| St. Vincent Medical Group | |
|
2 St. Vincent Circle Little Rock AR 72205-2936 | |
| (501) 552-3571 | |
| (501) 224-1927 |
| Full Name | St. Vincent Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 2 St. Vincent Circle, Little Rock, Arkansas |
| Authorized Official Name and Position | Jamie Dennis (DIRECTOR) |
| Authorized Official Contact | 5012241690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Vincent Medical Group Po Box 23410 Little Rock AR 72221-3410 Ph: (501) 224-1690 | St. Vincent Medical Group 2 St. Vincent Circle Little Rock AR 72205-2936 Ph: (501) 552-3571 |
| NPI Number | 1134176480 |
|---|---|
| Provider Enumeration Date | 05/30/2006 |
| Last Update Date | 08/12/2024 |
| Medicare PECOS PAC ID | 5698758803 |
|---|---|
| Medicare Enrollment ID | O20040622000224 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134176480 | NPI | - | NPPES |
| 138898002 | Medicaid | AR |
| Provider Name | Joseph M Beck |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1568441368 PECOS PAC ID: 4880599349 Enrollment ID: I20031206000115 |
| Provider Name | Jennifer M Co |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871642306 PECOS PAC ID: 6002716222 Enrollment ID: I20040112000558 |
| Provider Name | Lori Fawbush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760646020 PECOS PAC ID: 5496648735 Enrollment ID: I20040202001188 |
| Provider Name | Paula J Sargent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164416368 PECOS PAC ID: 3072406842 Enrollment ID: I20040205000321 |
| Provider Name | Kurtis S Vinsant |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1144257882 PECOS PAC ID: 4688569049 Enrollment ID: I20040216001136 |
| Provider Name | Kimberly K Shaffer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1821084500 PECOS PAC ID: 4587550025 Enrollment ID: I20040223001048 |
| Provider Name | Safwan H Sakr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053423350 PECOS PAC ID: 7618864307 Enrollment ID: I20040227000814 |
| Provider Name | Ann D Layton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700879970 PECOS PAC ID: 5496642795 Enrollment ID: I20040302000405 |
| Provider Name | Tiffany M Padilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497765010 PECOS PAC ID: 0042108755 Enrollment ID: I20040305000188 |
| Provider Name | Duane Gill |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427096544 PECOS PAC ID: 3577451194 Enrollment ID: I20040305000923 |
| Provider Name | Madhu Budhraja |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1568517456 PECOS PAC ID: 1052305521 Enrollment ID: I20040408001349 |
| Provider Name | John Norwood Meadors |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780673004 PECOS PAC ID: 9537153481 Enrollment ID: I20040413000868 |
| Provider Name | Theodore J Henning |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477542793 PECOS PAC ID: 6406842814 Enrollment ID: I20040421001760 |
| Provider Name | Bradley S Boop |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033145792 PECOS PAC ID: 7810984259 Enrollment ID: I20040428000668 |
| Provider Name | Elaine J Wilson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710932389 PECOS PAC ID: 0244227593 Enrollment ID: I20040428000801 |
| Provider Name | John Brett Ironside |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891727855 PECOS PAC ID: 2961499223 Enrollment ID: I20040428000906 |
| Provider Name | Beverly A Beadle |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1437181815 PECOS PAC ID: 9133116460 Enrollment ID: I20040428001338 |
| Provider Name | Robert F Silzer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881626257 PECOS PAC ID: 7618964859 Enrollment ID: I20040428001461 |
| Provider Name | Rhodora Raghavan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467418749 PECOS PAC ID: 8820086754 Enrollment ID: I20040430001279 |
| Provider Name | Charles Manning |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992803639 PECOS PAC ID: 0446240238 Enrollment ID: I20040513001427 |
| Provider Name | Jodi Barboza |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023007333 PECOS PAC ID: 7113917451 Enrollment ID: I20040517001470 |
| Provider Name | Wilma Jean Matchett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316934649 PECOS PAC ID: 3971584319 Enrollment ID: I20040601000336 |
| Provider Name | Don Williams |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679555064 PECOS PAC ID: 1951383900 Enrollment ID: I20040603000301 |
| Provider Name | John Scurlock |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619964822 PECOS PAC ID: 4880676642 Enrollment ID: I20040604000314 |
| Provider Name | Jaymie H Pennington |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780894717 PECOS PAC ID: 0244214294 Enrollment ID: I20040616001001 |
| Provider Name | Tamer Alsebai |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1528091071 PECOS PAC ID: 5395720304 Enrollment ID: I20040623000692 |
| Provider Name | Robert W Perry |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679537856 PECOS PAC ID: 6204819360 Enrollment ID: I20040708001353 |
| Provider Name | Jessica L Baker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1144312448 PECOS PAC ID: 0547248718 Enrollment ID: I20040713000883 |
| Provider Name | William Glyn Wagnon |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699789008 PECOS PAC ID: 1850378324 Enrollment ID: I20040730000545 |
| Provider Name | Rajesh Sethi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053375428 PECOS PAC ID: 9931172541 Enrollment ID: I20040812001362 |
| Provider Name | Donald E Ivy |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841285012 PECOS PAC ID: 7719972744 Enrollment ID: I20040817001386 |
| Provider Name | Farrell D Hass |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1073508263 PECOS PAC ID: 8527031517 Enrollment ID: I20040817001423 |
| Provider Name | Frank Martin Moix |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1518950823 PECOS PAC ID: 2466426853 Enrollment ID: I20040823000254 |
| Provider Name | Nidhi Jain |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1306936877 PECOS PAC ID: 8426016650 Enrollment ID: I20041220001069 |
| Provider Name | Zulekha Hamid |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1134214893 PECOS PAC ID: 9032167234 Enrollment ID: I20050104001029 |
| Provider Name | Mark A Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174529887 PECOS PAC ID: 6305897141 Enrollment ID: I20050209000284 |
| Provider Name | Richard Arthur Perkins |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1871589507 PECOS PAC ID: 7810988581 Enrollment ID: I20050302000927 |
| Provider Name | Neesa J Mccollum-flaxman |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1073509956 PECOS PAC ID: 9537113519 Enrollment ID: I20050311000868 |
| Provider Name | Lori E Cole |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407851439 PECOS PAC ID: 6103877931 Enrollment ID: I20050317000895 |
| Provider Name | Otis T Gordon |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1851355218 PECOS PAC ID: 2466407580 Enrollment ID: I20050413001272 |
| Provider Name | Aaron Michel Spann |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356338719 PECOS PAC ID: 5294778916 Enrollment ID: I20050603000567 |
| Provider Name | James Foster Beck |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114955085 PECOS PAC ID: 3870405475 Enrollment ID: I20050714000375 |
| Provider Name | Mark Dyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114085768 PECOS PAC ID: 4284661646 Enrollment ID: I20050718001030 |
| Provider Name | Sanjay R Dass |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1265497242 PECOS PAC ID: 2163450560 Enrollment ID: I20050727000840 |
| Provider Name | Ganesh Nair |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1710915954 PECOS PAC ID: 3274561907 Enrollment ID: I20050802001398 |
| Provider Name | Ghulam M Khaleel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669486007 PECOS PAC ID: 6305861048 Enrollment ID: I20051011001076 |
| Provider Name | Kristy M Roberts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578534012 PECOS PAC ID: 0547288102 Enrollment ID: I20051102001134 |
| Provider Name | Dennis Dean Kumpuris |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1932197118 PECOS PAC ID: 6406808724 Enrollment ID: I20051118000170 |
| Provider Name | Brad P Baltz |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1164484614 PECOS PAC ID: 8729055892 Enrollment ID: I20051220000798 |
| Provider Name | Amy M Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841380334 PECOS PAC ID: 1759303233 Enrollment ID: I20051227000520 |
| Provider Name | Nauman Yunus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487601712 PECOS PAC ID: 7911921994 Enrollment ID: I20060117000998 |
| Provider Name | Jeffrey J Carfagno |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073616934 PECOS PAC ID: 4183648108 Enrollment ID: I20060118000026 |
| Provider Name | Bobby D Perry |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528064821 PECOS PAC ID: 0648286534 Enrollment ID: I20060301000823 |
| Provider Name | Richard Griffiths |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1881646180 PECOS PAC ID: 8729972799 Enrollment ID: I20060511000193 |
| Provider Name | Raul R Ramirez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720081789 PECOS PAC ID: 9638126568 Enrollment ID: I20060717000359 |
| Provider Name | Srinivasan Ramaswamy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942247317 PECOS PAC ID: 4587677265 Enrollment ID: I20060725000192 |
| Provider Name | Rachel R White |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366481392 PECOS PAC ID: 4284647876 Enrollment ID: I20060727000155 |
| Provider Name | Shane Tharp |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104878420 PECOS PAC ID: 2668475385 Enrollment ID: I20060819000006 |
| Provider Name | Bryan Jennings |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831127786 PECOS PAC ID: 7719977545 Enrollment ID: I20060819000009 |
| Provider Name | Rogerich T Paylor |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699721811 PECOS PAC ID: 4284612037 Enrollment ID: I20060822000476 |
| Provider Name | Charlotte Chapple |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1659387769 PECOS PAC ID: 4789680752 Enrollment ID: I20061013000612 |
| Provider Name | Muhammad Shajaat |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417995457 PECOS PAC ID: 7416953252 Enrollment ID: I20061018000348 |
| Provider Name | John G Price |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538152699 PECOS PAC ID: 9739186156 Enrollment ID: I20061027000275 |
| Provider Name | Abdel Rahman D Saleh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467485151 PECOS PAC ID: 8123025475 Enrollment ID: I20061028000053 |
| Provider Name | Lee C Raley |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1730297979 PECOS PAC ID: 3870591092 Enrollment ID: I20061127000148 |
| Provider Name | Russell D Harris |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1780670638 PECOS PAC ID: 1557352234 Enrollment ID: I20070119000482 |
| Provider Name | Thomas R Braswell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164448858 PECOS PAC ID: 7517969199 Enrollment ID: I20070212000076 |
| Provider Name | Zainab Siddiqui |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1942389440 PECOS PAC ID: 7719089259 Enrollment ID: I20070301000231 |
| Provider Name | Daniel K Brown |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1730280165 PECOS PAC ID: 2264537182 Enrollment ID: I20070420000141 |
| Provider Name | Camille Braswell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437208030 PECOS PAC ID: 8426154881 Enrollment ID: I20070501000226 |
| Provider Name | Nosheen Mian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376631689 PECOS PAC ID: 1951407816 Enrollment ID: I20070509000603 |
| Provider Name | Gilbert C Foster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649262726 PECOS PAC ID: 9335245133 Enrollment ID: I20070510000168 |
| Provider Name | Deborah Wilmoth |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003802794 PECOS PAC ID: 6204933690 Enrollment ID: I20070518000475 |
| Provider Name | Ronald Owens |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598821829 PECOS PAC ID: 8224136346 Enrollment ID: I20070613000073 |
| Provider Name | Jacqueline R Caldwell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1992924237 PECOS PAC ID: 1658471008 Enrollment ID: I20070713000428 |
| Provider Name | Jennifer Mccallum |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1760695944 PECOS PAC ID: 0648370007 Enrollment ID: I20070713000543 |
| Provider Name | Megan L. Redam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861512105 PECOS PAC ID: 8224138516 Enrollment ID: I20070716000597 |
| Provider Name | Rayburn F Rego |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619922275 PECOS PAC ID: 3971568163 Enrollment ID: I20070828001157 |
| Provider Name | Julia C Ryscavage |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467653626 PECOS PAC ID: 1658464334 Enrollment ID: I20070911000863 |
| Provider Name | Asa Paul Pittman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1578699666 PECOS PAC ID: 9830285584 Enrollment ID: I20071011000304 |
| Provider Name | Charles J Watkins |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1033295878 PECOS PAC ID: 9032205463 Enrollment ID: I20071017000436 |
| Provider Name | Susanna Shermer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043236748 PECOS PAC ID: 2567558497 Enrollment ID: I20071023000466 |
| Provider Name | Melanie Hoover |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578550927 PECOS PAC ID: 0840387783 Enrollment ID: I20071024000642 |
| Provider Name | Kathleen Sitarik |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336136795 PECOS PAC ID: 8224125166 Enrollment ID: I20071024000700 |
| Provider Name | Heath Showalter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649494808 PECOS PAC ID: 4587751433 Enrollment ID: I20071024000707 |
| Provider Name | Jonathan Fravel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619964087 PECOS PAC ID: 8123115078 Enrollment ID: I20071024000711 |
| Provider Name | Shannon R Turner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083601447 PECOS PAC ID: 6709973324 Enrollment ID: I20071030000176 |
| Provider Name | Alina M Voinea |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1164482360 PECOS PAC ID: 8527156066 Enrollment ID: I20071115000633 |
| Provider Name | Peter D Emanuel |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1205844594 PECOS PAC ID: 3870682867 Enrollment ID: I20071128000463 |
| Provider Name | Joseph Elser |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972693539 PECOS PAC ID: 7719077064 Enrollment ID: I20071226000418 |
| Provider Name | Paul E Valentin-stone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144226010 PECOS PAC ID: 7719060995 Enrollment ID: I20080211000769 |
| Provider Name | Jessica Ann Joheim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336363597 PECOS PAC ID: 8224113063 Enrollment ID: I20080304000717 |
| Provider Name | Ryan E Browning |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194901355 PECOS PAC ID: 5193803609 Enrollment ID: I20080424000330 |
| Provider Name | Lara A Davis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1649458183 PECOS PAC ID: 9032298799 Enrollment ID: I20080506000616 |
| Provider Name | Margaret Feurtado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336136571 PECOS PAC ID: 3274605746 Enrollment ID: I20080630000098 |
| Provider Name | Sharon Pickens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467458539 PECOS PAC ID: 7719051812 Enrollment ID: I20080807000563 |
| Provider Name | Raghu C Reddy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1326219213 PECOS PAC ID: 1850384181 Enrollment ID: I20080814000760 |
| Provider Name | Samer Homsi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1366604902 PECOS PAC ID: 1658446828 Enrollment ID: I20080822000253 |
| Provider Name | Ali Raja |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1013131275 PECOS PAC ID: 3274621859 Enrollment ID: I20080909000415 |
| Provider Name | Shiva Nallur |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780706663 PECOS PAC ID: 7618043704 Enrollment ID: I20080915000374 |
| Provider Name | Aravind Nemargommula Rao |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1316162332 PECOS PAC ID: 7113094319 Enrollment ID: I20080929000763 |
| Provider Name | Charles W Armistead |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1952377517 PECOS PAC ID: 1052472792 Enrollment ID: I20081212000457 |
| Provider Name | Don L Kusenberger |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124016977 PECOS PAC ID: 7214099449 Enrollment ID: I20081223000400 |
| Provider Name | Albert E Alexander |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609863943 PECOS PAC ID: 9638232366 Enrollment ID: I20090107000231 |
| Provider Name | Benjamin J Bartnicke |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215924683 PECOS PAC ID: 8325101090 Enrollment ID: I20090107000475 |
| Provider Name | Charles W Deaton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144217282 PECOS PAC ID: 1355404922 Enrollment ID: I20090107000550 |
| Provider Name | Jerome J Gehl |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629064407 PECOS PAC ID: 4880757459 Enrollment ID: I20090107000562 |
| Provider Name | Dana A Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023026606 PECOS PAC ID: 1153488374 Enrollment ID: I20090316000113 |
| Provider Name | David Tamas |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407843675 PECOS PAC ID: 2860559473 Enrollment ID: I20090326000337 |
| Provider Name | Kashaf A Rasheed |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1013926062 PECOS PAC ID: 8628079019 Enrollment ID: I20090330000140 |
| Provider Name | Ashley Browning |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194978544 PECOS PAC ID: 4486701794 Enrollment ID: I20090402000224 |
| Provider Name | George A Norton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629065354 PECOS PAC ID: 7618024795 Enrollment ID: I20090406000651 |
| Provider Name | Robert Henry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457456808 PECOS PAC ID: 0143257246 Enrollment ID: I20090618000478 |
| Provider Name | Sarah M Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326282799 PECOS PAC ID: 2961553540 Enrollment ID: I20090622000108 |
| Provider Name | Michael E Kiersey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508090333 PECOS PAC ID: 6507917150 Enrollment ID: I20090622000683 |
| Provider Name | Rachel Wayne |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1780792689 PECOS PAC ID: 7416008073 Enrollment ID: I20090623000075 |
| Provider Name | Kristi Sutton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720202989 PECOS PAC ID: 8820149669 Enrollment ID: I20090707000723 |
| Provider Name | Nasim A Khan |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1710909098 PECOS PAC ID: 8325062169 Enrollment ID: I20090708000226 |
| Provider Name | Kristy King |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467422766 PECOS PAC ID: 5597721290 Enrollment ID: I20090725000094 |
| Provider Name | Khalid Rayaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023107935 PECOS PAC ID: 5193878379 Enrollment ID: I20090805000643 |
| Provider Name | Thomas M Kovaleski |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1629037338 PECOS PAC ID: 2860545902 Enrollment ID: I20090806000480 |
| Provider Name | Julian Hernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396935466 PECOS PAC ID: 6406900927 Enrollment ID: I20090819000022 |
| Provider Name | John T Baber |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1699762484 PECOS PAC ID: 3870647290 Enrollment ID: I20090820000092 |
| Provider Name | Christi Steijen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609087923 PECOS PAC ID: 8820142094 Enrollment ID: I20090902000721 |
| Provider Name | Laura M Otter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639256803 PECOS PAC ID: 5294880530 Enrollment ID: I20090909000749 |
| Provider Name | Rana Kayali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720041577 PECOS PAC ID: 9133265234 Enrollment ID: I20091002000542 |
| Provider Name | Robert W Balentine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609927706 PECOS PAC ID: 9032297288 Enrollment ID: I20091009000500 |
| Provider Name | Donna Elizabeth Wheeler |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1942431275 PECOS PAC ID: 0345387346 Enrollment ID: I20091023000413 |
| Provider Name | Gregory Lux |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1093946683 PECOS PAC ID: 2769529577 Enrollment ID: I20091028000175 |
| Provider Name | Mary K Sain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104860824 PECOS PAC ID: 6204974215 Enrollment ID: I20091112000115 |
| Provider Name | Jeremy Craig Davis |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1770566796 PECOS PAC ID: 1759420334 Enrollment ID: I20091120000677 |
| Provider Name | Raymond W Edwards |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851371314 PECOS PAC ID: 2466594668 Enrollment ID: I20100127000202 |
| Provider Name | Cummins Lue |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1497790562 PECOS PAC ID: 3274619010 Enrollment ID: I20100318000927 |
| Provider Name | Leslie F Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821050022 PECOS PAC ID: 7315073715 Enrollment ID: I20100324000925 |
| Provider Name | Lisa Lowery |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1376571281 PECOS PAC ID: 1557447398 Enrollment ID: I20100327000314 |
| Provider Name | James H Abraham |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1417985714 PECOS PAC ID: 0941386783 Enrollment ID: I20100329000680 |
| Provider Name | Ali Krisht |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1043300528 PECOS PAC ID: 0648306563 Enrollment ID: I20100330001307 |
| Provider Name | Beverly N. Baxter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356431837 PECOS PAC ID: 0941336531 Enrollment ID: I20100408000078 |
| Provider Name | Robert M Searcy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1366470270 PECOS PAC ID: 0446336283 Enrollment ID: I20100409000088 |
| Provider Name | Jeffrey Clint Russell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073842175 PECOS PAC ID: 9830227479 Enrollment ID: I20100503000320 |
| Provider Name | Laura Trigg |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1689619967 PECOS PAC ID: 9436235272 Enrollment ID: I20100504000240 |
| Provider Name | Donald K. Mooney |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1275508897 PECOS PAC ID: 8820986383 Enrollment ID: I20100507000466 |
| Provider Name | Allen Redding |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1538197256 PECOS PAC ID: 8628154465 Enrollment ID: I20100521000467 |
| Provider Name | Daniel Cole Clark |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396799342 PECOS PAC ID: 9436136769 Enrollment ID: I20100605000153 |
| Provider Name | Lori Piper |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073836599 PECOS PAC ID: 1052443645 Enrollment ID: I20100716000740 |
| Provider Name | Tammy M Copeland |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487870283 PECOS PAC ID: 4284766536 Enrollment ID: I20100721000950 |
| Provider Name | Michael R Ford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871502658 PECOS PAC ID: 5991885485 Enrollment ID: I20100722000492 |
| Provider Name | Jemeca D Edwards |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306059753 PECOS PAC ID: 3274666060 Enrollment ID: I20100730000234 |
| Provider Name | Darin A Wewers |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1417943150 PECOS PAC ID: 2466443130 Enrollment ID: I20100804000378 |
| Provider Name | Sridhar Madgula |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083808067 PECOS PAC ID: 4688708456 Enrollment ID: I20100816000419 |
| Provider Name | Thomas Cain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306816087 PECOS PAC ID: 3678608320 Enrollment ID: I20100817001437 |
| Provider Name | Keith Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295732816 PECOS PAC ID: 1658405212 Enrollment ID: I20100818000119 |
| Provider Name | William P. Groce |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1124247457 PECOS PAC ID: 7012041551 Enrollment ID: I20100818001377 |
| Provider Name | Becca C Austin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063725711 PECOS PAC ID: 9335264613 Enrollment ID: I20100909000662 |
| Provider Name | Lance K Burns |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1023286051 PECOS PAC ID: 3779608336 Enrollment ID: I20100920000599 |
| Provider Name | Stylianos Rammos |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1568669828 PECOS PAC ID: 4284750183 Enrollment ID: I20100929000020 |
| Provider Name | Robert B Casper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568469179 PECOS PAC ID: 8729270186 Enrollment ID: I20101005000182 |
| Provider Name | Robert J Eisenach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699767772 PECOS PAC ID: 7517159981 Enrollment ID: I20101005000232 |
| Provider Name | Ralph F Joseph |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881686962 PECOS PAC ID: 5294927661 Enrollment ID: I20101005000310 |
| Provider Name | Bilal Sadiq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275791402 PECOS PAC ID: 7416149687 Enrollment ID: I20101006000337 |
| Provider Name | William F Joseph |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245222348 PECOS PAC ID: 5799977617 Enrollment ID: I20101011001046 |
| Provider Name | John C Jones |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275585044 PECOS PAC ID: 4587696042 Enrollment ID: I20101018000337 |
| Provider Name | Candi R Coats |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265751101 PECOS PAC ID: 5092908145 Enrollment ID: I20101020001601 |
| Provider Name | Bernard D Stokes |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1205830080 PECOS PAC ID: 8921910217 Enrollment ID: I20101117001126 |
| Provider Name | Carol Jones |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1396767356 PECOS PAC ID: 5698961183 Enrollment ID: I20101123000618 |
| Provider Name | Billy H Harris |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922326131 PECOS PAC ID: 1456549419 Enrollment ID: I20101217000695 |
| Provider Name | David Martin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700863891 PECOS PAC ID: 4385606219 Enrollment ID: I20101229000218 |
| Provider Name | Kymberly R Amyett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760784771 PECOS PAC ID: 3375732431 Enrollment ID: I20110105001129 |
| Provider Name | Siddharth A Shah |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1386703619 PECOS PAC ID: 0143313130 Enrollment ID: I20110113001229 |
| Provider Name | Steve Simpson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730172958 PECOS PAC ID: 7618157009 Enrollment ID: I20110201000795 |
| Provider Name | Edward Lane Morris |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285939124 PECOS PAC ID: 8022299973 Enrollment ID: I20110224000748 |
| Provider Name | Thirumal R Dubbaka |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487881892 PECOS PAC ID: 0749461341 Enrollment ID: I20110301000883 |
| Provider Name | Ashley K Garner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841509684 PECOS PAC ID: 0042493819 Enrollment ID: I20110331000913 |
| Provider Name | Terry T Milam |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1619964012 PECOS PAC ID: 4688858772 Enrollment ID: I20110414000363 |
| Provider Name | Abul Bmk Kamal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821292319 PECOS PAC ID: 2062698095 Enrollment ID: I20110509000698 |
| Provider Name | Brian Bean |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003870049 PECOS PAC ID: 3476730524 Enrollment ID: I20110527000162 |
| Provider Name | Jessica E Carnathan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962714097 PECOS PAC ID: 6800073420 Enrollment ID: I20110608000615 |
| Provider Name | Raja K Pola |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770771297 PECOS PAC ID: 6103005525 Enrollment ID: I20110613000839 |
| Provider Name | Lisa G Pounders Sajovitz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992972517 PECOS PAC ID: 8022296003 Enrollment ID: I20110621000731 |
| Provider Name | Kevin Flinn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508070673 PECOS PAC ID: 6901084516 Enrollment ID: I20110630000492 |
| Provider Name | Chaitanya Musham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588866297 PECOS PAC ID: 2668650185 Enrollment ID: I20110701000046 |
| Provider Name | Susan A Barr |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891996823 PECOS PAC ID: 0840382214 Enrollment ID: I20110810000394 |
| Provider Name | Katherine A Frazier |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477845766 PECOS PAC ID: 6709055585 Enrollment ID: I20110811000810 |
| Provider Name | Shane E Sparks |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306032438 PECOS PAC ID: 4486825874 Enrollment ID: I20110915000056 |
| Provider Name | Apolinar B Bordador |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679862023 PECOS PAC ID: 4880866573 Enrollment ID: I20110929000746 |
| Provider Name | Lashond E Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073893673 PECOS PAC ID: 2668644337 Enrollment ID: I20111003000303 |
| Provider Name | Jeffrey W Myers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164791000 PECOS PAC ID: 9739347667 Enrollment ID: I20120223000858 |
| Provider Name | Robert J Delaney |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1295869774 PECOS PAC ID: 5496854911 Enrollment ID: I20120313000415 |
| Provider Name | Brooke A Seago |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962435768 PECOS PAC ID: 6406994037 Enrollment ID: I20120412000209 |
| Provider Name | Charles W Peace |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962775056 PECOS PAC ID: 7911167416 Enrollment ID: I20120503000337 |
| Provider Name | Christopher J Wright |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902983026 PECOS PAC ID: 7911000682 Enrollment ID: I20120509000279 |
| Provider Name | Tarek Abuelem |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1588984223 PECOS PAC ID: 9133382237 Enrollment ID: I20120530000524 |
| Provider Name | Shunzhong S Bao |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1619133519 PECOS PAC ID: 1951427491 Enrollment ID: I20120605000144 |
| Provider Name | Stephen Faraz Shafizadeh |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1508177114 PECOS PAC ID: 8123282894 Enrollment ID: I20120608000076 |
| Provider Name | Holly J Jacek |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255605267 PECOS PAC ID: 2264696780 Enrollment ID: I20120614000038 |
| Provider Name | Neadum J. Odum |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1548468077 PECOS PAC ID: 7517122575 Enrollment ID: I20120626000366 |
| Provider Name | Lekesha D Mcadoo |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477829547 PECOS PAC ID: 8123284171 Enrollment ID: I20120719000528 |
| Provider Name | Cammie G Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174881478 PECOS PAC ID: 0345406922 Enrollment ID: I20120726000080 |
| Provider Name | Sara Hanna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497986368 PECOS PAC ID: 2567628969 Enrollment ID: I20120731000245 |
| Provider Name | Wassim T Radwan Abd El Wahab |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629208434 PECOS PAC ID: 1951559335 Enrollment ID: I20120910000065 |
| Provider Name | James E Wilkerson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083934632 PECOS PAC ID: 9537318969 Enrollment ID: I20120928000633 |
| Provider Name | Robyn L Wilkerson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891015442 PECOS PAC ID: 0042460537 Enrollment ID: I20121018000111 |
| Provider Name | Laura K Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114029238 PECOS PAC ID: 3971652132 Enrollment ID: I20130206000479 |
| Provider Name | Michael Scott Fortner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1871595512 PECOS PAC ID: 0345215778 Enrollment ID: I20130227000572 |
| Provider Name | Courtney Leann Edgar-zarate |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740499961 PECOS PAC ID: 1254465008 Enrollment ID: I20130601000058 |
| Provider Name | Marcus Y Chu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609188614 PECOS PAC ID: 3274774484 Enrollment ID: I20130731000622 |
| Provider Name | David E Rainosek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326359472 PECOS PAC ID: 2668613779 Enrollment ID: I20130731000734 |
| Provider Name | Sallie S Oliphant |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205032281 PECOS PAC ID: 0648413310 Enrollment ID: I20130828000052 |
| Provider Name | Nutan Bhaskar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1922269604 PECOS PAC ID: 4587807292 Enrollment ID: I20130828000562 |
| Provider Name | Amber N Wiles |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972948594 PECOS PAC ID: 2668615022 Enrollment ID: I20130904000244 |
| Provider Name | Mary K Howard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821222068 PECOS PAC ID: 0143463539 Enrollment ID: I20130904000609 |
| Provider Name | Amy R Thurman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093054462 PECOS PAC ID: 5092958306 Enrollment ID: I20130905000094 |
| Provider Name | Nahid Shafi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760679500 PECOS PAC ID: 5597823914 Enrollment ID: I20130916000677 |
| Provider Name | Joshua D Dilley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1235371253 PECOS PAC ID: 7214171974 Enrollment ID: I20130918000828 |
| Provider Name | Vyjayanthi Ganga |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144553538 PECOS PAC ID: 5890945786 Enrollment ID: I20131122000274 |
| Provider Name | Brian Clay Poindexter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285889535 PECOS PAC ID: 2062578347 Enrollment ID: I20131218000989 |
| Provider Name | Cesalie D Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407104052 PECOS PAC ID: 5496986465 Enrollment ID: I20140317000980 |
| Provider Name | Brian L Anderson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497177836 PECOS PAC ID: 7315178134 Enrollment ID: I20140320000782 |
| Provider Name | Rhonda Kay Dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700207339 PECOS PAC ID: 2466675467 Enrollment ID: I20140520001601 |
| Provider Name | Daniel R Thrower |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1194968420 PECOS PAC ID: 5092955286 Enrollment ID: I20140603001331 |
| Provider Name | Michael Kendrick |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801069331 PECOS PAC ID: 4385877265 Enrollment ID: I20140612001613 |
| Provider Name | Tyler A King |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811287857 PECOS PAC ID: 1355567066 Enrollment ID: I20140731002407 |
| Provider Name | James C Walker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659513133 PECOS PAC ID: 0840417358 Enrollment ID: I20140806002470 |
| Provider Name | Pamela M Hatcher |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1851704118 PECOS PAC ID: 2860619723 Enrollment ID: I20140818000212 |
| Provider Name | Casey G Polk |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477968030 PECOS PAC ID: 7810115425 Enrollment ID: I20140822002276 |
| Provider Name | Shreelekha Nallur |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427331560 PECOS PAC ID: 8527286863 Enrollment ID: I20140827002006 |
| Provider Name | Jena Gray |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1457765182 PECOS PAC ID: 2769600691 Enrollment ID: I20140905001491 |
| Provider Name | Manuel A Warrior |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386064657 PECOS PAC ID: 0648499830 Enrollment ID: I20140922000496 |
| Provider Name | Leanne Careen Glidewell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073852877 PECOS PAC ID: 7911127329 Enrollment ID: I20141007002529 |
| Provider Name | Cindy G Fortner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1891099552 PECOS PAC ID: 8628250859 Enrollment ID: I20141013000756 |
| Provider Name | Neelima Rao |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1992929152 PECOS PAC ID: 8426279308 Enrollment ID: I20141017000288 |
| Provider Name | Ella Cathrine E Whaley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528386547 PECOS PAC ID: 8921229709 Enrollment ID: I20141020001961 |
| Provider Name | Tameka L Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730594342 PECOS PAC ID: 5496977555 Enrollment ID: I20141105002340 |
| Provider Name | Kristi Leigh Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518374610 PECOS PAC ID: 5799907333 Enrollment ID: I20141114000257 |
| Provider Name | Patrick Szeto |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1063671949 PECOS PAC ID: 8921237983 Enrollment ID: I20141117001137 |
| Provider Name | Jennifer E Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992125595 PECOS PAC ID: 6204058670 Enrollment ID: I20141119002098 |
| Provider Name | Russell Roberson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1750572277 PECOS PAC ID: 2769646272 Enrollment ID: I20141205001306 |
| Provider Name | Caroline Reynolds Mitchell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1215161054 PECOS PAC ID: 3971737255 Enrollment ID: I20141222002165 |
| Provider Name | Anthony R Sierra |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487042651 PECOS PAC ID: 1658695671 Enrollment ID: I20150122002352 |
| Provider Name | Brittney A Jones |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841619780 PECOS PAC ID: 8820311954 Enrollment ID: I20150309001867 |
| Provider Name | Richelle A Felicitas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538558812 PECOS PAC ID: 0648596593 Enrollment ID: I20150311002284 |
| Provider Name | Mark G Viegas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841589017 PECOS PAC ID: 4385968130 Enrollment ID: I20150504002041 |
| Provider Name | Karl Alvin Schultz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194967760 PECOS PAC ID: 3870813405 Enrollment ID: I20150522000609 |
| Provider Name | Bobby Rupjyoti Kakati |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1124252960 PECOS PAC ID: 5294047015 Enrollment ID: I20150708001851 |
| Provider Name | Khaled M Krisht |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689822314 PECOS PAC ID: 1759514284 Enrollment ID: I20150714001862 |
| Provider Name | Aaron Starks |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1225357676 PECOS PAC ID: 9830221456 Enrollment ID: I20150715001075 |
| Provider Name | Lara Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508252644 PECOS PAC ID: 0648584656 Enrollment ID: I20150805006585 |
| Provider Name | Christopher K Yancey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467858233 PECOS PAC ID: 5193049286 Enrollment ID: I20150806012362 |
| Provider Name | Megan Young |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184003378 PECOS PAC ID: 0547574287 Enrollment ID: I20150807015455 |
| Provider Name | Kristina D Raley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851670368 PECOS PAC ID: 2668787821 Enrollment ID: I20150817002355 |
| Provider Name | Matthew L Law |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598022535 PECOS PAC ID: 0345557609 Enrollment ID: I20150918000492 |
| Provider Name | Leilani G Mears |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912342585 PECOS PAC ID: 7214171248 Enrollment ID: I20150918002579 |
| Provider Name | Muhammad Shabbir Yusuf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790198133 PECOS PAC ID: 6406164698 Enrollment ID: I20151008000998 |
| Provider Name | Carroll J Kraus |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1104207273 PECOS PAC ID: 7012225188 Enrollment ID: I20151009001291 |
| Provider Name | Ananth Ranganathan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497045306 PECOS PAC ID: 2062712201 Enrollment ID: I20151119002912 |
| Provider Name | Whitney N Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184091415 PECOS PAC ID: 4880994904 Enrollment ID: I20151123000106 |
| Provider Name | Gracen E Hauk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972861821 PECOS PAC ID: 9133420102 Enrollment ID: I20151216000847 |
| Provider Name | Tulika Pandey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770846966 PECOS PAC ID: 8123334596 Enrollment ID: I20151230000676 |
| Provider Name | Christopher Benton |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518322098 PECOS PAC ID: 0446556781 Enrollment ID: I20160311001053 |
| Provider Name | Martha V Hobson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548626310 PECOS PAC ID: 0345548988 Enrollment ID: I20160414000349 |
| Provider Name | Morgan A Storey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063866341 PECOS PAC ID: 0941590368 Enrollment ID: I20160526000388 |
| Provider Name | Luke N Weiler |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1851657274 PECOS PAC ID: 1153648290 Enrollment ID: I20160705000608 |
| Provider Name | Umair Afzal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164786448 PECOS PAC ID: 7416249842 Enrollment ID: I20160706000531 |
| Provider Name | Joshua T Smith |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1902163264 PECOS PAC ID: 9335466507 Enrollment ID: I20160707000040 |
| Provider Name | Daniel L Emison |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992164461 PECOS PAC ID: 1456644913 Enrollment ID: I20160721002190 |
| Provider Name | Brandy Eason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548629199 PECOS PAC ID: 9032402185 Enrollment ID: I20160727000158 |
| Provider Name | Naval H Patel |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1760826887 PECOS PAC ID: 6204129257 Enrollment ID: I20160728000331 |
| Provider Name | Nicole R Bryson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760627707 PECOS PAC ID: 1850684622 Enrollment ID: I20160801002489 |
| Provider Name | Shelly L Gibbs |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922366863 PECOS PAC ID: 5799922738 Enrollment ID: I20160804002735 |
| Provider Name | Kimberly A Browning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922457753 PECOS PAC ID: 1557656998 Enrollment ID: I20160824000316 |
| Provider Name | Yevgeniy O Apostolov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285977769 PECOS PAC ID: 9830416064 Enrollment ID: I20161004000512 |
| Provider Name | Mahesh Bavineni |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013353150 PECOS PAC ID: 6800184615 Enrollment ID: I20161011002413 |
| Provider Name | Chen Wang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164715512 PECOS PAC ID: 0143518837 Enrollment ID: I20161012002392 |
| Provider Name | Eric N Joseph |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699118141 PECOS PAC ID: 5496070153 Enrollment ID: I20161019001174 |
| Provider Name | Sarah N Baxter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629522594 PECOS PAC ID: 4284916669 Enrollment ID: I20170119000902 |
| Provider Name | Audrey R Dillahunty |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982140380 PECOS PAC ID: 2961784137 Enrollment ID: I20170124000099 |
| Provider Name | Nahel N Saied |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1649295452 PECOS PAC ID: 7113993064 Enrollment ID: I20170217000856 |
| Provider Name | Patrick C Oeder |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194185546 PECOS PAC ID: 7315239746 Enrollment ID: I20170316002510 |
| Provider Name | David W Backstedt |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1245587203 PECOS PAC ID: 0941579791 Enrollment ID: I20170711000100 |
| Provider Name | David Patrick Shelley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1609211358 PECOS PAC ID: 0840432316 Enrollment ID: I20170721001253 |
| Provider Name | Ashley L Davis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1447597687 PECOS PAC ID: 0244475184 Enrollment ID: I20170804000807 |
| Provider Name | Madhvi Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184967945 PECOS PAC ID: 8022335454 Enrollment ID: I20171030000038 |
| Provider Name | Travis R Mosley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033584677 PECOS PAC ID: 5193027530 Enrollment ID: I20171206003350 |
| Provider Name | Jonathan Redic |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265940878 PECOS PAC ID: 4880953603 Enrollment ID: I20180123003066 |
| Provider Name | Winston Renfrow |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1871681718 PECOS PAC ID: 6507873510 Enrollment ID: I20180223000646 |
| Provider Name | Nathan Gerrell Fawbush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811401193 PECOS PAC ID: 8123389046 Enrollment ID: I20180309000735 |
| Provider Name | Sommer Francis Hefner Perry |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1316359219 PECOS PAC ID: 9931326394 Enrollment ID: I20180503001462 |
| Provider Name | Jeffrey D Robertson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1366709404 PECOS PAC ID: 9638329410 Enrollment ID: I20180510000589 |
| Provider Name | Ashish A Tikotekar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1982933909 PECOS PAC ID: 9133383912 Enrollment ID: I20180521001119 |
| Provider Name | Girish Singhania |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1558660217 PECOS PAC ID: 8527297100 Enrollment ID: I20180606001766 |
| Provider Name | Krishna Siva Sai Kakkera |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1831445261 PECOS PAC ID: 4587982152 Enrollment ID: I20180619001562 |
| Provider Name | Shawn Alexander Henry |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912495532 PECOS PAC ID: 3870848583 Enrollment ID: I20180621000714 |
| Provider Name | Matthew Bolding |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588151633 PECOS PAC ID: 4486909926 Enrollment ID: I20180625000872 |
| Provider Name | James Daniel Oswalt |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1659869253 PECOS PAC ID: 7416203740 Enrollment ID: I20180628003058 |
| Provider Name | Aleobe Eruemulor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538555248 PECOS PAC ID: 2769798214 Enrollment ID: I20180725002923 |
| Provider Name | Christopher Paul Vinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528440922 PECOS PAC ID: 9739487851 Enrollment ID: I20180813001743 |
| Provider Name | Vladimir Kostyurenko |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710476155 PECOS PAC ID: 7416206537 Enrollment ID: I20180823001040 |
| Provider Name | William R Copeland |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1245468255 PECOS PAC ID: 0446442164 Enrollment ID: I20180906001182 |
| Provider Name | Chelsea E Presson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548749906 PECOS PAC ID: 8123379518 Enrollment ID: I20180925000074 |
| Provider Name | Lindy M Page |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154818292 PECOS PAC ID: 6608128830 Enrollment ID: I20181016002195 |
| Provider Name | Ashley Renee Poppy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184107104 PECOS PAC ID: 7012260938 Enrollment ID: I20181023002107 |
| Provider Name | Mohanned H Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053725499 PECOS PAC ID: 0345539680 Enrollment ID: I20181108001977 |
| Provider Name | Ted Clowers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1801368576 PECOS PAC ID: 5597003244 Enrollment ID: I20190205002279 |
| Provider Name | Seth Minor |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1861956518 PECOS PAC ID: 3072852425 Enrollment ID: I20190228001994 |
| Provider Name | Benjamin J Spillyards |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1700343324 PECOS PAC ID: 2567704356 Enrollment ID: I20190503001436 |
| Provider Name | Shanna Mckeller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609333269 PECOS PAC ID: 2961745898 Enrollment ID: I20190516002185 |
| Provider Name | Bilal Alqam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982054250 PECOS PAC ID: 5193011047 Enrollment ID: I20190530001653 |
| Provider Name | Mario Baldassaro |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1437712668 PECOS PAC ID: 3870828296 Enrollment ID: I20190708002135 |
| Provider Name | Cody R Grant |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972768596 PECOS PAC ID: 3779818950 Enrollment ID: I20190710001755 |
| Provider Name | Heather A Borchert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396131447 PECOS PAC ID: 4880900257 Enrollment ID: I20190729000845 |
| Provider Name | Jeffrey Aubrey Goodhart |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124459680 PECOS PAC ID: 1456622331 Enrollment ID: I20191009002651 |
| Provider Name | Hina Mannan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1447648431 PECOS PAC ID: 6507126869 Enrollment ID: I20191025001917 |
| Provider Name | Sven Hida |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750612065 PECOS PAC ID: 7012101462 Enrollment ID: I20191028000886 |
| Provider Name | Megan Brooke Kellar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215596168 PECOS PAC ID: 5890127799 Enrollment ID: I20191114002041 |
| Provider Name | Magan Nichole Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649816794 PECOS PAC ID: 2860825486 Enrollment ID: I20191211002768 |
| Provider Name | David Wicker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306476957 PECOS PAC ID: 9234566654 Enrollment ID: I20200225001465 |
| Provider Name | Jennifer Minneman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003105289 PECOS PAC ID: 7012344146 Enrollment ID: I20200302000098 |
| Provider Name | Anuradha Kunthur |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1770526147 PECOS PAC ID: 1759304884 Enrollment ID: I20200406000023 |
| Provider Name | Anthony P Bucolo |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1497752638 PECOS PAC ID: 3870487432 Enrollment ID: I20200407000154 |
| Provider Name | Danish Perwaiz Abbasi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629466610 PECOS PAC ID: 2062716962 Enrollment ID: I20200407003082 |
| Provider Name | Sirinya Prasertvit |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366685703 PECOS PAC ID: 4385884188 Enrollment ID: I20200608002284 |
| Provider Name | Eric Louis Sessions |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1396365227 PECOS PAC ID: 6507287919 Enrollment ID: I20200610001229 |
| Provider Name | Nicholas Andrew Ware |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1952921215 PECOS PAC ID: 8325460611 Enrollment ID: I20200615000803 |
| Provider Name | Paul Lee |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1295199289 PECOS PAC ID: 2264724624 Enrollment ID: I20200630000122 |
| Provider Name | Madhura Borikar |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1467838441 PECOS PAC ID: 7012265374 Enrollment ID: I20200702000813 |
| Provider Name | Jordan S Schnebly |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679192942 PECOS PAC ID: 6406279447 Enrollment ID: I20200708003454 |
| Provider Name | Sarika Savajiyani |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1649531013 PECOS PAC ID: 4183917859 Enrollment ID: I20200710000053 |
| Provider Name | Josh Finley Edwards |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992325922 PECOS PAC ID: 4587087192 Enrollment ID: I20200714003227 |
| Provider Name | Nagasaranya Addepally |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275949265 PECOS PAC ID: 7214253707 Enrollment ID: I20200727002849 |
| Provider Name | Abhijit Godbole |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1609135797 PECOS PAC ID: 2062728546 Enrollment ID: I20200728001159 |
| Provider Name | Adedamola Adepoju |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1003259979 PECOS PAC ID: 3173868916 Enrollment ID: I20200728001431 |
| Provider Name | Joshua Cloud |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194280248 PECOS PAC ID: 8123369006 Enrollment ID: I20200728001944 |
| Provider Name | Chandra Nukala |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770715591 PECOS PAC ID: 3476780453 Enrollment ID: I20200804002058 |
| Provider Name | Sharat Penumpallil Sasi |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1104446426 PECOS PAC ID: 3577988542 Enrollment ID: I20200807001190 |
| Provider Name | Kayla Brooke Mazzanti |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356961114 PECOS PAC ID: 5092130088 Enrollment ID: I20200807002037 |
| Provider Name | Matthew Johnson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558469833 PECOS PAC ID: 6709978943 Enrollment ID: I20201016001705 |
| Provider Name | Brandon Davis Ingram |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851655229 PECOS PAC ID: 2567788938 Enrollment ID: I20201216001130 |
| Provider Name | Chitra Nadagoundla |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1134537020 PECOS PAC ID: 1153630561 Enrollment ID: I20210225000797 |
| Provider Name | Julius G Balogh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588923544 PECOS PAC ID: 3476969197 Enrollment ID: I20210304000441 |
| Provider Name | Brian Christopher Fulks |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134702855 PECOS PAC ID: 1850791641 Enrollment ID: I20210616000864 |
| Provider Name | Melissa Barre |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902488414 PECOS PAC ID: 9638570864 Enrollment ID: I20210625001271 |
| Provider Name | Joshua Lee Bryant |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154904894 PECOS PAC ID: 2264833201 Enrollment ID: I20210628001958 |
| Provider Name | Joshuah Daniel Lingo |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1861075400 PECOS PAC ID: 5698176600 Enrollment ID: I20210629000548 |
| Provider Name | Caroline Anne Foshee |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063095685 PECOS PAC ID: 8729489521 Enrollment ID: I20210630003791 |
| Provider Name | Zachary Walker Tilley |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1144726993 PECOS PAC ID: 6305192980 Enrollment ID: I20210709000955 |
| Provider Name | Cynthia Chapman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1154784502 PECOS PAC ID: 2365734654 Enrollment ID: I20210803000929 |
| Provider Name | Jaafar Basma |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1255750493 PECOS PAC ID: 3173927191 Enrollment ID: I20210812000519 |
| Provider Name | Rachana Dandamudi Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295231504 PECOS PAC ID: 5193120319 Enrollment ID: I20210825002754 |
| Provider Name | Panna Lal Bhattacharyya |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396277729 PECOS PAC ID: 9931457561 Enrollment ID: I20210831000122 |
| Provider Name | Abdelrahman Majdi Attili |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588049712 PECOS PAC ID: 2860899838 Enrollment ID: I20210920000694 |
| Provider Name | Dinesh Edem |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1144575960 PECOS PAC ID: 9638307879 Enrollment ID: I20211130001996 |
| Provider Name | Jennifer Cooper |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043624232 PECOS PAC ID: 0840514469 Enrollment ID: I20220106002685 |
| Provider Name | Katia Rayburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740870583 PECOS PAC ID: 8123412699 Enrollment ID: I20220225001827 |
| Provider Name | Wa'el Jamal Kamel Tuqan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346620606 PECOS PAC ID: 5496064784 Enrollment ID: I20220419001889 |
| Provider Name | Natalie Cobb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174160089 PECOS PAC ID: 2264534460 Enrollment ID: I20220420002264 |
| Provider Name | Hossam Ibrahim Youssef |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1770171209 PECOS PAC ID: 8527445493 Enrollment ID: I20220513002287 |
| Provider Name | Dana Aysha Niederhauser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265071427 PECOS PAC ID: 2264813070 Enrollment ID: I20220725001883 |
| Provider Name | Kalyan Kancherla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356909311 PECOS PAC ID: 0244565471 Enrollment ID: I20220815000201 |
| Provider Name | Calley E Dunn |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164085957 PECOS PAC ID: 1052648177 Enrollment ID: I20220817000441 |
| Provider Name | Yasser Jeelani |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1740619162 PECOS PAC ID: 6002299096 Enrollment ID: I20220824002604 |
| Provider Name | Emily K Reams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407414238 PECOS PAC ID: 0042545642 Enrollment ID: I20220825002775 |
| Provider Name | Shane Tyler Martin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1083361257 PECOS PAC ID: 1355723362 Enrollment ID: I20220830000421 |
| Provider Name | Shamsie Marie Lumpkin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1346971009 PECOS PAC ID: 8820472459 Enrollment ID: I20220831002654 |
| Provider Name | Tarah Adrianne Elrod |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013632736 PECOS PAC ID: 0042680985 Enrollment ID: I20230110001889 |
| Provider Name | Joe Alan Solomon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285734913 PECOS PAC ID: 2365512472 Enrollment ID: I20230112000790 |
| Provider Name | Shannon Timmerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821605346 PECOS PAC ID: 5496151011 Enrollment ID: I20230207003415 |
| Provider Name | Juiting Chen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235844952 PECOS PAC ID: 6709258353 Enrollment ID: I20230208002754 |
| Provider Name | Keith James |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598705691 PECOS PAC ID: 4284613589 Enrollment ID: I20230607000073 |
| Provider Name | Anil K Madadi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598020034 PECOS PAC ID: 5193948982 Enrollment ID: I20230609002094 |
| Provider Name | Monica Kothari |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548899636 PECOS PAC ID: 3476976341 Enrollment ID: I20230727001801 |
| Provider Name | Brandon K Duke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124641816 PECOS PAC ID: 3870908767 Enrollment ID: I20230817004129 |
| Provider Name | Lisa M Kottler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164186219 PECOS PAC ID: 4486009305 Enrollment ID: I20231012003647 |
| Provider Name | Meagan Cates Ripley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457130239 PECOS PAC ID: 4385090505 Enrollment ID: I20231025000041 |
| Provider Name | Michael Agbor |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730861287 PECOS PAC ID: 0547616633 Enrollment ID: I20231025003307 |
| Provider Name | Carter Alan Lowe |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477235091 PECOS PAC ID: 2466808258 Enrollment ID: I20231031001647 |
| Provider Name | Yolanda Denise Hargraves-shaw |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1700063245 PECOS PAC ID: 9335596865 Enrollment ID: I20231106001642 |
| Provider Name | Amond Rashad Baker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417731589 PECOS PAC ID: 0547617342 Enrollment ID: I20231116001586 |
| Provider Name | Sudhakar Tummala |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225120017 PECOS PAC ID: 7113112467 Enrollment ID: I20231212003230 |
| Provider Name | Terry Himes |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700995438 PECOS PAC ID: 2567441181 Enrollment ID: I20231219004156 |
| Provider Name | Iuliana Kiliment |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104138254 PECOS PAC ID: 7810135233 Enrollment ID: I20240104000949 |
| Provider Name | Din Z Kagalwala |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841385200 PECOS PAC ID: 2668608993 Enrollment ID: I20240117002848 |
| Provider Name | Joshua Bryan Landers |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841257060 PECOS PAC ID: 7214370626 Enrollment ID: I20240213000527 |
| Provider Name | Tilak Raj |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1760450084 PECOS PAC ID: 7517971609 Enrollment ID: I20240322003322 |
| Provider Name | Harish Bangalore Siddaiah |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1124251970 PECOS PAC ID: 6800196692 Enrollment ID: I20240409004136 |
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