| Kintegra Family Medicine - Hudson | |
|
991 West Hudson Boulevard Gastonia NC 28052-6430 | |
| (704) 853-5079 | |
| Not Available |
| Full Name | Kintegra Family Medicine - Hudson |
|---|---|
| Speciality | Clinic/Center |
| Location | 991 West Hudson Boulevard, Gastonia, North Carolina |
| Authorized Official Name and Position | Sharmila Alexander Anderson (BUSINESS SERVICE ADMINISTRATOR) |
| Authorized Official Contact | 7048741907 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kintegra Family Medicine - Hudson 200 E 2nd Ave Gastonia NC 28052-4358 Ph: (704) 874-1904 | Kintegra Family Medicine - Hudson 991 West Hudson Boulevard Gastonia NC 28052-6430 Ph: (704) 853-5079 |
| NPI Number | 1215932215 |
|---|---|
| Provider Enumeration Date | 06/16/2005 |
| Last Update Date | 01/15/2020 |
| Medicare PECOS PAC ID | 5496733925 |
|---|---|
| Medicare Enrollment ID | O20040712000470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215932215 | NPI | - | NPPES |
| 611963200 | Other | NC | BLACK LUNG PROGRAM |
| 0136X | Other | NC | BLUE CROSS NUMBER |
| NPB239 | Medicaid | SC | |
| 344574A | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Lisa B Huntsinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447367206 PECOS PAC ID: 5698674364 Enrollment ID: I20040102000242 |
| Provider Name | Van S Stitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497751481 PECOS PAC ID: 4587574553 Enrollment ID: I20040212000581 |
| Provider Name | Luredean Gale Hamilton-brandon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629006994 PECOS PAC ID: 1850355496 Enrollment ID: I20041115000330 |
| Provider Name | Steven L Sanderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508881681 PECOS PAC ID: 7911958574 Enrollment ID: I20050201000901 |
| Provider Name | Sarah T Jordan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740389600 PECOS PAC ID: 1456302686 Enrollment ID: I20050204000715 |
| Provider Name | Marshall G Gravely |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235247628 PECOS PAC ID: 3577515121 Enrollment ID: I20050211000515 |
| Provider Name | Shane O Summers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497751671 PECOS PAC ID: 5294789699 Enrollment ID: I20050309000221 |
| Provider Name | Curtis D Schultz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477572212 PECOS PAC ID: 2567402027 Enrollment ID: I20050504000960 |
| Provider Name | Aregai A Girmay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295731271 PECOS PAC ID: 5890736763 Enrollment ID: I20050603000551 |
| Provider Name | Andrew L Chesson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871519066 PECOS PAC ID: 4688605157 Enrollment ID: I20050824000604 |
| Provider Name | Brian G Kauth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780797803 PECOS PAC ID: 8527099472 Enrollment ID: I20050830000818 |
| Provider Name | Colin L Moffett |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1568411007 PECOS PAC ID: 4486676723 Enrollment ID: I20051229000566 |
| Provider Name | Surendra P S Sidhu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740251651 PECOS PAC ID: 5496769234 Enrollment ID: I20060131000646 |
| Provider Name | Thomas F Laney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891753687 PECOS PAC ID: 9032129531 Enrollment ID: I20060427000734 |
| Provider Name | David Glenn Locklear |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679535322 PECOS PAC ID: 3476658113 Enrollment ID: I20070425000112 |
| Provider Name | Lynda M Lachance |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811954258 PECOS PAC ID: 0749259745 Enrollment ID: I20070607000716 |
| Provider Name | Leigh E Howell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497860001 PECOS PAC ID: 7719086479 Enrollment ID: I20070620000495 |
| Provider Name | Robert A Forinash |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1639239254 PECOS PAC ID: 1254422157 Enrollment ID: I20070807000541 |
| Provider Name | Revonda L Jessup |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1235346172 PECOS PAC ID: 7214021989 Enrollment ID: I20070926000222 |
| Provider Name | David Mabe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821127796 PECOS PAC ID: 8729173984 Enrollment ID: I20071002000892 |
| Provider Name | Victoria M Caudill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225036510 PECOS PAC ID: 9032209622 Enrollment ID: I20071219000707 |
| Provider Name | Jane M Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417139742 PECOS PAC ID: 7719060920 Enrollment ID: I20080212000139 |
| Provider Name | Robert M Dorn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306805650 PECOS PAC ID: 0749274256 Enrollment ID: I20080320000253 |
| Provider Name | Palmer Edwards |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578521787 PECOS PAC ID: 5294811808 Enrollment ID: I20080324000447 |
| Provider Name | Stewart Todd Peters |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1093994816 PECOS PAC ID: 8628156270 Enrollment ID: I20080422000661 |
| Provider Name | Cheryl L Baxter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902829203 PECOS PAC ID: 4385713643 Enrollment ID: I20080513000583 |
| Provider Name | Virginia Fredericka Wright |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023211489 PECOS PAC ID: 3870669740 Enrollment ID: I20080829000504 |
| Provider Name | Deji O Okuboye |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528196227 PECOS PAC ID: 9335217322 Enrollment ID: I20081003000390 |
| Provider Name | Robert Hammill Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770529323 PECOS PAC ID: 2860488459 Enrollment ID: I20081009000444 |
| Provider Name | Scott D Polster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417936048 PECOS PAC ID: 7719076512 Enrollment ID: I20081013000577 |
| Provider Name | Karen Lynn Melendez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184675977 PECOS PAC ID: 8022170711 Enrollment ID: I20081213000228 |
| Provider Name | Jermaine A Joefield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164505400 PECOS PAC ID: 9133283583 Enrollment ID: I20090129000237 |
| Provider Name | Cecilia B Gordon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356401749 PECOS PAC ID: 4789572520 Enrollment ID: I20090309000674 |
| Provider Name | Christopher J Witke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811950769 PECOS PAC ID: 5395767719 Enrollment ID: I20090520000551 |
| Provider Name | Carl L Welch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649383605 PECOS PAC ID: 6204985005 Enrollment ID: I20090528000102 |
| Provider Name | Anita D Blanchett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578598355 PECOS PAC ID: 0345391314 Enrollment ID: I20090702000355 |
| Provider Name | Ashley C Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497936009 PECOS PAC ID: 5496807919 Enrollment ID: I20090714000780 |
| Provider Name | Latasha M Ellis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487832671 PECOS PAC ID: 7517012271 Enrollment ID: I20090901000378 |
| Provider Name | Omodele Julie Masha |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528164324 PECOS PAC ID: 7012951494 Enrollment ID: I20091007000446 |
| Provider Name | Elizabeth Diane Restino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467422501 PECOS PAC ID: 5597738260 Enrollment ID: I20091125000508 |
| Provider Name | Alan V Jubane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710965322 PECOS PAC ID: 8224178934 Enrollment ID: I20091210000361 |
| Provider Name | Kenneth K Cloninger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265411086 PECOS PAC ID: 6204976210 Enrollment ID: I20091223000487 |
| Provider Name | Donald S Hill |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811082365 PECOS PAC ID: 0547335820 Enrollment ID: I20100206000237 |
| Provider Name | Keith E Mcmanus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477563229 PECOS PAC ID: 6507901931 Enrollment ID: I20100309000778 |
| Provider Name | Shana D James Nzambele |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932152121 PECOS PAC ID: 0446386155 Enrollment ID: I20100406000549 |
| Provider Name | Lauri Sue Bausch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942525803 PECOS PAC ID: 6103954474 Enrollment ID: I20100506000467 |
| Provider Name | Rebecca T Yoder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033181557 PECOS PAC ID: 8921138660 Enrollment ID: I20100607000810 |
| Provider Name | Steven Gold |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538126081 PECOS PAC ID: 3274628896 Enrollment ID: I20100702000490 |
| Provider Name | Alan B Clark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427044155 PECOS PAC ID: 5799817730 Enrollment ID: I20100709000688 |
| Provider Name | Shirley D Ocloo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366448342 PECOS PAC ID: 7911022207 Enrollment ID: I20100909000873 |
| Provider Name | Eugene Reynolds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518963594 PECOS PAC ID: 1153447255 Enrollment ID: I20100927000579 |
| Provider Name | Tammy S Palumbo |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1245350305 PECOS PAC ID: 8123211257 Enrollment ID: I20101021001073 |
| Provider Name | Teresa Lynn Stump |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609854587 PECOS PAC ID: 7416141361 Enrollment ID: I20101104000537 |
| Provider Name | Amy P Shortridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457522252 PECOS PAC ID: 3375730534 Enrollment ID: I20101214000601 |
| Provider Name | Cynthia Witt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306914585 PECOS PAC ID: 5799720975 Enrollment ID: I20110222000139 |
| Provider Name | Christian Finn Sorensen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730138066 PECOS PAC ID: 5092782219 Enrollment ID: I20110412000629 |
| Provider Name | Bryan E Allf |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1700872892 PECOS PAC ID: 5698880094 Enrollment ID: I20110503000782 |
| Provider Name | Jean L Benton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467458588 PECOS PAC ID: 9638355191 Enrollment ID: I20110517000698 |
| Provider Name | Karen D Lum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922307636 PECOS PAC ID: 5698944759 Enrollment ID: I20110805000154 |
| Provider Name | Mitzi Lorraine Redmond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255470662 PECOS PAC ID: 1850485863 Enrollment ID: I20111205000585 |
| Provider Name | Jason B Kihneman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154634988 PECOS PAC ID: 9133302870 Enrollment ID: I20120627000676 |
| Provider Name | Jacques T Moua |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992931737 PECOS PAC ID: 1355598459 Enrollment ID: I20120824000263 |
| Provider Name | Penny J Matlock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043557069 PECOS PAC ID: 3476708538 Enrollment ID: I20130222000020 |
| Provider Name | David Mcdowell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528303559 PECOS PAC ID: 5294980298 Enrollment ID: I20130222000472 |
| Provider Name | Tracey S Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518901602 PECOS PAC ID: 8123026838 Enrollment ID: I20130513000628 |
| Provider Name | Kathleen Marie Wright Harknett |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346566833 PECOS PAC ID: 8628219284 Enrollment ID: I20130724000033 |
| Provider Name | Amanda Dillon Beasley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619125861 PECOS PAC ID: 5294974952 Enrollment ID: I20130724000044 |
| Provider Name | Ralph Luther Bentley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912999681 PECOS PAC ID: 4880878867 Enrollment ID: I20130829000637 |
| Provider Name | Cresencio Duran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689848137 PECOS PAC ID: 2668611328 Enrollment ID: I20130830000549 |
| Provider Name | Susanna Marie Shepard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003992058 PECOS PAC ID: 0244479913 Enrollment ID: I20131008000156 |
| Provider Name | Christina Zanakis Reid |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619057452 PECOS PAC ID: 9436238599 Enrollment ID: I20131018000954 |
| Provider Name | Joy M Duckworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518380344 PECOS PAC ID: 0941432694 Enrollment ID: I20140410001491 |
| Provider Name | Meryl Jones Snow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578723656 PECOS PAC ID: 8224207410 Enrollment ID: I20140527001035 |
| Provider Name | Tenesa Yashica Shevon Mccaskill-gainey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225454689 PECOS PAC ID: 3072737204 Enrollment ID: I20140610000814 |
| Provider Name | Quiana D Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932513314 PECOS PAC ID: 4486871332 Enrollment ID: I20140816000036 |
| Provider Name | Erin Myer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730506353 PECOS PAC ID: 7214156132 Enrollment ID: I20140908002181 |
| Provider Name | Sylvia Vang |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831590280 PECOS PAC ID: 3678794088 Enrollment ID: I20141029000828 |
| Provider Name | Roland Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740570449 PECOS PAC ID: 3971725169 Enrollment ID: I20141103001143 |
| Provider Name | Julie Tina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104228675 PECOS PAC ID: 0042432098 Enrollment ID: I20141107000378 |
| Provider Name | Kathleen J Craver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396059747 PECOS PAC ID: 3577785906 Enrollment ID: I20141119000887 |
| Provider Name | Christi A Lucus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659773919 PECOS PAC ID: 9537483854 Enrollment ID: I20150115000461 |
| Provider Name | Anita Emefa Kpodo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144432667 PECOS PAC ID: 9436398195 Enrollment ID: I20150122000230 |
| Provider Name | Barbara Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760747992 PECOS PAC ID: 4082930375 Enrollment ID: I20150304000689 |
| Provider Name | Tinka A Barnes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689714446 PECOS PAC ID: 0244312742 Enrollment ID: I20150507001418 |
| Provider Name | Cassandra J Duren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740686773 PECOS PAC ID: 7911211123 Enrollment ID: I20150731016668 |
| Provider Name | Casey Gilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740678606 PECOS PAC ID: 8921314717 Enrollment ID: I20150824001794 |
| Provider Name | Lindsey Bauman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184969057 PECOS PAC ID: 0345469524 Enrollment ID: I20150825003591 |
| Provider Name | Kelechi Ndubuizu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871852822 PECOS PAC ID: 6002122462 Enrollment ID: I20150831001268 |
| Provider Name | Brittney Cobb-farmer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699151852 PECOS PAC ID: 9335456052 Enrollment ID: I20150914000999 |
| Provider Name | Elizabeth Brittain |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1295952174 PECOS PAC ID: 4183931355 Enrollment ID: I20150921001829 |
| Provider Name | Kimberly R Mills |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407114168 PECOS PAC ID: 9830332808 Enrollment ID: I20151007001759 |
| Provider Name | Tiffani Lynee Bell Washington |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861789117 PECOS PAC ID: 2668784414 Enrollment ID: I20151026001644 |
| Provider Name | Jackson D Mullins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225408461 PECOS PAC ID: 9537462163 Enrollment ID: I20160114001833 |
| Provider Name | Hazel F Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235545658 PECOS PAC ID: 4587989769 Enrollment ID: I20160119001681 |
| Provider Name | Jeffrey Ellison |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649559873 PECOS PAC ID: 6507086394 Enrollment ID: I20160120001493 |
| Provider Name | Pa L Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528425105 PECOS PAC ID: 8224335815 Enrollment ID: I20160325000571 |
| Provider Name | Amanda B Killion |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629327341 PECOS PAC ID: 0143513820 Enrollment ID: I20160719001768 |
| Provider Name | Douglas Frederick Meardon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669818662 PECOS PAC ID: 7113210923 Enrollment ID: I20160801000636 |
| Provider Name | Claudia Turkson-ocran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013369073 PECOS PAC ID: 9931494804 Enrollment ID: I20160817002018 |
| Provider Name | Carrie C Herman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023467313 PECOS PAC ID: 0648566349 Enrollment ID: I20160907000002 |
| Provider Name | Hannah Sanii |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629524152 PECOS PAC ID: 9638466055 Enrollment ID: I20160928000805 |
| Provider Name | Victoria Spencer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225360290 PECOS PAC ID: 5496043648 Enrollment ID: I20161004001759 |
| Provider Name | W Lynette Sigmon Laws |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427501683 PECOS PAC ID: 4981992906 Enrollment ID: I20161006002185 |
| Provider Name | Michelle R Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295063790 PECOS PAC ID: 0042599235 Enrollment ID: I20161110001349 |
| Provider Name | Melissa Golden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427459858 PECOS PAC ID: 0547549321 Enrollment ID: I20161118000561 |
| Provider Name | Nancy Capel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215028063 PECOS PAC ID: 7315092806 Enrollment ID: I20170214000074 |
| Provider Name | Tamara Nicole Scott |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992188585 PECOS PAC ID: 4880977040 Enrollment ID: I20170214000091 |
| Provider Name | Llewellyn Mensah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659703395 PECOS PAC ID: 2860796331 Enrollment ID: I20170301001150 |
| Provider Name | Karen Elizabeth Rey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144769324 PECOS PAC ID: 5496031189 Enrollment ID: I20170412000855 |
| Provider Name | Elyssa D Rosenberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437558418 PECOS PAC ID: 3971889205 Enrollment ID: I20170420001770 |
| Provider Name | Kelley Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306211156 PECOS PAC ID: 9032413471 Enrollment ID: I20170427000654 |
| Provider Name | Janee Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699101584 PECOS PAC ID: 2567694987 Enrollment ID: I20170512000285 |
| Provider Name | Lauryn Fletcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154860443 PECOS PAC ID: 0446527485 Enrollment ID: I20170524000004 |
| Provider Name | Janelle Hoover |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538539903 PECOS PAC ID: 3678841954 Enrollment ID: I20170608002125 |
| Provider Name | Brandie Terifaj |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194250845 PECOS PAC ID: 5496023947 Enrollment ID: I20170626000136 |
| Provider Name | Marion Maria Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821526526 PECOS PAC ID: 9638449721 Enrollment ID: I20170722000072 |
| Provider Name | Ryan H Greemann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528487832 PECOS PAC ID: 5294059606 Enrollment ID: I20170726002468 |
| Provider Name | Suja Raju |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003254806 PECOS PAC ID: 4789957333 Enrollment ID: I20170905000376 |
| Provider Name | Jill Bumgardner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609398106 PECOS PAC ID: 2567735111 Enrollment ID: I20170905000538 |
| Provider Name | Brittany Fryer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528332053 PECOS PAC ID: 3577836675 Enrollment ID: I20170912003232 |
| Provider Name | Arvetta Batts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184096463 PECOS PAC ID: 0648545723 Enrollment ID: I20170929002470 |
| Provider Name | Yolanda Enrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619498987 PECOS PAC ID: 9739454190 Enrollment ID: I20171011000679 |
| Provider Name | Brittany Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215453543 PECOS PAC ID: 6709152481 Enrollment ID: I20171024003637 |
| Provider Name | Vaidehi Mahesh Trivedi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306284351 PECOS PAC ID: 2961700380 Enrollment ID: I20171027001408 |
| Provider Name | Jennifer Cashion Waugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154849107 PECOS PAC ID: 7315203114 Enrollment ID: I20171110001991 |
| Provider Name | Danielle M Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689087678 PECOS PAC ID: 1052530185 Enrollment ID: I20171113000399 |
| Provider Name | Kendall Hankins Nagy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992156202 PECOS PAC ID: 1850650847 Enrollment ID: I20180119002130 |
| Provider Name | Richard Ankrah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174038400 PECOS PAC ID: 8123388477 Enrollment ID: I20180205002071 |
| Provider Name | David A Robison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770891210 PECOS PAC ID: 7618158650 Enrollment ID: I20180212002748 |
| Provider Name | Sharon Hollifield Bryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942452974 PECOS PAC ID: 9032479951 Enrollment ID: I20180213003254 |
| Provider Name | Agatha Y Ofei |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053707984 PECOS PAC ID: 0042571234 Enrollment ID: I20180305000568 |
| Provider Name | Laura H Burgess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962901934 PECOS PAC ID: 2264797315 Enrollment ID: I20180521002053 |
| Provider Name | Kia Wiggins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811485071 PECOS PAC ID: 4789949066 Enrollment ID: I20180607002910 |
| Provider Name | John K Throckmorton |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1114983723 PECOS PAC ID: 0941207658 Enrollment ID: I20180710002646 |
| Provider Name | Jeidy Mercedes Fernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023379799 PECOS PAC ID: 1052668183 Enrollment ID: I20180720001479 |
| Provider Name | Jessica Moses |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407393911 PECOS PAC ID: 0143572362 Enrollment ID: I20181016001715 |
| Provider Name | Sarah Anne Blankenship |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295210649 PECOS PAC ID: 8527312297 Enrollment ID: I20181115001107 |
| Provider Name | Shannon Reed Blumhardt |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1205908282 PECOS PAC ID: 4183678782 Enrollment ID: I20181221002082 |
| Provider Name | Seong-hye Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063963155 PECOS PAC ID: 2668730219 Enrollment ID: I20181229000110 |
| Provider Name | Brandy Janae Fleurismond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366702649 PECOS PAC ID: 1658526157 Enrollment ID: I20190107000822 |
| Provider Name | Amanda Somers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477906543 PECOS PAC ID: 7719224039 Enrollment ID: I20190124002438 |
| Provider Name | Michele L Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477049708 PECOS PAC ID: 8224376504 Enrollment ID: I20190212001220 |
| Provider Name | Janine Jolly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629533831 PECOS PAC ID: 5092054445 Enrollment ID: I20190228002385 |
| Provider Name | Bradley Kent Hardee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952780876 PECOS PAC ID: 6507124187 Enrollment ID: I20190315000201 |
| Provider Name | Inga Marohn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730645854 PECOS PAC ID: 7618217811 Enrollment ID: I20190326002586 |
| Provider Name | Benjamin Robert Stacy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093127367 PECOS PAC ID: 4981821402 Enrollment ID: I20190507000000 |
| Provider Name | Carrie Beaver Ross |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730487406 PECOS PAC ID: 8022351543 Enrollment ID: I20190523001424 |
| Provider Name | Alicia Coleman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417309022 PECOS PAC ID: 2062748122 Enrollment ID: I20190726000930 |
| Provider Name | Sarah Vogler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194164251 PECOS PAC ID: 3971839085 Enrollment ID: I20190727000269 |
| Provider Name | Jennifer Leigh Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023671070 PECOS PAC ID: 9133456403 Enrollment ID: I20190808002759 |
| Provider Name | Sarah Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730749870 PECOS PAC ID: 8426386673 Enrollment ID: I20190826002096 |
| Provider Name | Sarah Emily Mclamb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568015303 PECOS PAC ID: 9537499017 Enrollment ID: I20190925003951 |
| Provider Name | Kaitlin Rose Padgett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891164810 PECOS PAC ID: 1557692431 Enrollment ID: I20191007003185 |
| Provider Name | Kierstin N Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609424431 PECOS PAC ID: 0244562411 Enrollment ID: I20191022000693 |
| Provider Name | Yvonne Andrea Valencia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477102143 PECOS PAC ID: 4385077213 Enrollment ID: I20191209000417 |
| Provider Name | Kelsey Dotson Wayne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598311821 PECOS PAC ID: 2062845845 Enrollment ID: I20191209002768 |
| Provider Name | Molly K Grant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164908166 PECOS PAC ID: 7618300146 Enrollment ID: I20191213001106 |
| Provider Name | Jasmine L Mcentyre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871145912 PECOS PAC ID: 4789019555 Enrollment ID: I20200124001659 |
| Provider Name | Kenzie Delrae Elmore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891109740 PECOS PAC ID: 1052747672 Enrollment ID: I20200130000784 |
| Provider Name | Joan Olschewske |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952315228 PECOS PAC ID: 8628258365 Enrollment ID: I20200310002472 |
| Provider Name | Stephanie Wilson Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033176714 PECOS PAC ID: 4587963442 Enrollment ID: I20200417000305 |
| Provider Name | Savannah Hodges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174162473 PECOS PAC ID: 5294156071 Enrollment ID: I20200603000720 |
| Provider Name | Alexis C Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699309211 PECOS PAC ID: 4981025533 Enrollment ID: I20200605002417 |
| Provider Name | Anne Olejarz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184152902 PECOS PAC ID: 1850666025 Enrollment ID: I20200713002976 |
| Provider Name | Emily Morgan Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386264513 PECOS PAC ID: 5890110472 Enrollment ID: I20200729002600 |
| Provider Name | Brittany Nicole Collins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750865648 PECOS PAC ID: 1052731650 Enrollment ID: I20201021000235 |
| Provider Name | Stephanie N Lane |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689042319 PECOS PAC ID: 9436568466 Enrollment ID: I20210504001862 |
| Provider Name | Richard Andrew Nagle |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1124231600 PECOS PAC ID: 9032528427 Enrollment ID: I20210517000041 |
| Provider Name | Najla Ahmed |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124025671 PECOS PAC ID: 4789083676 Enrollment ID: I20210526000760 |
| Provider Name | Charles William Browning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295302024 PECOS PAC ID: 9931503919 Enrollment ID: I20210812003296 |
| Provider Name | Leah Broadhurst |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437687993 PECOS PAC ID: 8123394715 Enrollment ID: I20210825001142 |
| Provider Name | Haley Jenelle Angel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740857788 PECOS PAC ID: 4284031006 Enrollment ID: I20210921003881 |
| Provider Name | Stephanie Nicole Hilderbran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164011359 PECOS PAC ID: 6901203520 Enrollment ID: I20210924001471 |
| Provider Name | Kenya E Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588285480 PECOS PAC ID: 2062810203 Enrollment ID: I20211001002248 |
| Provider Name | Emily Josephine Mears |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225706344 PECOS PAC ID: 6709284896 Enrollment ID: I20211004001606 |
| Provider Name | Kaitlyn Elizabeth Spencer Florence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962174359 PECOS PAC ID: 1456749084 Enrollment ID: I20211101000237 |
| Provider Name | Lula Crawford Lott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831867696 PECOS PAC ID: 9830588961 Enrollment ID: I20211111001257 |
| Provider Name | Albertina D Smith-banks |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386759108 PECOS PAC ID: 5597152280 Enrollment ID: I20220427002728 |
| Provider Name | Chantell Albert Alexander |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740710011 PECOS PAC ID: 2062809783 Enrollment ID: I20220428000162 |
| Provider Name | Lauren Johnson Mcfarland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639562143 PECOS PAC ID: 2264810274 Enrollment ID: I20220603000800 |
| Provider Name | Candice Nicole Pugh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578209813 PECOS PAC ID: 9537543079 Enrollment ID: I20220831003137 |
| Provider Name | Renee Susanne Mcguire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861141764 PECOS PAC ID: 8123404639 Enrollment ID: I20221006003553 |
| Provider Name | Kristin Marie Gottry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497494553 PECOS PAC ID: 9133596802 Enrollment ID: I20221109002097 |
| Provider Name | Ashby Kaylin Dellinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285393397 PECOS PAC ID: 9931579794 Enrollment ID: I20230112001037 |
| Provider Name | Regina Deviney Ledford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821719717 PECOS PAC ID: 9537530480 Enrollment ID: I20230201000381 |
| Provider Name | Brandy Nicole Mcmillan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578276077 PECOS PAC ID: 7719359488 Enrollment ID: I20230206001130 |
| Provider Name | Robbie Kevin Freeman |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1578294583 PECOS PAC ID: 4183097504 Enrollment ID: I20230307000256 |
| Provider Name | Esenam Dankwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093428013 PECOS PAC ID: 8426422114 Enrollment ID: I20230320002923 |
| Provider Name | Aveary Olivia Walsh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225586555 PECOS PAC ID: 6103290820 Enrollment ID: I20230321001116 |
| Provider Name | Hannah Ashlin Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821600842 PECOS PAC ID: 7810361557 Enrollment ID: I20230321002056 |
| Provider Name | Jessica Lorene Debnam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124746979 PECOS PAC ID: 3476918657 Enrollment ID: I20230421001005 |
| Provider Name | Felecia Ann Lockett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093334724 PECOS PAC ID: 9537524723 Enrollment ID: I20230421001180 |
| Provider Name | Brooklyn Doherty Barlow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386021418 PECOS PAC ID: 1052776143 Enrollment ID: I20230425000224 |
| Provider Name | Jessica M Mccain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528719747 PECOS PAC ID: 5597158998 Enrollment ID: I20230713003147 |
| Provider Name | Brooke Nicole Spano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831739259 PECOS PAC ID: 7810358595 Enrollment ID: I20230727001275 |
| Provider Name | Blake Austin Bond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730878174 PECOS PAC ID: 6507210010 Enrollment ID: I20231002001377 |
| Provider Name | Christina Campbell Hixson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619752300 PECOS PAC ID: 1052767233 Enrollment ID: I20231024002592 |
| Provider Name | Rachel Delany |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083224653 PECOS PAC ID: 6709232812 Enrollment ID: I20231026000387 |
| Provider Name | Maria Delany |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780294355 PECOS PAC ID: 2163878091 Enrollment ID: I20231027002165 |
| Provider Name | Jaime Leigh Graf |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982297420 PECOS PAC ID: 7416305453 Enrollment ID: I20231130002913 |
| Provider Name | Brooke L Trogdon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073008785 PECOS PAC ID: 3577981448 Enrollment ID: I20231204000498 |
| Provider Name | Patrick W Tankersley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154416592 PECOS PAC ID: 8224480413 Enrollment ID: I20240124000476 |
| Provider Name | Stacey Lopez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740858539 PECOS PAC ID: 4385097872 Enrollment ID: I20240131004269 |
| Provider Name | Natalie Danielle Proctor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750019741 PECOS PAC ID: 5193168441 Enrollment ID: I20240205000005 |
| Provider Name | Cayla Price |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679811038 PECOS PAC ID: 0244664688 Enrollment ID: I20240206001257 |
| Provider Name | Daria Ginae Barksdale |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518469204 PECOS PAC ID: 0143663245 Enrollment ID: I20240206001432 |
| Provider Name | Jaymie Lyn Rowe |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1639594765 PECOS PAC ID: 9335582469 Enrollment ID: I20240206002509 |
| Provider Name | Jennifer Drum |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538450804 PECOS PAC ID: 1850734914 Enrollment ID: I20240206003500 |
| Provider Name | Marcus Lee Springs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497339907 PECOS PAC ID: 7911340989 Enrollment ID: I20240206004386 |
| Provider Name | Nicole Sykes Mullen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790051217 PECOS PAC ID: 3870936800 Enrollment ID: I20240207000921 |
| Provider Name | Brandi Nicole Knight-harris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063751451 PECOS PAC ID: 9739522624 Enrollment ID: I20240207003332 |
| Provider Name | Tierra Watkins Bates |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780196261 PECOS PAC ID: 0648613489 Enrollment ID: I20240208001098 |
| Provider Name | Amanda Elizabeth Edwards |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518483890 PECOS PAC ID: 1557704103 Enrollment ID: I20240209003693 |
| Provider Name | Chakun Mcdaniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316416555 PECOS PAC ID: 7810237765 Enrollment ID: I20240213000014 |
| Provider Name | Kristi Mcdonald Boudreaux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669814513 PECOS PAC ID: 1355566159 Enrollment ID: I20240216003987 |
| Provider Name | Monica Fox Bradshaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043991680 PECOS PAC ID: 8426493545 Enrollment ID: I20240228004232 |
| Provider Name | Rachelle P Mckoy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225125123 PECOS PAC ID: 7012352925 Enrollment ID: I20240301001963 |
| Provider Name | Venessa Theresa Curlee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386238442 PECOS PAC ID: 5496190274 Enrollment ID: I20240302000641 |
| Provider Name | Laresia L Barnett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851709315 PECOS PAC ID: 8729419601 Enrollment ID: I20240305004618 |
| Provider Name | Shelby Jo Mcgee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386003135 PECOS PAC ID: 0547688335 Enrollment ID: I20240320003758 |
| Provider Name | Brendon Davis Mann |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447320809 PECOS PAC ID: 6901231844 Enrollment ID: I20240411000749 |
| Provider Name | John Summey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811491673 PECOS PAC ID: 6901233493 Enrollment ID: I20240411000873 |
| Provider Name | Meghan C Rosevally |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1598547754 PECOS PAC ID: 4284074709 Enrollment ID: I20240501002647 |
| Provider Name | Lyricist Dior Cotton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083221758 PECOS PAC ID: 2567802788 Enrollment ID: I20240503002740 |
| Provider Name | Madison Quinn Strickland |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326633686 PECOS PAC ID: 2264872498 Enrollment ID: I20240503002870 |
| Provider Name | Christina Dingledine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992215909 PECOS PAC ID: 1254766348 Enrollment ID: I20240506004908 |
| Provider Name | Rachel Abernathy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033615935 PECOS PAC ID: 7810313145 Enrollment ID: I20240509000251 |
| Provider Name | Michelle Sullivan |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1912120247 PECOS PAC ID: 7416398912 Enrollment ID: I20240515002035 |
| Provider Name | Sidney Lauren Rice |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649841800 PECOS PAC ID: 9931540366 Enrollment ID: I20240515003914 |
| Provider Name | Ariana Spencer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972934321 PECOS PAC ID: 6709217045 Enrollment ID: I20240613003425 |
Vance Internal Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3624 Easthampton Dr, Gastonia, NC 28056 Phone: 704-564-1312 Fax: 310-348-0201 | |
Gastonia Medical Specialty Clinic Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1021 X Ray Dr, Gastonia, NC 28054 Phone: 704-867-2341 Fax: 704-867-9019 | |
Gaston Family Health Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 137 Stowe Rd, Gastonia, NC 28056 Phone: 704-836-9112 Fax: 704-824-4715 | |
Southern Pulmonary Center, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 Cox Rd, Ste B, Gastonia, NC 28054 Phone: 704-868-3411 Fax: 704-865-9722 | |
Centerwell Senior Primary Care-gastonia Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2910 E Franklin Blvd, 1, Gastonia, NC 28056 Phone: 704-648-0460 Fax: 855-446-7146 | |
Cramerton Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1343 E Garrison Blvd, Ste A, Gastonia, NC 28054 Phone: 704-861-9117 Fax: 704-861-0142 | |
Whitestone Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 527 S New Hope Rd, Gastonia, NC 28054 Phone: 704-316-4979 Fax: 704-316-4978 |