|
| |
|
323 Cloverleaf Sq #1 Big Stone Gap VA 24219-2760 | |
| (276) 523-6715 | |
| (276) 523-6719 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 323 Cloverleaf Sq, Big Stone Gap, Virginia |
| Authorized Official Name and Position | Juanita L Harwood (DIRECTOR) |
| Authorized Official Contact | 4233026565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2020 Brookside Dr Kingsport TN 37660-4633 Ph: (423) 343-0434 | 323 Cloverleaf Sq #1 Big Stone Gap VA 24219-2760 Ph: (276) 523-6715 |
| NPI Number | 1174808216 |
|---|---|
| Provider Enumeration Date | 10/20/2011 |
| Last Update Date | 05/10/2024 |
| Medicare PECOS PAC ID | 8123291739 |
|---|---|
| Medicare Enrollment ID | O20120627000467 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174808216 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Marc Dalmond Counts |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1629002043 PECOS PAC ID: 7719884600 Enrollment ID: I20031218000119 |
| Provider Name | Marissa G Vito Cruz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922071448 PECOS PAC ID: 5597667857 Enrollment ID: I20040127000197 |
| Provider Name | Patrick A Molony |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386689230 PECOS PAC ID: 9830188234 Enrollment ID: I20040511000344 |
| Provider Name | Cristobal Nogues |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487622437 PECOS PAC ID: 0244221208 Enrollment ID: I20040519001278 |
| Provider Name | Oscar F Figueroa |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1801889720 PECOS PAC ID: 4981682689 Enrollment ID: I20040709000604 |
| Provider Name | Darlene B Litton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629001862 PECOS PAC ID: 6709864820 Enrollment ID: I20040713001257 |
| Provider Name | Douglas P Williams |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528051208 PECOS PAC ID: 3678552809 Enrollment ID: I20040720000347 |
| Provider Name | Michael A Ponder |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831155944 PECOS PAC ID: 3476454885 Enrollment ID: I20040731000359 |
| Provider Name | Earl K Wilson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568455244 PECOS PAC ID: 0648241141 Enrollment ID: I20040805001178 |
| Provider Name | Eleanor E Hess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982607099 PECOS PAC ID: 0143297747 Enrollment ID: I20040914000192 |
| Provider Name | Nsekenene Kolongo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487685301 PECOS PAC ID: 0941277263 Enrollment ID: I20040915000436 |
| Provider Name | Michael K Patrick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538109038 PECOS PAC ID: 6507824356 Enrollment ID: I20041227000204 |
| Provider Name | Jill K Couch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972561702 PECOS PAC ID: 6103878525 Enrollment ID: I20050214000956 |
| Provider Name | Shawn K Nelson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346233020 PECOS PAC ID: 8729031174 Enrollment ID: I20050224001013 |
| Provider Name | John H Ray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871562181 PECOS PAC ID: 8921038563 Enrollment ID: I20050815000183 |
| Provider Name | Brenda Jessee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457340598 PECOS PAC ID: 2961426218 Enrollment ID: I20060125000614 |
| Provider Name | Mary Mcclain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548247208 PECOS PAC ID: 1456302991 Enrollment ID: I20060214000652 |
| Provider Name | Karen S Prill |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1902899818 PECOS PAC ID: 4385637735 Enrollment ID: I20060504000638 |
| Provider Name | Damian H Sooklal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356338495 PECOS PAC ID: 5193738011 Enrollment ID: I20060719000159 |
| Provider Name | Kelley D Mayden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871526194 PECOS PAC ID: 9638188303 Enrollment ID: I20061101000281 |
| Provider Name | Vanessa T Salyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205861333 PECOS PAC ID: 9537161476 Enrollment ID: I20070206000740 |
| Provider Name | James W Campbell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629128640 PECOS PAC ID: 2961404769 Enrollment ID: I20070207000579 |
| Provider Name | Roger J Mcsharry |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1063405736 PECOS PAC ID: 1456346840 Enrollment ID: I20070319000137 |
| Provider Name | Ronnie S Sadler-chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942259007 PECOS PAC ID: 5294838868 Enrollment ID: I20070320000348 |
| Provider Name | Mark A Borsch |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1447288667 PECOS PAC ID: 3072544808 Enrollment ID: I20070705000438 |
| Provider Name | Pierre Md Istfan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679518989 PECOS PAC ID: 9133150964 Enrollment ID: I20070711000687 |
| Provider Name | Rajesh Shivaji Kadam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134336563 PECOS PAC ID: 6002909538 Enrollment ID: I20070829000598 |
| Provider Name | Jonathan Burress |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1760415582 PECOS PAC ID: 5092719377 Enrollment ID: I20070929000104 |
| Provider Name | Thomas Renfro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497726376 PECOS PAC ID: 1658459805 Enrollment ID: I20080429000233 |
| Provider Name | Kristen Nicole Yost |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982898193 PECOS PAC ID: 2567541352 Enrollment ID: I20080505000764 |
| Provider Name | Maurice E Nida |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285601344 PECOS PAC ID: 9931279981 Enrollment ID: I20080602000888 |
| Provider Name | Teresa Delawter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235212200 PECOS PAC ID: 7214007707 Enrollment ID: I20080610000739 |
| Provider Name | Bruce Grover |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1518919745 PECOS PAC ID: 8729055777 Enrollment ID: I20080612000762 |
| Provider Name | David E Thompson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558331033 PECOS PAC ID: 0941270680 Enrollment ID: I20080623000239 |
| Provider Name | Karen J Stallard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154339869 PECOS PAC ID: 4587735386 Enrollment ID: I20080623000361 |
| Provider Name | Sharjeel Iqbal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417142159 PECOS PAC ID: 2163595968 Enrollment ID: I20080725000515 |
| Provider Name | Mona D Speak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366682551 PECOS PAC ID: 0840357224 Enrollment ID: I20090330000636 |
| Provider Name | James L Raj |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1063496941 PECOS PAC ID: 2769460021 Enrollment ID: I20090424000379 |
| Provider Name | Shelley V Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962643403 PECOS PAC ID: 8820148232 Enrollment ID: I20090605000218 |
| Provider Name | Girendra V Hoskere |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1710970793 PECOS PAC ID: 4880618545 Enrollment ID: I20090723000724 |
| Provider Name | Wendy N Rumley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407082423 PECOS PAC ID: 2961555644 Enrollment ID: I20090728000441 |
| Provider Name | Mary Gehring Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295964179 PECOS PAC ID: 1456407626 Enrollment ID: I20090914000622 |
| Provider Name | Eduardo Fernandez |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1336176130 PECOS PAC ID: 5991757197 Enrollment ID: I20091103000414 |
| Provider Name | Christy R Swinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023281508 PECOS PAC ID: 6901945443 Enrollment ID: I20091123000498 |
| Provider Name | April M Osborne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871829044 PECOS PAC ID: 1759421373 Enrollment ID: I20091211000601 |
| Provider Name | Christopher Sutton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306824289 PECOS PAC ID: 1658402599 Enrollment ID: I20100622000093 |
| Provider Name | Clinton H Sutherland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487622320 PECOS PAC ID: 4981737970 Enrollment ID: I20100727001072 |
| Provider Name | Rohini Nathan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316130586 PECOS PAC ID: 0547394991 Enrollment ID: I20100820000135 |
| Provider Name | Freddie Williams |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1356553648 PECOS PAC ID: 1153473186 Enrollment ID: I20101019001005 |
| Provider Name | Jack H Whitaker |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1922064047 PECOS PAC ID: 5698757128 Enrollment ID: I20101221001144 |
| Provider Name | Zachary A Hammons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073779799 PECOS PAC ID: 6709075690 Enrollment ID: I20110107000255 |
| Provider Name | Herbert Ladley |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174552467 PECOS PAC ID: 0345154852 Enrollment ID: I20110124001248 |
| Provider Name | David Beckner |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1326074220 PECOS PAC ID: 5890788517 Enrollment ID: I20110209001093 |
| Provider Name | Christina K Hammonds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730488875 PECOS PAC ID: 7012192909 Enrollment ID: I20110419000311 |
| Provider Name | Gerald G Blackwell |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689600587 PECOS PAC ID: 4183676992 Enrollment ID: I20110429000101 |
| Provider Name | Pabitra Saha |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1992795066 PECOS PAC ID: 0941399901 Enrollment ID: I20110503000297 |
| Provider Name | Reshma Khetpal |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1336446020 PECOS PAC ID: 9335322122 Enrollment ID: I20110505000824 |
| Provider Name | Robert K Kramer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346285467 PECOS PAC ID: 9537247325 Enrollment ID: I20110602000549 |
| Provider Name | Samuel Deel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568625127 PECOS PAC ID: 9032397781 Enrollment ID: I20110628000243 |
| Provider Name | Dmitri Gagarin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114109089 PECOS PAC ID: 6608058672 Enrollment ID: I20111010000393 |
| Provider Name | John Khuu |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1063639011 PECOS PAC ID: 5597937649 Enrollment ID: I20111013000428 |
| Provider Name | Mihir H Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528226016 PECOS PAC ID: 4789855651 Enrollment ID: I20111019000688 |
| Provider Name | Timothy Schwob |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679543623 PECOS PAC ID: 0547340275 Enrollment ID: I20111107000488 |
| Provider Name | Lucinda Miller |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1174577464 PECOS PAC ID: 9234151168 Enrollment ID: I20111121001012 |
| Provider Name | Donald L Sargent |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184719692 PECOS PAC ID: 2961676077 Enrollment ID: I20111129000170 |
| Provider Name | Melinda Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861770380 PECOS PAC ID: 2668647553 Enrollment ID: I20111205000182 |
| Provider Name | Sallie B Lively |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063781714 PECOS PAC ID: 4284891623 Enrollment ID: I20120213000663 |
| Provider Name | Samantha G Addison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053684332 PECOS PAC ID: 6204095391 Enrollment ID: I20120308000717 |
| Provider Name | John Henry Phillips |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1992859706 PECOS PAC ID: 4880873694 Enrollment ID: I20120615000488 |
| Provider Name | Dane Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952305609 PECOS PAC ID: 7719143874 Enrollment ID: I20120718000590 |
| Provider Name | Leon C Bass |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1063639839 PECOS PAC ID: 8527223239 Enrollment ID: I20120802000316 |
| Provider Name | Amit Vashist |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598950644 PECOS PAC ID: 9335398130 Enrollment ID: I20121017000974 |
| Provider Name | Mark W Chang |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174632475 PECOS PAC ID: 9234027095 Enrollment ID: I20121115000579 |
| Provider Name | Carol S Keen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033461777 PECOS PAC ID: 0143471284 Enrollment ID: I20121119000220 |
| Provider Name | Adel M El Abbassi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1437346301 PECOS PAC ID: 1759423338 Enrollment ID: I20121126000536 |
| Provider Name | Kimberly Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619251626 PECOS PAC ID: 0749447753 Enrollment ID: I20121201000087 |
| Provider Name | Rasmiyah M Jastan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740474527 PECOS PAC ID: 2365595493 Enrollment ID: I20130401000279 |
| Provider Name | Anastasia Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548453327 PECOS PAC ID: 6002901543 Enrollment ID: I20130417000412 |
| Provider Name | Geoffrey G Correll |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861462426 PECOS PAC ID: 0143268763 Enrollment ID: I20130419000021 |
| Provider Name | William D Astin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356310759 PECOS PAC ID: 3577608280 Enrollment ID: I20130426000210 |
| Provider Name | Daniel E Simpson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073539078 PECOS PAC ID: 6103974803 Enrollment ID: I20130625000611 |
| Provider Name | Rachel K Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902244650 PECOS PAC ID: 5193965440 Enrollment ID: I20130709000732 |
| Provider Name | Janett M Pate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952609463 PECOS PAC ID: 9830374693 Enrollment ID: I20130710000146 |
| Provider Name | Kyle A Ward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831487222 PECOS PAC ID: 3779724497 Enrollment ID: I20130723000631 |
| Provider Name | Maung M Kyi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1043231988 PECOS PAC ID: 2769489038 Enrollment ID: I20130801000164 |
| Provider Name | Marc W Mayhew |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710098546 PECOS PAC ID: 1759327240 Enrollment ID: I20130802000828 |
| Provider Name | Beshir M Mohamed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356662340 PECOS PAC ID: 4587806781 Enrollment ID: I20130819000580 |
| Provider Name | Christine E Taylor-hall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730484452 PECOS PAC ID: 7517100019 Enrollment ID: I20130903000335 |
| Provider Name | Joseph D Foley |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1750418547 PECOS PAC ID: 2365542776 Enrollment ID: I20130906000783 |
| Provider Name | Robin M Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861832081 PECOS PAC ID: 6305089814 Enrollment ID: I20130919000618 |
| Provider Name | Gabriel A Zaietta |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1740477116 PECOS PAC ID: 8820232622 Enrollment ID: I20130926000022 |
| Provider Name | Lindsay Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003044694 PECOS PAC ID: 2163656232 Enrollment ID: I20131002000491 |
| Provider Name | Tonya Powers Cleveland |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1124061593 PECOS PAC ID: 0840374005 Enrollment ID: I20131122001419 |
| Provider Name | Tonya D Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386946267 PECOS PAC ID: 1951587492 Enrollment ID: I20131218001255 |
| Provider Name | Barret Blevins |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376973578 PECOS PAC ID: 3870722689 Enrollment ID: I20140127000748 |
| Provider Name | Pushkas Gopalan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376700930 PECOS PAC ID: 3274679949 Enrollment ID: I20140514001210 |
| Provider Name | Haytham F Adada |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1336324896 PECOS PAC ID: 6204980543 Enrollment ID: I20140527000162 |
| Provider Name | Adedoyin Gbadebo Akintide |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518142991 PECOS PAC ID: 5991856551 Enrollment ID: I20140707000690 |
| Provider Name | Jonathan D Dixon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962430496 PECOS PAC ID: 3870538606 Enrollment ID: I20140729001972 |
| Provider Name | Celeste Y Sorah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790101558 PECOS PAC ID: 1759508369 Enrollment ID: I20140805002280 |
| Provider Name | Brian K Stiltner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356638076 PECOS PAC ID: 6507083912 Enrollment ID: I20140808000467 |
| Provider Name | Nicholas D Crall |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316262645 PECOS PAC ID: 3274761333 Enrollment ID: I20140918000656 |
| Provider Name | Charise N Battel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316368814 PECOS PAC ID: 7810116928 Enrollment ID: I20140922001650 |
| Provider Name | Ralph Edward Fig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356750731 PECOS PAC ID: 9638390735 Enrollment ID: I20141014002176 |
| Provider Name | Virginia Ann Thurston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043611882 PECOS PAC ID: 8527280650 Enrollment ID: I20141105001380 |
| Provider Name | Melissa Green Begley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275549354 PECOS PAC ID: 9739405796 Enrollment ID: I20150310001288 |
| Provider Name | Leutshia C Franks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922499409 PECOS PAC ID: 7810214632 Enrollment ID: I20150316001137 |
| Provider Name | Judy C Umstott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548647787 PECOS PAC ID: 4385956333 Enrollment ID: I20150702002356 |
| Provider Name | Mohmad Tantary |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467732388 PECOS PAC ID: 2668785601 Enrollment ID: I20150720001569 |
| Provider Name | Ryan W Shao |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1649406190 PECOS PAC ID: 1759521867 Enrollment ID: I20150810001172 |
| Provider Name | Sherry W Love |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194104976 PECOS PAC ID: 4082929708 Enrollment ID: I20150810002525 |
| Provider Name | Gregory Houston Miller |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063445989 PECOS PAC ID: 3173547643 Enrollment ID: I20150820009690 |
| Provider Name | Geoff S Szabo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629482310 PECOS PAC ID: 0840418935 Enrollment ID: I20150827002573 |
| Provider Name | Kevin Wess |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316061526 PECOS PAC ID: 0446567358 Enrollment ID: I20150909002211 |
| Provider Name | Jasmine M Love |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902213275 PECOS PAC ID: 0648490672 Enrollment ID: I20150911001086 |
| Provider Name | Ashley Corinne Carroll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710369590 PECOS PAC ID: 6800100942 Enrollment ID: I20151009001873 |
| Provider Name | Kaushal Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275858516 PECOS PAC ID: 5092016188 Enrollment ID: I20151215000189 |
| Provider Name | Kelly Fugate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629442694 PECOS PAC ID: 5991009193 Enrollment ID: I20160209001517 |
| Provider Name | Deana J Duffield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124486626 PECOS PAC ID: 4284932310 Enrollment ID: I20160406000407 |
| Provider Name | Stephen P Combs |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144290552 PECOS PAC ID: 9638268477 Enrollment ID: I20160406002328 |
| Provider Name | Joseph W Frye |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1457617011 PECOS PAC ID: 6709178759 Enrollment ID: I20160726002995 |
| Provider Name | Nicholas A Cook |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1114015989 PECOS PAC ID: 1658386040 Enrollment ID: I20160801000430 |
| Provider Name | Furhan Rashid Qureshi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306194667 PECOS PAC ID: 7113233610 Enrollment ID: I20160805002349 |
| Provider Name | David M Mitchell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699724013 PECOS PAC ID: 3577546456 Enrollment ID: I20160817003187 |
| Provider Name | Sharon R Nunley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720436785 PECOS PAC ID: 1951694843 Enrollment ID: I20160906000846 |
| Provider Name | Kathryn A Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093165102 PECOS PAC ID: 7113212689 Enrollment ID: I20161012000567 |
| Provider Name | Stephanie Purvis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942754858 PECOS PAC ID: 3274829577 Enrollment ID: I20161123000133 |
| Provider Name | Kayla J Joyce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184077158 PECOS PAC ID: 7315232154 Enrollment ID: I20161206001529 |
| Provider Name | Jessica N Bembry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043769490 PECOS PAC ID: 9234418831 Enrollment ID: I20161208001581 |
| Provider Name | Melissa A Arrowood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992253140 PECOS PAC ID: 3274820410 Enrollment ID: I20161220002126 |
| Provider Name | Charlotte Fletcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154602217 PECOS PAC ID: 1951573831 Enrollment ID: I20161222000551 |
| Provider Name | Kristen Looney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053784157 PECOS PAC ID: 3971802307 Enrollment ID: I20170130002689 |
| Provider Name | Amanda G Combs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881133585 PECOS PAC ID: 0840577631 Enrollment ID: I20170503002834 |
| Provider Name | Tamara L Musgrave |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1922018605 PECOS PAC ID: 5395837330 Enrollment ID: I20170517002274 |
| Provider Name | Mirle Girish |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1205872876 PECOS PAC ID: 8325044514 Enrollment ID: I20170627001895 |
| Provider Name | Sasha Musick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306376108 PECOS PAC ID: 0345511010 Enrollment ID: I20170731001652 |
| Provider Name | Alana S Cozier |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821387721 PECOS PAC ID: 3173757135 Enrollment ID: I20170907002527 |
| Provider Name | Krissa M Trombetta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477079044 PECOS PAC ID: 7113293994 Enrollment ID: I20171023001882 |
| Provider Name | Michael Matthew Compton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902322126 PECOS PAC ID: 3870850811 Enrollment ID: I20171130000509 |
| Provider Name | April A Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427564079 PECOS PAC ID: 4385904358 Enrollment ID: I20180213000186 |
| Provider Name | Ashley Dawn Mcguire |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114151446 PECOS PAC ID: 9638431877 Enrollment ID: I20180327002731 |
| Provider Name | Rachel Anne Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306208798 PECOS PAC ID: 4385908607 Enrollment ID: I20180514000443 |
| Provider Name | Victoria A. Whitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780182253 PECOS PAC ID: 1153686340 Enrollment ID: I20180516002782 |
| Provider Name | Jennifer Leigh Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770095762 PECOS PAC ID: 6608121587 Enrollment ID: I20180801003970 |
| Provider Name | Denise L. Welsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962956516 PECOS PAC ID: 0345537817 Enrollment ID: I20180815001399 |
| Provider Name | Charles Anthony Villoch |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437251899 PECOS PAC ID: 6901856897 Enrollment ID: I20180821002741 |
| Provider Name | Whitney Fullen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548748486 PECOS PAC ID: 1951653229 Enrollment ID: I20181015002816 |
| Provider Name | Jeffrey Michael Manfredonia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487032157 PECOS PAC ID: 7315290202 Enrollment ID: I20181023000943 |
| Provider Name | Erin Elizabeth Labert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306314612 PECOS PAC ID: 0941544977 Enrollment ID: I20181203001641 |
| Provider Name | Camelia Chirculescu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285629089 PECOS PAC ID: 0648208322 Enrollment ID: I20181204001693 |
| Provider Name | Serena Elizabeth Blevins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952836751 PECOS PAC ID: 4385988062 Enrollment ID: I20181206002055 |
| Provider Name | Richard Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316208382 PECOS PAC ID: 0547552580 Enrollment ID: I20181207002029 |
| Provider Name | Morgan P Powers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881161859 PECOS PAC ID: 1052656774 Enrollment ID: I20181226002426 |
| Provider Name | Trenton Keel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194197475 PECOS PAC ID: 9830498674 Enrollment ID: I20190110001935 |
| Provider Name | Deborah Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710454376 PECOS PAC ID: 1658618202 Enrollment ID: I20190122000136 |
| Provider Name | Charles M. Helton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598168627 PECOS PAC ID: 3072887348 Enrollment ID: I20190122000188 |
| Provider Name | Allison Faith Herron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720563612 PECOS PAC ID: 9436497484 Enrollment ID: I20190218000057 |
| Provider Name | Shipeng Yu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063772150 PECOS PAC ID: 8325342397 Enrollment ID: I20190402001415 |
| Provider Name | Aaron Towe |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1750745477 PECOS PAC ID: 8325375041 Enrollment ID: I20190802002566 |
| Provider Name | Jane Spera Hayes Kestner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467964478 PECOS PAC ID: 7517223043 Enrollment ID: I20190807000090 |
| Provider Name | Keith White |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558620278 PECOS PAC ID: 5991002453 Enrollment ID: I20191002001276 |
| Provider Name | Alli D. Delp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992155303 PECOS PAC ID: 8921339490 Enrollment ID: I20191015000064 |
| Provider Name | Nathan Adam Varbanoff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134678667 PECOS PAC ID: 6406135714 Enrollment ID: I20191028001446 |
| Provider Name | Julius A Gasso |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1942232038 PECOS PAC ID: 8527083922 Enrollment ID: I20191104001201 |
| Provider Name | Andrew Preston Widener |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851875710 PECOS PAC ID: 0244662336 Enrollment ID: I20191111002090 |
| Provider Name | Erika Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295388379 PECOS PAC ID: 3779916531 Enrollment ID: I20191209001968 |
| Provider Name | Mhroos Faik Barak Peters |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1083734123 PECOS PAC ID: 6709959281 Enrollment ID: I20191219000459 |
| Provider Name | Emily Grace Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447895420 PECOS PAC ID: 9830525120 Enrollment ID: I20200205000323 |
| Provider Name | Allison Raettig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689185241 PECOS PAC ID: 3375801954 Enrollment ID: I20200210001958 |
| Provider Name | Wendy E. Abbott |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1497290241 PECOS PAC ID: 0648608307 Enrollment ID: I20200312001263 |
| Provider Name | Rekha Kadam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740719848 PECOS PAC ID: 5294086047 Enrollment ID: I20200402003332 |
| Provider Name | Kara Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629556196 PECOS PAC ID: 5890046270 Enrollment ID: I20200409000590 |
| Provider Name | Asha Sproles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831722966 PECOS PAC ID: 0941621296 Enrollment ID: I20200522000997 |
| Provider Name | Howard Leftin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295748184 PECOS PAC ID: 0941397194 Enrollment ID: I20200603002540 |
| Provider Name | Gail Stanley |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1437124641 PECOS PAC ID: 5092850701 Enrollment ID: I20200608001316 |
| Provider Name | Ayan Novruzov |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245681196 PECOS PAC ID: 5294064291 Enrollment ID: I20200721003908 |
| Provider Name | Gregory Hiett |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467972448 PECOS PAC ID: 9133492903 Enrollment ID: I20200803000357 |
| Provider Name | Sana Yakoob |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386174944 PECOS PAC ID: 5092087320 Enrollment ID: I20200805000762 |
| Provider Name | Derek Wayne White |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619497294 PECOS PAC ID: 3375816135 Enrollment ID: I20200818002539 |
| Provider Name | Tracy Romans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023466786 PECOS PAC ID: 8628364429 Enrollment ID: I20200903003526 |
| Provider Name | Jamie Bartley |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1386679462 PECOS PAC ID: 5496773467 Enrollment ID: I20200908002888 |
| Provider Name | Johnny Fraley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427666460 PECOS PAC ID: 8628029063 Enrollment ID: I20200911002704 |
| Provider Name | Sarah Gach |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235667841 PECOS PAC ID: 3375962202 Enrollment ID: I20200928000142 |
| Provider Name | Lena Manning |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487184974 PECOS PAC ID: 2668745431 Enrollment ID: I20201008002536 |
| Provider Name | Nafees Ameer Mohammed |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1013358167 PECOS PAC ID: 9335376789 Enrollment ID: I20201116000407 |
| Provider Name | Christopher Byrd |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306100789 PECOS PAC ID: 6901115757 Enrollment ID: I20210209001634 |
| Provider Name | Emily B Crabtree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639525975 PECOS PAC ID: 9638463037 Enrollment ID: I20210428000545 |
| Provider Name | Laura Lee Tiller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639755234 PECOS PAC ID: 3971910118 Enrollment ID: I20210506000277 |
| Provider Name | Theresa George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457944951 PECOS PAC ID: 7113336132 Enrollment ID: I20210603001162 |
| Provider Name | Thomas Helton |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1750345211 PECOS PAC ID: 4789620030 Enrollment ID: I20210623001839 |
| Provider Name | Jessica Ingle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609469212 PECOS PAC ID: 0840690756 Enrollment ID: I20210706000696 |
| Provider Name | Paul L Jett |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1780634469 PECOS PAC ID: 7315976032 Enrollment ID: I20210805000487 |
| Provider Name | Tiffany Schack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427667310 PECOS PAC ID: 4587074224 Enrollment ID: I20210805001033 |
| Provider Name | Misty Mabe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750055729 PECOS PAC ID: 2365849528 Enrollment ID: I20210930002163 |
| Provider Name | Melony Almany |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255999330 PECOS PAC ID: 9931507357 Enrollment ID: I20211014002172 |
| Provider Name | Laddie Crisp |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1184114175 PECOS PAC ID: 4789932203 Enrollment ID: I20211022000384 |
| Provider Name | Brent Coyle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275507642 PECOS PAC ID: 3072581669 Enrollment ID: I20211112000247 |
| Provider Name | Tabitha Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912464884 PECOS PAC ID: 0244560837 Enrollment ID: I20211209000378 |
| Provider Name | Jean Inderfurth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851959712 PECOS PAC ID: 6002145695 Enrollment ID: I20211221000508 |
| Provider Name | Kodjovi Kodjo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780100958 PECOS PAC ID: 7517203177 Enrollment ID: I20211227000984 |
| Provider Name | Kelly Harness |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154432003 PECOS PAC ID: 6901898063 Enrollment ID: I20220303001160 |
| Provider Name | Dana Meade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780337162 PECOS PAC ID: 8921493222 Enrollment ID: I20220324000173 |
| Provider Name | Shaena Blevins |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225214786 PECOS PAC ID: 2365580560 Enrollment ID: I20220728000195 |
| Provider Name | Andrew Jordan Rosenfeld |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740772359 PECOS PAC ID: 9032468160 Enrollment ID: I20220816001950 |
| Provider Name | Benjamin Culp |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1558520528 PECOS PAC ID: 2567604820 Enrollment ID: I20220928003763 |
| Provider Name | Saad S Ghumman |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1356723373 PECOS PAC ID: 0648569145 Enrollment ID: I20221013001127 |
| Provider Name | Erin Bicek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528516697 PECOS PAC ID: 2264709344 Enrollment ID: I20221020001777 |
| Provider Name | Chasity Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558025874 PECOS PAC ID: 7214304153 Enrollment ID: I20221104001564 |
| Provider Name | Zachary Gamble |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669901435 PECOS PAC ID: 7214202886 Enrollment ID: I20221107001736 |
| Provider Name | Hisham Amin |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1316443112 PECOS PAC ID: 9335499854 Enrollment ID: I20221110000298 |
| Provider Name | Manju Pushkas |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528629920 PECOS PAC ID: 5597133967 Enrollment ID: I20221116002759 |
| Provider Name | Megan Griffith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821676511 PECOS PAC ID: 0345647277 Enrollment ID: I20221213000660 |
| Provider Name | Juston F Owens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740771344 PECOS PAC ID: 3870842008 Enrollment ID: I20230103000974 |
| Provider Name | Carl Nicholas Chotas |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922488147 PECOS PAC ID: 4981916699 Enrollment ID: I20230103001400 |
| Provider Name | Andrea Newton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114636925 PECOS PAC ID: 1658741459 Enrollment ID: I20230124000649 |
| Provider Name | Jodie Ann Bolling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730801739 PECOS PAC ID: 2163895509 Enrollment ID: I20230306000267 |
| Provider Name | Scottie Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972212330 PECOS PAC ID: 5496706632 Enrollment ID: I20230306001035 |
| Provider Name | Alexander Buskill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740940147 PECOS PAC ID: 1355725920 Enrollment ID: I20230307002145 |
| Provider Name | Mackenzie Rasnake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528771052 PECOS PAC ID: 6103290051 Enrollment ID: I20230316001733 |
| Provider Name | Rodney J Deaton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003934274 PECOS PAC ID: 8921240425 Enrollment ID: I20230316002439 |
| Provider Name | Tabitha Paloian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275111684 PECOS PAC ID: 9335557891 Enrollment ID: I20230317000676 |
| Provider Name | Chen-wen C Heh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467449629 PECOS PAC ID: 6507885670 Enrollment ID: I20230317002677 |
| Provider Name | Ashley Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457708380 PECOS PAC ID: 4284920844 Enrollment ID: I20230322002439 |
| Provider Name | Mark Schuchman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467517300 PECOS PAC ID: 2961683487 Enrollment ID: I20230322002961 |
| Provider Name | Maura Munoz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720407364 PECOS PAC ID: 8729206529 Enrollment ID: I20230322003153 |
| Provider Name | Reena Baharani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659631950 PECOS PAC ID: 5395018865 Enrollment ID: I20230327002878 |
| Provider Name | Robert Weir |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437475266 PECOS PAC ID: 1850531419 Enrollment ID: I20230412000774 |
| Provider Name | Emily Leidig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841807625 PECOS PAC ID: 5193137164 Enrollment ID: I20230412001371 |
| Provider Name | Lisa Painter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437191434 PECOS PAC ID: 2264476753 Enrollment ID: I20230413003038 |
| Provider Name | Simon Jesus Kassis Hadid |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548410590 PECOS PAC ID: 5193917136 Enrollment ID: I20230501001342 |
| Provider Name | Preetham Talari |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265695399 PECOS PAC ID: 4385812171 Enrollment ID: I20230516000379 |
| Provider Name | Jenny Lynn Cyphers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902507353 PECOS PAC ID: 0143686188 Enrollment ID: I20230518000142 |
| Provider Name | Sydney Marie Lefay |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801215249 PECOS PAC ID: 7113216193 Enrollment ID: I20230519001101 |
| Provider Name | Stephen Rubenstein |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1467424044 PECOS PAC ID: 1658321153 Enrollment ID: I20230614002701 |
| Provider Name | Manasa Veluru |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477075760 PECOS PAC ID: 4789061342 Enrollment ID: I20230623000795 |
| Provider Name | Wei Lin |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1386621654 PECOS PAC ID: 1456383256 Enrollment ID: I20230627000060 |
| Provider Name | Steven Derick Todd Joyce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841985934 PECOS PAC ID: 2769840982 Enrollment ID: I20230627000224 |
| Provider Name | Matthew Robert Stawarz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376231548 PECOS PAC ID: 6901265529 Enrollment ID: I20230629002742 |
| Provider Name | Joseph Hill |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1508354572 PECOS PAC ID: 1355700774 Enrollment ID: I20230703002365 |
| Provider Name | Nathan E Gargus |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285928358 PECOS PAC ID: 1557656865 Enrollment ID: I20230711000153 |
| Provider Name | Babuji Gandra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215184726 PECOS PAC ID: 6800042219 Enrollment ID: I20230717003197 |
| Provider Name | Dakota John Robertson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972127413 PECOS PAC ID: 7214352749 Enrollment ID: I20230718001591 |
| Provider Name | Kristin Lea Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144918814 PECOS PAC ID: 2860852043 Enrollment ID: I20230719003309 |
| Provider Name | Jeffrey Steven Blackwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013544774 PECOS PAC ID: 2961826177 Enrollment ID: I20230802002747 |
| Provider Name | Ashima Kapoor |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1750811030 PECOS PAC ID: 8426430943 Enrollment ID: I20230810003250 |
| Provider Name | Fnu Warsha |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1205445079 PECOS PAC ID: 0345602967 Enrollment ID: I20230815000647 |
| Provider Name | Chad Cabell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326422312 PECOS PAC ID: 5294044251 Enrollment ID: I20230825002353 |
| Provider Name | Lindsey Marie Denton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205447604 PECOS PAC ID: 4183041742 Enrollment ID: I20230825002446 |
| Provider Name | Nadia Swanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902093925 PECOS PAC ID: 2860540754 Enrollment ID: I20230829001875 |
| Provider Name | Hershenta Cohen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619466844 PECOS PAC ID: 6204213325 Enrollment ID: I20230830004319 |
| Provider Name | Melinda L Mcdaniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497801559 PECOS PAC ID: 0345422622 Enrollment ID: I20230901000882 |
| Provider Name | Jessica M Elliott |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891215331 PECOS PAC ID: 5890069504 Enrollment ID: I20230901001730 |
| Provider Name | Inga Giske |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912471228 PECOS PAC ID: 1153752621 Enrollment ID: I20230907000381 |
| Provider Name | Brijesh Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790172773 PECOS PAC ID: 0042613689 Enrollment ID: I20230911002235 |
| Provider Name | Azad R Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558983247 PECOS PAC ID: 6406271030 Enrollment ID: I20230919001864 |
| Provider Name | Tyson B Nickels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982384129 PECOS PAC ID: 9436503984 Enrollment ID: I20231012000664 |
| Provider Name | Jackie Church |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629126321 PECOS PAC ID: 1153420195 Enrollment ID: I20231012001138 |
| Provider Name | Gregory Brewer |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1285621870 PECOS PAC ID: 2668367202 Enrollment ID: I20231101003848 |
| Provider Name | Denise J White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477624294 PECOS PAC ID: 4880921667 Enrollment ID: I20231218000100 |
| Provider Name | Katlin Hunt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487168662 PECOS PAC ID: 2466713474 Enrollment ID: I20231222002583 |
| Provider Name | Donald Pierce |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790197523 PECOS PAC ID: 4880811264 Enrollment ID: I20240122001734 |
| Provider Name | Julie Tenbrook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164417606 PECOS PAC ID: 6709876279 Enrollment ID: I20240124000118 |
| Provider Name | Chase Weaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144091422 PECOS PAC ID: 3971955105 Enrollment ID: I20240130000173 |
| Provider Name | Diana Oakes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063995249 PECOS PAC ID: 9537413695 Enrollment ID: I20240130001899 |
| Provider Name | Sophie Feller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134514540 PECOS PAC ID: 0446580260 Enrollment ID: I20240304001670 |
| Provider Name | Ryan L Hargraves |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306983556 PECOS PAC ID: 9234500745 Enrollment ID: I20240304002672 |
| Provider Name | Elizabeth Uzoma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326542523 PECOS PAC ID: 2062745268 Enrollment ID: I20240307002442 |
| Provider Name | Gehan Botrus |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1275910911 PECOS PAC ID: 9537415625 Enrollment ID: I20240404004421 |
| Provider Name | Pedro A Bauza-feliciano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104135128 PECOS PAC ID: 7810114840 Enrollment ID: I20240405000803 |
| Provider Name | Sherifat Forcey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043861438 PECOS PAC ID: 8022442235 Enrollment ID: I20240416000433 |
| Provider Name | Karisa Harpe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629304050 PECOS PAC ID: 2567501463 Enrollment ID: I20240509001862 |
| Provider Name | Tori Lafleur |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447639422 PECOS PAC ID: 7719212927 Enrollment ID: I20240516002874 |
| Provider Name | Mustafa Khan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861489601 PECOS PAC ID: 0345317277 Enrollment ID: I20240520002549 |
| Provider Name | Ann Collier |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487898458 PECOS PAC ID: 0042442915 Enrollment ID: I20240520003854 |
| Provider Name | Joel Radhames Nunez Gonzalez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497066997 PECOS PAC ID: 3577862622 Enrollment ID: I20240522002903 |
| Provider Name | Steven Tversky |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356683874 PECOS PAC ID: 1658633664 Enrollment ID: I20240529004218 |
| Provider Name | Jeremiah Bell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639533870 PECOS PAC ID: 0244524338 Enrollment ID: I20240530003561 |
| Provider Name | Pranusha Pinna |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861983660 PECOS PAC ID: 6406105154 Enrollment ID: I20240603000968 |
| Provider Name | Janette Coelho Leal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992090708 PECOS PAC ID: 4981844305 Enrollment ID: I20240603001481 |
| Provider Name | Aravind Reddy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548756588 PECOS PAC ID: 9436527447 Enrollment ID: I20240603002654 |
| Provider Name | Sam Kumar Saha |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629394390 PECOS PAC ID: 3870733181 Enrollment ID: I20240604002275 |
| Provider Name | Wesley Luke Anderson |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1851811053 PECOS PAC ID: 4486923349 Enrollment ID: I20240605001577 |
| Provider Name | Nataria Pitiyanuvath |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831301811 PECOS PAC ID: 7911069067 Enrollment ID: I20240612001763 |
| Provider Name | Michael Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558757757 PECOS PAC ID: 9335424449 Enrollment ID: I20240628001557 |
| Provider Name | Latangela Smith |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790162493 PECOS PAC ID: 4587979232 Enrollment ID: I20240719001925 |
| Provider Name | Mikayla Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053092122 PECOS PAC ID: 0840652616 Enrollment ID: I20240722000526 |
| Provider Name | Rami-james Assadi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265819478 PECOS PAC ID: 8325343247 Enrollment ID: I20240730001000 |
| Provider Name | Siddharth Dalal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811488455 PECOS PAC ID: 4789928730 Enrollment ID: I20240805004201 |
| Provider Name | Rajiv Narula |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982959979 PECOS PAC ID: 6709147689 Enrollment ID: I20240827001610 |
| Provider Name | Paula Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285912196 PECOS PAC ID: 1355581216 Enrollment ID: I20240827002677 |
| Provider Name | Sarah Nicole Carrier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801067848 PECOS PAC ID: 2668550971 Enrollment ID: I20240906001526 |
| Provider Name | Sos Nalghranyan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1740684646 PECOS PAC ID: 9830463538 Enrollment ID: I20240911000856 |
| Provider Name | Shaine Powers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841828993 PECOS PAC ID: 7810437027 Enrollment ID: I20240913001317 |
| Provider Name | Amy R Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699516500 PECOS PAC ID: 1153862735 Enrollment ID: I20240923003287 |
| Provider Name | Virginia Gail Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164528816 PECOS PAC ID: 0840350062 Enrollment ID: I20240925003124 |
| Provider Name | Aaron Afraim Desai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558758128 PECOS PAC ID: 6608170741 Enrollment ID: I20240926002318 |
| Provider Name | Robert Jones |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1629392410 PECOS PAC ID: 3274767983 Enrollment ID: I20241008002625 |
| Provider Name | Simona Nedelcu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1437689833 PECOS PAC ID: 3072886720 Enrollment ID: I20241015000919 |
| Provider Name | Kathleen Nelson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821067141 PECOS PAC ID: 4880673375 Enrollment ID: I20241018002018 |
| Provider Name | Sherri White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275602690 PECOS PAC ID: 5799882445 Enrollment ID: I20241113004537 |
| Provider Name | Saher Suleman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851747935 PECOS PAC ID: 6507235629 Enrollment ID: I20241114000199 |
| Provider Name | Tina Rose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174064950 PECOS PAC ID: 8224314497 Enrollment ID: I20241118000690 |
| Provider Name | Larisa Syrow |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639364037 PECOS PAC ID: 4082863022 Enrollment ID: I20241120003919 |
| Provider Name | Madhuri Tirumandas |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1043606320 PECOS PAC ID: 3678991130 Enrollment ID: I20241209002922 |
Cloverleaf Chiropractic Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Cloverleaf Sq Ste A2, Big Stone Gap, VA 24219 Phone: 276-523-7128 Fax: 276-523-7213 | |
Wise County Integrated Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 43 Champions Ave, Suite 1, Big Stone Gap, VA 24219 Phone: 276-523-8300 Fax: 423-467-3644 | |
Wellmont Physician Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Cloverleaf Sq, Suite F1, Big Stone Gap, VA 24219 Phone: 276-523-6175 Fax: 276-523-6719 | |
Lawrence J. Fleenor Jr Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1980 Holton Ave E, Big Stone Gap, VA 24219 Phone: 276-523-1600 Fax: 276-523-5308 | |
Pathway Healthcare-virginia, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1941 Neeley Rd, Big Stone Gap, VA 24219 Phone: 703-544-7861 | |
Cloverleaf Chiropractic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1 Cloverleaf Sq Ste A2, Big Stone Gap, VA 24219 Phone: 276-523-7128 Fax: 276-523-7213 |