| Ppcp Canterbury House | |
|
165 Market St Charleston SC 29401-1956 | |
| (843) 823-1215 | |
| (843) 823-7308 |
| Full Name | Ppcp Canterbury House |
|---|---|
| Speciality | Family Medicine |
| Location | 165 Market St, Charleston, South Carolina |
| Authorized Official Name and Position | Terry Cunningham (CEO) |
| Authorized Official Contact | 8436956071 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ppcp Canterbury House Po Box 530062 Atlanta GA 30353-0062 Ph: (843) 695-6071 | Ppcp Canterbury House 165 Market St Charleston SC 29401-1956 Ph: (843) 823-1215 |
| NPI Number | 1073234928 |
|---|---|
| Provider Enumeration Date | 09/08/2022 |
| Last Update Date | 09/09/2022 |
| Medicare PECOS PAC ID | 4880508068 |
|---|---|
| Medicare Enrollment ID | O20031113000287 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073234928 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Rhonda G Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730176504 PECOS PAC ID: 2567376650 Enrollment ID: I20031113000416 |
| Provider Name | David P Rodgers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619934346 PECOS PAC ID: 3779487921 Enrollment ID: I20031120000535 |
| Provider Name | Brian K Keller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215994959 PECOS PAC ID: 5991609703 Enrollment ID: I20031124000240 |
| Provider Name | David Louis Castellone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356308654 PECOS PAC ID: 1759285497 Enrollment ID: I20031124000426 |
| Provider Name | Gordon P Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871545517 PECOS PAC ID: 7315841061 Enrollment ID: I20031124000471 |
| Provider Name | Sara B Montoya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205893690 PECOS PAC ID: 4587569348 Enrollment ID: I20031204000604 |
| Provider Name | Amjad Abdulrahman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194718841 PECOS PAC ID: 4880590900 Enrollment ID: I20031210000201 |
| Provider Name | Brian D Dewhirst |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316965338 PECOS PAC ID: 6305746603 Enrollment ID: I20040112000381 |
| Provider Name | Christopher L Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740250877 PECOS PAC ID: 1951297266 Enrollment ID: I20040224000991 |
| Provider Name | Cary E Fechter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649235714 PECOS PAC ID: 2567354632 Enrollment ID: I20040325000956 |
| Provider Name | John Gould |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215922091 PECOS PAC ID: 0345221297 Enrollment ID: I20040526000986 |
| Provider Name | Sara L Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124071451 PECOS PAC ID: 9032196324 Enrollment ID: I20040706000212 |
| Provider Name | Colby Harold Grossman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619952371 PECOS PAC ID: 7719965789 Enrollment ID: I20040708000239 |
| Provider Name | David Eric Bolster |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144205824 PECOS PAC ID: 4082692058 Enrollment ID: I20040708000289 |
| Provider Name | Sarah M Schumacher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316916273 PECOS PAC ID: 0941289011 Enrollment ID: I20040714000677 |
| Provider Name | Dana M Nairn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801843529 PECOS PAC ID: 1850362237 Enrollment ID: I20040802000610 |
| Provider Name | Elizabeth Alison Lebel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881687440 PECOS PAC ID: 6103890066 Enrollment ID: I20040825000824 |
| Provider Name | John H Lucas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679571020 PECOS PAC ID: 1153396932 Enrollment ID: I20040826000920 |
| Provider Name | David Keith Bridgers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982696829 PECOS PAC ID: 9931176070 Enrollment ID: I20040916000747 |
| Provider Name | Claudius S Dawson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780675306 PECOS PAC ID: 0648249508 Enrollment ID: I20040928000316 |
| Provider Name | Mark A Mataosky |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699720821 PECOS PAC ID: 6608838842 Enrollment ID: I20041101000190 |
| Provider Name | Mary L Bowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790744662 PECOS PAC ID: 2668436494 Enrollment ID: I20041112000115 |
| Provider Name | Anoma S Gamage |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326141938 PECOS PAC ID: 4183678949 Enrollment ID: I20050304000549 |
| Provider Name | Joseph Gaglione |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689683468 PECOS PAC ID: 5294774113 Enrollment ID: I20050504000041 |
| Provider Name | Michael Charles Garovich |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558370353 PECOS PAC ID: 7517862899 Enrollment ID: I20050504000049 |
| Provider Name | Mark L Greenslit |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548279391 PECOS PAC ID: 8921048505 Enrollment ID: I20050504000141 |
| Provider Name | Joseph M Mullaney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437168226 PECOS PAC ID: 4981644465 Enrollment ID: I20050504000173 |
| Provider Name | Wendy L Lykes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194775866 PECOS PAC ID: 7911941885 Enrollment ID: I20050613000789 |
| Provider Name | William D Yarbrough |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225083702 PECOS PAC ID: 2860428059 Enrollment ID: I20050711000254 |
| Provider Name | Tasha M Boone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699745141 PECOS PAC ID: 1254360803 Enrollment ID: I20050804000639 |
| Provider Name | Jennifer R. Palo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215048764 PECOS PAC ID: 2163451998 Enrollment ID: I20050811000407 |
| Provider Name | Stacy J Gajewski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467553404 PECOS PAC ID: 0042242463 Enrollment ID: I20050907000470 |
| Provider Name | Leroy J Huffman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881689032 PECOS PAC ID: 0840283644 Enrollment ID: I20051005000912 |
| Provider Name | Amanda H Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891773990 PECOS PAC ID: 7911912530 Enrollment ID: I20060217000271 |
| Provider Name | Kaoru Joan Pridgen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790755353 PECOS PAC ID: 9032126990 Enrollment ID: I20060317000163 |
| Provider Name | James R Allison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750376521 PECOS PAC ID: 5496748295 Enrollment ID: I20060502000107 |
| Provider Name | James Thelbert Fields |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023087277 PECOS PAC ID: 1658376553 Enrollment ID: I20060928000075 |
| Provider Name | Elizabeth L Coons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902915127 PECOS PAC ID: 8224033923 Enrollment ID: I20061003000080 |
| Provider Name | Karen E Mccutcheon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881613610 PECOS PAC ID: 3375549991 Enrollment ID: I20061004000485 |
| Provider Name | Thomas Bolt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639136377 PECOS PAC ID: 2365337326 Enrollment ID: I20061005000460 |
| Provider Name | Christopher P Mccarty |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912916099 PECOS PAC ID: 5395742993 Enrollment ID: I20061024000356 |
| Provider Name | Luis R Vega |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033119854 PECOS PAC ID: 1052319969 Enrollment ID: I20061130000488 |
| Provider Name | Eileen M Neilan Snee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578639811 PECOS PAC ID: 4284692310 Enrollment ID: I20061221000364 |
| Provider Name | John Y Karl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831196773 PECOS PAC ID: 1355236407 Enrollment ID: I20070212000319 |
| Provider Name | Thomas Brantley Arnau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477510022 PECOS PAC ID: 2264327220 Enrollment ID: I20070403000624 |
| Provider Name | John Mark Redwine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548227101 PECOS PAC ID: 8426943473 Enrollment ID: I20070410000749 |
| Provider Name | Lucy G Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427015171 PECOS PAC ID: 8325143811 Enrollment ID: I20070411000260 |
| Provider Name | Meredith D. Floyd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538111760 PECOS PAC ID: 1658266606 Enrollment ID: I20070412000400 |
| Provider Name | Edward Jones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669424487 PECOS PAC ID: 5395630347 Enrollment ID: I20070426000128 |
| Provider Name | William M Tucker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790861409 PECOS PAC ID: 7810095874 Enrollment ID: I20070614000492 |
| Provider Name | Aaron Domm |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760527576 PECOS PAC ID: 8224016829 Enrollment ID: I20070723000907 |
| Provider Name | Beverly I Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801851738 PECOS PAC ID: 2769575919 Enrollment ID: I20070905000412 |
| Provider Name | John Edgar Kleckley |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1356544100 PECOS PAC ID: 0840385290 Enrollment ID: I20071001000637 |
| Provider Name | Samuel O Schumann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386649085 PECOS PAC ID: 7810083979 Enrollment ID: I20071105000026 |
| Provider Name | Vann Beth Myers Shuler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578565958 PECOS PAC ID: 5890875587 Enrollment ID: I20080108000247 |
| Provider Name | Gayle Lynn Brook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902987407 PECOS PAC ID: 3577552835 Enrollment ID: I20080312000018 |
| Provider Name | John D Sutterlin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780636423 PECOS PAC ID: 9931290509 Enrollment ID: I20080314000024 |
| Provider Name | Caisson Hogue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437230612 PECOS PAC ID: 9234209909 Enrollment ID: I20080606000487 |
| Provider Name | Elizabeth D Harmon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184602617 PECOS PAC ID: 1355412834 Enrollment ID: I20080611000866 |
| Provider Name | Christopher K Moses |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760564074 PECOS PAC ID: 1759452675 Enrollment ID: I20080620000378 |
| Provider Name | Odette D Fisher-glover |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053398792 PECOS PAC ID: 9931272259 Enrollment ID: I20080721000237 |
| Provider Name | Frampton W Henderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487730842 PECOS PAC ID: 2163596529 Enrollment ID: I20080801000498 |
| Provider Name | Deborah Berry-taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235157330 PECOS PAC ID: 7214004266 Enrollment ID: I20080917000595 |
| Provider Name | Ruta Rimkiene |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972795516 PECOS PAC ID: 2264592211 Enrollment ID: I20081120000138 |
| Provider Name | Robert J Teachman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205926920 PECOS PAC ID: 6800951260 Enrollment ID: I20090218000399 |
| Provider Name | Robin L Varella |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538152376 PECOS PAC ID: 5092870337 Enrollment ID: I20090219000468 |
| Provider Name | Jon A Carmain |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871542035 PECOS PAC ID: 6103856232 Enrollment ID: I20090609000512 |
| Provider Name | Tiffany G Mckeel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780828293 PECOS PAC ID: 8123178944 Enrollment ID: I20090616000558 |
| Provider Name | Joshua Nathan Macatol |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851506190 PECOS PAC ID: 6709945199 Enrollment ID: I20090625000482 |
| Provider Name | Christopher Buckingham Ballou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659400943 PECOS PAC ID: 9335291863 Enrollment ID: I20090715000135 |
| Provider Name | Nathan J. Averill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891824355 PECOS PAC ID: 1850447210 Enrollment ID: I20090925000596 |
| Provider Name | Thomas D Carico |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1205814175 PECOS PAC ID: 3072580083 Enrollment ID: I20100114000008 |
| Provider Name | Alison Macleod |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932151818 PECOS PAC ID: 4385775386 Enrollment ID: I20100707000468 |
| Provider Name | Pamela Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003826504 PECOS PAC ID: 8022140961 Enrollment ID: I20100713000335 |
| Provider Name | Roland Ivan Saavedra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427011089 PECOS PAC ID: 4183711880 Enrollment ID: I20100726000427 |
| Provider Name | Virginia E Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598753329 PECOS PAC ID: 7214053271 Enrollment ID: I20100927001427 |
| Provider Name | Clarence William Wimberly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932190139 PECOS PAC ID: 1254245814 Enrollment ID: I20100929001506 |
| Provider Name | Melton Roof Stuckey |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1861463432 PECOS PAC ID: 5597950949 Enrollment ID: I20101110001163 |
| Provider Name | Louis Hite |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265434013 PECOS PAC ID: 1658364450 Enrollment ID: I20101215000472 |
| Provider Name | Rosalie Elliott Browning |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356333223 PECOS PAC ID: 7618164773 Enrollment ID: I20101215000517 |
| Provider Name | Peggy V Toliver-dingle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477545325 PECOS PAC ID: 1557354354 Enrollment ID: I20101215000617 |
| Provider Name | Aron D Rosenthal |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245443258 PECOS PAC ID: 0547313728 Enrollment ID: I20110113000791 |
| Provider Name | Michael Winfree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619271681 PECOS PAC ID: 0941489652 Enrollment ID: I20110127000426 |
| Provider Name | Thomas S Rives |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1457342370 PECOS PAC ID: 3870773526 Enrollment ID: I20110211000870 |
| Provider Name | William R Gammon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164419941 PECOS PAC ID: 3072794049 Enrollment ID: I20110223001017 |
| Provider Name | Cynthia Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700812773 PECOS PAC ID: 0941230726 Enrollment ID: I20110511000279 |
| Provider Name | Mark A Coker |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1235189218 PECOS PAC ID: 2062698350 Enrollment ID: I20110523000268 |
| Provider Name | Chris L Kennedy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1598714198 PECOS PAC ID: 7416133715 Enrollment ID: I20110523000285 |
| Provider Name | Caroline M Yerich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023023827 PECOS PAC ID: 4587834908 Enrollment ID: I20110823000263 |
| Provider Name | Jason B Coker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811159924 PECOS PAC ID: 1153591979 Enrollment ID: I20110902000052 |
| Provider Name | John M Ferguson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952562969 PECOS PAC ID: 0547431405 Enrollment ID: I20110926000436 |
| Provider Name | Brandon Wade Palmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205134939 PECOS PAC ID: 7810169901 Enrollment ID: I20111014000228 |
| Provider Name | Christin L Austin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962783696 PECOS PAC ID: 2365615887 Enrollment ID: I20111028000383 |
| Provider Name | Frederick Walter Funke |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437357274 PECOS PAC ID: 9436323201 Enrollment ID: I20111114000688 |
| Provider Name | Lauren Dubose Neese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427320068 PECOS PAC ID: 6002075538 Enrollment ID: I20120301000935 |
| Provider Name | Celeste Julayne Curnick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184997348 PECOS PAC ID: 0547421539 Enrollment ID: I20120419000023 |
| Provider Name | James T Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063783942 PECOS PAC ID: 1456517127 Enrollment ID: I20120724000832 |
| Provider Name | Jennifer Darden Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437411097 PECOS PAC ID: 5698921062 Enrollment ID: I20120820000205 |
| Provider Name | James Michael Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871542571 PECOS PAC ID: 2769553718 Enrollment ID: I20120919000521 |
| Provider Name | Joseph Mathews |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811123300 PECOS PAC ID: 8325297534 Enrollment ID: I20121003000800 |
| Provider Name | Allison Fain Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144579806 PECOS PAC ID: 0345499372 Enrollment ID: I20121005000339 |
| Provider Name | Brian L Burke |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013977040 PECOS PAC ID: 6305827338 Enrollment ID: I20130724000665 |
| Provider Name | Anna D Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043650328 PECOS PAC ID: 7719129576 Enrollment ID: I20130808000156 |
| Provider Name | Denise K Hosenfeld |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861753204 PECOS PAC ID: 7618119827 Enrollment ID: I20130816000354 |
| Provider Name | Andrew Jonathan Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295784999 PECOS PAC ID: 6901067909 Enrollment ID: I20130820000379 |
| Provider Name | Matthew A Dunn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215240809 PECOS PAC ID: 2264676386 Enrollment ID: I20130911000458 |
| Provider Name | Dana L Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578890224 PECOS PAC ID: 5890923551 Enrollment ID: I20140102001412 |
| Provider Name | Kimberly Barrett Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932193489 PECOS PAC ID: 5799726725 Enrollment ID: I20140127001107 |
| Provider Name | Jeffrey Herman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043358286 PECOS PAC ID: 8224179288 Enrollment ID: I20140214001367 |
| Provider Name | Laura A Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578672697 PECOS PAC ID: 2163315219 Enrollment ID: I20140612001054 |
| Provider Name | Richard Andrew Philipp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144668930 PECOS PAC ID: 3971728387 Enrollment ID: I20140626002592 |
| Provider Name | Martha M Fletcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639583263 PECOS PAC ID: 2264651058 Enrollment ID: I20140909001805 |
| Provider Name | Erin K Godin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326456211 PECOS PAC ID: 1658591466 Enrollment ID: I20140930000185 |
| Provider Name | Kimberly Bova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841605078 PECOS PAC ID: 7012138480 Enrollment ID: I20141028002180 |
| Provider Name | Monique Kaur Sandhu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306043823 PECOS PAC ID: 6709103385 Enrollment ID: I20150318002467 |
| Provider Name | Catherine S Gallier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861890477 PECOS PAC ID: 9830416213 Enrollment ID: I20150324000184 |
| Provider Name | Allyson P Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255722708 PECOS PAC ID: 5496062101 Enrollment ID: I20150914000708 |
| Provider Name | Katherine Claire Proffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225420466 PECOS PAC ID: 7416267620 Enrollment ID: I20151029002944 |
| Provider Name | Elizabeth F Kekacs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467831024 PECOS PAC ID: 9234449919 Enrollment ID: I20151109002032 |
| Provider Name | Lauren C Carsten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689077356 PECOS PAC ID: 1759682370 Enrollment ID: I20151223001051 |
| Provider Name | Jennifer Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437521556 PECOS PAC ID: 0244533529 Enrollment ID: I20160120001094 |
| Provider Name | Lisa D Churchill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295196947 PECOS PAC ID: 4587963103 Enrollment ID: I20160504000424 |
| Provider Name | Kim Marie Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952762528 PECOS PAC ID: 4688963911 Enrollment ID: I20160510001189 |
| Provider Name | Lynnette Renee Booth |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669639332 PECOS PAC ID: 1850549874 Enrollment ID: I20160719001415 |
| Provider Name | Jennifer R Stolin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710274295 PECOS PAC ID: 6507159076 Enrollment ID: I20160720002166 |
| Provider Name | Reid D Castellone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154708543 PECOS PAC ID: 4587957543 Enrollment ID: I20160728000600 |
| Provider Name | Robert M Carlile |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740575307 PECOS PAC ID: 3476847716 Enrollment ID: I20160809001006 |
| Provider Name | Cherika Stephanie Gadson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881077253 PECOS PAC ID: 8426363524 Enrollment ID: I20160816002256 |
| Provider Name | Laura E Herbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043661986 PECOS PAC ID: 4486940251 Enrollment ID: I20160902000233 |
| Provider Name | Karen R Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093776866 PECOS PAC ID: 0244355170 Enrollment ID: I20160913001938 |
| Provider Name | Elizabeth A Byerly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528266459 PECOS PAC ID: 1658472832 Enrollment ID: I20161004001195 |
| Provider Name | Jennifer K Swiler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598117764 PECOS PAC ID: 1759679855 Enrollment ID: I20161005001000 |
| Provider Name | Wanda Fay Lowery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366683823 PECOS PAC ID: 8527116276 Enrollment ID: I20161025002572 |
| Provider Name | Binyue Chang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427497817 PECOS PAC ID: 0042433674 Enrollment ID: I20161107000541 |
| Provider Name | Jillian N White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902351448 PECOS PAC ID: 0446539878 Enrollment ID: I20161108000478 |
| Provider Name | Cielita K Halyard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154872919 PECOS PAC ID: 8527348002 Enrollment ID: I20161130000491 |
| Provider Name | Allison D Hamm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902264062 PECOS PAC ID: 8022391424 Enrollment ID: I20170209000498 |
| Provider Name | Sara B Thacker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720521917 PECOS PAC ID: 6002191095 Enrollment ID: I20170313001965 |
| Provider Name | Nicole M Schwede |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972859684 PECOS PAC ID: 8426325572 Enrollment ID: I20170522001528 |
| Provider Name | Ciara M Scurry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265971543 PECOS PAC ID: 7810264843 Enrollment ID: I20170523002519 |
| Provider Name | Diane N Mcneil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801334412 PECOS PAC ID: 8921376377 Enrollment ID: I20170608000311 |
| Provider Name | Rhonda Cumbee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992237275 PECOS PAC ID: 7810265113 Enrollment ID: I20170608002781 |
| Provider Name | Mary D Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437579083 PECOS PAC ID: 5496025066 Enrollment ID: I20170714002097 |
| Provider Name | David S Cosper |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811140361 PECOS PAC ID: 8628244753 Enrollment ID: I20170728001420 |
| Provider Name | Megan K Huff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619405172 PECOS PAC ID: 6103197983 Enrollment ID: I20170814000834 |
| Provider Name | Elizabeth G Van |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891216073 PECOS PAC ID: 9133493042 Enrollment ID: I20170915001692 |
| Provider Name | Candice Alise Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174983258 PECOS PAC ID: 9830463611 Enrollment ID: I20170918001099 |
| Provider Name | Tonya Renae Skipper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790295988 PECOS PAC ID: 1951668102 Enrollment ID: I20171127001980 |
| Provider Name | Victoria M Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477981108 PECOS PAC ID: 7214150598 Enrollment ID: I20171127002180 |
| Provider Name | Serena Cobb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396286431 PECOS PAC ID: 2860765641 Enrollment ID: I20171205000534 |
| Provider Name | Dana West |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366955635 PECOS PAC ID: 9931468337 Enrollment ID: I20180110001867 |
| Provider Name | Mark E Degarmo |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083706642 PECOS PAC ID: 9931114667 Enrollment ID: I20180111002644 |
| Provider Name | Lynn Ann Leclerc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114450657 PECOS PAC ID: 2769741628 Enrollment ID: I20180123000051 |
| Provider Name | Katherine A Kreber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306350046 PECOS PAC ID: 5698035533 Enrollment ID: I20180214000776 |
| Provider Name | Taylor S Brewer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700305356 PECOS PAC ID: 5496016297 Enrollment ID: I20180219000205 |
| Provider Name | Linda Leeko Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245742782 PECOS PAC ID: 4688935497 Enrollment ID: I20180219000567 |
| Provider Name | Vanessa Nichole Albury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780194191 PECOS PAC ID: 9234490640 Enrollment ID: I20180228000485 |
| Provider Name | Jeremy M Lloyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457866899 PECOS PAC ID: 7517228802 Enrollment ID: I20180301001134 |
| Provider Name | Arielya Binn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669776761 PECOS PAC ID: 6608138110 Enrollment ID: I20180321002348 |
| Provider Name | Briana M Huyck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720594914 PECOS PAC ID: 5799048773 Enrollment ID: I20180405000655 |
| Provider Name | Rochelle Elayda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336649953 PECOS PAC ID: 9133483639 Enrollment ID: I20180509002132 |
| Provider Name | Kimberly Harvey |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699955898 PECOS PAC ID: 6103061882 Enrollment ID: I20180605002021 |
| Provider Name | Whitney M Dellinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487154894 PECOS PAC ID: 4880949122 Enrollment ID: I20180611000350 |
| Provider Name | Laura Patricia Starks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235647009 PECOS PAC ID: 4183979354 Enrollment ID: I20180613000373 |
| Provider Name | Mary Legette Fredrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376084970 PECOS PAC ID: 8224384888 Enrollment ID: I20180712000407 |
| Provider Name | Sasha Milleman Perez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720467525 PECOS PAC ID: 0941556484 Enrollment ID: I20180713000206 |
| Provider Name | Alisa Whittington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447749015 PECOS PAC ID: 9638428873 Enrollment ID: I20180821001478 |
| Provider Name | Kori A Borneman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073090965 PECOS PAC ID: 8123372661 Enrollment ID: I20181119002893 |
| Provider Name | Anna B Schluter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922582048 PECOS PAC ID: 2860736337 Enrollment ID: I20181211000252 |
| Provider Name | Jayme Leigh Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497272421 PECOS PAC ID: 6204198112 Enrollment ID: I20181213001742 |
| Provider Name | Chelsea Diane Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952877599 PECOS PAC ID: 0345585147 Enrollment ID: I20181226001338 |
| Provider Name | Sasa Martinovic |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619297926 PECOS PAC ID: 3072646579 Enrollment ID: I20190111002139 |
| Provider Name | Lori M Roses |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1174783021 PECOS PAC ID: 1153495619 Enrollment ID: I20190305001527 |
| Provider Name | Brittany Shipes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194110924 PECOS PAC ID: 9436478112 Enrollment ID: I20190315001710 |
| Provider Name | Quana Mardena Singleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639640386 PECOS PAC ID: 5395085807 Enrollment ID: I20190320001363 |
| Provider Name | Robin Lisa Infinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376008243 PECOS PAC ID: 5597006585 Enrollment ID: I20190329002099 |
| Provider Name | Michael Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043873888 PECOS PAC ID: 9234472945 Enrollment ID: I20190521002284 |
| Provider Name | Sofy Landes |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265790133 PECOS PAC ID: 2668774423 Enrollment ID: I20190606001538 |
| Provider Name | Brittany L Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497172779 PECOS PAC ID: 2264765981 Enrollment ID: I20190612002836 |
| Provider Name | Melissa Ann Maxwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518471192 PECOS PAC ID: 4880921402 Enrollment ID: I20190806000178 |
| Provider Name | Lauren N Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689239915 PECOS PAC ID: 7416285101 Enrollment ID: I20190819003315 |
| Provider Name | Michael Paul Beavers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588225106 PECOS PAC ID: 5597093765 Enrollment ID: I20190826003254 |
| Provider Name | Michael J. Colby |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1407140940 PECOS PAC ID: 5597927467 Enrollment ID: I20190826004009 |
| Provider Name | Shelley Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487216529 PECOS PAC ID: 0749518892 Enrollment ID: I20190827002849 |
| Provider Name | Lindsay B Fried |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902312812 PECOS PAC ID: 1052640372 Enrollment ID: I20190912000699 |
| Provider Name | Joseph Anothony Nellis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053382093 PECOS PAC ID: 1557660453 Enrollment ID: I20191001000644 |
| Provider Name | Chelsea N Rich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386292787 PECOS PAC ID: 2769815851 Enrollment ID: I20191203002708 |
| Provider Name | Ashely Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457993677 PECOS PAC ID: 8628402229 Enrollment ID: I20200106003058 |
| Provider Name | Jessica L Ionno |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1053514612 PECOS PAC ID: 0345313110 Enrollment ID: I20200107003501 |
| Provider Name | Dahlyn Marie Painter |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720624315 PECOS PAC ID: 8921433194 Enrollment ID: I20200116000033 |
| Provider Name | Shayna Lynn Dillane |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073158945 PECOS PAC ID: 5395171045 Enrollment ID: I20200129000395 |
| Provider Name | William R Andrews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154969012 PECOS PAC ID: 5395171938 Enrollment ID: I20200130001361 |
| Provider Name | Rachel Elizabeth Yaghi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205484250 PECOS PAC ID: 5597191734 Enrollment ID: I20200205003058 |
| Provider Name | Bridgette R Bunker |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932141371 PECOS PAC ID: 1456394196 Enrollment ID: I20200211002788 |
| Provider Name | Loree Ann Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316580863 PECOS PAC ID: 0244667780 Enrollment ID: I20200224001214 |
| Provider Name | Shakilya Khalif |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013335884 PECOS PAC ID: 7113356254 Enrollment ID: I20200410001247 |
| Provider Name | Autumn R Painter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346610086 PECOS PAC ID: 6901104181 Enrollment ID: I20200416001789 |
| Provider Name | Seth Osenkarski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649819608 PECOS PAC ID: 4587094867 Enrollment ID: I20200429001281 |
| Provider Name | Tammy Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538794565 PECOS PAC ID: 2567892771 Enrollment ID: I20200430000336 |
| Provider Name | Brett Daniel Van Leer Greenberg |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1871911867 PECOS PAC ID: 5294150942 Enrollment ID: I20200729001157 |
| Provider Name | Ann Kelly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104270651 PECOS PAC ID: 8224328588 Enrollment ID: I20200908002103 |
| Provider Name | Jarelle Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477163905 PECOS PAC ID: 8729407028 Enrollment ID: I20201007000118 |
| Provider Name | Tyler James Lotz |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1679039028 PECOS PAC ID: 0648511188 Enrollment ID: I20201009002073 |
| Provider Name | Allen Cooke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851909162 PECOS PAC ID: 7911317813 Enrollment ID: I20201104001703 |
| Provider Name | Wilson Fitchett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174121206 PECOS PAC ID: 8123438033 Enrollment ID: I20201104002067 |
| Provider Name | Christina Marie Cottrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558877357 PECOS PAC ID: 0749690196 Enrollment ID: I20201210001059 |
| Provider Name | Allison Marie Grimes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174128938 PECOS PAC ID: 4082027487 Enrollment ID: I20210104000279 |
| Provider Name | Maureen O Nwajiaku |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790321917 PECOS PAC ID: 0840604062 Enrollment ID: I20210129002158 |
| Provider Name | Carolyn Rines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952936528 PECOS PAC ID: 6507271442 Enrollment ID: I20210226001165 |
| Provider Name | Jennifer Berger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588255343 PECOS PAC ID: 5597172569 Enrollment ID: I20210319000069 |
| Provider Name | Nicholas Arthur Hathaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003431511 PECOS PAC ID: 5294142071 Enrollment ID: I20210323000613 |
| Provider Name | Kristen N Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841876554 PECOS PAC ID: 1355759895 Enrollment ID: I20210421001393 |
| Provider Name | Gail Marie Detjen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1659543460 PECOS PAC ID: 3971912254 Enrollment ID: I20210518000710 |
| Provider Name | Leah M Bagley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962030809 PECOS PAC ID: 2466874706 Enrollment ID: I20210519002376 |
| Provider Name | Christopher William Daily |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497300735 PECOS PAC ID: 6800297300 Enrollment ID: I20210622000509 |
| Provider Name | Nathan Gentry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770147332 PECOS PAC ID: 3173854817 Enrollment ID: I20210804000924 |
| Provider Name | Tracy Raphaela Neilan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639462591 PECOS PAC ID: 0244551646 Enrollment ID: I20210818000308 |
| Provider Name | Emily D Hodskins |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1487034054 PECOS PAC ID: 6103126610 Enrollment ID: I20210910000364 |
| Provider Name | Eveline T Paul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154097095 PECOS PAC ID: 1850797077 Enrollment ID: I20210913002891 |
| Provider Name | Lauren R Lethco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891366795 PECOS PAC ID: 1759789571 Enrollment ID: I20211008001756 |
| Provider Name | Lisa Nicole Covell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437826716 PECOS PAC ID: 7012305360 Enrollment ID: I20211019002878 |
| Provider Name | Irene Margarette Louis Spanos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457027682 PECOS PAC ID: 2062800501 Enrollment ID: I20211102002037 |
| Provider Name | Veronica L Stukes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457995375 PECOS PAC ID: 2365831559 Enrollment ID: I20211109001969 |
| Provider Name | Whitney Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467122127 PECOS PAC ID: 5193114783 Enrollment ID: I20211122000485 |
| Provider Name | Maura Forte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952700197 PECOS PAC ID: 1355664129 Enrollment ID: I20211124001905 |
| Provider Name | Kelly Steen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093309098 PECOS PAC ID: 2163812637 Enrollment ID: I20211124002064 |
| Provider Name | Melissa Webber Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518541861 PECOS PAC ID: 1355731209 Enrollment ID: I20211208000518 |
| Provider Name | Amber S Moses |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700549334 PECOS PAC ID: 7315338985 Enrollment ID: I20211216000179 |
| Provider Name | Ashley P Tuttle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750053039 PECOS PAC ID: 2668863036 Enrollment ID: I20211217001753 |
| Provider Name | Hannah Sloger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801469556 PECOS PAC ID: 5991197501 Enrollment ID: I20220111001706 |
| Provider Name | Courtney L Tutterow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184382418 PECOS PAC ID: 1355733155 Enrollment ID: I20220127001057 |
| Provider Name | Kristina Dibartolo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033711981 PECOS PAC ID: 4688073273 Enrollment ID: I20220318001412 |
| Provider Name | Crystal Jean Connors |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629357272 PECOS PAC ID: 9638341779 Enrollment ID: I20220328001376 |
| Provider Name | Emily Rose Thieme |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336892033 PECOS PAC ID: 2769878057 Enrollment ID: I20220414000399 |
| Provider Name | Diana Broadway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265002554 PECOS PAC ID: 3274937834 Enrollment ID: I20220526002197 |
| Provider Name | Samantha Mcdaniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174005185 PECOS PAC ID: 6204171671 Enrollment ID: I20220528000047 |
| Provider Name | Valerie Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801348982 PECOS PAC ID: 2567745664 Enrollment ID: I20220610000372 |
| Provider Name | Mary Conlon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730181322 PECOS PAC ID: 3375877699 Enrollment ID: I20220714002815 |
| Provider Name | Katelyn Watson Zerbst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396490843 PECOS PAC ID: 9830573187 Enrollment ID: I20220906000427 |
| Provider Name | Stefani Piacentine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982330544 PECOS PAC ID: 0042695462 Enrollment ID: I20220920003294 |
| Provider Name | Elizabeth C Anisis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851687016 PECOS PAC ID: 0749407021 Enrollment ID: I20220929000664 |
| Provider Name | Kyle R Libbey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033620943 PECOS PAC ID: 7911374236 Enrollment ID: I20221029000159 |
| Provider Name | Toni D Gallo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598327975 PECOS PAC ID: 6406183318 Enrollment ID: I20221101000082 |
| Provider Name | Kelly M Bistline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144947391 PECOS PAC ID: 4082082276 Enrollment ID: I20221118001714 |
| Provider Name | Jennifer Leah Stayton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841913845 PECOS PAC ID: 4486022324 Enrollment ID: I20221123002936 |
| Provider Name | Brandi L. Mann |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134845639 PECOS PAC ID: 5597133140 Enrollment ID: I20221201002743 |
| Provider Name | Nancy E Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184003436 PECOS PAC ID: 9739495979 Enrollment ID: I20230320001492 |
| Provider Name | Emily Kachelmeyer |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1396466991 PECOS PAC ID: 3870969751 Enrollment ID: I20230413002236 |
| Provider Name | Brooke Houshiar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295469765 PECOS PAC ID: 9830554567 Enrollment ID: I20230502000379 |
| Provider Name | Bary Kemble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356032072 PECOS PAC ID: 9830557248 Enrollment ID: I20230616000884 |
| Provider Name | Emily Alison Bond |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881018521 PECOS PAC ID: 2365757127 Enrollment ID: I20230725001725 |
| Provider Name | Cayce Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962187278 PECOS PAC ID: 9234590720 Enrollment ID: I20230731004022 |
| Provider Name | John-matthew Allen Swords |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982189122 PECOS PAC ID: 0143565150 Enrollment ID: I20230816002641 |
| Provider Name | Clay J. Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386268860 PECOS PAC ID: 9436511789 Enrollment ID: I20230817002877 |
| Provider Name | Joanna Elzbieta Andracka-kudla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982392692 PECOS PAC ID: 2567825383 Enrollment ID: I20230828001054 |
| Provider Name | Ali Chahine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013545961 PECOS PAC ID: 7315360211 Enrollment ID: I20231109003683 |
Palmetto Primary Care Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2097 Henry Tecklenburg Dr, Charleston, SC 29414 Phone: 843-572-7727 Fax: 843-569-5881 | |
Musc Physicians Pcp Peninsular Charleston Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 30 Bee St, Suite 2100, Charleston, SC 29403 Phone: 843-792-6500 | |
Roper St. Francis Hospitalist Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 316 Calhoun St, Charleston, SC 29401 Phone: 843-724-2450 Fax: 843-724-2455 | |
Jeffrey Akhtar Do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2270 Ashley Crossing Dr Ste 155, Charleston, SC 29414 Phone: 843-990-5866 Fax: 843-868-8041 | |
Musc Physicians Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2060 Sam Rittenburg Blvd, Charleston, SC 29425 Phone: 843-792-6200 | |
Harold R Nicolette, Do, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6 Carriage Ln, Suite B, Charleston, SC 29407 Phone: 843-766-4100 Fax: 843-571-4177 | |
Empowerme Medical Group, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2333 Ashley River Rd, Charleston, SC 29414 Phone: 877-367-9772 |