| Martha Jefferson Medical Group Llc | |
|
590 Peter Jefferson Pkwy Ste 300 Charlottesville VA 22911-4628 | |
| (434) 654-7340 | |
| (434) 654-7752 |
| Full Name | Martha Jefferson Medical Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 590 Peter Jefferson Pkwy Ste 300, Charlottesville, Virginia |
| Authorized Official Name and Position | Bruce Clemons (VICE PRESIDENT, MEDICAL DIRECTOR) |
| Authorized Official Contact | 4346545229 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Martha Jefferson Medical Group Llc Po Box 746550 Atlanta GA 30374-6550 Ph: (434) 654-7340 | Martha Jefferson Medical Group Llc 590 Peter Jefferson Pkwy Ste 300 Charlottesville VA 22911-4628 Ph: (434) 654-7340 |
| NPI Number | 1275720559 |
|---|---|
| Provider Enumeration Date | 10/01/2007 |
| Last Update Date | 09/29/2022 |
| Medicare PECOS PAC ID | 5991889081 |
|---|---|
| Medicare Enrollment ID | O20080228000055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275720559 | NPI | - | NPPES |
| Provider Name | Kevin C Mccarthy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588638761 PECOS PAC ID: 5597661926 Enrollment ID: I20031209000975 |
| Provider Name | John Ligush |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1740253251 PECOS PAC ID: 5597653832 Enrollment ID: I20040308001153 |
| Provider Name | Ann M Klecan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871570002 PECOS PAC ID: 3577451624 Enrollment ID: I20040309001146 |
| Provider Name | Katherine Smyth |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316991227 PECOS PAC ID: 4183617723 Enrollment ID: I20040407001344 |
| Provider Name | Matthew J Mildonian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114035433 PECOS PAC ID: 5597751040 Enrollment ID: I20040421001249 |
| Provider Name | William J Maloney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508803230 PECOS PAC ID: 5698762102 Enrollment ID: I20040427001384 |
| Provider Name | Kurtis Scott Elward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144225277 PECOS PAC ID: 7719976919 Enrollment ID: I20040512000108 |
| Provider Name | Gregory Gerard Degnan |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1154315398 PECOS PAC ID: 2163403320 Enrollment ID: I20040525001248 |
| Provider Name | Bruce D Clemons |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871536755 PECOS PAC ID: 0143204818 Enrollment ID: I20040618000044 |
| Provider Name | Keri K Hall |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1245309871 PECOS PAC ID: 4587642053 Enrollment ID: I20040712000046 |
| Provider Name | Stephen Palmer Schmitz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053352724 PECOS PAC ID: 1759361884 Enrollment ID: I20040721000231 |
| Provider Name | Yemisrach Mulugeta |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770675829 PECOS PAC ID: 5496720344 Enrollment ID: I20040901001482 |
| Provider Name | Alexander A Schult |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1871573568 PECOS PAC ID: 7113993585 Enrollment ID: I20040908000417 |
| Provider Name | John Qunicy Adams Mattern |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164495354 PECOS PAC ID: 3870556053 Enrollment ID: I20041109000354 |
| Provider Name | Mary E Jensen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205914157 PECOS PAC ID: 4981661584 Enrollment ID: I20041215000632 |
| Provider Name | Victoria Lee Vastine |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1174587141 PECOS PAC ID: 6305887746 Enrollment ID: I20050517000183 |
| Provider Name | Cynthia F Napier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780627844 PECOS PAC ID: 5799728739 Enrollment ID: I20050609000962 |
| Provider Name | Duncan L Hill |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174566640 PECOS PAC ID: 1052349503 Enrollment ID: I20050727000438 |
| Provider Name | Sharon L Meth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093753493 PECOS PAC ID: 6305870163 Enrollment ID: I20050921000395 |
| Provider Name | Linda M Sommers |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992715957 PECOS PAC ID: 5597749234 Enrollment ID: I20051026000433 |
| Provider Name | Clara S Eden |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1194763268 PECOS PAC ID: 9830113257 Enrollment ID: I20060124000608 |
| Provider Name | Rebecca A Dillingham |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1336161314 PECOS PAC ID: 8820005838 Enrollment ID: I20060316000275 |
| Provider Name | Kevin R Mcconnell |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1225018294 PECOS PAC ID: 7810907755 Enrollment ID: I20060421000489 |
| Provider Name | Charles James Edward Cole |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487788550 PECOS PAC ID: 9830109578 Enrollment ID: I20060426000312 |
| Provider Name | Tara D Balint |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1932156304 PECOS PAC ID: 5395757124 Enrollment ID: I20060619000175 |
| Provider Name | James Edward Boyer |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1093769903 PECOS PAC ID: 9133132996 Enrollment ID: I20060720000237 |
| Provider Name | John M Carl |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437193323 PECOS PAC ID: 1456355825 Enrollment ID: I20060828000365 |
| Provider Name | Ilham C Grant |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1457355075 PECOS PAC ID: 4385649722 Enrollment ID: I20060919000167 |
| Provider Name | John Hall |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1588658777 PECOS PAC ID: 7113924879 Enrollment ID: I20061023000446 |
| Provider Name | Christopher D Willms |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1093786329 PECOS PAC ID: 6406853498 Enrollment ID: I20061106000165 |
| Provider Name | Naga S Chigurupati |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1043298805 PECOS PAC ID: 9234109653 Enrollment ID: I20070117000502 |
| Provider Name | Marsha L Taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164506945 PECOS PAC ID: 0547364010 Enrollment ID: I20070323000135 |
| Provider Name | Lindsay D Friesen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295869741 PECOS PAC ID: 6507957891 Enrollment ID: I20070731000566 |
| Provider Name | William Murray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730120577 PECOS PAC ID: 2365534153 Enrollment ID: I20070824000303 |
| Provider Name | Tiffani D Dennis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831307560 PECOS PAC ID: 5799867370 Enrollment ID: I20080205000263 |
| Provider Name | Lisa A Mcdermott |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902849433 PECOS PAC ID: 3173607298 Enrollment ID: I20080228000331 |
| Provider Name | Anne E Boyland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942248950 PECOS PAC ID: 4981788908 Enrollment ID: I20080228000342 |
| Provider Name | John J Mcgovern |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831130509 PECOS PAC ID: 4789768706 Enrollment ID: I20080228000352 |
| Provider Name | Paul J Tesoriere |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1447299862 PECOS PAC ID: 4082798020 Enrollment ID: I20080228000490 |
| Provider Name | Russell C Sawyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245272376 PECOS PAC ID: 1850475823 Enrollment ID: I20080228000721 |
| Provider Name | Brooke A Bostic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730121823 PECOS PAC ID: 0941384937 Enrollment ID: I20080229000134 |
| Provider Name | Mark Niehaus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972541548 PECOS PAC ID: 6901980820 Enrollment ID: I20080229000465 |
| Provider Name | William Laffond |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558309583 PECOS PAC ID: 8820172752 Enrollment ID: I20080229000549 |
| Provider Name | David Duani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992746739 PECOS PAC ID: 5890879720 Enrollment ID: I20080229000565 |
| Provider Name | Joseph B Evans |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629088844 PECOS PAC ID: 0446336952 Enrollment ID: I20080325000163 |
| Provider Name | Francis Effiduase Ansa |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1255427944 PECOS PAC ID: 8527060755 Enrollment ID: I20080502000460 |
| Provider Name | Anthony Martinez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497821896 PECOS PAC ID: 0648340323 Enrollment ID: I20080606000554 |
| Provider Name | Bryce Kellams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700823689 PECOS PAC ID: 0648341487 Enrollment ID: I20080620000579 |
| Provider Name | Lee D Litvinas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497792493 PECOS PAC ID: 6204907801 Enrollment ID: I20080625000032 |
| Provider Name | John R Gaughen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942418660 PECOS PAC ID: 7113099854 Enrollment ID: I20080711000449 |
| Provider Name | William R Hammond |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1740223320 PECOS PAC ID: 4981601143 Enrollment ID: I20080814000677 |
| Provider Name | Thomas S Weber |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1295766525 PECOS PAC ID: 0244208288 Enrollment ID: I20081002000342 |
| Provider Name | Robert E Adams |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003896762 PECOS PAC ID: 5890853329 Enrollment ID: I20081027000808 |
| Provider Name | David S Herring |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932173432 PECOS PAC ID: 2961561949 Enrollment ID: I20081110000533 |
| Provider Name | Gerard D Santos |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1336241272 PECOS PAC ID: 0244287456 Enrollment ID: I20081201000462 |
| Provider Name | John Z Edwards |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679553523 PECOS PAC ID: 0648259531 Enrollment ID: I20090124000049 |
| Provider Name | Louisa J Hann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508960972 PECOS PAC ID: 0143111740 Enrollment ID: I20090826000469 |
| Provider Name | Lindsay A Aguero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326270034 PECOS PAC ID: 0840345591 Enrollment ID: I20090901000321 |
| Provider Name | Mesele Alemu Gebreyes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114150067 PECOS PAC ID: 2062559206 Enrollment ID: I20091021000353 |
| Provider Name | Richard A Muller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700989134 PECOS PAC ID: 8325186075 Enrollment ID: I20091117000579 |
| Provider Name | Christopher J Scherer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861444374 PECOS PAC ID: 5890706204 Enrollment ID: I20100215000311 |
| Provider Name | Barry Dicicco |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1093717324 PECOS PAC ID: 3173582392 Enrollment ID: I20100414000169 |
| Provider Name | Lewis V Owens |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1508839028 PECOS PAC ID: 2264516269 Enrollment ID: I20100513000158 |
| Provider Name | Jacob N Young |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1043312648 PECOS PAC ID: 1254353162 Enrollment ID: I20100519000167 |
| Provider Name | Matthew J Panzarella |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1720313570 PECOS PAC ID: 8325177660 Enrollment ID: I20100526000060 |
| Provider Name | Kevin B Mercure |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1598767402 PECOS PAC ID: 3678529153 Enrollment ID: I20100701000175 |
| Provider Name | William S Knight |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598969859 PECOS PAC ID: 9537292610 Enrollment ID: I20100727000889 |
| Provider Name | Mark Mandichak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386849644 PECOS PAC ID: 9537292511 Enrollment ID: I20100727000906 |
| Provider Name | Albert I Soriano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942249073 PECOS PAC ID: 8729129697 Enrollment ID: I20101007000150 |
| Provider Name | Fouzia Siddiqui |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609031699 PECOS PAC ID: 7214121987 Enrollment ID: I20101027000756 |
| Provider Name | Joseph Devon Lowdon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619930963 PECOS PAC ID: 9335289172 Enrollment ID: I20101101001253 |
| Provider Name | Jeffrey Dean Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891758140 PECOS PAC ID: 0244370088 Enrollment ID: I20101101001268 |
| Provider Name | Joshua Marks Greenhoe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780640680 PECOS PAC ID: 9638121551 Enrollment ID: I20101101001304 |
| Provider Name | Gregory Harrison Doull |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114980737 PECOS PAC ID: 2264439421 Enrollment ID: I20101103000571 |
| Provider Name | Michael A Sty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649223181 PECOS PAC ID: 4688774748 Enrollment ID: I20101111000465 |
| Provider Name | Jennifer Langer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962617308 PECOS PAC ID: 4688853435 Enrollment ID: I20110125001018 |
| Provider Name | Geoffrey S Keenan |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1356309397 PECOS PAC ID: 5395931711 Enrollment ID: I20110321000002 |
| Provider Name | Genevieve F Harway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154553170 PECOS PAC ID: 7517142219 Enrollment ID: I20110422000162 |
| Provider Name | Khanh-kathy H Phan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215985379 PECOS PAC ID: 4789696402 Enrollment ID: I20110426000439 |
| Provider Name | Gregory Wiaterek |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1255538633 PECOS PAC ID: 6305023441 Enrollment ID: I20110527000001 |
| Provider Name | Lane Atleigh Ritter |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558524777 PECOS PAC ID: 8628246394 Enrollment ID: I20110725000097 |
| Provider Name | Jefferson Mark Prichard |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1609899400 PECOS PAC ID: 9032188958 Enrollment ID: I20110726000033 |
| Provider Name | Chetna Dua |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093980419 PECOS PAC ID: 0446421739 Enrollment ID: I20110916000328 |
| Provider Name | Stephen Burke Gunther |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1285613034 PECOS PAC ID: 5698678316 Enrollment ID: I20120113000688 |
| Provider Name | Owen T Regan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518074889 PECOS PAC ID: 9537178413 Enrollment ID: I20120416000332 |
| Provider Name | Nicole B Lepsch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023275146 PECOS PAC ID: 0941462568 Enrollment ID: I20120427000035 |
| Provider Name | Jeremy F Gill |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760549323 PECOS PAC ID: 1557553559 Enrollment ID: I20120621000459 |
| Provider Name | Erika Struble |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1114907359 PECOS PAC ID: 6002091105 Enrollment ID: I20120705000324 |
| Provider Name | Ajay Shah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992943450 PECOS PAC ID: 9335290717 Enrollment ID: I20120821001149 |
| Provider Name | Alan A Brijbassie |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1992964704 PECOS PAC ID: 7810145083 Enrollment ID: I20120912000633 |
| Provider Name | Jessica C James |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730317835 PECOS PAC ID: 6305081472 Enrollment ID: I20130320000111 |
| Provider Name | Kara Brenn Hawkins |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1992992895 PECOS PAC ID: 0941371983 Enrollment ID: I20130913000791 |
| Provider Name | Clark Case Baumbusch |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548411515 PECOS PAC ID: 9335373406 Enrollment ID: I20131002000504 |
| Provider Name | Jason T Strampe |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1295059012 PECOS PAC ID: 4486889474 Enrollment ID: I20131029000615 |
| Provider Name | Hua Wang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982865135 PECOS PAC ID: 3678709607 Enrollment ID: I20131122000629 |
| Provider Name | Laura Kharsa |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598993552 PECOS PAC ID: 3870729775 Enrollment ID: I20131125000924 |
| Provider Name | Roshni D Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578992566 PECOS PAC ID: 9436388089 Enrollment ID: I20140206000351 |
| Provider Name | Sorin C Laza |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124036736 PECOS PAC ID: 0840298113 Enrollment ID: I20140421000075 |
| Provider Name | Margaret F Bishop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982631669 PECOS PAC ID: 6507858917 Enrollment ID: I20140625001748 |
| Provider Name | Adedoyin G Akintide |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518142991 PECOS PAC ID: 5991856551 Enrollment ID: I20140707000690 |
| Provider Name | Brian Michael Showalter |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1447415625 PECOS PAC ID: 1355567041 Enrollment ID: I20140804000080 |
| Provider Name | Stephen A Hoover |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1043431935 PECOS PAC ID: 7012189103 Enrollment ID: I20140824000038 |
| Provider Name | Adrian D Parasca |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1760701478 PECOS PAC ID: 8729231048 Enrollment ID: I20140922002214 |
| Provider Name | Kimberly M St. Jean |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1780909531 PECOS PAC ID: 5294956132 Enrollment ID: I20141018000111 |
| Provider Name | Evan Hollister Pryse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053712299 PECOS PAC ID: 9739301227 Enrollment ID: I20141118001731 |
| Provider Name | Marko Toshich |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285903609 PECOS PAC ID: 6305169939 Enrollment ID: I20150106001377 |
| Provider Name | Waseem Ismail Aziz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023038270 PECOS PAC ID: 9436184116 Enrollment ID: I20150107001372 |
| Provider Name | Timothy J Doherty |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467613422 PECOS PAC ID: 6002077302 Enrollment ID: I20150122000469 |
| Provider Name | Kimberly R T Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932443736 PECOS PAC ID: 0648409607 Enrollment ID: I20150321000241 |
| Provider Name | Dejene Getachew Kassaye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912260134 PECOS PAC ID: 2567783947 Enrollment ID: I20150610002450 |
| Provider Name | Mohammad Shakhatreh |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1649430216 PECOS PAC ID: 7911160270 Enrollment ID: I20150706002027 |
| Provider Name | Shabnum Haleem |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1831400696 PECOS PAC ID: 2769794387 Enrollment ID: I20150709002221 |
| Provider Name | Nicholas A Spinelli |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992976369 PECOS PAC ID: 4688897747 Enrollment ID: I20150723007497 |
| Provider Name | Zachary A Gregg |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1285836312 PECOS PAC ID: 2668787961 Enrollment ID: I20150817000010 |
| Provider Name | Sophia Leung |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376786251 PECOS PAC ID: 3779701065 Enrollment ID: I20150922001240 |
| Provider Name | Jason Moore |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1023037348 PECOS PAC ID: 9032427950 Enrollment ID: I20150925002495 |
| Provider Name | Michael David Longo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528053600 PECOS PAC ID: 4789762261 Enrollment ID: I20151223000198 |
| Provider Name | Jennifer L Broyles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467868919 PECOS PAC ID: 9234358342 Enrollment ID: I20160309001650 |
| Provider Name | Michelle D Bushrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336523422 PECOS PAC ID: 2567760770 Enrollment ID: I20160420002075 |
| Provider Name | Jessica N Kenty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750736757 PECOS PAC ID: 0547559429 Enrollment ID: I20160516002272 |
| Provider Name | James A Mcgowan |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1922216308 PECOS PAC ID: 5092848242 Enrollment ID: I20160712000659 |
| Provider Name | Hannah M R Rice |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649619032 PECOS PAC ID: 0547586844 Enrollment ID: I20160715001571 |
| Provider Name | Joseph Kyle Swingle |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1851730840 PECOS PAC ID: 1658693353 Enrollment ID: I20160721000612 |
| Provider Name | Andrew M Romano |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1093036113 PECOS PAC ID: 7719114065 Enrollment ID: I20160816000032 |
| Provider Name | Barrie Carveth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023429982 PECOS PAC ID: 8022305119 Enrollment ID: I20160916001015 |
| Provider Name | Mary Whittemore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023452562 PECOS PAC ID: 0143457325 Enrollment ID: I20161003002435 |
| Provider Name | Randolph M Baker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265448310 PECOS PAC ID: 3072706522 Enrollment ID: I20161004001673 |
| Provider Name | Erin M Mcloughlin |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1801139274 PECOS PAC ID: 8426286022 Enrollment ID: I20161011000210 |
| Provider Name | William Avery Mix |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720086622 PECOS PAC ID: 5698816569 Enrollment ID: I20161220002556 |
| Provider Name | Imtiaz Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225370471 PECOS PAC ID: 7113238940 Enrollment ID: I20170112001016 |
| Provider Name | Jennifer B Lambka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417355355 PECOS PAC ID: 4183949076 Enrollment ID: I20170810003786 |
| Provider Name | Melissa Leigh Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467975250 PECOS PAC ID: 4486927290 Enrollment ID: I20170830000831 |
| Provider Name | Abdallah Selah Abdelrazeq |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1649686429 PECOS PAC ID: 9335442870 Enrollment ID: I20170908000395 |
| Provider Name | Melanie Winningham |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588954788 PECOS PAC ID: 9335434752 Enrollment ID: I20170908002600 |
| Provider Name | Alison B Heavenridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013437854 PECOS PAC ID: 3678475332 Enrollment ID: I20170911001394 |
| Provider Name | Mark S Mason |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366886921 PECOS PAC ID: 5991078008 Enrollment ID: I20170911002545 |
| Provider Name | Gina L Gilmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497277396 PECOS PAC ID: 3870869688 Enrollment ID: I20171024000203 |
| Provider Name | Jonas R. Te Paske |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780950949 PECOS PAC ID: 9537398318 Enrollment ID: I20171211001509 |
| Provider Name | Jennifer L Raymond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629585450 PECOS PAC ID: 9931469392 Enrollment ID: I20180202000092 |
| Provider Name | Elizabeth Monahan Driscoll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699001016 PECOS PAC ID: 5294098646 Enrollment ID: I20180417001654 |
| Provider Name | Yuriy O Zhukov |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1962666396 PECOS PAC ID: 8921153677 Enrollment ID: I20180514001580 |
| Provider Name | Laura R Trissel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376068973 PECOS PAC ID: 3577836055 Enrollment ID: I20180716000557 |
| Provider Name | Charles Benford Sauls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548269889 PECOS PAC ID: 0749537926 Enrollment ID: I20180718003963 |
| Provider Name | Christine Ou |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1851684666 PECOS PAC ID: 5496004244 Enrollment ID: I20180828000848 |
| Provider Name | Jennifer Graham Stancil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013496116 PECOS PAC ID: 1254678055 Enrollment ID: I20190201001403 |
| Provider Name | Gregory W Mallard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235146846 PECOS PAC ID: 3577570746 Enrollment ID: I20190201002004 |
| Provider Name | Caroline A Brand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457795841 PECOS PAC ID: 0042454233 Enrollment ID: I20190208000237 |
| Provider Name | Elizabeth Lawwill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366897803 PECOS PAC ID: 7113217167 Enrollment ID: I20190213001760 |
| Provider Name | David Slottje |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1720353873 PECOS PAC ID: 1052690054 Enrollment ID: I20190702002922 |
| Provider Name | Mark Robert Anderson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1922156181 PECOS PAC ID: 6103141585 Enrollment ID: I20190702003004 |
| Provider Name | Osmond Chia-liang Wu |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1972861201 PECOS PAC ID: 1850627308 Enrollment ID: I20190723000094 |
| Provider Name | Aric Jordan Moran |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1003203555 PECOS PAC ID: 0749516045 Enrollment ID: I20190724002364 |
| Provider Name | Samuel Oliver |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1134573215 PECOS PAC ID: 6406149202 Enrollment ID: I20190819001176 |
| Provider Name | Christine Ann Arcidicono |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588216014 PECOS PAC ID: 9234467804 Enrollment ID: I20190820002930 |
| Provider Name | Rebecca Casey Burke |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255573374 PECOS PAC ID: 3072778695 Enrollment ID: I20190823001982 |
| Provider Name | Tracy J Moll |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427430396 PECOS PAC ID: 0446524276 Enrollment ID: I20190925000212 |
| Provider Name | Parker C Schmidt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689028003 PECOS PAC ID: 5294020640 Enrollment ID: I20191001001272 |
| Provider Name | Normand Roland Dube |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053897033 PECOS PAC ID: 7911241849 Enrollment ID: I20191016000482 |
| Provider Name | Timothy S Snow |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730449810 PECOS PAC ID: 6204184898 Enrollment ID: I20191023000276 |
| Provider Name | Andrew Denardo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437154028 PECOS PAC ID: 0749174126 Enrollment ID: I20191112001338 |
| Provider Name | Kara Lynn Potts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659928083 PECOS PAC ID: 3375977796 Enrollment ID: I20191218000344 |
| Provider Name | Peter Nock |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578561361 PECOS PAC ID: 5991706392 Enrollment ID: I20191228000026 |
| Provider Name | Brittany Hallberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942842539 PECOS PAC ID: 5597199588 Enrollment ID: I20191228000340 |
| Provider Name | David A Calhoun |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1164468229 PECOS PAC ID: 5597889253 Enrollment ID: I20200128002804 |
| Provider Name | Angela Dillard Honeycutt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295063170 PECOS PAC ID: 5193948933 Enrollment ID: I20200227000898 |
| Provider Name | Anne T Roane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124649413 PECOS PAC ID: 7810328085 Enrollment ID: I20200504002577 |
| Provider Name | Ashleigh Suthers Bergstrom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518356260 PECOS PAC ID: 6406287572 Enrollment ID: I20200506001210 |
| Provider Name | Deveryn Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174094114 PECOS PAC ID: 9537581483 Enrollment ID: I20200622002585 |
| Provider Name | Leslie Sixten Hilding |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124376199 PECOS PAC ID: 7315201043 Enrollment ID: I20200727001457 |
| Provider Name | John Thomas Watson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1144617424 PECOS PAC ID: 5991026411 Enrollment ID: I20200813002372 |
| Provider Name | Brittany Hallberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942842539 PECOS PAC ID: 5597199588 Enrollment ID: I20210208000045 |
| Provider Name | Jimi O Akingbade |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1942269881 PECOS PAC ID: 7214826064 Enrollment ID: I20210215001082 |
| Provider Name | Michael S Mcclincy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073504130 PECOS PAC ID: 2668574229 Enrollment ID: I20210504001145 |
| Provider Name | Leah J Shirey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245696160 PECOS PAC ID: 7214232644 Enrollment ID: I20210628000064 |
| Provider Name | Allison Mui Yeaman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427547256 PECOS PAC ID: 7113275199 Enrollment ID: I20210629002152 |
| Provider Name | Whitney Paige Mcclincy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841265014 PECOS PAC ID: 3779554597 Enrollment ID: I20210713003672 |
| Provider Name | Scott M Goldberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952797425 PECOS PAC ID: 7416265715 Enrollment ID: I20210805000180 |
| Provider Name | Gurleen Pahal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831694470 PECOS PAC ID: 0042568198 Enrollment ID: I20210810002094 |
| Provider Name | Caitlyn Buller |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700383734 PECOS PAC ID: 4385996750 Enrollment ID: I20210812000537 |
| Provider Name | Lyndsey Jackson Lantz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457921058 PECOS PAC ID: 5294130639 Enrollment ID: I20210827001175 |
| Provider Name | Joshua Lee Landis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053983635 PECOS PAC ID: 7911395975 Enrollment ID: I20211023000145 |
| Provider Name | Mary Carolyn C Vinson |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1700043197 PECOS PAC ID: 2163726241 Enrollment ID: I20220224002028 |
| Provider Name | Leah Damiani Strain |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841621869 PECOS PAC ID: 7618288523 Enrollment ID: I20220322002419 |
| Provider Name | Micah Garrett Lindsey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033679808 PECOS PAC ID: 3375923568 Enrollment ID: I20220706001042 |
| Provider Name | Tiffany Jen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083110597 PECOS PAC ID: 6901153659 Enrollment ID: I20220718000376 |
| Provider Name | Daniel Scott Brennan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184985129 PECOS PAC ID: 6709124464 Enrollment ID: I20220719001273 |
| Provider Name | Kevin A Volkema |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023512001 PECOS PAC ID: 8628313202 Enrollment ID: I20220727000432 |
| Provider Name | David O Riley |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1881042232 PECOS PAC ID: 3173818416 Enrollment ID: I20220802000322 |
| Provider Name | Michelle K Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871972976 PECOS PAC ID: 9335563030 Enrollment ID: I20220914000433 |
| Provider Name | Martina Diana Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962133140 PECOS PAC ID: 9335515063 Enrollment ID: I20221020000205 |
| Provider Name | Conner B Lawrence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023739810 PECOS PAC ID: 9436527215 Enrollment ID: I20221129001741 |
| Provider Name | Zachariah Nealy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366805699 PECOS PAC ID: 0941596282 Enrollment ID: I20221208001459 |
| Provider Name | Kimberly Suppes |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1821042060 PECOS PAC ID: 3678670726 Enrollment ID: I20230112000267 |
| Provider Name | Katherine Anne Carlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750013348 PECOS PAC ID: 8820460918 Enrollment ID: I20230220000775 |
| Provider Name | Morgan Vorwald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265151161 PECOS PAC ID: 5395117352 Enrollment ID: I20230221001410 |
| Provider Name | Natalie Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346570058 PECOS PAC ID: 7012199615 Enrollment ID: I20230224002139 |
| Provider Name | Maria Mayorga |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1558457127 PECOS PAC ID: 4880730977 Enrollment ID: I20230317002029 |
| Provider Name | Demetrius Rizos |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1063491397 PECOS PAC ID: 0648379180 Enrollment ID: I20230406002746 |
| Provider Name | Meenakshi Chavan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265140818 PECOS PAC ID: 2860857588 Enrollment ID: I20230503000663 |
| Provider Name | Kimberly Chong Zibert |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023300274 PECOS PAC ID: 5698091148 Enrollment ID: I20230503001049 |
| Provider Name | Conrad Deel |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1598762916 PECOS PAC ID: 6608849609 Enrollment ID: I20230509000682 |
| Provider Name | Tolga Sursal |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1265810956 PECOS PAC ID: 6608253182 Enrollment ID: I20230616001859 |
| Provider Name | Albert Tao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184248031 PECOS PAC ID: 1951763424 Enrollment ID: I20230815003317 |
| Provider Name | Emanuel C Haug |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205367075 PECOS PAC ID: 4880964501 Enrollment ID: I20230823002211 |
| Provider Name | Shaela Nichelle Shifflett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346921707 PECOS PAC ID: 0840654760 Enrollment ID: I20230912000274 |
| Provider Name | Jeffrey Wayne Lantz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164929311 PECOS PAC ID: 2567712011 Enrollment ID: I20230913001446 |
| Provider Name | Kendra Michaela Kriener |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942988233 PECOS PAC ID: 4385008028 Enrollment ID: I20230913001901 |
| Provider Name | Travis M Skipina |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043779150 PECOS PAC ID: 2062745383 Enrollment ID: I20230919000280 |
| Provider Name | Nicole C Stephens |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770014037 PECOS PAC ID: 3971950460 Enrollment ID: I20231106000040 |
| Provider Name | Kristen Mcconnell Gogoli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689203317 PECOS PAC ID: 6103249073 Enrollment ID: I20231110002825 |
| Provider Name | Terrell David Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902433089 PECOS PAC ID: 6002232113 Enrollment ID: I20231113001189 |
| Provider Name | Rachel Ann Blair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174305957 PECOS PAC ID: 6608219514 Enrollment ID: I20240207004324 |
| Provider Name | Fabio Roberti |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1962450023 PECOS PAC ID: 9638181761 Enrollment ID: I20240422003275 |
| Provider Name | Dannette Nichelle Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093576340 PECOS PAC ID: 5698115657 Enrollment ID: I20240424003902 |
| Provider Name | Hanisha R Manickavasagan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437539640 PECOS PAC ID: 8820499577 Enrollment ID: I20240506004719 |
Davis Med Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 515 Ray C. Hunt Dr, Charlottesville, VA 22903 Phone: 434-244-2000 | |
Rivers Edge Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 Winding River Lane, Charlottesville, VA 22911 Phone: 434-295-3705 Fax: 434-295-3705 | |
Wellfamily Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1885 Seminole Trl Ste 105, Charlottesville, VA 22901 Phone: 434-962-6234 | |
Charlottesville Wellness Center Family Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 901 Preston Ave, Suite 300, Charlottesville, VA 22903 Phone: 434-977-3140 Fax: 434-977-4984 | |
Blue Ridge Endocrinology And Diabetes Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 199 Spotnap Rd, Suite 2, Charlottesville, VA 22911 Phone: 434-293-7811 Fax: 434-293-7818 | |
M Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 406 Albemarle Square, Charlottesville, VA 22901 Phone: 434-321-5257 Fax: 434-321-5259 | |
Blue Ridge Well Being Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 375 Four Leaf Ln Ste 202, Charlottesville, VA 22903 Phone: 434-205-4477 Fax: 434-205-4705 |