| Licking Memorial Professional Corporation | |
|
1320 W Main St Newark OH 43055-1822 | |
| (220) 564-4027 | |
| (220) 564-4012 |
| Full Name | Licking Memorial Professional Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 1320 W Main St, Newark, Ohio |
| Authorized Official Name and Position | Cynthia L. Webster (VP FINANCIAL SERVICE) |
| Authorized Official Contact | 2205644027 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Licking Memorial Professional Corporation 1320 W Main St Newark OH 43055-1822 Ph: (220) 564-4027 | Licking Memorial Professional Corporation 1320 W Main St Newark OH 43055-1822 Ph: (220) 564-4027 |
| NPI Number | 1326072265 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 02/07/2018 |
| Medicare PECOS PAC ID | 6204740731 |
|---|---|
| Medicare Enrollment ID | O20031203000131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326072265 | NPI | - | NPPES |
| 2144629 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208M00000X | Hospitalist | (* (Not Available)) | Secondary |
| Provider Name | Anil S Gokhale |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1740353879 PECOS PAC ID: 0244136554 Enrollment ID: I20031209000205 |
| Provider Name | Hassan Rajjoub |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1811060999 PECOS PAC ID: 6800798455 Enrollment ID: I20040127001212 |
| Provider Name | Jennifer J Aikey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1548359268 PECOS PAC ID: 7517860414 Enrollment ID: I20040128001176 |
| Provider Name | Evan B Cohn |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1164463451 PECOS PAC ID: 7113810482 Enrollment ID: I20040203000118 |
| Provider Name | Nathan H Kander |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1073518940 PECOS PAC ID: 6204738057 Enrollment ID: I20040303000551 |
| Provider Name | Laura J Schaeffer |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1326047028 PECOS PAC ID: 5294625679 Enrollment ID: I20040318000944 |
| Provider Name | Mohamud Si Mohamed |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700869377 PECOS PAC ID: 4981697935 Enrollment ID: I20040406000208 |
| Provider Name | Mazen Issa |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1598755464 PECOS PAC ID: 8729072335 Enrollment ID: I20040414000970 |
| Provider Name | Bassam Kret |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104824960 PECOS PAC ID: 1254327984 Enrollment ID: I20040420001594 |
| Provider Name | Laurian Mark Dean |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1043299274 PECOS PAC ID: 5890785349 Enrollment ID: I20040517000018 |
| Provider Name | Jane Mannag Zamora Rodgers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710991260 PECOS PAC ID: 9335122357 Enrollment ID: I20040610001188 |
| Provider Name | James Wright Desapri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851334072 PECOS PAC ID: 9537143862 Enrollment ID: I20040615001036 |
| Provider Name | David Edward Subler |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1881693349 PECOS PAC ID: 8123003118 Enrollment ID: I20040628000544 |
| Provider Name | Andrew C Seipel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578530127 PECOS PAC ID: 1951387117 Enrollment ID: I20040628001003 |
| Provider Name | Brian William Korn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912988155 PECOS PAC ID: 4183601347 Enrollment ID: I20040706000729 |
| Provider Name | Olugbenga F Tolani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255439675 PECOS PAC ID: 8426020041 Enrollment ID: I20040812000613 |
| Provider Name | Ejaz Ahmad |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1831158070 PECOS PAC ID: 1951374933 Enrollment ID: I20040817001366 |
| Provider Name | Mark Defrancisco |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1588605729 PECOS PAC ID: 6709852551 Enrollment ID: I20040903000008 |
| Provider Name | Laura Kenny Fortner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710973508 PECOS PAC ID: 8527037407 Enrollment ID: I20040928000414 |
| Provider Name | Garth Allen Bennington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184606303 PECOS PAC ID: 8729047022 Enrollment ID: I20041004000273 |
| Provider Name | May U Mbah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669428504 PECOS PAC ID: 9638132343 Enrollment ID: I20041104000286 |
| Provider Name | Kevin J Finley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205835394 PECOS PAC ID: 1850355009 Enrollment ID: I20041117000287 |
| Provider Name | Tina M Harmon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356312102 PECOS PAC ID: 8820053697 Enrollment ID: I20041122000659 |
| Provider Name | Gary D Sutliff |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699755603 PECOS PAC ID: 9739138546 Enrollment ID: I20050119000761 |
| Provider Name | Phillip Savage |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609875202 PECOS PAC ID: 7517912363 Enrollment ID: I20050315000590 |
| Provider Name | Talya R Greathouse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063411155 PECOS PAC ID: 4688611577 Enrollment ID: I20050412001152 |
| Provider Name | Megan E Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255330072 PECOS PAC ID: 4082653878 Enrollment ID: I20050502000244 |
| Provider Name | Scott W Rossio |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1689858292 PECOS PAC ID: 1052350675 Enrollment ID: I20050503000221 |
| Provider Name | Susan Christine Zwiebel |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1366411621 PECOS PAC ID: 1153362157 Enrollment ID: I20050519000927 |
| Provider Name | Ralph J Napolitano |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1831240795 PECOS PAC ID: 8022057959 Enrollment ID: I20050804000944 |
| Provider Name | Melissa Ann Lenko |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730105065 PECOS PAC ID: 6800826181 Enrollment ID: I20050816001004 |
| Provider Name | William A Highberger |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1629022207 PECOS PAC ID: 4082645551 Enrollment ID: I20050824000572 |
| Provider Name | Eric Candler |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1962481416 PECOS PAC ID: 0345144994 Enrollment ID: I20050824000614 |
| Provider Name | Gloria M Galloway |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265433635 PECOS PAC ID: 4688691546 Enrollment ID: I20051031000003 |
| Provider Name | Vinay K Chitkara |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1659336337 PECOS PAC ID: 2860448545 Enrollment ID: I20051103000096 |
| Provider Name | Craig B Cairns |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508865858 PECOS PAC ID: 8628097862 Enrollment ID: I20051116000643 |
| Provider Name | Bradley R Allen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700893013 PECOS PAC ID: 8729000229 Enrollment ID: I20051227000704 |
| Provider Name | Donald Astorian |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1992798557 PECOS PAC ID: 2769471036 Enrollment ID: I20060202000367 |
| Provider Name | Anita L Schrader |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518978915 PECOS PAC ID: 0143234765 Enrollment ID: I20060202000378 |
| Provider Name | Brent M Savage |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366437949 PECOS PAC ID: 3173599073 Enrollment ID: I20060623000254 |
| Provider Name | Richard A Roy |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1366449464 PECOS PAC ID: 0446263933 Enrollment ID: I20060803000280 |
| Provider Name | Asegid H Kebede |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1598716201 PECOS PAC ID: 7810991833 Enrollment ID: I20060906000360 |
| Provider Name | Ryan Longstreth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447290580 PECOS PAC ID: 4183628035 Enrollment ID: I20060907000000 |
| Provider Name | Kenneth Parker |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1841256765 PECOS PAC ID: 3971405184 Enrollment ID: I20060919000008 |
| Provider Name | Janae M Davis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891808861 PECOS PAC ID: 4880691302 Enrollment ID: I20061026000034 |
| Provider Name | Robert Mueller |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1316916752 PECOS PAC ID: 4082612551 Enrollment ID: I20061116000196 |
| Provider Name | Mark E Plaugher |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1306921770 PECOS PAC ID: 5092701045 Enrollment ID: I20061213000189 |
| Provider Name | Michael D Barth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326046541 PECOS PAC ID: 3375543630 Enrollment ID: I20070110000392 |
| Provider Name | Joel W Anders |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780622563 PECOS PAC ID: 9931201431 Enrollment ID: I20070302000026 |
| Provider Name | Nawar Saieg |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1750400867 PECOS PAC ID: 5395843817 Enrollment ID: I20070607000188 |
| Provider Name | Victor Frank Ferrini |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629018700 PECOS PAC ID: 1456451756 Enrollment ID: I20070716000766 |
| Provider Name | Veera Veerla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053524868 PECOS PAC ID: 1355433707 Enrollment ID: I20070815000629 |
| Provider Name | Aruna C Gowda |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1407070576 PECOS PAC ID: 3274520291 Enrollment ID: I20070830000460 |
| Provider Name | Christopher P Reedy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639162803 PECOS PAC ID: 3870681067 Enrollment ID: I20071126000145 |
| Provider Name | David W Koontz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730193137 PECOS PAC ID: 0749214492 Enrollment ID: I20080307000307 |
| Provider Name | Maria M Defante |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1811106289 PECOS PAC ID: 0244315349 Enrollment ID: I20080313000491 |
| Provider Name | Eric J Hoff |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063681393 PECOS PAC ID: 3779668694 Enrollment ID: I20080317000239 |
| Provider Name | Katrina M Timson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144228131 PECOS PAC ID: 5799861894 Enrollment ID: I20080331000181 |
| Provider Name | Niranjan Seshadri |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306840210 PECOS PAC ID: 3072594852 Enrollment ID: I20080409000041 |
| Provider Name | Bradley R Lewis |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1710108865 PECOS PAC ID: 2567549694 Enrollment ID: I20080414000266 |
| Provider Name | Joan M Crumrine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023042660 PECOS PAC ID: 3173601614 Enrollment ID: I20080423000508 |
| Provider Name | Colleen M Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255330965 PECOS PAC ID: 6406934629 Enrollment ID: I20080429000002 |
| Provider Name | Kristine Plotts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184895567 PECOS PAC ID: 3072692672 Enrollment ID: I20080508000003 |
| Provider Name | Derrick Lamar Reedus |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1194929463 PECOS PAC ID: 8022197482 Enrollment ID: I20080509000422 |
| Provider Name | Arinze Echezona Akusoba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366517591 PECOS PAC ID: 5092886374 Enrollment ID: I20080613000031 |
| Provider Name | Erica L Brown |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1881863736 PECOS PAC ID: 1658443551 Enrollment ID: I20080710000050 |
| Provider Name | Ilyas Ikramuddin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1457352940 PECOS PAC ID: 7214002161 Enrollment ID: I20080812000720 |
| Provider Name | Roy R Brown |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1417990565 PECOS PAC ID: 3779658646 Enrollment ID: I20080813000026 |
| Provider Name | Kurt Palazzo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649298258 PECOS PAC ID: 4284700915 Enrollment ID: I20080904000164 |
| Provider Name | Donald L West |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528097995 PECOS PAC ID: 7113005190 Enrollment ID: I20080922000135 |
| Provider Name | Latha Urs |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1215197421 PECOS PAC ID: 3476620634 Enrollment ID: I20080930000430 |
| Provider Name | Abhay J Anand |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1083634927 PECOS PAC ID: 5395730220 Enrollment ID: I20081018000270 |
| Provider Name | Petter Andre Vaagenes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982810289 PECOS PAC ID: 8820158272 Enrollment ID: I20081115000110 |
| Provider Name | Ryan Hartnett |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1275781965 PECOS PAC ID: 4385708254 Enrollment ID: I20090122000170 |
| Provider Name | Brittney Anne Bracone |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073770368 PECOS PAC ID: 0749344729 Enrollment ID: I20090206000101 |
| Provider Name | Michael L Clark |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114988540 PECOS PAC ID: 5092749721 Enrollment ID: I20090224000633 |
| Provider Name | Saad A Hagras |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740460161 PECOS PAC ID: 4880744143 Enrollment ID: I20090608000147 |
| Provider Name | Emilia N Anigbo |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1083816953 PECOS PAC ID: 1052466455 Enrollment ID: I20090909000274 |
| Provider Name | Bethany A Wyles |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1245238120 PECOS PAC ID: 1557416716 Enrollment ID: I20090911000450 |
| Provider Name | Nosayaba Agidigbi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1356572879 PECOS PAC ID: 3779629696 Enrollment ID: I20091007000368 |
| Provider Name | Lori Jane Elwood |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1417956624 PECOS PAC ID: 0244376846 Enrollment ID: I20091013000402 |
| Provider Name | Mary Scott |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316946908 PECOS PAC ID: 5698811057 Enrollment ID: I20091015000391 |
| Provider Name | Terrill Burnworth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578561676 PECOS PAC ID: 9032256425 Enrollment ID: I20091016000003 |
| Provider Name | Laura Higgins |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861618357 PECOS PAC ID: 4183725385 Enrollment ID: I20091030000016 |
| Provider Name | Jeff Allen Bare |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629076898 PECOS PAC ID: 2264570894 Enrollment ID: I20091118000672 |
| Provider Name | Khanh Vinh Dang |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922007111 PECOS PAC ID: 4688695471 Enrollment ID: I20091123000198 |
| Provider Name | Scott D Jolly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790783694 PECOS PAC ID: 4688713076 Enrollment ID: I20091124000367 |
| Provider Name | Matthew C Bromley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003023771 PECOS PAC ID: 2365581337 Enrollment ID: I20091203000766 |
| Provider Name | Marita L Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528157468 PECOS PAC ID: 4981679776 Enrollment ID: I20091231000031 |
| Provider Name | Todd F Lemmon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730187501 PECOS PAC ID: 1658412432 Enrollment ID: I20091231000320 |
| Provider Name | William H Phillips |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1356343586 PECOS PAC ID: 4385789155 Enrollment ID: I20100304000224 |
| Provider Name | Charles L Geiger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235115270 PECOS PAC ID: 5597892802 Enrollment ID: I20100419000404 |
| Provider Name | Timothy Rossi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477610046 PECOS PAC ID: 5799813465 Enrollment ID: I20100518000095 |
| Provider Name | Ibiene A Osuobeni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215197165 PECOS PAC ID: 2365573086 Enrollment ID: I20100624000496 |
| Provider Name | Rachel Demita |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1750562666 PECOS PAC ID: 4880726454 Enrollment ID: I20100716000500 |
| Provider Name | Yanjuan Zhu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316143498 PECOS PAC ID: 4385778695 Enrollment ID: I20100820001114 |
| Provider Name | John Abboud |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1417957416 PECOS PAC ID: 2365481983 Enrollment ID: I20100908000069 |
| Provider Name | Howard L Reeves |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1639245350 PECOS PAC ID: 1254359631 Enrollment ID: I20101215000787 |
| Provider Name | Christopher S Meyer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639130701 PECOS PAC ID: 4688863293 Enrollment ID: I20110113000413 |
| Provider Name | Karen Lynn Smith-silone |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356320667 PECOS PAC ID: 9436338605 Enrollment ID: I20110120000869 |
| Provider Name | Usman Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245494392 PECOS PAC ID: 8921289570 Enrollment ID: I20110302000233 |
| Provider Name | Abdul Elhabyan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104847144 PECOS PAC ID: 6901805043 Enrollment ID: I20110321000658 |
| Provider Name | Donald Fairbanks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164441457 PECOS PAC ID: 1850357328 Enrollment ID: I20110406000118 |
| Provider Name | Bryan M Cairns |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841419165 PECOS PAC ID: 9133305618 Enrollment ID: I20110518000086 |
| Provider Name | Sejal R Patel |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1902052129 PECOS PAC ID: 5890965628 Enrollment ID: I20110902000177 |
| Provider Name | Jamie A Rhodes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619120276 PECOS PAC ID: 4880865898 Enrollment ID: I20110923000314 |
| Provider Name | Amanda S John |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164409124 PECOS PAC ID: 4789856972 Enrollment ID: I20111012000468 |
| Provider Name | Tabatha L Menapace |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922382233 PECOS PAC ID: 5890967699 Enrollment ID: I20111019000786 |
| Provider Name | Lea Ann Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134496227 PECOS PAC ID: 9739355884 Enrollment ID: I20111220000780 |
| Provider Name | Michael Mcfarlane |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093755126 PECOS PAC ID: 3870750623 Enrollment ID: I20120206000574 |
| Provider Name | Shelley A Gittens |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801895990 PECOS PAC ID: 7012175029 Enrollment ID: I20120222000573 |
| Provider Name | Catherine Chiodo |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1063580199 PECOS PAC ID: 7012175714 Enrollment ID: I20120227000810 |
| Provider Name | Nadia K Gill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770628893 PECOS PAC ID: 3779748835 Enrollment ID: I20120622000629 |
| Provider Name | Muhannad Heif |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1710088471 PECOS PAC ID: 5991875452 Enrollment ID: I20120710000581 |
| Provider Name | Valerie Denise Collins |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1467627406 PECOS PAC ID: 9335317544 Enrollment ID: I20120829000331 |
| Provider Name | Rachel M Terlecky |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245550904 PECOS PAC ID: 6406004696 Enrollment ID: I20120912000904 |
| Provider Name | Mary E Moyer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013268671 PECOS PAC ID: 0840440186 Enrollment ID: I20121023000725 |
| Provider Name | Bashar A Alawad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396024121 PECOS PAC ID: 4688825334 Enrollment ID: I20121106000648 |
| Provider Name | Kathy Williams |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013269141 PECOS PAC ID: 7810148038 Enrollment ID: I20121117000098 |
| Provider Name | Rosemari Kauser |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740620459 PECOS PAC ID: 1153563671 Enrollment ID: I20130813000766 |
| Provider Name | Sylvia Zucco |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467893735 PECOS PAC ID: 7315180924 Enrollment ID: I20130829000790 |
| Provider Name | Tabitha G Mcconnell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881032530 PECOS PAC ID: 8820232739 Enrollment ID: I20130916000373 |
| Provider Name | Darren L Burgin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629239322 PECOS PAC ID: 3375777535 Enrollment ID: I20131002000306 |
| Provider Name | Dustin E Alspach |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598067209 PECOS PAC ID: 3173704848 Enrollment ID: I20140224001500 |
| Provider Name | Jennifer Brockmeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073952446 PECOS PAC ID: 7517182454 Enrollment ID: I20140708002283 |
| Provider Name | Courtney N Rengel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427460039 PECOS PAC ID: 3971728783 Enrollment ID: I20140711001258 |
| Provider Name | Henry W Turner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730503624 PECOS PAC ID: 7416173463 Enrollment ID: I20140728001265 |
| Provider Name | Jesse Michael Ewald |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104196591 PECOS PAC ID: 2062638877 Enrollment ID: I20140730001757 |
| Provider Name | D'anna N Mullins |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1790946861 PECOS PAC ID: 5395984264 Enrollment ID: I20140805003036 |
| Provider Name | Grant Leo Yoder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477714640 PECOS PAC ID: 6709066905 Enrollment ID: I20140811001116 |
| Provider Name | Mohammed K Mazumder |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1891935250 PECOS PAC ID: 3779764337 Enrollment ID: I20140908002087 |
| Provider Name | Michelle Monro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225228943 PECOS PAC ID: 7517186539 Enrollment ID: I20140923002486 |
| Provider Name | Jennifer A White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710392923 PECOS PAC ID: 8426279217 Enrollment ID: I20141020002228 |
| Provider Name | Elizabeth A Yoder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346324167 PECOS PAC ID: 2062634561 Enrollment ID: I20141118001916 |
| Provider Name | Katie M. Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982009288 PECOS PAC ID: 7012234891 Enrollment ID: I20150317000954 |
| Provider Name | Kevin M Ouweleen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1598781460 PECOS PAC ID: 3678487311 Enrollment ID: I20150728004587 |
| Provider Name | Henry Y Lu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1558658914 PECOS PAC ID: 3274847108 Enrollment ID: I20150805007310 |
| Provider Name | Summiyah Nasir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962692103 PECOS PAC ID: 7911194030 Enrollment ID: I20150901000510 |
| Provider Name | Christopher M Forbush |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396905584 PECOS PAC ID: 3870801871 Enrollment ID: I20150924000943 |
| Provider Name | Keri Lynn Hershberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114210374 PECOS PAC ID: 4880810928 Enrollment ID: I20160610001489 |
| Provider Name | Rami M Hanna |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1821028242 PECOS PAC ID: 1557350675 Enrollment ID: I20160727000341 |
| Provider Name | Daniel Fitzmaurice |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568823987 PECOS PAC ID: 7810281664 Enrollment ID: I20160802002566 |
| Provider Name | Thomas J Hagele |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1659638443 PECOS PAC ID: 0042506750 Enrollment ID: I20160907000544 |
| Provider Name | Fikadu Tekleyes |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679787386 PECOS PAC ID: 6507948361 Enrollment ID: I20160915001154 |
| Provider Name | Maruf A Ali |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104258979 PECOS PAC ID: 4284864497 Enrollment ID: I20160927000153 |
| Provider Name | Clinton Norris |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679921894 PECOS PAC ID: 4385931500 Enrollment ID: I20160930002201 |
| Provider Name | Harrison Taylor King |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528411121 PECOS PAC ID: 8325326580 Enrollment ID: I20161024001379 |
| Provider Name | Andrew J Terlecky |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467729442 PECOS PAC ID: 4688813272 Enrollment ID: I20161102002520 |
| Provider Name | Jennifer Michelle Edwards |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124573928 PECOS PAC ID: 3577845940 Enrollment ID: I20170119000796 |
| Provider Name | Wondwossen Y Dererie |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1760793897 PECOS PAC ID: 4981831328 Enrollment ID: I20170206002690 |
| Provider Name | Bradley R Lawson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1033405139 PECOS PAC ID: 6608192349 Enrollment ID: I20170322000542 |
| Provider Name | Gabrielle A Farkas |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487997896 PECOS PAC ID: 8224335641 Enrollment ID: I20170524001631 |
| Provider Name | Leah Thornton |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1518302066 PECOS PAC ID: 8224270798 Enrollment ID: I20170712002961 |
| Provider Name | Tyler James Weese |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790197689 PECOS PAC ID: 7719257062 Enrollment ID: I20170720000146 |
| Provider Name | Ana Elisa Pantel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366784712 PECOS PAC ID: 1052683638 Enrollment ID: I20170816002566 |
| Provider Name | Rory Nesbitt |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164488367 PECOS PAC ID: 2961394507 Enrollment ID: I20170823003696 |
| Provider Name | Alexandra M Haffner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588193171 PECOS PAC ID: 7911273198 Enrollment ID: I20171017001524 |
| Provider Name | Leslie Solomon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790203842 PECOS PAC ID: 0648546705 Enrollment ID: I20171018001112 |
| Provider Name | Erika Dickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356854491 PECOS PAC ID: 4183986813 Enrollment ID: I20180316001986 |
| Provider Name | Amanda N Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437667607 PECOS PAC ID: 2567724750 Enrollment ID: I20180328001845 |
| Provider Name | Justin R Lee |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1578067724 PECOS PAC ID: 4082977566 Enrollment ID: I20180416000819 |
| Provider Name | Angela Marie Raake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205329513 PECOS PAC ID: 6103175260 Enrollment ID: I20180822002267 |
| Provider Name | Matthew Peter Arrowsmith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932527447 PECOS PAC ID: 1052633302 Enrollment ID: I20180829002451 |
| Provider Name | January Lee Beach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265910384 PECOS PAC ID: 5496005969 Enrollment ID: I20180904001419 |
| Provider Name | Christopher T Brower |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427323682 PECOS PAC ID: 1951562073 Enrollment ID: I20180919003749 |
| Provider Name | Jeremy Ryan Hughes |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1437630134 PECOS PAC ID: 2668725516 Enrollment ID: I20181023003479 |
| Provider Name | Lacie A Emerine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487151833 PECOS PAC ID: 5890031512 Enrollment ID: I20190116002243 |
| Provider Name | Tabitha A Gartner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851860589 PECOS PAC ID: 1850639295 Enrollment ID: I20190211002215 |
| Provider Name | Leonid Levertov |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1720552714 PECOS PAC ID: 4082957311 Enrollment ID: I20190529003021 |
| Provider Name | Laura Emily Roache |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003297383 PECOS PAC ID: 1052628930 Enrollment ID: I20190613003327 |
| Provider Name | Marco M De Santis |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1104080977 PECOS PAC ID: 2961630447 Enrollment ID: I20190626002006 |
| Provider Name | Gregory Harrison Tanquary |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932569571 PECOS PAC ID: 0941576490 Enrollment ID: I20190822000848 |
| Provider Name | Andrew Michael Reaven |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1366862906 PECOS PAC ID: 7113276965 Enrollment ID: I20190828004176 |
| Provider Name | Rahel Mitiku |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376195248 PECOS PAC ID: 1557699444 Enrollment ID: I20190830001538 |
| Provider Name | Navin Muni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710331715 PECOS PAC ID: 1254624232 Enrollment ID: I20190903000882 |
| Provider Name | Cynthia Kearse |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164853735 PECOS PAC ID: 8224367826 Enrollment ID: I20190906002439 |
| Provider Name | Wendell Ronald Parrish |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609419670 PECOS PAC ID: 9830526342 Enrollment ID: I20200224000133 |
| Provider Name | John Marvin Mitchell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427044114 PECOS PAC ID: 2961479746 Enrollment ID: I20200317001773 |
| Provider Name | Brandon Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689207292 PECOS PAC ID: 8123457868 Enrollment ID: I20200401002047 |
| Provider Name | Frank K Boateng |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609025527 PECOS PAC ID: 7719169713 Enrollment ID: I20200408002101 |
| Provider Name | Richard S Scarborough |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1003159088 PECOS PAC ID: 4082995485 Enrollment ID: I20200427002651 |
| Provider Name | Lydia E Cortes-betancourt |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1912308024 PECOS PAC ID: 7416212162 Enrollment ID: I20200610003171 |
| Provider Name | Courtney Marie Adams |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912521451 PECOS PAC ID: 1456773878 Enrollment ID: I20200611003055 |
| Provider Name | Paul Nicholson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962934109 PECOS PAC ID: 6800166117 Enrollment ID: I20200618001447 |
| Provider Name | Dwight Justin Goddard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407835572 PECOS PAC ID: 9931150356 Enrollment ID: I20200723003524 |
| Provider Name | Kari Vance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720646037 PECOS PAC ID: 8820413123 Enrollment ID: I20200804000988 |
| Provider Name | Sami Getahun |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285161653 PECOS PAC ID: 0446520753 Enrollment ID: I20200813001383 |
| Provider Name | Elizabeth W Mcintosh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518490317 PECOS PAC ID: 7810268133 Enrollment ID: I20200821002845 |
| Provider Name | Yuxuan Qiu |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417451840 PECOS PAC ID: 7911253257 Enrollment ID: I20201005002811 |
| Provider Name | Emily I Tseng |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871999573 PECOS PAC ID: 2567726649 Enrollment ID: I20201015003143 |
| Provider Name | Brandon M Arehart |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912401407 PECOS PAC ID: 2365799301 Enrollment ID: I20201109000835 |
| Provider Name | Jacqueline L Cleland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285961805 PECOS PAC ID: 4789723057 Enrollment ID: I20201120002045 |
| Provider Name | Davin Barnett |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144723917 PECOS PAC ID: 9739437476 Enrollment ID: I20201208001675 |
| Provider Name | Robert S Speelman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104431352 PECOS PAC ID: 0840603817 Enrollment ID: I20210112001194 |
| Provider Name | Richard J Straker |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1639156300 PECOS PAC ID: 9032180146 Enrollment ID: I20210326001669 |
| Provider Name | Nicole C Miller |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1720303662 PECOS PAC ID: 8820220650 Enrollment ID: I20210415002827 |
| Provider Name | Eric Aaserude |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811491194 PECOS PAC ID: 6608122932 Enrollment ID: I20210602000669 |
| Provider Name | Mohamed A Bouhara |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1316473242 PECOS PAC ID: 3870994320 Enrollment ID: I20210622002573 |
| Provider Name | Suba Pathmanathan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205191871 PECOS PAC ID: 7315252822 Enrollment ID: I20210622002738 |
| Provider Name | Gurunanthan Palani |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1477865285 PECOS PAC ID: 9032350624 Enrollment ID: I20210624003201 |
| Provider Name | Dzifaa Kofi Lotsu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1770739211 PECOS PAC ID: 1355582354 Enrollment ID: I20210723002706 |
| Provider Name | Gbeminiyi O Samuel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1215322664 PECOS PAC ID: 9830488022 Enrollment ID: I20210809002732 |
| Provider Name | Erin N Fraser |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306340088 PECOS PAC ID: 4486901436 Enrollment ID: I20210922003298 |
| Provider Name | John S Delong |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841302353 PECOS PAC ID: 6305144742 Enrollment ID: I20220105003041 |
| Provider Name | Lucas J Halliday |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154072866 PECOS PAC ID: 4981097474 Enrollment ID: I20220204001138 |
| Provider Name | Kalpana Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265608004 PECOS PAC ID: 4981778073 Enrollment ID: I20220406002781 |
| Provider Name | Michael Trent Mcbride |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1225284276 PECOS PAC ID: 9436315439 Enrollment ID: I20220621001813 |
| Provider Name | Noman M. Ahmed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144464769 PECOS PAC ID: 6901053859 Enrollment ID: I20220627002791 |
| Provider Name | Mohammad K. Islam |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1003268095 PECOS PAC ID: 2860785144 Enrollment ID: I20220629002248 |
| Provider Name | Oluwatoyin V. Aduloju-odunaiya |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1720479959 PECOS PAC ID: 3173842085 Enrollment ID: I20220727000484 |
| Provider Name | Sarah E. Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417681974 PECOS PAC ID: 6800278904 Enrollment ID: I20220805002984 |
| Provider Name | Tanner Hurley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285130997 PECOS PAC ID: 5890045439 Enrollment ID: I20220816003588 |
| Provider Name | Robert Lee Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770216913 PECOS PAC ID: 7214310556 Enrollment ID: I20220818001722 |
| Provider Name | Cheng Zhang |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558549428 PECOS PAC ID: 3779747977 Enrollment ID: I20221013000711 |
| Provider Name | Sarah Elizabeth Karling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043932304 PECOS PAC ID: 6800263377 Enrollment ID: I20221114001292 |
| Provider Name | Eesha Maiodna |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689075632 PECOS PAC ID: 1557653292 Enrollment ID: I20221202001463 |
| Provider Name | Diana Pereira |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1730837816 PECOS PAC ID: 2264801018 Enrollment ID: I20221216002465 |
| Provider Name | Thomas M. Grogan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1821250895 PECOS PAC ID: 4789862905 Enrollment ID: I20221221002580 |
| Provider Name | Hao Zhang |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346637485 PECOS PAC ID: 0042614653 Enrollment ID: I20230125001657 |
| Provider Name | Richard A. Baltisberger |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467450668 PECOS PAC ID: 2264804764 Enrollment ID: I20230209002034 |
| Provider Name | Clayton Young |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619596103 PECOS PAC ID: 7012339666 Enrollment ID: I20230308000861 |
| Provider Name | Michael Aaron Skaletsky |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740818566 PECOS PAC ID: 1355763178 Enrollment ID: I20230414000698 |
| Provider Name | Pamela Lynn Fincato |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871290684 PECOS PAC ID: 9739544073 Enrollment ID: I20230420001725 |
| Provider Name | Zachary Werner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407483431 PECOS PAC ID: 2062834872 Enrollment ID: I20230515002473 |
| Provider Name | Marianna Lucia Oppenheimer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538657762 PECOS PAC ID: 2769739812 Enrollment ID: I20230615002399 |
| Provider Name | Benjamin A Pasley |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326676917 PECOS PAC ID: 5597167783 Enrollment ID: I20230720000234 |
| Provider Name | Kush Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073140620 PECOS PAC ID: 2163844952 Enrollment ID: I20230728001930 |
| Provider Name | Sara I Ali |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184158487 PECOS PAC ID: 4880055334 Enrollment ID: I20230731001897 |
| Provider Name | Taylor John Kovalycsik |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134749674 PECOS PAC ID: 7719364322 Enrollment ID: I20230802003021 |
| Provider Name | Nathaniel Wesley Wilburn-ogletree |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205455417 PECOS PAC ID: 2668894130 Enrollment ID: I20230804001075 |
| Provider Name | Kara Kaplan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043751456 PECOS PAC ID: 3971877515 Enrollment ID: I20230807000814 |
| Provider Name | Kwame N Doh |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1104216803 PECOS PAC ID: 0648631663 Enrollment ID: I20230807001540 |
| Provider Name | Kimiko Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750843637 PECOS PAC ID: 9436533734 Enrollment ID: I20230811003411 |
| Provider Name | Catherine R Wohlford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104146711 PECOS PAC ID: 3375906043 Enrollment ID: I20230828003816 |
| Provider Name | Zeyn T. Mirza |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1578095717 PECOS PAC ID: 4880057272 Enrollment ID: I20230901001108 |
| Provider Name | Clare Elise Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053804922 PECOS PAC ID: 7911351226 Enrollment ID: I20230920001928 |
| Provider Name | Corey L. Salyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720544232 PECOS PAC ID: 1456707744 Enrollment ID: I20231023001931 |
| Provider Name | Mechelle Ann Mckee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376321216 PECOS PAC ID: 6901254580 Enrollment ID: I20231120002358 |
| Provider Name | Courtney Elizabeth Cox |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225615529 PECOS PAC ID: 4486053758 Enrollment ID: I20231204002725 |
| Provider Name | Zackary Birchard |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376064642 PECOS PAC ID: 2062771678 Enrollment ID: I20231214001317 |
| Provider Name | Jessica L. Englehart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821436650 PECOS PAC ID: 8628421567 Enrollment ID: I20240127000275 |
| Provider Name | Nelson Lorenzo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700462637 PECOS PAC ID: 4587063557 Enrollment ID: I20240206003509 |
| Provider Name | Whitney R Byers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700569308 PECOS PAC ID: 0648614685 Enrollment ID: I20240219001597 |
| Provider Name | Stephanie Michael |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679159438 PECOS PAC ID: 4587065727 Enrollment ID: I20240423000826 |
| Provider Name | Benjamin Allen Kastenbauer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801472535 PECOS PAC ID: 4880137124 Enrollment ID: I20240614003225 |
Licking Memorial Family Practice Licking Valley Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2181 W High St, Newark, OH 43055 Phone: 740-348-1720 Fax: 740-348-1726 | |
Licking Memorial Family Practice East Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 399 E Main St, Newark, OH 43055 Phone: 740-348-1849 Fax: 740-348-1847 | |
Licking Memorial Endocrinology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1272 W Main St, Bldg 2 Ste 3, Newark, OH 43055 Phone: 740-348-7950 Fax: 740-348-7951 | |
Licking Memorial Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 Mcmillen Dr, Newark, OH 43055 Phone: 740-348-4827 Fax: 740-348-1894 | |
Primetown Ohio Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 905 N 21st St Ste A, Newark, OH 43055 Phone: 740-281-3663 Fax: 740-281-3818 | |
Lower Lights Christian Health Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 69 S Terrace Ave, Newark, OH 43055 Phone: 614-274-1455 Fax: 614-274-1433 | |
Licking Memorial Physician Wound Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2000 Tamarack Rd, Newark, OH 43055 Phone: 740-348-1993 Fax: 740-348-1994 |