| American Health Network Of Indiana, Llc | |
|
7440 Woodland Dr Ste 200 Indianapolis IN 46278-1720 | |
| (317) 580-6309 | |
| (317) 580-6309 |
| Full Name | American Health Network Of Indiana, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7440 Woodland Dr Ste 200, Indianapolis, Indiana |
| Authorized Official Name and Position | Brad Alan Courter (VP PRIMARY CARE OPERATIONS IN/OH) |
| Authorized Official Contact | 6147945053 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| American Health Network Of Indiana, Llc 7440 Woodland Dr Ste 200 Indianapolis IN 46278-1720 Ph: (317) 580-6309 | American Health Network Of Indiana, Llc 7440 Woodland Dr Ste 200 Indianapolis IN 46278-1720 Ph: (317) 580-6309 |
| NPI Number | 1831236272 |
|---|---|
| Provider Enumeration Date | 02/01/2007 |
| Last Update Date | 08/19/2024 |
| Medicare PECOS PAC ID | 9830093533 |
|---|---|
| Medicare Enrollment ID | O20031124000691 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831236272 | NPI | - | NPPES |
| Provider Name | Andrew M Cougill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508959487 PECOS PAC ID: 8022921162 Enrollment ID: I20031106000121 |
| Provider Name | Jayakrishnakamal Konijeti |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1295739076 PECOS PAC ID: 0547168007 Enrollment ID: I20031222000790 |
| Provider Name | Donald I Smith |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1114020567 PECOS PAC ID: 6002701216 Enrollment ID: I20040217000772 |
| Provider Name | Coby T Richeson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700835204 PECOS PAC ID: 4981698727 Enrollment ID: I20040413001591 |
| Provider Name | Paula A Hall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558455899 PECOS PAC ID: 7214921063 Enrollment ID: I20040413001693 |
| Provider Name | Michael J Hodkin |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1003899436 PECOS PAC ID: 2264427640 Enrollment ID: I20040415001080 |
| Provider Name | Anthony Charles Simchak |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639176530 PECOS PAC ID: 7517952807 Enrollment ID: I20040416000604 |
| Provider Name | Lloyd D Lorenz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255418125 PECOS PAC ID: 1557358678 Enrollment ID: I20040429000453 |
| Provider Name | Heather A Weber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013094994 PECOS PAC ID: 5698762763 Enrollment ID: I20040429000809 |
| Provider Name | Michael W Mull |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134206014 PECOS PAC ID: 1456348556 Enrollment ID: I20040429001011 |
| Provider Name | Cassandra E Curtis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093808917 PECOS PAC ID: 7517956303 Enrollment ID: I20040507000542 |
| Provider Name | William A Rauh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811914443 PECOS PAC ID: 1153310594 Enrollment ID: I20040520001446 |
| Provider Name | Bonnie Jean Webster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255331112 PECOS PAC ID: 3678554326 Enrollment ID: I20040527000956 |
| Provider Name | Wanda L Estep |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386632644 PECOS PAC ID: 4183606122 Enrollment ID: I20040603000961 |
| Provider Name | Raud Duane Estep |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497723605 PECOS PAC ID: 3173506490 Enrollment ID: I20040609000251 |
| Provider Name | Monica C Hauger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659460541 PECOS PAC ID: 6507840998 Enrollment ID: I20040615000003 |
| Provider Name | Karen D Johns |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427147446 PECOS PAC ID: 5597741561 Enrollment ID: I20040629000844 |
| Provider Name | Kay M Lowney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740276161 PECOS PAC ID: 2062492135 Enrollment ID: I20040721000499 |
| Provider Name | Gregory K Gahl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124105879 PECOS PAC ID: 2365412277 Enrollment ID: I20040728001130 |
| Provider Name | James B Stewart |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194702639 PECOS PAC ID: 0446221782 Enrollment ID: I20040802001132 |
| Provider Name | Murugavel Muthusamy |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1467420760 PECOS PAC ID: 1850362062 Enrollment ID: I20040803000072 |
| Provider Name | Douglas K Blacklidge |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1003901133 PECOS PAC ID: 3274505656 Enrollment ID: I20040806000722 |
| Provider Name | Alexandru N Nitu |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1396828638 PECOS PAC ID: 2769455765 Enrollment ID: I20040817001472 |
| Provider Name | James David Brinkruff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578657813 PECOS PAC ID: 2264408665 Enrollment ID: I20040908000090 |
| Provider Name | Christopher M Wilson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467553149 PECOS PAC ID: 1254308448 Enrollment ID: I20040916000371 |
| Provider Name | Philippe B Delalande |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114961182 PECOS PAC ID: 3971562745 Enrollment ID: I20041007000222 |
| Provider Name | Dawn Denise Lagerkvist |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407802531 PECOS PAC ID: 0941261440 Enrollment ID: I20041019000661 |
| Provider Name | Robert J Blok |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497748552 PECOS PAC ID: 6800857723 Enrollment ID: I20041025000331 |
| Provider Name | Rajiv Tewari |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1245292606 PECOS PAC ID: 0345208047 Enrollment ID: I20041229000298 |
| Provider Name | Stephen M Schultz |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1033188719 PECOS PAC ID: 9234189655 Enrollment ID: I20050124000958 |
| Provider Name | Frank J Pistoia |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558346627 PECOS PAC ID: 4486604659 Enrollment ID: I20050125001006 |
| Provider Name | Lori J Wells |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154306124 PECOS PAC ID: 0244280428 Enrollment ID: I20050125001064 |
| Provider Name | Brian J Wiegel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609852359 PECOS PAC ID: 1052361235 Enrollment ID: I20050125001072 |
| Provider Name | Lynn L Strueh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609953561 PECOS PAC ID: 7214987379 Enrollment ID: I20050126000618 |
| Provider Name | John M Miller |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1972698009 PECOS PAC ID: 8729032313 Enrollment ID: I20050307000452 |
| Provider Name | Julie Crystle Grannan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639173594 PECOS PAC ID: 3971557216 Enrollment ID: I20050309000492 |
| Provider Name | Dennis F Lawton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417041773 PECOS PAC ID: 2163462557 Enrollment ID: I20050504001254 |
| Provider Name | William E Sowers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841378833 PECOS PAC ID: 9133169444 Enrollment ID: I20050505001033 |
| Provider Name | Christopher L Winters |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1275628398 PECOS PAC ID: 8820039019 Enrollment ID: I20050518000466 |
| Provider Name | Mohammad S Bahrami |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083791719 PECOS PAC ID: 5890738249 Enrollment ID: I20050607000090 |
| Provider Name | Travis A Richardson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073606984 PECOS PAC ID: 1557305471 Enrollment ID: I20050613000328 |
| Provider Name | Jonathan D Condit |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194803189 PECOS PAC ID: 9931143880 Enrollment ID: I20050613000575 |
| Provider Name | Steve L Rousseau |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306924394 PECOS PAC ID: 2860436730 Enrollment ID: I20050613000763 |
| Provider Name | Kimberly R Mauller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164500153 PECOS PAC ID: 6901840875 Enrollment ID: I20050613000797 |
| Provider Name | Mark A Reedy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508944596 PECOS PAC ID: 6103860929 Enrollment ID: I20050613001239 |
| Provider Name | Tina Michelle Lawson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528044161 PECOS PAC ID: 1052357605 Enrollment ID: I20050705000776 |
| Provider Name | Adam A A French |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902857147 PECOS PAC ID: 4284612425 Enrollment ID: I20050707000089 |
| Provider Name | Patricia A Hallett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194802611 PECOS PAC ID: 1658308952 Enrollment ID: I20050719000442 |
| Provider Name | Rita K Singh Parikshak |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1538142872 PECOS PAC ID: 7911930201 Enrollment ID: I20050916000414 |
| Provider Name | Samuel M Horton |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073531257 PECOS PAC ID: 7113951476 Enrollment ID: I20050926000646 |
| Provider Name | Sondi L Beeler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497838072 PECOS PAC ID: 8325067259 Enrollment ID: I20051121000184 |
| Provider Name | George M Cornett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902808199 PECOS PAC ID: 5496776148 Enrollment ID: I20051209000525 |
| Provider Name | Ronald A Bennett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740284470 PECOS PAC ID: 8123008927 Enrollment ID: I20051209000576 |
| Provider Name | Dawn T Zapinski |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1720086739 PECOS PAC ID: 9436164829 Enrollment ID: I20060206000923 |
| Provider Name | William C Hoover |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689602062 PECOS PAC ID: 9234138108 Enrollment ID: I20061204000573 |
| Provider Name | Michelle R Cropper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669480315 PECOS PAC ID: 2860491800 Enrollment ID: I20061220000363 |
| Provider Name | Kenneth A Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437150067 PECOS PAC ID: 0244230589 Enrollment ID: I20070110000278 |
| Provider Name | Laurence M Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508961475 PECOS PAC ID: 9931109188 Enrollment ID: I20070111000359 |
| Provider Name | Martha J Hoshaw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275616864 PECOS PAC ID: 7517060213 Enrollment ID: I20070319000293 |
| Provider Name | Tabitha A Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336299221 PECOS PAC ID: 5991809089 Enrollment ID: I20070329000352 |
| Provider Name | Therese L Defabis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538250618 PECOS PAC ID: 3072617935 Enrollment ID: I20070402000654 |
| Provider Name | Karen Denise Kinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255464665 PECOS PAC ID: 7810096757 Enrollment ID: I20070619000197 |
| Provider Name | Brian Patrick Murphy |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376599506 PECOS PAC ID: 2365454386 Enrollment ID: I20070801000405 |
| Provider Name | Mahesh K Jindal |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1194948364 PECOS PAC ID: 4789664962 Enrollment ID: I20071001000717 |
| Provider Name | Emily Marie Bell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952448995 PECOS PAC ID: 1658467345 Enrollment ID: I20071010000682 |
| Provider Name | John M Beerbower |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891832846 PECOS PAC ID: 0840388450 Enrollment ID: I20071115000326 |
| Provider Name | Sabrina L Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912986217 PECOS PAC ID: 1456438605 Enrollment ID: I20080411000401 |
| Provider Name | Ashish Thapar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174724207 PECOS PAC ID: 2365516515 Enrollment ID: I20080806000019 |
| Provider Name | Marina Behrad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821267873 PECOS PAC ID: 9830267004 Enrollment ID: I20081001000731 |
| Provider Name | Aftab A Chaudhry |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1912977281 PECOS PAC ID: 6305736745 Enrollment ID: I20090513000154 |
| Provider Name | Theresa D Atkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992946677 PECOS PAC ID: 9638228737 Enrollment ID: I20090520000310 |
| Provider Name | Derek A Oldham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346338894 PECOS PAC ID: 2466503610 Enrollment ID: I20090629000205 |
| Provider Name | Brian T Heimer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972597540 PECOS PAC ID: 8224069240 Enrollment ID: I20091216000529 |
| Provider Name | James Kozarek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235216763 PECOS PAC ID: 9739113903 Enrollment ID: I20100115000515 |
| Provider Name | Wayne C Snyder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629155130 PECOS PAC ID: 4486796174 Enrollment ID: I20100119000218 |
| Provider Name | Mark R Benson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194808436 PECOS PAC ID: 9234273368 Enrollment ID: I20100212000513 |
| Provider Name | Mark R Lamb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316036213 PECOS PAC ID: 6608910468 Enrollment ID: I20100217000051 |
| Provider Name | Thaddaeus M Poe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598855967 PECOS PAC ID: 7810031671 Enrollment ID: I20100217000115 |
| Provider Name | Donald P Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427141357 PECOS PAC ID: 2062556871 Enrollment ID: I20100217000572 |
| Provider Name | Stephanie J Kinnaman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275627523 PECOS PAC ID: 1658415237 Enrollment ID: I20100219000655 |
| Provider Name | Subha Elango |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841465994 PECOS PAC ID: 1052455680 Enrollment ID: I20100220000409 |
| Provider Name | Thomas M O'connor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043304306 PECOS PAC ID: 2567551674 Enrollment ID: I20100222000096 |
| Provider Name | Talessa L Powell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629162987 PECOS PAC ID: 0941344485 Enrollment ID: I20100222000205 |
| Provider Name | Stephen W Nale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134153463 PECOS PAC ID: 1052339991 Enrollment ID: I20100302000484 |
| Provider Name | John D Crase |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902820798 PECOS PAC ID: 6204971211 Enrollment ID: I20100302000531 |
| Provider Name | Jonathan L Grief |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548281967 PECOS PAC ID: 0446395453 Enrollment ID: I20100302000566 |
| Provider Name | Joseph J Vanvaler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689629180 PECOS PAC ID: 2365519352 Enrollment ID: I20100303000750 |
| Provider Name | Thomas J Moretto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326133612 PECOS PAC ID: 1759470867 Enrollment ID: I20100312000733 |
| Provider Name | Christina M Pinkerton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477648665 PECOS PAC ID: 2961537188 Enrollment ID: I20100312000815 |
| Provider Name | Jill R Stanton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710060058 PECOS PAC ID: 0648305755 Enrollment ID: I20100315000670 |
| Provider Name | Mark A Wyant |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558456632 PECOS PAC ID: 6406981513 Enrollment ID: I20100315000722 |
| Provider Name | Cheryl L Shaw |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1285965541 PECOS PAC ID: 5193850212 Enrollment ID: I20100315000771 |
| Provider Name | Alison R Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043305279 PECOS PAC ID: 5496880403 Enrollment ID: I20100316000693 |
| Provider Name | Susan L Jacob |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508951872 PECOS PAC ID: 6305971250 Enrollment ID: I20100317000155 |
| Provider Name | George A Desilvester |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982798195 PECOS PAC ID: 1658406558 Enrollment ID: I20100317000600 |
| Provider Name | Douglas W Robertson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790879914 PECOS PAC ID: 0244365161 Enrollment ID: I20100317000886 |
| Provider Name | Nicole L Lockwood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225111826 PECOS PAC ID: 5294862645 Enrollment ID: I20100416000439 |
| Provider Name | Sherri L Nuss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174609150 PECOS PAC ID: 5890822183 Enrollment ID: I20100419000179 |
| Provider Name | Marjorie E Wiseman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093783193 PECOS PAC ID: 6800926114 Enrollment ID: I20100614000319 |
| Provider Name | Andrew T Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871798793 PECOS PAC ID: 6901939461 Enrollment ID: I20100804000376 |
| Provider Name | Andrew A Houston |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093980609 PECOS PAC ID: 1951434281 Enrollment ID: I20100806000103 |
| Provider Name | Daniel Williams |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1699984641 PECOS PAC ID: 4284775057 Enrollment ID: I20100828000051 |
| Provider Name | Praveen C Perni |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1437368479 PECOS PAC ID: 1759427610 Enrollment ID: I20100913000923 |
| Provider Name | John M Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720021769 PECOS PAC ID: 7113043290 Enrollment ID: I20100927000341 |
| Provider Name | Chrystal L Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053308056 PECOS PAC ID: 0244356061 Enrollment ID: I20100929000333 |
| Provider Name | Doris M Carden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558661744 PECOS PAC ID: 0840470753 Enrollment ID: I20110210000132 |
| Provider Name | Andrew T Bridge |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1174780837 PECOS PAC ID: 7618157231 Enrollment ID: I20110214000525 |
| Provider Name | Abbie M Tolliver |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437318706 PECOS PAC ID: 6507047016 Enrollment ID: I20110216000730 |
| Provider Name | Sharron P Grannis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194773267 PECOS PAC ID: 6901089150 Enrollment ID: I20110324000719 |
| Provider Name | Sarah Allison Feider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639483753 PECOS PAC ID: 6204013444 Enrollment ID: I20110615000551 |
| Provider Name | Marc Underhill |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619188661 PECOS PAC ID: 8022155464 Enrollment ID: I20110627000455 |
| Provider Name | Larry L Stover |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366647034 PECOS PAC ID: 9032387337 Enrollment ID: I20110712000266 |
| Provider Name | Terry I Neal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053306712 PECOS PAC ID: 4385818863 Enrollment ID: I20111118000119 |
| Provider Name | Travis Edward Clegg |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1740494418 PECOS PAC ID: 2062675705 Enrollment ID: I20120517000045 |
| Provider Name | Brian J Coppinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649407685 PECOS PAC ID: 8628232014 Enrollment ID: I20120615000034 |
| Provider Name | Ryan N. Sauer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427243385 PECOS PAC ID: 1052491883 Enrollment ID: I20120628000224 |
| Provider Name | Ashwin K Vasudevamurthy |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1497998520 PECOS PAC ID: 6800052713 Enrollment ID: I20120723000047 |
| Provider Name | Hope L Spitzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164782645 PECOS PAC ID: 8325204712 Enrollment ID: I20120731000079 |
| Provider Name | Aaron C Coats |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376752071 PECOS PAC ID: 8426208075 Enrollment ID: I20121017000580 |
| Provider Name | Denise M Brehmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831443977 PECOS PAC ID: 5496906547 Enrollment ID: I20121119000369 |
| Provider Name | Pacia A Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760753487 PECOS PAC ID: 2062650609 Enrollment ID: I20130521000502 |
| Provider Name | Cayla Burke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427131143 PECOS PAC ID: 1557361797 Enrollment ID: I20130626000450 |
| Provider Name | Kathy J Scifres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437408150 PECOS PAC ID: 8527217579 Enrollment ID: I20130805000025 |
| Provider Name | Daniel K Storey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215252754 PECOS PAC ID: 2769626415 Enrollment ID: I20130918000710 |
| Provider Name | Jeremy M Paden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982044764 PECOS PAC ID: 2365677085 Enrollment ID: I20131104001574 |
| Provider Name | Michelle M Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609201680 PECOS PAC ID: 5698903045 Enrollment ID: I20140110001583 |
| Provider Name | Andrea S Tearman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396179537 PECOS PAC ID: 6204064538 Enrollment ID: I20140114000577 |
| Provider Name | Susan Blakemore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437583390 PECOS PAC ID: 3072741040 Enrollment ID: I20140121000831 |
| Provider Name | Shantaniece Sherrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609203884 PECOS PAC ID: 8527296474 Enrollment ID: I20140122001595 |
| Provider Name | Tamera Crowe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275520629 PECOS PAC ID: 6305888629 Enrollment ID: I20140212001544 |
| Provider Name | Scott M Hoffman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1437447620 PECOS PAC ID: 2062635832 Enrollment ID: I20140523000439 |
| Provider Name | Caleb R Overpeck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740576529 PECOS PAC ID: 4789820655 Enrollment ID: I20140623000870 |
| Provider Name | Drew W Bright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962796649 PECOS PAC ID: 8729226659 Enrollment ID: I20140627001373 |
| Provider Name | Todd J Capes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568757227 PECOS PAC ID: 6406094929 Enrollment ID: I20140710000411 |
| Provider Name | Martin Pruss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053363861 PECOS PAC ID: 6800811985 Enrollment ID: I20140730001429 |
| Provider Name | Parminder Wadhwa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346479375 PECOS PAC ID: 5092979039 Enrollment ID: I20140804000192 |
| Provider Name | Sean Michael Kellihan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467867028 PECOS PAC ID: 0042534703 Enrollment ID: I20150129000344 |
| Provider Name | Eric W Hewitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265531909 PECOS PAC ID: 4183848468 Enrollment ID: I20150210002196 |
| Provider Name | Cacia L Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619362076 PECOS PAC ID: 9739409681 Enrollment ID: I20150518001338 |
| Provider Name | Sarah K Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316337744 PECOS PAC ID: 0042523763 Enrollment ID: I20150723007652 |
| Provider Name | Colin Blackburn |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1790042638 PECOS PAC ID: 6901110220 Enrollment ID: I20150730013478 |
| Provider Name | Meagan Lee Mcdurfee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033439542 PECOS PAC ID: 7719291889 Enrollment ID: I20150803001386 |
| Provider Name | Jennie Maguire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215306444 PECOS PAC ID: 9537461561 Enrollment ID: I20160108000435 |
| Provider Name | Andrew T Daluga |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790103315 PECOS PAC ID: 3072739960 Enrollment ID: I20160506001367 |
| Provider Name | Staci D Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417400755 PECOS PAC ID: 6507152808 Enrollment ID: I20160913002077 |
| Provider Name | Angela M Cottey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669830592 PECOS PAC ID: 1355638701 Enrollment ID: I20160928001619 |
| Provider Name | Melissa Grimes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053860502 PECOS PAC ID: 4486933306 Enrollment ID: I20161117000999 |
| Provider Name | David B Murphy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750762506 PECOS PAC ID: 9335451541 Enrollment ID: I20161213002013 |
| Provider Name | Yousuf A Bahrami |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548641525 PECOS PAC ID: 8224341359 Enrollment ID: I20170119002368 |
| Provider Name | Sei Young V Kwak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689126674 PECOS PAC ID: 4587949946 Enrollment ID: I20170327001574 |
| Provider Name | Anuj Amrut Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336439652 PECOS PAC ID: 1355564543 Enrollment ID: I20170605001549 |
| Provider Name | Andrew Kapsalis |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1780093765 PECOS PAC ID: 5698076230 Enrollment ID: I20170731000753 |
| Provider Name | Abby N Merrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255862223 PECOS PAC ID: 4082985577 Enrollment ID: I20170801003595 |
| Provider Name | Candace R Wooten |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174941801 PECOS PAC ID: 4688960354 Enrollment ID: I20170816001224 |
| Provider Name | Aimee Hamm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508383803 PECOS PAC ID: 9830463090 Enrollment ID: I20170927000384 |
| Provider Name | Kelly E Ryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801306808 PECOS PAC ID: 4880960814 Enrollment ID: I20171019000697 |
| Provider Name | Heather R Hutchens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548700511 PECOS PAC ID: 0941566632 Enrollment ID: I20171114000093 |
| Provider Name | Matthew Nettleman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659756484 PECOS PAC ID: 6800193095 Enrollment ID: I20180710001919 |
| Provider Name | Jurga Tritenko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942788559 PECOS PAC ID: 7517218555 Enrollment ID: I20181001002778 |
| Provider Name | Karen Louise Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770062440 PECOS PAC ID: 0941554638 Enrollment ID: I20181115001804 |
| Provider Name | Angela Elise Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437625506 PECOS PAC ID: 0446595615 Enrollment ID: I20181215000174 |
| Provider Name | Amanda K Goins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255815379 PECOS PAC ID: 1951646850 Enrollment ID: I20190130002765 |
| Provider Name | Lashelle M Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497219430 PECOS PAC ID: 3274873658 Enrollment ID: I20190321001141 |
| Provider Name | Amber Rowan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023572906 PECOS PAC ID: 7810238425 Enrollment ID: I20190409001460 |
| Provider Name | James G Horton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164407326 PECOS PAC ID: 7012001902 Enrollment ID: I20190508000569 |
| Provider Name | Namrata M Shah |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1023252665 PECOS PAC ID: 4385951904 Enrollment ID: I20190524002100 |
| Provider Name | Amy Staritz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427168145 PECOS PAC ID: 1759370984 Enrollment ID: I20191126001511 |
| Provider Name | Michelle Lynn Wyatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609426220 PECOS PAC ID: 4587097829 Enrollment ID: I20191127001474 |
| Provider Name | Jordan K Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174157929 PECOS PAC ID: 2264861194 Enrollment ID: I20200328000123 |
| Provider Name | Lisa Lemons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245861988 PECOS PAC ID: 4082043914 Enrollment ID: I20200328000146 |
| Provider Name | Sarah Knoth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083245088 PECOS PAC ID: 0840629903 Enrollment ID: I20200411000214 |
| Provider Name | Juliet M Nottingham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437717279 PECOS PAC ID: 4880024397 Enrollment ID: I20200424000934 |
| Provider Name | Angela Ni Yang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821618521 PECOS PAC ID: 3779914189 Enrollment ID: I20200518002710 |
| Provider Name | Sarah Lynne Weber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053932970 PECOS PAC ID: 8426479601 Enrollment ID: I20200526000150 |
| Provider Name | Elizabeth Chan |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1104351352 PECOS PAC ID: 4183049299 Enrollment ID: I20200806002683 |
| Provider Name | Andrew R Morrow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689194086 PECOS PAC ID: 5698040160 Enrollment ID: I20200813001947 |
| Provider Name | Charles Sisovsky |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1922459908 PECOS PAC ID: 8123352069 Enrollment ID: I20200814002150 |
| Provider Name | Nathan S Timm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902301195 PECOS PAC ID: 5698193373 Enrollment ID: I20200911001643 |
| Provider Name | Donna Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790390136 PECOS PAC ID: 8628497237 Enrollment ID: I20201014000609 |
| Provider Name | Jennifer J Pelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972104461 PECOS PAC ID: 9739592346 Enrollment ID: I20201228001347 |
| Provider Name | Gabrielle Ann Peterman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396367165 PECOS PAC ID: 2264848910 Enrollment ID: I20210304001721 |
| Provider Name | Rebecca M Phipps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447833207 PECOS PAC ID: 0840609798 Enrollment ID: I20210506001005 |
| Provider Name | Tyler Jon Beach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861983348 PECOS PAC ID: 5496000861 Enrollment ID: I20210712001701 |
| Provider Name | Donna M Beaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215593983 PECOS PAC ID: 7214332303 Enrollment ID: I20210827001752 |
| Provider Name | Abigail Ann Langenstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588236608 PECOS PAC ID: 2163828435 Enrollment ID: I20210913000531 |
| Provider Name | Aliza Mazhar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417454505 PECOS PAC ID: 9830439561 Enrollment ID: I20211019003104 |
| Provider Name | Jesse David Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114590080 PECOS PAC ID: 6002204419 Enrollment ID: I20211103002198 |
| Provider Name | Brandi Tolman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841653482 PECOS PAC ID: 9436441037 Enrollment ID: I20211117001954 |
| Provider Name | Rina A Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962576330 PECOS PAC ID: 3779573530 Enrollment ID: I20211130000798 |
| Provider Name | Akxay S Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841368222 PECOS PAC ID: 2668481748 Enrollment ID: I20211130001561 |
| Provider Name | Adriana K Segatta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831695402 PECOS PAC ID: 5395092647 Enrollment ID: I20211214001753 |
| Provider Name | Nageshwari Golla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811661499 PECOS PAC ID: 4981096245 Enrollment ID: I20220118001109 |
| Provider Name | Allison Elizabeth Goetz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992267991 PECOS PAC ID: 7315327137 Enrollment ID: I20220711000358 |
| Provider Name | Rebecca Irene Smock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063974814 PECOS PAC ID: 3870826076 Enrollment ID: I20220711002504 |
| Provider Name | Casey Danielle Hurlock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881326155 PECOS PAC ID: 0840671632 Enrollment ID: I20220726001465 |
| Provider Name | Kelcey L Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629705298 PECOS PAC ID: 5698159226 Enrollment ID: I20220831002499 |
| Provider Name | Robyn Lyn Weaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134843907 PECOS PAC ID: 8325410780 Enrollment ID: I20230211000376 |
| Provider Name | Elaine Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023717907 PECOS PAC ID: 4981079886 Enrollment ID: I20230406001408 |
| Provider Name | Elisha Carol Trapp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215504147 PECOS PAC ID: 4082089990 Enrollment ID: I20230406001877 |
| Provider Name | Melissa L Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841995537 PECOS PAC ID: 6305201807 Enrollment ID: I20230506000192 |
| Provider Name | Amanda Nichole Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144915455 PECOS PAC ID: 5991161259 Enrollment ID: I20230512000278 |
| Provider Name | Howard Kessler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477500775 PECOS PAC ID: 2769387620 Enrollment ID: I20230530003223 |
| Provider Name | Paul Depippo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114939063 PECOS PAC ID: 9830126051 Enrollment ID: I20230601003226 |
| Provider Name | Kalen Farr |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1639794225 PECOS PAC ID: 1254798291 Enrollment ID: I20230606001862 |
| Provider Name | Serge Sicular |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326276866 PECOS PAC ID: 0941442958 Enrollment ID: I20230607000492 |
| Provider Name | Leyla Nasehi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043629504 PECOS PAC ID: 3577859271 Enrollment ID: I20230607003779 |
| Provider Name | Michael Ramsay |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942272562 PECOS PAC ID: 5092709014 Enrollment ID: I20230620002473 |
| Provider Name | Wendell Wilmoth |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245499003 PECOS PAC ID: 8123258746 Enrollment ID: I20230620002519 |
| Provider Name | Anthony Hamame |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184872327 PECOS PAC ID: 8022250752 Enrollment ID: I20230621001985 |
| Provider Name | Samantha Avery |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215178090 PECOS PAC ID: 0143443697 Enrollment ID: I20230622003161 |
| Provider Name | William Strimel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366425134 PECOS PAC ID: 0345243028 Enrollment ID: I20230623002683 |
| Provider Name | Clayton Boyd |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720463698 PECOS PAC ID: 9436466901 Enrollment ID: I20230629002364 |
| Provider Name | Donald T Mcdonald |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1871159772 PECOS PAC ID: 0648692681 Enrollment ID: I20230629002578 |
| Provider Name | Carlos Zamora |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023314952 PECOS PAC ID: 9436303138 Enrollment ID: I20230703001221 |
| Provider Name | Tejas Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861768152 PECOS PAC ID: 9739481292 Enrollment ID: I20230717003480 |
| Provider Name | Jaime Shouse Gossan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1275827297 PECOS PAC ID: 2567639487 Enrollment ID: I20230726001597 |
| Provider Name | Karena Wong |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1760610786 PECOS PAC ID: 9537213756 Enrollment ID: I20230726003130 |
| Provider Name | Johnathan Hays |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366654162 PECOS PAC ID: 5698825867 Enrollment ID: I20230726003434 |
| Provider Name | Amy Levine |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457394884 PECOS PAC ID: 9931148418 Enrollment ID: I20230802004286 |
| Provider Name | James Silvestri |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083712483 PECOS PAC ID: 7517957483 Enrollment ID: I20230803001824 |
| Provider Name | Phillip A Triantos |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104821297 PECOS PAC ID: 9931003035 Enrollment ID: I20230808001092 |
| Provider Name | Corinna Chang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770651416 PECOS PAC ID: 1759357320 Enrollment ID: I20230811001441 |
| Provider Name | Abhimanyu Aggarwal |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447605704 PECOS PAC ID: 7618365511 Enrollment ID: I20230821000510 |
| Provider Name | Todd Schirmang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134347305 PECOS PAC ID: 8123142882 Enrollment ID: I20230914001577 |
| Provider Name | Monik Lala |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194847038 PECOS PAC ID: 9830264290 Enrollment ID: I20231108001940 |
| Provider Name | Zachary Redus |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831325307 PECOS PAC ID: 7911146915 Enrollment ID: I20240316000249 |
| Provider Name | Swaminatha Gurudevan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265525174 PECOS PAC ID: 5294779021 Enrollment ID: I20240316000401 |
| Provider Name | Monique Fox |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952433641 PECOS PAC ID: 6800980376 Enrollment ID: I20240316000446 |
| Provider Name | Jamie Giesbrandt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700020179 PECOS PAC ID: 3779720289 Enrollment ID: I20240411004413 |
| Provider Name | Christopher Kauffman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316110364 PECOS PAC ID: 1254571912 Enrollment ID: I20240514002241 |
Moazzam Habib Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9240 N Meridian St, Suite 240, Indianapolis, IN 46260 Phone: 317-571-0030 Fax: 317-571-0031 | |
Shalom 56th Street-new Access Point Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5750 W 56th St, Indianapolis, IN 46254 Phone: 317-291-7422 Fax: 317-291-4912 | |
Franciscan Health Indianapolis & Mooresville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5230a East Stop 11 Road, Suite 250, Indianapolis, IN 46237 Phone: 317-528-8921 Fax: 317-528-6916 | |
Evernorth Care Providers - Delaware Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8888 Keystone Xing Ste 1300, Indianapolis, IN 46240 Phone: 773-292-4800 Fax: 312-564-4059 | |
Eskenazi Health Center Cottage Corner Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1434 Shelby St, Indianapolis, IN 46203 Phone: 317-655-3200 Fax: 317-655-3210 | |
Hello Wellness Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1040 E 86th St, Suite 48-a, Indianapolis, IN 46240 Phone: 317-569-1800 | |
Indiana Neurodiagnostics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9465 Counselors Row, Ste. 200 Office 257, Indianapolis, IN 46240 Phone: 317-614-0310 Fax: 866-279-4704 |