| Ochsner Mississippi, Llc | |
|
149 Drinkwater Rd Bay Saint Louis MS 39520-1658 | |
| (228) 220-5200 | |
| (228) 467-8799 |
| Full Name | Ochsner Mississippi, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 149 Drinkwater Rd, Bay Saint Louis, Mississippi |
| Authorized Official Name and Position | Eduardo Benitez (DIRECTOR) |
| Authorized Official Contact | 5044300025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ochsner Mississippi, Llc 1514 Jefferson Hwy New Orleans LA 70121-2429 Ph: () - | Ochsner Mississippi, Llc 149 Drinkwater Rd Bay Saint Louis MS 39520-1658 Ph: (228) 220-5200 |
| NPI Number | 1538674239 |
|---|---|
| Provider Enumeration Date | 12/05/2017 |
| Last Update Date | 05/21/2024 |
| Medicare PECOS PAC ID | 0143580993 |
|---|---|
| Medicare Enrollment ID | O20180216000366 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538674239 | NPI | - | NPPES |
| 09627255 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Cyril Vk Bethala |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1528178415 PECOS PAC ID: 7214922301 Enrollment ID: I20040419000053 |
| Provider Name | Lawrence L Haber |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962441352 PECOS PAC ID: 5890782783 Enrollment ID: I20040430000918 |
| Provider Name | Stephen Baker |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013011303 PECOS PAC ID: 2466440573 Enrollment ID: I20040505001201 |
| Provider Name | William B Troutman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1538195805 PECOS PAC ID: 2163403411 Enrollment ID: I20040525000331 |
| Provider Name | Nancy Bladsacker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336309921 PECOS PAC ID: 1153300207 Enrollment ID: I20040714000571 |
| Provider Name | Magdy Gorgi-mikhail |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619993367 PECOS PAC ID: 8123095361 Enrollment ID: I20040915001233 |
| Provider Name | Joseph D Hajjar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720046121 PECOS PAC ID: 9133188279 Enrollment ID: I20041005001055 |
| Provider Name | Shahira Hanna |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720025968 PECOS PAC ID: 8729043773 Enrollment ID: I20041201000532 |
| Provider Name | Jeffrey R Benzing |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1255332458 PECOS PAC ID: 5890734768 Enrollment ID: I20050503000388 |
| Provider Name | Tracy G Benzing |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1225020498 PECOS PAC ID: 3072552942 Enrollment ID: I20050503000460 |
| Provider Name | Mary Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861522807 PECOS PAC ID: 8820031537 Enrollment ID: I20050603000499 |
| Provider Name | Laura C Singley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023064276 PECOS PAC ID: 5597781146 Enrollment ID: I20051021000879 |
| Provider Name | Richard T Lane |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1447261805 PECOS PAC ID: 9931116803 Enrollment ID: I20060317000183 |
| Provider Name | Hoshall Barrett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932100898 PECOS PAC ID: 8325042856 Enrollment ID: I20060914000177 |
| Provider Name | William Frederick Krooss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588653901 PECOS PAC ID: 5193778090 Enrollment ID: I20060920000029 |
| Provider Name | Roberto H Lopez-santini |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316960867 PECOS PAC ID: 1951308709 Enrollment ID: I20061108000721 |
| Provider Name | Peter Michael Lucore |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841238557 PECOS PAC ID: 5991723066 Enrollment ID: I20061207000132 |
| Provider Name | Eric J Letonoff |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306872171 PECOS PAC ID: 9133120231 Enrollment ID: I20070116000175 |
| Provider Name | Earnest C Simmons |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598751281 PECOS PAC ID: 9335170984 Enrollment ID: I20070301000216 |
| Provider Name | Carl Ramsey |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1003884305 PECOS PAC ID: 7719953025 Enrollment ID: I20070430000641 |
| Provider Name | Donald K Gaddy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659358869 PECOS PAC ID: 7315948163 Enrollment ID: I20070514000383 |
| Provider Name | Charles L Robinson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487631750 PECOS PAC ID: 6608973466 Enrollment ID: I20070514000422 |
| Provider Name | Mark Morgan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1629042957 PECOS PAC ID: 7012912215 Enrollment ID: I20070530000599 |
| Provider Name | Kimsey M Cavalier |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588775795 PECOS PAC ID: 3375641020 Enrollment ID: I20070605000126 |
| Provider Name | James E Corder |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1285656850 PECOS PAC ID: 4082714407 Enrollment ID: I20070713000163 |
| Provider Name | Kathrine I Gaddy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538287479 PECOS PAC ID: 4183724339 Enrollment ID: I20070717000468 |
| Provider Name | Robin H Schwartz |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1518990266 PECOS PAC ID: 4789774324 Enrollment ID: I20071219000426 |
| Provider Name | Peter J Casano |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1134239171 PECOS PAC ID: 1052493996 Enrollment ID: I20080130000585 |
| Provider Name | Kimberly M Williams |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1235107004 PECOS PAC ID: 6305930116 Enrollment ID: I20080207000179 |
| Provider Name | Ajay A Acharya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831201862 PECOS PAC ID: 0648349902 Enrollment ID: I20080513000597 |
| Provider Name | Frederick T Duggan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1003893652 PECOS PAC ID: 3678643681 Enrollment ID: I20080604000006 |
| Provider Name | Alexandra Shaye Brown |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1669640850 PECOS PAC ID: 3173695640 Enrollment ID: I20080630000108 |
| Provider Name | Brian R Pitre |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295779007 PECOS PAC ID: 8123193679 Enrollment ID: I20080818000416 |
| Provider Name | Brian Anthony |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356349401 PECOS PAC ID: 7113086810 Enrollment ID: I20081111000076 |
| Provider Name | Barbara Denise Franceski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134377187 PECOS PAC ID: 0749342343 Enrollment ID: I20081216000295 |
| Provider Name | Connie B Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629136221 PECOS PAC ID: 7113080284 Enrollment ID: I20090115000421 |
| Provider Name | Aqib Sultan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841267598 PECOS PAC ID: 0648209577 Enrollment ID: I20090505000295 |
| Provider Name | Erick Blaudeau |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255340949 PECOS PAC ID: 3870509672 Enrollment ID: I20090506000076 |
| Provider Name | Joel Kavanagh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740391390 PECOS PAC ID: 7315098530 Enrollment ID: I20090630000188 |
| Provider Name | James W Embry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154509628 PECOS PAC ID: 0143393926 Enrollment ID: I20090805000561 |
| Provider Name | Rachel L Rauls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003055617 PECOS PAC ID: 8527113281 Enrollment ID: I20090901000368 |
| Provider Name | Lisa H Nicoletti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427050822 PECOS PAC ID: 5193778439 Enrollment ID: I20100421000230 |
| Provider Name | Hans Warner Adams |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1194811471 PECOS PAC ID: 5193849289 Enrollment ID: I20100826000021 |
| Provider Name | Tracy Blair Pittman |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1942207014 PECOS PAC ID: 4183790496 Enrollment ID: I20101011000233 |
| Provider Name | Joel Roy Brunt |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1689672156 PECOS PAC ID: 0648346957 Enrollment ID: I20101011000292 |
| Provider Name | Paul Gerard Matherne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730245739 PECOS PAC ID: 1658404512 Enrollment ID: I20101015000013 |
| Provider Name | Richard J Orange |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164514915 PECOS PAC ID: 0143321182 Enrollment ID: I20101029000762 |
| Provider Name | Jami C Rutherford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629300231 PECOS PAC ID: 0446439509 Enrollment ID: I20110121000868 |
| Provider Name | Carricka Cartrica D Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538469689 PECOS PAC ID: 5294919064 Enrollment ID: I20110404000369 |
| Provider Name | Lamar Davis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003006206 PECOS PAC ID: 3779761119 Enrollment ID: I20110707000119 |
| Provider Name | Amber Mcilwain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336378819 PECOS PAC ID: 1759569197 Enrollment ID: I20110707000140 |
| Provider Name | Casey M Favre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073806246 PECOS PAC ID: 4587836044 Enrollment ID: I20111006000185 |
| Provider Name | Mary Diane Martin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356443220 PECOS PAC ID: 5799959425 Enrollment ID: I20111115000724 |
| Provider Name | Becky F Hollibaugh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982618369 PECOS PAC ID: 9032110036 Enrollment ID: I20111201000175 |
| Provider Name | George R Smith |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063709418 PECOS PAC ID: 4385811652 Enrollment ID: I20120127000356 |
| Provider Name | Terry Pummer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528056637 PECOS PAC ID: 2769418698 Enrollment ID: I20120726000402 |
| Provider Name | Ronald Boa Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245571124 PECOS PAC ID: 5991945115 Enrollment ID: I20130712000068 |
| Provider Name | Michael T Friel |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1265698195 PECOS PAC ID: 7416097845 Enrollment ID: I20131126000298 |
| Provider Name | Mario A Nievas |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043553944 PECOS PAC ID: 1951549518 Enrollment ID: I20140213001006 |
| Provider Name | Glenn M Polin |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1598928418 PECOS PAC ID: 8224162151 Enrollment ID: I20140221000462 |
| Provider Name | Christie Theriot |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255643268 PECOS PAC ID: 5698907327 Enrollment ID: I20140411001551 |
| Provider Name | Michele Q Pisciotta |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235116401 PECOS PAC ID: 5294821880 Enrollment ID: I20140710000126 |
| Provider Name | Melissa A Wheat |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1063619047 PECOS PAC ID: 1153588629 Enrollment ID: I20141001000348 |
| Provider Name | Gachavis Green |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1376848077 PECOS PAC ID: 4789815069 Enrollment ID: I20141013001609 |
| Provider Name | Esteban O Romano |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1386643682 PECOS PAC ID: 1052316387 Enrollment ID: I20141023002208 |
| Provider Name | Mahmoud Daftary |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1063411361 PECOS PAC ID: 4688728504 Enrollment ID: I20141024001963 |
| Provider Name | Richard T Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003151945 PECOS PAC ID: 6507010741 Enrollment ID: I20141031001453 |
| Provider Name | Andrew Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013204742 PECOS PAC ID: 8527280809 Enrollment ID: I20141121001066 |
| Provider Name | Jennifer C Chamberlain |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1265669295 PECOS PAC ID: 6608090444 Enrollment ID: I20150223000997 |
| Provider Name | Brittany Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073905923 PECOS PAC ID: 8426375106 Enrollment ID: I20150317001190 |
| Provider Name | Stephen J Fortunato |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669422440 PECOS PAC ID: 9638081995 Enrollment ID: I20150514000665 |
| Provider Name | Cierra Celeste Green |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063709525 PECOS PAC ID: 7416171855 Enrollment ID: I20150918001924 |
| Provider Name | David P Taylor |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508186990 PECOS PAC ID: 0547409294 Enrollment ID: I20151002001868 |
| Provider Name | Kevin Michael Doulens |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1447263694 PECOS PAC ID: 7113023334 Enrollment ID: I20151216000697 |
| Provider Name | Mary Boyte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750756367 PECOS PAC ID: 7416259676 Enrollment ID: I20160105000813 |
| Provider Name | Joanna Bayles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629365358 PECOS PAC ID: 9638390529 Enrollment ID: I20160229000059 |
| Provider Name | Sarah Barowka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396184909 PECOS PAC ID: 4385934900 Enrollment ID: I20160609001000 |
| Provider Name | Asahel L Gridley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578723599 PECOS PAC ID: 2264666742 Enrollment ID: I20160727001143 |
| Provider Name | Gabriel A Vidal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871788216 PECOS PAC ID: 9335291020 Enrollment ID: I20160806000139 |
| Provider Name | Shanen Wangler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710376611 PECOS PAC ID: 7012234768 Enrollment ID: I20160922000720 |
| Provider Name | Jennifer F Cacioppo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396290607 PECOS PAC ID: 8527346220 Enrollment ID: I20161101001061 |
| Provider Name | Richard Zweifler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295774347 PECOS PAC ID: 4486725603 Enrollment ID: I20170104000594 |
| Provider Name | Lesley Meng |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1144287137 PECOS PAC ID: 0345215026 Enrollment ID: I20170106000382 |
| Provider Name | Micah A Ladner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285187930 PECOS PAC ID: 0749566511 Enrollment ID: I20170410001168 |
| Provider Name | Spencer Richardson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942564315 PECOS PAC ID: 8921324047 Enrollment ID: I20170629002227 |
| Provider Name | Joseph R Biggio |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437104668 PECOS PAC ID: 4688613607 Enrollment ID: I20170905001247 |
| Provider Name | Ashley N Dean-reaves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962950303 PECOS PAC ID: 1951675651 Enrollment ID: I20170919003070 |
| Provider Name | Mary Catherine Hess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346249570 PECOS PAC ID: 6901978212 Enrollment ID: I20170922001209 |
| Provider Name | Kimberly Choina-karamat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962704957 PECOS PAC ID: 1254573322 Enrollment ID: I20171018000449 |
| Provider Name | Koteswara Pothineni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093903726 PECOS PAC ID: 9436232600 Enrollment ID: I20171116000196 |
| Provider Name | Ratnakar Pernenkil |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386647782 PECOS PAC ID: 5799727418 Enrollment ID: I20171214001949 |
| Provider Name | Erin Quave |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1629517461 PECOS PAC ID: 3678831922 Enrollment ID: I20171214002948 |
| Provider Name | Jessica Guin Piediscalzo |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992092001 PECOS PAC ID: 7416129499 Enrollment ID: I20180215000480 |
| Provider Name | Joseph Kulpeksa |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154388056 PECOS PAC ID: 9234125378 Enrollment ID: I20180329000231 |
| Provider Name | Laurie Ann Bishop |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508964990 PECOS PAC ID: 3577553478 Enrollment ID: I20180420000295 |
| Provider Name | Richard W Mankinen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639379209 PECOS PAC ID: 6608032131 Enrollment ID: I20180423001571 |
| Provider Name | Ujwal Meka |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023197142 PECOS PAC ID: 8820190010 Enrollment ID: I20180425002104 |
| Provider Name | Robert L Tassin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306014667 PECOS PAC ID: 4082764154 Enrollment ID: I20180430000764 |
| Provider Name | Jennifer Katherine Durst |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245558162 PECOS PAC ID: 0042456279 Enrollment ID: I20180509002126 |
| Provider Name | Alfred G Robichaux |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356397947 PECOS PAC ID: 5991600900 Enrollment ID: I20180510002374 |
| Provider Name | Dawn Marie Pekarek |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205846722 PECOS PAC ID: 5193756443 Enrollment ID: I20180514002529 |
| Provider Name | Lesley S Walsh |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1235310715 PECOS PAC ID: 7315118742 Enrollment ID: I20180817000171 |
| Provider Name | Jenna P Marciante |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972936219 PECOS PAC ID: 5395977391 Enrollment ID: I20180817001653 |
| Provider Name | Sharon K Tomberlin |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1003808700 PECOS PAC ID: 5991838179 Enrollment ID: I20180821002397 |
| Provider Name | Miranda Reeves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942798301 PECOS PAC ID: 3274882303 Enrollment ID: I20180822001426 |
| Provider Name | Matthew Proctor |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831326610 PECOS PAC ID: 9830313634 Enrollment ID: I20180906002724 |
| Provider Name | David Joseph Donaldson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962502591 PECOS PAC ID: 1355331240 Enrollment ID: I20180913001749 |
| Provider Name | George Garib |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1144413840 PECOS PAC ID: 8729350749 Enrollment ID: I20180925002311 |
| Provider Name | Gabrielle Deschamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225521982 PECOS PAC ID: 2769734797 Enrollment ID: I20181002003443 |
| Provider Name | Jessica Necaise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770079337 PECOS PAC ID: 2264784537 Enrollment ID: I20181015002586 |
| Provider Name | Vasanth Kumar Bethala |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548263999 PECOS PAC ID: 3375501562 Enrollment ID: I20181018000623 |
| Provider Name | James B Lam |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1598762536 PECOS PAC ID: 0244331320 Enrollment ID: I20181231001212 |
| Provider Name | Lauren Elizabeth Dunn |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881038305 PECOS PAC ID: 0446515878 Enrollment ID: I20190515000547 |
| Provider Name | Ann M Mclindon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710075742 PECOS PAC ID: 1850433038 Enrollment ID: I20190606001424 |
| Provider Name | Diego Arturo Lara |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891953741 PECOS PAC ID: 8325215189 Enrollment ID: I20190613000259 |
| Provider Name | Rebecca A F Phillips |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1447417159 PECOS PAC ID: 3476624677 Enrollment ID: I20190617002183 |
| Provider Name | Evangelos A Liokis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538187471 PECOS PAC ID: 0345243580 Enrollment ID: I20190617002778 |
| Provider Name | Joseph Tarsia |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619292356 PECOS PAC ID: 6406151729 Enrollment ID: I20190617003074 |
| Provider Name | Osvaldo A Camilo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902829898 PECOS PAC ID: 6204831399 Enrollment ID: I20190618000843 |
| Provider Name | Courtney Carol Jackson |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1588831952 PECOS PAC ID: 7113091489 Enrollment ID: I20190618001419 |
| Provider Name | Patricia Thomas |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1366754970 PECOS PAC ID: 9436283744 Enrollment ID: I20190618001987 |
| Provider Name | Li Huang |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1912969452 PECOS PAC ID: 7315979093 Enrollment ID: I20190619001197 |
| Provider Name | Laura Ellen Bratton |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1770882672 PECOS PAC ID: 0446559843 Enrollment ID: I20190620000011 |
| Provider Name | Jacqueline Carter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336188960 PECOS PAC ID: 8527972488 Enrollment ID: I20190620000017 |
| Provider Name | William John Knox |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538362496 PECOS PAC ID: 6709986276 Enrollment ID: I20190620000409 |
| Provider Name | Kelly Sayle Davis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740386812 PECOS PAC ID: 7416042189 Enrollment ID: I20190627001661 |
| Provider Name | Amanda Yong Rowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013412139 PECOS PAC ID: 3870857337 Enrollment ID: I20190723001023 |
| Provider Name | Michael David Weiland |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003172248 PECOS PAC ID: 1759625965 Enrollment ID: I20190731000101 |
| Provider Name | Hristo S Shivarov |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1245639939 PECOS PAC ID: 3173852068 Enrollment ID: I20190830001695 |
| Provider Name | Sahiba Ahluwalia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962856419 PECOS PAC ID: 1355629817 Enrollment ID: I20190831000091 |
| Provider Name | Jessica Lynn Douglas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194188722 PECOS PAC ID: 0345538971 Enrollment ID: I20190906002922 |
| Provider Name | Rebecca Lynn Grob |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770040248 PECOS PAC ID: 9133461031 Enrollment ID: I20190909000889 |
| Provider Name | Tonye A Jones |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1326483678 PECOS PAC ID: 8325391899 Enrollment ID: I20190911000449 |
| Provider Name | Neilson Vuong Tran |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1093132938 PECOS PAC ID: 5395964548 Enrollment ID: I20190913001518 |
| Provider Name | Vineeth-joseph John Sankoorikal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396199840 PECOS PAC ID: 6800184102 Enrollment ID: I20190924000444 |
| Provider Name | Bria Goff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457904989 PECOS PAC ID: 4688906183 Enrollment ID: I20191104000414 |
| Provider Name | Jennifer S Stauter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144627316 PECOS PAC ID: 1850617655 Enrollment ID: I20191107002449 |
| Provider Name | Lynsey J Cox |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487941225 PECOS PAC ID: 3971731258 Enrollment ID: I20191115000039 |
| Provider Name | Taylor Ronquillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790347540 PECOS PAC ID: 6204269020 Enrollment ID: I20191210001309 |
| Provider Name | Ryan L Hebert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841533437 PECOS PAC ID: 6800010422 Enrollment ID: I20200115002944 |
| Provider Name | Mary E Lobrano |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164427753 PECOS PAC ID: 7911968383 Enrollment ID: I20200123002869 |
| Provider Name | David B Mcnease |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285267476 PECOS PAC ID: 5193154581 Enrollment ID: I20200406003310 |
| Provider Name | Ayslin Beckett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083769236 PECOS PAC ID: 6204973308 Enrollment ID: I20200408003007 |
| Provider Name | Alisa M Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457986564 PECOS PAC ID: 3577993492 Enrollment ID: I20200416002970 |
| Provider Name | Elise A Occhipinti |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1801091962 PECOS PAC ID: 3779683149 Enrollment ID: I20200518001440 |
| Provider Name | Cody Lee Holliman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063042448 PECOS PAC ID: 1557782950 Enrollment ID: I20200610000892 |
| Provider Name | Brittany Janel-helen Roussel |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1104485390 PECOS PAC ID: 9032444252 Enrollment ID: I20200619000671 |
| Provider Name | Patricia Gremillion |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417053588 PECOS PAC ID: 1456446889 Enrollment ID: I20200708000236 |
| Provider Name | Jennifer Dyanne Peoples |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205305455 PECOS PAC ID: 7012335334 Enrollment ID: I20200917001628 |
| Provider Name | Michele Lajaunie |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972514784 PECOS PAC ID: 4587650635 Enrollment ID: I20201007003329 |
| Provider Name | Jane Elizabeth Curry |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558418046 PECOS PAC ID: 8729303441 Enrollment ID: I20201020002690 |
| Provider Name | Dee Malkerneker |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1619024593 PECOS PAC ID: 7618146507 Enrollment ID: I20201207002125 |
| Provider Name | Cadence Griffing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245860725 PECOS PAC ID: 7214367622 Enrollment ID: I20201228000331 |
| Provider Name | Darshan Trivedi |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1366861023 PECOS PAC ID: 9335569318 Enrollment ID: I20210106001476 |
| Provider Name | Betty Chung |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1578820213 PECOS PAC ID: 7012342991 Enrollment ID: I20210120000026 |
| Provider Name | Ryan M Rhodes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245674118 PECOS PAC ID: 0143455360 Enrollment ID: I20210120001997 |
| Provider Name | Theresa Nuttli |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1346484235 PECOS PAC ID: 8628369212 Enrollment ID: I20210121002002 |
| Provider Name | Xinyu Wu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1114305232 PECOS PAC ID: 5496067605 Enrollment ID: I20210122001836 |
| Provider Name | Kristen Gurtner |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1962899633 PECOS PAC ID: 8022324508 Enrollment ID: I20210204000248 |
| Provider Name | Julie H Galloway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215526017 PECOS PAC ID: 3971918962 Enrollment ID: I20210225001649 |
| Provider Name | Aaron D Duracher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053925487 PECOS PAC ID: 5496161622 Enrollment ID: I20210312000167 |
| Provider Name | Dana Brown-acker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275044331 PECOS PAC ID: 5698030070 Enrollment ID: I20210331000726 |
| Provider Name | Deborah Kimberlin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093742546 PECOS PAC ID: 4587567813 Enrollment ID: I20210409000954 |
| Provider Name | Supriya Donthamsetty |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1922252576 PECOS PAC ID: 5799068045 Enrollment ID: I20210412000059 |
| Provider Name | Sherrie Ann Dean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467046581 PECOS PAC ID: 9335557297 Enrollment ID: I20210414002578 |
| Provider Name | Michael Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508470568 PECOS PAC ID: 8022427210 Enrollment ID: I20210428002721 |
| Provider Name | Aimee G Sell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669581609 PECOS PAC ID: 8729089610 Enrollment ID: I20210519000266 |
| Provider Name | Ifeanyi Iwuchukwu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215169974 PECOS PAC ID: 6608056312 Enrollment ID: I20210527001061 |
| Provider Name | Shaun Xiao |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1063726206 PECOS PAC ID: 0345476388 Enrollment ID: I20210527002250 |
| Provider Name | Layla Alizadeh |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1124331129 PECOS PAC ID: 0840434627 Enrollment ID: I20210604000363 |
| Provider Name | Ronda Sanders |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1285877340 PECOS PAC ID: 4880968080 Enrollment ID: I20210604001038 |
| Provider Name | Kim Mayhall |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1427349448 PECOS PAC ID: 1456649722 Enrollment ID: I20210604001085 |
| Provider Name | Courtney Hanna |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1467770214 PECOS PAC ID: 4587800206 Enrollment ID: I20210712002297 |
| Provider Name | Jonathan Cagle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659963882 PECOS PAC ID: 7113329962 Enrollment ID: I20210715002619 |
| Provider Name | Michael Hulin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710278247 PECOS PAC ID: 7810135860 Enrollment ID: I20210802000820 |
| Provider Name | Mary Hulin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679993257 PECOS PAC ID: 5496184194 Enrollment ID: I20210803003468 |
| Provider Name | Melanie Williams |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013351774 PECOS PAC ID: 2860783768 Enrollment ID: I20210804003014 |
| Provider Name | Abhishek Garg |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891135794 PECOS PAC ID: 0840434510 Enrollment ID: I20210825000065 |
| Provider Name | Katie Scott |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1801258918 PECOS PAC ID: 8921393992 Enrollment ID: I20210831002101 |
| Provider Name | Leslie Weeks |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811199102 PECOS PAC ID: 9234528613 Enrollment ID: I20211105002478 |
| Provider Name | Joseph Pedone |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093816696 PECOS PAC ID: 9234035940 Enrollment ID: I20211115002940 |
| Provider Name | Zohreh Mancil |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1386197184 PECOS PAC ID: 9537403985 Enrollment ID: I20211116002696 |
| Provider Name | Courtney A Clark |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790100113 PECOS PAC ID: 4284023821 Enrollment ID: I20211119000917 |
| Provider Name | Giuseppe Ciccotto |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275858540 PECOS PAC ID: 7719102482 Enrollment ID: I20211215000971 |
| Provider Name | Muhammad Khan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053670414 PECOS PAC ID: 1254633860 Enrollment ID: I20211215002213 |
| Provider Name | Aimee Goodier |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1609069384 PECOS PAC ID: 9436329364 Enrollment ID: I20211216000758 |
| Provider Name | Andrea Olofson |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1063823805 PECOS PAC ID: 5092012054 Enrollment ID: I20211216001061 |
| Provider Name | Alyse Jewel Prieur Hussey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093485070 PECOS PAC ID: 1850782889 Enrollment ID: I20211229001012 |
| Provider Name | Sadie Slocum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053073007 PECOS PAC ID: 0345631313 Enrollment ID: I20211230000046 |
| Provider Name | Megan Weidemann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962013581 PECOS PAC ID: 1355753146 Enrollment ID: I20220420002775 |
| Provider Name | Karen Elizabeth Mcday |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396496253 PECOS PAC ID: 8820475254 Enrollment ID: I20220524001502 |
| Provider Name | Kristen Stricklin |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1629658687 PECOS PAC ID: 2668850074 Enrollment ID: I20220525002041 |
| Provider Name | Angela Lafontaine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962154062 PECOS PAC ID: 6608255427 Enrollment ID: I20220623003108 |
| Provider Name | Charit A Fares |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194952119 PECOS PAC ID: 7113178880 Enrollment ID: I20220808001596 |
| Provider Name | Timothy K Copeland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780188151 PECOS PAC ID: 7315374865 Enrollment ID: I20220809002381 |
| Provider Name | Hassan A Fares |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114246105 PECOS PAC ID: 2961644752 Enrollment ID: I20220810002265 |
| Provider Name | Denise Elaine Powell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982163960 PECOS PAC ID: 9537583174 Enrollment ID: I20220912001488 |
| Provider Name | Dona M Kioseff |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285122622 PECOS PAC ID: 2860743770 Enrollment ID: I20220916002658 |
| Provider Name | Claudia Nkeih Sampong |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477080836 PECOS PAC ID: 0042696858 Enrollment ID: I20221003000418 |
| Provider Name | Rene Hinton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376859975 PECOS PAC ID: 8022256668 Enrollment ID: I20221110000765 |
| Provider Name | Elizabeth D Cole |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265470900 PECOS PAC ID: 3274529201 Enrollment ID: I20221122000909 |
| Provider Name | Cheryl Hickey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831630144 PECOS PAC ID: 7911276316 Enrollment ID: I20221122003443 |
| Provider Name | Christopher G Palmer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1366434078 PECOS PAC ID: 0244299014 Enrollment ID: I20221128000136 |
| Provider Name | Jared Robertson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265428734 PECOS PAC ID: 2860467354 Enrollment ID: I20221128001997 |
| Provider Name | Brittany Lander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639803430 PECOS PAC ID: 3870962590 Enrollment ID: I20221219002422 |
| Provider Name | Heather Nicole Moran |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1295450690 PECOS PAC ID: 4880064062 Enrollment ID: I20230104001663 |
| Provider Name | Jane C Martin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801231873 PECOS PAC ID: 0749552602 Enrollment ID: I20230326000023 |
| Provider Name | Roberto Calix |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891054094 PECOS PAC ID: 2062708480 Enrollment ID: I20230327002107 |
| Provider Name | Ryan Durel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578822979 PECOS PAC ID: 2668696428 Enrollment ID: I20230417002653 |
| Provider Name | Ajsa Nikolic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265487789 PECOS PAC ID: 2466417647 Enrollment ID: I20230502000972 |
| Provider Name | Katie S Mason |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962768127 PECOS PAC ID: 5799087409 Enrollment ID: I20230503001617 |
| Provider Name | Rashad Saeed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477604296 PECOS PAC ID: 7315331691 Enrollment ID: I20230504001897 |
| Provider Name | Effie Branton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356365217 PECOS PAC ID: 0547331191 Enrollment ID: I20230505000818 |
| Provider Name | Jill Rayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568983468 PECOS PAC ID: 7810263415 Enrollment ID: I20230512000816 |
| Provider Name | Angelina M. Leblanc |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1457374928 PECOS PAC ID: 5395630248 Enrollment ID: I20230516000743 |
| Provider Name | Debra Bermudez |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1366634867 PECOS PAC ID: 1951498815 Enrollment ID: I20230516001859 |
| Provider Name | Karee Balfantz |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1629596325 PECOS PAC ID: 1951676998 Enrollment ID: I20230516002920 |
| Provider Name | Rebecca Dupuy |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1679739767 PECOS PAC ID: 9234453358 Enrollment ID: I20230516003169 |
| Provider Name | Vicky Morales |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1265679070 PECOS PAC ID: 0042365256 Enrollment ID: I20230516003709 |
| Provider Name | William W Bivin |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1295091361 PECOS PAC ID: 6608189857 Enrollment ID: I20230605001953 |
| Provider Name | Aurash Khoobehi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1548535883 PECOS PAC ID: 7012212988 Enrollment ID: I20230612000604 |
| Provider Name | Michael A Mclarty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376162438 PECOS PAC ID: 3678996634 Enrollment ID: I20230830001311 |
| Provider Name | Tong Yang |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1811296718 PECOS PAC ID: 7315218161 Enrollment ID: I20230901003196 |
| Provider Name | Jean-victor Bonnaig |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710240775 PECOS PAC ID: 7719116672 Enrollment ID: I20230922000918 |
| Provider Name | Kang-lin Tsai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760010045 PECOS PAC ID: 3476974726 Enrollment ID: I20230925002424 |
| Provider Name | Taylor N Hairston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255950416 PECOS PAC ID: 7315361326 Enrollment ID: I20231121001727 |
| Provider Name | Son Dang |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1114954849 PECOS PAC ID: 5496855983 Enrollment ID: I20240117002750 |
| Provider Name | Michelle Gibbs |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1801029897 PECOS PAC ID: 9436297157 Enrollment ID: I20240118004615 |
| Provider Name | Ryan Adell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578060059 PECOS PAC ID: 5597013680 Enrollment ID: I20240209000784 |
| Provider Name | Stephanie Raynell Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750844106 PECOS PAC ID: 8527396373 Enrollment ID: I20240509003907 |
| Provider Name | Anthony Scurria |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1962579573 PECOS PAC ID: 7517935638 Enrollment ID: I20240521003089 |
Ochsner Mississippi, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3068 Port And Harbor Dr, Bay Saint Louis, MS 39520 Phone: 228-533-9000 Fax: 228-395-1290 |