| Maury Regional Medical Group, Inc | |
|
854 W James Campbell Blvd Suite 303 Columbia TN 38401-4659 | |
| (931) 540-4255 | |
| (931) 490-4654 |
| Full Name | Maury Regional Medical Group, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 854 W James Campbell Blvd, Columbia, Tennessee |
| Authorized Official Name and Position | Nick A Swift (CFO) |
| Authorized Official Contact | 9315404255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maury Regional Medical Group, Inc 854 W James Campbell Blvd Suite 303 Columbia TN 38401-4659 Ph: (931) 540-4255 | Maury Regional Medical Group, Inc 854 W James Campbell Blvd Suite 303 Columbia TN 38401-4659 Ph: (931) 540-4255 |
| NPI Number | 1205886264 |
|---|---|
| Provider Enumeration Date | 05/11/2006 |
| Last Update Date | 02/20/2024 |
| Medicare PECOS PAC ID | 7911810742 |
|---|---|
| Medicare Enrollment ID | O20040227000252 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205886264 | NPI | - | NPPES |
| 3710089 | Medicaid | TN |
| Provider Name | Rosemary E Davenport |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811900095 PECOS PAC ID: 9638063829 Enrollment ID: I20040210000067 |
| Provider Name | Brian R Mcmurray |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750324315 PECOS PAC ID: 0941196000 Enrollment ID: I20040225000649 |
| Provider Name | Nathanael L Lafferty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750494969 PECOS PAC ID: 1456249937 Enrollment ID: I20040306000243 |
| Provider Name | James R Hayes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730292913 PECOS PAC ID: 3577451053 Enrollment ID: I20040306000291 |
| Provider Name | Shawn N Gentry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891708012 PECOS PAC ID: 9436049707 Enrollment ID: I20040318001633 |
| Provider Name | Thomas W Farmer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114019833 PECOS PAC ID: 4880586833 Enrollment ID: I20040325001410 |
| Provider Name | Esmeraldo D Herrera |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174501597 PECOS PAC ID: 3779575584 Enrollment ID: I20040401000441 |
| Provider Name | Robert A Bain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891887659 PECOS PAC ID: 4587656111 Enrollment ID: I20040401001396 |
| Provider Name | James C Couch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376635052 PECOS PAC ID: 5597757153 Enrollment ID: I20040401001588 |
| Provider Name | Dannylu J Wilson |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1972673648 PECOS PAC ID: 4486649563 Enrollment ID: I20040417000604 |
| Provider Name | Joseph Anthony Destefano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508841032 PECOS PAC ID: 4688669526 Enrollment ID: I20040419001314 |
| Provider Name | Christina L Lannom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700871191 PECOS PAC ID: 0749276913 Enrollment ID: I20040422001123 |
| Provider Name | Jalila Hudson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598773889 PECOS PAC ID: 4284615337 Enrollment ID: I20040526000139 |
| Provider Name | Kelly J Snyder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487749446 PECOS PAC ID: 7214835222 Enrollment ID: I20040610001791 |
| Provider Name | Laurence T Britt |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548245285 PECOS PAC ID: 9830173772 Enrollment ID: I20040617000136 |
| Provider Name | Jacqueline R Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326192519 PECOS PAC ID: 8325023633 Enrollment ID: I20040621001953 |
| Provider Name | Jon L Freels |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1336200385 PECOS PAC ID: 7618955972 Enrollment ID: I20040712001608 |
| Provider Name | James Marshall |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1710955034 PECOS PAC ID: 7214915412 Enrollment ID: I20040713001068 |
| Provider Name | Paula A Cole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649202953 PECOS PAC ID: 3173503885 Enrollment ID: I20040722001355 |
| Provider Name | Joe R Fite |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346291952 PECOS PAC ID: 6002896727 Enrollment ID: I20040722001387 |
| Provider Name | Leonard Gleen Webster |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386710762 PECOS PAC ID: 8325019177 Enrollment ID: I20040804000973 |
| Provider Name | Robbie M Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043283765 PECOS PAC ID: 0749254712 Enrollment ID: I20040825000046 |
| Provider Name | Patrick A Souris |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1467506576 PECOS PAC ID: 8921077652 Enrollment ID: I20040929001020 |
| Provider Name | Gordon L Melton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619064748 PECOS PAC ID: 2365407327 Enrollment ID: I20041201000634 |
| Provider Name | Karen J Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659463206 PECOS PAC ID: 9537125745 Enrollment ID: I20041208000880 |
| Provider Name | Jawaid Kamal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538131073 PECOS PAC ID: 7113820739 Enrollment ID: I20041210000573 |
| Provider Name | Martin M Chaney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891773057 PECOS PAC ID: 4486692035 Enrollment ID: I20050422000928 |
| Provider Name | Mark A Seago |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497732762 PECOS PAC ID: 5991743544 Enrollment ID: I20050422000981 |
| Provider Name | Dayaker R Mallipeddi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1548225444 PECOS PAC ID: 1153364898 Enrollment ID: I20050603000806 |
| Provider Name | John W Coursey |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1114998507 PECOS PAC ID: 0446289466 Enrollment ID: I20050810000747 |
| Provider Name | Denise G Werner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306953161 PECOS PAC ID: 1658397500 Enrollment ID: I20051019001118 |
| Provider Name | Timothy A Nash |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851407548 PECOS PAC ID: 4284650136 Enrollment ID: I20051019001121 |
| Provider Name | Julie S Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255323721 PECOS PAC ID: 5597788414 Enrollment ID: I20060106000197 |
| Provider Name | Russell J Berscheid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386795326 PECOS PAC ID: 0749203594 Enrollment ID: I20060109000243 |
| Provider Name | Barbara N Hinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780753509 PECOS PAC ID: 1052334216 Enrollment ID: I20060113000385 |
| Provider Name | Rodney B Gilbert |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1861478026 PECOS PAC ID: 2365465614 Enrollment ID: I20060118000112 |
| Provider Name | Bhaskar Reddy |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1285610105 PECOS PAC ID: 2567426182 Enrollment ID: I20060118000140 |
| Provider Name | Charles A Ball |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154344836 PECOS PAC ID: 9537137401 Enrollment ID: I20060209000275 |
| Provider Name | Thomas Edward Quinn |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1386710051 PECOS PAC ID: 7719968460 Enrollment ID: I20060316000354 |
| Provider Name | John Beuerlein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417040205 PECOS PAC ID: 5092723395 Enrollment ID: I20060328000756 |
| Provider Name | Holly K Meeker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295778785 PECOS PAC ID: 1052320389 Enrollment ID: I20060414000086 |
| Provider Name | Kendra R Prater-holt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548292840 PECOS PAC ID: 7517961501 Enrollment ID: I20060906000093 |
| Provider Name | Hrishi M Kanth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154342046 PECOS PAC ID: 3072518877 Enrollment ID: I20060929000441 |
| Provider Name | Susana I Donaghey |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427073451 PECOS PAC ID: 3072418953 Enrollment ID: I20061213000393 |
| Provider Name | David M Turner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932188554 PECOS PAC ID: 7113021361 Enrollment ID: I20070414000120 |
| Provider Name | John G Garrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770594079 PECOS PAC ID: 0345349890 Enrollment ID: I20070623000105 |
| Provider Name | Takasha L Stewart-hubbard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467423491 PECOS PAC ID: 3173418043 Enrollment ID: I20070625000755 |
| Provider Name | Patricia W Cagle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184672446 PECOS PAC ID: 2961594528 Enrollment ID: I20070828000074 |
| Provider Name | Michael J Pelletier |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841295672 PECOS PAC ID: 5193818813 Enrollment ID: I20070911000321 |
| Provider Name | Angela M Zuill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023233780 PECOS PAC ID: 0345334611 Enrollment ID: I20070917000687 |
| Provider Name | Loretta Davidson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295952505 PECOS PAC ID: 6608960976 Enrollment ID: I20070917000693 |
| Provider Name | William Robert Stewart |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1821068040 PECOS PAC ID: 8426035866 Enrollment ID: I20080304000600 |
| Provider Name | Gibran B Naddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962470567 PECOS PAC ID: 4880783737 Enrollment ID: I20080506000042 |
| Provider Name | Kelley V Jefferson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154398105 PECOS PAC ID: 9335210616 Enrollment ID: I20080613000067 |
| Provider Name | Mark A Mclean |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265450597 PECOS PAC ID: 9638250236 Enrollment ID: I20080630000050 |
| Provider Name | Maura J Lipp |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1821257502 PECOS PAC ID: 6800969973 Enrollment ID: I20080723000220 |
| Provider Name | Reba J Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780848226 PECOS PAC ID: 2668547589 Enrollment ID: I20080812000511 |
| Provider Name | Grace Wu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689891889 PECOS PAC ID: 3577639558 Enrollment ID: I20080828000256 |
| Provider Name | Brandi L King |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1245488162 PECOS PAC ID: 7012077324 Enrollment ID: I20081117000434 |
| Provider Name | Anthony L Aird |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457513517 PECOS PAC ID: 0446313944 Enrollment ID: I20090109000278 |
| Provider Name | Oliver Patrick Archibald |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174508105 PECOS PAC ID: 8022197169 Enrollment ID: I20090224000651 |
| Provider Name | Michelle Desha Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871733725 PECOS PAC ID: 5698824860 Enrollment ID: I20090518000393 |
| Provider Name | Monica Peeler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952507063 PECOS PAC ID: 4789735549 Enrollment ID: I20090708000196 |
| Provider Name | Dana J Chandler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518143122 PECOS PAC ID: 6305998303 Enrollment ID: I20090722000737 |
| Provider Name | Christopher P Turner |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659474336 PECOS PAC ID: 0547313736 Enrollment ID: I20090805000733 |
| Provider Name | Steven C Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972708667 PECOS PAC ID: 6608929807 Enrollment ID: I20090805000760 |
| Provider Name | Srikar S Reddy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1467418087 PECOS PAC ID: 6709861735 Enrollment ID: I20090807000174 |
| Provider Name | Michael J Davidson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740240902 PECOS PAC ID: 5698773091 Enrollment ID: I20100208000023 |
| Provider Name | Michael D Brunson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1679500102 PECOS PAC ID: 2961580006 Enrollment ID: I20100223000173 |
| Provider Name | John O Simmons |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245208602 PECOS PAC ID: 0840276762 Enrollment ID: I20100311000115 |
| Provider Name | Shawn L Reed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104894401 PECOS PAC ID: 0244329183 Enrollment ID: I20100318000104 |
| Provider Name | Gaylon L Harris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740258011 PECOS PAC ID: 5799874632 Enrollment ID: I20100318000123 |
| Provider Name | Emilio J Rodriguez-viera |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1578531851 PECOS PAC ID: 7517056450 Enrollment ID: I20100318000144 |
| Provider Name | Anuradha P Mann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578531174 PECOS PAC ID: 1153410097 Enrollment ID: I20100318000163 |
| Provider Name | Anthony D Khim |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1295736940 PECOS PAC ID: 7113988197 Enrollment ID: I20100602000493 |
| Provider Name | Sandra Kilburn Daniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992947568 PECOS PAC ID: 5294866067 Enrollment ID: I20100623000872 |
| Provider Name | Carey L Barr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720070949 PECOS PAC ID: 0648301986 Enrollment ID: I20100630000162 |
| Provider Name | Harish Veeramachineni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821217852 PECOS PAC ID: 0244362937 Enrollment ID: I20100715000537 |
| Provider Name | Charlotte Anne Batey |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1265433916 PECOS PAC ID: 5890827976 Enrollment ID: I20100726000475 |
| Provider Name | Tinu Emmanuel Thomas |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1740404227 PECOS PAC ID: 5496889487 Enrollment ID: I20100812000522 |
| Provider Name | Kenneth D Fulks |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1144237751 PECOS PAC ID: 3971637463 Enrollment ID: I20100819000628 |
| Provider Name | Kanthi Charan Narra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982829297 PECOS PAC ID: 9638295488 Enrollment ID: I20100929000694 |
| Provider Name | Chet H Jameson |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1891788840 PECOS PAC ID: 4789877358 Enrollment ID: I20101015000505 |
| Provider Name | James H Vernier |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1457334328 PECOS PAC ID: 8921095217 Enrollment ID: I20101029000710 |
| Provider Name | Jodie M Baumtrog |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295059186 PECOS PAC ID: 4486849833 Enrollment ID: I20101110001181 |
| Provider Name | Robert Mcclure |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1386600906 PECOS PAC ID: 5890770820 Enrollment ID: I20101208000864 |
| Provider Name | Amit A Choksi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376508374 PECOS PAC ID: 4981689916 Enrollment ID: I20101208000890 |
| Provider Name | Ben A Gardner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316054133 PECOS PAC ID: 9537356001 Enrollment ID: I20101209000498 |
| Provider Name | Akberet B Hadgu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548471501 PECOS PAC ID: 1850588369 Enrollment ID: I20101209001030 |
| Provider Name | Deborah Lynn Goldsmith |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1710058136 PECOS PAC ID: 3476740671 Enrollment ID: I20101214001096 |
| Provider Name | Kathrynne O Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346545746 PECOS PAC ID: 4385826114 Enrollment ID: I20110315000605 |
| Provider Name | Mark H Messenger |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1568455517 PECOS PAC ID: 2264615871 Enrollment ID: I20110318000786 |
| Provider Name | Justin K Kropf |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1942428628 PECOS PAC ID: 0749467306 Enrollment ID: I20110608000252 |
| Provider Name | Joe Mobley |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1356597983 PECOS PAC ID: 2264626498 Enrollment ID: I20110719000399 |
| Provider Name | Christopher Edwards |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104897164 PECOS PAC ID: 1153306931 Enrollment ID: I20110823000964 |
| Provider Name | Giorgi Sirbiladze |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407037112 PECOS PAC ID: 4587834445 Enrollment ID: I20110901000105 |
| Provider Name | Robert B Lee |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1285785709 PECOS PAC ID: 8325933385 Enrollment ID: I20110921000525 |
| Provider Name | Mark A Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881977684 PECOS PAC ID: 4486827342 Enrollment ID: I20111109000623 |
| Provider Name | Daniel Davidson Oxley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174572796 PECOS PAC ID: 7618860065 Enrollment ID: I20111202000712 |
| Provider Name | Shelly M Hargrove |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780961987 PECOS PAC ID: 3779759568 Enrollment ID: I20111228000554 |
| Provider Name | Lindsey Shay Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346517927 PECOS PAC ID: 3870760036 Enrollment ID: I20120111000849 |
| Provider Name | John S Jensen |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1124246681 PECOS PAC ID: 4789851346 Enrollment ID: I20120123000276 |
| Provider Name | Melissa J Raymer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467609735 PECOS PAC ID: 4486811957 Enrollment ID: I20120210000626 |
| Provider Name | Mark A Cobb |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1336144245 PECOS PAC ID: 3678753183 Enrollment ID: I20120229000655 |
| Provider Name | Cenchrea Lanier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962775999 PECOS PAC ID: 7911168448 Enrollment ID: I20120410000702 |
| Provider Name | Sarah E Fitzgerald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164607073 PECOS PAC ID: 5890957195 Enrollment ID: I20120503000080 |
| Provider Name | Tara T Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619242187 PECOS PAC ID: 0648434621 Enrollment ID: I20120605000168 |
| Provider Name | Alisha M Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265707350 PECOS PAC ID: 4385808641 Enrollment ID: I20120618000238 |
| Provider Name | Selorm A Adzokpa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508002015 PECOS PAC ID: 4183880214 Enrollment ID: I20120718000296 |
| Provider Name | Candice T Olechowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962656322 PECOS PAC ID: 6305092727 Enrollment ID: I20120817000030 |
| Provider Name | Brandie H Gorrell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871754515 PECOS PAC ID: 8820244262 Enrollment ID: I20120817000198 |
| Provider Name | Olivia M Granillo Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437316106 PECOS PAC ID: 1456507896 Enrollment ID: I20120817000213 |
| Provider Name | Andrew T Szaflarski |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366695363 PECOS PAC ID: 5890941447 Enrollment ID: I20120821000912 |
| Provider Name | Cyrilyn A Walters |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487867487 PECOS PAC ID: 2264680578 Enrollment ID: I20120911000725 |
| Provider Name | Padma Narra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902035371 PECOS PAC ID: 1355599309 Enrollment ID: I20120917000189 |
| Provider Name | Robin E Lapre |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194741488 PECOS PAC ID: 1557510856 Enrollment ID: I20121002000214 |
| Provider Name | Lynda S Murff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104912013 PECOS PAC ID: 7517117930 Enrollment ID: I20121022000087 |
| Provider Name | Chassie E Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851636203 PECOS PAC ID: 2860646031 Enrollment ID: I20130218000199 |
| Provider Name | Evans N Mize |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831414358 PECOS PAC ID: 6709031750 Enrollment ID: I20130225000312 |
| Provider Name | David B Beck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659619161 PECOS PAC ID: 2264677277 Enrollment ID: I20130322000154 |
| Provider Name | Timothy C Dickey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750621579 PECOS PAC ID: 6800032681 Enrollment ID: I20130424000190 |
| Provider Name | Kendra L Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013256064 PECOS PAC ID: 7618113143 Enrollment ID: I20130429000249 |
| Provider Name | Margaret C Norris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609886142 PECOS PAC ID: 6305803990 Enrollment ID: I20130529000460 |
| Provider Name | Shavonne Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720326200 PECOS PAC ID: 5294974564 Enrollment ID: I20130617000709 |
| Provider Name | Jim T Harris |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598994147 PECOS PAC ID: 8527237478 Enrollment ID: I20130618000128 |
| Provider Name | Karthik Jothianandan |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1184867939 PECOS PAC ID: 0244386571 Enrollment ID: I20130802000237 |
| Provider Name | Joe Philip |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1831345669 PECOS PAC ID: 1254484892 Enrollment ID: I20130805000277 |
| Provider Name | Rodney James Deaton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003934274 PECOS PAC ID: 8921240425 Enrollment ID: I20130813000561 |
| Provider Name | Dominic J Papa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134355647 PECOS PAC ID: 5092954313 Enrollment ID: I20130828000879 |
| Provider Name | Courtney B Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376985036 PECOS PAC ID: 0345483756 Enrollment ID: I20130904000862 |
| Provider Name | Lance Micheel Freeman |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1205097565 PECOS PAC ID: 4688817869 Enrollment ID: I20130909000342 |
| Provider Name | Brett Norman |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1881850667 PECOS PAC ID: 3971773847 Enrollment ID: I20130916000318 |
| Provider Name | Jerald L Taggart |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881851483 PECOS PAC ID: 6204017247 Enrollment ID: I20130917000503 |
| Provider Name | Jennifer J Feldhaus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033353487 PECOS PAC ID: 9537305354 Enrollment ID: I20131004000382 |
| Provider Name | Wanda Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720212350 PECOS PAC ID: 1355592916 Enrollment ID: I20131009001567 |
| Provider Name | Zakaria M Botros |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275828089 PECOS PAC ID: 2264668524 Enrollment ID: I20131115001439 |
| Provider Name | Louise A Hawkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952744286 PECOS PAC ID: 4183851173 Enrollment ID: I20131219000747 |
| Provider Name | Ben R Barton |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1487757605 PECOS PAC ID: 7517971294 Enrollment ID: I20140325000259 |
| Provider Name | Julie L Finch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629490032 PECOS PAC ID: 3577786334 Enrollment ID: I20140523000191 |
| Provider Name | Steven R Mead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427473792 PECOS PAC ID: 1153545579 Enrollment ID: I20140604002396 |
| Provider Name | Leopoldo Mario Basilico |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538480603 PECOS PAC ID: 7214150051 Enrollment ID: I20140821002098 |
| Provider Name | Megan R Rahmlow |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043475288 PECOS PAC ID: 1456520345 Enrollment ID: I20140904001626 |
| Provider Name | Danielle L Henson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982999413 PECOS PAC ID: 4082857107 Enrollment ID: I20140922000334 |
| Provider Name | Lindsay Randle Norton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164748430 PECOS PAC ID: 7810117066 Enrollment ID: I20141009002627 |
| Provider Name | Jeffry Ruff |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265753339 PECOS PAC ID: 8224278320 Enrollment ID: I20141013001299 |
| Provider Name | Rebecca H Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861639031 PECOS PAC ID: 5294874764 Enrollment ID: I20141020000499 |
| Provider Name | Bradley K Rodgers |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1285950006 PECOS PAC ID: 9032432661 Enrollment ID: I20150106001361 |
| Provider Name | Nilay B Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619397957 PECOS PAC ID: 2466776760 Enrollment ID: I20150114002037 |
| Provider Name | Bradley Holmes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043483316 PECOS PAC ID: 0648597963 Enrollment ID: I20150326000584 |
| Provider Name | Jessica M Barnwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417345521 PECOS PAC ID: 0941527071 Enrollment ID: I20150328000165 |
| Provider Name | Barry Michael Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225420490 PECOS PAC ID: 7012237654 Enrollment ID: I20150521000720 |
| Provider Name | Leslie Nowlin Mcbroom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629465133 PECOS PAC ID: 4587985395 Enrollment ID: I20150604002957 |
| Provider Name | Amy Lynn Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205221884 PECOS PAC ID: 3779895834 Enrollment ID: I20150701001832 |
| Provider Name | Jessica L Oliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851782486 PECOS PAC ID: 0941512081 Enrollment ID: I20150702001438 |
| Provider Name | Sarah D Essary |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578857017 PECOS PAC ID: 4981919057 Enrollment ID: I20150818006113 |
| Provider Name | Joanna Christine Shepherd |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407141302 PECOS PAC ID: 1557682499 Enrollment ID: I20150902000890 |
| Provider Name | Loraine Ogbenyealu Achebe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073807582 PECOS PAC ID: 6507172434 Enrollment ID: I20150908002418 |
| Provider Name | Izuchukwu Iwueke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568717734 PECOS PAC ID: 2567779614 Enrollment ID: I20150922001569 |
| Provider Name | Kelly K Foltermann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407141773 PECOS PAC ID: 0648435123 Enrollment ID: I20151014003407 |
| Provider Name | Nicole Falls |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982993572 PECOS PAC ID: 5496064164 Enrollment ID: I20151020001137 |
| Provider Name | Jacob Don Kelley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992095376 PECOS PAC ID: 5395982193 Enrollment ID: I20151023001550 |
| Provider Name | Elijah Kim |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003045097 PECOS PAC ID: 0840500906 Enrollment ID: I20151103000186 |
| Provider Name | Michael Nottidge |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1700922630 PECOS PAC ID: 7012059090 Enrollment ID: I20151104002129 |
| Provider Name | Griffin Andrew Guice |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891085270 PECOS PAC ID: 7517103153 Enrollment ID: I20151112002098 |
| Provider Name | Niccole R Crowley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750750790 PECOS PAC ID: 8224348792 Enrollment ID: I20151112002491 |
| Provider Name | Lindsey Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265809305 PECOS PAC ID: 1658681978 Enrollment ID: I20151117000322 |
| Provider Name | Jason L Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285004085 PECOS PAC ID: 1759681950 Enrollment ID: I20151119001372 |
| Provider Name | Thang M Phan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558653923 PECOS PAC ID: 8820398662 Enrollment ID: I20151130000845 |
| Provider Name | Christopher Michael Merrick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942566419 PECOS PAC ID: 7719289693 Enrollment ID: I20160224000149 |
| Provider Name | Chessica L Runyon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174990105 PECOS PAC ID: 2466751367 Enrollment ID: I20160427001598 |
| Provider Name | Elizabeth F Farrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619335866 PECOS PAC ID: 9133428030 Enrollment ID: I20160427001745 |
| Provider Name | William M Rasberry |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1356786669 PECOS PAC ID: 0143469817 Enrollment ID: I20160603000433 |
| Provider Name | Heather A Steele |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1538209606 PECOS PAC ID: 3577883883 Enrollment ID: I20160707000551 |
| Provider Name | Kerry Peete |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639530934 PECOS PAC ID: 8426341637 Enrollment ID: I20160726002112 |
| Provider Name | Jennifer L Krauland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548557150 PECOS PAC ID: 1153615539 Enrollment ID: I20160808001728 |
| Provider Name | Geraldo Enrique Holguin |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1528360765 PECOS PAC ID: 9436320926 Enrollment ID: I20160816000040 |
| Provider Name | Alexis Dunlap |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588051726 PECOS PAC ID: 8628381431 Enrollment ID: I20161012000695 |
| Provider Name | Rafael Favela |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659631299 PECOS PAC ID: 7012146665 Enrollment ID: I20161018002923 |
| Provider Name | James Hall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073533956 PECOS PAC ID: 1658475843 Enrollment ID: I20161019000588 |
| Provider Name | Jennifer Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013331941 PECOS PAC ID: 5092948752 Enrollment ID: I20161201000958 |
| Provider Name | Peter Hsu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003173592 PECOS PAC ID: 1557597176 Enrollment ID: I20170302000480 |
| Provider Name | Linda P Monroe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912006859 PECOS PAC ID: 9032007521 Enrollment ID: I20170328000403 |
| Provider Name | Jennifer Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073064242 PECOS PAC ID: 5294012555 Enrollment ID: I20170516000177 |
| Provider Name | John M Douglas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730566175 PECOS PAC ID: 1557681756 Enrollment ID: I20170601000895 |
| Provider Name | Kimberly Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689101503 PECOS PAC ID: 6002186640 Enrollment ID: I20170714000959 |
| Provider Name | Amy E Vertrees |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134324544 PECOS PAC ID: 0941447106 Enrollment ID: I20170802002957 |
| Provider Name | Peter Y Shi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1336569904 PECOS PAC ID: 6901178946 Enrollment ID: I20170825000224 |
| Provider Name | Sean C Cannady |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487067963 PECOS PAC ID: 1658673900 Enrollment ID: I20170901002626 |
| Provider Name | Gretchen R Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851484000 PECOS PAC ID: 5799783452 Enrollment ID: I20170913003914 |
| Provider Name | Varun C Dhulipala |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1902196165 PECOS PAC ID: 1254578800 Enrollment ID: I20170922001174 |
| Provider Name | John C Welker |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1346477221 PECOS PAC ID: 9638478787 Enrollment ID: I20170923000457 |
| Provider Name | Phillip A Rodriguez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043658867 PECOS PAC ID: 3375832017 Enrollment ID: I20171002000905 |
| Provider Name | Jonathan Dale Casey |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1780904631 PECOS PAC ID: 8123266624 Enrollment ID: I20171004003143 |
| Provider Name | Stephen Halliday |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154612554 PECOS PAC ID: 0941502785 Enrollment ID: I20171006000895 |
| Provider Name | Ryan Milo Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164865507 PECOS PAC ID: 6608170576 Enrollment ID: I20171016000773 |
| Provider Name | Andrius Lescauskas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316351844 PECOS PAC ID: 8224304472 Enrollment ID: I20171016003364 |
| Provider Name | Patrick T Davis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003101684 PECOS PAC ID: 3577839117 Enrollment ID: I20171025003026 |
| Provider Name | Emily Turner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790120541 PECOS PAC ID: 5597994137 Enrollment ID: I20171201001446 |
| Provider Name | Romany Anne Nilanthi Johnpulle |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1962632968 PECOS PAC ID: 0941466288 Enrollment ID: I20171214000393 |
| Provider Name | Deanna R White |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063521292 PECOS PAC ID: 9234122623 Enrollment ID: I20180504002248 |
| Provider Name | Brenda M May |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1265610380 PECOS PAC ID: 8022295351 Enrollment ID: I20180514002776 |
| Provider Name | Manisha Raj |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023452331 PECOS PAC ID: 4385947993 Enrollment ID: I20180521001763 |
| Provider Name | Billy Dean Bailey |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1396730552 PECOS PAC ID: 0840327862 Enrollment ID: I20180525002204 |
| Provider Name | Taylor M Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497270474 PECOS PAC ID: 8628333192 Enrollment ID: I20180604002171 |
| Provider Name | Anthony D Haase |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043400435 PECOS PAC ID: 5799963401 Enrollment ID: I20180609000144 |
| Provider Name | Laurie E Bates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477067429 PECOS PAC ID: 0547516338 Enrollment ID: I20180710000648 |
| Provider Name | Jennifer Puentes Concepcion |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841705241 PECOS PAC ID: 4880941749 Enrollment ID: I20180724000573 |
| Provider Name | Joseph Anthony Veys |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1861464208 PECOS PAC ID: 8628053618 Enrollment ID: I20180807001306 |
| Provider Name | Fauzi N Rizvi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699734269 PECOS PAC ID: 6709848450 Enrollment ID: I20180807002761 |
| Provider Name | Matthew R Endara |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1033370937 PECOS PAC ID: 2668696733 Enrollment ID: I20180815001815 |
| Provider Name | Christian W Petrauskis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407274251 PECOS PAC ID: 3678822061 Enrollment ID: I20180817001902 |
| Provider Name | Raymond J Howard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295199719 PECOS PAC ID: 2466751912 Enrollment ID: I20180821001972 |
| Provider Name | Brandon Cody Banks |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1326485426 PECOS PAC ID: 9335383033 Enrollment ID: I20180831002005 |
| Provider Name | Rebecca P Haase |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174948210 PECOS PAC ID: 8729211461 Enrollment ID: I20180919003154 |
| Provider Name | Kirstin A Agent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154808574 PECOS PAC ID: 6305197740 Enrollment ID: I20180924001580 |
| Provider Name | David Glenn Ransom |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1144616996 PECOS PAC ID: 9436460466 Enrollment ID: I20180925002555 |
| Provider Name | Micheal Shane Blocker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487134052 PECOS PAC ID: 5698026862 Enrollment ID: I20180927000716 |
| Provider Name | Thu M Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457746331 PECOS PAC ID: 1153615844 Enrollment ID: I20181002003844 |
| Provider Name | Katelin Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194202614 PECOS PAC ID: 2062765407 Enrollment ID: I20181031002984 |
| Provider Name | Andrew K Nielsen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093155913 PECOS PAC ID: 1254650146 Enrollment ID: I20181115001161 |
| Provider Name | Michael Gregory Lester |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255750501 PECOS PAC ID: 7911209721 Enrollment ID: I20190724000627 |
| Provider Name | Karen E Jackson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871989483 PECOS PAC ID: 7214239813 Enrollment ID: I20190729002956 |
| Provider Name | Brittany M Legg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386116697 PECOS PAC ID: 8729314604 Enrollment ID: I20190730004009 |
| Provider Name | Brandon M Gentry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730575689 PECOS PAC ID: 0244566131 Enrollment ID: I20190731000018 |
| Provider Name | John R Roberts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740635440 PECOS PAC ID: 0042500761 Enrollment ID: I20190807002788 |
| Provider Name | Luke E Habegger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649699893 PECOS PAC ID: 2860794880 Enrollment ID: I20190808004193 |
| Provider Name | Courtney B Hollis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518522309 PECOS PAC ID: 7214264373 Enrollment ID: I20190812003588 |
| Provider Name | Megan L Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811554884 PECOS PAC ID: 8022345024 Enrollment ID: I20190814001686 |
| Provider Name | Nicole M Grinnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154985018 PECOS PAC ID: 2668700691 Enrollment ID: I20190828002959 |
| Provider Name | Octavia L Graham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134581549 PECOS PAC ID: 9830441658 Enrollment ID: I20190920002904 |
| Provider Name | Shawn L Price |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962899575 PECOS PAC ID: 7719295138 Enrollment ID: I20190925002310 |
| Provider Name | Megan Lorraine Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538721501 PECOS PAC ID: 1254663420 Enrollment ID: I20191022001068 |
| Provider Name | Lucas Wilmore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215399092 PECOS PAC ID: 7810286192 Enrollment ID: I20191106000443 |
| Provider Name | Robert E Bilbao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568817286 PECOS PAC ID: 1850689563 Enrollment ID: I20191114002641 |
| Provider Name | Shakevia V Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104236850 PECOS PAC ID: 5092008052 Enrollment ID: I20191115001310 |
| Provider Name | Martin Lawrence Serene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952947244 PECOS PAC ID: 1456787837 Enrollment ID: I20200203001381 |
| Provider Name | Michael J Blanco |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508284456 PECOS PAC ID: 7315376944 Enrollment ID: I20200402003140 |
| Provider Name | Edward Tang Qian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124472774 PECOS PAC ID: 3870886310 Enrollment ID: I20200609002734 |
| Provider Name | Joshua Smith |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1669719258 PECOS PAC ID: 2769600121 Enrollment ID: I20200713003753 |
| Provider Name | Dustin H Minix |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548701220 PECOS PAC ID: 0244509388 Enrollment ID: I20200722002207 |
| Provider Name | Amanda Glynn Goethals |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255872933 PECOS PAC ID: 6002185139 Enrollment ID: I20200820003415 |
| Provider Name | Michael R Hallenbeck |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275989725 PECOS PAC ID: 0446545248 Enrollment ID: I20200824003376 |
| Provider Name | Doreen Biribwa Arinaitwe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851743819 PECOS PAC ID: 8729371620 Enrollment ID: I20200917000238 |
| Provider Name | Nicholas A Coman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205287760 PECOS PAC ID: 8325466592 Enrollment ID: I20200921001525 |
| Provider Name | Pinky R Chugani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972957405 PECOS PAC ID: 9739476904 Enrollment ID: I20200929002424 |
| Provider Name | Vanessa Henri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659734606 PECOS PAC ID: 6002235645 Enrollment ID: I20200930002410 |
| Provider Name | Carly Cooke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831705953 PECOS PAC ID: 4688084213 Enrollment ID: I20201110000701 |
| Provider Name | Mary Ebueku-smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639514805 PECOS PAC ID: 8426329897 Enrollment ID: I20210303003100 |
| Provider Name | Samuel Welch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427631944 PECOS PAC ID: 5294135166 Enrollment ID: I20210615000120 |
| Provider Name | Peter J Edmonds |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417301334 PECOS PAC ID: 8426341850 Enrollment ID: I20210708001503 |
| Provider Name | Abraham Scott Mccall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295264026 PECOS PAC ID: 2769885342 Enrollment ID: I20210720001253 |
| Provider Name | Bushra Z Osmani |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1760746127 PECOS PAC ID: 6406079151 Enrollment ID: I20210826000272 |
| Provider Name | Liane P Gozmao |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801317953 PECOS PAC ID: 6507263480 Enrollment ID: I20210920001559 |
| Provider Name | Benjamin J Newcomb |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295229276 PECOS PAC ID: 6608201546 Enrollment ID: I20211117000857 |
| Provider Name | Mayonne Renner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477926517 PECOS PAC ID: 1850694514 Enrollment ID: I20220103002049 |
| Provider Name | John Patrick Selph |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1336383934 PECOS PAC ID: 9537382726 Enrollment ID: I20220218000421 |
| Provider Name | Jill Mcdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528712841 PECOS PAC ID: 2062807753 Enrollment ID: I20220316000316 |
| Provider Name | Bailee M Horton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659022366 PECOS PAC ID: 6709263080 Enrollment ID: I20220509000468 |
| Provider Name | Carolyn N Lowery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679211650 PECOS PAC ID: 9133500671 Enrollment ID: I20220715000149 |
| Provider Name | Ruchika Talwar |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1003349440 PECOS PAC ID: 9234511775 Enrollment ID: I20220801001456 |
| Provider Name | Troy Larson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1023542610 PECOS PAC ID: 4082987581 Enrollment ID: I20220808001277 |
| Provider Name | Frances M Hardin |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1417477266 PECOS PAC ID: 9032489653 Enrollment ID: I20220825001783 |
| Provider Name | Michael A Kreis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881257343 PECOS PAC ID: 5597153353 Enrollment ID: I20220825002195 |
| Provider Name | Blake E Funke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497281992 PECOS PAC ID: 3476824509 Enrollment ID: I20220825003482 |
| Provider Name | Elizabeth M Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700447521 PECOS PAC ID: 8325373558 Enrollment ID: I20220826000288 |
| Provider Name | Joshua Ryan Bates |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922598325 PECOS PAC ID: 3274880828 Enrollment ID: I20220928000135 |
| Provider Name | Reena Baharani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659631950 PECOS PAC ID: 5395018865 Enrollment ID: I20221115003607 |
| Provider Name | Ryan L Hargraves |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306983556 PECOS PAC ID: 9234500745 Enrollment ID: I20230120000465 |
| Provider Name | Zachery T Sensing |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346804176 PECOS PAC ID: 5193059699 Enrollment ID: I20230124002494 |
| Provider Name | Daniel Scheurich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659396539 PECOS PAC ID: 7810082724 Enrollment ID: I20230209001649 |
| Provider Name | Esteban Miller |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346236478 PECOS PAC ID: 6709074529 Enrollment ID: I20230410000469 |
| Provider Name | Htet Htet Kyaw |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669932638 PECOS PAC ID: 0143695759 Enrollment ID: I20230413001132 |
| Provider Name | Abhish Koirala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134474471 PECOS PAC ID: 6507186913 Enrollment ID: I20230609000405 |
| Provider Name | Ashley N Perez |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1215216031 PECOS PAC ID: 2769653005 Enrollment ID: I20230616000177 |
| Provider Name | Matthew T. Stier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407410137 PECOS PAC ID: 5597094268 Enrollment ID: I20230821001973 |
| Provider Name | Rebecca Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457041006 PECOS PAC ID: 2769845049 Enrollment ID: I20230905001229 |
| Provider Name | Braden V Schuster |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023515897 PECOS PAC ID: 4789939232 Enrollment ID: I20230908000043 |
| Provider Name | Chaohua Yan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1417191115 PECOS PAC ID: 9638223209 Enrollment ID: I20230914000364 |
| Provider Name | Laura A Penny |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689134298 PECOS PAC ID: 7012240872 Enrollment ID: I20230927000967 |
| Provider Name | John C. Forstall |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1326571720 PECOS PAC ID: 5294009015 Enrollment ID: I20230927002179 |
| Provider Name | Taylor K Masters |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720549744 PECOS PAC ID: 3274966866 Enrollment ID: I20231010001159 |
| Provider Name | Kathleen Anne Hiltz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861057275 PECOS PAC ID: 9931529419 Enrollment ID: I20231027000862 |
| Provider Name | Zalika T Nisbeth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902256027 PECOS PAC ID: 9436438280 Enrollment ID: I20231214000499 |
| Provider Name | Robert T Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780325787 PECOS PAC ID: 3173972114 Enrollment ID: I20231215000785 |
| Provider Name | Sydney E Osborne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568233419 PECOS PAC ID: 0446694087 Enrollment ID: I20240222000266 |
| Provider Name | Shilpa Salpekar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528685492 PECOS PAC ID: 2466875737 Enrollment ID: I20240307001629 |
| Provider Name | Prunetta O Brunson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538662556 PECOS PAC ID: 8820353071 Enrollment ID: I20240321000370 |
Columbia Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1222 Trotwood Ave, Ste 101, Columbia, TN 38401 Phone: 931-388-8965 Fax: 931-388-0815 | |
Ybs Health And Wellness Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1040 N James Campbell Blvd Suite 114, Columbia, TN 38401 Phone: 662-212-4386 | |
Core Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1114 W 7th St, Columbia, TN 38401 Phone: 931-388-9706 Fax: 931-490-1062 | |
Stat Wellness Center, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1225 Hampshire Pike, Columbia, TN 38401 Phone: 931-982-6333 | |
Agape Family Health, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 915 S Garden St, Columbia, TN 38401 Phone: 931-548-8090 Fax: 931-548-8110 | |
Prohealth Rural Health Services, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 180 Bear Creek Pike, Columbia, TN 38401 Phone: 931-381-7567 Fax: 931-374-9958 | |
Joe R Fite Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1218 Trotwood Ave, Columbia, TN 38401 Phone: 931-490-7440 Fax: 931-540-4143 |