| Piedmont Specialty Hospital Billing Llc | |
|
1266 Highway 515 S Jasper GA 30143-4872 | |
| (770) 801-2500 | |
| (770) 803-2121 |
| Full Name | Piedmont Specialty Hospital Billing Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1266 Highway 515 S, Jasper, Georgia |
| Authorized Official Name and Position | Christy Aquino (DIRECTOR OF PROVIDER ENORLLMENT) |
| Authorized Official Contact | 4702713427 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Piedmont Specialty Hospital Billing Llc Po Box 102847 Atlanta GA 30368-2847 Ph: (770) 801-2500 | Piedmont Specialty Hospital Billing Llc 1266 Highway 515 S Jasper GA 30143-4872 Ph: (770) 801-2500 |
| NPI Number | 1699290510 |
|---|---|
| Provider Enumeration Date | 08/11/2017 |
| Last Update Date | 02/06/2023 |
| Medicare PECOS PAC ID | 4183986490 |
|---|---|
| Medicare Enrollment ID | O20180327001180 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699290510 | NPI | - | NPPES |
| 003202949A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| Provider Name | Sharon J White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205999877 PECOS PAC ID: 0345140513 Enrollment ID: I20040113000191 |
| Provider Name | Vijay M Patel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1336123439 PECOS PAC ID: 0648265595 Enrollment ID: I20040618000451 |
| Provider Name | Paul Zolty |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1033117940 PECOS PAC ID: 5092703819 Enrollment ID: I20040618000581 |
| Provider Name | Jimmy D Pruitt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346298262 PECOS PAC ID: 2567440720 Enrollment ID: I20040713000784 |
| Provider Name | Belinda E Marcus |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457440281 PECOS PAC ID: 1456325703 Enrollment ID: I20040823000763 |
| Provider Name | Carrie W Fleming |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467420307 PECOS PAC ID: 8729052931 Enrollment ID: I20040824000308 |
| Provider Name | Shankar Kandaswamy |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1689657181 PECOS PAC ID: 8325015431 Enrollment ID: I20041116000484 |
| Provider Name | David J Gower |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1881670180 PECOS PAC ID: 5092771105 Enrollment ID: I20041213000056 |
| Provider Name | Heather H Germann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841288925 PECOS PAC ID: 5698744209 Enrollment ID: I20041214000884 |
| Provider Name | Maureen Haley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1750483970 PECOS PAC ID: 2769478981 Enrollment ID: I20050224000171 |
| Provider Name | Samuel Szumstein |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790783603 PECOS PAC ID: 7012961022 Enrollment ID: I20050311000283 |
| Provider Name | Brett L Sandifer |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1285632190 PECOS PAC ID: 1951342229 Enrollment ID: I20050517000569 |
| Provider Name | Olumuyiwa Adeoye Rotimi Joshua |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144322157 PECOS PAC ID: 5991748048 Enrollment ID: I20050708000705 |
| Provider Name | Gayla J Dillard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649291659 PECOS PAC ID: 4183644149 Enrollment ID: I20051208000069 |
| Provider Name | Clifford P Settle |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1659373512 PECOS PAC ID: 4789607060 Enrollment ID: I20060112000667 |
| Provider Name | Brion J Lock |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1295785731 PECOS PAC ID: 0547279622 Enrollment ID: I20060418000588 |
| Provider Name | Donald Maynard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194772749 PECOS PAC ID: 3577575380 Enrollment ID: I20060619000027 |
| Provider Name | Mutinhima Moyo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497763015 PECOS PAC ID: 4486658119 Enrollment ID: I20060911000536 |
| Provider Name | Michael C Thompson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184732521 PECOS PAC ID: 1759387137 Enrollment ID: I20061006000375 |
| Provider Name | Neil A Epperly |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1447232715 PECOS PAC ID: 2769489004 Enrollment ID: I20061031000161 |
| Provider Name | Olufunsho Bankole |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487714911 PECOS PAC ID: 2668474164 Enrollment ID: I20070213000513 |
| Provider Name | Jorge B Pisarello |
|---|---|
| Provider Type | Practitioner - Undersea And Hyperbaric Medicine |
| Provider Identifiers | NPI Number: 1992795876 PECOS PAC ID: 8628017340 Enrollment ID: I20070409000466 |
| Provider Name | Charles C Lassiter |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1386671998 PECOS PAC ID: 9739285560 Enrollment ID: I20070510000413 |
| Provider Name | Walter S James |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1972552008 PECOS PAC ID: 2365533999 Enrollment ID: I20070810000174 |
| Provider Name | Rebecca L Bass |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861532103 PECOS PAC ID: 7113010349 Enrollment ID: I20070905000115 |
| Provider Name | Matthew Hoffman |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1982727749 PECOS PAC ID: 6204920598 Enrollment ID: I20070918000090 |
| Provider Name | Steven R Whitworth |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881694388 PECOS PAC ID: 7113004342 Enrollment ID: I20080411000290 |
| Provider Name | Angela D Swayne |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1790885960 PECOS PAC ID: 4880763200 Enrollment ID: I20080527000192 |
| Provider Name | Jermaine Marquette Jackson |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1225214745 PECOS PAC ID: 0345226239 Enrollment ID: I20080603000004 |
| Provider Name | Chad I Case |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1780898338 PECOS PAC ID: 7618047671 Enrollment ID: I20080603000008 |
| Provider Name | David R Schmidt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366440992 PECOS PAC ID: 4082785043 Enrollment ID: I20080618000488 |
| Provider Name | Chad E Miller |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1538373071 PECOS PAC ID: 4385712389 Enrollment ID: I20081003000443 |
| Provider Name | Georgi K Ralev |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447442256 PECOS PAC ID: 2466520044 Enrollment ID: I20081009000243 |
| Provider Name | Rosina I Ellington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184873549 PECOS PAC ID: 2264590868 Enrollment ID: I20081027000492 |
| Provider Name | Anthony Mwangi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1083604532 PECOS PAC ID: 3476535683 Enrollment ID: I20081103000245 |
| Provider Name | William R Kenny |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1780633818 PECOS PAC ID: 2062570518 Enrollment ID: I20081111000341 |
| Provider Name | Vithal Kusuma |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750375051 PECOS PAC ID: 9436053774 Enrollment ID: I20090122000674 |
| Provider Name | Alexander Gluzman |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1194900704 PECOS PAC ID: 8628128121 Enrollment ID: I20090603000541 |
| Provider Name | Kevin M Mcgill |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1144454497 PECOS PAC ID: 1658423470 Enrollment ID: I20090708000698 |
| Provider Name | Tatum S Mealing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316157076 PECOS PAC ID: 5597819193 Enrollment ID: I20090817000522 |
| Provider Name | Donald H Loebl |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1679787212 PECOS PAC ID: 3274689591 Enrollment ID: I20090928000560 |
| Provider Name | Bradley J Battaglia |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619125754 PECOS PAC ID: 7315085909 Enrollment ID: I20091119000438 |
| Provider Name | Steven B Vaughn |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1396727673 PECOS PAC ID: 5799788816 Enrollment ID: I20100210000055 |
| Provider Name | Connie A Trello |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1609858984 PECOS PAC ID: 2163425281 Enrollment ID: I20100210000062 |
| Provider Name | Benjamin C Rogers |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1528068046 PECOS PAC ID: 5799814059 Enrollment ID: I20100525000250 |
| Provider Name | Craig M Patterson |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1063624377 PECOS PAC ID: 4789716234 Enrollment ID: I20100719000441 |
| Provider Name | Judith A Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053452649 PECOS PAC ID: 2365542529 Enrollment ID: I20100728000336 |
| Provider Name | Joseph P Mims |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487694022 PECOS PAC ID: 7517091275 Enrollment ID: I20100817000428 |
| Provider Name | Bryant W Wilson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275573388 PECOS PAC ID: 8123152899 Enrollment ID: I20100817000619 |
| Provider Name | Christopher R Kuzniak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558418400 PECOS PAC ID: 3779607007 Enrollment ID: I20100824000416 |
| Provider Name | Stuart J Simon |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1225036122 PECOS PAC ID: 8820113640 Enrollment ID: I20100917000094 |
| Provider Name | Aristidis Iatridis |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1952309957 PECOS PAC ID: 3577688258 Enrollment ID: I20100917000932 |
| Provider Name | Steven Bobby Ellison |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1992724769 PECOS PAC ID: 9830214311 Enrollment ID: I20100921000969 |
| Provider Name | Carliss C Graham |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1841441458 PECOS PAC ID: 1456544618 Enrollment ID: I20101020000262 |
| Provider Name | Urviben R Patel |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1306053731 PECOS PAC ID: 4183817349 Enrollment ID: I20101020000264 |
| Provider Name | Absar A Mirza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265415541 PECOS PAC ID: 1153219027 Enrollment ID: I20101021001272 |
| Provider Name | Sriram Iyer Paramesh |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1912905860 PECOS PAC ID: 5193919660 Enrollment ID: I20101028000664 |
| Provider Name | Steven Edward Harris |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1346248267 PECOS PAC ID: 0143414193 Enrollment ID: I20101103000774 |
| Provider Name | Priya Dharshini Ravindran |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033167333 PECOS PAC ID: 1355371808 Enrollment ID: I20101229000440 |
| Provider Name | Mobin Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932319613 PECOS PAC ID: 3870649981 Enrollment ID: I20110112000649 |
| Provider Name | James S Franklin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891752960 PECOS PAC ID: 7517997786 Enrollment ID: I20110119000130 |
| Provider Name | Raxit R Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417118605 PECOS PAC ID: 9436338571 Enrollment ID: I20110121000627 |
| Provider Name | Russell A Flint |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962457895 PECOS PAC ID: 4284702432 Enrollment ID: I20110223001202 |
| Provider Name | Frank K Jones |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386644276 PECOS PAC ID: 4082897566 Enrollment ID: I20110321000699 |
| Provider Name | Trang Mai Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073825501 PECOS PAC ID: 9638352834 Enrollment ID: I20110325000296 |
| Provider Name | Susan M Mucha |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1447415906 PECOS PAC ID: 4082898044 Enrollment ID: I20110415000369 |
| Provider Name | Yodit Katrell Oliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508161555 PECOS PAC ID: 9032396411 Enrollment ID: I20110613000261 |
| Provider Name | Seth D Walker |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1104935469 PECOS PAC ID: 3870664014 Enrollment ID: I20110627000166 |
| Provider Name | Amy H Case |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1467664466 PECOS PAC ID: 0042488348 Enrollment ID: I20110712000259 |
| Provider Name | Nagamalar Raju |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285894188 PECOS PAC ID: 1355539982 Enrollment ID: I20110726000882 |
| Provider Name | Ryan Carrick |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1063542280 PECOS PAC ID: 3971784299 Enrollment ID: I20110823001034 |
| Provider Name | Ngozika Orjioke |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1275754731 PECOS PAC ID: 7315117140 Enrollment ID: I20110902000206 |
| Provider Name | Enoch B Lule |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013147107 PECOS PAC ID: 8325218019 Enrollment ID: I20110907001500 |
| Provider Name | Thomas C Woodyard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629002365 PECOS PAC ID: 6800931569 Enrollment ID: I20111020000620 |
| Provider Name | Babatunde Edun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154624427 PECOS PAC ID: 7517130107 Enrollment ID: I20111027000905 |
| Provider Name | David Green |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164607974 PECOS PAC ID: 5395911192 Enrollment ID: I20111228000582 |
| Provider Name | Charles B Hartley |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1659379642 PECOS PAC ID: 7719144484 Enrollment ID: I20120208000193 |
| Provider Name | David A Patrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457633968 PECOS PAC ID: 3678730090 Enrollment ID: I20120213000494 |
| Provider Name | Kimberly S Singleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609148758 PECOS PAC ID: 4385803956 Enrollment ID: I20120319000120 |
| Provider Name | Clark A Mcdonough |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1578531935 PECOS PAC ID: 1153585203 Enrollment ID: I20120621000214 |
| Provider Name | Kathryn Marie Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336389980 PECOS PAC ID: 2264624006 Enrollment ID: I20120918000908 |
| Provider Name | Shanthan Pendem |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1659425817 PECOS PAC ID: 4789609975 Enrollment ID: I20121115000278 |
| Provider Name | Jungyung Ko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760711774 PECOS PAC ID: 9234319112 Enrollment ID: I20130131000136 |
| Provider Name | Fredicia L Stembridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134467301 PECOS PAC ID: 1456505767 Enrollment ID: I20130213000348 |
| Provider Name | Taryn Prestidge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790032910 PECOS PAC ID: 8729223912 Enrollment ID: I20130315000370 |
| Provider Name | James M Stevens |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1265680730 PECOS PAC ID: 5294973608 Enrollment ID: I20130524000104 |
| Provider Name | Mayur C Patel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1164603676 PECOS PAC ID: 9335227446 Enrollment ID: I20130715000314 |
| Provider Name | David S Grenda |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1336344928 PECOS PAC ID: 9234379264 Enrollment ID: I20130724000581 |
| Provider Name | Ralitza T Martin |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1306011739 PECOS PAC ID: 9133361611 Enrollment ID: I20130813000394 |
| Provider Name | Salvador Ramos Camacho |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861790552 PECOS PAC ID: 0042452534 Enrollment ID: I20130813000511 |
| Provider Name | Gregory Evans |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1073788816 PECOS PAC ID: 6800039355 Enrollment ID: I20130830000519 |
| Provider Name | Carole J Lovering |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265783112 PECOS PAC ID: 8022251206 Enrollment ID: I20130909000352 |
| Provider Name | Mary A Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003244021 PECOS PAC ID: 0042446866 Enrollment ID: I20131126000450 |
| Provider Name | Michelle M Irwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851678817 PECOS PAC ID: 2668633884 Enrollment ID: I20140114000651 |
| Provider Name | Kalemah S Woolfolk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508121351 PECOS PAC ID: 7618106147 Enrollment ID: I20140204000667 |
| Provider Name | Sherika S Newman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740442599 PECOS PAC ID: 6103993233 Enrollment ID: I20140311001582 |
| Provider Name | Kanye Willis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437350527 PECOS PAC ID: 6103941620 Enrollment ID: I20140513002136 |
| Provider Name | Christie Maria Somers Arietti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508116740 PECOS PAC ID: 8921222431 Enrollment ID: I20140623002696 |
| Provider Name | Bradley D Hare |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013154632 PECOS PAC ID: 1658530753 Enrollment ID: I20140910000155 |
| Provider Name | Michael N Metry |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1124187695 PECOS PAC ID: 7113818410 Enrollment ID: I20140912000998 |
| Provider Name | Lawrence Eugene Wilson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1962633164 PECOS PAC ID: 3476773417 Enrollment ID: I20140925001539 |
| Provider Name | Jonathan Lawson |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1992933584 PECOS PAC ID: 5698913390 Enrollment ID: I20141009002500 |
| Provider Name | Lori G Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811398001 PECOS PAC ID: 3173845351 Enrollment ID: I20141124001974 |
| Provider Name | Laquita Martinez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609063239 PECOS PAC ID: 8527382464 Enrollment ID: I20150123000692 |
| Provider Name | Bridget R Mclendon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598167694 PECOS PAC ID: 6709101264 Enrollment ID: I20150205000268 |
| Provider Name | Deepak Kadiyala |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1417129610 PECOS PAC ID: 9335295823 Enrollment ID: I20150512000188 |
| Provider Name | Laura L Nannini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770874455 PECOS PAC ID: 9830401108 Enrollment ID: I20150630001735 |
| Provider Name | Sherley Samuels |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770873929 PECOS PAC ID: 7810203650 Enrollment ID: I20150825003633 |
| Provider Name | Clay D Ditty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316223829 PECOS PAC ID: 3971763426 Enrollment ID: I20151009001625 |
| Provider Name | Sebastian Circo |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1710275359 PECOS PAC ID: 7315113073 Enrollment ID: I20151027003205 |
| Provider Name | Angela Harvey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578953006 PECOS PAC ID: 6901107457 Enrollment ID: I20151229000848 |
| Provider Name | Maria E Traverso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619340965 PECOS PAC ID: 4486956539 Enrollment ID: I20160106000608 |
| Provider Name | Rhonda Findley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790153450 PECOS PAC ID: 9032412408 Enrollment ID: I20160119000459 |
| Provider Name | Brandon Lebron Griggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083072367 PECOS PAC ID: 2567767379 Enrollment ID: I20160216001602 |
| Provider Name | Ronald Collier |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942466750 PECOS PAC ID: 2466777602 Enrollment ID: I20160513001923 |
| Provider Name | Elizabeth A Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477959914 PECOS PAC ID: 1052601127 Enrollment ID: I20160601001726 |
| Provider Name | Roxana Coman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1568616498 PECOS PAC ID: 7719159284 Enrollment ID: I20160728001780 |
| Provider Name | Curtis J Coley |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1316102502 PECOS PAC ID: 9335217629 Enrollment ID: I20160817001601 |
| Provider Name | Ogbonna C Ogbu |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1184883985 PECOS PAC ID: 1951589134 Enrollment ID: I20160921002149 |
| Provider Name | Arvind J Ponnambalam |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1073704581 PECOS PAC ID: 7113178070 Enrollment ID: I20161019002063 |
| Provider Name | Neha Shashikant Shah |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1629251715 PECOS PAC ID: 7517154826 Enrollment ID: I20161019002647 |
| Provider Name | Shilpa Gadde |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336450964 PECOS PAC ID: 7214179019 Enrollment ID: I20161214000077 |
| Provider Name | Juan Israel Gaitan Rueda |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1720241094 PECOS PAC ID: 2567625999 Enrollment ID: I20170119001587 |
| Provider Name | Ibrahim Wiah Adamu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013238245 PECOS PAC ID: 5991933103 Enrollment ID: I20170411001690 |
| Provider Name | Igor Sister |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518149467 PECOS PAC ID: 4981787975 Enrollment ID: I20170419002897 |
| Provider Name | Megan Naylor Massey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053769570 PECOS PAC ID: 9739456146 Enrollment ID: I20170606000823 |
| Provider Name | Kyle Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386179257 PECOS PAC ID: 6002187739 Enrollment ID: I20170729000013 |
| Provider Name | Ikemefula Ekekwe |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1952505570 PECOS PAC ID: 4789868654 Enrollment ID: I20170829002752 |
| Provider Name | Erica Scott |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871564252 PECOS PAC ID: 8729019211 Enrollment ID: I20170913003415 |
| Provider Name | Matthew Schmitt |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1144558545 PECOS PAC ID: 4981851045 Enrollment ID: I20170929002147 |
| Provider Name | Diana Durrance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356882252 PECOS PAC ID: 1153696703 Enrollment ID: I20171006001117 |
| Provider Name | Jewell Robinson Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275988289 PECOS PAC ID: 6103104161 Enrollment ID: I20171011003845 |
| Provider Name | Leslie Narain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265956031 PECOS PAC ID: 4688940836 Enrollment ID: I20171016003428 |
| Provider Name | Bethany Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285156745 PECOS PAC ID: 3779849898 Enrollment ID: I20171106003137 |
| Provider Name | Khushboo L Chokshi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1619269529 PECOS PAC ID: 3870859796 Enrollment ID: I20171113001890 |
| Provider Name | David Kashmer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275748386 PECOS PAC ID: 9638243173 Enrollment ID: I20171116002622 |
| Provider Name | Scott Franklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710492574 PECOS PAC ID: 1658635214 Enrollment ID: I20180507001605 |
| Provider Name | Maria Christina M Barfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831600980 PECOS PAC ID: 6901151802 Enrollment ID: I20180618001996 |
| Provider Name | Jema Day |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801397724 PECOS PAC ID: 7911253695 Enrollment ID: I20180711000811 |
| Provider Name | Mah Clavia Foje Tendoh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447607163 PECOS PAC ID: 2365728409 Enrollment ID: I20180806002969 |
| Provider Name | Richard Ulf David Hedelius |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1376703645 PECOS PAC ID: 7618114042 Enrollment ID: I20180813001092 |
| Provider Name | Hannah Dawn Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407358732 PECOS PAC ID: 5294085908 Enrollment ID: I20180829004750 |
| Provider Name | Alishia Mary Mccoullough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982197570 PECOS PAC ID: 9931459484 Enrollment ID: I20180905001137 |
| Provider Name | Geraldo Enrique Holguin |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1528360765 PECOS PAC ID: 9436320926 Enrollment ID: I20180910000479 |
| Provider Name | Le Roy Hodges |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700856432 PECOS PAC ID: 2163430554 Enrollment ID: I20180912002838 |
| Provider Name | Lindsay Danielle Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659884328 PECOS PAC ID: 9638429533 Enrollment ID: I20180913001002 |
| Provider Name | Jessica A Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356860670 PECOS PAC ID: 5092066951 Enrollment ID: I20180917001695 |
| Provider Name | James Woojong Chang |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1952661969 PECOS PAC ID: 0244534758 Enrollment ID: I20180918001359 |
| Provider Name | Samit A Patel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053545228 PECOS PAC ID: 5092061259 Enrollment ID: I20181001002228 |
| Provider Name | Loan L Vu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780909879 PECOS PAC ID: 3870769557 Enrollment ID: I20181004003060 |
| Provider Name | Jared Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124516661 PECOS PAC ID: 5597017343 Enrollment ID: I20181006000180 |
| Provider Name | Eric Steven Bour |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548245913 PECOS PAC ID: 2466354493 Enrollment ID: I20181008003550 |
| Provider Name | Rajeev Nagaraj Mysorekar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093783169 PECOS PAC ID: 8022076728 Enrollment ID: I20181024002997 |
| Provider Name | Asif Nadeem Tahir |
|---|---|
| Provider Type | Practitioner - Undersea And Hyperbaric Medicine |
| Provider Identifiers | NPI Number: 1750329728 PECOS PAC ID: 5698787521 Enrollment ID: I20181101000623 |
| Provider Name | Asharul Usmani |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1013140227 PECOS PAC ID: 2860644325 Enrollment ID: I20181106001970 |
| Provider Name | Rahul M Hooda |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1578634390 PECOS PAC ID: 1153354139 Enrollment ID: I20181121002077 |
| Provider Name | Tamika Lynette Saunders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205324548 PECOS PAC ID: 0749525038 Enrollment ID: I20181213003235 |
| Provider Name | Ellen Marie Morris-white |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174099410 PECOS PAC ID: 4183960107 Enrollment ID: I20190113000020 |
| Provider Name | Kylie C Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811465263 PECOS PAC ID: 0143566091 Enrollment ID: I20190114001735 |
| Provider Name | Kimberly E Miller-hammond |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164665428 PECOS PAC ID: 7517289846 Enrollment ID: I20190117003507 |
| Provider Name | Robert J Rosenblatt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649259052 PECOS PAC ID: 9830003961 Enrollment ID: I20190128001870 |
| Provider Name | Courtney Burch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538640891 PECOS PAC ID: 3375880248 Enrollment ID: I20190130002445 |
| Provider Name | Karen Maria Deal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427512334 PECOS PAC ID: 9931449725 Enrollment ID: I20190313002514 |
| Provider Name | Candace Marie Gates |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790076693 PECOS PAC ID: 9032423900 Enrollment ID: I20190313002914 |
| Provider Name | Chukwunonso Chekwube Obijiofor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306349097 PECOS PAC ID: 2466794854 Enrollment ID: I20190506000965 |
| Provider Name | Arturo Gilberto Torres |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1871657221 PECOS PAC ID: 4587980057 Enrollment ID: I20190606000039 |
| Provider Name | Kevin Charles |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1649616558 PECOS PAC ID: 0042519704 Enrollment ID: I20190617000970 |
| Provider Name | Rahim Wooley |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1952643157 PECOS PAC ID: 6709112105 Enrollment ID: I20190723002268 |
| Provider Name | Ashlie Arthur |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1558701847 PECOS PAC ID: 8628305745 Enrollment ID: I20190813001984 |
| Provider Name | Kathleen H Giarla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184077174 PECOS PAC ID: 5193010627 Enrollment ID: I20191014001369 |
| Provider Name | Joshua Jackson |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1528441870 PECOS PAC ID: 2567793912 Enrollment ID: I20191016000325 |
| Provider Name | Jeff Frederick Seebach |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851320857 PECOS PAC ID: 6709920721 Enrollment ID: I20191024002537 |
| Provider Name | Mary Catherine Waite |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235782228 PECOS PAC ID: 7719219062 Enrollment ID: I20191106000568 |
| Provider Name | Leonel Elias Carrasco Abinader |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1619224623 PECOS PAC ID: 5193060309 Enrollment ID: I20191107003257 |
| Provider Name | Yaquisha Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902453673 PECOS PAC ID: 7618309550 Enrollment ID: I20191115000155 |
| Provider Name | Brooke L Defrancisco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922652809 PECOS PAC ID: 4587098884 Enrollment ID: I20191219000942 |
| Provider Name | Kimberly Jennings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609227628 PECOS PAC ID: 6103107107 Enrollment ID: I20200323002413 |
| Provider Name | Crystal Elaine Ayer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558901264 PECOS PAC ID: 7214367812 Enrollment ID: I20200422002705 |
| Provider Name | Akshay Bhatnagar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407267511 PECOS PAC ID: 1759633027 Enrollment ID: I20200424002075 |
| Provider Name | Frankie Ann Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912533548 PECOS PAC ID: 1951732932 Enrollment ID: I20200506002378 |
| Provider Name | Kayla R Exum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194148007 PECOS PAC ID: 8022375963 Enrollment ID: I20200601002454 |
| Provider Name | Edward M Timmins |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649290016 PECOS PAC ID: 2365474038 Enrollment ID: I20200714001443 |
| Provider Name | Seung Geun Yoon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417338617 PECOS PAC ID: 5799076261 Enrollment ID: I20200716002095 |
| Provider Name | Olufisayo Otusanya |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1336552785 PECOS PAC ID: 7517212103 Enrollment ID: I20200723001116 |
| Provider Name | Syed Ashad Abid |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1578948261 PECOS PAC ID: 4284050808 Enrollment ID: I20200813001404 |
| Provider Name | Carol Vanbuul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679136279 PECOS PAC ID: 6103242383 Enrollment ID: I20200818003827 |
| Provider Name | Atul Kumar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1316049257 PECOS PAC ID: 3072790831 Enrollment ID: I20200917001917 |
| Provider Name | William J Lagaly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356371272 PECOS PAC ID: 3870491236 Enrollment ID: I20201005001014 |
| Provider Name | Troy D Kramer |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1831108620 PECOS PAC ID: 9032201785 Enrollment ID: I20201014000441 |
| Provider Name | Denise M Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447770193 PECOS PAC ID: 6305256546 Enrollment ID: I20201029001519 |
| Provider Name | Stephen Gale |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1407862410 PECOS PAC ID: 1052386273 Enrollment ID: I20201104001919 |
| Provider Name | Xing Gao |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659490944 PECOS PAC ID: 2163694811 Enrollment ID: I20201203000739 |
| Provider Name | Christina Danielle Palau Vaccari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477154110 PECOS PAC ID: 1759794217 Enrollment ID: I20201230002886 |
| Provider Name | Tiffany Cobb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548613904 PECOS PAC ID: 0547520264 Enrollment ID: I20210120001848 |
| Provider Name | Cynthia L Harris |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1407808207 PECOS PAC ID: 5496785479 Enrollment ID: I20210323002434 |
| Provider Name | Noel P Curcio |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1053322172 PECOS PAC ID: 7214948199 Enrollment ID: I20210402000583 |
| Provider Name | Youssef Salim Anid |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1902891864 PECOS PAC ID: 5597770362 Enrollment ID: I20210419000598 |
| Provider Name | Mohamed S Elfar |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1457514226 PECOS PAC ID: 6002967585 Enrollment ID: I20210503002062 |
| Provider Name | Yvonne A Berko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326434150 PECOS PAC ID: 9133453574 Enrollment ID: I20210504002044 |
| Provider Name | Shimool Rabbani |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1851772073 PECOS PAC ID: 8426307687 Enrollment ID: I20210602000228 |
| Provider Name | Georges Al-helou |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1992011175 PECOS PAC ID: 8325338841 Enrollment ID: I20210603002166 |
| Provider Name | Rachel Branton Larsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255890703 PECOS PAC ID: 9739510504 Enrollment ID: I20210608001082 |
| Provider Name | Hershel Bhadsavle |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1568881639 PECOS PAC ID: 3779851761 Enrollment ID: I20210617001622 |
| Provider Name | Marcus Markette Tedder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407467038 PECOS PAC ID: 4183034176 Enrollment ID: I20210722004051 |
| Provider Name | Kathryn Horner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396245593 PECOS PAC ID: 3779845698 Enrollment ID: I20210802003020 |
| Provider Name | Hadi Hatoum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891953378 PECOS PAC ID: 0143462275 Enrollment ID: I20210816002228 |
| Provider Name | Madhuri Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932649514 PECOS PAC ID: 3072884998 Enrollment ID: I20210817002917 |
| Provider Name | Kendol Kirk Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013357375 PECOS PAC ID: 9739474172 Enrollment ID: I20210819002019 |
| Provider Name | Sean Yoder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780078469 PECOS PAC ID: 1456670421 Enrollment ID: I20210819002901 |
| Provider Name | Kawanjit Kaur Surapur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093120768 PECOS PAC ID: 1658697248 Enrollment ID: I20210819002992 |
| Provider Name | Jarvis Reese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508476581 PECOS PAC ID: 3476951625 Enrollment ID: I20211001002516 |
| Provider Name | Stephanie Garrett Intorcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013680172 PECOS PAC ID: 6002214095 Enrollment ID: I20211005002577 |
| Provider Name | Zenebe G Woldegebriel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962072710 PECOS PAC ID: 9638577919 Enrollment ID: I20211018002778 |
| Provider Name | Jeffrey Wang |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1730573064 PECOS PAC ID: 6103145487 Enrollment ID: I20211019000270 |
| Provider Name | Judith Edwina Sorrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497970495 PECOS PAC ID: 8527169689 Enrollment ID: I20211022001438 |
| Provider Name | Annette R Mcfarland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942453477 PECOS PAC ID: 0345304135 Enrollment ID: I20211123003332 |
| Provider Name | Brittany L Spiegel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265964134 PECOS PAC ID: 6608145412 Enrollment ID: I20220210002559 |
| Provider Name | Henri R Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174276711 PECOS PAC ID: 9537555818 Enrollment ID: I20220414000152 |
| Provider Name | Mwaba Chisela |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710631593 PECOS PAC ID: 0547656753 Enrollment ID: I20220414001566 |
| Provider Name | Christin-lauren Tanksley |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1093177354 PECOS PAC ID: 6507253770 Enrollment ID: I20220419000874 |
| Provider Name | Hollie J Bauman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477034775 PECOS PAC ID: 2668726159 Enrollment ID: I20220603000956 |
| Provider Name | Jeremy Courtney |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1407235682 PECOS PAC ID: 5991011280 Enrollment ID: I20220615001432 |
| Provider Name | Vikas Punjabi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1780874313 PECOS PAC ID: 3476677675 Enrollment ID: I20220701001688 |
| Provider Name | Venu M. Madhipatla |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578623278 PECOS PAC ID: 0941305452 Enrollment ID: I20220810003934 |
| Provider Name | Tyler Evan Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932842341 PECOS PAC ID: 4880077593 Enrollment ID: I20220812002185 |
| Provider Name | Rebecca L White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396311015 PECOS PAC ID: 4183000821 Enrollment ID: I20221003002381 |
| Provider Name | Radu Zamfir |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457857757 PECOS PAC ID: 0345672168 Enrollment ID: I20221026001423 |
| Provider Name | Carlos Silva |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1659675296 PECOS PAC ID: 9436372638 Enrollment ID: I20221228003191 |
| Provider Name | Miranda Epstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881330827 PECOS PAC ID: 0345610572 Enrollment ID: I20230105000417 |
| Provider Name | Erika Benjumea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255937306 PECOS PAC ID: 6305216417 Enrollment ID: I20230106001057 |
| Provider Name | Avinesh Singh Bhar Jaswindar Singh |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1760634505 PECOS PAC ID: 0244472223 Enrollment ID: I20230206003205 |
| Provider Name | Rachna Patel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1386024859 PECOS PAC ID: 5698027118 Enrollment ID: I20230310002557 |
| Provider Name | Brian Schultz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922393909 PECOS PAC ID: 2769797471 Enrollment ID: I20230323000204 |
| Provider Name | Charles Ray Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326750563 PECOS PAC ID: 5092171777 Enrollment ID: I20230523001077 |
| Provider Name | Simone Lescott |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083106397 PECOS PAC ID: 3476889247 Enrollment ID: I20230526000329 |
| Provider Name | Garrett Harp |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1053677641 PECOS PAC ID: 6901120542 Enrollment ID: I20230608002264 |
| Provider Name | Anjali Patel |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1801329404 PECOS PAC ID: 9436572310 Enrollment ID: I20230818002869 |
| Provider Name | Joseph Lamar |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1073928883 PECOS PAC ID: 7618193913 Enrollment ID: I20230901003653 |
| Provider Name | Lauren Jurecic Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508390477 PECOS PAC ID: 0345510277 Enrollment ID: I20230914002635 |
| Provider Name | Hector E Santiago Belledonne |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1487852919 PECOS PAC ID: 4385885268 Enrollment ID: I20230915000351 |
| Provider Name | Hamza Aziz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1306230362 PECOS PAC ID: 4789933128 Enrollment ID: I20231023002394 |
| Provider Name | Anuradha Bommakanti |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1003265455 PECOS PAC ID: 2961884374 Enrollment ID: I20231228002886 |
| Provider Name | Audrey Wong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003469560 PECOS PAC ID: 1254763048 Enrollment ID: I20240318001093 |
| Provider Name | Dallin Lindahl |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1700370327 PECOS PAC ID: 6800144106 Enrollment ID: I20240329001201 |
The Aicher Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 35 W Church St Ste 101, Jasper, GA 30143 Phone: 404-796-7011 Fax: 404-796-7099 | |
M & M Interventional Spine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 91 Sammy Mcghee Blvd Ste 101, Jasper, GA 30143 Phone: 706-253-3367 Fax: 706-253-3361 | |
Internal Medicine Associates Of Jasper, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 51 Gordon Rd, Suite 201, Jasper, GA 30143 Phone: 706-692-9768 Fax: 706-692-4040 | |
Jasper Family Health And Urgent Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14 Sammy Mcghee Boulevard, Suite 204, Jasper, GA 30143 Phone: 706-253-4224 | |
Ball Ground Family Practice,p.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 91 Sammy Mcghee Blvd, Suite 101, Jasper, GA 30143 Phone: 706-253-6200 Fax: 706-253-6276 | |
Archway Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 735 Martin Rd, Suite A, Jasper, GA 30143 Phone: 706-253-3366 Fax: 706-253-2243 | |
Pickens Urgent Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 744 Noah Dr Ste 108-109, Jasper, GA 30143 Phone: 706-692-0119 |