Trigg County Hospital, Inc | |
254 Main St Cadiz KY 42211-9153 | |
(270) 522-3215 | |
(270) 522-6974 |
Full Name | Trigg County Hospital, Inc |
---|---|
Speciality | General Acute Care Hospital |
Location | 254 Main St, Cadiz, Kentucky |
Authorized Official Name and Position | John Sumner (CEO) |
Authorized Official Contact | 2705223215 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Trigg County Hospital, Inc 254 Main St Cadiz KY 42211-9153 Ph: (270) 522-3215 | Trigg County Hospital, Inc 254 Main St Cadiz KY 42211-9153 Ph: (270) 522-3215 |
NPI Number | 1538218680 |
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Provider Enumeration Date | 01/09/2007 |
Last Update Date | 10/24/2024 |
Certification Date | 10/24/2024 |
Medicare PECOS PAC ID | 5193620805 |
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Medicare Enrollment ID | O20031205000118 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538218680 | NPI | - | NPPES |
7100483490 | Medicaid | KY | |
01002724 | Medicaid | KY | |
65939779 | Medicaid | KY |
Provider Name | Deepak Patel |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1609969369 PECOS PAC ID: 5496650517 Enrollment ID: I20031203000145 |
Provider Name | Clarence E Patty |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1497782122 PECOS PAC ID: 7214834985 Enrollment ID: I20031219000006 |
Provider Name | Ehsan Qadir |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1114919404 PECOS PAC ID: 9234034695 Enrollment ID: I20040106000142 |
Provider Name | Gary D Singer |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1275573974 PECOS PAC ID: 9638083462 Enrollment ID: I20040409000168 |
Provider Name | Paresh V Sheth |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1669479911 PECOS PAC ID: 5991796393 Enrollment ID: I20040601000032 |
Provider Name | Charles L Waller |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1306841341 PECOS PAC ID: 0244212645 Enrollment ID: I20040601000835 |
Provider Name | Carl B Hinton |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1386610095 PECOS PAC ID: 5395727630 Enrollment ID: I20040602000318 |
Provider Name | Kevin L Hardesty |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1891762233 PECOS PAC ID: 0042299729 Enrollment ID: I20040716000021 |
Provider Name | Michael Edmond Howard |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1689613499 PECOS PAC ID: 7113997966 Enrollment ID: I20040728001538 |
Provider Name | Anthony R France |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1376506717 PECOS PAC ID: 4587632518 Enrollment ID: I20040917000929 |
Provider Name | James Harold |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1851355739 PECOS PAC ID: 2668440694 Enrollment ID: I20040917000950 |
Provider Name | George W Thomas |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1700806437 PECOS PAC ID: 1254309602 Enrollment ID: I20040922001196 |
Provider Name | Sanjay M Chavda |
---|---|
Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1437124484 PECOS PAC ID: 5496719445 Enrollment ID: I20041118000696 |
Provider Name | Maria Dawn Jennings |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1285786285 PECOS PAC ID: 6406814649 Enrollment ID: I20041221000006 |
Provider Name | John E Broadbent |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1902894983 PECOS PAC ID: 3577517234 Enrollment ID: I20050307000164 |
Provider Name | Peter J Doll |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1144232992 PECOS PAC ID: 0244286755 Enrollment ID: I20050329000011 |
Provider Name | Kimberly Covington |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1164551156 PECOS PAC ID: 4183661135 Enrollment ID: I20050413000774 |
Provider Name | Steven W Mayfield |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1104874718 PECOS PAC ID: 1658385489 Enrollment ID: I20060201000405 |
Provider Name | Ronald R Wilson |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1093883225 PECOS PAC ID: 1759487564 Enrollment ID: I20070510000287 |
Provider Name | Jennifer A Green |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1265597728 PECOS PAC ID: 7517065204 Enrollment ID: I20070604000410 |
Provider Name | Tabitha Myers |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396828596 PECOS PAC ID: 9537268073 Enrollment ID: I20070623000001 |
Provider Name | Shea A Godwin |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1538257910 PECOS PAC ID: 6406957554 Enrollment ID: I20070719000625 |
Provider Name | Lillian E Gierhart |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649319518 PECOS PAC ID: 9335231638 Enrollment ID: I20070816000229 |
Provider Name | Stephen P Montgomery |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1245334598 PECOS PAC ID: 2860589678 Enrollment ID: I20071025000572 |
Provider Name | Michael D Crider |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1053509265 PECOS PAC ID: 7315035425 Enrollment ID: I20071126000457 |
Provider Name | Venkateswara Velaga |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1740246289 PECOS PAC ID: 4183704265 Enrollment ID: I20081003000736 |
Provider Name | Harshul Patel |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1427213842 PECOS PAC ID: 0941378350 Enrollment ID: I20081010000696 |
Provider Name | Prakash N Shah |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1902803513 PECOS PAC ID: 0446230650 Enrollment ID: I20090122000166 |
Provider Name | Heith W Robertson |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1306083092 PECOS PAC ID: 0446315147 Enrollment ID: I20090212000394 |
Provider Name | Saka R Disu |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1972780781 PECOS PAC ID: 3971650151 Enrollment ID: I20090403000193 |
Provider Name | Laressa Bazzell |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1962641431 PECOS PAC ID: 5395892061 Enrollment ID: I20090415000324 |
Provider Name | Dale L Kile |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1619918174 PECOS PAC ID: 2961493838 Enrollment ID: I20090630000439 |
Provider Name | Jeffrey L Frederich |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508882010 PECOS PAC ID: 3779610167 Enrollment ID: I20100415000751 |
Provider Name | Vaishali H Patel |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1942437603 PECOS PAC ID: 8820112659 Enrollment ID: I20100901000185 |
Provider Name | David W French |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1649336306 PECOS PAC ID: 1850379058 Enrollment ID: I20100909000226 |
Provider Name | Kelly G Mcdaniel |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1962718908 PECOS PAC ID: 5294923850 Enrollment ID: I20101223000152 |
Provider Name | Jonathan Manuel Rey |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1679745368 PECOS PAC ID: 1254529613 Enrollment ID: I20101229000507 |
Provider Name | Amy O Lockwood |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1497051957 PECOS PAC ID: 5496936189 Enrollment ID: I20110301000610 |
Provider Name | James M Fellows |
---|---|
Provider Type | Practitioner - Urology |
Provider Identifiers | NPI Number: 1497762892 PECOS PAC ID: 9133117559 Enrollment ID: I20110304000413 |
Provider Name | Keenan Williams |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1518261536 PECOS PAC ID: 5294916797 Enrollment ID: I20110318000122 |
Provider Name | William C Eason |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1386611838 PECOS PAC ID: 4688860257 Enrollment ID: I20110419000333 |
Provider Name | Sanjay Bose |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1225038698 PECOS PAC ID: 1355362617 Enrollment ID: I20110422000413 |
Provider Name | Mackenzie S Guizio Crockett |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1427347814 PECOS PAC ID: 8729265632 Enrollment ID: I20110601000760 |
Provider Name | Harry J Dempsey |
---|---|
Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1821058538 PECOS PAC ID: 1254319155 Enrollment ID: I20110720000725 |
Provider Name | Stuart W Rice |
---|---|
Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1962525865 PECOS PAC ID: 5395915441 Enrollment ID: I20110826000519 |
Provider Name | Brian Daniel |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1730460361 PECOS PAC ID: 1052586617 Enrollment ID: I20111208000797 |
Provider Name | Brian Raymond |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1952670846 PECOS PAC ID: 1658538939 Enrollment ID: I20120130000679 |
Provider Name | Jeanine M Evans |
---|---|
Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1447520853 PECOS PAC ID: 1759540065 Enrollment ID: I20120306000607 |
Provider Name | Stefanie K Lacy |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1427329523 PECOS PAC ID: 7416111992 Enrollment ID: I20120613000347 |
Provider Name | Syed Ahmed Naseeruddin |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1760599575 PECOS PAC ID: 4981754017 Enrollment ID: I20130108000089 |
Provider Name | Kimberley W Evans |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841540952 PECOS PAC ID: 3173776770 Enrollment ID: I20130110000112 |
Provider Name | Ashley J Young |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1215273271 PECOS PAC ID: 9133373616 Enrollment ID: I20130326000451 |
Provider Name | George S Gilliam |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1023016912 PECOS PAC ID: 2466452461 Enrollment ID: I20130409000637 |
Provider Name | Anthony M Briningstool |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1215036322 PECOS PAC ID: 0446217806 Enrollment ID: I20130529000675 |
Provider Name | Yekolla M Reddy |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1386698058 PECOS PAC ID: 2961478441 Enrollment ID: I20130720000066 |
Provider Name | Mary Sullivan Jolly |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093056038 PECOS PAC ID: 0840426375 Enrollment ID: I20131111001486 |
Provider Name | Joshua Lee |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1164844486 PECOS PAC ID: 2163650276 Enrollment ID: I20140117001677 |
Provider Name | Tina L Tomlinson |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1376824672 PECOS PAC ID: 9739318387 Enrollment ID: I20140131001320 |
Provider Name | Terry R Perkins |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1679552681 PECOS PAC ID: 1951322676 Enrollment ID: I20140410002174 |
Provider Name | David Wanjohi Kabithe |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1790775914 PECOS PAC ID: 0840323341 Enrollment ID: I20140603000680 |
Provider Name | Skylar Pharris |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1154733772 PECOS PAC ID: 8325262959 Enrollment ID: I20140620001414 |
Provider Name | Callie Wells |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851470496 PECOS PAC ID: 6507961596 Enrollment ID: I20140922001505 |
Provider Name | Jenny Sheffer |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1699093096 PECOS PAC ID: 0547497489 Enrollment ID: I20141007001324 |
Provider Name | Carlton A Lee |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1396150413 PECOS PAC ID: 8426279795 Enrollment ID: I20141030000934 |
Provider Name | Christopher A Weatherspoon |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992771778 PECOS PAC ID: 9032432828 Enrollment ID: I20141231001463 |
Provider Name | James Thomas |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1386771061 PECOS PAC ID: 9830270255 Enrollment ID: I20150112001998 |
Provider Name | Landon Atcher |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1659760403 PECOS PAC ID: 8820313075 Enrollment ID: I20150210000510 |
Provider Name | Camille R Jordan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972909570 PECOS PAC ID: 0840502233 Enrollment ID: I20150626000662 |
Provider Name | Jonathan F Thomas |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1033473970 PECOS PAC ID: 1759527476 Enrollment ID: I20150911001703 |
Provider Name | Chelsea Adams |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598213647 PECOS PAC ID: 1254610512 Enrollment ID: I20161109002999 |
Provider Name | Rockne Brubaker |
---|---|
Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1407854037 PECOS PAC ID: 3476444639 Enrollment ID: I20161202001880 |
Provider Name | Deepak Reddy |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1518087568 PECOS PAC ID: 0840356028 Enrollment ID: I20161209001952 |
Provider Name | Cheryl A Vinson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164964870 PECOS PAC ID: 7810278942 Enrollment ID: I20170104002122 |
Provider Name | Rakesh R Shah |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1063414522 PECOS PAC ID: 9234036229 Enrollment ID: I20170113000852 |
Provider Name | Travis W Mckinzie |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1326465691 PECOS PAC ID: 6103108683 Enrollment ID: I20170117002592 |
Provider Name | Matthew Stine |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1356885198 PECOS PAC ID: 7911289954 Enrollment ID: I20170126001320 |
Provider Name | Billie D Stokes |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538689666 PECOS PAC ID: 0547539876 Enrollment ID: I20170630000033 |
Provider Name | James D Sloderbeck |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1285622381 PECOS PAC ID: 6800700923 Enrollment ID: I20180202001547 |
Provider Name | Jeanie L Wadlington |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861974495 PECOS PAC ID: 3375897572 Enrollment ID: I20181106002412 |
Provider Name | David Zimmerman |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1609165687 PECOS PAC ID: 3577793454 Enrollment ID: I20181204000978 |
Provider Name | Todd A Wical |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1164861159 PECOS PAC ID: 0143597948 Enrollment ID: I20190122003526 |
Provider Name | Richard T Baird |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1205152105 PECOS PAC ID: 1951542232 Enrollment ID: I20190130002540 |
Provider Name | Payton Kuhlenbeck |
---|---|
Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1518413384 PECOS PAC ID: 5496172322 Enrollment ID: I20200824002795 |
Provider Name | Elizabeth Ann Gill |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982252748 PECOS PAC ID: 0143632646 Enrollment ID: I20201207001143 |
Provider Name | Benjamin B Mattingly |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1235348194 PECOS PAC ID: 9234239930 Enrollment ID: I20210212001183 |
Provider Name | Tasha J Mitchell |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1205414364 PECOS PAC ID: 1456769652 Enrollment ID: I20210427002198 |
Provider Name | Alexander E Lanigan |
---|---|
Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1992125066 PECOS PAC ID: 9335465335 Enrollment ID: I20210716002181 |
Provider Name | John Paul Fanning |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1952740060 PECOS PAC ID: 3173889235 Enrollment ID: I20210719003464 |
Provider Name | Allen A Lill |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1356838213 PECOS PAC ID: 9234485715 Enrollment ID: I20211115002171 |
Provider Name | Folaranmi Ajiboye |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1386273654 PECOS PAC ID: 2264822071 Enrollment ID: I20211210001090 |
Provider Name | Angela Acree |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487324836 PECOS PAC ID: 3577955541 Enrollment ID: I20220125001170 |
Provider Name | Mckenzie Kunnecke |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881366227 PECOS PAC ID: 7416332648 Enrollment ID: I20220923001261 |
Provider Name | Ronald Awtry |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1629595079 PECOS PAC ID: 6103183553 Enrollment ID: I20221206001329 |
Provider Name | Ernest P Jones |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1235210204 PECOS PAC ID: 9931337144 Enrollment ID: I20221219001168 |
Provider Name | David S. Goldberg |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1407836356 PECOS PAC ID: 2567418254 Enrollment ID: I20230110002032 |
Provider Name | Antonio Chantill Capps |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1548559693 PECOS PAC ID: 8022258821 Enrollment ID: I20230626001294 |
Provider Name | Andrea M Infantino |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1508238916 PECOS PAC ID: 1850690637 Enrollment ID: I20230802000569 |
Provider Name | Mark Royer |
---|---|
Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1699933648 PECOS PAC ID: 8527224526 Enrollment ID: I20230817000603 |
Provider Name | Lauren A Raby |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1861830929 PECOS PAC ID: 0840553814 Enrollment ID: I20230824000984 |
Provider Name | Christy Oliphant |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487434726 PECOS PAC ID: 6103181987 Enrollment ID: I20231026001794 |
Provider Name | Taylor E Allen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619470010 PECOS PAC ID: 3678921202 Enrollment ID: I20231121000550 |
Provider Name | Alyssa Beach |
---|---|
Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1205614427 PECOS PAC ID: 8325499346 Enrollment ID: I20240103004521 |
Provider Name | Nancy E Jolly |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1962905950 PECOS PAC ID: 8224361530 Enrollment ID: I20240105001291 |
Provider Name | Paloma I Perez |
---|---|
Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1881134658 PECOS PAC ID: 8426308669 Enrollment ID: I20240227002841 |
Provider Name | Joseph L Hull |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1245084003 PECOS PAC ID: 7911347752 Enrollment ID: I20240426003084 |