| South Graham Medical Center | |
|
1205 S Main St Graham NC 27253-4511 | |
| (336) 570-0344 | |
| (336) 570-3045 |
| Full Name | South Graham Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 1205 S Main St, Graham, North Carolina |
| Authorized Official Name and Position | Robert L Goldstein (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Contact | 3366635001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Graham Medical Center 1200 N Elm St Greensboro NC 27401-1020 Ph: (336) 832-9513 | South Graham Medical Center 1205 S Main St Graham NC 27253-4511 Ph: (336) 570-0344 |
| NPI Number | 1881938405 |
|---|---|
| Provider Enumeration Date | 11/20/2012 |
| Last Update Date | 01/27/2017 |
| Medicare PECOS PAC ID | 4284623497 |
|---|---|
| Medicare Enrollment ID | O20040511001278 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881938405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Stephen Michael Dahlstedt |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1861487936 PECOS PAC ID: 6305742750 Enrollment ID: I20031208000998 |
| Provider Name | Richard L Gilbert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336230747 PECOS PAC ID: 2264336353 Enrollment ID: I20040429001061 |
| Provider Name | Amy Singleton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780647925 PECOS PAC ID: 7911986575 Enrollment ID: I20040716000564 |
| Provider Name | Richard D Hart |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1528063203 PECOS PAC ID: 6204808629 Enrollment ID: I20040806000950 |
| Provider Name | Peggy M Bynum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942231188 PECOS PAC ID: 8224000237 Enrollment ID: I20040810001191 |
| Provider Name | Himabindu Ravi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629152541 PECOS PAC ID: 1759357775 Enrollment ID: I20040909001025 |
| Provider Name | Martin Defrancesco |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770501835 PECOS PAC ID: 1052388584 Enrollment ID: I20040914001022 |
| Provider Name | Bradley J Stoneking |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1336172543 PECOS PAC ID: 0941278543 Enrollment ID: I20040921001264 |
| Provider Name | Melody Newsome Shambley |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1427095256 PECOS PAC ID: 9234193228 Enrollment ID: I20041118000884 |
| Provider Name | Robert W Wilson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780758094 PECOS PAC ID: 5294785143 Enrollment ID: I20050127000896 |
| Provider Name | Kimberly Dawn Shaw |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1639241490 PECOS PAC ID: 9537112073 Enrollment ID: I20050224000854 |
| Provider Name | Syed Taj Ul Arfeen |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1245298702 PECOS PAC ID: 2264487446 Enrollment ID: I20050321000872 |
| Provider Name | Marie L Williams |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1548332406 PECOS PAC ID: 7214975465 Enrollment ID: I20050419001152 |
| Provider Name | Ramakrishna P Rao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457397903 PECOS PAC ID: 7810959665 Enrollment ID: I20050503000061 |
| Provider Name | Deborah Rosalie Ross |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952458820 PECOS PAC ID: 5799726170 Enrollment ID: I20050516000810 |
| Provider Name | Fernando A Cobos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356383947 PECOS PAC ID: 8820030604 Enrollment ID: I20050523001209 |
| Provider Name | Nadeem Akhtar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912914300 PECOS PAC ID: 8123056678 Enrollment ID: I20050727000392 |
| Provider Name | Kurian D Kasa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457335457 PECOS PAC ID: 6103856323 Enrollment ID: I20050817000836 |
| Provider Name | Wayland C Stephens |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811989486 PECOS PAC ID: 9638073992 Enrollment ID: I20051012001013 |
| Provider Name | Frances H Cresenzo-dishmon |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1821187998 PECOS PAC ID: 3072532043 Enrollment ID: I20051121000446 |
| Provider Name | Martha Lee James |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174623623 PECOS PAC ID: 4880623255 Enrollment ID: I20051207000190 |
| Provider Name | Marshall C Hall |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1881676484 PECOS PAC ID: 1456367358 Enrollment ID: I20060302000097 |
| Provider Name | Eugene H Wade |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548256266 PECOS PAC ID: 2163400623 Enrollment ID: I20060327000024 |
| Provider Name | David J Evans |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164457446 PECOS PAC ID: 2466497870 Enrollment ID: I20060427000184 |
| Provider Name | Gerald Plovsky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982641858 PECOS PAC ID: 1759392814 Enrollment ID: I20060606000085 |
| Provider Name | Scott A Macdiarmid |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1346222775 PECOS PAC ID: 7113939463 Enrollment ID: I20060703000105 |
| Provider Name | Ralph L Ely |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720006547 PECOS PAC ID: 1153328810 Enrollment ID: I20061023000497 |
| Provider Name | Lester S Borden |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1245249929 PECOS PAC ID: 0143246371 Enrollment ID: I20061211000080 |
| Provider Name | John J Wrenn |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1659372019 PECOS PAC ID: 3678572617 Enrollment ID: I20061220000364 |
| Provider Name | Janardhana R Jonnalagadda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053351015 PECOS PAC ID: 4284736075 Enrollment ID: I20070226000286 |
| Provider Name | Darren Wohl |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1649289836 PECOS PAC ID: 0244333276 Enrollment ID: I20070313000308 |
| Provider Name | William N Garrot |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902813421 PECOS PAC ID: 7214032804 Enrollment ID: I20070410000157 |
| Provider Name | Krichna F Sowles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861594871 PECOS PAC ID: 4880660513 Enrollment ID: I20070529000486 |
| Provider Name | Uzma Faheem |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033209838 PECOS PAC ID: 7517998461 Enrollment ID: I20070825000006 |
| Provider Name | Scott C Stoioff |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1881763316 PECOS PAC ID: 0446344311 Enrollment ID: I20070922000147 |
| Provider Name | Melinda P Lada |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437258282 PECOS PAC ID: 7517055700 Enrollment ID: I20071126000138 |
| Provider Name | Myra C Dove |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1124025655 PECOS PAC ID: 4880775220 Enrollment ID: I20080111000296 |
| Provider Name | Agnes I Nwoko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679673511 PECOS PAC ID: 0042396012 Enrollment ID: I20080401000203 |
| Provider Name | Cheryl A Wicker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659319291 PECOS PAC ID: 3678642840 Enrollment ID: I20080514000811 |
| Provider Name | Luther Eure |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881783975 PECOS PAC ID: 1850461146 Enrollment ID: I20080529000220 |
| Provider Name | John T Clapacs |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528071610 PECOS PAC ID: 4486725215 Enrollment ID: I20080620000548 |
| Provider Name | Aarti K Kapur |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922216902 PECOS PAC ID: 6103978622 Enrollment ID: I20090714000796 |
| Provider Name | Archana Kumar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326116286 PECOS PAC ID: 8820143407 Enrollment ID: I20090903000129 |
| Provider Name | Greg Lawson Clary |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659317360 PECOS PAC ID: 1951338219 Enrollment ID: I20090910000496 |
| Provider Name | Brigitte Eva Miller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881679439 PECOS PAC ID: 7012058050 Enrollment ID: I20100112000777 |
| Provider Name | Donald Douglas Peterson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1396743548 PECOS PAC ID: 8224171194 Enrollment ID: I20100202000072 |
| Provider Name | Lemont M Morrisey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801882626 PECOS PAC ID: 1254319718 Enrollment ID: I20100423000910 |
| Provider Name | Laura Berglund |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760406375 PECOS PAC ID: 8022147388 Enrollment ID: I20100525000289 |
| Provider Name | Bradley Tanner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447348131 PECOS PAC ID: 8325178650 Enrollment ID: I20100614000466 |
| Provider Name | Sabino Zani |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649469610 PECOS PAC ID: 7214068030 Enrollment ID: I20100623000299 |
| Provider Name | Deanna C Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033119425 PECOS PAC ID: 4789641887 Enrollment ID: I20100909000941 |
| Provider Name | Peggy Constant |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417287764 PECOS PAC ID: 4587789573 Enrollment ID: I20100914001142 |
| Provider Name | Donald E Fisher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730270141 PECOS PAC ID: 6709780893 Enrollment ID: I20110316000075 |
| Provider Name | Richard E Cooper |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114923182 PECOS PAC ID: 9537053830 Enrollment ID: I20110712000389 |
| Provider Name | Brian Andrew Farah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174552079 PECOS PAC ID: 2264608322 Enrollment ID: I20111221000001 |
| Provider Name | Jun He |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376704213 PECOS PAC ID: 1557537412 Enrollment ID: I20111228000087 |
| Provider Name | Mark A Crissman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447293980 PECOS PAC ID: 9638189939 Enrollment ID: I20120125000094 |
| Provider Name | Matthew R Eskridge |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1588747539 PECOS PAC ID: 5193878676 Enrollment ID: I20120627000392 |
| Provider Name | Vinay Paran Saranga |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144428673 PECOS PAC ID: 9739361718 Enrollment ID: I20120816000826 |
| Provider Name | Diego Fernando Pabon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104945864 PECOS PAC ID: 6901053057 Enrollment ID: I20120825000001 |
| Provider Name | Theodore Manny |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1871773143 PECOS PAC ID: 6507014719 Enrollment ID: I20120913000205 |
| Provider Name | Avanti Vigg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649417353 PECOS PAC ID: 8527226042 Enrollment ID: I20120927000204 |
| Provider Name | Veeraindar Goli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295819993 PECOS PAC ID: 2062408016 Enrollment ID: I20121115000594 |
| Provider Name | Jamila M Crawford |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295951903 PECOS PAC ID: 7113170408 Enrollment ID: I20130117000432 |
| Provider Name | Carolyn L Harraway Smith |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922116250 PECOS PAC ID: 0446214035 Enrollment ID: I20130807000509 |
| Provider Name | Shuvon B Rankin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922128198 PECOS PAC ID: 2264668730 Enrollment ID: I20131112001413 |
| Provider Name | Syed Asad A Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821319344 PECOS PAC ID: 9133356017 Enrollment ID: I20131221000144 |
| Provider Name | Jamison Yvonne Lord |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033546494 PECOS PAC ID: 3375770266 Enrollment ID: I20131223000413 |
| Provider Name | Regina W Baity |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891123667 PECOS PAC ID: 3779712179 Enrollment ID: I20140205001501 |
| Provider Name | Joshua A Sheets |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619254901 PECOS PAC ID: 4981834066 Enrollment ID: I20140312000367 |
| Provider Name | Marieda J Grossman-orr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043631344 PECOS PAC ID: 5597998781 Enrollment ID: I20140423001038 |
| Provider Name | Lindsay C Overton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720401136 PECOS PAC ID: 7315170297 Enrollment ID: I20140429002289 |
| Provider Name | Laura Ann Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770908337 PECOS PAC ID: 5597998864 Enrollment ID: I20140513000296 |
| Provider Name | Takia S Starkes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164857124 PECOS PAC ID: 8224251137 Enrollment ID: I20140522000356 |
| Provider Name | Karissa A Brone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811327422 PECOS PAC ID: 2769606086 Enrollment ID: I20140606000989 |
| Provider Name | Josephine Ochulo-chinwe Onuoha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881033678 PECOS PAC ID: 1254555295 Enrollment ID: I20140613001783 |
| Provider Name | Anika Shannel Cherry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497075105 PECOS PAC ID: 7618290776 Enrollment ID: I20141220000183 |
| Provider Name | Benjamin Herrick |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1588838965 PECOS PAC ID: 3173848025 Enrollment ID: I20150217001175 |
| Provider Name | Salina Agarwal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467619957 PECOS PAC ID: 7618294943 Enrollment ID: I20150326000738 |
| Provider Name | Catherine Leigh Loflin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649582602 PECOS PAC ID: 0446564611 Enrollment ID: I20150731015512 |
| Provider Name | Ashley Jf Brandon |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1790912574 PECOS PAC ID: 0143443598 Enrollment ID: I20150803001085 |
| Provider Name | Chad Ryan Gonczy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487965356 PECOS PAC ID: 7911148200 Enrollment ID: I20150824002621 |
| Provider Name | Jagannath Subedi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245521343 PECOS PAC ID: 2860709383 Enrollment ID: I20150916001540 |
| Provider Name | Mandeep Kaur |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215298856 PECOS PAC ID: 5092022160 Enrollment ID: I20150922002453 |
| Provider Name | Megan Payseur Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063708378 PECOS PAC ID: 7113235870 Enrollment ID: I20150929001938 |
| Provider Name | Saramma Eappen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225397987 PECOS PAC ID: 9133438203 Enrollment ID: I20151013000650 |
| Provider Name | Tiffani Lynee Bell Washington |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861789117 PECOS PAC ID: 2668784414 Enrollment ID: I20151026001644 |
| Provider Name | Amy L Krebs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386017630 PECOS PAC ID: 1951603539 Enrollment ID: I20160113003107 |
| Provider Name | Mary Alice Bowman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801206420 PECOS PAC ID: 5597061697 Enrollment ID: I20160316001336 |
| Provider Name | Stephanie Leigh Hill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891956058 PECOS PAC ID: 8325280068 Enrollment ID: I20160406000287 |
| Provider Name | Lawrence A Bass |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467481945 PECOS PAC ID: 6800831918 Enrollment ID: I20160413001041 |
| Provider Name | Travis Bo Money |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225419625 PECOS PAC ID: 0648573204 Enrollment ID: I20160502000124 |
| Provider Name | Patrick Mckenzie |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1225359920 PECOS PAC ID: 9830402726 Enrollment ID: I20160608002385 |
| Provider Name | Charles T Woodham |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1699968933 PECOS PAC ID: 3476702697 Enrollment ID: I20160906001973 |
| Provider Name | Nicole M Peacock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831428523 PECOS PAC ID: 8527354836 Enrollment ID: I20160913002381 |
| Provider Name | Melanie Bhambri |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1215349006 PECOS PAC ID: 7012205222 Enrollment ID: I20161004000653 |
| Provider Name | Walidah N Karim |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1649435603 PECOS PAC ID: 3779515101 Enrollment ID: I20161123000712 |
| Provider Name | Vincent Izediuno |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396078549 PECOS PAC ID: 6103083647 Enrollment ID: I20161214001439 |
| Provider Name | Tanika Niko Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538616263 PECOS PAC ID: 8628359619 Enrollment ID: I20170105002329 |
| Provider Name | Sarita M Oneal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336435577 PECOS PAC ID: 4587954904 Enrollment ID: I20170112001286 |
| Provider Name | Kashif Nadeem Malik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760682025 PECOS PAC ID: 0941486500 Enrollment ID: I20170220000683 |
| Provider Name | Lashunda D Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770031627 PECOS PAC ID: 8123303542 Enrollment ID: I20170328001053 |
| Provider Name | Darren T Livingston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962534610 PECOS PAC ID: 8426325390 Enrollment ID: I20170524001517 |
| Provider Name | Jenny I Edminson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790184661 PECOS PAC ID: 0840560249 Enrollment ID: I20170718001597 |
| Provider Name | Jason Evan Davis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285809475 PECOS PAC ID: 6507003498 Enrollment ID: I20170905003131 |
| Provider Name | Michael L Ervin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720048929 PECOS PAC ID: 5890870232 Enrollment ID: I20171005002559 |
| Provider Name | Reina Hisada |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457615585 PECOS PAC ID: 3375842974 Enrollment ID: I20171021000036 |
| Provider Name | Lauren Paige O'reilly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902326333 PECOS PAC ID: 0547536815 Enrollment ID: I20171101001522 |
| Provider Name | Jose L Piscoya |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578723102 PECOS PAC ID: 0345506317 Enrollment ID: I20171107001988 |
| Provider Name | Alexander Karamalegos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942610159 PECOS PAC ID: 3577829209 Enrollment ID: I20171113000999 |
| Provider Name | Kiran Anna |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1255596268 PECOS PAC ID: 8022273382 Enrollment ID: I20171114001988 |
| Provider Name | Jason Arthur Berry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437680196 PECOS PAC ID: 7517225832 Enrollment ID: I20171214001742 |
| Provider Name | Laurie Parks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306375670 PECOS PAC ID: 1557629383 Enrollment ID: I20171227001269 |
| Provider Name | Jenkins Michelle Lawhorn |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1255845178 PECOS PAC ID: 0244599421 Enrollment ID: I20180116000662 |
| Provider Name | Kathryn Lorraine Kooistra |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1619492154 PECOS PAC ID: 7719246537 Enrollment ID: I20180123002890 |
| Provider Name | Annie Marie Thompson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1285148833 PECOS PAC ID: 2860753613 Enrollment ID: I20180219002206 |
| Provider Name | Lauren Renee Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497257042 PECOS PAC ID: 4688937568 Enrollment ID: I20180405001099 |
| Provider Name | Kim Gloria Hoover |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003922733 PECOS PAC ID: 9830452457 Enrollment ID: I20180413000042 |
| Provider Name | Michelle Smith Flinchum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568859288 PECOS PAC ID: 7517222169 Enrollment ID: I20180531001284 |
| Provider Name | Christina Robertson Hussami |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770965386 PECOS PAC ID: 2466717939 Enrollment ID: I20180604002094 |
| Provider Name | Anand Mahesh Joshi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801187794 PECOS PAC ID: 3072743806 Enrollment ID: I20180629001356 |
| Provider Name | Christopher A Winter |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1982043824 PECOS PAC ID: 0840434569 Enrollment ID: I20180718003898 |
| Provider Name | Eugene D Bell |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1588992168 PECOS PAC ID: 8224270269 Enrollment ID: I20180807002371 |
| Provider Name | Angela Marie Bacigalupo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093193641 PECOS PAC ID: 7012266638 Enrollment ID: I20180815001429 |
| Provider Name | Jessica Rose Schlosberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245504125 PECOS PAC ID: 1658622980 Enrollment ID: I20180925002630 |
| Provider Name | Holly Rose Mcnew |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548601313 PECOS PAC ID: 4587895867 Enrollment ID: I20181008003162 |
| Provider Name | Gopalkumar Rakesh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902211378 PECOS PAC ID: 6406109263 Enrollment ID: I20181024000642 |
| Provider Name | Elizabeth Edacheril Poulose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205304409 PECOS PAC ID: 7719225275 Enrollment ID: I20190208001961 |
| Provider Name | Terry T Carter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831520527 PECOS PAC ID: 6406195411 Enrollment ID: I20190307003253 |
| Provider Name | Christopher Thomas Rainville |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609217611 PECOS PAC ID: 8527299908 Enrollment ID: I20190422002585 |
| Provider Name | Samantha Cochrane Weinhold |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1447725379 PECOS PAC ID: 9436492121 Enrollment ID: I20190521001602 |
| Provider Name | Aviva Wallace Kaplin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346676988 PECOS PAC ID: 0840549549 Enrollment ID: I20190530001365 |
| Provider Name | Hiren Mansukhlal Umrania |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396152203 PECOS PAC ID: 6709129075 Enrollment ID: I20190530001491 |
| Provider Name | Maryellen Dolat Pace |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1134411390 PECOS PAC ID: 3678713948 Enrollment ID: I20190605001604 |
| Provider Name | Sheila Maria Maurer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689659161 PECOS PAC ID: 4486627221 Enrollment ID: I20190812004083 |
| Provider Name | Brian C Sninsky |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1336568807 PECOS PAC ID: 1456575653 Enrollment ID: I20190903002421 |
| Provider Name | Jolene Tadzia Cannady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104366038 PECOS PAC ID: 9335493196 Enrollment ID: I20190909000842 |
| Provider Name | Jessica Rein Cody |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710372305 PECOS PAC ID: 3476822636 Enrollment ID: I20191017002553 |
| Provider Name | Clifford Hendrickson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992816888 PECOS PAC ID: 9739214073 Enrollment ID: I20191029002013 |
| Provider Name | Aquicha Renee Duff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558714667 PECOS PAC ID: 0042542557 Enrollment ID: I20191104000892 |
| Provider Name | Shalon Evette Bobbitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932750593 PECOS PAC ID: 9739513649 Enrollment ID: I20200102000037 |
| Provider Name | Justin R Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669882122 PECOS PAC ID: 2466752969 Enrollment ID: I20200107001982 |
| Provider Name | Janet Elisabeth Sykes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710544580 PECOS PAC ID: 7416382825 Enrollment ID: I20200113002092 |
| Provider Name | Bethany Dare Southern Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003169202 PECOS PAC ID: 6709211139 Enrollment ID: I20200114000212 |
| Provider Name | Jacqueline L Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356982797 PECOS PAC ID: 4789019035 Enrollment ID: I20200115001787 |
| Provider Name | Tanvir Iqbal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902248073 PECOS PAC ID: 1355681420 Enrollment ID: I20200306000428 |
| Provider Name | Jacqueline Parker Hatch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265832612 PECOS PAC ID: 1355779562 Enrollment ID: I20200323002302 |
| Provider Name | Rashaun Milese Dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609269596 PECOS PAC ID: 3072935154 Enrollment ID: I20200618000185 |
| Provider Name | Alisa Paliy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609263599 PECOS PAC ID: 9234433772 Enrollment ID: I20200618002370 |
| Provider Name | Shnese Evelyn Mills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154806719 PECOS PAC ID: 3870915804 Enrollment ID: I20200622000975 |
| Provider Name | Tina Lawson Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518581412 PECOS PAC ID: 9335559665 Enrollment ID: I20201027003508 |
| Provider Name | Cory Ray Bates |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477045862 PECOS PAC ID: 5496166332 Enrollment ID: I20201124002389 |
| Provider Name | Adaku Anike |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184249393 PECOS PAC ID: 2264843077 Enrollment ID: I20201201000311 |
| Provider Name | Brittney Elease Parsons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306442363 PECOS PAC ID: 1052723400 Enrollment ID: I20201209001625 |
| Provider Name | Jessica Asaro Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972110708 PECOS PAC ID: 6608288055 Enrollment ID: I20201209001957 |
| Provider Name | Paige Y Cozart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043788912 PECOS PAC ID: 1355758806 Enrollment ID: I20210329001509 |
| Provider Name | Paul Anthony Cristofano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336596998 PECOS PAC ID: 9537590351 Enrollment ID: I20210407001473 |
| Provider Name | Adam Scott Goldammer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356924534 PECOS PAC ID: 4789083908 Enrollment ID: I20210520001165 |
| Provider Name | Karen Rich Dolby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184202277 PECOS PAC ID: 1850790387 Enrollment ID: I20210603000024 |
| Provider Name | Jasmine Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386921476 PECOS PAC ID: 3577963461 Enrollment ID: I20210615000882 |
| Provider Name | Matthew Ryan Gay |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1730541780 PECOS PAC ID: 8628361425 Enrollment ID: I20210621002114 |
| Provider Name | Jolan Elaine Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538730734 PECOS PAC ID: 5597169367 Enrollment ID: I20210802002913 |
| Provider Name | Megan Freeman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548797517 PECOS PAC ID: 0749550010 Enrollment ID: I20210803002396 |
| Provider Name | Deirdre Hamill Mcarthur |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053934497 PECOS PAC ID: 3779987961 Enrollment ID: I20210810003139 |
| Provider Name | Meredith Carolyn Turner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407377971 PECOS PAC ID: 7214331396 Enrollment ID: I20210811002938 |
| Provider Name | Kelsea Jo Just |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538742523 PECOS PAC ID: 5092119990 Enrollment ID: I20210813000727 |
| Provider Name | Katherine S Laubach |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881129484 PECOS PAC ID: 3678843224 Enrollment ID: I20210819002149 |
| Provider Name | Alison Mitchell Rumball |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386133502 PECOS PAC ID: 4385040468 Enrollment ID: I20210915002332 |
| Provider Name | Marcia Cowen |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1427432111 PECOS PAC ID: 5092091306 Enrollment ID: I20210927000753 |
| Provider Name | Brooke Anya Leevy-johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518532837 PECOS PAC ID: 4183012271 Enrollment ID: I20211021002371 |
| Provider Name | Louise Feeney Barthold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659043297 PECOS PAC ID: 1456741800 Enrollment ID: I20211130000141 |
| Provider Name | Lauren Anne Mcelwee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700557089 PECOS PAC ID: 7618367061 Enrollment ID: I20211130000209 |
| Provider Name | Ene Ann Ajibola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013582022 PECOS PAC ID: 2365832631 Enrollment ID: I20211130001489 |
| Provider Name | Karen Leigh Holdsworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104454842 PECOS PAC ID: 2860823226 Enrollment ID: I20211217000484 |
| Provider Name | Jason Matthews |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962844142 PECOS PAC ID: 0749598597 Enrollment ID: I20220119002858 |
| Provider Name | Carolyn Hall Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942968763 PECOS PAC ID: 7618362138 Enrollment ID: I20220321001409 |
| Provider Name | Cicely E Penn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487073623 PECOS PAC ID: 2062899594 Enrollment ID: I20220521000353 |
| Provider Name | Patrice Lashawn White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386390920 PECOS PAC ID: 9931588928 Enrollment ID: I20220622001133 |
| Provider Name | Elise T Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700458742 PECOS PAC ID: 2062892821 Enrollment ID: I20220711001929 |
| Provider Name | Julie Flowers Pender |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326798398 PECOS PAC ID: 2769422682 Enrollment ID: I20220718003450 |
| Provider Name | Paula Ashley Duncan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639471568 PECOS PAC ID: 1355575069 Enrollment ID: I20220804001060 |
| Provider Name | Nathan Wasson Massengill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124523428 PECOS PAC ID: 0648528703 Enrollment ID: I20220822002381 |
| Provider Name | Elisabeth Andrews |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154982072 PECOS PAC ID: 3072946532 Enrollment ID: I20220823004179 |
| Provider Name | Alexandra Maria Cupito |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992112569 PECOS PAC ID: 1850700485 Enrollment ID: I20221007002160 |
| Provider Name | Graham Luke Machen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1447695317 PECOS PAC ID: 4880981372 Enrollment ID: I20221010000856 |
| Provider Name | Margaret Anne Cinderella |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124551650 PECOS PAC ID: 3072888510 Enrollment ID: I20221013002304 |
| Provider Name | Melissa Marie Swanson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1366162349 PECOS PAC ID: 5294104675 Enrollment ID: I20221206003061 |
| Provider Name | John Victor Cresenzo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649890864 PECOS PAC ID: 3577921220 Enrollment ID: I20230628000679 |
| Provider Name | Karim Abdalla Reda Fetouh Hebishi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144707902 PECOS PAC ID: 4981956802 Enrollment ID: I20230713000938 |
| Provider Name | Makiera Lenae Simmons-robinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386263119 PECOS PAC ID: 6507227915 Enrollment ID: I20230802000314 |
| Provider Name | Brad Michael Burgess |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285193458 PECOS PAC ID: 6103152137 Enrollment ID: I20230809004125 |
| Provider Name | Samuel Andrew Stinson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285297937 PECOS PAC ID: 1850634601 Enrollment ID: I20230918004277 |
| Provider Name | Sarah Bahraini |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578126892 PECOS PAC ID: 2567795834 Enrollment ID: I20231018003901 |
| Provider Name | Carol Ann Queen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760159438 PECOS PAC ID: 7012365513 Enrollment ID: I20231121003845 |
| Provider Name | Rashelle Rhonda Pearley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689446841 PECOS PAC ID: 4082063425 Enrollment ID: I20231212000447 |
| Provider Name | Chaney Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235564550 PECOS PAC ID: 4789034620 Enrollment ID: I20231219001680 |
| Provider Name | Tiarra Charelle Morris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558743542 PECOS PAC ID: 2466802079 Enrollment ID: I20231222000660 |
| Provider Name | Whitney Jeanette Cobia |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114417185 PECOS PAC ID: 6901256528 Enrollment ID: I20231222001282 |
| Provider Name | Katherine Marie Bounds |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043834617 PECOS PAC ID: 1759733215 Enrollment ID: I20240119002788 |
| Provider Name | Erika Simone Quinlan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992173082 PECOS PAC ID: 5294188686 Enrollment ID: I20240201002797 |
| Provider Name | Sarah E M Pardue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821612292 PECOS PAC ID: 9335564996 Enrollment ID: I20240322001520 |
| Provider Name | Karen J. Rudd |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1356469951 PECOS PAC ID: 3375985443 Enrollment ID: I20240522000332 |
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Jack H Wolf Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 236 Riverbend Rd, Graham, NC 27253 Phone: 336-578-3465 Fax: 336-578-3466 | |
Crissman Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 214 E Elm St, Graham, NC 27253 Phone: 336-266-2448 Fax: 336-226-5894 |