| Legacy Silverton Medical Center | |
|
342 Fairview St Silverton OR 97381-1917 | |
| (503) 873-1500 | |
| (503) 873-1534 |
| Full Name | Legacy Silverton Medical Center |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 342 Fairview St, Silverton, Oregon |
| Authorized Official Name and Position | Anna Loomis (CFO) |
| Authorized Official Contact | 5034155730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Silverton Medical Center Po Box 3417 Portland OR 97208-3417 Ph: (503) 413-3900 | Legacy Silverton Medical Center 342 Fairview St Silverton OR 97381-1917 Ph: (503) 873-1500 |
| NPI Number | 1669424354 |
|---|---|
| Provider Enumeration Date | 05/17/2006 |
| Last Update Date | 10/29/2019 |
| Medicare PECOS PAC ID | 8921901877 |
|---|---|
| Medicare Enrollment ID | O20040129000172 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669424354 | NPI | - | NPPES |
| 000146 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 140030 (Oregon) | Secondary |
| 282N00000X | General Acute Care Hospital | 14 0030 (Oregon) | Primary |
| Provider Name | Samuel S M Lau |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1811995087 PECOS PAC ID: 9931012226 Enrollment ID: I20031112000210 |
| Provider Name | Michael A Maurer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457313108 PECOS PAC ID: 6002720034 Enrollment ID: I20031114000204 |
| Provider Name | Christopher N Walton |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1437159498 PECOS PAC ID: 9739083957 Enrollment ID: I20031125000102 |
| Provider Name | Christine M Kenlan Laurent |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1568438182 PECOS PAC ID: 9234035700 Enrollment ID: I20031208000579 |
| Provider Name | Deborah A Alexander |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255369559 PECOS PAC ID: 6901703362 Enrollment ID: I20031215000832 |
| Provider Name | Ameet Jhooty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295795938 PECOS PAC ID: 5799684031 Enrollment ID: I20040106000146 |
| Provider Name | David S Peizner |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245235233 PECOS PAC ID: 0042104051 Enrollment ID: I20040211000246 |
| Provider Name | Tana M Haynes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639160369 PECOS PAC ID: 7911809082 Enrollment ID: I20040217000588 |
| Provider Name | Keith A White |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407959422 PECOS PAC ID: 6709774961 Enrollment ID: I20040309000491 |
| Provider Name | Daniel Urbach |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952386377 PECOS PAC ID: 2769371012 Enrollment ID: I20040313000554 |
| Provider Name | Mark S Harrington |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659346252 PECOS PAC ID: 5799777959 Enrollment ID: I20040330001645 |
| Provider Name | Charles Y Hu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659598944 PECOS PAC ID: 0941294441 Enrollment ID: I20040408000883 |
| Provider Name | Gordon Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235103276 PECOS PAC ID: 8820083603 Enrollment ID: I20040420000392 |
| Provider Name | Lori C Rumbaugh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710903315 PECOS PAC ID: 0345238150 Enrollment ID: I20040503000074 |
| Provider Name | Joshua Johnson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659363190 PECOS PAC ID: 5092704791 Enrollment ID: I20040507001348 |
| Provider Name | Karen Joan Wesenberg |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1811980998 PECOS PAC ID: 0042209744 Enrollment ID: I20040508000015 |
| Provider Name | Patra J Murdock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932277944 PECOS PAC ID: 0143210146 Enrollment ID: I20040513000071 |
| Provider Name | David L Maccabee |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114018033 PECOS PAC ID: 9234110172 Enrollment ID: I20040526001650 |
| Provider Name | Erich J Meihoff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144295916 PECOS PAC ID: 3173505245 Enrollment ID: I20040602001349 |
| Provider Name | Richard N Hamilton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851387484 PECOS PAC ID: 6901795012 Enrollment ID: I20040624000304 |
| Provider Name | Kenneth J Kolarsky |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760424121 PECOS PAC ID: 1254319106 Enrollment ID: I20040708000881 |
| Provider Name | Denis J Dalisky |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891729778 PECOS PAC ID: 5395726889 Enrollment ID: I20040819001496 |
| Provider Name | Marc Houston |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801822911 PECOS PAC ID: 9032186911 Enrollment ID: I20040910000907 |
| Provider Name | Cliffton T. Bong |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1609950849 PECOS PAC ID: 6608845763 Enrollment ID: I20040927000594 |
| Provider Name | Andrew Vincent |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629040563 PECOS PAC ID: 9234198730 Enrollment ID: I20041008001334 |
| Provider Name | Erling Y Chavez |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1801836721 PECOS PAC ID: 8729981261 Enrollment ID: I20041222000091 |
| Provider Name | Petya Nikolova Gueordjeva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346268059 PECOS PAC ID: 1052379922 Enrollment ID: I20041222000765 |
| Provider Name | Anil Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629047212 PECOS PAC ID: 0345295796 Enrollment ID: I20050317000990 |
| Provider Name | Isaac J Kobzeff |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1851338263 PECOS PAC ID: 2264488162 Enrollment ID: I20050323001243 |
| Provider Name | Isadora Roth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972603553 PECOS PAC ID: 5991751232 Enrollment ID: I20050329001338 |
| Provider Name | Julie C Broyhill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083663009 PECOS PAC ID: 0840247664 Enrollment ID: I20050405000062 |
| Provider Name | David Thorsett |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1558387779 PECOS PAC ID: 4082608005 Enrollment ID: I20050429000974 |
| Provider Name | Blake A Nonweiler |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1912923152 PECOS PAC ID: 7719972330 Enrollment ID: I20050503000751 |
| Provider Name | Robert G Mcgreevy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770545477 PECOS PAC ID: 0446292668 Enrollment ID: I20050527000513 |
| Provider Name | James G Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841240348 PECOS PAC ID: 5496799975 Enrollment ID: I20050615000623 |
| Provider Name | John W Witczak |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1811913825 PECOS PAC ID: 6305873357 Enrollment ID: I20050723000031 |
| Provider Name | James E Domst |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437107083 PECOS PAC ID: 8022045749 Enrollment ID: I20050725000235 |
| Provider Name | Beth A Stebbins |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1285600692 PECOS PAC ID: 1557399938 Enrollment ID: I20050727000743 |
| Provider Name | Suzan Chandler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770574303 PECOS PAC ID: 0042248734 Enrollment ID: I20050803000376 |
| Provider Name | Faith L Koschmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942268354 PECOS PAC ID: 4082643598 Enrollment ID: I20050804001104 |
| Provider Name | Song Jin Sunny Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275685455 PECOS PAC ID: 5991736456 Enrollment ID: I20050824000479 |
| Provider Name | Andrew D Glass |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437103223 PECOS PAC ID: 9537192083 Enrollment ID: I20050914001278 |
| Provider Name | Megumi M Morishita |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609854272 PECOS PAC ID: 7113951690 Enrollment ID: I20050923000445 |
| Provider Name | Elizabeth Tacvorian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467414417 PECOS PAC ID: 3779508742 Enrollment ID: I20051008000186 |
| Provider Name | Michael R Wray |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1790730059 PECOS PAC ID: 1456377944 Enrollment ID: I20051024000863 |
| Provider Name | Daniel K Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285723726 PECOS PAC ID: 8628096393 Enrollment ID: I20051110000882 |
| Provider Name | Lisa M Adams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447223987 PECOS PAC ID: 9234126897 Enrollment ID: I20051130000228 |
| Provider Name | Michael E Grady |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922014463 PECOS PAC ID: 1658393327 Enrollment ID: I20051221000849 |
| Provider Name | Naji M Hamdan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679570873 PECOS PAC ID: 2163438227 Enrollment ID: I20060227000362 |
| Provider Name | Elizabeth M Marik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750351185 PECOS PAC ID: 1456367655 Enrollment ID: I20060227000696 |
| Provider Name | Soriah N Hamide |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417051665 PECOS PAC ID: 3476561895 Enrollment ID: I20060327000827 |
| Provider Name | Christine M Barlow Reed |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1568481216 PECOS PAC ID: 3375551229 Enrollment ID: I20060404000201 |
| Provider Name | Mikeanne Minter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053376715 PECOS PAC ID: 8921019126 Enrollment ID: I20060602000138 |
| Provider Name | Robb N Larsen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396738274 PECOS PAC ID: 5294738142 Enrollment ID: I20060814000370 |
| Provider Name | Douglas R Grossnickle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669418810 PECOS PAC ID: 6002819992 Enrollment ID: I20060815000085 |
| Provider Name | Maziar Azadpour |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730131855 PECOS PAC ID: 6103882923 Enrollment ID: I20060901000021 |
| Provider Name | Amy E Page |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225093131 PECOS PAC ID: 9537135702 Enrollment ID: I20060921000439 |
| Provider Name | Reynaldo Danilo T Franco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134148927 PECOS PAC ID: 8527064518 Enrollment ID: I20061016000104 |
| Provider Name | Janet C West |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447299284 PECOS PAC ID: 0143237628 Enrollment ID: I20070118000608 |
| Provider Name | David C Nazemi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457329286 PECOS PAC ID: 3173524683 Enrollment ID: I20070126000181 |
| Provider Name | Thomas Newton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679535785 PECOS PAC ID: 7113943523 Enrollment ID: I20070209000609 |
| Provider Name | Gabriel L Aron |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699746305 PECOS PAC ID: 2668428970 Enrollment ID: I20070309000240 |
| Provider Name | Sanjiv Manharlal Panwala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023047321 PECOS PAC ID: 9739282823 Enrollment ID: I20070309000367 |
| Provider Name | Keith A Haugen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104806959 PECOS PAC ID: 1759317464 Enrollment ID: I20070413000288 |
| Provider Name | Jack L Otterstrom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922163096 PECOS PAC ID: 5991801052 Enrollment ID: I20070507000154 |
| Provider Name | Steven L Grund |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1851420863 PECOS PAC ID: 4385744606 Enrollment ID: I20070716000117 |
| Provider Name | Karen A Vernier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144309204 PECOS PAC ID: 2860421070 Enrollment ID: I20070723000409 |
| Provider Name | Diana K Boss |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023239407 PECOS PAC ID: 5597866269 Enrollment ID: I20070725000094 |
| Provider Name | Annabelle L Sammis |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1588792568 PECOS PAC ID: 6709977028 Enrollment ID: I20070801000110 |
| Provider Name | Elizabeth J Blount |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912921313 PECOS PAC ID: 5092808923 Enrollment ID: I20070907000542 |
| Provider Name | Paula A Folger |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1558564492 PECOS PAC ID: 1658465638 Enrollment ID: I20070921000083 |
| Provider Name | Elizabeth H Robinson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1598705642 PECOS PAC ID: 5193733756 Enrollment ID: I20071002000027 |
| Provider Name | Shandra D Greig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063432805 PECOS PAC ID: 6103912944 Enrollment ID: I20071010000104 |
| Provider Name | Brian A Rainka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407075534 PECOS PAC ID: 7517053663 Enrollment ID: I20071019000529 |
| Provider Name | Daniel S Schweigert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417964602 PECOS PAC ID: 2163329368 Enrollment ID: I20071121000341 |
| Provider Name | Marcus Bergen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508061664 PECOS PAC ID: 0648369330 Enrollment ID: I20071203000747 |
| Provider Name | Charles M Wood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902961907 PECOS PAC ID: 0244333607 Enrollment ID: I20071210000253 |
| Provider Name | Todd W Meyer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1447229877 PECOS PAC ID: 6002857570 Enrollment ID: I20071219000883 |
| Provider Name | Joseph Mark Evans |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063527471 PECOS PAC ID: 1254411457 Enrollment ID: I20071228000484 |
| Provider Name | Holly I Tse |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912089947 PECOS PAC ID: 9234219304 Enrollment ID: I20071231000569 |
| Provider Name | Ashit G Patel |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1427276757 PECOS PAC ID: 3173606886 Enrollment ID: I20080218000522 |
| Provider Name | John A Gilliam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598781429 PECOS PAC ID: 9537242854 Enrollment ID: I20080307000251 |
| Provider Name | Leslie Root |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831167907 PECOS PAC ID: 2163591520 Enrollment ID: I20080527000577 |
| Provider Name | Catherine J Markin |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1285731059 PECOS PAC ID: 9032288402 Enrollment ID: I20080527000609 |
| Provider Name | Mark E Zeitzer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437174307 PECOS PAC ID: 4486683927 Enrollment ID: I20080603000427 |
| Provider Name | Philipp Klotz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538374640 PECOS PAC ID: 6800968850 Enrollment ID: I20080708000287 |
| Provider Name | John M Aregood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427168608 PECOS PAC ID: 2961575303 Enrollment ID: I20080718000225 |
| Provider Name | Mary M Tippin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316018864 PECOS PAC ID: 5890860662 Enrollment ID: I20080814000063 |
| Provider Name | Gregory M Eilers |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134323843 PECOS PAC ID: 1355416660 Enrollment ID: I20080821000344 |
| Provider Name | Mark W Sands |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043416191 PECOS PAC ID: 9537234588 Enrollment ID: I20080826000587 |
| Provider Name | Patrick J O Leary |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194774547 PECOS PAC ID: 0446142400 Enrollment ID: I20080912000154 |
| Provider Name | Gail A Moses |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841259389 PECOS PAC ID: 5597774513 Enrollment ID: I20081010000101 |
| Provider Name | Aaron L Kabb |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780852517 PECOS PAC ID: 4880753821 Enrollment ID: I20081106000153 |
| Provider Name | Tracy L Read |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952350910 PECOS PAC ID: 8729140843 Enrollment ID: I20081229000122 |
| Provider Name | Stacy M Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518139617 PECOS PAC ID: 4385707728 Enrollment ID: I20090112000717 |
| Provider Name | Rebecca G Hills |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942259833 PECOS PAC ID: 6800950593 Enrollment ID: I20090123000528 |
| Provider Name | Jean H Waring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891870622 PECOS PAC ID: 9133186562 Enrollment ID: I20090420000627 |
| Provider Name | Robert J Hillstrom |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811057862 PECOS PAC ID: 9133129042 Enrollment ID: I20090527000610 |
| Provider Name | Rhonda K Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538341490 PECOS PAC ID: 9436200300 Enrollment ID: I20090706000688 |
| Provider Name | Harminder P Gandhok |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1053585935 PECOS PAC ID: 5799756243 Enrollment ID: I20090709000340 |
| Provider Name | Amy Zastrow |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942219431 PECOS PAC ID: 5597818914 Enrollment ID: I20090803000573 |
| Provider Name | Kevin Breger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497925143 PECOS PAC ID: 0648338459 Enrollment ID: I20090914000176 |
| Provider Name | Heidi M Abreu-pacheco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669691721 PECOS PAC ID: 0941346050 Enrollment ID: I20091002000594 |
| Provider Name | Jose Gutierrez-holguin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942428826 PECOS PAC ID: 0840336962 Enrollment ID: I20091002000616 |
| Provider Name | Charles D Hyde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972644250 PECOS PAC ID: 7416999727 Enrollment ID: I20091014000517 |
| Provider Name | Nathan B Bay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518161546 PECOS PAC ID: 7315084704 Enrollment ID: I20091015000695 |
| Provider Name | James H Stageman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639152549 PECOS PAC ID: 5890685978 Enrollment ID: I20100107000570 |
| Provider Name | David P Andrews |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144407123 PECOS PAC ID: 5991848640 Enrollment ID: I20100204000009 |
| Provider Name | Andrew P Rose-innes |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578649224 PECOS PAC ID: 3971583238 Enrollment ID: I20100406000075 |
| Provider Name | Jay P Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306874037 PECOS PAC ID: 0446387716 Enrollment ID: I20100416000719 |
| Provider Name | Alex C Bahrke |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568794055 PECOS PAC ID: 3870621733 Enrollment ID: I20100513000581 |
| Provider Name | Anne Juliana Lockman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871708529 PECOS PAC ID: 8224162094 Enrollment ID: I20100816000410 |
| Provider Name | Jeffrey C Hemstreet |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538156179 PECOS PAC ID: 0547384497 Enrollment ID: I20100828000189 |
| Provider Name | Sarah M Jump |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912101569 PECOS PAC ID: 4082739925 Enrollment ID: I20100915000365 |
| Provider Name | Anika Denali-luengo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871774281 PECOS PAC ID: 6103941851 Enrollment ID: I20100917000531 |
| Provider Name | Annamarie Bain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588814172 PECOS PAC ID: 9436275831 Enrollment ID: I20100922001098 |
| Provider Name | Timothy W. Stewart |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669455952 PECOS PAC ID: 7719170745 Enrollment ID: I20101021001130 |
| Provider Name | Gwen Grewe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326014234 PECOS PAC ID: 2961696240 Enrollment ID: I20101101000210 |
| Provider Name | David S Wakeling |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770544900 PECOS PAC ID: 6406043850 Enrollment ID: I20101210000288 |
| Provider Name | Daniel J Gilden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578532289 PECOS PAC ID: 0749477198 Enrollment ID: I20101210000322 |
| Provider Name | Michael R Tangum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497729321 PECOS PAC ID: 5890982250 Enrollment ID: I20101210000381 |
| Provider Name | Timothy Persse |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396710810 PECOS PAC ID: 6305034208 Enrollment ID: I20101220000335 |
| Provider Name | Curtis Mark Climer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538151857 PECOS PAC ID: 4082894340 Enrollment ID: I20110203001158 |
| Provider Name | Gilbert E Nicholson Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104982818 PECOS PAC ID: 6800079567 Enrollment ID: I20110318000178 |
| Provider Name | Simona A Parau |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932381316 PECOS PAC ID: 4183785389 Enrollment ID: I20110428000653 |
| Provider Name | Maurice Iii Golden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659328649 PECOS PAC ID: 1456434778 Enrollment ID: I20110714000658 |
| Provider Name | Ting Ting Zhou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598930851 PECOS PAC ID: 1951570548 Enrollment ID: I20110817000081 |
| Provider Name | June L Jia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225204886 PECOS PAC ID: 5698945210 Enrollment ID: I20110908002002 |
| Provider Name | Mallik N Tella |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1649380395 PECOS PAC ID: 1153591706 Enrollment ID: I20110908002357 |
| Provider Name | Cameron D Klug |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114139029 PECOS PAC ID: 2062683584 Enrollment ID: I20110913000927 |
| Provider Name | Fredrick S An |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194991901 PECOS PAC ID: 5496926867 Enrollment ID: I20110914000679 |
| Provider Name | David Andrew Stenstrom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265607485 PECOS PAC ID: 9133391345 Enrollment ID: I20111012000617 |
| Provider Name | Gladys Vu Phuong Ho |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982871869 PECOS PAC ID: 6608048640 Enrollment ID: I20111017000376 |
| Provider Name | Brian L Puskas |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1053586016 PECOS PAC ID: 3173648771 Enrollment ID: I20111018000395 |
| Provider Name | Caroline A Motika |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1245359454 PECOS PAC ID: 6406029636 Enrollment ID: I20111102000785 |
| Provider Name | Miriam Nehama Rosenberg |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1861771230 PECOS PAC ID: 4981877867 Enrollment ID: I20111110000056 |
| Provider Name | Mukesh K Thawani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174716427 PECOS PAC ID: 5890832810 Enrollment ID: I20120216000232 |
| Provider Name | Eleanor Zawada |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992758643 PECOS PAC ID: 5496913998 Enrollment ID: I20120229000453 |
| Provider Name | Corrin E Ginnow |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942443114 PECOS PAC ID: 4880850445 Enrollment ID: I20120725000974 |
| Provider Name | Esther Rawner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093999211 PECOS PAC ID: 1850467275 Enrollment ID: I20120730000584 |
| Provider Name | Robert A Abernathy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063433449 PECOS PAC ID: 4981662798 Enrollment ID: I20120815000094 |
| Provider Name | Jessica A A Lehrfeld |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780910265 PECOS PAC ID: 8325295736 Enrollment ID: I20120820000848 |
| Provider Name | Julian J Uselman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306075791 PECOS PAC ID: 4587811997 Enrollment ID: I20120820000889 |
| Provider Name | Jonathan S Rogers |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1972738847 PECOS PAC ID: 5294982252 Enrollment ID: I20120827000209 |
| Provider Name | Nicole Lorenz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1073719639 PECOS PAC ID: 8426205006 Enrollment ID: I20120905000050 |
| Provider Name | Victor O Macias |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093095929 PECOS PAC ID: 3274781737 Enrollment ID: I20120907000501 |
| Provider Name | Milton W Kim |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871740787 PECOS PAC ID: 3072789213 Enrollment ID: I20120919000107 |
| Provider Name | John Dewayne Powell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1457652679 PECOS PAC ID: 3870773955 Enrollment ID: I20121023000828 |
| Provider Name | Richard Paul Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275626137 PECOS PAC ID: 5294626685 Enrollment ID: I20130204000549 |
| Provider Name | Antonio M Germann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235394107 PECOS PAC ID: 9830351881 Enrollment ID: I20130207000464 |
| Provider Name | Shawn Mackenzie |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487846267 PECOS PAC ID: 9032292172 Enrollment ID: I20130304000447 |
| Provider Name | Diana L Smith |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1821372715 PECOS PAC ID: 3779756820 Enrollment ID: I20130308000468 |
| Provider Name | Brian T Pavic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972822195 PECOS PAC ID: 1254577869 Enrollment ID: I20130425000569 |
| Provider Name | Elizabeth G Gienger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366793846 PECOS PAC ID: 7012155393 Enrollment ID: I20130528000358 |
| Provider Name | Annie E Johnson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1396029930 PECOS PAC ID: 9436397379 Enrollment ID: I20130604000628 |
| Provider Name | Michael J Mooney |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609985647 PECOS PAC ID: 7315984622 Enrollment ID: I20130614000124 |
| Provider Name | Nicholas Hedden |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992007298 PECOS PAC ID: 5799924809 Enrollment ID: I20130621000328 |
| Provider Name | Heather M Larson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730383514 PECOS PAC ID: 4082854435 Enrollment ID: I20130708000158 |
| Provider Name | Christopher L Fraley |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1821011693 PECOS PAC ID: 6608870845 Enrollment ID: I20130716000154 |
| Provider Name | Emmanuel Tavan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1003007907 PECOS PAC ID: 8224283056 Enrollment ID: I20130820000325 |
| Provider Name | Ange Mong Ly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114248218 PECOS PAC ID: 6901049493 Enrollment ID: I20130903000171 |
| Provider Name | Jenny Nordeen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871789024 PECOS PAC ID: 2163614389 Enrollment ID: I20130918000607 |
| Provider Name | Bryan C Rimel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295902831 PECOS PAC ID: 6608044284 Enrollment ID: I20130923000615 |
| Provider Name | Jill C Pearson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760584536 PECOS PAC ID: 3274777610 Enrollment ID: I20130925000014 |
| Provider Name | Smitha R Chadaga |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952362295 PECOS PAC ID: 7214999325 Enrollment ID: I20131002000055 |
| Provider Name | Karen Lavery Weis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912227646 PECOS PAC ID: 2062646136 Enrollment ID: I20131002000508 |
| Provider Name | Laura Ostrom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528371382 PECOS PAC ID: 1850526955 Enrollment ID: I20131025001590 |
| Provider Name | Lisa J Sabally |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1992093819 PECOS PAC ID: 6305091992 Enrollment ID: I20131028000351 |
| Provider Name | Kristine K Roesen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962644005 PECOS PAC ID: 5597902122 Enrollment ID: I20140107000688 |
| Provider Name | Wendy S Berger |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1427119387 PECOS PAC ID: 2961630330 Enrollment ID: I20140109000816 |
| Provider Name | Urmee Hossain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285865923 PECOS PAC ID: 7113155359 Enrollment ID: I20140114001266 |
| Provider Name | Timothy Ericson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376836981 PECOS PAC ID: 4082844253 Enrollment ID: I20140310000189 |
| Provider Name | Marie Hebert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033533278 PECOS PAC ID: 2365675717 Enrollment ID: I20140509000377 |
| Provider Name | Christina L Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417079146 PECOS PAC ID: 5890928121 Enrollment ID: I20140512001179 |
| Provider Name | Allison L Abraham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831488444 PECOS PAC ID: 8527283290 Enrollment ID: I20140714001573 |
| Provider Name | Christopher K Kwock |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619103553 PECOS PAC ID: 2567627276 Enrollment ID: I20140721000407 |
| Provider Name | Qian Leng |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154637015 PECOS PAC ID: 1658524723 Enrollment ID: I20140724000599 |
| Provider Name | Dallas D Regan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1053323170 PECOS PAC ID: 0648276055 Enrollment ID: I20140811001909 |
| Provider Name | Dean J Taylor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689964116 PECOS PAC ID: 6507084613 Enrollment ID: I20140903001486 |
| Provider Name | Erin M Wallace |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730405598 PECOS PAC ID: 4981849684 Enrollment ID: I20140910002169 |
| Provider Name | Tanja Epley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336119635 PECOS PAC ID: 9436212230 Enrollment ID: I20140925000324 |
| Provider Name | Alexandra E Stanculescu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932342722 PECOS PAC ID: 4789824376 Enrollment ID: I20141002001680 |
| Provider Name | Tom Shi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538454723 PECOS PAC ID: 2860613460 Enrollment ID: I20141023002505 |
| Provider Name | Veronica Mary Rayburn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063691608 PECOS PAC ID: 6507946225 Enrollment ID: I20141030001168 |
| Provider Name | Mary S Mckenzie |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1447417100 PECOS PAC ID: 6800027657 Enrollment ID: I20141204000680 |
| Provider Name | Joshua D Jones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417112673 PECOS PAC ID: 4789848052 Enrollment ID: I20150120001670 |
| Provider Name | Leslie Ann Sanchez Goettler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306985312 PECOS PAC ID: 6608919568 Enrollment ID: I20150204001247 |
| Provider Name | Luong M Banh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457560609 PECOS PAC ID: 1557416179 Enrollment ID: I20150318000198 |
| Provider Name | Audra R Norris-jacob |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770809303 PECOS PAC ID: 8224283791 Enrollment ID: I20150327002611 |
| Provider Name | Joshua D Dillard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982954715 PECOS PAC ID: 6901123991 Enrollment ID: I20150401001422 |
| Provider Name | Allean C Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144540063 PECOS PAC ID: 8325164304 Enrollment ID: I20150417000893 |
| Provider Name | Judith Tamarah Marcus |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437139011 PECOS PAC ID: 6103954771 Enrollment ID: I20150519000225 |
| Provider Name | Bradford Chaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417383886 PECOS PAC ID: 2163743147 Enrollment ID: I20150602002249 |
| Provider Name | Kenneth M Leclerc |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1760483754 PECOS PAC ID: 6507836814 Enrollment ID: I20150615002057 |
| Provider Name | Jennie Butsch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902207830 PECOS PAC ID: 5991016685 Enrollment ID: I20150622002561 |
| Provider Name | Shao-hwa P Wei |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205062361 PECOS PAC ID: 7517278146 Enrollment ID: I20150623001219 |
| Provider Name | Paul Andrew Brewer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962525204 PECOS PAC ID: 3375726839 Enrollment ID: I20150630000914 |
| Provider Name | Michelle T Turney |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1790055960 PECOS PAC ID: 4587976337 Enrollment ID: I20150707003338 |
| Provider Name | Jennifer R Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396001517 PECOS PAC ID: 2264745462 Enrollment ID: I20150716002746 |
| Provider Name | Joshua David Thompson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902163934 PECOS PAC ID: 8729304456 Enrollment ID: I20150722006195 |
| Provider Name | Robert M Mayer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154753457 PECOS PAC ID: 4082928320 Enrollment ID: I20150731014349 |
| Provider Name | Megan E Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437302270 PECOS PAC ID: 6103988688 Enrollment ID: I20150804005685 |
| Provider Name | Abigail Vautrain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710208921 PECOS PAC ID: 3173767019 Enrollment ID: I20150831002712 |
| Provider Name | James W Jensen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194926485 PECOS PAC ID: 3173695764 Enrollment ID: I20150911000443 |
| Provider Name | Glenn I Bernstein |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366441925 PECOS PAC ID: 9638076706 Enrollment ID: I20150914001479 |
| Provider Name | Erica Coppola |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1811305220 PECOS PAC ID: 6901113042 Enrollment ID: I20150922001259 |
| Provider Name | Jamey L Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114239936 PECOS PAC ID: 7618105081 Enrollment ID: I20150922002212 |
| Provider Name | Rebecca D Dorsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770984841 PECOS PAC ID: 8325356611 Enrollment ID: I20151006003184 |
| Provider Name | John P Yang |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144312166 PECOS PAC ID: 8921008749 Enrollment ID: I20151015001849 |
| Provider Name | Devin Salazar |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1104200799 PECOS PAC ID: 7012226749 Enrollment ID: I20151021000356 |
| Provider Name | Khalil I Shasha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942233564 PECOS PAC ID: 2466558432 Enrollment ID: I20151113001468 |
| Provider Name | Molly A Macmorris-adix |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1154707008 PECOS PAC ID: 5597075820 Enrollment ID: I20151117000672 |
| Provider Name | Cibi Arumugam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376822742 PECOS PAC ID: 9436378106 Enrollment ID: I20160114001785 |
| Provider Name | Bradley Johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1548531973 PECOS PAC ID: 1951534643 Enrollment ID: I20160208000762 |
| Provider Name | Sarah Moore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487943569 PECOS PAC ID: 5597087965 Enrollment ID: I20160223001487 |
| Provider Name | Margaret M Bowden |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881624138 PECOS PAC ID: 9234262551 Enrollment ID: I20160226002266 |
| Provider Name | Christopher Y Way |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598024515 PECOS PAC ID: 1456579267 Enrollment ID: I20160509000122 |
| Provider Name | Jonathan Crandall |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1346591179 PECOS PAC ID: 3375862469 Enrollment ID: I20160512002124 |
| Provider Name | Kelsey M Conklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801255120 PECOS PAC ID: 0840589651 Enrollment ID: I20160518001305 |
| Provider Name | Douglas A Valenta |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851553879 PECOS PAC ID: 4688728181 Enrollment ID: I20160525002408 |
| Provider Name | Michelle D Pies |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700224516 PECOS PAC ID: 2769772664 Enrollment ID: I20160606001427 |
| Provider Name | Nicholas O Beach |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568805786 PECOS PAC ID: 4486973468 Enrollment ID: I20160630001797 |
| Provider Name | Rachel Castelli |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265879142 PECOS PAC ID: 9133427800 Enrollment ID: I20160719000847 |
| Provider Name | Heather Fox |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669815791 PECOS PAC ID: 2668798976 Enrollment ID: I20160719002403 |
| Provider Name | Thatcher M Jones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194168971 PECOS PAC ID: 4385969336 Enrollment ID: I20160720001583 |
| Provider Name | Ashley E Zielinski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053754390 PECOS PAC ID: 2466689690 Enrollment ID: I20160726002143 |
| Provider Name | Pratishtha Gupta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417365503 PECOS PAC ID: 8123312451 Enrollment ID: I20160810000726 |
| Provider Name | Alicia E Knecht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164679916 PECOS PAC ID: 3274827142 Enrollment ID: I20160816001335 |
| Provider Name | Anne E Amspoker |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1720340151 PECOS PAC ID: 0547418154 Enrollment ID: I20160823001781 |
| Provider Name | Lara A Weyl |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629333414 PECOS PAC ID: 6204121726 Enrollment ID: I20160823002499 |
| Provider Name | Jesse Bohrer-clancy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952662967 PECOS PAC ID: 3173835741 Enrollment ID: I20160831003113 |
| Provider Name | Samuel R. Glickman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1912149790 PECOS PAC ID: 9638325186 Enrollment ID: I20160912000279 |
| Provider Name | Sara Marie Weber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447703624 PECOS PAC ID: 0840586137 Enrollment ID: I20160913001769 |
| Provider Name | Lori L Swain |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1578897963 PECOS PAC ID: 3971890963 Enrollment ID: I20160919001697 |
| Provider Name | Sonia Rajput |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609119551 PECOS PAC ID: 3476840380 Enrollment ID: I20160920003139 |
| Provider Name | Arjun K Chagarlamudi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568699932 PECOS PAC ID: 4587954847 Enrollment ID: I20160922001234 |
| Provider Name | Alicia D Hidalgo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659799989 PECOS PAC ID: 2466777420 Enrollment ID: I20160926001364 |
| Provider Name | Lena Soo Hee Wood |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1285181974 PECOS PAC ID: 7911286257 Enrollment ID: I20161109001957 |
| Provider Name | Sarah A Paeth |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1225410400 PECOS PAC ID: 8527347665 Enrollment ID: I20161114001837 |
| Provider Name | Katie Wright |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1154685485 PECOS PAC ID: 4789977208 Enrollment ID: I20161115000192 |
| Provider Name | Kathryn Lynn Blachly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487736971 PECOS PAC ID: 0143508978 Enrollment ID: I20161214002764 |
| Provider Name | Laura A Mcguire |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841386703 PECOS PAC ID: 1153412515 Enrollment ID: I20161230001308 |
| Provider Name | Carlye Spaulding |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699225201 PECOS PAC ID: 3577845601 Enrollment ID: I20170124002774 |
| Provider Name | Rachael Chantal Morin-rayburn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558611665 PECOS PAC ID: 1153604830 Enrollment ID: I20170202001490 |
| Provider Name | Ashleigh L Smith |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1720489644 PECOS PAC ID: 6608150552 Enrollment ID: I20170221002637 |
| Provider Name | Christopher Gordon Yheulon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770894602 PECOS PAC ID: 5092090589 Enrollment ID: I20170324000304 |
| Provider Name | Lenny E Dickens |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1235532318 PECOS PAC ID: 9537445184 Enrollment ID: I20170413000931 |
| Provider Name | Alfonso Espina Capuras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083096507 PECOS PAC ID: 7911213483 Enrollment ID: I20170413001097 |
| Provider Name | Dalyn J Molinaro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164800405 PECOS PAC ID: 2466738794 Enrollment ID: I20170420001636 |
| Provider Name | Sandra V Law |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144454877 PECOS PAC ID: 0648427013 Enrollment ID: I20170427001332 |
| Provider Name | Elizabeth Jane Harbottle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639501737 PECOS PAC ID: 3274858238 Enrollment ID: I20170519002047 |
| Provider Name | Matthew D Champion |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1962778902 PECOS PAC ID: 9537477047 Enrollment ID: I20170522000791 |
| Provider Name | Jacob R Adams |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1518256585 PECOS PAC ID: 1355596909 Enrollment ID: I20170615002388 |
| Provider Name | Camille M Santarpio |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497781702 PECOS PAC ID: 3072510338 Enrollment ID: I20170621001319 |
| Provider Name | Nikolaus A Kashey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538155775 PECOS PAC ID: 4183653389 Enrollment ID: I20170717003501 |
| Provider Name | Ricky Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063779213 PECOS PAC ID: 6901039734 Enrollment ID: I20170816004306 |
| Provider Name | Angela M Gibbs |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487034484 PECOS PAC ID: 1951614304 Enrollment ID: I20170818002042 |
| Provider Name | Kelly Lorelle Rickman |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1932577400 PECOS PAC ID: 6507166212 Enrollment ID: I20170829004313 |
| Provider Name | Christin Trost |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1285159186 PECOS PAC ID: 6002182656 Enrollment ID: I20171025003216 |
| Provider Name | Kathrin R Meyers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013258383 PECOS PAC ID: 6901122621 Enrollment ID: I20171028000224 |
| Provider Name | Katherine A Mahar |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1710347935 PECOS PAC ID: 5799078135 Enrollment ID: I20171031001997 |
| Provider Name | Eric Turner |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942560487 PECOS PAC ID: 0042576308 Enrollment ID: I20171102002122 |
| Provider Name | Mohamed Refaat |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053607457 PECOS PAC ID: 1557591625 Enrollment ID: I20171129000688 |
| Provider Name | Jessica Morton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528486180 PECOS PAC ID: 5991922742 Enrollment ID: I20171211002767 |
| Provider Name | Danielle Laura Maier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891124574 PECOS PAC ID: 2264663939 Enrollment ID: I20171214000852 |
| Provider Name | Gene S Lui |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1669496535 PECOS PAC ID: 9032275763 Enrollment ID: I20180201002014 |
| Provider Name | Constance Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992090724 PECOS PAC ID: 9335409283 Enrollment ID: I20180214001221 |
| Provider Name | Cyrus Ghavam |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1023063989 PECOS PAC ID: 0345206900 Enrollment ID: I20180309001438 |
| Provider Name | Mary M Tippin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1316018864 PECOS PAC ID: 5890860662 Enrollment ID: I20180313000920 |
| Provider Name | Naveena S Bushan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952309007 PECOS PAC ID: 5890740906 Enrollment ID: I20180320001702 |
| Provider Name | Elizabeth Diane Krainchich |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1467902965 PECOS PAC ID: 4789947680 Enrollment ID: I20180405002022 |
| Provider Name | Diane Mary Inda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871962589 PECOS PAC ID: 1557670130 Enrollment ID: I20180417002832 |
| Provider Name | Nicholas D Boespflug |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497140909 PECOS PAC ID: 2668789728 Enrollment ID: I20180516002994 |
| Provider Name | Stewart A Weber |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609118009 PECOS PAC ID: 3870712680 Enrollment ID: I20180530003212 |
| Provider Name | Patricia Funk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003203993 PECOS PAC ID: 3375858509 Enrollment ID: I20180531002488 |
| Provider Name | Maura J Frith |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124429691 PECOS PAC ID: 2961779038 Enrollment ID: I20180621001763 |
| Provider Name | Yelena G Vidgop |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336300771 PECOS PAC ID: 0941444095 Enrollment ID: I20180717002142 |
| Provider Name | Jess Ransom Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215230651 PECOS PAC ID: 2163712969 Enrollment ID: I20180723002756 |
| Provider Name | John Robert Turner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992145775 PECOS PAC ID: 1557647575 Enrollment ID: I20180802002066 |
| Provider Name | Rebecca L Corbett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912391830 PECOS PAC ID: 9032424171 Enrollment ID: I20180807001819 |
| Provider Name | Dean K Peterson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033559869 PECOS PAC ID: 2668789876 Enrollment ID: I20180808000916 |
| Provider Name | Robert E Morgan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689068652 PECOS PAC ID: 5193031771 Enrollment ID: I20180813000643 |
| Provider Name | Katherine Colleen Riordan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689832107 PECOS PAC ID: 8224174354 Enrollment ID: I20180823003280 |
| Provider Name | Jessica Lorenz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750775698 PECOS PAC ID: 3971819368 Enrollment ID: I20180919002045 |
| Provider Name | Kendall Christensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750873436 PECOS PAC ID: 0345592168 Enrollment ID: I20181005001762 |
| Provider Name | Seth Alkire |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942615869 PECOS PAC ID: 3971899444 Enrollment ID: I20181010001197 |
| Provider Name | Andrew D Nelson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1083900419 PECOS PAC ID: 8527311547 Enrollment ID: I20181022001053 |
| Provider Name | Samuel W Bullick |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1386904662 PECOS PAC ID: 2860633286 Enrollment ID: I20181022002155 |
| Provider Name | Laura E Holton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487090270 PECOS PAC ID: 5890920714 Enrollment ID: I20181022002396 |
| Provider Name | Masayo Ozaki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932594082 PECOS PAC ID: 0345593166 Enrollment ID: I20181024003374 |
| Provider Name | Stephen Ki Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689917700 PECOS PAC ID: 5193010296 Enrollment ID: I20181212000210 |
| Provider Name | Suzanna Davis Barnhart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083193338 PECOS PAC ID: 9638414766 Enrollment ID: I20181218003374 |
| Provider Name | Ricardo Sanchez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679048979 PECOS PAC ID: 3870838659 Enrollment ID: I20181226000597 |
| Provider Name | Stanley Garken Lue |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003017427 PECOS PAC ID: 6204005648 Enrollment ID: I20190108002578 |
| Provider Name | Tara Marie Mcgarry |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184975260 PECOS PAC ID: 3971856543 Enrollment ID: I20190110003432 |
| Provider Name | Miranda A Meng |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336373950 PECOS PAC ID: 5991041840 Enrollment ID: I20190114001628 |
| Provider Name | Chut Sombutmai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649320987 PECOS PAC ID: 4284807413 Enrollment ID: I20190125002834 |
| Provider Name | Analiesse M Carter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134503287 PECOS PAC ID: 2365743382 Enrollment ID: I20190211001808 |
| Provider Name | Patricia Colon-garcia |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427157270 PECOS PAC ID: 0446356216 Enrollment ID: I20190221002435 |
| Provider Name | Peter Clemens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487858940 PECOS PAC ID: 6103814256 Enrollment ID: I20190222001667 |
| Provider Name | Robin Kenning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700215225 PECOS PAC ID: 8628290814 Enrollment ID: I20190314001731 |
| Provider Name | Nikhil Pillarisetti Rao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629211347 PECOS PAC ID: 5496063430 Enrollment ID: I20190325001717 |
| Provider Name | Suzannah Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477816353 PECOS PAC ID: 2365669165 Enrollment ID: I20190530002770 |
| Provider Name | Julie E Chaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174042824 PECOS PAC ID: 7719210079 Enrollment ID: I20190531002097 |
| Provider Name | Tuan Ngoc Hoang |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1265590905 PECOS PAC ID: 7618272568 Enrollment ID: I20190611002066 |
| Provider Name | Amy C Anderton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568802361 PECOS PAC ID: 5395012942 Enrollment ID: I20190613001836 |
| Provider Name | Dennis Patrick Grusenmeyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871568113 PECOS PAC ID: 0648299644 Enrollment ID: I20190621002037 |
| Provider Name | Penny Denise Leininger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265928428 PECOS PAC ID: 2264783786 Enrollment ID: I20190626000920 |
| Provider Name | Steven Sears |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1275890675 PECOS PAC ID: 5496990921 Enrollment ID: I20190725003264 |
| Provider Name | Elizabeth R Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780022848 PECOS PAC ID: 8628392941 Enrollment ID: I20190726000526 |
| Provider Name | Kathryn R Foutch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568826386 PECOS PAC ID: 8123311750 Enrollment ID: I20190729000568 |
| Provider Name | Michael D Fox |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043685407 PECOS PAC ID: 4789977992 Enrollment ID: I20190801001929 |
| Provider Name | Lauren M Piacente |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225484967 PECOS PAC ID: 6305139502 Enrollment ID: I20190816003027 |
| Provider Name | Mary E Walker |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1639730666 PECOS PAC ID: 3274861117 Enrollment ID: I20190829003663 |
| Provider Name | Geetanjali Vajapey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740523935 PECOS PAC ID: 5799087441 Enrollment ID: I20190903001145 |
| Provider Name | Theresa B. Sevilis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407111461 PECOS PAC ID: 6608191911 Enrollment ID: I20190906002846 |
| Provider Name | Vivian Marie Suarez Gonzalez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801107388 PECOS PAC ID: 7618145830 Enrollment ID: I20190912002014 |
| Provider Name | Michelle Boudreau |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346534864 PECOS PAC ID: 7416182480 Enrollment ID: I20190918000941 |
| Provider Name | Raelin Fullmer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528487956 PECOS PAC ID: 8921393448 Enrollment ID: I20190925002472 |
| Provider Name | Rebecca L Niemeyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083895551 PECOS PAC ID: 4385714336 Enrollment ID: I20191002002788 |
| Provider Name | Stephanie Nickson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023460946 PECOS PAC ID: 7012248008 Enrollment ID: I20191004002084 |
| Provider Name | Nicholas J Saenger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700146891 PECOS PAC ID: 7719319607 Enrollment ID: I20191114001511 |
| Provider Name | Neetu Dhadwal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962842492 PECOS PAC ID: 4183852270 Enrollment ID: I20191115001266 |
| Provider Name | Heidi Michelle Nolan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487205035 PECOS PAC ID: 1355773896 Enrollment ID: I20191121000672 |
| Provider Name | Nicole Behnke |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1952595936 PECOS PAC ID: 3072747294 Enrollment ID: I20191216000163 |
| Provider Name | Tracy Lynn Whitmire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679119101 PECOS PAC ID: 1850726449 Enrollment ID: I20200108000806 |
| Provider Name | Joao Mc-oneil Plancher |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700142668 PECOS PAC ID: 9638317837 Enrollment ID: I20200121000749 |
| Provider Name | Tarris Webber |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154771780 PECOS PAC ID: 5193018307 Enrollment ID: I20200127001385 |
| Provider Name | Hannah M Hewitt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770970006 PECOS PAC ID: 3870800717 Enrollment ID: I20200204001396 |
| Provider Name | Daniel Lawrence Smith |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1851816854 PECOS PAC ID: 3476981127 Enrollment ID: I20200312000829 |
| Provider Name | Tenzin D Gorab |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700277001 PECOS PAC ID: 0941638431 Enrollment ID: I20200323000970 |
| Provider Name | Marjorie Selene Camarda |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1891253712 PECOS PAC ID: 9830527878 Enrollment ID: I20200325001218 |
| Provider Name | Jeffrey M Levine |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154418457 PECOS PAC ID: 5698956936 Enrollment ID: I20200326002240 |
| Provider Name | Sarah Lottie Rankin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891330288 PECOS PAC ID: 2466889084 Enrollment ID: I20200327000648 |
| Provider Name | Angela Massoni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043649908 PECOS PAC ID: 9234361825 Enrollment ID: I20200414003476 |
| Provider Name | Samuel Loeb |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508091521 PECOS PAC ID: 5294985974 Enrollment ID: I20200415003838 |
| Provider Name | Julie M Riley |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1053961144 PECOS PAC ID: 7416387345 Enrollment ID: I20200416004001 |
| Provider Name | Gordon Jeremy Juriansz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023151735 PECOS PAC ID: 8224938451 Enrollment ID: I20200615002874 |
| Provider Name | Lauren Noll |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659708386 PECOS PAC ID: 9537430251 Enrollment ID: I20200702001842 |
| Provider Name | Monica E Venn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992039309 PECOS PAC ID: 7315106630 Enrollment ID: I20200715001857 |
| Provider Name | Sui Li |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992026371 PECOS PAC ID: 0345554929 Enrollment ID: I20200803000615 |
| Provider Name | Kristin E Sinn |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427366632 PECOS PAC ID: 7517159254 Enrollment ID: I20200810001449 |
| Provider Name | Larissa M Brodsky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578090197 PECOS PAC ID: 8820366651 Enrollment ID: I20200813000104 |
| Provider Name | Murtaza Amir |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508971920 PECOS PAC ID: 4688602915 Enrollment ID: I20200817002847 |
| Provider Name | Britta Ameel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558777342 PECOS PAC ID: 4183910847 Enrollment ID: I20200902002524 |
| Provider Name | Julice Ogando |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558892786 PECOS PAC ID: 8426301003 Enrollment ID: I20200903002018 |
| Provider Name | Matthew Sabongi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760878243 PECOS PAC ID: 5193022507 Enrollment ID: I20200909001861 |
| Provider Name | John Sauer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548259773 PECOS PAC ID: 6103725486 Enrollment ID: I20201005001751 |
| Provider Name | James Boyd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720254204 PECOS PAC ID: 3476728908 Enrollment ID: I20201013002466 |
| Provider Name | Carlotto A Fisher |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205157732 PECOS PAC ID: 0446564595 Enrollment ID: I20201021002796 |
| Provider Name | Nina Grace Bradley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750692422 PECOS PAC ID: 6709025505 Enrollment ID: I20201116003004 |
| Provider Name | Kelly D Carrier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144757311 PECOS PAC ID: 2365710340 Enrollment ID: I20201124001077 |
| Provider Name | Mark Mitchell Mcdonald |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366837429 PECOS PAC ID: 6709156334 Enrollment ID: I20210112000324 |
| Provider Name | Mimi S Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164684973 PECOS PAC ID: 4587883475 Enrollment ID: I20210119000595 |
| Provider Name | Sandro James Corti |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538503131 PECOS PAC ID: 4789953696 Enrollment ID: I20210120000239 |
| Provider Name | Angela M Vitek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841797990 PECOS PAC ID: 9436414919 Enrollment ID: I20210126002477 |
| Provider Name | Joshua Todd Mendelson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265641070 PECOS PAC ID: 8921139023 Enrollment ID: I20210211001592 |
| Provider Name | Joel Masami Oyama |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154915338 PECOS PAC ID: 9739595042 Enrollment ID: I20210311001885 |
| Provider Name | Eugene Alfred Mcgough |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639131923 PECOS PAC ID: 7810935509 Enrollment ID: I20210316002788 |
| Provider Name | Jessica J Bonilla |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1710593967 PECOS PAC ID: 1456768936 Enrollment ID: I20210330000155 |
| Provider Name | Sabrina M Bowers |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1093098964 PECOS PAC ID: 3274945787 Enrollment ID: I20210410000025 |
| Provider Name | Patricia Elizabeth Mansilla Diaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790362481 PECOS PAC ID: 0345659819 Enrollment ID: I20210513000744 |
| Provider Name | Jennifer Hines |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1205274370 PECOS PAC ID: 0547486730 Enrollment ID: I20210709002595 |
| Provider Name | Mariecken V Fowler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548200116 PECOS PAC ID: 4688602758 Enrollment ID: I20210824000308 |
| Provider Name | Benzion Chaim Yitzchok Blech |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538515465 PECOS PAC ID: 9638461056 Enrollment ID: I20210914000645 |
| Provider Name | Jenna R Kanter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063737302 PECOS PAC ID: 1850514456 Enrollment ID: I20210927001400 |
| Provider Name | Deepti G Singhvi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1639411291 PECOS PAC ID: 9032408331 Enrollment ID: I20210928003530 |
| Provider Name | Christopher M Brown |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891173043 PECOS PAC ID: 1355689381 Enrollment ID: I20210929001439 |
| Provider Name | Hsiong Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912165374 PECOS PAC ID: 1456548601 Enrollment ID: I20210929002860 |
| Provider Name | Kelsey Tassinari Poppe |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1023605870 PECOS PAC ID: 1153729322 Enrollment ID: I20211004000187 |
| Provider Name | Sara E Wohlgemuth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699291708 PECOS PAC ID: 3274931191 Enrollment ID: I20211007001145 |
| Provider Name | Colby A. Richardson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558724799 PECOS PAC ID: 2567866973 Enrollment ID: I20211208003192 |
| Provider Name | Darshana Pritesh Amin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407901382 PECOS PAC ID: 4082750468 Enrollment ID: I20211209001683 |
| Provider Name | Birenkumar Rajandrakumar Patel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679900062 PECOS PAC ID: 0547533788 Enrollment ID: I20211209002367 |
| Provider Name | Morgan Elizabeth Figurelle |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801241260 PECOS PAC ID: 8729373642 Enrollment ID: I20211209002921 |
| Provider Name | Fermina Alia Pirmohamed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508138314 PECOS PAC ID: 9133369754 Enrollment ID: I20211210000793 |
| Provider Name | Brandee Black |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477864429 PECOS PAC ID: 5698919959 Enrollment ID: I20211210002204 |
| Provider Name | Morgan Patrylo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972946002 PECOS PAC ID: 4880948959 Enrollment ID: I20211214002963 |
| Provider Name | Candice Kam |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205283462 PECOS PAC ID: 8628360898 Enrollment ID: I20211223001542 |
| Provider Name | Qudsia Shaikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245553098 PECOS PAC ID: 6507006517 Enrollment ID: I20211229002278 |
| Provider Name | Srividya Reddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922388255 PECOS PAC ID: 1951528181 Enrollment ID: I20220105002306 |
| Provider Name | Kartik Ramakrishna |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1528323755 PECOS PAC ID: 7012210263 Enrollment ID: I20220110001084 |
| Provider Name | Joanne P Parker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962452433 PECOS PAC ID: 4587655527 Enrollment ID: I20220121002135 |
| Provider Name | William Andrew Heymann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457646333 PECOS PAC ID: 9032347802 Enrollment ID: I20220124002947 |
| Provider Name | Bradley T Boye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578940623 PECOS PAC ID: 1355658162 Enrollment ID: I20220128000203 |
| Provider Name | Andrew Novick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316568728 PECOS PAC ID: 7315335361 Enrollment ID: I20220201001130 |
| Provider Name | Peter A Engdall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457842940 PECOS PAC ID: 1052669504 Enrollment ID: I20220207002366 |
| Provider Name | Michelle M Wayne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689051534 PECOS PAC ID: 3678889821 Enrollment ID: I20220208001822 |
| Provider Name | Georgy Cherkassky |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760827778 PECOS PAC ID: 7416197702 Enrollment ID: I20220215001183 |
| Provider Name | Jeremy Pottash |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497142046 PECOS PAC ID: 9931443470 Enrollment ID: I20220217001488 |
| Provider Name | Hao Kee Ho |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649791385 PECOS PAC ID: 3779993522 Enrollment ID: I20220217001604 |
| Provider Name | Ravneet Dhaliwal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841647443 PECOS PAC ID: 3577855972 Enrollment ID: I20220303001629 |
| Provider Name | Jessica Shin Choe |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215194030 PECOS PAC ID: 3678857323 Enrollment ID: I20220304001750 |
| Provider Name | Abhi H Kapuria |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730542812 PECOS PAC ID: 8820493935 Enrollment ID: I20220317002070 |
| Provider Name | Yu-hsuan Liao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063868677 PECOS PAC ID: 9133523350 Enrollment ID: I20220323002280 |
| Provider Name | Jonathan Christian Cook |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417163510 PECOS PAC ID: 2264558485 Enrollment ID: I20220324001106 |
| Provider Name | Satinder Kaur Grewal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386085546 PECOS PAC ID: 7618229436 Enrollment ID: I20220404001864 |
| Provider Name | Elizabeth Neal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356455265 PECOS PAC ID: 1254354046 Enrollment ID: I20220412001892 |
| Provider Name | Joshua L Hoerger |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1801257712 PECOS PAC ID: 6406119353 Enrollment ID: I20220419001238 |
| Provider Name | Samantha Banks Kaiser |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619468972 PECOS PAC ID: 6901293893 Enrollment ID: I20220422002016 |
| Provider Name | Robert Myers |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700248937 PECOS PAC ID: 7416356324 Enrollment ID: I20220427002856 |
| Provider Name | Colleen Fleming |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881027241 PECOS PAC ID: 7113151556 Enrollment ID: I20220502000711 |
| Provider Name | Kelly Block |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740786631 PECOS PAC ID: 4688061187 Enrollment ID: I20220502002362 |
| Provider Name | Jonathan P Daniels |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043214935 PECOS PAC ID: 8325101223 Enrollment ID: I20220511002266 |
| Provider Name | Katherine M Olson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1962153361 PECOS PAC ID: 9436536075 Enrollment ID: I20220519001720 |
| Provider Name | Peter A Brown |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083019574 PECOS PAC ID: 1052738986 Enrollment ID: I20220606001519 |
| Provider Name | Anant Shenoy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194998005 PECOS PAC ID: 5991855140 Enrollment ID: I20220624002678 |
| Provider Name | Lori A Gore-green |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578658654 PECOS PAC ID: 7618974585 Enrollment ID: I20220630002748 |
| Provider Name | Linda Y. Jiang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427476456 PECOS PAC ID: 3678870276 Enrollment ID: I20220706003432 |
| Provider Name | Martin R Box |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033773775 PECOS PAC ID: 9234467408 Enrollment ID: I20220714001548 |
| Provider Name | Casey M Sullivan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356965701 PECOS PAC ID: 8527483114 Enrollment ID: I20220722001172 |
| Provider Name | Ashley Dennis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255826673 PECOS PAC ID: 9931581121 Enrollment ID: I20220804001687 |
| Provider Name | Anthony L Joseph |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831298223 PECOS PAC ID: 5890883219 Enrollment ID: I20220808003013 |
| Provider Name | Steven Gangloff |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952756058 PECOS PAC ID: 4587951637 Enrollment ID: I20220826003015 |
| Provider Name | Karen D Banks |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083998371 PECOS PAC ID: 4587899570 Enrollment ID: I20220920001476 |
| Provider Name | Lorie A Kelley Norton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043832041 PECOS PAC ID: 9830433564 Enrollment ID: I20221007000283 |
| Provider Name | Aswathnarayan R Manandhi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568662385 PECOS PAC ID: 0547386963 Enrollment ID: I20221017002490 |
| Provider Name | Kristen Selleck |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508305533 PECOS PAC ID: 4688945439 Enrollment ID: I20221019001290 |
| Provider Name | Ravi Yarlagadda |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679531636 PECOS PAC ID: 7911975560 Enrollment ID: I20221020002620 |
| Provider Name | Sheldon Rhee Fox |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1306515556 PECOS PAC ID: 6103292545 Enrollment ID: I20221026001185 |
| Provider Name | Maggie Schein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558873547 PECOS PAC ID: 4880061035 Enrollment ID: I20221101002559 |
| Provider Name | Lam Truong |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477278174 PECOS PAC ID: 3375910482 Enrollment ID: I20221102002248 |
| Provider Name | Ryna Then |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427346303 PECOS PAC ID: 4587891080 Enrollment ID: I20221108002843 |
| Provider Name | Mary E Stoddard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811435373 PECOS PAC ID: 3173895364 Enrollment ID: I20221114000443 |
| Provider Name | Ebunoluwa Oluwatosin Babalola |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023541968 PECOS PAC ID: 1759651813 Enrollment ID: I20221128002182 |
| Provider Name | Penny Lee Satre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376250100 PECOS PAC ID: 3173991916 Enrollment ID: I20221129000070 |
| Provider Name | Mohd J Jibreel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225267156 PECOS PAC ID: 9436300209 Enrollment ID: I20221216002648 |
| Provider Name | Madhavi Murthy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144323619 PECOS PAC ID: 5890947154 Enrollment ID: I20221221003161 |
| Provider Name | Frank J Williams |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1780974774 PECOS PAC ID: 6709175185 Enrollment ID: I20221227001108 |
| Provider Name | Maya E Sanchez-rotunno |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255625778 PECOS PAC ID: 4486958188 Enrollment ID: I20230104002030 |
| Provider Name | Tara Dawn Marlett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962988154 PECOS PAC ID: 4587035266 Enrollment ID: I20230116000876 |
| Provider Name | Carlos A Salazar |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407261456 PECOS PAC ID: 7810216967 Enrollment ID: I20230120001425 |
| Provider Name | Samuel Saad Elias-ausi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639432156 PECOS PAC ID: 5092031377 Enrollment ID: I20230203001528 |
| Provider Name | Roger Young |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952480683 PECOS PAC ID: 7911187679 Enrollment ID: I20230209002498 |
| Provider Name | Igor Alexandrovich Malenky |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740714054 PECOS PAC ID: 8820361330 Enrollment ID: I20230313001387 |
| Provider Name | Jimmy Diep Nguyen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1285815605 PECOS PAC ID: 5799837621 Enrollment ID: I20230319000101 |
| Provider Name | Mehwish Farooqi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750872214 PECOS PAC ID: 7416386685 Enrollment ID: I20230406002391 |
| Provider Name | Mark Sabra |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942616560 PECOS PAC ID: 7911200340 Enrollment ID: I20230407000403 |
| Provider Name | Nathanael J Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255794525 PECOS PAC ID: 0648560250 Enrollment ID: I20230410001099 |
| Provider Name | Patricia Kleinholz-owens |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629344882 PECOS PAC ID: 5496043440 Enrollment ID: I20230410001528 |
| Provider Name | Felix Rivera-perez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003078692 PECOS PAC ID: 4981755733 Enrollment ID: I20230410002516 |
| Provider Name | Monica M Noya Santana |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598297228 PECOS PAC ID: 1658755574 Enrollment ID: I20230413000524 |
| Provider Name | Neil G Jhamb |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477787067 PECOS PAC ID: 4082852769 Enrollment ID: I20230427000823 |
| Provider Name | Donna Pam Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952819831 PECOS PAC ID: 1850756644 Enrollment ID: I20230501001089 |
| Provider Name | Mariama Bayoh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407203243 PECOS PAC ID: 2466730593 Enrollment ID: I20230501001747 |
| Provider Name | William F Dotson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033343579 PECOS PAC ID: 7719103332 Enrollment ID: I20230503001895 |
| Provider Name | Kristen L Veal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821594789 PECOS PAC ID: 5698141604 Enrollment ID: I20230515001986 |
| Provider Name | Amna Ramzan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063953297 PECOS PAC ID: 0244612356 Enrollment ID: I20230517003386 |
| Provider Name | Edward George Boyer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073953683 PECOS PAC ID: 3779885678 Enrollment ID: I20230523001870 |
| Provider Name | Celeste Arden Swain |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225598964 PECOS PAC ID: 4183080781 Enrollment ID: I20230524003223 |
| Provider Name | Mallory Noelle Luckey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770932170 PECOS PAC ID: 4183902356 Enrollment ID: I20230605000732 |
| Provider Name | Srijana Zarkou |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649482340 PECOS PAC ID: 3779617139 Enrollment ID: I20230612000597 |
| Provider Name | Kelly Milton |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770882458 PECOS PAC ID: 8729206099 Enrollment ID: I20230615001696 |
| Provider Name | Stafford A Conway |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366498206 PECOS PAC ID: 3870515752 Enrollment ID: I20230616000896 |
| Provider Name | Indira De Jesus Alvelo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700074796 PECOS PAC ID: 2264651207 Enrollment ID: I20230626002237 |
| Provider Name | Ellie Frazey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003472366 PECOS PAC ID: 2567820848 Enrollment ID: I20230717002180 |
| Provider Name | Abigail Beth Swanson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1366129066 PECOS PAC ID: 1951762806 Enrollment ID: I20230725003326 |
| Provider Name | Megan K Guffey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427287911 PECOS PAC ID: 4183871288 Enrollment ID: I20230807003176 |
| Provider Name | Teresa Joy Nitti |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1255705521 PECOS PAC ID: 1557666823 Enrollment ID: I20230807003369 |
| Provider Name | Agnelio Silverio Cardentey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164957452 PECOS PAC ID: 3870960412 Enrollment ID: I20230808002141 |
| Provider Name | Parham J Zamani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184287427 PECOS PAC ID: 6800254327 Enrollment ID: I20230809003376 |
| Provider Name | Krystal Lynn Taulai |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811418395 PECOS PAC ID: 0143682245 Enrollment ID: I20230821002507 |
| Provider Name | Elizabeth T Walz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609817261 PECOS PAC ID: 5597796375 Enrollment ID: I20230824003261 |
| Provider Name | Numthip Chitravas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073761789 PECOS PAC ID: 4486898095 Enrollment ID: I20230901001023 |
| Provider Name | Chris R Collins |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114362613 PECOS PAC ID: 7416196639 Enrollment ID: I20230905001867 |
| Provider Name | Justin De'prey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356872063 PECOS PAC ID: 3274806674 Enrollment ID: I20230905003910 |
| Provider Name | Benjamin C Groves |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396242202 PECOS PAC ID: 7012399033 Enrollment ID: I20230908001184 |
| Provider Name | Adam Mitchell Koss |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760801112 PECOS PAC ID: 2769604123 Enrollment ID: I20230908001625 |
| Provider Name | Coleen Ju |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275130510 PECOS PAC ID: 1052766219 Enrollment ID: I20231009002782 |
| Provider Name | Ndubuisi D Ahuruonye |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467959494 PECOS PAC ID: 7911258264 Enrollment ID: I20231010000849 |
| Provider Name | Janet L Moore |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225091440 PECOS PAC ID: 9638258601 Enrollment ID: I20231013002295 |
| Provider Name | Kyle Binder |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841635422 PECOS PAC ID: 8325479116 Enrollment ID: I20231016000580 |
| Provider Name | Cara S Riley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508003815 PECOS PAC ID: 3779759600 Enrollment ID: I20231120002993 |
| Provider Name | Karli Whittam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639123300 PECOS PAC ID: 4183662026 Enrollment ID: I20231127001315 |
| Provider Name | Gerald E Bieniek |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720491970 PECOS PAC ID: 4688043300 Enrollment ID: I20231207001338 |
| Provider Name | Danny S Benjamin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386699494 PECOS PAC ID: 8921091265 Enrollment ID: I20231212001251 |
| Provider Name | Roy Morley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043659006 PECOS PAC ID: 0244453132 Enrollment ID: I20231218001679 |
| Provider Name | Christopher Niehues |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518453448 PECOS PAC ID: 7315296357 Enrollment ID: I20231226001727 |
| Provider Name | Ryan D Arams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134788771 PECOS PAC ID: 0345690517 Enrollment ID: I20231229002345 |
| Provider Name | Cynthia R Murphy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184826125 PECOS PAC ID: 2466533047 Enrollment ID: I20240102003563 |
| Provider Name | Jin B Jyung |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780636852 PECOS PAC ID: 6608816202 Enrollment ID: I20240104001411 |
| Provider Name | Bjai A Rice |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912490954 PECOS PAC ID: 9436552759 Enrollment ID: I20240105002468 |
| Provider Name | Kimberly L Clinite |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366837163 PECOS PAC ID: 5991052482 Enrollment ID: I20240124002847 |
| Provider Name | Rashmi Sharma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487207130 PECOS PAC ID: 0143550376 Enrollment ID: I20240131003976 |
| Provider Name | Stephen Joseph Comella |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114124641 PECOS PAC ID: 0749623569 Enrollment ID: I20240208003323 |
| Provider Name | Darcy Faith Shearer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750507125 PECOS PAC ID: 2769826197 Enrollment ID: I20240214000307 |
| Provider Name | Naomi Sheff |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1932804200 PECOS PAC ID: 5799121646 Enrollment ID: I20240313003341 |
| Provider Name | Marilynn J Denson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902861909 PECOS PAC ID: 6406899277 Enrollment ID: I20240313003568 |
| Provider Name | Ryan A Lehotay |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841581733 PECOS PAC ID: 3072959766 Enrollment ID: I20240316000532 |
| Provider Name | Wendi I Kulin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043411333 PECOS PAC ID: 5193857647 Enrollment ID: I20240322003939 |
| Provider Name | Piotr T Tekiela |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902268626 PECOS PAC ID: 2264725290 Enrollment ID: I20240326001864 |
| Provider Name | Charles Michel Lavigne |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023138799 PECOS PAC ID: 1254409667 Enrollment ID: I20240403002321 |
| Provider Name | Christopher K Ewing |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932546579 PECOS PAC ID: 1254739246 Enrollment ID: I20240411001174 |
| Provider Name | Mofei Lu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952806390 PECOS PAC ID: 1759744063 Enrollment ID: I20240411002261 |
| Provider Name | Natalie B San Luis |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1366193856 PECOS PAC ID: 2062851140 Enrollment ID: I20240423000871 |
| Provider Name | Julie B Seibert |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740253822 PECOS PAC ID: 9436115961 Enrollment ID: I20240503002285 |
| Provider Name | William T Jackson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649706474 PECOS PAC ID: 6204105380 Enrollment ID: I20240508000965 |
Silverton Internal Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 452 Welch St, Silverton, OR 97381 Phone: 503-873-8740 Fax: 503-874-2470 | |
Silver Creek Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 111 W C St, Silverton, OR 97381 Phone: 503-301-4997 | |
Clinton C. Sanford Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 333 Fairview St, Silverton, OR 97381 Phone: 503-873-2770 Fax: 503-873-2735 | |
Olwyn K Davies Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Welch Street, Silverton, OR 97381 Phone: 503-873-5331 Fax: 503-873-8513 | |
Legacy Medical Group Silverton Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 347 Fairview St, Silverton, OR 97381 Phone: 503-873-5667 Fax: 503-873-5687 | |
Vance Chiropractic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 208 S Water St, Silverton, OR 97381 Phone: 503-873-4226 | |
Silverton Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 347 Fairview St, Silverton, OR 97381 Phone: 503-873-5667 Fax: 503-873-5687 |