| Mercy Clinic Joplin Llc | |
|
100 Mercy Way Joplin MO 64804-4524 | |
| (417) 556-2727 | |
| Not Available |
| Full Name | Mercy Clinic Joplin Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 100 Mercy Way, Joplin, Missouri |
| Authorized Official Name and Position | Tracy A Godfrey (PRESIDENT) |
| Authorized Official Contact | 4175568962 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Clinic Joplin Llc 100 Mercy Way Joplin MO 64804-4524 Ph: (417) 556-2727 | Mercy Clinic Joplin Llc 100 Mercy Way Joplin MO 64804-4524 Ph: (417) 556-2727 |
| NPI Number | 1215264817 |
|---|---|
| Provider Enumeration Date | 11/03/2009 |
| Last Update Date | 04/20/2015 |
| Medicare PECOS PAC ID | 0547300196 |
|---|---|
| Medicare Enrollment ID | O20091218000092 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215264817 | NPI | - | NPPES |
| 1215264817 | Medicaid | MO | |
| 200639810A | Medicaid | KS | |
| 200274980B | Medicaid | OK | |
| 181336002 | Medicaid | AR |
| Provider Name | Tamon B Paige |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104807635 PECOS PAC ID: 6103720420 Enrollment ID: I20031119000906 |
| Provider Name | David S Cochran |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1467541433 PECOS PAC ID: 5991609828 Enrollment ID: I20031121000871 |
| Provider Name | Alan M Scarrow |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1972537132 PECOS PAC ID: 9638077936 Enrollment ID: I20031223000633 |
| Provider Name | Jason K Sloan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730126376 PECOS PAC ID: 9830080035 Enrollment ID: I20040324001104 |
| Provider Name | Laishang P Zhang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235143942 PECOS PAC ID: 7719974682 Enrollment ID: I20040430000804 |
| Provider Name | Abdul M Memon |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1720193642 PECOS PAC ID: 8426035049 Enrollment ID: I20040701001015 |
| Provider Name | Cheryl A Fogarty |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316974207 PECOS PAC ID: 4981681947 Enrollment ID: I20040707000857 |
| Provider Name | Syed A Ahmed |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1245273150 PECOS PAC ID: 7517946056 Enrollment ID: I20040717000077 |
| Provider Name | Grzegorz Szarnecki |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336166008 PECOS PAC ID: 4183604432 Enrollment ID: I20040726000755 |
| Provider Name | Jordan C Page |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053459800 PECOS PAC ID: 8729051164 Enrollment ID: I20040816000027 |
| Provider Name | Gerald J Ondr |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285772046 PECOS PAC ID: 2466425731 Enrollment ID: I20040816000371 |
| Provider Name | Julie A Alford |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720126691 PECOS PAC ID: 0941273221 Enrollment ID: I20040816000436 |
| Provider Name | Kenneth B Snyder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538207212 PECOS PAC ID: 4385617661 Enrollment ID: I20040816000450 |
| Provider Name | Chris Chernesky |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619015484 PECOS PAC ID: 2567435852 Enrollment ID: I20040816000464 |
| Provider Name | John Mark Wilson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902944606 PECOS PAC ID: 3577536804 Enrollment ID: I20040816000806 |
| Provider Name | Jinna Su Chen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215075189 PECOS PAC ID: 0648243972 Enrollment ID: I20040816000826 |
| Provider Name | David E Hargroder |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811039621 PECOS PAC ID: 9335117456 Enrollment ID: I20040917000016 |
| Provider Name | Jenifer H Zhai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144388745 PECOS PAC ID: 3870567621 Enrollment ID: I20040928000211 |
| Provider Name | Terry D Schwab |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1407883911 PECOS PAC ID: 5496724320 Enrollment ID: I20040928000790 |
| Provider Name | Ling Li |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235207028 PECOS PAC ID: 2062473507 Enrollment ID: I20041019000946 |
| Provider Name | William R Craig |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831130020 PECOS PAC ID: 9638070220 Enrollment ID: I20041208000362 |
| Provider Name | David S Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154363232 PECOS PAC ID: 8022074293 Enrollment ID: I20041209000045 |
| Provider Name | John Agnone |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346311404 PECOS PAC ID: 0941251755 Enrollment ID: I20050209000017 |
| Provider Name | Shang-chiun Lee |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1588754402 PECOS PAC ID: 4486606498 Enrollment ID: I20050218000013 |
| Provider Name | Mary L Kennedy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659312841 PECOS PAC ID: 8426001579 Enrollment ID: I20050301000344 |
| Provider Name | Russell L Kennedy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316985989 PECOS PAC ID: 6406809557 Enrollment ID: I20050301000355 |
| Provider Name | James W Dailey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730120759 PECOS PAC ID: 3173421997 Enrollment ID: I20050314000081 |
| Provider Name | Sunghoon Lee |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1184642175 PECOS PAC ID: 1850334541 Enrollment ID: I20050603000363 |
| Provider Name | Robert Leroy Kail |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558354605 PECOS PAC ID: 6507809183 Enrollment ID: I20050606000041 |
| Provider Name | Robert F Merritt |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1649369661 PECOS PAC ID: 1052355575 Enrollment ID: I20050615000913 |
| Provider Name | Blake Little |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1386688778 PECOS PAC ID: 0749172237 Enrollment ID: I20050616000216 |
| Provider Name | Sami Khoshyomn |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1699719963 PECOS PAC ID: 6709815244 Enrollment ID: I20050805000097 |
| Provider Name | Julie Chrisco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487682563 PECOS PAC ID: 9830093608 Enrollment ID: I20050808000169 |
| Provider Name | Brian J Ipsen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1851371769 PECOS PAC ID: 1951373083 Enrollment ID: I20050811001007 |
| Provider Name | Mark Jarek |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1013955541 PECOS PAC ID: 6406886209 Enrollment ID: I20050820000070 |
| Provider Name | Anna K Clark Gibson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700801073 PECOS PAC ID: 3870523376 Enrollment ID: I20050906000897 |
| Provider Name | Brian L Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619926250 PECOS PAC ID: 9133152176 Enrollment ID: I20050912000498 |
| Provider Name | Malik I Ahmed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770557985 PECOS PAC ID: 5294752648 Enrollment ID: I20051026000073 |
| Provider Name | Julie Ann Hoffmann Janisch |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316900921 PECOS PAC ID: 3779520267 Enrollment ID: I20051213000824 |
| Provider Name | Stephen E Slawson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962447292 PECOS PAC ID: 2961314257 Enrollment ID: I20060109000011 |
| Provider Name | Dawn L Viets |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053359091 PECOS PAC ID: 1254355415 Enrollment ID: I20060116000274 |
| Provider Name | Jon C Banwart |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1760410542 PECOS PAC ID: 4183639156 Enrollment ID: I20060213000209 |
| Provider Name | Chad E Wagoner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871582130 PECOS PAC ID: 3678588530 Enrollment ID: I20060214000199 |
| Provider Name | Novella Lynn Keyler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750444063 PECOS PAC ID: 2860408267 Enrollment ID: I20060224000044 |
| Provider Name | Hope Cranston D Amato |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1821033069 PECOS PAC ID: 3577573344 Enrollment ID: I20060425000497 |
| Provider Name | Carrie M Osiier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497793608 PECOS PAC ID: 4082626114 Enrollment ID: I20060608000032 |
| Provider Name | Trevor Axford |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1528094224 PECOS PAC ID: 0648274449 Enrollment ID: I20060911000212 |
| Provider Name | Mark E Mcnemar |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1023126893 PECOS PAC ID: 6204830813 Enrollment ID: I20060912000525 |
| Provider Name | Xujun Wu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1235117425 PECOS PAC ID: 3375517188 Enrollment ID: I20061114000557 |
| Provider Name | Ashok V Palagiri |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790899151 PECOS PAC ID: 8224036736 Enrollment ID: I20061117000002 |
| Provider Name | Brenda M Cupp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366530628 PECOS PAC ID: 8729087598 Enrollment ID: I20061206000163 |
| Provider Name | Glen W King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558303784 PECOS PAC ID: 6709885130 Enrollment ID: I20061213000303 |
| Provider Name | John T Ogden |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1801832738 PECOS PAC ID: 7315948676 Enrollment ID: I20070130000051 |
| Provider Name | Rafael J Gaytan |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1376602649 PECOS PAC ID: 5395630354 Enrollment ID: I20070206000207 |
| Provider Name | Jonathan L Grantham |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386671238 PECOS PAC ID: 5496757742 Enrollment ID: I20070219000002 |
| Provider Name | Dennis Daniels |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1265404222 PECOS PAC ID: 5991808628 Enrollment ID: I20070316000244 |
| Provider Name | Jessica D Kirk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235262924 PECOS PAC ID: 0941305221 Enrollment ID: I20070416000073 |
| Provider Name | Saima B Memon |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1952484339 PECOS PAC ID: 5294833141 Enrollment ID: I20070531000301 |
| Provider Name | Elizabeth M Barlet |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346298353 PECOS PAC ID: 3072611094 Enrollment ID: I20070614000137 |
| Provider Name | James Freeman |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1821035684 PECOS PAC ID: 5799676607 Enrollment ID: I20070615000154 |
| Provider Name | Festus A Ndukwu |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1154543999 PECOS PAC ID: 3072605625 Enrollment ID: I20070827000895 |
| Provider Name | James Orlando |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629051123 PECOS PAC ID: 7315030368 Enrollment ID: I20070906000610 |
| Provider Name | Amanda G Vance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750428959 PECOS PAC ID: 8820185432 Enrollment ID: I20071030000066 |
| Provider Name | Maria Fe Fiel Bruce |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124136718 PECOS PAC ID: 6800790775 Enrollment ID: I20071105000071 |
| Provider Name | Sonu Suri |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528006533 PECOS PAC ID: 1658469614 Enrollment ID: I20071109000013 |
| Provider Name | Johnny L Venter |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1003852054 PECOS PAC ID: 7113016254 Enrollment ID: I20071127000824 |
| Provider Name | Kristin K Stovern |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1629005327 PECOS PAC ID: 6901996206 Enrollment ID: I20071226000048 |
| Provider Name | Bradley R Burnett |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1174683254 PECOS PAC ID: 1355431776 Enrollment ID: I20080213000220 |
| Provider Name | Susan Pumphrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134243819 PECOS PAC ID: 0042397093 Enrollment ID: I20080401000898 |
| Provider Name | Stephen J Bazzano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063423150 PECOS PAC ID: 4486741600 Enrollment ID: I20080508000426 |
| Provider Name | Andra J Fontaine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083890461 PECOS PAC ID: 9234208216 Enrollment ID: I20080516000171 |
| Provider Name | Robert F Stringer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1861497117 PECOS PAC ID: 6608817093 Enrollment ID: I20080620000679 |
| Provider Name | Timothy M Okeefe |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730178336 PECOS PAC ID: 5597771220 Enrollment ID: I20080731000389 |
| Provider Name | Katherine A Bunn |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1487819637 PECOS PAC ID: 9133294812 Enrollment ID: I20080814000271 |
| Provider Name | Charles Youngho Ro |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295945681 PECOS PAC ID: 9032205208 Enrollment ID: I20080919000252 |
| Provider Name | Jacob A Roberts |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265474472 PECOS PAC ID: 7517975071 Enrollment ID: I20081007000686 |
| Provider Name | Franklin E Mayhue |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669428421 PECOS PAC ID: 2668530882 Enrollment ID: I20081016000394 |
| Provider Name | David Tannehill |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1750591053 PECOS PAC ID: 4486714623 Enrollment ID: I20081118000791 |
| Provider Name | Eden M Esguerra |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1164460762 PECOS PAC ID: 1355403940 Enrollment ID: I20081216000105 |
| Provider Name | Jonathan D Haffner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093818031 PECOS PAC ID: 6709949498 Enrollment ID: I20090106000751 |
| Provider Name | William D Kessler |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265421739 PECOS PAC ID: 8224044953 Enrollment ID: I20090114000295 |
| Provider Name | Richard J Price |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275594087 PECOS PAC ID: 1850299827 Enrollment ID: I20090216000425 |
| Provider Name | Steven J Taggart |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497716716 PECOS PAC ID: 6103724174 Enrollment ID: I20090318000234 |
| Provider Name | Joe Olivi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578663191 PECOS PAC ID: 7214084136 Enrollment ID: I20090413000115 |
| Provider Name | Luke D Pyron |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720093396 PECOS PAC ID: 3173671898 Enrollment ID: I20090506000138 |
| Provider Name | Essam Elkady |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1124125190 PECOS PAC ID: 1355309642 Enrollment ID: I20090527000485 |
| Provider Name | Bruce Jones |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1679531453 PECOS PAC ID: 2163465576 Enrollment ID: I20090702000080 |
| Provider Name | Judith A Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982859237 PECOS PAC ID: 7719040310 Enrollment ID: I20090706000634 |
| Provider Name | Gretchen D Shull |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1689621336 PECOS PAC ID: 4284639626 Enrollment ID: I20090728000455 |
| Provider Name | Kapil Passi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1194953851 PECOS PAC ID: 6608920426 Enrollment ID: I20090813000345 |
| Provider Name | Roberto Antonio Moran-bojorquez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063689651 PECOS PAC ID: 5597811893 Enrollment ID: I20090928000367 |
| Provider Name | Kerry Jean Williams-wuch |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1073655585 PECOS PAC ID: 0547307514 Enrollment ID: I20091023000081 |
| Provider Name | Jahan Qamar Zeb |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699710996 PECOS PAC ID: 8022018027 Enrollment ID: I20091112000313 |
| Provider Name | Trina M Larery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124207667 PECOS PAC ID: 8729168885 Enrollment ID: I20100121000077 |
| Provider Name | Thomas A Schneider |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255392189 PECOS PAC ID: 9830232966 Enrollment ID: I20100211000223 |
| Provider Name | Larry D Deffenbaugh |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1447290622 PECOS PAC ID: 5496890782 Enrollment ID: I20100311000485 |
| Provider Name | Fred D Biggs |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1750335121 PECOS PAC ID: 2668508383 Enrollment ID: I20100331001066 |
| Provider Name | James E Miller |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1992758148 PECOS PAC ID: 3971661471 Enrollment ID: I20100504000227 |
| Provider Name | Brenton R Coger |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1427107283 PECOS PAC ID: 7416085774 Enrollment ID: I20100506000298 |
| Provider Name | Chandria Lynn Johnson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437250750 PECOS PAC ID: 3577654201 Enrollment ID: I20100605000130 |
| Provider Name | Jose C De Hoyos |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689600850 PECOS PAC ID: 8628176294 Enrollment ID: I20100607000382 |
| Provider Name | Irving E. Lafrancis |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1750358487 PECOS PAC ID: 5991835449 Enrollment ID: I20100610000599 |
| Provider Name | David W Croy |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1164499588 PECOS PAC ID: 7719017169 Enrollment ID: I20100610000614 |
| Provider Name | Renae Lyn Bateman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952628307 PECOS PAC ID: 0446380679 Enrollment ID: I20100614000580 |
| Provider Name | John R Coleman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861475279 PECOS PAC ID: 4486784550 Enrollment ID: I20100616000475 |
| Provider Name | Jessica A Birchem |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1285803353 PECOS PAC ID: 8729110432 Enrollment ID: I20100715000754 |
| Provider Name | Steven E Collum |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1093722357 PECOS PAC ID: 1456484096 Enrollment ID: I20100803000217 |
| Provider Name | Juliette A Gibbons |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548333727 PECOS PAC ID: 0941333496 Enrollment ID: I20100804000291 |
| Provider Name | Meera R Scarrow |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881629863 PECOS PAC ID: 4880727361 Enrollment ID: I20100804000695 |
| Provider Name | Danine T Willis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710953559 PECOS PAC ID: 0648208579 Enrollment ID: I20100809000080 |
| Provider Name | Mark V Griesemer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295990059 PECOS PAC ID: 2264581586 Enrollment ID: I20100813001090 |
| Provider Name | Laura A Adam |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396954657 PECOS PAC ID: 2264566587 Enrollment ID: I20100823000007 |
| Provider Name | Anthonia O Ekpenike |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659577484 PECOS PAC ID: 8426174814 Enrollment ID: I20100922000975 |
| Provider Name | Jeffrey Lynn Dryden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316923956 PECOS PAC ID: 5991613846 Enrollment ID: I20101028000789 |
| Provider Name | Gregory D Nanney |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1780784645 PECOS PAC ID: 3779520317 Enrollment ID: I20101119000173 |
| Provider Name | Susan Myers |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1992024491 PECOS PAC ID: 9436339348 Enrollment ID: I20110210000195 |
| Provider Name | Michelle Pannell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144427543 PECOS PAC ID: 7214114164 Enrollment ID: I20110602000304 |
| Provider Name | Saumitra Biswas |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1699861740 PECOS PAC ID: 7810999133 Enrollment ID: I20110621000610 |
| Provider Name | Jacob Taussig |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346326782 PECOS PAC ID: 6305941626 Enrollment ID: I20110912000104 |
| Provider Name | Anthony R Divito |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336303411 PECOS PAC ID: 2769515030 Enrollment ID: I20110912000257 |
| Provider Name | Anoop Parameswaran |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1144435728 PECOS PAC ID: 0042385098 Enrollment ID: I20111012000248 |
| Provider Name | Eman Gibral Spaulding |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750571840 PECOS PAC ID: 4284891862 Enrollment ID: I20120209000387 |
| Provider Name | Martin Musumbi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1215185699 PECOS PAC ID: 9638336035 Enrollment ID: I20120213000277 |
| Provider Name | Marjorie F Lantum |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669537312 PECOS PAC ID: 0345348645 Enrollment ID: I20120222000908 |
| Provider Name | Thad L Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023381357 PECOS PAC ID: 4284893611 Enrollment ID: I20120305000409 |
| Provider Name | Maripat Gatter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649374208 PECOS PAC ID: 9638171184 Enrollment ID: I20120316000494 |
| Provider Name | Katherine M Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891068896 PECOS PAC ID: 6204097116 Enrollment ID: I20120419000340 |
| Provider Name | Jill Lynn Feurt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063421048 PECOS PAC ID: 4880748433 Enrollment ID: I20120524000085 |
| Provider Name | Carey S Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891068540 PECOS PAC ID: 7719147248 Enrollment ID: I20120719000111 |
| Provider Name | Nikhil Organti |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1891925558 PECOS PAC ID: 9032375415 Enrollment ID: I20120730000779 |
| Provider Name | Talon C Maningas |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1487971008 PECOS PAC ID: 7113173477 Enrollment ID: I20120802000289 |
| Provider Name | Scott Allen Andelin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013245000 PECOS PAC ID: 1456547348 Enrollment ID: I20120914000102 |
| Provider Name | Joan M Dutton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336494319 PECOS PAC ID: 1355590571 Enrollment ID: I20121003000890 |
| Provider Name | Gretchen A Barone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225380579 PECOS PAC ID: 0244481265 Enrollment ID: I20121121000048 |
| Provider Name | Jaime Penix |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760597025 PECOS PAC ID: 5890792543 Enrollment ID: I20130323000069 |
| Provider Name | Christopher Jones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316131253 PECOS PAC ID: 1254417793 Enrollment ID: I20130513000370 |
| Provider Name | Amanda K Lewton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922329382 PECOS PAC ID: 1557501772 Enrollment ID: I20130712000039 |
| Provider Name | Danny T Liu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1740487552 PECOS PAC ID: 1951541010 Enrollment ID: I20130712000629 |
| Provider Name | Ryan N Davies |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295927473 PECOS PAC ID: 9032375159 Enrollment ID: I20130731000640 |
| Provider Name | Ryan A Birlew |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598963761 PECOS PAC ID: 1355581463 Enrollment ID: I20130806000088 |
| Provider Name | David G Blancho |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1366753055 PECOS PAC ID: 5496999252 Enrollment ID: I20130917000331 |
| Provider Name | George Berberian |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1962569046 PECOS PAC ID: 7214016658 Enrollment ID: I20130925000526 |
| Provider Name | Jeremy D Onnen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1255599841 PECOS PAC ID: 3274767025 Enrollment ID: I20131009001459 |
| Provider Name | Seth E Sewell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982036299 PECOS PAC ID: 3375779705 Enrollment ID: I20131114000280 |
| Provider Name | Lindsey K Heeter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982036026 PECOS PAC ID: 8820224959 Enrollment ID: I20131120001375 |
| Provider Name | Kimberly J Dent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477988277 PECOS PAC ID: 5799911830 Enrollment ID: I20131125000625 |
| Provider Name | Mark L Brown |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699064279 PECOS PAC ID: 1355578220 Enrollment ID: I20131220001809 |
| Provider Name | Chakradhar Venkata Krishna Venkata |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1285846576 PECOS PAC ID: 1153494216 Enrollment ID: I20140225001176 |
| Provider Name | Rebecca C Moss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225452873 PECOS PAC ID: 9234360942 Enrollment ID: I20140322000024 |
| Provider Name | Robert R Bruce |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1407877970 PECOS PAC ID: 1355358896 Enrollment ID: I20140702000440 |
| Provider Name | Marc S Milsten |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1952323362 PECOS PAC ID: 4880775600 Enrollment ID: I20140709000299 |
| Provider Name | Enquan Gao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295051548 PECOS PAC ID: 0446475198 Enrollment ID: I20140714000586 |
| Provider Name | James B Mcgeady |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1194921486 PECOS PAC ID: 1153585427 Enrollment ID: I20140714000688 |
| Provider Name | William Jason Cook |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1578583423 PECOS PAC ID: 4981785706 Enrollment ID: I20140714000708 |
| Provider Name | Sean M Doyle |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1679694822 PECOS PAC ID: 1951451715 Enrollment ID: I20140714000759 |
| Provider Name | Cole Brian Davis |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1205975224 PECOS PAC ID: 6507927142 Enrollment ID: I20140722001851 |
| Provider Name | Oren F Miller |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1295757607 PECOS PAC ID: 2365419140 Enrollment ID: I20140723002075 |
| Provider Name | Curtis R Powell |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912978511 PECOS PAC ID: 8426041724 Enrollment ID: I20140724002451 |
| Provider Name | Scott E Litwiller |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1558382028 PECOS PAC ID: 8527149343 Enrollment ID: I20140728001328 |
| Provider Name | Jeremy C Carrico |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1922028828 PECOS PAC ID: 3870535800 Enrollment ID: I20140728002693 |
| Provider Name | Shaun S. Grewal |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1972764496 PECOS PAC ID: 2365677168 Enrollment ID: I20140729000492 |
| Provider Name | Kevin J Gancarczyk |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1013983741 PECOS PAC ID: 1052464617 Enrollment ID: I20140729000713 |
| Provider Name | Sunshine N Murray |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1184818551 PECOS PAC ID: 1759423726 Enrollment ID: I20140729001160 |
| Provider Name | Holly Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275974719 PECOS PAC ID: 3476779182 Enrollment ID: I20140731002693 |
| Provider Name | Wesley Todd Brookover |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1659457455 PECOS PAC ID: 0042288672 Enrollment ID: I20140814002760 |
| Provider Name | Chiazo Amene |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1245435056 PECOS PAC ID: 0446478291 Enrollment ID: I20140820001706 |
| Provider Name | Michael N Wilkin |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1861414302 PECOS PAC ID: 8820064322 Enrollment ID: I20140821002218 |
| Provider Name | Samir Mukundray Dalia |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1235331455 PECOS PAC ID: 7416080858 Enrollment ID: I20140821002848 |
| Provider Name | Kristina J Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982933727 PECOS PAC ID: 6507993011 Enrollment ID: I20140904001975 |
| Provider Name | Charles R Pritchard |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1275654246 PECOS PAC ID: 4082705959 Enrollment ID: I20140904002777 |
| Provider Name | Heath R Merkley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942430103 PECOS PAC ID: 1153549092 Enrollment ID: I20140905001788 |
| Provider Name | Jamal F Rabbi |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1457506388 PECOS PAC ID: 7810011822 Enrollment ID: I20140923000387 |
| Provider Name | Zachary W Dalton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497017693 PECOS PAC ID: 2668692880 Enrollment ID: I20141009001794 |
| Provider Name | Robert B Carr |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1538194774 PECOS PAC ID: 5890973358 Enrollment ID: I20141201001252 |
| Provider Name | Crystal M Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134437411 PECOS PAC ID: 2062680150 Enrollment ID: I20150226001711 |
| Provider Name | Clinton J Pace |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821234717 PECOS PAC ID: 8022148154 Enrollment ID: I20150330000107 |
| Provider Name | Teyoni Tuck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942625447 PECOS PAC ID: 6901038652 Enrollment ID: I20150427000135 |
| Provider Name | Heather L Newell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295967917 PECOS PAC ID: 6800934894 Enrollment ID: I20150518001736 |
| Provider Name | Scott Grigg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023240744 PECOS PAC ID: 2769521921 Enrollment ID: I20150521002584 |
| Provider Name | Courtney C Farwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447633961 PECOS PAC ID: 3577877893 Enrollment ID: I20150730013314 |
| Provider Name | Glenn J Makowski |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1275592701 PECOS PAC ID: 1355312174 Enrollment ID: I20150810001529 |
| Provider Name | Aaron Weber |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1164758470 PECOS PAC ID: 5294051959 Enrollment ID: I20150916000029 |
| Provider Name | Katherine Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528437936 PECOS PAC ID: 2264741933 Enrollment ID: I20151020000920 |
| Provider Name | John M Derfelt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912377862 PECOS PAC ID: 1951610492 Enrollment ID: I20151022002197 |
| Provider Name | Krishnamraju Kosuru |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013204296 PECOS PAC ID: 2264743053 Enrollment ID: I20160112002271 |
| Provider Name | Amanda L Hunter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700242005 PECOS PAC ID: 0840594453 Enrollment ID: I20160202001286 |
| Provider Name | Omolola Ajoke Omotoso |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154514529 PECOS PAC ID: 4183781420 Enrollment ID: I20160314000288 |
| Provider Name | Morris S Glover |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447416862 PECOS PAC ID: 6608933080 Enrollment ID: I20160419002658 |
| Provider Name | Carolyn D Hoekstra |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679539746 PECOS PAC ID: 4284696980 Enrollment ID: I20160531001913 |
| Provider Name | Srikant Nannapaneni |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1407174782 PECOS PAC ID: 5193016178 Enrollment ID: I20160622001131 |
| Provider Name | Ronen Dudaie |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1861782237 PECOS PAC ID: 1759559792 Enrollment ID: I20160623000178 |
| Provider Name | Kelly Marie Derganc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881900058 PECOS PAC ID: 3072709666 Enrollment ID: I20160627001242 |
| Provider Name | Lakshminarayana Chekuri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144589284 PECOS PAC ID: 3274859889 Enrollment ID: I20160706001418 |
| Provider Name | Jared A Stanton |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1194017996 PECOS PAC ID: 4284867078 Enrollment ID: I20160719000828 |
| Provider Name | Elizabeth Barnica |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1649694431 PECOS PAC ID: 0345533568 Enrollment ID: I20160726002392 |
| Provider Name | Suhasini Rallabandi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1750729539 PECOS PAC ID: 2163716267 Enrollment ID: I20160812000897 |
| Provider Name | Barry I Katz |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1467408641 PECOS PAC ID: 6002955945 Enrollment ID: I20160815001524 |
| Provider Name | Deborah Capshaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295186203 PECOS PAC ID: 6002101904 Enrollment ID: I20160816002980 |
| Provider Name | Jordan A Chance |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548571524 PECOS PAC ID: 0941515142 Enrollment ID: I20160817002652 |
| Provider Name | Amy M Buckner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669920807 PECOS PAC ID: 2961790969 Enrollment ID: I20161006001483 |
| Provider Name | Summer D Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770031593 PECOS PAC ID: 9436437779 Enrollment ID: I20161020002155 |
| Provider Name | Saurav Raj Baral |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316225774 PECOS PAC ID: 9739482514 Enrollment ID: I20161101002561 |
| Provider Name | Noaman F Siddiqi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124294749 PECOS PAC ID: 7618157470 Enrollment ID: I20161108001131 |
| Provider Name | Mahdi A Mussa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821229089 PECOS PAC ID: 2264618842 Enrollment ID: I20161109000144 |
| Provider Name | Echo L Mills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285181255 PECOS PAC ID: 1153618616 Enrollment ID: I20161109001407 |
| Provider Name | Cedric Emden Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356534994 PECOS PAC ID: 9931243128 Enrollment ID: I20161122000942 |
| Provider Name | Ryan Charles Morris |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1588975973 PECOS PAC ID: 9133449192 Enrollment ID: I20161205000042 |
| Provider Name | Tracy D Southern |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740726660 PECOS PAC ID: 0042285256 Enrollment ID: I20170207002012 |
| Provider Name | James O L'esperance |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1922068105 PECOS PAC ID: 6507048071 Enrollment ID: I20170301001284 |
| Provider Name | Robert C Montana |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649290370 PECOS PAC ID: 1850397282 Enrollment ID: I20170303001110 |
| Provider Name | Pierre E Laughton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578523999 PECOS PAC ID: 2860579778 Enrollment ID: I20170306000491 |
| Provider Name | Amanda Brosseau Andrade |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528354008 PECOS PAC ID: 0446408447 Enrollment ID: I20170613002321 |
| Provider Name | Alicia S Stogsdill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619497740 PECOS PAC ID: 9931479425 Enrollment ID: I20170717000538 |
| Provider Name | Christopher B Stapley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396703187 PECOS PAC ID: 2365733227 Enrollment ID: I20170803000389 |
| Provider Name | Olkanmi J Deleawe |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033515168 PECOS PAC ID: 1052682481 Enrollment ID: I20170803001976 |
| Provider Name | Elizabeth Swarna Troilo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891218541 PECOS PAC ID: 8628349693 Enrollment ID: I20170809002651 |
| Provider Name | Betty C Murray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003104118 PECOS PAC ID: 1557595444 Enrollment ID: I20170822003506 |
| Provider Name | David Rochelin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093037632 PECOS PAC ID: 1355508532 Enrollment ID: I20170825002197 |
| Provider Name | Sam Valid |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1912318783 PECOS PAC ID: 1456668185 Enrollment ID: I20171010002643 |
| Provider Name | Sarah M Dodson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598275406 PECOS PAC ID: 6002181203 Enrollment ID: I20171013000087 |
| Provider Name | Deep Bharatbhai Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316338957 PECOS PAC ID: 8527374180 Enrollment ID: I20171221001540 |
| Provider Name | Jordan Lefevers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114432150 PECOS PAC ID: 8426316076 Enrollment ID: I20180103001621 |
| Provider Name | Mindi Suzanne Garner |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831192921 PECOS PAC ID: 1658274204 Enrollment ID: I20180307002685 |
| Provider Name | Christy Lynn Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821499336 PECOS PAC ID: 6608139100 Enrollment ID: I20180416001977 |
| Provider Name | Rangan Murali |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1164687224 PECOS PAC ID: 2860569183 Enrollment ID: I20180420001036 |
| Provider Name | Maegan Elise Burr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093212177 PECOS PAC ID: 1052676384 Enrollment ID: I20180607000892 |
| Provider Name | Brian Snyders |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962797126 PECOS PAC ID: 3577856327 Enrollment ID: I20180612001531 |
| Provider Name | Aloysius F Jackson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1477821155 PECOS PAC ID: 1355562273 Enrollment ID: I20180615001477 |
| Provider Name | Janell Tabora |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811334410 PECOS PAC ID: 7113168477 Enrollment ID: I20180622002424 |
| Provider Name | Kerry Jepsen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1326073537 PECOS PAC ID: 1254510712 Enrollment ID: I20180628001076 |
| Provider Name | Anastasia N Beezley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518275668 PECOS PAC ID: 7113274416 Enrollment ID: I20180718000824 |
| Provider Name | William M Rambo |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1619079753 PECOS PAC ID: 6002018447 Enrollment ID: I20180718003696 |
| Provider Name | Johat Aponte |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033504030 PECOS PAC ID: 6406103233 Enrollment ID: I20180724003685 |
| Provider Name | Andrew J Kochevar |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1871781765 PECOS PAC ID: 0648409995 Enrollment ID: I20180726001693 |
| Provider Name | Kasey King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710472444 PECOS PAC ID: 5395093488 Enrollment ID: I20180806003206 |
| Provider Name | Janet K Frazier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891272431 PECOS PAC ID: 6800145152 Enrollment ID: I20180820001039 |
| Provider Name | Samantha Helene Mcroy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699253849 PECOS PAC ID: 3870842891 Enrollment ID: I20180823001525 |
| Provider Name | Susan Annette Pitts |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316207137 PECOS PAC ID: 0749530624 Enrollment ID: I20180914000595 |
| Provider Name | Rebecca Asiamah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740664457 PECOS PAC ID: 2264783059 Enrollment ID: I20180918001033 |
| Provider Name | Lydia Annette Espinoza Morales |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255726642 PECOS PAC ID: 8123379336 Enrollment ID: I20180927002275 |
| Provider Name | Anthony J Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831676287 PECOS PAC ID: 4486906369 Enrollment ID: I20181003002105 |
| Provider Name | Michele Carey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295104867 PECOS PAC ID: 6901115690 Enrollment ID: I20181016001808 |
| Provider Name | Karl G. Keczkemethy |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1912488891 PECOS PAC ID: 8224381116 Enrollment ID: I20181023000944 |
| Provider Name | Kelly Susanne Biddle |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821496480 PECOS PAC ID: 7113270422 Enrollment ID: I20181101002972 |
| Provider Name | Kara Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720555683 PECOS PAC ID: 6608120506 Enrollment ID: I20181113000534 |
| Provider Name | William Birsic |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851307854 PECOS PAC ID: 7315992757 Enrollment ID: I20181116001932 |
| Provider Name | Paige N Palmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922581073 PECOS PAC ID: 2961756499 Enrollment ID: I20181119002365 |
| Provider Name | Kevin Kierl |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992148407 PECOS PAC ID: 6103133640 Enrollment ID: I20181204003871 |
| Provider Name | Jesse L Hatfield |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1275822298 PECOS PAC ID: 3274779822 Enrollment ID: I20181206000637 |
| Provider Name | Timothy D Herrington |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710321765 PECOS PAC ID: 9830412915 Enrollment ID: I20181210002034 |
| Provider Name | Jeffrey Dixon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669463865 PECOS PAC ID: 4082680962 Enrollment ID: I20181212001435 |
| Provider Name | William Knight Gray |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891786000 PECOS PAC ID: 6709852684 Enrollment ID: I20181213001491 |
| Provider Name | Emily Williams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174814727 PECOS PAC ID: 6305073792 Enrollment ID: I20181227001144 |
| Provider Name | Alec M Watson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629455449 PECOS PAC ID: 1254610637 Enrollment ID: I20190109002918 |
| Provider Name | Kevin N Oguayo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1477849461 PECOS PAC ID: 0749584274 Enrollment ID: I20190111000701 |
| Provider Name | Stephanie Marie Rapp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154894475 PECOS PAC ID: 5092052977 Enrollment ID: I20190130002890 |
| Provider Name | Craig Allen Kennedy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356332555 PECOS PAC ID: 0941219687 Enrollment ID: I20190412001078 |
| Provider Name | Ahmad Abou Leila |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1861741126 PECOS PAC ID: 4183993546 Enrollment ID: I20190417000333 |
| Provider Name | Travis Alexander Melton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821487455 PECOS PAC ID: 2567760812 Enrollment ID: I20190509000743 |
| Provider Name | Jessica Cornett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942768833 PECOS PAC ID: 3476896119 Enrollment ID: I20190520002403 |
| Provider Name | Derek Knotts |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235497363 PECOS PAC ID: 2769605013 Enrollment ID: I20190521002978 |
| Provider Name | Eric Avery Reddick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225354012 PECOS PAC ID: 2668613639 Enrollment ID: I20190521003130 |
| Provider Name | Jeffrey A Johnson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356386528 PECOS PAC ID: 2668406935 Enrollment ID: I20190606002181 |
| Provider Name | Edmond Nelson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912285446 PECOS PAC ID: 1951541754 Enrollment ID: I20190613000446 |
| Provider Name | Jeffrey Milles |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1194164244 PECOS PAC ID: 8729222120 Enrollment ID: I20190613002879 |
| Provider Name | Eric Woolley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043231749 PECOS PAC ID: 5092713008 Enrollment ID: I20190619002196 |
| Provider Name | Samantha Jo Primm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407412406 PECOS PAC ID: 8224362272 Enrollment ID: I20190625000829 |
| Provider Name | Brian Andrew Tessaro |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043693724 PECOS PAC ID: 9638416654 Enrollment ID: I20190627001162 |
| Provider Name | Jerad Ball |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790158764 PECOS PAC ID: 4183902299 Enrollment ID: I20190702001319 |
| Provider Name | Luke Monell Wicke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588926620 PECOS PAC ID: 3870828353 Enrollment ID: I20190708000333 |
| Provider Name | Garrett Taylor |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083906143 PECOS PAC ID: 1850530973 Enrollment ID: I20190709000373 |
| Provider Name | David M Kraus |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043698962 PECOS PAC ID: 5193028975 Enrollment ID: I20190712000639 |
| Provider Name | Naser Eddin M. Gharaibeh |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1427468164 PECOS PAC ID: 4789983768 Enrollment ID: I20190715000339 |
| Provider Name | Shreyans Bengani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710334610 PECOS PAC ID: 6103151139 Enrollment ID: I20190715000459 |
| Provider Name | Salman Saeed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497106983 PECOS PAC ID: 9032401989 Enrollment ID: I20190715001419 |
| Provider Name | Krunal Raval |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578903365 PECOS PAC ID: 5698071462 Enrollment ID: I20190715003054 |
| Provider Name | Dale R Bays |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1326025461 PECOS PAC ID: 3274722145 Enrollment ID: I20190722003278 |
| Provider Name | Neeraja Mariserla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851748289 PECOS PAC ID: 9638418544 Enrollment ID: I20190724002676 |
| Provider Name | Mahmoud Halawa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790230704 PECOS PAC ID: 1850628363 Enrollment ID: I20190806004332 |
| Provider Name | Augustus Caine |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1043657844 PECOS PAC ID: 7012208358 Enrollment ID: I20190808004104 |
| Provider Name | Shelah Radke |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366695967 PECOS PAC ID: 8426386319 Enrollment ID: I20190830001285 |
| Provider Name | Adina R Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558694000 PECOS PAC ID: 9335331743 Enrollment ID: I20190905000608 |
| Provider Name | Rameez Malik |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1376999417 PECOS PAC ID: 1254660905 Enrollment ID: I20190906000225 |
| Provider Name | David G Uhls |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629481460 PECOS PAC ID: 7113144874 Enrollment ID: I20190918002144 |
| Provider Name | Crystal Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063066363 PECOS PAC ID: 3971833732 Enrollment ID: I20190923000886 |
| Provider Name | Kathryn Shemwell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700263506 PECOS PAC ID: 0749582542 Enrollment ID: I20191007000249 |
| Provider Name | Carrie Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689140832 PECOS PAC ID: 6204168560 Enrollment ID: I20191106000894 |
| Provider Name | Parker L Simon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093855066 PECOS PAC ID: 6305092743 Enrollment ID: I20191114001954 |
| Provider Name | Jequita D Snyder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255511309 PECOS PAC ID: 3476622267 Enrollment ID: I20200109003014 |
| Provider Name | Elias Solomon |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1770624694 PECOS PAC ID: 9931295391 Enrollment ID: I20200229000149 |
| Provider Name | Jeffrey Don Lee |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1659309128 PECOS PAC ID: 8224926464 Enrollment ID: I20200303001220 |
| Provider Name | Bamidele Ganiyu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073155933 PECOS PAC ID: 1153759394 Enrollment ID: I20200320002762 |
| Provider Name | Kaitlyn Terrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841823770 PECOS PAC ID: 8123457850 Enrollment ID: I20200401001588 |
| Provider Name | Tami Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174164263 PECOS PAC ID: 5496184848 Enrollment ID: I20200406001675 |
| Provider Name | Lynda D Banwart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851328769 PECOS PAC ID: 6901808989 Enrollment ID: I20200413002365 |
| Provider Name | Joshua Zachariah Vicena |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1336347392 PECOS PAC ID: 4587820816 Enrollment ID: I20200420003460 |
| Provider Name | Rena L Stewart |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386696391 PECOS PAC ID: 0143227694 Enrollment ID: I20200424001718 |
| Provider Name | Jody M Pryor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629602024 PECOS PAC ID: 8123459112 Enrollment ID: I20200506002997 |
| Provider Name | Toby G Moore |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1235321381 PECOS PAC ID: 6002056686 Enrollment ID: I20200510000193 |
| Provider Name | Meghan Metzger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417570821 PECOS PAC ID: 9537580857 Enrollment ID: I20200521003069 |
| Provider Name | Tiffany Weathers |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215960471 PECOS PAC ID: 2466457023 Enrollment ID: I20200526000629 |
| Provider Name | Megan Crowder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669011888 PECOS PAC ID: 2365863388 Enrollment ID: I20200529002332 |
| Provider Name | Michael Hearndon |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972625853 PECOS PAC ID: 4183774508 Enrollment ID: I20200603000399 |
| Provider Name | Eugerie A Hanley |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1205063476 PECOS PAC ID: 6103959655 Enrollment ID: I20200603000798 |
| Provider Name | Jickie Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386016954 PECOS PAC ID: 1658671789 Enrollment ID: I20200603003132 |
| Provider Name | Darian Arman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992236053 PECOS PAC ID: 3072851500 Enrollment ID: I20200605001144 |
| Provider Name | Tara Moore |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740608884 PECOS PAC ID: 6204121551 Enrollment ID: I20200731000295 |
| Provider Name | Jordan Magarik |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1205279213 PECOS PAC ID: 8325347933 Enrollment ID: I20200804001628 |
| Provider Name | Corey Weicht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992315857 PECOS PAC ID: 5799103941 Enrollment ID: I20200921000728 |
| Provider Name | Kelsey L Hobbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295344109 PECOS PAC ID: 3971922576 Enrollment ID: I20201001000641 |
| Provider Name | Andrew Nelson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1861810541 PECOS PAC ID: 4587880794 Enrollment ID: I20201007001117 |
| Provider Name | Byungsoo Ko |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1285945295 PECOS PAC ID: 5799917431 Enrollment ID: I20201012000181 |
| Provider Name | Kyle W Helm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861090748 PECOS PAC ID: 1355752221 Enrollment ID: I20201125000138 |
| Provider Name | Amy Carolyn Houston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487191268 PECOS PAC ID: 5496039794 Enrollment ID: I20210106001324 |
| Provider Name | Jessica N Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013522150 PECOS PAC ID: 9830504521 Enrollment ID: I20210210000861 |
| Provider Name | Bonnie J Daniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235715962 PECOS PAC ID: 9234547704 Enrollment ID: I20210421002853 |
| Provider Name | Michael Patlajan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467843136 PECOS PAC ID: 9638448004 Enrollment ID: I20210507000434 |
| Provider Name | Preston L Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205400033 PECOS PAC ID: 7618378142 Enrollment ID: I20210622001692 |
| Provider Name | Lizbeth Brice |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548555113 PECOS PAC ID: 0840415154 Enrollment ID: I20210714001140 |
| Provider Name | Segun Oladipo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245727684 PECOS PAC ID: 4385047877 Enrollment ID: I20210721001922 |
| Provider Name | Krishna S Patel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1225533615 PECOS PAC ID: 2264857580 Enrollment ID: I20210727001830 |
| Provider Name | Matthew A Nations |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073017638 PECOS PAC ID: 3476809542 Enrollment ID: I20210810001083 |
| Provider Name | Stuart Conner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568704088 PECOS PAC ID: 3274852686 Enrollment ID: I20210817002231 |
| Provider Name | Laura Carrizo Barber |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1982803631 PECOS PAC ID: 5496871519 Enrollment ID: I20210819001818 |
| Provider Name | Evan J Clark |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154819951 PECOS PAC ID: 4688009574 Enrollment ID: I20210820000146 |
| Provider Name | Angela George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750962510 PECOS PAC ID: 9739585365 Enrollment ID: I20210908001025 |
| Provider Name | Shannon Coles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700551470 PECOS PAC ID: 5294132205 Enrollment ID: I20210917001072 |
| Provider Name | Ethan J Reznicek |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174059661 PECOS PAC ID: 9931446150 Enrollment ID: I20210927002402 |
| Provider Name | Cody A Baker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750842944 PECOS PAC ID: 6103151899 Enrollment ID: I20211004000337 |
| Provider Name | Lauren Nueske |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003492059 PECOS PAC ID: 6002214004 Enrollment ID: I20211005003077 |
| Provider Name | Patricia Myers |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1336381474 PECOS PAC ID: 5092603753 Enrollment ID: I20211013001628 |
| Provider Name | Christopher Henry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215295373 PECOS PAC ID: 8527349638 Enrollment ID: I20211014000859 |
| Provider Name | Annie Christian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538537501 PECOS PAC ID: 9335457894 Enrollment ID: I20211026002650 |
| Provider Name | Christine Conner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295120533 PECOS PAC ID: 2062732191 Enrollment ID: I20211123001487 |
| Provider Name | Russell Leon Mcelveen |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1275714735 PECOS PAC ID: 1951540343 Enrollment ID: I20211203001122 |
| Provider Name | Richard Rothfleisch |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1316967318 PECOS PAC ID: 8729177423 Enrollment ID: I20220114000828 |
| Provider Name | Daraspreet Kainth |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1497915904 PECOS PAC ID: 1658692215 Enrollment ID: I20220118000778 |
| Provider Name | Sharon Marie Napier |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1578673455 PECOS PAC ID: 7810181369 Enrollment ID: I20220121000707 |
| Provider Name | Richard Toon |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1679533392 PECOS PAC ID: 8729180526 Enrollment ID: I20220121001695 |
| Provider Name | Sundeep Mummaneni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831693076 PECOS PAC ID: 8123421674 Enrollment ID: I20220209001091 |
| Provider Name | Hemn H Qader |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952797490 PECOS PAC ID: 0446588263 Enrollment ID: I20220216001391 |
| Provider Name | Jason Heflin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043829815 PECOS PAC ID: 7719379361 Enrollment ID: I20220303001216 |
| Provider Name | Shiv Bhandari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417246877 PECOS PAC ID: 6103048954 Enrollment ID: I20220303001236 |
| Provider Name | Sarah Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053072330 PECOS PAC ID: 2365836442 Enrollment ID: I20220307001799 |
| Provider Name | Lindsey Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346899671 PECOS PAC ID: 2769818616 Enrollment ID: I20220308002426 |
| Provider Name | Chris Allen Benge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245900398 PECOS PAC ID: 5294120226 Enrollment ID: I20220309002617 |
| Provider Name | Heather Niccole Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851052427 PECOS PAC ID: 7911392592 Enrollment ID: I20220317000719 |
| Provider Name | Jessica Renee Engle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346993714 PECOS PAC ID: 1052706587 Enrollment ID: I20220321001551 |
| Provider Name | Shoaib Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548767130 PECOS PAC ID: 4385909951 Enrollment ID: I20220329001083 |
| Provider Name | Emily Lynn Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982206066 PECOS PAC ID: 0941696827 Enrollment ID: I20220331002548 |
| Provider Name | Jaime L Bellamy |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548420458 PECOS PAC ID: 1557504107 Enrollment ID: I20220412000339 |
| Provider Name | Teresa Michelle White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932855475 PECOS PAC ID: 2961899679 Enrollment ID: I20220427003106 |
| Provider Name | April Nicole Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174268551 PECOS PAC ID: 2466839915 Enrollment ID: I20220523000633 |
| Provider Name | Rustin Chanc Walters |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1053381467 PECOS PAC ID: 6507004033 Enrollment ID: I20220608001000 |
| Provider Name | Carlos Silva |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1659675296 PECOS PAC ID: 9436372638 Enrollment ID: I20220624000437 |
| Provider Name | Amod Amritphale |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1053675157 PECOS PAC ID: 0244452118 Enrollment ID: I20220624001089 |
| Provider Name | Song Md Hong |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1043311806 PECOS PAC ID: 9537129390 Enrollment ID: I20220701002224 |
| Provider Name | Bradley Anderson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477016319 PECOS PAC ID: 8426439969 Enrollment ID: I20220715000450 |
| Provider Name | Jessica L Temm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487391520 PECOS PAC ID: 7618358094 Enrollment ID: I20220715002092 |
| Provider Name | Jon Patrick Patterson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548828072 PECOS PAC ID: 8820479249 Enrollment ID: I20220718000589 |
| Provider Name | Leah R. Joyner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942761762 PECOS PAC ID: 4385978261 Enrollment ID: I20220726001637 |
| Provider Name | Jeffery Alexander Gross |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992238380 PECOS PAC ID: 1951637644 Enrollment ID: I20220726002986 |
| Provider Name | Nathaniel C Rider |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629539390 PECOS PAC ID: 8628303310 Enrollment ID: I20220728001676 |
| Provider Name | Fresca Swaniker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982754719 PECOS PAC ID: 4789652678 Enrollment ID: I20220809000639 |
| Provider Name | Caitlin Busch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164189411 PECOS PAC ID: 9436532371 Enrollment ID: I20220810002006 |
| Provider Name | Rodney Clark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649590886 PECOS PAC ID: 8325287733 Enrollment ID: I20220818000269 |
| Provider Name | Andrew Russell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326509365 PECOS PAC ID: 1052648169 Enrollment ID: I20220819002310 |
| Provider Name | Edwin Suarez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588169965 PECOS PAC ID: 4284968926 Enrollment ID: I20220820000050 |
| Provider Name | Linsey Shouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578232070 PECOS PAC ID: 9436281250 Enrollment ID: I20220822002473 |
| Provider Name | David Da-wei Lin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1144270497 PECOS PAC ID: 1456331164 Enrollment ID: I20220822003413 |
| Provider Name | David H Rice |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043311202 PECOS PAC ID: 5395732267 Enrollment ID: I20220824002230 |
| Provider Name | Eddie Tang |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1093729691 PECOS PAC ID: 3870562267 Enrollment ID: I20220826001196 |
| Provider Name | Adnan Kassier |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1144575283 PECOS PAC ID: 7719118116 Enrollment ID: I20220907001182 |
| Provider Name | Alexandrea H Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467172957 PECOS PAC ID: 3678959780 Enrollment ID: I20220927002470 |
| Provider Name | Htin Aung |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1982040580 PECOS PAC ID: 4486893989 Enrollment ID: I20220928001296 |
| Provider Name | Vemana Jampala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538509385 PECOS PAC ID: 4587950274 Enrollment ID: I20220930001971 |
| Provider Name | Ahadi Hakki |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1194816389 PECOS PAC ID: 5496800997 Enrollment ID: I20221005000919 |
| Provider Name | Alan Howell |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1710180252 PECOS PAC ID: 4082701941 Enrollment ID: I20221010000217 |
| Provider Name | David Bendorf |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639107881 PECOS PAC ID: 1254326721 Enrollment ID: I20221010000322 |
| Provider Name | Carrie Bailey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730529546 PECOS PAC ID: 4981969557 Enrollment ID: I20221014000413 |
| Provider Name | Brett Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629790126 PECOS PAC ID: 8921474644 Enrollment ID: I20221021000684 |
| Provider Name | Derek B Douglas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902307762 PECOS PAC ID: 6901202951 Enrollment ID: I20221027001672 |
| Provider Name | David S Lewis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003096116 PECOS PAC ID: 0446557037 Enrollment ID: I20221103000253 |
| Provider Name | Junaid Haroon |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1669736682 PECOS PAC ID: 1052687589 Enrollment ID: I20221205000776 |
| Provider Name | Jonathan Nwiloh |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1194782011 PECOS PAC ID: 1254244932 Enrollment ID: I20221205001181 |
| Provider Name | Clive A Goulbourne |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1083024970 PECOS PAC ID: 9032451976 Enrollment ID: I20221205001317 |
| Provider Name | Linda Idun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609047844 PECOS PAC ID: 8224109145 Enrollment ID: I20221206000289 |
| Provider Name | Riki Lee Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104541150 PECOS PAC ID: 3870962301 Enrollment ID: I20221206000720 |
| Provider Name | Fabio Alberto Barrera Pena |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487038105 PECOS PAC ID: 8325397516 Enrollment ID: I20221210000207 |
| Provider Name | Bradley Bowles |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1922458892 PECOS PAC ID: 4486941945 Enrollment ID: I20221214002860 |
| Provider Name | Samuel Kimani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053576496 PECOS PAC ID: 8628203882 Enrollment ID: I20221215000809 |
| Provider Name | Wanda Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720212350 PECOS PAC ID: 1355592916 Enrollment ID: I20221215000889 |
| Provider Name | Memory Gunsaru |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891081303 PECOS PAC ID: 5496124372 Enrollment ID: I20221215002390 |
| Provider Name | Benjamen Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255416558 PECOS PAC ID: 3173799491 Enrollment ID: I20221217000051 |
| Provider Name | Frank Bonpietro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861835670 PECOS PAC ID: 7618241548 Enrollment ID: I20221224000153 |
| Provider Name | Murtuza Habeeb |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1881897205 PECOS PAC ID: 0345370664 Enrollment ID: I20230105000940 |
| Provider Name | Mohanad Abu Speitan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942563820 PECOS PAC ID: 7618286675 Enrollment ID: I20230124001756 |
| Provider Name | Nida Junaid |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1053678755 PECOS PAC ID: 5597037986 Enrollment ID: I20230214001074 |
| Provider Name | Amr Aly Ahmed El-aawar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780065599 PECOS PAC ID: 2668723875 Enrollment ID: I20230223002935 |
| Provider Name | Paige Soper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205541588 PECOS PAC ID: 6002289105 Enrollment ID: I20230309002495 |
| Provider Name | Sabrina Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750085064 PECOS PAC ID: 5698130193 Enrollment ID: I20230607000717 |
| Provider Name | Karlee Ann Heilig |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1851099311 PECOS PAC ID: 8921466897 Enrollment ID: I20230626000329 |
| Provider Name | Patrick Duffy |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1477726271 PECOS PAC ID: 2264599869 Enrollment ID: I20230705000401 |
| Provider Name | Miesca Mcfarland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902435860 PECOS PAC ID: 2668803693 Enrollment ID: I20230718001045 |
| Provider Name | Mark Morasch |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1790719219 PECOS PAC ID: 0648300533 Enrollment ID: I20230719003543 |
| Provider Name | Noureddine El Moghrabi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124655378 PECOS PAC ID: 0244690394 Enrollment ID: I20230720002125 |
| Provider Name | Manuel Ramos Ramirez |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1790190296 PECOS PAC ID: 5395046296 Enrollment ID: I20230721001640 |
| Provider Name | Cindy Sturt |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1073838173 PECOS PAC ID: 0042342719 Enrollment ID: I20230727000943 |
| Provider Name | Luke George Foley Smith |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1912382987 PECOS PAC ID: 5597126789 Enrollment ID: I20230803004044 |
| Provider Name | Rene Mosada |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013906759 PECOS PAC ID: 4789670423 Enrollment ID: I20230804000636 |
| Provider Name | Shuruk Haib |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124649033 PECOS PAC ID: 0042672065 Enrollment ID: I20230808002511 |
| Provider Name | Lisa Xunzhuo Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154000495 PECOS PAC ID: 6800258625 Enrollment ID: I20230810003290 |
| Provider Name | Umer Muhammad |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629698865 PECOS PAC ID: 1557780947 Enrollment ID: I20230815000414 |
| Provider Name | Reona Kenai Sowers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154946879 PECOS PAC ID: 5799147187 Enrollment ID: I20230817000150 |
| Provider Name | Jacqueline Ann Marie Ford |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164085023 PECOS PAC ID: 6507228822 Enrollment ID: I20230817001630 |
| Provider Name | Jaron Richard Nielson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992332035 PECOS PAC ID: 5395107635 Enrollment ID: I20230817002644 |
| Provider Name | Muhammad Saad Farooq |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215546676 PECOS PAC ID: 6901268127 Enrollment ID: I20230818001952 |
| Provider Name | Adam Olszewski |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1164818753 PECOS PAC ID: 9436479516 Enrollment ID: I20230829000651 |
| Provider Name | Vonzell Williams |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1861674921 PECOS PAC ID: 4082884333 Enrollment ID: I20230829000714 |
| Provider Name | Christopher D'silva |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285254722 PECOS PAC ID: 4183011406 Enrollment ID: I20230830004264 |
| Provider Name | Dalton Vance Hoose |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578192837 PECOS PAC ID: 3870957889 Enrollment ID: I20230908003527 |
| Provider Name | Shida Bangash |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871159541 PECOS PAC ID: 9638408727 Enrollment ID: I20230921001219 |
| Provider Name | Heather R Heady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801477070 PECOS PAC ID: 9335557859 Enrollment ID: I20230926001978 |
| Provider Name | Rime Mehannek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811500101 PECOS PAC ID: 2668826066 Enrollment ID: I20231003001927 |
| Provider Name | Hassan A Hassan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1285862185 PECOS PAC ID: 9133353576 Enrollment ID: I20231222001398 |
| Provider Name | Olubunmi O Esan |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1558795377 PECOS PAC ID: 6103131487 Enrollment ID: I20231222002062 |
| Provider Name | Lauren Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336926047 PECOS PAC ID: 5294184578 Enrollment ID: I20240104003231 |
| Provider Name | Michelle L Jones |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760764229 PECOS PAC ID: 4880826841 Enrollment ID: I20240119001101 |
| Provider Name | Bassem Koleilat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578680831 PECOS PAC ID: 1456410349 Enrollment ID: I20240131003155 |
| Provider Name | Omid Hajiseyed Javadi |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1720032808 PECOS PAC ID: 6507878378 Enrollment ID: I20240212001825 |
| Provider Name | Emilyn Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205604261 PECOS PAC ID: 0345685111 Enrollment ID: I20240302000409 |
| Provider Name | Arielle Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437913514 PECOS PAC ID: 5092152041 Enrollment ID: I20240326001882 |
| Provider Name | Kevin L Wagner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821620451 PECOS PAC ID: 9931539574 Enrollment ID: I20240404001577 |
| Provider Name | Keane Mccullum |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841793510 PECOS PAC ID: 2466801709 Enrollment ID: I20240422002286 |
| Provider Name | Patrick Martin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205013919 PECOS PAC ID: 5698813624 Enrollment ID: I20240502000330 |
| Provider Name | Jeffry Kriegshauser |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265416861 PECOS PAC ID: 5092856005 Enrollment ID: I20240509002956 |
| Provider Name | Amber N Billiard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629844030 PECOS PAC ID: 5890137376 Enrollment ID: I20240529003548 |
Joplin Mo Caregiving Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1412 S Joplin Ave, Joplin, MO 64801 Phone: 417-392-0913 | |
Family Health Center Of Joplin Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2504 S Jackson Ave, Joplin, MO 64804 Phone: 417-624-4060 Fax: 417-624-6131 | |
Healthsource Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 E 32nd St Ste 5, Joplin, MO 64804 Phone: 417-623-8187 Fax: 417-623-9011 | |
Joplin Urgent Care Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2700 N Range Line, Suite 100, Joplin, MO 64801 Phone: 417-782-4300 Fax: 417-782-5870 | |
Cornerstone Medical, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2613 S Main St Ste D, Joplin, MO 64804 Phone: 417-624-8730 | |
Thomas K Hamilton, Do P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2807 Arizona Ave, Suite 2, Joplin, MO 64804 Phone: 417-781-6722 | |
Physicians Medical Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2700 Mcclelland Blvd, Bldg. B Ste. 216, Joplin, MO 64804 Phone: 417-627-9600 Fax: 417-627-9632 |