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1221 S Gear Ave West Burlington IA 52655-1679 | |
| (319) 768-3626 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | General Practice |
| Location | 1221 S Gear Ave, West Burlington, Iowa |
| Authorized Official Name and Position | Michael Mccoy (CEO) |
| Authorized Official Contact | 3197683268 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1221 S Gear Ave West Burlington IA 52655-1679 Ph: (319) 768-3626 | 1221 S Gear Ave West Burlington IA 52655-1679 Ph: (319) 768-3626 |
| NPI Number | 1164433884 |
|---|---|
| Provider Enumeration Date | 08/10/2006 |
| Last Update Date | 10/18/2022 |
| Medicare PECOS PAC ID | 3870496417 |
|---|---|
| Medicare Enrollment ID | O20040130000139 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164433884 | NPI | - | NPPES |
| 0121129 | Medicaid | IA | |
| CH2540 | Other | TRAVELERS MEDICARE | |
| 35449 | Other | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Sarah A Von Harz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447206289 PECOS PAC ID: 4587556741 Enrollment ID: I20040325000299 |
| Provider Name | Michael J Niehaus |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992764096 PECOS PAC ID: 4486647187 Enrollment ID: I20040407001046 |
| Provider Name | Tiffany A.s. Hauptman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1982608584 PECOS PAC ID: 3072508480 Enrollment ID: I20040415001268 |
| Provider Name | Roseller Lim Libarnes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427028760 PECOS PAC ID: 0345236360 Enrollment ID: I20040423000559 |
| Provider Name | Gary L Jennett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982693941 PECOS PAC ID: 1355338161 Enrollment ID: I20040426000978 |
| Provider Name | Rhea Janine Allen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366429177 PECOS PAC ID: 5890783146 Enrollment ID: I20040504001641 |
| Provider Name | Mark L Woodard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114975141 PECOS PAC ID: 8022007103 Enrollment ID: I20040513000008 |
| Provider Name | Timothy S Staudte |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114990660 PECOS PAC ID: 5193715597 Enrollment ID: I20040517001130 |
| Provider Name | David C Wenger Keller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538157383 PECOS PAC ID: 7618869504 Enrollment ID: I20040519000340 |
| Provider Name | Martin Izakovic |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285681197 PECOS PAC ID: 7911988324 Enrollment ID: I20040601000095 |
| Provider Name | Kimberly A Marshall |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225099302 PECOS PAC ID: 0042280869 Enrollment ID: I20040729000232 |
| Provider Name | Laura Lynn Hadden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912935016 PECOS PAC ID: 3577537323 Enrollment ID: I20040825001594 |
| Provider Name | Ajay Labroo |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1831199371 PECOS PAC ID: 7416924279 Enrollment ID: I20040913000522 |
| Provider Name | Benjamin E Reinking |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1972579233 PECOS PAC ID: 5496718736 Enrollment ID: I20041124000395 |
| Provider Name | John R Gipple |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1336126127 PECOS PAC ID: 9436134186 Enrollment ID: I20050106001044 |
| Provider Name | Christopher D Nicholas |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1316037195 PECOS PAC ID: 5799734117 Enrollment ID: I20050112000935 |
| Provider Name | John Rashid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558381426 PECOS PAC ID: 8820980220 Enrollment ID: I20050304000137 |
| Provider Name | Kelly L Kadel |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1639160435 PECOS PAC ID: 3779520184 Enrollment ID: I20050415000745 |
| Provider Name | Amy D Wallis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275598864 PECOS PAC ID: 1052356490 Enrollment ID: I20050625000013 |
| Provider Name | Joel Ryon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063523728 PECOS PAC ID: 9537190962 Enrollment ID: I20050825000780 |
| Provider Name | Ron Mark Oren |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1366422438 PECOS PAC ID: 5395761134 Enrollment ID: I20051020000556 |
| Provider Name | Michelle R Gerdes-boelens |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1588614069 PECOS PAC ID: 1052322286 Enrollment ID: I20060531000230 |
| Provider Name | Sean D Brodale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629029822 PECOS PAC ID: 8820091572 Enrollment ID: I20060818000153 |
| Provider Name | Scott D.m. Miller |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1356384754 PECOS PAC ID: 0345248027 Enrollment ID: I20061113000008 |
| Provider Name | Mirza Omer M Baig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285720490 PECOS PAC ID: 2668471715 Enrollment ID: I20061219000072 |
| Provider Name | Brandon R Beauchamp |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982637112 PECOS PAC ID: 1052314077 Enrollment ID: I20070830000322 |
| Provider Name | Christina Goebel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760469589 PECOS PAC ID: 6305830043 Enrollment ID: I20070924000730 |
| Provider Name | Jose W Calderon |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1255389854 PECOS PAC ID: 5890889554 Enrollment ID: I20070926000181 |
| Provider Name | Francis M Sanchez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639101934 PECOS PAC ID: 9335113802 Enrollment ID: I20070926000254 |
| Provider Name | Susan A Walz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1851554703 PECOS PAC ID: 6204900434 Enrollment ID: I20080805000800 |
| Provider Name | Kelly R Samberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376635482 PECOS PAC ID: 3577452150 Enrollment ID: I20090224000254 |
| Provider Name | Stephanie Lee Hastings |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689811184 PECOS PAC ID: 7416012562 Enrollment ID: I20090224000604 |
| Provider Name | Srikrishna Chundru |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932162815 PECOS PAC ID: 8527064120 Enrollment ID: I20090414000318 |
| Provider Name | Beverly Ann Christy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821231002 PECOS PAC ID: 0749339893 Enrollment ID: I20090519000603 |
| Provider Name | Jose G Aguilar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760681597 PECOS PAC ID: 1052462884 Enrollment ID: I20090707000657 |
| Provider Name | Jennifer De La Rosa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417915208 PECOS PAC ID: 8628095445 Enrollment ID: I20090709000525 |
| Provider Name | Louis C Kantzavelos |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1811106826 PECOS PAC ID: 3870645260 Enrollment ID: I20090715000773 |
| Provider Name | Timothy J Hunter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922003003 PECOS PAC ID: 7315088986 Enrollment ID: I20100104000636 |
| Provider Name | Nicole S Gellatly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831427467 PECOS PAC ID: 2860533148 Enrollment ID: I20100108000434 |
| Provider Name | Ian H Law |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093700783 PECOS PAC ID: 2163492448 Enrollment ID: I20100123000112 |
| Provider Name | Kathy J Anderson |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1285636100 PECOS PAC ID: 5698819068 Enrollment ID: I20100223000628 |
| Provider Name | Raymond P Smith |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1477526259 PECOS PAC ID: 3577524941 Enrollment ID: I20100301000044 |
| Provider Name | Gisella P Puga |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417285032 PECOS PAC ID: 9830234707 Enrollment ID: I20100303000296 |
| Provider Name | Michael J Mccoy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003877184 PECOS PAC ID: 0244244002 Enrollment ID: I20100322000132 |
| Provider Name | Peggy Ann Hirte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942298294 PECOS PAC ID: 3678602208 Enrollment ID: I20100520000143 |
| Provider Name | Valerie S Velho Denz |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1609893510 PECOS PAC ID: 9234269036 Enrollment ID: I20100604000423 |
| Provider Name | Jeremy R Murphy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699841411 PECOS PAC ID: 0345370094 Enrollment ID: I20100608000043 |
| Provider Name | Michael K Abouassaly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184790909 PECOS PAC ID: 0840321287 Enrollment ID: I20100628001038 |
| Provider Name | Douglas W Peters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528134343 PECOS PAC ID: 3072656347 Enrollment ID: I20100629000069 |
| Provider Name | David W Carlson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033285945 PECOS PAC ID: 2062544091 Enrollment ID: I20100709000538 |
| Provider Name | David E Fishbaugher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598960452 PECOS PAC ID: 9537283635 Enrollment ID: I20100826000168 |
| Provider Name | Erin M Haeger |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134387012 PECOS PAC ID: 5799977187 Enrollment ID: I20101004000781 |
| Provider Name | Cynthia M Walljasper Mcwilliams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932278439 PECOS PAC ID: 7012109127 Enrollment ID: I20101007000946 |
| Provider Name | Eric Timothy Hogan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144343435 PECOS PAC ID: 5193894301 Enrollment ID: I20101022000760 |
| Provider Name | Steven R Gorsch |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972579548 PECOS PAC ID: 9032304738 Enrollment ID: I20101108000854 |
| Provider Name | Jane A Schuler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760790851 PECOS PAC ID: 3971798349 Enrollment ID: I20101110001380 |
| Provider Name | Carlos Falcon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619959277 PECOS PAC ID: 0345439501 Enrollment ID: I20110104001142 |
| Provider Name | Todd A. Janicki |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265533301 PECOS PAC ID: 2769588813 Enrollment ID: I20110712000727 |
| Provider Name | Brent Woodbury |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1558412130 PECOS PAC ID: 0840469490 Enrollment ID: I20110816000445 |
| Provider Name | Craig Alan Murphy |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1124097688 PECOS PAC ID: 6507036605 Enrollment ID: I20110829000369 |
| Provider Name | Susan E Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346521739 PECOS PAC ID: 7416128913 Enrollment ID: I20110913000661 |
| Provider Name | Richard G To |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1962788687 PECOS PAC ID: 4183898794 Enrollment ID: I20111116000891 |
| Provider Name | Gerald M Arnold |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184606493 PECOS PAC ID: 5496929788 Enrollment ID: I20111123000159 |
| Provider Name | Christian A Khoury |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1477694867 PECOS PAC ID: 3173677101 Enrollment ID: I20111208000835 |
| Provider Name | Rachel A Oliverio |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1447454145 PECOS PAC ID: 2062670367 Enrollment ID: I20120215000807 |
| Provider Name | Melissa Mahon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003047820 PECOS PAC ID: 8123165313 Enrollment ID: I20120321000713 |
| Provider Name | Jennifer A Fullenkamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760550396 PECOS PAC ID: 4486819034 Enrollment ID: I20120703000672 |
| Provider Name | Heather L Perry |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1801021431 PECOS PAC ID: 6406002468 Enrollment ID: I20120807000176 |
| Provider Name | Karla A Williams |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255685731 PECOS PAC ID: 7315199932 Enrollment ID: I20121206000061 |
| Provider Name | Branden J Briggs |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700160959 PECOS PAC ID: 3173765591 Enrollment ID: I20130815000151 |
| Provider Name | Amanda C Garr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609218304 PECOS PAC ID: 1456595065 Enrollment ID: I20130923000275 |
| Provider Name | Kendra M Bonnesen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548694771 PECOS PAC ID: 7618103334 Enrollment ID: I20131202000075 |
| Provider Name | Joseph P Tansey |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1821023987 PECOS PAC ID: 9133137367 Enrollment ID: I20131220000027 |
| Provider Name | Amanda J Winters |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003020496 PECOS PAC ID: 8426220989 Enrollment ID: I20140123000164 |
| Provider Name | Hannah M Heckart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881905768 PECOS PAC ID: 9537303672 Enrollment ID: I20140804001687 |
| Provider Name | Ashley Coffey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427465095 PECOS PAC ID: 6800013350 Enrollment ID: I20140807001080 |
| Provider Name | Evangeline Z De Sagun |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1356446322 PECOS PAC ID: 8426238445 Enrollment ID: I20140825000355 |
| Provider Name | Sandra J Hoffmann |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518039189 PECOS PAC ID: 0941108658 Enrollment ID: I20141119000975 |
| Provider Name | Walid Y Saad |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1164752499 PECOS PAC ID: 5092937318 Enrollment ID: I20141120001473 |
| Provider Name | Stephen Holley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235325994 PECOS PAC ID: 4082798046 Enrollment ID: I20141208001084 |
| Provider Name | Mark L Walz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1093119083 PECOS PAC ID: 0840231247 Enrollment ID: I20141209000520 |
| Provider Name | Jessica Jade Dutka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619371168 PECOS PAC ID: 5799007407 Enrollment ID: I20141209000636 |
| Provider Name | Sarah Lundin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699084350 PECOS PAC ID: 1456575935 Enrollment ID: I20141210000910 |
| Provider Name | Kari Jeanne Payne |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1902200264 PECOS PAC ID: 0941523013 Enrollment ID: I20141222000138 |
| Provider Name | Timothy M Volk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801141726 PECOS PAC ID: 0941448773 Enrollment ID: I20150102000749 |
| Provider Name | Anthony E Magalski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174508014 PECOS PAC ID: 6002837523 Enrollment ID: I20150210000927 |
| Provider Name | Carrie F Helmick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578542163 PECOS PAC ID: 5193041028 Enrollment ID: I20150311001491 |
| Provider Name | Corey Lalonde |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1538242839 PECOS PAC ID: 3274698949 Enrollment ID: I20150320000452 |
| Provider Name | Lisa A Lake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013398023 PECOS PAC ID: 2668784299 Enrollment ID: I20150709002518 |
| Provider Name | John R Thurman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619237849 PECOS PAC ID: 8921221896 Enrollment ID: I20150814013276 |
| Provider Name | Grace A Totoe |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1538335302 PECOS PAC ID: 3072782929 Enrollment ID: I20151015000596 |
| Provider Name | Mark Grieves |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245229640 PECOS PAC ID: 3375736796 Enrollment ID: I20151023001570 |
| Provider Name | Anne D Grieves |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861444614 PECOS PAC ID: 5991997082 Enrollment ID: I20151026000644 |
| Provider Name | Timothy P Monson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1740207281 PECOS PAC ID: 1850200239 Enrollment ID: I20151112002484 |
| Provider Name | Katrina V Hotka-truempler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215301791 PECOS PAC ID: 4183925464 Enrollment ID: I20151210000047 |
| Provider Name | Laura L Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902270317 PECOS PAC ID: 7911209838 Enrollment ID: I20160111000463 |
| Provider Name | Craig A Bottke |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1730186933 PECOS PAC ID: 5395747463 Enrollment ID: I20160128001248 |
| Provider Name | Loren K Reed |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386089803 PECOS PAC ID: 9739321985 Enrollment ID: I20160630000954 |
| Provider Name | Shanmuga Priyan Vasudevan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245670678 PECOS PAC ID: 5395041339 Enrollment ID: I20160714000569 |
| Provider Name | Breanne L Vogel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679920045 PECOS PAC ID: 0446544043 Enrollment ID: I20160804000896 |
| Provider Name | Cara E Sawyer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316218191 PECOS PAC ID: 1850530445 Enrollment ID: I20160804002110 |
| Provider Name | Eli M Fouerte |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1588022818 PECOS PAC ID: 6103110721 Enrollment ID: I20160823001759 |
| Provider Name | Brandy D Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083168967 PECOS PAC ID: 9335435957 Enrollment ID: I20160908001180 |
| Provider Name | Vinodkumar Paddolkar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619108842 PECOS PAC ID: 2860628484 Enrollment ID: I20161010000308 |
| Provider Name | Dawn M Rohrer |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1346795226 PECOS PAC ID: 7911295738 Enrollment ID: I20161011002712 |
| Provider Name | Tiffany R Rhoades |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518415298 PECOS PAC ID: 5698063311 Enrollment ID: I20161013000243 |
| Provider Name | Joyce L Chouinard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770033888 PECOS PAC ID: 8224316112 Enrollment ID: I20161027001550 |
| Provider Name | John A Lothrop |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780024489 PECOS PAC ID: 1759512254 Enrollment ID: I20161108000937 |
| Provider Name | Winnie T Chua |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780028530 PECOS PAC ID: 9335447838 Enrollment ID: I20170223000713 |
| Provider Name | Meghan E Wooster |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1710305628 PECOS PAC ID: 1052691789 Enrollment ID: I20170327000324 |
| Provider Name | Meredith A Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689115727 PECOS PAC ID: 4082990981 Enrollment ID: I20170407000063 |
| Provider Name | Maria T Story |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1639581895 PECOS PAC ID: 2860619962 Enrollment ID: I20170530000058 |
| Provider Name | Bobbi J Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902327604 PECOS PAC ID: 4688945900 Enrollment ID: I20170804002099 |
| Provider Name | Carrie A Skibba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457877177 PECOS PAC ID: 7214202373 Enrollment ID: I20170929001208 |
| Provider Name | Siva Gadde |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033518949 PECOS PAC ID: 7719280031 Enrollment ID: I20171003004144 |
| Provider Name | Alexander D Pederson |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1841307899 PECOS PAC ID: 9133297922 Enrollment ID: I20171201001703 |
| Provider Name | Gregory F Gorski |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073707345 PECOS PAC ID: 7416215710 Enrollment ID: I20171214000813 |
| Provider Name | Jennifer R Mazza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366968968 PECOS PAC ID: 6204194939 Enrollment ID: I20171229000595 |
| Provider Name | Mara B Syring |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609166180 PECOS PAC ID: 7517270689 Enrollment ID: I20180118000061 |
| Provider Name | Nicole F Wilcox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659896587 PECOS PAC ID: 0941569883 Enrollment ID: I20180122002288 |
| Provider Name | Luz N Cortes |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1205897352 PECOS PAC ID: 4284526856 Enrollment ID: I20180226001258 |
| Provider Name | Ryan M Foulkes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851893135 PECOS PAC ID: 1557623014 Enrollment ID: I20180321000185 |
| Provider Name | Umang Gupta |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1336346782 PECOS PAC ID: 1153592746 Enrollment ID: I20180328000098 |
| Provider Name | Ryan L Deets |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1326305830 PECOS PAC ID: 5092955187 Enrollment ID: I20180615001677 |
| Provider Name | Rauf Javadov |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992189831 PECOS PAC ID: 6507162542 Enrollment ID: I20180628000352 |
| Provider Name | Scott T Joyce |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1144680216 PECOS PAC ID: 7719284462 Enrollment ID: I20180810000746 |
| Provider Name | Katelyn G Thurman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174018592 PECOS PAC ID: 9133478522 Enrollment ID: I20180817001836 |
| Provider Name | Ruth Barosy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518349539 PECOS PAC ID: 5991054058 Enrollment ID: I20180822002391 |
| Provider Name | Liberty A Balbort |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356597090 PECOS PAC ID: 5193975894 Enrollment ID: I20180823002130 |
| Provider Name | Mariah E Skelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629506829 PECOS PAC ID: 4082988688 Enrollment ID: I20180831001585 |
| Provider Name | Devin J Juel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518443647 PECOS PAC ID: 4183974280 Enrollment ID: I20180911003670 |
| Provider Name | Christina A Metternich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902355233 PECOS PAC ID: 0042598013 Enrollment ID: I20180924001137 |
| Provider Name | Amy Samah Kathrine Moses-nanthan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679984181 PECOS PAC ID: 9537484795 Enrollment ID: I20181002001406 |
| Provider Name | Michelle L Hornung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205315116 PECOS PAC ID: 7214280742 Enrollment ID: I20181030001111 |
| Provider Name | Seth L Olson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013498120 PECOS PAC ID: 7315291853 Enrollment ID: I20181119002856 |
| Provider Name | Sara L Ragar |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1235610296 PECOS PAC ID: 2668726100 Enrollment ID: I20181119002940 |
| Provider Name | Urime N Mehmedi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487137428 PECOS PAC ID: 7810231990 Enrollment ID: I20181129002635 |
| Provider Name | Pauline W Mungai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407260953 PECOS PAC ID: 6204135817 Enrollment ID: I20181206000453 |
| Provider Name | Prashob Porayette |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1851551428 PECOS PAC ID: 4486934601 Enrollment ID: I20190513000593 |
| Provider Name | Michael F Merrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538633748 PECOS PAC ID: 5294068045 Enrollment ID: I20190610002072 |
| Provider Name | Nasim Heckenberg |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285020743 PECOS PAC ID: 9436462629 Enrollment ID: I20190716001801 |
| Provider Name | Mohamed Gashouta |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1427311877 PECOS PAC ID: 1456599190 Enrollment ID: I20190801000134 |
| Provider Name | Walter G Downey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407967011 PECOS PAC ID: 9032013149 Enrollment ID: I20190816002723 |
| Provider Name | Stephanie M Hansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457905705 PECOS PAC ID: 2567792815 Enrollment ID: I20190930000661 |
| Provider Name | Audra A Zimmer |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1558749275 PECOS PAC ID: 7911290911 Enrollment ID: I20191022002522 |
| Provider Name | Ahmad M Nafe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841640190 PECOS PAC ID: 9638401078 Enrollment ID: I20191104002513 |
| Provider Name | Wendell Spencer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1861593071 PECOS PAC ID: 3375688203 Enrollment ID: I20200120000476 |
| Provider Name | Julie A Snavely |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841838638 PECOS PAC ID: 5395171748 Enrollment ID: I20200204001475 |
| Provider Name | Whitney A Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700436474 PECOS PAC ID: 2365870201 Enrollment ID: I20200307000123 |
| Provider Name | Bailey A Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528627122 PECOS PAC ID: 2264860584 Enrollment ID: I20200320001509 |
| Provider Name | Logan T Chiri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750900809 PECOS PAC ID: 6305277211 Enrollment ID: I20200508002391 |
| Provider Name | Marissa A Crowdis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215386578 PECOS PAC ID: 2668893207 Enrollment ID: I20200605002087 |
| Provider Name | Bryan C Blacker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528590189 PECOS PAC ID: 6305117268 Enrollment ID: I20200605002144 |
| Provider Name | Mark Frisch |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093753865 PECOS PAC ID: 9436188976 Enrollment ID: I20200618002423 |
| Provider Name | Samer Abu Alula |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447782578 PECOS PAC ID: 5597188292 Enrollment ID: I20200714002429 |
| Provider Name | Scott Gleason |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1225454044 PECOS PAC ID: 0042505489 Enrollment ID: I20200720000536 |
| Provider Name | Theresa Mckoon |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1356747166 PECOS PAC ID: 9537589908 Enrollment ID: I20201023001985 |
| Provider Name | William Douglas Tressel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174785505 PECOS PAC ID: 7113106584 Enrollment ID: I20201103001815 |
| Provider Name | Vanessa L Pitts |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588691687 PECOS PAC ID: 4183654346 Enrollment ID: I20201209000145 |
| Provider Name | Adam E Culver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710538244 PECOS PAC ID: 6103232806 Enrollment ID: I20210303003151 |
| Provider Name | Joshua Hucklenbrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851986608 PECOS PAC ID: 7012324494 Enrollment ID: I20210331002002 |
| Provider Name | Catherine T Vanmilligen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427543941 PECOS PAC ID: 2163778036 Enrollment ID: I20210610000665 |
| Provider Name | Lynette B Prickett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487271904 PECOS PAC ID: 1052711876 Enrollment ID: I20210616001942 |
| Provider Name | Rachel Nicole Kalenkiewicz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588228027 PECOS PAC ID: 1658772793 Enrollment ID: I20210628001861 |
| Provider Name | Sumathi Vijaya Rangan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235650805 PECOS PAC ID: 1951732247 Enrollment ID: I20210712001213 |
| Provider Name | Crystal Lynn Iddings |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1891365235 PECOS PAC ID: 4789087404 Enrollment ID: I20210719002608 |
| Provider Name | Mohaddeseh Sharifzadeh |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1497201610 PECOS PAC ID: 2567702129 Enrollment ID: I20210722002766 |
| Provider Name | Ruchie Bhattarai |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1760915375 PECOS PAC ID: 7113358482 Enrollment ID: I20210722002824 |
| Provider Name | Molly Davis |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1407434400 PECOS PAC ID: 1658774070 Enrollment ID: I20210722003163 |
| Provider Name | Kaleb Davidson Frazier |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427612860 PECOS PAC ID: 5698178416 Enrollment ID: I20210730000661 |
| Provider Name | John Q Vu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1497250336 PECOS PAC ID: 3870840143 Enrollment ID: I20210730000685 |
| Provider Name | Zeina Hajar |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1124549720 PECOS PAC ID: 8224309463 Enrollment ID: I20210730002664 |
| Provider Name | Michelle L Houghton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609445733 PECOS PAC ID: 4385048586 Enrollment ID: I20210810003743 |
| Provider Name | Dennis Robins Solomon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851387377 PECOS PAC ID: 7315840931 Enrollment ID: I20210831000479 |
| Provider Name | Ira H Lubkin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548329923 PECOS PAC ID: 6800794744 Enrollment ID: I20210922001526 |
| Provider Name | Darci Heap |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700554995 PECOS PAC ID: 2961800636 Enrollment ID: I20211011001039 |
| Provider Name | Arnold J Feltoon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639124050 PECOS PAC ID: 6608765219 Enrollment ID: I20211201000140 |
| Provider Name | Kenneth Matthew Zino |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285161562 PECOS PAC ID: 6507131281 Enrollment ID: I20211228001908 |
| Provider Name | William S Snyder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093065369 PECOS PAC ID: 6204156185 Enrollment ID: I20211228001982 |
| Provider Name | Stephanie N Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821757519 PECOS PAC ID: 8729470422 Enrollment ID: I20220107001873 |
| Provider Name | Kaitlyn M Fedler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316606999 PECOS PAC ID: 6103218128 Enrollment ID: I20220124002105 |
| Provider Name | Sophie D Rinker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346900578 PECOS PAC ID: 3476946906 Enrollment ID: I20220207000132 |
| Provider Name | Jorden A Doubet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023777091 PECOS PAC ID: 4981098803 Enrollment ID: I20220218000648 |
| Provider Name | Sara De La Rosa |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1992190821 PECOS PAC ID: 8921390055 Enrollment ID: I20220228001147 |
| Provider Name | Fawad Mian |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306006242 PECOS PAC ID: 0042364622 Enrollment ID: I20220228001956 |
| Provider Name | Lauren Tada |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730558636 PECOS PAC ID: 2062712060 Enrollment ID: I20220321001118 |
| Provider Name | Jennifer R Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912667973 PECOS PAC ID: 6305232026 Enrollment ID: I20220406001132 |
| Provider Name | Elvis Kasi |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972000438 PECOS PAC ID: 4789007774 Enrollment ID: I20220427001147 |
| Provider Name | Raza Kazmi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548764962 PECOS PAC ID: 5890198485 Enrollment ID: I20220504000322 |
| Provider Name | Muhammad Rena Ajmal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1639552433 PECOS PAC ID: 7113317173 Enrollment ID: I20220506000144 |
| Provider Name | Robert N Tiballi |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1194757427 PECOS PAC ID: 6406839737 Enrollment ID: I20220518002213 |
| Provider Name | Cassandra Dunivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639826316 PECOS PAC ID: 4688052475 Enrollment ID: I20220607002213 |
| Provider Name | Sandra L Worrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285841775 PECOS PAC ID: 8325103310 Enrollment ID: I20220713003431 |
| Provider Name | Shereen A Santee |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659861797 PECOS PAC ID: 8628325776 Enrollment ID: I20220713003462 |
| Provider Name | Megan L Warneke |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689231045 PECOS PAC ID: 5597091728 Enrollment ID: I20220720001871 |
| Provider Name | Charles J Frank |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396196432 PECOS PAC ID: 5799057477 Enrollment ID: I20220804001454 |
| Provider Name | Amy Gnann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760121651 PECOS PAC ID: 6002298056 Enrollment ID: I20220808001074 |
| Provider Name | Seth Wolff |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558509398 PECOS PAC ID: 8820140189 Enrollment ID: I20220823003682 |
| Provider Name | Seth Mendenhall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427793710 PECOS PAC ID: 4688058043 Enrollment ID: I20220902000641 |
| Provider Name | Vivian Anderson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063144210 PECOS PAC ID: 9234505470 Enrollment ID: I20221013001211 |
| Provider Name | Balarama Krishna Surapaneni |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003311648 PECOS PAC ID: 0941676985 Enrollment ID: I20221017002580 |
| Provider Name | Steven Alexander Ilko |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144859331 PECOS PAC ID: 5496179822 Enrollment ID: I20221104002296 |
| Provider Name | Maureen Heitmeier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770207664 PECOS PAC ID: 1153798087 Enrollment ID: I20221107002330 |
| Provider Name | Krystal Schmieg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427774074 PECOS PAC ID: 2961871272 Enrollment ID: I20221208001729 |
| Provider Name | Zackary Glen Byard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902302052 PECOS PAC ID: 9537497268 Enrollment ID: I20221214001630 |
| Provider Name | Viren Manoj Kumar Raheja |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215559455 PECOS PAC ID: 1355749425 Enrollment ID: I20230519001513 |
| Provider Name | Amanda M Johnson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457970030 PECOS PAC ID: 4981022597 Enrollment ID: I20230521000055 |
| Provider Name | Ayesha Javed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831610690 PECOS PAC ID: 6204186265 Enrollment ID: I20230522002311 |
| Provider Name | Shevani Uveni Ganesh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003306499 PECOS PAC ID: 8123377611 Enrollment ID: I20230523000959 |
| Provider Name | Ajith Kumar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609952381 PECOS PAC ID: 7719052521 Enrollment ID: I20230525003032 |
| Provider Name | Jeremy R Owens |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639798895 PECOS PAC ID: 4284663774 Enrollment ID: I20230602000701 |
| Provider Name | Peter Rubin |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1912950411 PECOS PAC ID: 4688659980 Enrollment ID: I20230613001629 |
| Provider Name | Mark Borsody |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215179767 PECOS PAC ID: 5890844575 Enrollment ID: I20230623001696 |
| Provider Name | Frederique St-pierre |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1427579853 PECOS PAC ID: 0446522882 Enrollment ID: I20230624000303 |
| Provider Name | Terence J Cullen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1982228839 PECOS PAC ID: 0941621338 Enrollment ID: I20230628001691 |
| Provider Name | Alexander Kudinov |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962953539 PECOS PAC ID: 8426329012 Enrollment ID: I20230719003837 |
| Provider Name | Benjamin William Hale |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124464599 PECOS PAC ID: 7214232313 Enrollment ID: I20230726001197 |
| Provider Name | Jeffery C Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548953300 PECOS PAC ID: 2961864749 Enrollment ID: I20230810001302 |
| Provider Name | Emily S Mynatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356066310 PECOS PAC ID: 9133599251 Enrollment ID: I20230810001748 |
| Provider Name | Diana Mahbod |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1689931974 PECOS PAC ID: 6901110089 Enrollment ID: I20230821002680 |
| Provider Name | Patrick G Williams |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962585844 PECOS PAC ID: 0345247581 Enrollment ID: I20230830003698 |
| Provider Name | Reed Stockman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1326071952 PECOS PAC ID: 9739107541 Enrollment ID: I20230831000706 |
| Provider Name | Diane M Madsen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568788677 PECOS PAC ID: 4385774884 Enrollment ID: I20230901000654 |
| Provider Name | Norma Hagans |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750741237 PECOS PAC ID: 3577860956 Enrollment ID: I20231024002843 |
| Provider Name | Jayaraj Salimath |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720020308 PECOS PAC ID: 3274546411 Enrollment ID: I20231113002418 |
| Provider Name | Stephanie A Acosta |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609261718 PECOS PAC ID: 0941657951 Enrollment ID: I20231114000317 |
| Provider Name | Nicholas P Pollock |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1871516484 PECOS PAC ID: 2668470741 Enrollment ID: I20231115002820 |
| Provider Name | Khyla Kline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598445678 PECOS PAC ID: 1759739873 Enrollment ID: I20231130001702 |
| Provider Name | Elisa K Roth |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629464102 PECOS PAC ID: 8820446883 Enrollment ID: I20231130003670 |
| Provider Name | Laura Kasi |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1275243636 PECOS PAC ID: 8022466952 Enrollment ID: I20231202000083 |
| Provider Name | Piyush Poddar |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1104132554 PECOS PAC ID: 4486963550 Enrollment ID: I20231214000279 |
| Provider Name | Regan Stellern |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205615416 PECOS PAC ID: 0345690160 Enrollment ID: I20231220000873 |
| Provider Name | Saad George Ajja |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982709911 PECOS PAC ID: 0648329557 Enrollment ID: I20231228002366 |
| Provider Name | Audrey Cook |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659632768 PECOS PAC ID: 9436500303 Enrollment ID: I20240105000170 |
| Provider Name | Dalton Tran |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437504313 PECOS PAC ID: 4284968256 Enrollment ID: I20240105000275 |
| Provider Name | Monika M Banach |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1396042263 PECOS PAC ID: 7911183686 Enrollment ID: I20240116001239 |
| Provider Name | Clyde M Grady |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851484075 PECOS PAC ID: 9335278886 Enrollment ID: I20240124000593 |
| Provider Name | Craig Bone |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1073668075 PECOS PAC ID: 4789625278 Enrollment ID: I20240205003216 |
| Provider Name | Paula M Dobrowolska |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417353319 PECOS PAC ID: 1850614199 Enrollment ID: I20240207002463 |
| Provider Name | Nancy Wise |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558652743 PECOS PAC ID: 3072790914 Enrollment ID: I20240215000978 |
| Provider Name | Tonya R Gibbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205482254 PECOS PAC ID: 6406187228 Enrollment ID: I20240222000518 |
| Provider Name | Arthur Manoli |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1700271137 PECOS PAC ID: 4688977572 Enrollment ID: I20240229000700 |
| Provider Name | Michelle R Floyd |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245327576 PECOS PAC ID: 1355343039 Enrollment ID: I20240229000730 |
| Provider Name | Jeffrey Wilson |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1003287079 PECOS PAC ID: 4981999893 Enrollment ID: I20240312000363 |
| Provider Name | Nicole Battaglioli |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295173730 PECOS PAC ID: 5890085682 Enrollment ID: I20240412004112 |
| Provider Name | Heather Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659149862 PECOS PAC ID: 8224477096 Enrollment ID: I20240413000196 |
| Provider Name | Dusty Lynn Johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265494785 PECOS PAC ID: 4486663994 Enrollment ID: I20240530000587 |
| Provider Name | Syed Muhammad Hussain Zaidi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700451606 PECOS PAC ID: 2567904683 Enrollment ID: I20240604004276 |
| Provider Name | Daniel Lister |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1073599817 PECOS PAC ID: 0547217655 Enrollment ID: I20240625002262 |
| Provider Name | Sargine Brutus |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417999285 PECOS PAC ID: 5294767455 Enrollment ID: I20240702001596 |
| Provider Name | Raafat Alameddine |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1740842418 PECOS PAC ID: 9133457898 Enrollment ID: I20240709000612 |
| Provider Name | Lauren Bigger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346797180 PECOS PAC ID: 6305382839 Enrollment ID: I20240722000103 |
| Provider Name | Rachel Crooks |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003662149 PECOS PAC ID: 3173069390 Enrollment ID: I20240724002811 |
| Provider Name | Camilla Frederick |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1457324865 PECOS PAC ID: 9638616436 Enrollment ID: I20240729004226 |
| Provider Name | Aftab Sharif |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346811957 PECOS PAC ID: 7618370792 Enrollment ID: I20240730000316 |
| Provider Name | Robert W Lopez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669053948 PECOS PAC ID: 3870998370 Enrollment ID: I20240730001288 |
| Provider Name | Andrew S Root |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851034540 PECOS PAC ID: 3274912704 Enrollment ID: I20240801002795 |
| Provider Name | Sarah Kottenstette |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831775576 PECOS PAC ID: 7214384544 Enrollment ID: I20240820002770 |
| Provider Name | Donna Wirt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093559981 PECOS PAC ID: 1759829831 Enrollment ID: I20240820004038 |
| Provider Name | Carly Keenan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942822630 PECOS PAC ID: 9931526589 Enrollment ID: I20240829001019 |
| Provider Name | Lyssa Lynn Hill |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1205421757 PECOS PAC ID: 3476955998 Enrollment ID: I20240910003272 |
| Provider Name | Moldovan Sabov |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1912403403 PECOS PAC ID: 8527467166 Enrollment ID: I20240917003419 |
| Provider Name | Aadit Shah |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1730686882 PECOS PAC ID: 5799012456 Enrollment ID: I20240930002477 |
| Provider Name | John S Harris |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306929252 PECOS PAC ID: 9234294703 Enrollment ID: I20241008001560 |
| Provider Name | Michael Rayner Leedom |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003951823 PECOS PAC ID: 0749332922 Enrollment ID: I20241026000358 |
| Provider Name | Jeffrey D. Hall |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013413293 PECOS PAC ID: 8729333778 Enrollment ID: I20241030000998 |
| Provider Name | Kimberly Hinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588482095 PECOS PAC ID: 0042744161 Enrollment ID: I20241112004409 |
| Provider Name | Sharron Gingrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205821923 PECOS PAC ID: 6800824509 Enrollment ID: I20241204001443 |
| Provider Name | Christy L Walter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801859160 PECOS PAC ID: 2062479504 Enrollment ID: I20241205003818 |
| Provider Name | Onyinyechi Uloma Eke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568937084 PECOS PAC ID: 0749525798 Enrollment ID: I20241205004052 |
| Provider Name | Joshua Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003236449 PECOS PAC ID: 2567786098 Enrollment ID: I20241205004185 |
| Provider Name | Kelly Bowman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386180354 PECOS PAC ID: 2961786678 Enrollment ID: I20241206002521 |
Community Health Centers Of Southeastern Iowa, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 545 Ramsey St, Mobile Unit Room 2, West Burlington, IA 52655 Phone: 319-768-5858 | |
Community Health Centers Of Southeastern Iowa, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1223 S Gear Ave Ste 108, West Burlington, IA 52655 Phone: 319-753-5177 | |
The Gastroenterology Clinic, Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1223 S Gear Ave, Suite 201, West Burlington, IA 52655 Phone: 319-758-9075 Fax: 319-758-9079 | |
Community Health Centers Of Southeastern Iowa Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1706 West Agency Road, West Burlington, IA 52655 Phone: 319-768-5858 Fax: 319-752-4653 | |