| Sanford Clinic Tracy | |
|
249 5th St E Tracy MN 56175-1536 | |
| (507) 629-3520 | |
| (507) 212-4199 |
| Full Name | Sanford Clinic Tracy |
|---|---|
| Speciality | Family Medicine |
| Location | 249 5th St E, Tracy, Minnesota |
| Authorized Official Name and Position | Tony Lee Morrison (VICE PRESIDENT, REVENUE CYCLE) |
| Authorized Official Contact | 6053288380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sanford Clinic Tracy Po Box 5074 Sioux Falls SD 57117-5074 Ph: (605) 328-6585 | Sanford Clinic Tracy 249 5th St E Tracy MN 56175-1536 Ph: (507) 629-3520 |
| NPI Number | 1699869875 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 11/27/2023 |
| Certification Date | 07/02/2020 |
| Medicare PECOS PAC ID | 6800707100 |
|---|---|
| Medicare Enrollment ID | O20040715001116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699869875 | NPI | - | NPPES |
| Provider Name | Amer G Qazi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720050560 PECOS PAC ID: 3375437510 Enrollment ID: I20040210000385 |
| Provider Name | Brian C Aamlid |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1710984133 PECOS PAC ID: 7517959943 Enrollment ID: I20040402000979 |
| Provider Name | Rodney W Dynes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356314223 PECOS PAC ID: 0941298657 Enrollment ID: I20040503000818 |
| Provider Name | Ronald F Kline |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922088855 PECOS PAC ID: 5799774592 Enrollment ID: I20040507000629 |
| Provider Name | Jason D Klein |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477520542 PECOS PAC ID: 7911996228 Enrollment ID: I20040511001284 |
| Provider Name | Mark A Rawson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407836224 PECOS PAC ID: 4284613316 Enrollment ID: I20040714000371 |
| Provider Name | John H. L. Odom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215953732 PECOS PAC ID: 3274502455 Enrollment ID: I20040927000127 |
| Provider Name | Theresa M Stamato |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649225129 PECOS PAC ID: 3173504750 Enrollment ID: I20041022000506 |
| Provider Name | Anwar Khokhar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477661825 PECOS PAC ID: 6709848344 Enrollment ID: I20041027000445 |
| Provider Name | Karen A Uecker-bezdicek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588661995 PECOS PAC ID: 0648233171 Enrollment ID: I20041105000741 |
| Provider Name | Tomasz P Stys |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1891790978 PECOS PAC ID: 9537155650 Enrollment ID: I20041111000596 |
| Provider Name | Christopher Previn Peck |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912959313 PECOS PAC ID: 2668438482 Enrollment ID: I20041203000376 |
| Provider Name | Betty Kemper |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033155205 PECOS PAC ID: 3779478706 Enrollment ID: I20050210000245 |
| Provider Name | Carol J Campbell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407834534 PECOS PAC ID: 1557316098 Enrollment ID: I20050317000102 |
| Provider Name | Jalal U Akbar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720063795 PECOS PAC ID: 3971559626 Enrollment ID: I20050324001062 |
| Provider Name | Kelly J Hoffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033126503 PECOS PAC ID: 9537116637 Enrollment ID: I20050331000912 |
| Provider Name | Timothy A Klassen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003973157 PECOS PAC ID: 6002840931 Enrollment ID: I20050921000097 |
| Provider Name | Esther Doele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730191990 PECOS PAC ID: 6800811332 Enrollment ID: I20051013000177 |
| Provider Name | Fred L Webber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770508103 PECOS PAC ID: 0648296996 Enrollment ID: I20051017000712 |
| Provider Name | Robin R Uithoven |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255392353 PECOS PAC ID: 8820016850 Enrollment ID: I20051108000379 |
| Provider Name | Alicia A Frankwitz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720027303 PECOS PAC ID: 9234159450 Enrollment ID: I20051202000518 |
| Provider Name | Amy Lynn Winter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790750875 PECOS PAC ID: 0547283640 Enrollment ID: I20060104000269 |
| Provider Name | Robert M Smith |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1538113337 PECOS PAC ID: 9032190434 Enrollment ID: I20060201000293 |
| Provider Name | Adam T Stys |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1083656821 PECOS PAC ID: 5496736019 Enrollment ID: I20061113000295 |
| Provider Name | Dawn M Bos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053323345 PECOS PAC ID: 8022017888 Enrollment ID: I20061206000038 |
| Provider Name | Theresa A Person |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689688921 PECOS PAC ID: 7618976663 Enrollment ID: I20061220000426 |
| Provider Name | Ali B Shehata |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205997665 PECOS PAC ID: 6002890647 Enrollment ID: I20070221000103 |
| Provider Name | Wendy A Vanderkooi |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710952478 PECOS PAC ID: 9032213087 Enrollment ID: I20070330000262 |
| Provider Name | John C Yu |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1922005461 PECOS PAC ID: 0345262929 Enrollment ID: I20070418000415 |
| Provider Name | Viorel I Guter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194813287 PECOS PAC ID: 0345280152 Enrollment ID: I20070711000222 |
| Provider Name | Joseph D Scuderi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043292253 PECOS PAC ID: 7517957988 Enrollment ID: I20070830000695 |
| Provider Name | Loretta R Krahn |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821088725 PECOS PAC ID: 0941396261 Enrollment ID: I20071018000277 |
| Provider Name | Neil K Jessen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1205800646 PECOS PAC ID: 4486615580 Enrollment ID: I20071025000347 |
| Provider Name | Stacey J Jumbeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417024993 PECOS PAC ID: 9638266455 Enrollment ID: I20071025000629 |
| Provider Name | Jennifer Thone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386616704 PECOS PAC ID: 8224062914 Enrollment ID: I20071029000748 |
| Provider Name | Louisa Paul |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932328226 PECOS PAC ID: 1557458023 Enrollment ID: I20071030000607 |
| Provider Name | Lindy Cyrus Eatwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124132956 PECOS PAC ID: 8426042573 Enrollment ID: I20071110000109 |
| Provider Name | Michael B Rath |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013996008 PECOS PAC ID: 3678580628 Enrollment ID: I20071220000176 |
| Provider Name | Elmer D Calica |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932392438 PECOS PAC ID: 6507953825 Enrollment ID: I20080110000611 |
| Provider Name | Erika I Freking |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487840005 PECOS PAC ID: 7113008871 Enrollment ID: I20080118000514 |
| Provider Name | Michael L Moeller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598765877 PECOS PAC ID: 2365437274 Enrollment ID: I20080326000865 |
| Provider Name | Kimberly J Haycraft Schmotter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306800107 PECOS PAC ID: 7810073855 Enrollment ID: I20080331000428 |
| Provider Name | Roland Armstrong |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265450969 PECOS PAC ID: 0143122648 Enrollment ID: I20080403000447 |
| Provider Name | Laurie B Landeen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043216799 PECOS PAC ID: 5193808327 Enrollment ID: I20080409000464 |
| Provider Name | Lachelle J Wieme |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568635068 PECOS PAC ID: 2860571981 Enrollment ID: I20080430000786 |
| Provider Name | Kathleen J Harder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174707848 PECOS PAC ID: 5597834762 Enrollment ID: I20080514000801 |
| Provider Name | Tara J Denke |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1124210398 PECOS PAC ID: 7618046459 Enrollment ID: I20080519000792 |
| Provider Name | Mark R Dahlquist |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1225044118 PECOS PAC ID: 3072529460 Enrollment ID: I20080530000587 |
| Provider Name | Rajesh Singh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710933684 PECOS PAC ID: 5092767087 Enrollment ID: I20080618000126 |
| Provider Name | Gordon D Kaplan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588606735 PECOS PAC ID: 7911948757 Enrollment ID: I20080702000014 |
| Provider Name | Ronald M Haan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1861425753 PECOS PAC ID: 9537183165 Enrollment ID: I20080715000488 |
| Provider Name | Ramon A Issa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891748836 PECOS PAC ID: 9234104910 Enrollment ID: I20080807000118 |
| Provider Name | Gaddum H Reddy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356389118 PECOS PAC ID: 9739156746 Enrollment ID: I20080814000278 |
| Provider Name | Janice D Briones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386804532 PECOS PAC ID: 4183782568 Enrollment ID: I20081029000614 |
| Provider Name | Erika K Beckett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861649071 PECOS PAC ID: 9638230279 Enrollment ID: I20081202000100 |
| Provider Name | Debra Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285611616 PECOS PAC ID: 3173587342 Enrollment ID: I20090205000609 |
| Provider Name | Jeffrey Eikanger |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699793653 PECOS PAC ID: 0749241586 Enrollment ID: I20090217000723 |
| Provider Name | Ram Prasad Paneru |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740457902 PECOS PAC ID: 7719043926 Enrollment ID: I20090312000344 |
| Provider Name | Roderick Ralph Byron |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003849092 PECOS PAC ID: 7416013651 Enrollment ID: I20090312000676 |
| Provider Name | Ibkhan Ansine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194786467 PECOS PAC ID: 7214084185 Enrollment ID: I20090409000659 |
| Provider Name | Hector E Aybar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538171962 PECOS PAC ID: 2668520693 Enrollment ID: I20090501000192 |
| Provider Name | Jonathan S Bleeker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457573974 PECOS PAC ID: 2860557998 Enrollment ID: I20091012000375 |
| Provider Name | Michael S Towey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376553164 PECOS PAC ID: 3577609114 Enrollment ID: I20091012000499 |
| Provider Name | Jonathan H Pap |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235360173 PECOS PAC ID: 1254478563 Enrollment ID: I20091019000550 |
| Provider Name | Jennifer L Hoefert |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760672984 PECOS PAC ID: 7214074475 Enrollment ID: I20091021000500 |
| Provider Name | Brooke D Vandenhoek |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669604013 PECOS PAC ID: 6406993302 Enrollment ID: I20091026000630 |
| Provider Name | Stephen M Winselman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942262225 PECOS PAC ID: 2365583929 Enrollment ID: I20100105000704 |
| Provider Name | Brenna L Tate |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1164756243 PECOS PAC ID: 4981745015 Enrollment ID: I20100111000612 |
| Provider Name | Diane L Kennedy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316939721 PECOS PAC ID: 1951443498 Enrollment ID: I20100122000115 |
| Provider Name | Joshua J Crabtree |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538151949 PECOS PAC ID: 9830231372 Enrollment ID: I20100122000141 |
| Provider Name | Richard J Morgan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447242870 PECOS PAC ID: 7719882836 Enrollment ID: I20100122000157 |
| Provider Name | Maritza Lopez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598777948 PECOS PAC ID: 0648312009 Enrollment ID: I20100122000393 |
| Provider Name | Jane K Willett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548236292 PECOS PAC ID: 4789727769 Enrollment ID: I20100130000350 |
| Provider Name | Judy S Chesley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780676189 PECOS PAC ID: 0042353997 Enrollment ID: I20100201000684 |
| Provider Name | Stephan L Chesley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205828605 PECOS PAC ID: 0547303497 Enrollment ID: I20100201000714 |
| Provider Name | Glenn A Gaunt |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932183050 PECOS PAC ID: 3779487913 Enrollment ID: I20100218000754 |
| Provider Name | Charles O Dike |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003143256 PECOS PAC ID: 8820132160 Enrollment ID: I20100224000406 |
| Provider Name | William Mason Bone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750335055 PECOS PAC ID: 8628979002 Enrollment ID: I20100602000979 |
| Provider Name | Dawn R Bucher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992713739 PECOS PAC ID: 4587705744 Enrollment ID: I20100622000198 |
| Provider Name | Chalermkiat Thanasawat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255507877 PECOS PAC ID: 1052437464 Enrollment ID: I20100922001272 |
| Provider Name | Eric William Simons |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598762577 PECOS PAC ID: 8820069222 Enrollment ID: I20101020000593 |
| Provider Name | Louis J Sonstegard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427010214 PECOS PAC ID: 9830382712 Enrollment ID: I20101023000241 |
| Provider Name | Craig P Mckay |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164528055 PECOS PAC ID: 8527098433 Enrollment ID: I20101111000748 |
| Provider Name | Efthimios A Bakalakos |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1407868706 PECOS PAC ID: 2163583162 Enrollment ID: I20101122000336 |
| Provider Name | Andrew J Kopperud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629294533 PECOS PAC ID: 0345392957 Enrollment ID: I20110210001068 |
| Provider Name | Anthony A Sierra |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942283163 PECOS PAC ID: 6901906114 Enrollment ID: I20110215001147 |
| Provider Name | Kristofer Kimber |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942493721 PECOS PAC ID: 2163575622 Enrollment ID: I20110224001011 |
| Provider Name | Justin K Kane |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487885745 PECOS PAC ID: 1850574443 Enrollment ID: I20110318000594 |
| Provider Name | Julie A Sherman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750688867 PECOS PAC ID: 7214112325 Enrollment ID: I20110504000395 |
| Provider Name | Marvin J Hobbs |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063710457 PECOS PAC ID: 5092991893 Enrollment ID: I20110511000822 |
| Provider Name | Rearabiloe Sebata |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275700254 PECOS PAC ID: 6507035573 Enrollment ID: I20110808000755 |
| Provider Name | Heather E Reber |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245444363 PECOS PAC ID: 4082883889 Enrollment ID: I20110812000168 |
| Provider Name | Margaret J Hart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942426689 PECOS PAC ID: 2769670918 Enrollment ID: I20110907001417 |
| Provider Name | Gretchen D Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336101849 PECOS PAC ID: 1658402862 Enrollment ID: I20110909002884 |
| Provider Name | Martin G Fedko |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134351430 PECOS PAC ID: 4981877594 Enrollment ID: I20111026000872 |
| Provider Name | Geoffrey T Tufty |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1104886654 PECOS PAC ID: 7618869678 Enrollment ID: I20111028000473 |
| Provider Name | Mohammad Qamar |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1104035955 PECOS PAC ID: 6002954195 Enrollment ID: I20111031000636 |
| Provider Name | Amanda L Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699056069 PECOS PAC ID: 8426220021 Enrollment ID: I20120131000230 |
| Provider Name | Brian D Lindaman |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912121229 PECOS PAC ID: 4183718315 Enrollment ID: I20120131000565 |
| Provider Name | Miranda M Pray Dede |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174668107 PECOS PAC ID: 5193828853 Enrollment ID: I20120209000425 |
| Provider Name | Setshedi Sebata |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245568500 PECOS PAC ID: 7012044571 Enrollment ID: I20120530000235 |
| Provider Name | Michelle D Vanhove |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679837413 PECOS PAC ID: 8820247828 Enrollment ID: I20121008000503 |
| Provider Name | Obinna E Nwadibia |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790940658 PECOS PAC ID: 0547431470 Enrollment ID: I20121018000656 |
| Provider Name | Kelly L Lillie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841555281 PECOS PAC ID: 2961654629 Enrollment ID: I20121204000486 |
| Provider Name | Hina Rahman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1114234986 PECOS PAC ID: 5890983647 Enrollment ID: I20130125000188 |
| Provider Name | Zachary R Nolz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205128055 PECOS PAC ID: 7214181924 Enrollment ID: I20130205000412 |
| Provider Name | Godfrey O Wabwire |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1225325459 PECOS PAC ID: 1759552722 Enrollment ID: I20130315000433 |
| Provider Name | Thomas B Matheson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558365106 PECOS PAC ID: 8921035213 Enrollment ID: I20130325000077 |
| Provider Name | David L Kallas |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902166911 PECOS PAC ID: 2961667969 Enrollment ID: I20130717000897 |
| Provider Name | Johnathon Michael Edward Aho |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639431026 PECOS PAC ID: 2567608383 Enrollment ID: I20130802000813 |
| Provider Name | Jennifer A Wesenberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497064059 PECOS PAC ID: 2365676251 Enrollment ID: I20131008001467 |
| Provider Name | Tomasz P Lis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003122151 PECOS PAC ID: 8325273832 Enrollment ID: I20131108000055 |
| Provider Name | Habiba Alero Ikoghode |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669783106 PECOS PAC ID: 5890933824 Enrollment ID: I20131112001927 |
| Provider Name | Peter Joachim Niemann |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669602918 PECOS PAC ID: 1557517950 Enrollment ID: I20131115000830 |
| Provider Name | Andrea L Roberts |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1295866507 PECOS PAC ID: 0547341513 Enrollment ID: I20131217000360 |
| Provider Name | Carolyn J Larson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760709240 PECOS PAC ID: 4082745294 Enrollment ID: I20140107001224 |
| Provider Name | Sohrab R Irani |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144225384 PECOS PAC ID: 4082629134 Enrollment ID: I20140114001487 |
| Provider Name | Todd S Kessler |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366453011 PECOS PAC ID: 0547413411 Enrollment ID: I20140226000058 |
| Provider Name | Nathalie Jean |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700134293 PECOS PAC ID: 2264663186 Enrollment ID: I20140320000269 |
| Provider Name | Geri M Bunkers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770905580 PECOS PAC ID: 1153554092 Enrollment ID: I20140430001598 |
| Provider Name | Nicholas J Harms |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295965457 PECOS PAC ID: 4486879426 Enrollment ID: I20140707000692 |
| Provider Name | Ahmad J Yusuf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992097992 PECOS PAC ID: 0042461071 Enrollment ID: I20140724000319 |
| Provider Name | Grant W Botker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295026532 PECOS PAC ID: 5294980009 Enrollment ID: I20140807002191 |
| Provider Name | Ricky C Jensen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1780685651 PECOS PAC ID: 2860490380 Enrollment ID: I20140819001147 |
| Provider Name | Giridhar Guntreddi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467706846 PECOS PAC ID: 8921227364 Enrollment ID: I20140916002583 |
| Provider Name | Karen Marie Schleehauf |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346244332 PECOS PAC ID: 8426039389 Enrollment ID: I20141009000402 |
| Provider Name | Sabrina Rae Sowles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649670316 PECOS PAC ID: 2365663945 Enrollment ID: I20141023001777 |
| Provider Name | Karen E Pennings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588660203 PECOS PAC ID: 0244274215 Enrollment ID: I20141122000284 |
| Provider Name | Theresa L Hurley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689077232 PECOS PAC ID: 2769704725 Enrollment ID: I20141201002346 |
| Provider Name | Micara L Kolander |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689093783 PECOS PAC ID: 9335364876 Enrollment ID: I20141205000880 |
| Provider Name | Tracy R Kramer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1780876052 PECOS PAC ID: 9830412816 Enrollment ID: I20141223001728 |
| Provider Name | Lisa B Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831161413 PECOS PAC ID: 1355377763 Enrollment ID: I20141224000937 |
| Provider Name | Naomi N Bach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003229204 PECOS PAC ID: 2466776513 Enrollment ID: I20150120000522 |
| Provider Name | Melissa J Magstadt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093794596 PECOS PAC ID: 8628053428 Enrollment ID: I20150120002130 |
| Provider Name | Kruti J Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043574262 PECOS PAC ID: 7012232218 Enrollment ID: I20150210002426 |
| Provider Name | Amadin O Osayomore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700198660 PECOS PAC ID: 2466694138 Enrollment ID: I20150218001454 |
| Provider Name | Douglas J Miedema |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720080237 PECOS PAC ID: 7911952296 Enrollment ID: I20150318002065 |
| Provider Name | Miroslaw A Mazurczak |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1437155140 PECOS PAC ID: 8921029554 Enrollment ID: I20150508000409 |
| Provider Name | Adam H Nichols |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1063856136 PECOS PAC ID: 3870816788 Enrollment ID: I20150509000112 |
| Provider Name | David Ray Jones |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174682843 PECOS PAC ID: 7517146806 Enrollment ID: I20150601002426 |
| Provider Name | Ryan J Becker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336431055 PECOS PAC ID: 6305089673 Enrollment ID: I20150702002053 |
| Provider Name | Abrea A Roark |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508156613 PECOS PAC ID: 9234441262 Enrollment ID: I20150706001629 |
| Provider Name | Mehdi Dastrange |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982967139 PECOS PAC ID: 4880906734 Enrollment ID: I20150706002597 |
| Provider Name | Brett Jon Glawe |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548589054 PECOS PAC ID: 9133367501 Enrollment ID: I20150827003288 |
| Provider Name | Kimberly A Versteeg |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790763043 PECOS PAC ID: 5294723334 Enrollment ID: I20151120001417 |
| Provider Name | Catherine S Sybrant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427054428 PECOS PAC ID: 0345365557 Enrollment ID: I20151216002827 |
| Provider Name | Thomas A Bruns |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1851763932 PECOS PAC ID: 4789985318 Enrollment ID: I20151223001345 |
| Provider Name | Bethany K Schultz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013263979 PECOS PAC ID: 6406007079 Enrollment ID: I20151223001512 |
| Provider Name | David J Springer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649353681 PECOS PAC ID: 9638113418 Enrollment ID: I20151223001790 |
| Provider Name | Dana L Mack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881067817 PECOS PAC ID: 3577864024 Enrollment ID: I20151229000731 |
| Provider Name | Robert W Harms |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942210687 PECOS PAC ID: 1557541448 Enrollment ID: I20160107001917 |
| Provider Name | Scott J Barnacle |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457346926 PECOS PAC ID: 1759457070 Enrollment ID: I20160215002414 |
| Provider Name | Tracy E Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649638339 PECOS PAC ID: 5890091995 Enrollment ID: I20160316001241 |
| Provider Name | Lindsey A Hanson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659716629 PECOS PAC ID: 3779712047 Enrollment ID: I20160412000742 |
| Provider Name | Rachael Dekker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033423322 PECOS PAC ID: 7719003565 Enrollment ID: I20160920001898 |
| Provider Name | Allison P Watson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750709739 PECOS PAC ID: 4284930439 Enrollment ID: I20160926000701 |
| Provider Name | Susan Halbritter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295788271 PECOS PAC ID: 8325042765 Enrollment ID: I20161013000736 |
| Provider Name | Eric James Jensen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1871922666 PECOS PAC ID: 6204066426 Enrollment ID: I20161024000961 |
| Provider Name | Worku A Metaferia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437500972 PECOS PAC ID: 1557640158 Enrollment ID: I20161123001235 |
| Provider Name | Amanda L Glanzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023565645 PECOS PAC ID: 8628358140 Enrollment ID: I20161129001245 |
| Provider Name | Sumit Bhandari |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1336452572 PECOS PAC ID: 2264627553 Enrollment ID: I20161208002529 |
| Provider Name | Polina B Rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700335551 PECOS PAC ID: 2062793508 Enrollment ID: I20161221001736 |
| Provider Name | April D Cook |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730325176 PECOS PAC ID: 8022171958 Enrollment ID: I20170113001050 |
| Provider Name | Gregory M Olszewski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952741050 PECOS PAC ID: 6608096748 Enrollment ID: I20170213002686 |
| Provider Name | Keely M Hack |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1184743148 PECOS PAC ID: 7810154671 Enrollment ID: I20170505000248 |
| Provider Name | Jennifer Marie Oakes |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215232350 PECOS PAC ID: 5193908234 Enrollment ID: I20170505001011 |
| Provider Name | Kayla J Pineda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285171579 PECOS PAC ID: 0244517977 Enrollment ID: I20170508000853 |
| Provider Name | Jacqueline R Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245644780 PECOS PAC ID: 3971808874 Enrollment ID: I20170511001170 |
| Provider Name | Blanca G Gomez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164807780 PECOS PAC ID: 3274800321 Enrollment ID: I20170522001826 |
| Provider Name | Erin A Moeller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235589797 PECOS PAC ID: 8820367220 Enrollment ID: I20170628000705 |
| Provider Name | Jessica L Grant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700210226 PECOS PAC ID: 8426322470 Enrollment ID: I20170914003158 |
| Provider Name | Joanne R Kingsley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497833446 PECOS PAC ID: 3779508874 Enrollment ID: I20170927003957 |
| Provider Name | Laura Davis Huggins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013335520 PECOS PAC ID: 9032337449 Enrollment ID: I20171004000053 |
| Provider Name | Nicole J Woodley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992148985 PECOS PAC ID: 4880999127 Enrollment ID: I20171006001769 |
| Provider Name | Megan S Hansen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568861607 PECOS PAC ID: 5991071276 Enrollment ID: I20171101002068 |
| Provider Name | Michelle L Kutzke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972995371 PECOS PAC ID: 3779865373 Enrollment ID: I20171106000393 |
| Provider Name | Susan J Goodemote |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912416124 PECOS PAC ID: 1658639760 Enrollment ID: I20171219002108 |
| Provider Name | Paige A Meester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215446802 PECOS PAC ID: 6709144421 Enrollment ID: I20180111000015 |
| Provider Name | Chelsea A Dewaard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497264063 PECOS PAC ID: 9931467263 Enrollment ID: I20180205002572 |
| Provider Name | Alyson J Malchow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073806006 PECOS PAC ID: 4284994468 Enrollment ID: I20180208000212 |
| Provider Name | Conrad G Hanstein |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972544369 PECOS PAC ID: 2567493299 Enrollment ID: I20180214001747 |
| Provider Name | Bailey A Dykema |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1942717046 PECOS PAC ID: 2769744069 Enrollment ID: I20180327000473 |
| Provider Name | Austin W Spronk |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801240502 PECOS PAC ID: 2365706165 Enrollment ID: I20180502002121 |
| Provider Name | Holly Marie Klink |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497255509 PECOS PAC ID: 6406101807 Enrollment ID: I20180626000015 |
| Provider Name | Jennifer J Pirkl |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104008424 PECOS PAC ID: 1052661402 Enrollment ID: I20180905001492 |
| Provider Name | Nicole J Grossenburg |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285755587 PECOS PAC ID: 5799971768 Enrollment ID: I20180918000782 |
| Provider Name | Katy M Zogg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548753684 PECOS PAC ID: 8628329687 Enrollment ID: I20181002000169 |
| Provider Name | Michelle M Danielson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477031086 PECOS PAC ID: 4880947365 Enrollment ID: I20181031000139 |
| Provider Name | Brett D Van Kley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063896298 PECOS PAC ID: 7517274996 Enrollment ID: I20181101000369 |
| Provider Name | Brock C Ball |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558705863 PECOS PAC ID: 6608014626 Enrollment ID: I20181105000367 |
| Provider Name | Parveen Kumar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558522003 PECOS PAC ID: 0143498550 Enrollment ID: I20181127001487 |
| Provider Name | Sarah Jo Tacke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902388341 PECOS PAC ID: 7810232667 Enrollment ID: I20181221002498 |
| Provider Name | Shelley Janelle Morrison |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093712630 PECOS PAC ID: 5991770729 Enrollment ID: I20190102002909 |
| Provider Name | Jodi L Scott |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073585667 PECOS PAC ID: 9436125978 Enrollment ID: I20190110002363 |
| Provider Name | Thomas H Flesher |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1053407619 PECOS PAC ID: 2163458712 Enrollment ID: I20190211003211 |
| Provider Name | Dennis Joseph Thum |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1245619543 PECOS PAC ID: 4486904877 Enrollment ID: I20190226000192 |
| Provider Name | Kortney M Krick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598243321 PECOS PAC ID: 7315286689 Enrollment ID: I20190304002028 |
| Provider Name | Myles E Tieszen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063464683 PECOS PAC ID: 3678473949 Enrollment ID: I20190307000965 |
| Provider Name | Nicole L Block |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518433879 PECOS PAC ID: 0244579357 Enrollment ID: I20190307002641 |
| Provider Name | Rachelle D Vandegriend |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659849784 PECOS PAC ID: 8426399205 Enrollment ID: I20190403002684 |
| Provider Name | Heather N Spies |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023024213 PECOS PAC ID: 9537163126 Enrollment ID: I20190424000028 |
| Provider Name | Johanna Marie Kallemeyn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336687425 PECOS PAC ID: 7416234315 Enrollment ID: I20190501000622 |
| Provider Name | Michael W Grevengoed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356837579 PECOS PAC ID: 1456695329 Enrollment ID: I20190508002652 |
| Provider Name | David M Kellerman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1619117330 PECOS PAC ID: 8224185400 Enrollment ID: I20190826000351 |
| Provider Name | Dennis A Silver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780726273 PECOS PAC ID: 9234295528 Enrollment ID: I20190911000010 |
| Provider Name | Elena Canfield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346693397 PECOS PAC ID: 2961747258 Enrollment ID: I20190919002753 |
| Provider Name | Jenna R Gehl |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679923973 PECOS PAC ID: 3779876529 Enrollment ID: I20191028002480 |
| Provider Name | Rachel Leigh Rodel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023378726 PECOS PAC ID: 1850670605 Enrollment ID: I20191030001927 |
| Provider Name | Ashley R Geraets |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1497391528 PECOS PAC ID: 5496182081 Enrollment ID: I20200220000676 |
| Provider Name | Jonas Dravland |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134164502 PECOS PAC ID: 0042645244 Enrollment ID: I20200423003018 |
| Provider Name | Yvonne B Oppold |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548205123 PECOS PAC ID: 8729975602 Enrollment ID: I20200508000990 |
| Provider Name | Elizabeth M Jensen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780695437 PECOS PAC ID: 2860499639 Enrollment ID: I20200513002415 |
| Provider Name | Naomi Joy Samuelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093345571 PECOS PAC ID: 5698196707 Enrollment ID: I20200528000198 |
| Provider Name | Kelli Jo Kolander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396296935 PECOS PAC ID: 1658644844 Enrollment ID: I20200626000077 |
| Provider Name | Pamela Barthle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881837946 PECOS PAC ID: 9739239567 Enrollment ID: I20200720001291 |
| Provider Name | Thomas Michael Kalinoski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881128957 PECOS PAC ID: 7810319910 Enrollment ID: I20200901001324 |
| Provider Name | Akram Ahmed Ibrahim Ahmed |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477960060 PECOS PAC ID: 2567680747 Enrollment ID: I20201006000158 |
| Provider Name | Christen H Duke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437327343 PECOS PAC ID: 1456531409 Enrollment ID: I20201006003206 |
| Provider Name | Kathryn K Dahl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568969210 PECOS PAC ID: 2264852029 Enrollment ID: I20201015002221 |
| Provider Name | Julie Trouy Morgan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295771863 PECOS PAC ID: 6709770175 Enrollment ID: I20201109002298 |
| Provider Name | George N Hirschboeck |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1720544521 PECOS PAC ID: 2365854619 Enrollment ID: I20201210002377 |
| Provider Name | Jacob Jenner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1811423346 PECOS PAC ID: 5294012522 Enrollment ID: I20201217000625 |
| Provider Name | Austyn J Reker |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689271934 PECOS PAC ID: 9133549652 Enrollment ID: I20201222000364 |
| Provider Name | Emily Renee Haggerty |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1336581552 PECOS PAC ID: 7214224021 Enrollment ID: I20210121000028 |
| Provider Name | Andrew Ollerton |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1619233806 PECOS PAC ID: 6305074055 Enrollment ID: I20210202000345 |
| Provider Name | Varunpal Reddy Sama |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326490012 PECOS PAC ID: 6608280706 Enrollment ID: I20210202000407 |
| Provider Name | Brittany Ann Dahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275148009 PECOS PAC ID: 0749694545 Enrollment ID: I20210205000272 |
| Provider Name | Sarah Heckel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285177782 PECOS PAC ID: 2163703273 Enrollment ID: I20210416000975 |
| Provider Name | Kaley Joy Mcnab |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093304065 PECOS PAC ID: 8123436573 Enrollment ID: I20210423000447 |
| Provider Name | Michael Olson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356341150 PECOS PAC ID: 2365355989 Enrollment ID: I20210430000100 |
| Provider Name | Destinie Lee Stapleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649852252 PECOS PAC ID: 1052715315 Enrollment ID: I20210809001537 |
| Provider Name | Scott Daniel Murray |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457435760 PECOS PAC ID: 4183751126 Enrollment ID: I20210901000537 |
| Provider Name | Suzie Ann Walgrave |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770169344 PECOS PAC ID: 9335545284 Enrollment ID: I20210901002362 |
| Provider Name | Georgie Philip |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871098830 PECOS PAC ID: 0941607089 Enrollment ID: I20210916001139 |
| Provider Name | Lloyd David Hubler |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1215986419 PECOS PAC ID: 3173414570 Enrollment ID: I20210920001830 |
| Provider Name | Jennifer Ann Monson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083208904 PECOS PAC ID: 7416345970 Enrollment ID: I20211102002949 |
| Provider Name | Elishia A Christians |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760150569 PECOS PAC ID: 3678964038 Enrollment ID: I20211220002365 |
| Provider Name | Subba Alapati |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487642039 PECOS PAC ID: 7012974686 Enrollment ID: I20220111001983 |
| Provider Name | Harvey A Oliver |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1669735676 PECOS PAC ID: 1456585660 Enrollment ID: I20220314001649 |
| Provider Name | Molly M Post |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912522681 PECOS PAC ID: 1850710989 Enrollment ID: I20220405002598 |
| Provider Name | Miranda J Obaniana |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1538811138 PECOS PAC ID: 9537556394 Enrollment ID: I20220425002270 |
| Provider Name | Spencer Schilling |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831585462 PECOS PAC ID: 0244524379 Enrollment ID: I20220505000248 |
| Provider Name | Aneta K Mergen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235778507 PECOS PAC ID: 8921436791 Enrollment ID: I20220511000497 |
| Provider Name | Salina A Neuman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972081453 PECOS PAC ID: 5193064111 Enrollment ID: I20220519002119 |
| Provider Name | Katherine A. Greenlee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699446674 PECOS PAC ID: 7911387253 Enrollment ID: I20220706003995 |
| Provider Name | Travis D Rath |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386265734 PECOS PAC ID: 9234555384 Enrollment ID: I20220719003609 |
| Provider Name | Ann Busker |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1831663509 PECOS PAC ID: 3274875513 Enrollment ID: I20220810000480 |
| Provider Name | Jesyca Ruth Haines |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902166259 PECOS PAC ID: 3678729795 Enrollment ID: I20220916002605 |
| Provider Name | Ashley B Briggs |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902851140 PECOS PAC ID: 6709803265 Enrollment ID: I20220922001220 |
| Provider Name | Melanie Lynn Behrends |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831810480 PECOS PAC ID: 4486030707 Enrollment ID: I20221010002249 |
| Provider Name | Amber Van Voorst |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134543580 PECOS PAC ID: 9638392012 Enrollment ID: I20221018002488 |
| Provider Name | Kermit Brion Brunelle |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477529006 PECOS PAC ID: 3476872763 Enrollment ID: I20221031002212 |
| Provider Name | Jared Laverne Harwood |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942393954 PECOS PAC ID: 7113161225 Enrollment ID: I20221107000300 |
| Provider Name | Luke Vincent Fuhrman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336602010 PECOS PAC ID: 7012384795 Enrollment ID: I20221111001511 |
| Provider Name | Anand Dayama |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1891050969 PECOS PAC ID: 3577963495 Enrollment ID: I20221222000175 |
| Provider Name | Todd R Luedeke |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1700832839 PECOS PAC ID: 2466354907 Enrollment ID: I20230110001515 |
| Provider Name | Jeanette Schlimme |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225752819 PECOS PAC ID: 4587035431 Enrollment ID: I20230201000212 |
| Provider Name | Tonya M Grissam |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043385131 PECOS PAC ID: 8022376938 Enrollment ID: I20230220001334 |
| Provider Name | Kristine Ranae Shaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275286551 PECOS PAC ID: 3678947785 Enrollment ID: I20230313000845 |
| Provider Name | Kase Allen Jacobs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336857655 PECOS PAC ID: 1759755689 Enrollment ID: I20230316000692 |
| Provider Name | Chioma B Osemwegie |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1467947119 PECOS PAC ID: 0648524439 Enrollment ID: I20230322002447 |
| Provider Name | Stephanie Rae Meinerts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144955949 PECOS PAC ID: 2668846833 Enrollment ID: I20230330000826 |
| Provider Name | Terry R Perkins |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679552681 PECOS PAC ID: 1951322676 Enrollment ID: I20230420000901 |
| Provider Name | Jade Ryan Tinklenberg |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265108369 PECOS PAC ID: 1557759438 Enrollment ID: I20230427002783 |
| Provider Name | Paul T Denna |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376838839 PECOS PAC ID: 8426291717 Enrollment ID: I20230502001574 |
| Provider Name | John Mate-kole |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558374371 PECOS PAC ID: 3577705755 Enrollment ID: I20230530002768 |
| Provider Name | Jeannette Marie Loftin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104435148 PECOS PAC ID: 4486058005 Enrollment ID: I20230608001669 |
| Provider Name | Nofil Irfan Arain |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568543932 PECOS PAC ID: 3971773920 Enrollment ID: I20230818002505 |
| Provider Name | Nicole Marie Deprez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790471027 PECOS PAC ID: 6709230139 Enrollment ID: I20231003003217 |
| Provider Name | Emily R Penning |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477174837 PECOS PAC ID: 0547685885 Enrollment ID: I20231010001871 |
| Provider Name | Brittany Nichole Larson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700565819 PECOS PAC ID: 6305292657 Enrollment ID: I20231024000842 |
| Provider Name | Barbara Asare-afriyie |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639781172 PECOS PAC ID: 1951757020 Enrollment ID: I20231025002553 |
| Provider Name | Katia Ilieva |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821195603 PECOS PAC ID: 1658305214 Enrollment ID: I20231106000101 |
| Provider Name | Anna Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881372506 PECOS PAC ID: 8921453036 Enrollment ID: I20231127001970 |
| Provider Name | Richard L Derrick |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1649803172 PECOS PAC ID: 2163844697 Enrollment ID: I20231129001023 |
| Provider Name | David W. Bursack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508545294 PECOS PAC ID: 3678921400 Enrollment ID: I20231204003451 |
| Provider Name | Jared Phelps |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700293354 PECOS PAC ID: 8426351263 Enrollment ID: I20231220002778 |
| Provider Name | Meghana Khedekar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578171468 PECOS PAC ID: 0648696484 Enrollment ID: I20231222002761 |
| Provider Name | Tonya Anne Grothe-bumgardner |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1881805125 PECOS PAC ID: 6800247057 Enrollment ID: I20240111003750 |
| Provider Name | Angela Kay Nolz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528325347 PECOS PAC ID: 3274984307 Enrollment ID: I20240112001772 |
| Provider Name | Drake Rothstein |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700800992 PECOS PAC ID: 7810994514 Enrollment ID: I20240122002262 |
| Provider Name | Alan Michael Alabaster |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1295840510 PECOS PAC ID: 7214955830 Enrollment ID: I20240220001557 |
| Provider Name | Leland Murren |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639815277 PECOS PAC ID: 0941683262 Enrollment ID: I20240304001504 |
| Provider Name | Josie Lynn Grosz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1578292868 PECOS PAC ID: 4880062884 Enrollment ID: I20240326003217 |
| Provider Name | Justin T Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043508492 PECOS PAC ID: 5092026765 Enrollment ID: I20240327002949 |
Safe Haven Counseling Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10622 160th St, Tracy, MN 56175 Phone: 507-626-2063 Fax: 507-516-0102 |