| Aleknagik North | |
|
73 Main Street Aleknagik North AK 99555 | |
| (907) 842-5201 | |
| (907) 842-9250 |
| Full Name | Aleknagik North |
|---|---|
| Speciality | Clinic/Center |
| Location | 73 Main Street, Aleknagik North, Alaska |
| Authorized Official Name and Position | Robert Clark (CEO) |
| Authorized Official Contact | 9078425201 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aleknagik North Po Box 130 Dillingham AK 99576-0130 Ph: (907) 842-5201 | Aleknagik North 73 Main Street Aleknagik North AK 99555 Ph: (907) 842-5201 |
| NPI Number | 1235291246 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 10/06/2023 |
| Medicare PECOS PAC ID | 5890699920 |
|---|---|
| Medicare Enrollment ID | O20031120000998 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235291246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | David J Powers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962485276 PECOS PAC ID: 5294639795 Enrollment ID: I20031125000945 |
| Provider Name | William L Lubke |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1578501466 PECOS PAC ID: 4688572142 Enrollment ID: I20031222000757 |
| Provider Name | Stephen E Livingston |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619996923 PECOS PAC ID: 4587562855 Enrollment ID: I20031223000477 |
| Provider Name | Juliana C Montooth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760465181 PECOS PAC ID: 4486550811 Enrollment ID: I20040129001151 |
| Provider Name | John F Kokesh |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1427090430 PECOS PAC ID: 2668364977 Enrollment ID: I20040329001750 |
| Provider Name | Christy Scoggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760477632 PECOS PAC ID: 1153314547 Enrollment ID: I20040402001374 |
| Provider Name | Arnold Loera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225012628 PECOS PAC ID: 3870497902 Enrollment ID: I20040414000580 |
| Provider Name | Elizabeth D. Ferucci |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1598705121 PECOS PAC ID: 2163418567 Enrollment ID: I20040421001677 |
| Provider Name | Bryan G Wachter |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1801827027 PECOS PAC ID: 2961481718 Enrollment ID: I20040715001184 |
| Provider Name | Richard W Asher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205876448 PECOS PAC ID: 3375514011 Enrollment ID: I20040804001690 |
| Provider Name | David E Magaret |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801845953 PECOS PAC ID: 4385617851 Enrollment ID: I20040816000897 |
| Provider Name | Patrick S Kelley |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1508853128 PECOS PAC ID: 6709850894 Enrollment ID: I20040824000917 |
| Provider Name | Nancy E Henderson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265559223 PECOS PAC ID: 5991772097 Enrollment ID: I20040916000430 |
| Provider Name | William Andrew Paton |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790710747 PECOS PAC ID: 0840267928 Enrollment ID: I20040916001056 |
| Provider Name | Linda E Keyes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962411298 PECOS PAC ID: 8123918562 Enrollment ID: I20040921000515 |
| Provider Name | Marc B Connelly |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1922049253 PECOS PAC ID: 8325000425 Enrollment ID: I20041101000823 |
| Provider Name | Judith E Steyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427047539 PECOS PAC ID: 2466492921 Enrollment ID: I20050504000967 |
| Provider Name | Frank D Sacco |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174548580 PECOS PAC ID: 4880620194 Enrollment ID: I20050708000549 |
| Provider Name | Pornson P Linton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104017755 PECOS PAC ID: 1052347879 Enrollment ID: I20050714001019 |
| Provider Name | Claudia Christensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124067673 PECOS PAC ID: 0446287205 Enrollment ID: I20050722000686 |
| Provider Name | Matthew G Guarino |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467679118 PECOS PAC ID: 3274565726 Enrollment ID: I20050906000366 |
| Provider Name | Joan A Maceachen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205865334 PECOS PAC ID: 7719891811 Enrollment ID: I20051005000794 |
| Provider Name | Patricia Mcadoo |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699800144 PECOS PAC ID: 7719907104 Enrollment ID: I20051130000473 |
| Provider Name | Aryeh L Levenson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245303650 PECOS PAC ID: 7214944461 Enrollment ID: I20060503000751 |
| Provider Name | Barbara L Riley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558301796 PECOS PAC ID: 5496750283 Enrollment ID: I20060929000281 |
| Provider Name | Mark J Thorndike |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1124051743 PECOS PAC ID: 7618077579 Enrollment ID: I20070709000148 |
| Provider Name | Susan Mermelstein |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1841315124 PECOS PAC ID: 2062509086 Enrollment ID: I20071107000329 |
| Provider Name | Ronald N Talaga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427099043 PECOS PAC ID: 5092747709 Enrollment ID: I20080118000211 |
| Provider Name | Youssef K Barbour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588846042 PECOS PAC ID: 5991888067 Enrollment ID: I20080212000715 |
| Provider Name | Sandra L Graham |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629250998 PECOS PAC ID: 5092891895 Enrollment ID: I20080319000290 |
| Provider Name | Rebecca I Coupchiak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386834125 PECOS PAC ID: 6103902416 Enrollment ID: I20080327000245 |
| Provider Name | Raymond James Walsh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306983093 PECOS PAC ID: 6901985860 Enrollment ID: I20080502000421 |
| Provider Name | Paul W Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467462887 PECOS PAC ID: 6709952880 Enrollment ID: I20080915000366 |
| Provider Name | Mitchell F Horan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952388449 PECOS PAC ID: 9133119928 Enrollment ID: I20080929000179 |
| Provider Name | Clay A Brown |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841441086 PECOS PAC ID: 0749341295 Enrollment ID: I20081203000251 |
| Provider Name | James D Andrews |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1558528745 PECOS PAC ID: 1153482617 Enrollment ID: I20081203000301 |
| Provider Name | Clifford C Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457503823 PECOS PAC ID: 5890851737 Enrollment ID: I20090302000519 |
| Provider Name | John A Kulits |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1659391837 PECOS PAC ID: 0941387229 Enrollment ID: I20090324000081 |
| Provider Name | David G Chamberlain |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1407895949 PECOS PAC ID: 2062562929 Enrollment ID: I20090615000605 |
| Provider Name | Peter E Cornell |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1235120866 PECOS PAC ID: 9830221548 Enrollment ID: I20100715000747 |
| Provider Name | Kerrick L Stout |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710961172 PECOS PAC ID: 0648333492 Enrollment ID: I20100802000318 |
| Provider Name | Jennifer L Grunert |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1538482054 PECOS PAC ID: 2163556275 Enrollment ID: I20100811000554 |
| Provider Name | Kristen L Solana Walkinshaw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245337138 PECOS PAC ID: 5092856997 Enrollment ID: I20100817001133 |
| Provider Name | Anne K Mccue |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467441535 PECOS PAC ID: 6103720552 Enrollment ID: I20100907000792 |
| Provider Name | James W Neumann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851583280 PECOS PAC ID: 8527120922 Enrollment ID: I20101012000989 |
| Provider Name | Dona R Brekke |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477527992 PECOS PAC ID: 1254412877 Enrollment ID: I20110222000195 |
| Provider Name | Amalia R Steinberg |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1316109895 PECOS PAC ID: 8527249572 Enrollment ID: I20110223000752 |
| Provider Name | Tzu-ching Liu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285930933 PECOS PAC ID: 7911180435 Enrollment ID: I20110322000073 |
| Provider Name | Angela J Manderfeld |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1275833469 PECOS PAC ID: 9234181827 Enrollment ID: I20110413000155 |
| Provider Name | Heather Johnson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346466489 PECOS PAC ID: 2365627643 Enrollment ID: I20110502000308 |
| Provider Name | Beverly J Lemaster |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1902826597 PECOS PAC ID: 5890971246 Enrollment ID: I20110519000093 |
| Provider Name | David Brauner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346213196 PECOS PAC ID: 6103914940 Enrollment ID: I20110629000019 |
| Provider Name | John P Downey |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164491445 PECOS PAC ID: 5193822518 Enrollment ID: I20110922000290 |
| Provider Name | Rachel Kerford Lescher |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043480643 PECOS PAC ID: 7517138480 Enrollment ID: I20110926000584 |
| Provider Name | Katie E Dawson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639212657 PECOS PAC ID: 0446421333 Enrollment ID: I20110926000830 |
| Provider Name | Clifford Schneider |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1699932772 PECOS PAC ID: 3779754676 Enrollment ID: I20110926000887 |
| Provider Name | Kena K Desai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124285945 PECOS PAC ID: 3173794070 Enrollment ID: I20110927000022 |
| Provider Name | Mary J Caffee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487725958 PECOS PAC ID: 7315048329 Enrollment ID: I20120208000707 |
| Provider Name | Dirk C Bringhurst |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609865948 PECOS PAC ID: 0345323408 Enrollment ID: I20120601000337 |
| Provider Name | Mark B Lorenz |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1174649784 PECOS PAC ID: 0042474603 Enrollment ID: I20120611000442 |
| Provider Name | Sarah L Sindell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649473208 PECOS PAC ID: 4486810330 Enrollment ID: I20120723000434 |
| Provider Name | Shiloh N Small |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871758813 PECOS PAC ID: 1153587829 Enrollment ID: I20120724000861 |
| Provider Name | Leanne K Komorowski |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700045648 PECOS PAC ID: 9234385030 Enrollment ID: I20120810000177 |
| Provider Name | Laura L Levoy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669543088 PECOS PAC ID: 7911000989 Enrollment ID: I20120914000458 |
| Provider Name | Thomas Eugene Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912172305 PECOS PAC ID: 7810067139 Enrollment ID: I20130410000120 |
| Provider Name | Christi M Angelo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902955891 PECOS PAC ID: 3072602705 Enrollment ID: I20130503000492 |
| Provider Name | Jeffrey A Westerfield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114241213 PECOS PAC ID: 0648419929 Enrollment ID: I20130617000725 |
| Provider Name | Richard K Winkle |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1194799619 PECOS PAC ID: 0749429876 Enrollment ID: I20130620000274 |
| Provider Name | Joseph H Park |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962552729 PECOS PAC ID: 3375635279 Enrollment ID: I20130826000860 |
| Provider Name | Donna Gayle Warner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154389393 PECOS PAC ID: 5698719086 Enrollment ID: I20130911000609 |
| Provider Name | Robert W Davis |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1932172178 PECOS PAC ID: 7911050810 Enrollment ID: I20131028001588 |
| Provider Name | Angela D St John |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558428458 PECOS PAC ID: 1850365495 Enrollment ID: I20131108001717 |
| Provider Name | Laura L Shively |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174797088 PECOS PAC ID: 1254568231 Enrollment ID: I20131219000400 |
| Provider Name | Shelyna A Thawer-rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235147646 PECOS PAC ID: 9739270695 Enrollment ID: I20140128001590 |
| Provider Name | Samuel Salen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629073804 PECOS PAC ID: 1254231814 Enrollment ID: I20140131001658 |
| Provider Name | Robert S Rippner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932127602 PECOS PAC ID: 7315859428 Enrollment ID: I20140205001104 |
| Provider Name | Richard Mitchell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255368353 PECOS PAC ID: 9436045713 Enrollment ID: I20140210000640 |
| Provider Name | Huma S Qureshi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568447357 PECOS PAC ID: 9335167733 Enrollment ID: I20140212000771 |
| Provider Name | Alix Vincent |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003802265 PECOS PAC ID: 4789602194 Enrollment ID: I20140227000925 |
| Provider Name | Atul Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528045374 PECOS PAC ID: 6103844774 Enrollment ID: I20140228000080 |
| Provider Name | Jason Lue |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619141223 PECOS PAC ID: 2466525563 Enrollment ID: I20140303000440 |
| Provider Name | Vinod Nigam |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376542753 PECOS PAC ID: 3971653387 Enrollment ID: I20140304000855 |
| Provider Name | Kamiar Massrour |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376791343 PECOS PAC ID: 4587704119 Enrollment ID: I20140310001736 |
| Provider Name | Michael C Diantonio |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528118163 PECOS PAC ID: 4284714429 Enrollment ID: I20140328001437 |
| Provider Name | Namory D Bagayoko |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1891999322 PECOS PAC ID: 3274776570 Enrollment ID: I20140328001823 |
| Provider Name | Nicholas W Napoli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275844201 PECOS PAC ID: 6800020702 Enrollment ID: I20140401000449 |
| Provider Name | Rachel Jane Muir |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467733824 PECOS PAC ID: 4385877612 Enrollment ID: I20140512001003 |
| Provider Name | Jeffrey Caverly |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912968686 PECOS PAC ID: 2961509500 Enrollment ID: I20140522002123 |
| Provider Name | Peilin Reed |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265484794 PECOS PAC ID: 5991783227 Enrollment ID: I20140602001890 |
| Provider Name | Joshua Albrektson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104155258 PECOS PAC ID: 2466699855 Enrollment ID: I20140603002393 |
| Provider Name | Christy S Pierce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639349798 PECOS PAC ID: 6507923919 Enrollment ID: I20140614000013 |
| Provider Name | Jose A Ospina |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033373287 PECOS PAC ID: 7618147653 Enrollment ID: I20140626002168 |
| Provider Name | Prabhat Bhama |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1962415430 PECOS PAC ID: 6901024694 Enrollment ID: I20140821000393 |
| Provider Name | Daniel Tieva |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639464050 PECOS PAC ID: 5890932792 Enrollment ID: I20140917001663 |
| Provider Name | Phillip B Storm |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1588742993 PECOS PAC ID: 9234119553 Enrollment ID: I20140930002523 |
| Provider Name | Eric Lim |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396952560 PECOS PAC ID: 8527257302 Enrollment ID: I20141001002072 |
| Provider Name | Casey K Gokey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912228115 PECOS PAC ID: 2466605928 Enrollment ID: I20141006001919 |
| Provider Name | William Boylston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700172962 PECOS PAC ID: 1850544768 Enrollment ID: I20141006002129 |
| Provider Name | Devon G Huning |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1174851034 PECOS PAC ID: 9234267212 Enrollment ID: I20141105001884 |
| Provider Name | David B Trowbridge |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356367007 PECOS PAC ID: 9335338706 Enrollment ID: I20150127000514 |
| Provider Name | Esther O Udechukwu |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1093113334 PECOS PAC ID: 0648259242 Enrollment ID: I20150129002051 |
| Provider Name | Leanna M Brooks Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407847726 PECOS PAC ID: 6204917917 Enrollment ID: I20150209000244 |
| Provider Name | Elaine L Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780856229 PECOS PAC ID: 8123165040 Enrollment ID: I20150324000086 |
| Provider Name | Cynthia A Foran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073883344 PECOS PAC ID: 0941459622 Enrollment ID: I20150602000298 |
| Provider Name | James P Ford |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1144511304 PECOS PAC ID: 2264748367 Enrollment ID: I20150904000079 |
| Provider Name | Debra Waddell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134366156 PECOS PAC ID: 0143545640 Enrollment ID: I20150910002216 |
| Provider Name | Charles R Baldwin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831418490 PECOS PAC ID: 1951524255 Enrollment ID: I20151001002644 |
| Provider Name | Melissa Rs Tondre |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295034536 PECOS PAC ID: 7618108762 Enrollment ID: I20151015000130 |
| Provider Name | Mariam Miller |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1659533222 PECOS PAC ID: 3870713605 Enrollment ID: I20151024000191 |
| Provider Name | Shannon Fraser |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1568783173 PECOS PAC ID: 7911216387 Enrollment ID: I20151026001761 |
| Provider Name | Roger M Allyn |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1093979874 PECOS PAC ID: 6406089911 Enrollment ID: I20151105000725 |
| Provider Name | Ann Patricia Bollmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427154608 PECOS PAC ID: 1557329208 Enrollment ID: I20151111000295 |
| Provider Name | Patricia Jane Clark-capo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588862684 PECOS PAC ID: 1951571140 Enrollment ID: I20151119000431 |
| Provider Name | Dawn R Lovisa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841212321 PECOS PAC ID: 3779776158 Enrollment ID: I20160316000197 |
| Provider Name | Steven F Gordon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700847365 PECOS PAC ID: 1153451380 Enrollment ID: I20160324000782 |
| Provider Name | Derek Jay Bowers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871933465 PECOS PAC ID: 9931338894 Enrollment ID: I20160401001563 |
| Provider Name | Cheryl Landry |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457319113 PECOS PAC ID: 3072611052 Enrollment ID: I20160412000407 |
| Provider Name | Jennifer L Scholl |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1669457362 PECOS PAC ID: 6305731449 Enrollment ID: I20160602000514 |
| Provider Name | Surender Kurapati |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073558383 PECOS PAC ID: 8628982428 Enrollment ID: I20160714001549 |
| Provider Name | Frederick Eugene Powers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548526759 PECOS PAC ID: 5597927913 Enrollment ID: I20160802002716 |
| Provider Name | Hannah M Foley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184727125 PECOS PAC ID: 4880595008 Enrollment ID: I20160804002594 |
| Provider Name | Ai-ling Lin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982947479 PECOS PAC ID: 1052605482 Enrollment ID: I20160809000148 |
| Provider Name | Sarah M Doaty |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1215254818 PECOS PAC ID: 2668767211 Enrollment ID: I20160823000164 |
| Provider Name | Doron Ben Avi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003846379 PECOS PAC ID: 1355346800 Enrollment ID: I20160824000251 |
| Provider Name | Kristen M Stille |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801078100 PECOS PAC ID: 2769644467 Enrollment ID: I20160830000338 |
| Provider Name | Zachary Wayne Bear |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1124313614 PECOS PAC ID: 0446552913 Enrollment ID: I20160917000262 |
| Provider Name | Linda Ann Carlisle-hodson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689732661 PECOS PAC ID: 3779651476 Enrollment ID: I20160922000191 |
| Provider Name | Jessie Willow Janowski |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1144545476 PECOS PAC ID: 9931406295 Enrollment ID: I20161014001085 |
| Provider Name | Rima M Butler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235579822 PECOS PAC ID: 8224261854 Enrollment ID: I20161202000787 |
| Provider Name | Whitney M Holmes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568850295 PECOS PAC ID: 0648567339 Enrollment ID: I20170217000595 |
| Provider Name | Marlena G Strandir |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619317203 PECOS PAC ID: 7214160878 Enrollment ID: I20170308000307 |
| Provider Name | Suzanne Yoon Homer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194767582 PECOS PAC ID: 1759367162 Enrollment ID: I20170313001242 |
| Provider Name | Anne M Kosacheff |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1053530527 PECOS PAC ID: 0840464046 Enrollment ID: I20170426002688 |
| Provider Name | Ellen K Kohler-krava |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710390620 PECOS PAC ID: 3274752043 Enrollment ID: I20170503001074 |
| Provider Name | William T Chythlook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467676155 PECOS PAC ID: 3577654912 Enrollment ID: I20170619000443 |
| Provider Name | James Lee Christiansen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326080102 PECOS PAC ID: 5193906485 Enrollment ID: I20170705000891 |
| Provider Name | Joshua Tokita |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1548581234 PECOS PAC ID: 1658511597 Enrollment ID: I20170725000242 |
| Provider Name | Andrew L Cornelius |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1447426424 PECOS PAC ID: 1557541364 Enrollment ID: I20170725001514 |
| Provider Name | Megan M Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972923654 PECOS PAC ID: 2860617867 Enrollment ID: I20170824001106 |
| Provider Name | Cynthia L Sherwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942554050 PECOS PAC ID: 3678718293 Enrollment ID: I20171005000060 |
| Provider Name | Alan Reid Hay |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1710048061 PECOS PAC ID: 9234324245 Enrollment ID: I20171011000387 |
| Provider Name | Tirza A Cannon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275842510 PECOS PAC ID: 1759607013 Enrollment ID: I20171107001045 |
| Provider Name | Lisa S Schuerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811212780 PECOS PAC ID: 2567642226 Enrollment ID: I20171113001186 |
| Provider Name | Mario Cruz |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1962926956 PECOS PAC ID: 6103182860 Enrollment ID: I20171113002243 |
| Provider Name | Joseph F Bachtold |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437134582 PECOS PAC ID: 9537132816 Enrollment ID: I20171218002503 |
| Provider Name | David Emerson Good |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770786618 PECOS PAC ID: 3274615711 Enrollment ID: I20171220000708 |
| Provider Name | Kristofor A Sargent |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912133588 PECOS PAC ID: 0840428249 Enrollment ID: I20180228000713 |
| Provider Name | Pierre Lanthiez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801864970 PECOS PAC ID: 2769570860 Enrollment ID: I20180319000669 |
| Provider Name | Jennifer Lynn Davis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538377528 PECOS PAC ID: 3678605789 Enrollment ID: I20180409002472 |
| Provider Name | Danita N Koehler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750455150 PECOS PAC ID: 9638193659 Enrollment ID: I20180412002429 |
| Provider Name | Saaransh R Desai |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093070138 PECOS PAC ID: 4587978184 Enrollment ID: I20180703002322 |
| Provider Name | Maureen A Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114190048 PECOS PAC ID: 6800960774 Enrollment ID: I20180911001981 |
| Provider Name | Colleen Britt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497159669 PECOS PAC ID: 0840515011 Enrollment ID: I20180918003973 |
| Provider Name | Mark Krich |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144238767 PECOS PAC ID: 4789585985 Enrollment ID: I20180924000921 |
| Provider Name | Moniquea J Degan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205933884 PECOS PAC ID: 2668447202 Enrollment ID: I20181003003066 |
| Provider Name | Kira Bendixen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821401423 PECOS PAC ID: 2062733850 Enrollment ID: I20181210002844 |
| Provider Name | Whitney Hine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497139943 PECOS PAC ID: 4082915756 Enrollment ID: I20190228000446 |
| Provider Name | Jamie Kristine Gale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871856179 PECOS PAC ID: 0345462537 Enrollment ID: I20190401000771 |
| Provider Name | Vivek R Mehta |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1538501812 PECOS PAC ID: 9537481619 Enrollment ID: I20190416000969 |
| Provider Name | Richard Fitzgerald Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902314511 PECOS PAC ID: 9931468725 Enrollment ID: I20190417000351 |
| Provider Name | Daniel N Lucas |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417905522 PECOS PAC ID: 8527040195 Enrollment ID: I20190502000487 |
| Provider Name | Philip Martin |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1124168042 PECOS PAC ID: 3173536638 Enrollment ID: I20190503000684 |
| Provider Name | Chris Glenn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457315533 PECOS PAC ID: 4385720317 Enrollment ID: I20190701002182 |
| Provider Name | Lawrence P. Wood |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861509333 PECOS PAC ID: 5496835753 Enrollment ID: I20190813002656 |
| Provider Name | Sheridan Morgan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831432020 PECOS PAC ID: 0345586533 Enrollment ID: I20190827002680 |
| Provider Name | Samuel Chase Werner |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1467866038 PECOS PAC ID: 4587929773 Enrollment ID: I20190828000418 |
| Provider Name | Krysta Byrnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073027942 PECOS PAC ID: 1456689314 Enrollment ID: I20190830000119 |
| Provider Name | Matthew Cronin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821103714 PECOS PAC ID: 5890937395 Enrollment ID: I20190918003382 |
| Provider Name | Elysia Sophia Spencer |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1861831273 PECOS PAC ID: 5193940468 Enrollment ID: I20190926003340 |
| Provider Name | Brandon L Chiu |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1710391271 PECOS PAC ID: 2769785427 Enrollment ID: I20191010000340 |
| Provider Name | Javaneh Lyons |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1477969640 PECOS PAC ID: 2163724980 Enrollment ID: I20191016000023 |
| Provider Name | Andrew Moran |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619077476 PECOS PAC ID: 6406755107 Enrollment ID: I20191021000960 |
| Provider Name | Joshua David Ring |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1487069696 PECOS PAC ID: 9133344997 Enrollment ID: I20191025001602 |
| Provider Name | Suman Tohan |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1932584448 PECOS PAC ID: 9032416888 Enrollment ID: I20191217002595 |
| Provider Name | Jason R Savikko |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649504267 PECOS PAC ID: 1355650474 Enrollment ID: I20191219000442 |
| Provider Name | Julee K. Holayter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972538445 PECOS PAC ID: 7214017573 Enrollment ID: I20191227000366 |
| Provider Name | David G Davenport |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174511919 PECOS PAC ID: 5294834156 Enrollment ID: I20191230000759 |
| Provider Name | Kelly Powers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992923155 PECOS PAC ID: 1759433238 Enrollment ID: I20200106002118 |
| Provider Name | Adam Colton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174957062 PECOS PAC ID: 4284914219 Enrollment ID: I20200107000087 |
| Provider Name | Hunter M Keys |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649696279 PECOS PAC ID: 2668697624 Enrollment ID: I20200206000136 |
| Provider Name | Karin J Edwards |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144370313 PECOS PAC ID: 1254302540 Enrollment ID: I20200224000386 |
| Provider Name | Faith Murray-taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942693346 PECOS PAC ID: 4183934110 Enrollment ID: I20200313001290 |
| Provider Name | Timothy Aaron Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134211568 PECOS PAC ID: 9739197567 Enrollment ID: I20200317000393 |
| Provider Name | Thomas Michael Peterson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639131014 PECOS PAC ID: 7911809843 Enrollment ID: I20200317000591 |
| Provider Name | Meghan Beddow |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689069767 PECOS PAC ID: 1052626603 Enrollment ID: I20200422000128 |
| Provider Name | Joseph N Holman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790104107 PECOS PAC ID: 7214249564 Enrollment ID: I20200512000109 |
| Provider Name | Jennifer A Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821644808 PECOS PAC ID: 4587085766 Enrollment ID: I20200526000268 |
| Provider Name | John B Tanner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043475999 PECOS PAC ID: 8921276270 Enrollment ID: I20200619001326 |
| Provider Name | Shane C Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942720032 PECOS PAC ID: 8628490497 Enrollment ID: I20200624001200 |
| Provider Name | Catherine Ulrickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821357427 PECOS PAC ID: 9335389717 Enrollment ID: I20200625000152 |
| Provider Name | Matthew J Pitera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225097702 PECOS PAC ID: 9436111077 Enrollment ID: I20200702000180 |
| Provider Name | Stephanie Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043520489 PECOS PAC ID: 4587819826 Enrollment ID: I20200710001094 |
| Provider Name | Sarah B De Almeida E Silva |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962842856 PECOS PAC ID: 3577889401 Enrollment ID: I20200720001522 |
| Provider Name | William Perry |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033557418 PECOS PAC ID: 0749516458 Enrollment ID: I20200807002163 |
| Provider Name | Sarah J Virnig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487180774 PECOS PAC ID: 3476822610 Enrollment ID: I20200819000154 |
| Provider Name | Tyler Smith |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1508270877 PECOS PAC ID: 8820215577 Enrollment ID: I20200828001132 |
| Provider Name | Vanina Chavarri |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1528454451 PECOS PAC ID: 1658686258 Enrollment ID: I20200831000047 |
| Provider Name | Courtney Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790347268 PECOS PAC ID: 2062741077 Enrollment ID: I20200831000996 |
| Provider Name | Pamela Sherwill-navarro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487181624 PECOS PAC ID: 8224462734 Enrollment ID: I20200902000045 |
| Provider Name | Daniel Andrew Davignon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851624449 PECOS PAC ID: 2466885629 Enrollment ID: I20200922002206 |
| Provider Name | Edgar A Suter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588637326 PECOS PAC ID: 2466449350 Enrollment ID: I20200923000797 |
| Provider Name | Harold F Cable |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629049762 PECOS PAC ID: 1052382678 Enrollment ID: I20200928002745 |
| Provider Name | Terrence J O'malia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972738532 PECOS PAC ID: 6406022169 Enrollment ID: I20200930003203 |
| Provider Name | Wallace J Salter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851491070 PECOS PAC ID: 4183618572 Enrollment ID: I20201005001185 |
| Provider Name | Andrea A Lui |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780036491 PECOS PAC ID: 4789977570 Enrollment ID: I20201028002745 |
| Provider Name | Debra S Salter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285734491 PECOS PAC ID: 8325032717 Enrollment ID: I20201103002355 |
| Provider Name | John J Mccormick |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144291295 PECOS PAC ID: 9335110956 Enrollment ID: I20201116000398 |
| Provider Name | Jessa Marie Vankleeck |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1255991840 PECOS PAC ID: 7416369343 Enrollment ID: I20201216002890 |
| Provider Name | Maurice Yoskin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639137334 PECOS PAC ID: 4284718651 Enrollment ID: I20210108001230 |
| Provider Name | Tad Willis Buckingham |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992876056 PECOS PAC ID: 7719081421 Enrollment ID: I20210218002646 |
| Provider Name | Scott R Wambolt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427582881 PECOS PAC ID: 4486079241 Enrollment ID: I20210308001961 |
| Provider Name | Charles R Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194840231 PECOS PAC ID: 2668460130 Enrollment ID: I20210319000121 |
| Provider Name | Marie Dowling |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073717732 PECOS PAC ID: 9537215702 Enrollment ID: I20210422000486 |
| Provider Name | Rafael Torres |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487745980 PECOS PAC ID: 7416923305 Enrollment ID: I20210426002373 |
| Provider Name | Edward T Chen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396273132 PECOS PAC ID: 6103237987 Enrollment ID: I20210427000282 |
| Provider Name | Sean D Kalagher |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972715282 PECOS PAC ID: 4587810189 Enrollment ID: I20210429000270 |
| Provider Name | Shawn H Wilson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790794931 PECOS PAC ID: 5597709402 Enrollment ID: I20210518000042 |
| Provider Name | Amy Fuller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366898710 PECOS PAC ID: 3779876610 Enrollment ID: I20210520000608 |
| Provider Name | Charissa M Kamps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821361650 PECOS PAC ID: 6709047020 Enrollment ID: I20210601000690 |
| Provider Name | Kristen Aili Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629679782 PECOS PAC ID: 6608275284 Enrollment ID: I20210602001245 |
| Provider Name | Susan Renteria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881631786 PECOS PAC ID: 1153365739 Enrollment ID: I20210623000685 |
| Provider Name | Devon R Kienzle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003313222 PECOS PAC ID: 8022362664 Enrollment ID: I20210630002004 |
| Provider Name | Paulette Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093943458 PECOS PAC ID: 7517194681 Enrollment ID: I20210630002292 |
| Provider Name | George Banks |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1720449655 PECOS PAC ID: 6901105477 Enrollment ID: I20210812002226 |
| Provider Name | Katherine S Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730479833 PECOS PAC ID: 3274788864 Enrollment ID: I20210826003276 |
| Provider Name | Adam L Woelk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912340597 PECOS PAC ID: 2466765854 Enrollment ID: I20210902000279 |
| Provider Name | Ammar Ali |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083962708 PECOS PAC ID: 7911211396 Enrollment ID: I20210908001833 |
| Provider Name | Stephen Thorp |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1790136158 PECOS PAC ID: 3678979002 Enrollment ID: I20210909001643 |
| Provider Name | Selvasaravanakumar Navaneethakrishnanpoovana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841409935 PECOS PAC ID: 2769529353 Enrollment ID: I20210923000452 |
| Provider Name | Brittany N Speed |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912427576 PECOS PAC ID: 1658642640 Enrollment ID: I20211004002754 |
| Provider Name | Kathryn L Regan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1043985914 PECOS PAC ID: 8022406719 Enrollment ID: I20211029000768 |
| Provider Name | Gabrielle K Flamm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427542828 PECOS PAC ID: 2860881000 Enrollment ID: I20211110000515 |
| Provider Name | Sarah N Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841863164 PECOS PAC ID: 5193120509 Enrollment ID: I20211207000251 |
| Provider Name | Sean A Smith |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1003395328 PECOS PAC ID: 6507101862 Enrollment ID: I20220111000280 |
| Provider Name | Ryan Greene |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104231505 PECOS PAC ID: 2668691700 Enrollment ID: I20220321002468 |
| Provider Name | Stephan Max Becker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063678795 PECOS PAC ID: 2062660921 Enrollment ID: I20220516000871 |
| Provider Name | Kevin M Omilusik |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679579122 PECOS PAC ID: 4183670219 Enrollment ID: I20220622000469 |
| Provider Name | Melinda N Stone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649648148 PECOS PAC ID: 3173852399 Enrollment ID: I20220706000105 |
| Provider Name | Emily P Oliver |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720722879 PECOS PAC ID: 4385025923 Enrollment ID: I20220714000063 |
| Provider Name | Christian S Welch |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669791844 PECOS PAC ID: 5799006953 Enrollment ID: I20220720000150 |
| Provider Name | Bradley Wine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578126561 PECOS PAC ID: 0648505537 Enrollment ID: I20220726000380 |
| Provider Name | Jessica J Delorme |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245612449 PECOS PAC ID: 4183938780 Enrollment ID: I20220728000671 |
| Provider Name | Jessica A Lynch |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154322105 PECOS PAC ID: 6305994310 Enrollment ID: I20220810003922 |
| Provider Name | Matthew Markey-crimp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366903171 PECOS PAC ID: 3072842764 Enrollment ID: I20220909001436 |
| Provider Name | Anna M Mcluen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174936082 PECOS PAC ID: 0941524235 Enrollment ID: I20221110001637 |
| Provider Name | Tiana Michele Oswill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760943534 PECOS PAC ID: 8628310620 Enrollment ID: I20221207000083 |
| Provider Name | William R Harjes |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760862155 PECOS PAC ID: 2163841743 Enrollment ID: I20221212001700 |
| Provider Name | Christopher Ryan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386090496 PECOS PAC ID: 6800224916 Enrollment ID: I20221221002790 |
| Provider Name | Rajiv Girish Rao |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548603574 PECOS PAC ID: 2163756594 Enrollment ID: I20230110001172 |
| Provider Name | Robert W Gneiting |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225105919 PECOS PAC ID: 3678709383 Enrollment ID: I20230210000169 |
| Provider Name | Jeremy Serreyn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194286880 PECOS PAC ID: 1254666944 Enrollment ID: I20230217002213 |
| Provider Name | Ruby Lee Ayres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801369921 PECOS PAC ID: 5193059673 Enrollment ID: I20230324000308 |
| Provider Name | Steven W Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457462335 PECOS PAC ID: 5890827133 Enrollment ID: I20230522003121 |
| Provider Name | Melissa Sousley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518067214 PECOS PAC ID: 1052201431 Enrollment ID: I20230622000028 |
| Provider Name | Adan F Hernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043709850 PECOS PAC ID: 8426485640 Enrollment ID: I20230624000396 |
| Provider Name | Kathleen Cohen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922489343 PECOS PAC ID: 2264726264 Enrollment ID: I20230705000666 |
| Provider Name | Jennifer Patel |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639466121 PECOS PAC ID: 2062684996 Enrollment ID: I20230706002850 |
| Provider Name | Christopher Kowalski |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1154761898 PECOS PAC ID: 5496092108 Enrollment ID: I20230720002931 |
| Provider Name | Jackee I Clement |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861011223 PECOS PAC ID: 6800219809 Enrollment ID: I20230816000498 |
| Provider Name | William R Gailmard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124022884 PECOS PAC ID: 8325077084 Enrollment ID: I20230817000274 |
| Provider Name | Sharon Stake |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942271846 PECOS PAC ID: 5496785461 Enrollment ID: I20230821000973 |
| Provider Name | Laina Gay Cafego |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831539378 PECOS PAC ID: 2769778588 Enrollment ID: I20230904000219 |
| Provider Name | Abasi I Bomani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104388180 PECOS PAC ID: 5092040527 Enrollment ID: I20230905001090 |
| Provider Name | David K Klee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497763809 PECOS PAC ID: 6709881600 Enrollment ID: I20230905001217 |
| Provider Name | Dolores I Van Bourgondien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457788390 PECOS PAC ID: 9032332275 Enrollment ID: I20231003000399 |
| Provider Name | David W Kaminski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831295583 PECOS PAC ID: 7113916701 Enrollment ID: I20231003001530 |
| Provider Name | Eldon Snyder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033503990 PECOS PAC ID: 6800103193 Enrollment ID: I20231004000012 |
| Provider Name | Sarah Beebe |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1821594805 PECOS PAC ID: 4880941830 Enrollment ID: I20231005000783 |
| Provider Name | Jeremiah B Stringam |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942737663 PECOS PAC ID: 0446614440 Enrollment ID: I20231009001506 |
| Provider Name | David C Rogers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407198823 PECOS PAC ID: 3577956200 Enrollment ID: I20231010003028 |
| Provider Name | Alison P Liewen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306374236 PECOS PAC ID: 0547694424 Enrollment ID: I20231031001856 |
| Provider Name | Nicole A Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932122587 PECOS PAC ID: 8820902869 Enrollment ID: I20231130001556 |
| Provider Name | Vikramjeet Singh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598260606 PECOS PAC ID: 0345593554 Enrollment ID: I20231208000196 |
| Provider Name | Dennis A Everson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396351953 PECOS PAC ID: 5496105157 Enrollment ID: I20231221002473 |
| Provider Name | Kelly T Locke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376546002 PECOS PAC ID: 5991778854 Enrollment ID: I20231224000066 |
| Provider Name | Matthew Kluckman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992242028 PECOS PAC ID: 0749630176 Enrollment ID: I20231228000644 |
| Provider Name | Maria E Gallo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396181103 PECOS PAC ID: 7416180500 Enrollment ID: I20240124003966 |
| Provider Name | Lindsey Marie Johanning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649055195 PECOS PAC ID: 5395192314 Enrollment ID: I20240209000384 |
| Provider Name | Geoffrey Waite |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1417292590 PECOS PAC ID: 6800191073 Enrollment ID: I20240424002477 |
| Provider Name | Alyssa Horstman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427627876 PECOS PAC ID: 4183006562 Enrollment ID: I20240513000135 |
| Provider Name | John Bradford Lichlyter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629852900 PECOS PAC ID: 7719320779 Enrollment ID: I20240513000542 |
| Provider Name | Edwin P Davis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205824661 PECOS PAC ID: 7911225073 Enrollment ID: I20240513000761 |
| Provider Name | Aaron Luther Bennett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174984421 PECOS PAC ID: 9335496157 Enrollment ID: I20240513001875 |
| Provider Name | Alonzo Martinez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922882836 PECOS PAC ID: 6305287020 Enrollment ID: I20240513002620 |
| Provider Name | Nicholas J Myers |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558715854 PECOS PAC ID: 9133412281 Enrollment ID: I20240516000861 |
| Provider Name | Leslie A Schwietz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811204456 PECOS PAC ID: 0547495525 Enrollment ID: I20240516002606 |
| Provider Name | Christy Lee Tunney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043853625 PECOS PAC ID: 5698103539 Enrollment ID: I20240531000093 |