Provider Name | Devin Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790125649 PECOS PAC ID: 1052689163 Enrollment ID: I20180907000638 |
| Provider Name | Sydney Marie Lefay |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801215249 PECOS PAC ID: 7113216193 Enrollment ID: I20181029001864 |
| Provider Name | Verena C Samara |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1376886846 PECOS PAC ID: 0345564399 Enrollment ID: I20181029002937 |
| Provider Name | Michael A Hall |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1487134557 PECOS PAC ID: 3870847015 Enrollment ID: I20181107000908 |
| Provider Name | Jennifer L Mitchell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508244260 PECOS PAC ID: 6608169354 Enrollment ID: I20181107001291 |
| Provider Name | Glacel A Salagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962985408 PECOS PAC ID: 3577807957 Enrollment ID: I20181212001648 |
| Provider Name | Joeann C Pansoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679055594 PECOS PAC ID: 7911242045 Enrollment ID: I20181218003344 |
| Provider Name | Marie Didario |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740591304 PECOS PAC ID: 3678700291 Enrollment ID: I20181231001893 |
| Provider Name | Melody C Weitkamp |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1831665397 PECOS PAC ID: 7416294095 Enrollment ID: I20190122001154 |
| Provider Name | Crystal L Rowland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528374857 PECOS PAC ID: 8921347345 Enrollment ID: I20190301002152 |
| Provider Name | Shawn Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891264974 PECOS PAC ID: 2567702285 Enrollment ID: I20190315001994 |
| Provider Name | Melissa C Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689151920 PECOS PAC ID: 9739429275 Enrollment ID: I20190320002591 |
| Provider Name | Brock D Bernsten |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528070752 PECOS PAC ID: 5890036115 Enrollment ID: I20190412001784 |
| Provider Name | Amy N Kinkel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538383526 PECOS PAC ID: 1153654314 Enrollment ID: I20190604000857 |
| Provider Name | Noriko N Delacruz |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1902846702 PECOS PAC ID: 9739111493 Enrollment ID: I20190618003554 |
| Provider Name | Valeria Clarke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427370139 PECOS PAC ID: 8628305489 Enrollment ID: I20190816001102 |
| Provider Name | Victoria Perkins |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1659374676 PECOS PAC ID: 4082697537 Enrollment ID: I20190828001538 |
| Provider Name | Rachel L Zubko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578737342 PECOS PAC ID: 7012189889 Enrollment ID: I20190909003266 |
| Provider Name | Krista Dae Stieglitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114392842 PECOS PAC ID: 5193054591 Enrollment ID: I20190910003635 |
| Provider Name | Jeffrey D Crawford |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1003106071 PECOS PAC ID: 2769627462 Enrollment ID: I20190913000380 |
| Provider Name | Cierra B Hibbs Porter Rogge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033762901 PECOS PAC ID: 4981935988 Enrollment ID: I20191004002316 |
| Provider Name | Heidi A Grove |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952956492 PECOS PAC ID: 8325379258 Enrollment ID: I20191008001834 |
| Provider Name | Nicole F Drahuschak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144518788 PECOS PAC ID: 9537330162 Enrollment ID: I20191011001142 |
| Provider Name | Keely M Beach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407280134 PECOS PAC ID: 4981936143 Enrollment ID: I20191022000637 |
| Provider Name | Dustin K Mckague |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427618974 PECOS PAC ID: 6406188291 Enrollment ID: I20191028003162 |
| Provider Name | Jayme S Mcallister |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235589136 PECOS PAC ID: 0345536215 Enrollment ID: I20191113001039 |
| Provider Name | Eric Clayton Christensen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134577810 PECOS PAC ID: 6800228396 Enrollment ID: I20191121003127 |
| Provider Name | Haley Grace Ruljancich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821647173 PECOS PAC ID: 8820420292 Enrollment ID: I20191125000243 |
| Provider Name | Katherine E Omernick |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316396385 PECOS PAC ID: 9234424037 Enrollment ID: I20191125000695 |
| Provider Name | Alysha L Bennett |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902217748 PECOS PAC ID: 2769815190 Enrollment ID: I20191126000013 |
| Provider Name | David M Nadeau |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982000808 PECOS PAC ID: 6901117803 Enrollment ID: I20200123001871 |
| Provider Name | Michelle J Gohl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093345654 PECOS PAC ID: 9032546445 Enrollment ID: I20200225001137 |
| Provider Name | Shannon M Greenlee |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1558613604 PECOS PAC ID: 9739516022 Enrollment ID: I20200226001738 |
| Provider Name | Habib M Fanny |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1164837639 PECOS PAC ID: 4587881099 Enrollment ID: I20200305001626 |
| Provider Name | Lizzie I Colon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992115851 PECOS PAC ID: 1850729948 Enrollment ID: I20200324002328 |
| Provider Name | Emma E Sachs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740667419 PECOS PAC ID: 1759678675 Enrollment ID: I20200427002536 |
| Provider Name | Inga Marie Giske |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912471228 PECOS PAC ID: 1153752621 Enrollment ID: I20200518000683 |
| Provider Name | Sarbmeet S Mann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902320039 PECOS PAC ID: 0749602738 Enrollment ID: I20200619002148 |
| Provider Name | Sidra Manzoor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821510504 PECOS PAC ID: 6800218850 Enrollment ID: I20200626001953 |
| Provider Name | Richard A Mcewen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386968303 PECOS PAC ID: 4486928496 Enrollment ID: I20200713002392 |
| Provider Name | Christopher L White |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528377553 PECOS PAC ID: 1355577909 Enrollment ID: I20200714001998 |
| Provider Name | Joseph Severo Simon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285013375 PECOS PAC ID: 6103241732 Enrollment ID: I20200730000247 |
| Provider Name | Amilyn Taplin |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1295027472 PECOS PAC ID: 0648539130 Enrollment ID: I20200818001949 |
| Provider Name | Grace Tan |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1619389020 PECOS PAC ID: 8325262991 Enrollment ID: I20200824001658 |
| Provider Name | Alanna Hannegraf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710332986 PECOS PAC ID: 5294153904 Enrollment ID: I20200911002555 |
| Provider Name | Consuela E Perez-jefferis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710402177 PECOS PAC ID: 8123447968 Enrollment ID: I20200929001382 |
| Provider Name | Emily M Jaksich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336510635 PECOS PAC ID: 2062721830 Enrollment ID: I20201106001461 |
| Provider Name | Rachel A Hadley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477836351 PECOS PAC ID: 8820409212 Enrollment ID: I20201116000449 |
| Provider Name | Virginia Barak |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063948461 PECOS PAC ID: 5890106298 Enrollment ID: I20201116000614 |
| Provider Name | Tiffany Marie Noone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093314122 PECOS PAC ID: 6103237508 Enrollment ID: I20201116000833 |
| Provider Name | Seth E Cohen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508013269 PECOS PAC ID: 3779995121 Enrollment ID: I20201209001662 |
| Provider Name | Michael J Naughton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326401431 PECOS PAC ID: 6002229366 Enrollment ID: I20210105001280 |
| Provider Name | Maria-alejandra De Araujo Sanchez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902345457 PECOS PAC ID: 0143634550 Enrollment ID: I20210126003023 |
| Provider Name | Stephen James Ferney |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1043270358 PECOS PAC ID: 9133129992 Enrollment ID: I20210217001051 |
| Provider Name | Emily M Griffith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083276307 PECOS PAC ID: 3678804176 Enrollment ID: I20210224002585 |
| Provider Name | Sarah L Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215481163 PECOS PAC ID: 2163856162 Enrollment ID: I20210420001205 |
| Provider Name | Elizabeth Bellinger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821499377 PECOS PAC ID: 9335557966 Enrollment ID: I20210421000601 |
| Provider Name | Moina Snyder |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1760861801 PECOS PAC ID: 6406113174 Enrollment ID: I20210506002982 |
| Provider Name | Sandeep S Jhajj |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1174962369 PECOS PAC ID: 8022369941 Enrollment ID: I20210520003155 |
| Provider Name | Brian Mccarthy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336461813 PECOS PAC ID: 3072644228 Enrollment ID: I20210524000565 |
| Provider Name | Tamara K Barstow |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184696924 PECOS PAC ID: 2860892973 Enrollment ID: I20210610003571 |
| Provider Name | Ame Phitwong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255858247 PECOS PAC ID: 3375819675 Enrollment ID: I20210616000530 |
| Provider Name | Abhinav Tiwari |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1225411598 PECOS PAC ID: 9830494558 Enrollment ID: I20210629003471 |
| Provider Name | Arissa R Walberg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891185286 PECOS PAC ID: 2062709660 Enrollment ID: I20210723003226 |
| Provider Name | Paul C Benda |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790757557 PECOS PAC ID: 1850794611 Enrollment ID: I20210730002083 |
| Provider Name | Susan M Bertilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639208291 PECOS PAC ID: 5193129559 Enrollment ID: I20210806000841 |
| Provider Name | Shawn J John |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801374483 PECOS PAC ID: 1355693904 Enrollment ID: I20210810001571 |
| Provider Name | Suchita Kotnala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558854539 PECOS PAC ID: 0648674804 Enrollment ID: I20210810001953 |
| Provider Name | Katherine E Kunigelis |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1598108383 PECOS PAC ID: 0143461319 Enrollment ID: I20210810003065 |
| Provider Name | Maura Munoz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720407364 PECOS PAC ID: 8729206529 Enrollment ID: I20210813000754 |
| Provider Name | Irena Kuca |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366931644 PECOS PAC ID: 5092110940 Enrollment ID: I20210816003532 |
| Provider Name | Kelley F Shippey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245431105 PECOS PAC ID: 0345302949 Enrollment ID: I20210823002031 |
| Provider Name | James K Pohl |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1144239138 PECOS PAC ID: 9739268020 Enrollment ID: I20210907002074 |
| Provider Name | Sarah M Holtschlag |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326521196 PECOS PAC ID: 8224435573 Enrollment ID: I20210929001160 |
| Provider Name | Desirae Bloomquist |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699267963 PECOS PAC ID: 7618216300 Enrollment ID: I20211011002415 |
| Provider Name | Kirsten D Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013400555 PECOS PAC ID: 7618205287 Enrollment ID: I20211018001084 |
| Provider Name | Dennis G Polzin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447757885 PECOS PAC ID: 1557751997 Enrollment ID: I20211129002440 |
| Provider Name | Jorge Francisco Ganem |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306075395 PECOS PAC ID: 4880851237 Enrollment ID: I20211130002277 |
| Provider Name | Christopher M Kalinyak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730168287 PECOS PAC ID: 9537189493 Enrollment ID: I20211207000847 |
| Provider Name | Thomasean Britten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790195386 PECOS PAC ID: 3072730662 Enrollment ID: I20211214002785 |
| Provider Name | Lydia Fazzio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770986176 PECOS PAC ID: 0749503993 Enrollment ID: I20220111001502 |
| Provider Name | Carol Lydia Wiediger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033285242 PECOS PAC ID: 2567546773 Enrollment ID: I20220308002640 |
| Provider Name | Erica Rose Yolanda Sprado |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649672882 PECOS PAC ID: 7517352370 Enrollment ID: I20220315001426 |
| Provider Name | Jonathan W. Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023641743 PECOS PAC ID: 2769729060 Enrollment ID: I20220404002010 |
| Provider Name | Nicholas Crall |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316262645 PECOS PAC ID: 3274761333 Enrollment ID: I20220421001341 |
| Provider Name | Julie Tenbrook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164417606 PECOS PAC ID: 6709876279 Enrollment ID: I20220425002464 |
| Provider Name | Aaron Gabriel Jacobs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609395912 PECOS PAC ID: 8325425507 Enrollment ID: I20220509000943 |
| Provider Name | Alp Ozpinar |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1417397233 PECOS PAC ID: 9436538774 Enrollment ID: I20220616002796 |
| Provider Name | Jeffrey Lynn Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073965992 PECOS PAC ID: 6103206396 Enrollment ID: I20220706001015 |
| Provider Name | Kristi Mckenzie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265742811 PECOS PAC ID: 1254712672 Enrollment ID: I20220718000690 |
| Provider Name | Shanna Swezey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265827265 PECOS PAC ID: 6204217045 Enrollment ID: I20220725003014 |
| Provider Name | Reena Baharani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659631950 PECOS PAC ID: 5395018865 Enrollment ID: I20220804001265 |
| Provider Name | Palak Dwarkesh Parikh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295909331 PECOS PAC ID: 2668629205 Enrollment ID: I20220815000887 |
| Provider Name | Megan Dorenkamp |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1417307042 PECOS PAC ID: 5395129027 Enrollment ID: I20220830002730 |
| Provider Name | Sally L Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134850043 PECOS PAC ID: 5092199745 Enrollment ID: I20220830003856 |
| Provider Name | Khuram Ameen |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1881600450 PECOS PAC ID: 6406800192 Enrollment ID: I20220915003935 |
| Provider Name | Sarah Cook |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487944450 PECOS PAC ID: 9931415528 Enrollment ID: I20220921002912 |
| Provider Name | Sabo Uba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508106873 PECOS PAC ID: 4385889849 Enrollment ID: I20221003000681 |
| Provider Name | Wendy Maurer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588093264 PECOS PAC ID: 9537545256 Enrollment ID: I20221004002599 |
| Provider Name | Dela Amoussou |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639464431 PECOS PAC ID: 0941441356 Enrollment ID: I20221014000644 |
| Provider Name | Robert Elder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740635531 PECOS PAC ID: 8527471259 Enrollment ID: I20221014002623 |
| Provider Name | Maximilian Taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699206193 PECOS PAC ID: 4284961525 Enrollment ID: I20221017001868 |
| Provider Name | Megan C Bowers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659660678 PECOS PAC ID: 1557763927 Enrollment ID: I20221019002036 |
| Provider Name | Alexandria Lennetta Davidson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962843243 PECOS PAC ID: 4587031554 Enrollment ID: I20221103001734 |
| Provider Name | Sophie Claire Feller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134514540 PECOS PAC ID: 0446580260 Enrollment ID: I20221114000251 |
| Provider Name | Audra Michelle Landry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770728701 PECOS PAC ID: 2062880438 Enrollment ID: I20221116002631 |
| Provider Name | Ashna Wadhawan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366002776 PECOS PAC ID: 6608102579 Enrollment ID: I20221117000129 |
| Provider Name | Jessica Hammond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811329105 PECOS PAC ID: 5294104485 Enrollment ID: I20221209001944 |
| Provider Name | Pennapa Chan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457405128 PECOS PAC ID: 2163418336 Enrollment ID: I20221227001541 |
| Provider Name | Angie Lynn Wharfield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376561548 PECOS PAC ID: 0345610242 Enrollment ID: I20230111000951 |
| Provider Name | Ali Sangi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083268494 PECOS PAC ID: 8325377401 Enrollment ID: I20230118002318 |
| Provider Name | Anita Dhulipalli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457911042 PECOS PAC ID: 0345571915 Enrollment ID: I20230206002103 |
| Provider Name | Irma Magdalena Moody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831861335 PECOS PAC ID: 1658743141 Enrollment ID: I20230209001430 |
| Provider Name | Byron Patrick Elliott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538819990 PECOS PAC ID: 2264804244 Enrollment ID: I20230221002612 |
| Provider Name | Peter Grubel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376531335 PECOS PAC ID: 3375610173 Enrollment ID: I20230224000604 |
| Provider Name | Patricia Kapsner |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1710993464 PECOS PAC ID: 6103903158 Enrollment ID: I20230228001717 |
| Provider Name | Marlene Joy Monette-showker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053600395 PECOS PAC ID: 4587037106 Enrollment ID: I20230302000307 |
| Provider Name | Cassidy Bachelot |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1962114074 PECOS PAC ID: 6406229939 Enrollment ID: I20230303002213 |
| Provider Name | Joan Tompkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700013109 PECOS PAC ID: 5890168256 Enrollment ID: I20230306001049 |
| Provider Name | Allison Lynn O'brien |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982824108 PECOS PAC ID: 9638356017 Enrollment ID: I20230307002978 |
| Provider Name | Benjamin J Smith |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1760730907 PECOS PAC ID: 3779852892 Enrollment ID: I20230407000522 |
| Provider Name | Ann Tsai |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801349592 PECOS PAC ID: 1355716713 Enrollment ID: I20230417002474 |
| Provider Name | Mashael Don-nell Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689833196 PECOS PAC ID: 8325403017 Enrollment ID: I20230502003243 |
| Provider Name | Heidi F Lopez Coonjohn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679581508 PECOS PAC ID: 7810901055 Enrollment ID: I20230504002723 |
| Provider Name | Virginia Durrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073281069 PECOS PAC ID: 2365839297 Enrollment ID: I20230508002831 |
| Provider Name | Genevieve Murstig |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1285245696 PECOS PAC ID: 1850757048 Enrollment ID: I20230512001847 |
| Provider Name | Donald L Pierce |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790197523 PECOS PAC ID: 4880811264 Enrollment ID: I20230517002436 |
| Provider Name | Anna Higgins Nothum |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1336843960 PECOS PAC ID: 5294191979 Enrollment ID: I20230523000999 |
| Provider Name | Joshua A Skufca |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760863369 PECOS PAC ID: 9032423181 Enrollment ID: I20230523001042 |
| Provider Name | Janette Coelho Leal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992090708 PECOS PAC ID: 4981844305 Enrollment ID: I20230523002747 |
| Provider Name | Jonathan Lin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1578668927 PECOS PAC ID: 3375540404 Enrollment ID: I20230525001942 |
| Provider Name | Leah Fertig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871293886 PECOS PAC ID: 0749647964 Enrollment ID: I20230602002255 |
| Provider Name | Kodjovi Kodjo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780100958 PECOS PAC ID: 7517203177 Enrollment ID: I20230607001792 |
| Provider Name | Nathaniel Avila |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346683323 PECOS PAC ID: 6305132556 Enrollment ID: I20230608002448 |
| Provider Name | Rodney Camp |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972568228 PECOS PAC ID: 5698787943 Enrollment ID: I20230612002136 |
| Provider Name | Frank Chen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1841670007 PECOS PAC ID: 8022310093 Enrollment ID: I20230629003158 |
| Provider Name | Chalapathi Rao Medavarapu |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1750876868 PECOS PAC ID: 8325407547 Enrollment ID: I20230706002832 |
| Provider Name | Michael Zammit |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1841251188 PECOS PAC ID: 5496658213 Enrollment ID: I20230724001398 |
| Provider Name | Khaled Mohamed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124049861 PECOS PAC ID: 7012905367 Enrollment ID: I20230809000187 |
| Provider Name | Elijah John Strong Lotz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437542446 PECOS PAC ID: 7416223383 Enrollment ID: I20230821001968 |
| Provider Name | Judith Raboy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447706841 PECOS PAC ID: 4587943436 Enrollment ID: I20230823002926 |
| Provider Name | Jose Francisco Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669086641 PECOS PAC ID: 4183043383 Enrollment ID: I20230824002628 |
| Provider Name | Alexander Tal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306879374 PECOS PAC ID: 9234309493 Enrollment ID: I20230828003170 |
| Provider Name | Cory Scott |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1073037495 PECOS PAC ID: 3375805260 Enrollment ID: I20230829004470 |
| Provider Name | David James Nestor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306481916 PECOS PAC ID: 6608232780 Enrollment ID: I20230906001211 |
| Provider Name | Sherifat Forcey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043861438 PECOS PAC ID: 8022442235 Enrollment ID: I20230925000635 |
| Provider Name | Allan Young |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659514321 PECOS PAC ID: 8426338872 Enrollment ID: I20230929001370 |
| Provider Name | Jeff Wong |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1205369485 PECOS PAC ID: 3476953712 Enrollment ID: I20231003001934 |
| Provider Name | Hershenta Cohen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619466844 PECOS PAC ID: 6204213325 Enrollment ID: I20231018001778 |
| Provider Name | Nicholas Bryce Woods |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699126011 PECOS PAC ID: 7315392867 Enrollment ID: I20231018002659 |
| Provider Name | Nadia Swanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902093925 PECOS PAC ID: 2860540754 Enrollment ID: I20231108001925 |
| Provider Name | Stephens Taylor |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1508841966 PECOS PAC ID: 9234031550 Enrollment ID: I20231127002773 |
| Provider Name | Jeffry Jacobs |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063477545 PECOS PAC ID: 7113961012 Enrollment ID: I20231222002631 |
| Provider Name | Kelly Grace Shaw |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1962068650 PECOS PAC ID: 3375993579 Enrollment ID: I20240101000368 |
| Provider Name | Beverly Shoopman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568665669 PECOS PAC ID: 5193175123 Enrollment ID: I20240103000688 |
| Provider Name | Laura Schulte |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1972930907 PECOS PAC ID: 4385095348 Enrollment ID: I20240104000829 |
| Provider Name | Shirley Ann Spencer |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1306397666 PECOS PAC ID: 5496106957 Enrollment ID: I20240109002268 |
| Provider Name | Bradley Roe Shumate |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558607994 PECOS PAC ID: 1658618335 Enrollment ID: I20240109004356 |
| Provider Name | Paul Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447662796 PECOS PAC ID: 1759732969 Enrollment ID: I20240111002260 |
| Provider Name | David A Neale |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083739957 PECOS PAC ID: 4880045079 Enrollment ID: I20240112000084 |
| Provider Name | Karen Marie |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659937142 PECOS PAC ID: 4688025877 Enrollment ID: I20240112000146 |
| Provider Name | Brandon Pipkin |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1356659395 PECOS PAC ID: 8022355700 Enrollment ID: I20240112002669 |
| Provider Name | Candice Anne Elliott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225312929 PECOS PAC ID: 7911359641 Enrollment ID: I20240118002497 |
| Provider Name | Anthony Rios |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194952911 PECOS PAC ID: 0244500742 Enrollment ID: I20240124002858 |
| Provider Name | Joseph Steiner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346270964 PECOS PAC ID: 8224481007 Enrollment ID: I20240129001080 |
| Provider Name | Nicholas Hamilton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811013840 PECOS PAC ID: 0143384370 Enrollment ID: I20240206001669 |
| Provider Name | Phung Le |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1932424066 PECOS PAC ID: 9436448479 Enrollment ID: I20240206004002 |
| Provider Name | Chaine Mabray |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1679974166 PECOS PAC ID: 5799129839 Enrollment ID: I20240216002779 |
| Provider Name | William David Chance Young |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386267516 PECOS PAC ID: 8921442856 Enrollment ID: I20240220001346 |
| Provider Name | Gabriele Morrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356054118 PECOS PAC ID: 1052755691 Enrollment ID: I20240222000375 |
| Provider Name | Madalyn Taylor |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699538777 PECOS PAC ID: 5597100800 Enrollment ID: I20240227000806 |
| Provider Name | Mark Morasch |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1790719219 PECOS PAC ID: 0648300533 Enrollment ID: I20240229001895 |
| Provider Name | Andria Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457502486 PECOS PAC ID: 7810332491 Enrollment ID: I20240305003636 |
| Provider Name | Terese Jay |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023495371 PECOS PAC ID: 5193161503 Enrollment ID: I20240307003035 |
| Provider Name | Shelly Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689044026 PECOS PAC ID: 4385947589 Enrollment ID: I20240311002187 |
| Provider Name | Rodney James Deaton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003934274 PECOS PAC ID: 8921240425 Enrollment ID: I20240401003225 |
| Provider Name | James Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962437988 PECOS PAC ID: 8022908797 Enrollment ID: I20240411000703 |
| Provider Name | Ryan L Hargraves |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306983556 PECOS PAC ID: 9234500745 Enrollment ID: I20240412003934 |
| Provider Name | Erin Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376982678 PECOS PAC ID: 1557700598 Enrollment ID: I20240423003271 |
| Provider Name | Lynzy Lonette Elzinga Weekes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083495584 PECOS PAC ID: 9638510266 Enrollment ID: I20240514003806 |
| Provider Name | Camille Claire Rain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346891603 PECOS PAC ID: 7012330400 Enrollment ID: I20240518000421 |
| Provider Name | Andrei Gasic |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184623407 PECOS PAC ID: 3779550009 Enrollment ID: I20240520002042 |
| Provider Name | Elizabeth Finley-belgrad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780780304 PECOS PAC ID: 2365697406 Enrollment ID: I20240530003201 |
Emerald Tms, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1140 Willagillespie Rd Ste 44, Eugene, OR 97401 Phone: 541-735-3241 | |
Looking Glass Youth & Family Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2655 Mlk Jr Blvd, Eugene, OR 97401 Phone: 541-682-7950 | |
Looking Glass Youth & Family Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2655 Martin Luther King Jr Blvd, Eugene, OR 97401 Phone: 541-682-7950 | |
University Of Oregon Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1590 East 13th Avenue, Eugene, OR 97403 Phone: 541-346-3227 Fax: 541-346-2842 | |
Steve Pethick, Phd Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 401 E 10th Ave Ste 530, Eugene, OR 97401 Phone: 541-687-7787 Fax: 855-646-7433 | |
Behavioral Health Center Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 399 E 10th Ave, Suite #113, Eugene, OR 97401 Phone: 541-342-8208 Fax: 541-687-8159 | |
New Destiny Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5 E 24th Ave, Eugene, OR 97405 Phone: 541-515-0900 Fax: 541-799-0789 |