| Thorne Bay Health Clinic | |
|
120 Freeman Dr Thorne Bay AK 99919-0423 | |
| (907) 828-8848 | |
| Not Available |
| Full Name | Thorne Bay Health Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 120 Freeman Dr, Thorne Bay, Alaska |
| Authorized Official Name and Position | Daniel Harris (SR. VP CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 9074634000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thorne Bay Health Clinic 3100 Channel Dr Ste 300 Juneau AK 99801 Ph: (907) 463-4074 | Thorne Bay Health Clinic 120 Freeman Dr Thorne Bay AK 99919-0423 Ph: (907) 828-8848 |
| NPI Number | 1376758037 |
|---|---|
| Provider Enumeration Date | 05/14/2007 |
| Last Update Date | 07/25/2022 |
| Medicare PECOS PAC ID | 1456265362 |
|---|---|
| Medicare Enrollment ID | O20031114000631 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376758037 | NPI | - | NPPES |
| CL9200 | Medicaid | AK | |
| MDG632 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 70206 (Alaska) | Primary |
| Provider Name | Catherine M Buley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700863339 PECOS PAC ID: 2365348042 Enrollment ID: I20031211001070 |
| Provider Name | William L Lubke |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1578501466 PECOS PAC ID: 4688572142 Enrollment ID: I20031222000757 |
| Provider Name | Julien L Naylor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154354652 PECOS PAC ID: 3476451758 Enrollment ID: I20031223000498 |
| Provider Name | Katherine L Sterner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003860164 PECOS PAC ID: 1355244054 Enrollment ID: I20040129001129 |
| Provider Name | Gregg Mcneil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922205582 PECOS PAC ID: 7810886728 Enrollment ID: I20040310001315 |
| Provider Name | Kendall Jones |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548240955 PECOS PAC ID: 9335039056 Enrollment ID: I20040317000666 |
| Provider Name | Arnold Loera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225012628 PECOS PAC ID: 3870497902 Enrollment ID: I20040414000580 |
| Provider Name | Elizabeth D. Ferucci |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1598705121 PECOS PAC ID: 2163418567 Enrollment ID: I20040421001677 |
| Provider Name | Linda A Keirstead |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558492827 PECOS PAC ID: 6204822398 Enrollment ID: I20040423000282 |
| Provider Name | Janice Heaton Sheufelt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336193739 PECOS PAC ID: 6507852621 Enrollment ID: I20040423000485 |
| Provider Name | Andre J Duerinckx |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760434625 PECOS PAC ID: 4486639739 Enrollment ID: I20040621001426 |
| Provider Name | Lisa A Fenn |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1124154851 PECOS PAC ID: 5395721328 Enrollment ID: I20040709000265 |
| Provider Name | Richard Louis Kraft |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437296787 PECOS PAC ID: 1850370883 Enrollment ID: I20040714001147 |
| Provider Name | Supriya Mathur Gianchandani |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1508801044 PECOS PAC ID: 1759284367 Enrollment ID: I20040716000380 |
| Provider Name | Sharon A Inman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144220468 PECOS PAC ID: 0941270193 Enrollment ID: I20040727000746 |
| Provider Name | Lynn E Gras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578528006 PECOS PAC ID: 5597735142 Enrollment ID: I20040729001353 |
| Provider Name | Myron A Fribush |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184702102 PECOS PAC ID: 1456323997 Enrollment ID: I20040806000360 |
| Provider Name | Patrick S Kelley |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1508853128 PECOS PAC ID: 6709850894 Enrollment ID: I20040824000917 |
| Provider Name | Leon Toye |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457304990 PECOS PAC ID: 9739158858 Enrollment ID: I20040927000397 |
| Provider Name | Brian J Mcmahon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427093574 PECOS PAC ID: 7517925738 Enrollment ID: I20041220000998 |
| Provider Name | Charles C Edwards |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1447291067 PECOS PAC ID: 3476448796 Enrollment ID: I20050302000119 |
| Provider Name | Hector E Salcedo-dovi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679566525 PECOS PAC ID: 7012961469 Enrollment ID: I20050309000296 |
| Provider Name | Nathan Tillotson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770670473 PECOS PAC ID: 3274589064 Enrollment ID: I20050324000552 |
| Provider Name | Delphia Clarke |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255316873 PECOS PAC ID: 0749180644 Enrollment ID: I20050420000467 |
| Provider Name | Elizabeth K Tieman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396774873 PECOS PAC ID: 3577477868 Enrollment ID: I20050521000084 |
| Provider Name | Kimberly L Bakkes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841245388 PECOS PAC ID: 9032014733 Enrollment ID: I20050614001354 |
| Provider Name | Pornson P Linton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104017755 PECOS PAC ID: 1052347879 Enrollment ID: I20050714001019 |
| Provider Name | Marnie Hartman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1538381009 PECOS PAC ID: 5193754588 Enrollment ID: I20050805000487 |
| Provider Name | Bruce Matthew Weeks |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649392184 PECOS PAC ID: 3779518915 Enrollment ID: I20050927001040 |
| Provider Name | Jennifer S Mcnichol |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780897405 PECOS PAC ID: 7315972585 Enrollment ID: I20050927001257 |
| Provider Name | Benjamin Strong |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205811569 PECOS PAC ID: 8426048232 Enrollment ID: I20051004000655 |
| Provider Name | Donald Nicell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689679631 PECOS PAC ID: 2769458819 Enrollment ID: I20051004000740 |
| Provider Name | Phi-nga J Le |
|---|---|
| Provider Type | Practitioner - Undersea And Hyperbaric Medicine |
| Provider Identifiers | NPI Number: 1770568479 PECOS PAC ID: 9739158718 Enrollment ID: I20051026000913 |
| Provider Name | Carmencita T Palma |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1952352809 PECOS PAC ID: 9739109554 Enrollment ID: I20051122000850 |
| Provider Name | Pamela M Steffes |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023046638 PECOS PAC ID: 6608882691 Enrollment ID: I20060228000734 |
| Provider Name | Karl V Bausler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205909702 PECOS PAC ID: 1052328622 Enrollment ID: I20060307000861 |
| Provider Name | Elliot J Bruhl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083691612 PECOS PAC ID: 1254348444 Enrollment ID: I20060313000674 |
| Provider Name | Mark G Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629129168 PECOS PAC ID: 2466469341 Enrollment ID: I20060317000296 |
| Provider Name | David J Vastola |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710012323 PECOS PAC ID: 2769396688 Enrollment ID: I20060320000543 |
| Provider Name | John A Baciocco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124005731 PECOS PAC ID: 8820005614 Enrollment ID: I20060320000691 |
| Provider Name | Julia I Heinz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669501862 PECOS PAC ID: 5496763930 Enrollment ID: I20060324000653 |
| Provider Name | Stephanie Runyan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740351543 PECOS PAC ID: 2668413576 Enrollment ID: I20060424000501 |
| Provider Name | Jerry Z Ainsworth |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1003893611 PECOS PAC ID: 7113937574 Enrollment ID: I20060428000484 |
| Provider Name | Terrence Babb |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427168764 PECOS PAC ID: 8022029818 Enrollment ID: I20060508000822 |
| Provider Name | Graham Timothy Chelius |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063459311 PECOS PAC ID: 8729078324 Enrollment ID: I20060616000031 |
| Provider Name | George Lopez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578588752 PECOS PAC ID: 9638172034 Enrollment ID: I20060823000674 |
| Provider Name | Pamela A Gruchacz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598732042 PECOS PAC ID: 8628076510 Enrollment ID: I20061202000073 |
| Provider Name | Noble E Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811091366 PECOS PAC ID: 2769465780 Enrollment ID: I20061220000135 |
| Provider Name | James J Tiesinga |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1366475105 PECOS PAC ID: 8921008590 Enrollment ID: I20070104000258 |
| Provider Name | Deborah A Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609882026 PECOS PAC ID: 3274534508 Enrollment ID: I20070129000538 |
| Provider Name | Jennifer E Edwards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063467512 PECOS PAC ID: 0446272934 Enrollment ID: I20070308000663 |
| Provider Name | Peter M Sapin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346265659 PECOS PAC ID: 2365549490 Enrollment ID: I20070523000672 |
| Provider Name | Marna L. Schwartz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548259872 PECOS PAC ID: 1456247923 Enrollment ID: I20070604000476 |
| Provider Name | Brian A Trimble |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972529220 PECOS PAC ID: 6305937673 Enrollment ID: I20070801000579 |
| Provider Name | Parina G Cho |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790770261 PECOS PAC ID: 5193623486 Enrollment ID: I20070801000820 |
| Provider Name | Gregory Lee Higgins |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053323907 PECOS PAC ID: 5991604381 Enrollment ID: I20070925000269 |
| Provider Name | Susan Mermelstein |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1841315124 PECOS PAC ID: 2062509086 Enrollment ID: I20071107000329 |
| Provider Name | Daniel C Weaver |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144376369 PECOS PAC ID: 7315034386 Enrollment ID: I20071107000733 |
| Provider Name | Youssef K Barbour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588846042 PECOS PAC ID: 5991888067 Enrollment ID: I20080212000715 |
| Provider Name | Steven O Greer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851497184 PECOS PAC ID: 0446250419 Enrollment ID: I20080225000725 |
| Provider Name | Shannon Farr |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1215915590 PECOS PAC ID: 1951339704 Enrollment ID: I20080305000321 |
| Provider Name | Elisabeth Diane Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023297652 PECOS PAC ID: 0244317642 Enrollment ID: I20080409000714 |
| Provider Name | Matthew J Schnellbaecher |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1942233481 PECOS PAC ID: 1557440211 Enrollment ID: I20080506000563 |
| Provider Name | John Andrew Lang |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396719415 PECOS PAC ID: 2466481528 Enrollment ID: I20080728000583 |
| Provider Name | Grace Hwang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154350569 PECOS PAC ID: 5294702684 Enrollment ID: I20081006000042 |
| Provider Name | Valerie S Edwards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942307822 PECOS PAC ID: 8224106711 Enrollment ID: I20081010000394 |
| Provider Name | Mark W Tuccillo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942237441 PECOS PAC ID: 0648338723 Enrollment ID: I20081017000457 |
| Provider Name | Mary A Rowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982881397 PECOS PAC ID: 4486625068 Enrollment ID: I20081017000473 |
| Provider Name | Larry Kessler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033197652 PECOS PAC ID: 5698666501 Enrollment ID: I20090223000398 |
| Provider Name | Faraz Khan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790776771 PECOS PAC ID: 3870658032 Enrollment ID: I20090302000408 |
| Provider Name | Christopher T Todd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508872441 PECOS PAC ID: 7416851084 Enrollment ID: I20090324000478 |
| Provider Name | Peter A De Schweinitz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427085711 PECOS PAC ID: 1951375088 Enrollment ID: I20090327000456 |
| Provider Name | Ketan Davae |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700838620 PECOS PAC ID: 7012996366 Enrollment ID: I20090610000266 |
| Provider Name | David G Chamberlain |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1407895949 PECOS PAC ID: 2062562929 Enrollment ID: I20090615000605 |
| Provider Name | Dana Sue Mathis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568643831 PECOS PAC ID: 9739231549 Enrollment ID: I20090708000600 |
| Provider Name | David K Zetterman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245239524 PECOS PAC ID: 9436106044 Enrollment ID: I20090721000517 |
| Provider Name | David S Zumbro |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1184684177 PECOS PAC ID: 3779591177 Enrollment ID: I20090723000452 |
| Provider Name | Michael Rethy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689601502 PECOS PAC ID: 4880635630 Enrollment ID: I20090914000775 |
| Provider Name | Kurtis Tedesco |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396969945 PECOS PAC ID: 5496809709 Enrollment ID: I20100427000803 |
| Provider Name | Sul Ross O Thorward |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013003938 PECOS PAC ID: 2961530415 Enrollment ID: I20100504000841 |
| Provider Name | Chloe Wurr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598846933 PECOS PAC ID: 9830227156 Enrollment ID: I20100506001023 |
| Provider Name | Carmen M Sugai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073638649 PECOS PAC ID: 3072642420 Enrollment ID: I20100524000914 |
| Provider Name | Alice B. Viroslav |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316914914 PECOS PAC ID: 8123167020 Enrollment ID: I20100610000317 |
| Provider Name | Brenda M Bowie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073579678 PECOS PAC ID: 2860438991 Enrollment ID: I20100915000071 |
| Provider Name | Thomas Gene Elder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174842918 PECOS PAC ID: 9032234539 Enrollment ID: I20100920001174 |
| Provider Name | Luis M Taveras |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447298278 PECOS PAC ID: 3173420239 Enrollment ID: I20101108000151 |
| Provider Name | Shirley Workman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124103825 PECOS PAC ID: 7618975053 Enrollment ID: I20101214001173 |
| Provider Name | John Kennon Kirk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578769428 PECOS PAC ID: 8820286016 Enrollment ID: I20110104000212 |
| Provider Name | Arthur D Barnes |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780758151 PECOS PAC ID: 2860433695 Enrollment ID: I20110207000974 |
| Provider Name | Dona R Brekke |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477527992 PECOS PAC ID: 1254412877 Enrollment ID: I20110222000195 |
| Provider Name | Lola D Reyna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124330360 PECOS PAC ID: 2961684600 Enrollment ID: I20110316000829 |
| Provider Name | Tzu-ching Liu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285930933 PECOS PAC ID: 7911180435 Enrollment ID: I20110322000073 |
| Provider Name | Kelly A Whitcomb-tincher |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1578779005 PECOS PAC ID: 9931382918 Enrollment ID: I20110329000588 |
| Provider Name | Kelly Moxley |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1669673596 PECOS PAC ID: 7618047614 Enrollment ID: I20110330000138 |
| Provider Name | Mark G Schultz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235438433 PECOS PAC ID: 2264610955 Enrollment ID: I20110628000715 |
| Provider Name | Kristen Homer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104998707 PECOS PAC ID: 0042488850 Enrollment ID: I20110721000871 |
| Provider Name | Sergy Lemeshko |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376780866 PECOS PAC ID: 4486823259 Enrollment ID: I20110811000647 |
| Provider Name | Somerset M Dunn |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1982867529 PECOS PAC ID: 5092860353 Enrollment ID: I20110823000993 |
| Provider Name | Richard Mcmaster |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1134103310 PECOS PAC ID: 0648218453 Enrollment ID: I20110912000044 |
| Provider Name | Rachel Kerford Lescher |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043480643 PECOS PAC ID: 7517138480 Enrollment ID: I20110926000584 |
| Provider Name | Elizabeth H Steiner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386641488 PECOS PAC ID: 6305860925 Enrollment ID: I20110926000857 |
| Provider Name | Orlando Gio G Villanueva |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972726743 PECOS PAC ID: 7618140591 Enrollment ID: I20111110000043 |
| Provider Name | Carey Robert Terry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992851570 PECOS PAC ID: 0941477541 Enrollment ID: I20120123000660 |
| Provider Name | Brian J Benjamin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700980281 PECOS PAC ID: 6103884168 Enrollment ID: I20120208000460 |
| Provider Name | Mary J Caffee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487725958 PECOS PAC ID: 7315048329 Enrollment ID: I20120208000707 |
| Provider Name | David Oliver Mccandless |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104982909 PECOS PAC ID: 1355324484 Enrollment ID: I20120309000647 |
| Provider Name | Jerilyn Latini |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1710078076 PECOS PAC ID: 5890699599 Enrollment ID: I20120312000891 |
| Provider Name | Jon N Manwaring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841582962 PECOS PAC ID: 6406017961 Enrollment ID: I20120411000204 |
| Provider Name | Elizabeth C Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003183252 PECOS PAC ID: 1456512557 Enrollment ID: I20120417000726 |
| Provider Name | Kimberly Starnes-parr |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417012014 PECOS PAC ID: 3476688243 Enrollment ID: I20120606000084 |
| Provider Name | Annelle G Maygren |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1477556488 PECOS PAC ID: 4688745805 Enrollment ID: I20120710000689 |
| Provider Name | Mary A Barrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437374600 PECOS PAC ID: 0648294595 Enrollment ID: I20120719000615 |
| Provider Name | Trenton Donald Vanooteghem |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164716312 PECOS PAC ID: 9032365358 Enrollment ID: I20120801000911 |
| Provider Name | Matthew Aaron Taintor |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174776306 PECOS PAC ID: 4981851375 Enrollment ID: I20120820000578 |
| Provider Name | Kieara A Conway |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770713851 PECOS PAC ID: 1557531399 Enrollment ID: I20120821000405 |
| Provider Name | Jacob M Gray |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1699821215 PECOS PAC ID: 9133390305 Enrollment ID: I20120917000267 |
| Provider Name | Lylith S Widmer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720221211 PECOS PAC ID: 4880845577 Enrollment ID: I20121105000686 |
| Provider Name | Matthew C Allison |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316958580 PECOS PAC ID: 7618959297 Enrollment ID: I20130117000328 |
| Provider Name | Roman Rodriguez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568484863 PECOS PAC ID: 1052484987 Enrollment ID: I20130426000503 |
| Provider Name | Karen S Caldemeyer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679511356 PECOS PAC ID: 9931003506 Enrollment ID: I20130726000311 |
| Provider Name | Christopher E Rickman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497759898 PECOS PAC ID: 4082703277 Enrollment ID: I20130805000914 |
| Provider Name | Joseph H Park |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962552729 PECOS PAC ID: 3375635279 Enrollment ID: I20130826000860 |
| Provider Name | Ann A Tran |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336133974 PECOS PAC ID: 2567465909 Enrollment ID: I20130910000569 |
| Provider Name | Marc Paul |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750375390 PECOS PAC ID: 1557398419 Enrollment ID: I20130911000756 |
| Provider Name | Robert W Davis |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1932172178 PECOS PAC ID: 7911050810 Enrollment ID: I20131028001588 |
| Provider Name | Gregory Kenyherz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417953795 PECOS PAC ID: 1759462625 Enrollment ID: I20131108001494 |
| Provider Name | Richard Mitchell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255368353 PECOS PAC ID: 9436045713 Enrollment ID: I20140210000640 |
| Provider Name | Renato Aller-zumaeta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639433980 PECOS PAC ID: 9537399126 Enrollment ID: I20140227000087 |
| Provider Name | Annette M Hewitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225045727 PECOS PAC ID: 7618161878 Enrollment ID: I20140408001636 |
| Provider Name | Brenda S Gilmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144253386 PECOS PAC ID: 3072701515 Enrollment ID: I20140423001947 |
| Provider Name | Joshua Albrektson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104155258 PECOS PAC ID: 2466699855 Enrollment ID: I20140603002393 |
| Provider Name | Randall C Zernzach |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730175662 PECOS PAC ID: 9931324514 Enrollment ID: I20140716000576 |
| Provider Name | Edward Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689905952 PECOS PAC ID: 8820214604 Enrollment ID: I20140731001194 |
| Provider Name | Hanna R Fylpaa |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427462258 PECOS PAC ID: 2163641457 Enrollment ID: I20140918001875 |
| Provider Name | Phillip B Storm |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1588742993 PECOS PAC ID: 9234119553 Enrollment ID: I20140930002523 |
| Provider Name | Eric Lim |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396952560 PECOS PAC ID: 8527257302 Enrollment ID: I20141001002072 |
| Provider Name | Tessa Dahlen Amos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699187849 PECOS PAC ID: 7012239320 Enrollment ID: I20141122000085 |
| Provider Name | Mindona I Billings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255764163 PECOS PAC ID: 0840512992 Enrollment ID: I20141201001516 |
| Provider Name | Laura A Ballou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811278484 PECOS PAC ID: 2860714698 Enrollment ID: I20141206000317 |
| Provider Name | Courtney Ah Vickery |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023339348 PECOS PAC ID: 3072750108 Enrollment ID: I20141209001843 |
| Provider Name | Christopher P Jones |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1801171301 PECOS PAC ID: 7618299264 Enrollment ID: I20141209002559 |
| Provider Name | Margaret Gallin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730583303 PECOS PAC ID: 4981926565 Enrollment ID: I20141210001210 |
| Provider Name | Kenneth Wallenfelsz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457649998 PECOS PAC ID: 0749433506 Enrollment ID: I20141230000263 |
| Provider Name | Jessica Ross Priddy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932440997 PECOS PAC ID: 9830338169 Enrollment ID: I20150109001747 |
| Provider Name | Bradelle L Padon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427332378 PECOS PAC ID: 7911221395 Enrollment ID: I20150112002116 |
| Provider Name | Scott Chang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962454645 PECOS PAC ID: 9537146212 Enrollment ID: I20150122000280 |
| Provider Name | David B Trowbridge |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356367007 PECOS PAC ID: 9335338706 Enrollment ID: I20150127000514 |
| Provider Name | Lisa Ona Ballehr |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1417996018 PECOS PAC ID: 9537063771 Enrollment ID: I20150219001224 |
| Provider Name | David S Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275924417 PECOS PAC ID: 1658697529 Enrollment ID: I20150312000321 |
| Provider Name | Toni M Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700175924 PECOS PAC ID: 2860632601 Enrollment ID: I20150325000895 |
| Provider Name | Carmen Plott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306064308 PECOS PAC ID: 4486849965 Enrollment ID: I20150330000838 |
| Provider Name | Nausheen Naveed |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508182742 PECOS PAC ID: 8022234582 Enrollment ID: I20150417001634 |
| Provider Name | Cynthia A Foran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073883344 PECOS PAC ID: 0941459622 Enrollment ID: I20150602000298 |
| Provider Name | Aaron R Whittington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497138101 PECOS PAC ID: 4587979331 Enrollment ID: I20150824000020 |
| Provider Name | Guillermo E Espinoza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194081042 PECOS PAC ID: 0840506556 Enrollment ID: I20150826000595 |
| Provider Name | James P Ford |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1144511304 PECOS PAC ID: 2264748367 Enrollment ID: I20150904000079 |
| Provider Name | Catherine Otten |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396060612 PECOS PAC ID: 1254651342 Enrollment ID: I20151016001540 |
| Provider Name | Mariam Miller |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1659533222 PECOS PAC ID: 3870713605 Enrollment ID: I20151024000191 |
| Provider Name | Karen Marie Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427447457 PECOS PAC ID: 4183934987 Enrollment ID: I20151106001388 |
| Provider Name | Dixie W Ishee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508057811 PECOS PAC ID: 2062594864 Enrollment ID: I20151119000952 |
| Provider Name | John P Block |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053677021 PECOS PAC ID: 3870813066 Enrollment ID: I20151123001457 |
| Provider Name | Keegan M Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104143072 PECOS PAC ID: 5698948578 Enrollment ID: I20151207000819 |
| Provider Name | Katherine P Vo Dinh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376849323 PECOS PAC ID: 4587841150 Enrollment ID: I20151207002827 |
| Provider Name | Adam C Mcmahan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790071959 PECOS PAC ID: 0840444212 Enrollment ID: I20151208002640 |
| Provider Name | Rebecca S Malone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841481983 PECOS PAC ID: 9830378066 Enrollment ID: I20151208002902 |
| Provider Name | Emily C Bos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336435593 PECOS PAC ID: 3870746332 Enrollment ID: I20160111001124 |
| Provider Name | Melissa Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073893772 PECOS PAC ID: 4587899125 Enrollment ID: I20160129000137 |
| Provider Name | Kelly J Gebler |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699985994 PECOS PAC ID: 4284804287 Enrollment ID: I20160210000682 |
| Provider Name | Loren E Laybourn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548393424 PECOS PAC ID: 5193823300 Enrollment ID: I20160217001542 |
| Provider Name | Alison M Robinette |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649444761 PECOS PAC ID: 1355529157 Enrollment ID: I20160223001116 |
| Provider Name | Kimberly C Capp |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386834539 PECOS PAC ID: 8123192051 Enrollment ID: I20160308002690 |
| Provider Name | Jeannette L Cook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346560042 PECOS PAC ID: 7517117542 Enrollment ID: I20160408000140 |
| Provider Name | Carolyn R Annerud |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1275586927 PECOS PAC ID: 9234190539 Enrollment ID: I20160412000550 |
| Provider Name | Jessica Holland |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1003244435 PECOS PAC ID: 3173822418 Enrollment ID: I20160509000690 |
| Provider Name | Keith William Merrifield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588974976 PECOS PAC ID: 5395739650 Enrollment ID: I20160517000761 |
| Provider Name | Charles P Morgan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174696660 PECOS PAC ID: 3577755339 Enrollment ID: I20160519000997 |
| Provider Name | Lawanda Pulley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750743308 PECOS PAC ID: 3779872346 Enrollment ID: I20160520001459 |
| Provider Name | Trudy J Moore |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023099488 PECOS PAC ID: 7416904305 Enrollment ID: I20160621002483 |
| Provider Name | Hannah M Foley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184727125 PECOS PAC ID: 4880595008 Enrollment ID: I20160804002594 |
| Provider Name | Katherine Louiise Fossman |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1275914921 PECOS PAC ID: 5991019432 Enrollment ID: I20160818002108 |
| Provider Name | Oleg Odin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851704076 PECOS PAC ID: 5890080550 Enrollment ID: I20160820000075 |
| Provider Name | Sarah M Doaty |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1215254818 PECOS PAC ID: 2668767211 Enrollment ID: I20160823000164 |
| Provider Name | Adam Hecht |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619957834 PECOS PAC ID: 4587695085 Enrollment ID: I20160825001755 |
| Provider Name | Sara Lang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548394190 PECOS PAC ID: 9638465057 Enrollment ID: I20160912002009 |
| Provider Name | Kendra Godwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093043770 PECOS PAC ID: 8628112349 Enrollment ID: I20160914000124 |
| Provider Name | Bonnie L Anderson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013916022 PECOS PAC ID: 2062418858 Enrollment ID: I20160916000199 |
| Provider Name | Joy Neyhart |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255433942 PECOS PAC ID: 7618271552 Enrollment ID: I20160921002654 |
| Provider Name | Rebecca Young Gephart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548523418 PECOS PAC ID: 8224284872 Enrollment ID: I20161010000885 |
| Provider Name | Donald Lehmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497851612 PECOS PAC ID: 9537051693 Enrollment ID: I20161102000109 |
| Provider Name | Claire Waite |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164537544 PECOS PAC ID: 0042221053 Enrollment ID: I20161112000004 |
| Provider Name | David Allen Brown |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1730269341 PECOS PAC ID: 0648448654 Enrollment ID: I20161116000478 |
| Provider Name | Robert C Hunter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093887358 PECOS PAC ID: 7517859671 Enrollment ID: I20170104002259 |
| Provider Name | Lindsey Morgan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821322348 PECOS PAC ID: 7618260159 Enrollment ID: I20170105000089 |
| Provider Name | Thomas H Wendel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790720258 PECOS PAC ID: 0345240255 Enrollment ID: I20170109000240 |
| Provider Name | Camilla E Juhl-petersen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073809232 PECOS PAC ID: 2769637768 Enrollment ID: I20170120000482 |
| Provider Name | Jason Koskinen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801970215 PECOS PAC ID: 0143351247 Enrollment ID: I20170127000766 |
| Provider Name | Jeffrey Lockwood |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1144641903 PECOS PAC ID: 6204069610 Enrollment ID: I20170215000096 |
| Provider Name | Eula Marie Crippen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255562666 PECOS PAC ID: 4688957665 Enrollment ID: I20170217000772 |
| Provider Name | Sean Tomkinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366757197 PECOS PAC ID: 2062796923 Enrollment ID: I20170222000178 |
| Provider Name | Todd Galuszka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104262195 PECOS PAC ID: 4587802491 Enrollment ID: I20170223002049 |
| Provider Name | Jamilee Adams |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194069385 PECOS PAC ID: 4880978428 Enrollment ID: I20170228000559 |
| Provider Name | Cody D Johnston |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285900605 PECOS PAC ID: 2769639962 Enrollment ID: I20170308001193 |
| Provider Name | Jeffrey Ryan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548200504 PECOS PAC ID: 7517933559 Enrollment ID: I20170309000378 |
| Provider Name | Mary L Phillips |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861412991 PECOS PAC ID: 0648208645 Enrollment ID: I20170314000887 |
| Provider Name | Susan Lamb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962575001 PECOS PAC ID: 9335197334 Enrollment ID: I20170321000309 |
| Provider Name | Bernadette R Curtis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407858970 PECOS PAC ID: 2860420346 Enrollment ID: I20170327002800 |
| Provider Name | Brenda Wycoff Mercer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922106889 PECOS PAC ID: 0446210041 Enrollment ID: I20170406001078 |
| Provider Name | Paul S Havrilka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801071543 PECOS PAC ID: 8921236829 Enrollment ID: I20170425000092 |
| Provider Name | David C Ogilbee |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811311970 PECOS PAC ID: 5496032609 Enrollment ID: I20170425002600 |
| Provider Name | Glenn J Schultes |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346309168 PECOS PAC ID: 4284788837 Enrollment ID: I20170426001561 |
| Provider Name | Jerilyn Vanfossen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265856926 PECOS PAC ID: 8224254958 Enrollment ID: I20170504002124 |
| Provider Name | Margaret R Zimmerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407022122 PECOS PAC ID: 5193036275 Enrollment ID: I20170510000561 |
| Provider Name | Deborah Harris |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891717112 PECOS PAC ID: 5294717591 Enrollment ID: I20170515000904 |
| Provider Name | Robert Joodi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376800342 PECOS PAC ID: 8426325796 Enrollment ID: I20170517002164 |
| Provider Name | Tyler B Gilson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710290929 PECOS PAC ID: 6608064944 Enrollment ID: I20170525002275 |
| Provider Name | Tasha Powell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790914091 PECOS PAC ID: 9234316936 Enrollment ID: I20170526000113 |
| Provider Name | Dennis Linderman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124467014 PECOS PAC ID: 2668761933 Enrollment ID: I20170626002924 |
| Provider Name | James Lee Christiansen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326080102 PECOS PAC ID: 5193906485 Enrollment ID: I20170705000891 |
| Provider Name | John Schwartz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225040157 PECOS PAC ID: 0941485262 Enrollment ID: I20170719000316 |
| Provider Name | Rebecca Sturdevant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396802112 PECOS PAC ID: 0143120402 Enrollment ID: I20170803002864 |
| Provider Name | Jacob A Brown |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356537088 PECOS PAC ID: 7315015229 Enrollment ID: I20170816000231 |
| Provider Name | Elaine R Mcelhinny |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1245678978 PECOS PAC ID: 2769607225 Enrollment ID: I20170816004101 |
| Provider Name | Bijiibaa' Md Garrison |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033485743 PECOS PAC ID: 6204139728 Enrollment ID: I20170818000554 |
| Provider Name | Tavis Shaw |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1871662809 PECOS PAC ID: 9638113921 Enrollment ID: I20170830000089 |
| Provider Name | Adrienne Forkois |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1386618346 PECOS PAC ID: 2062785637 Enrollment ID: I20170901000404 |
| Provider Name | Matthew C Bowers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497044283 PECOS PAC ID: 7517143712 Enrollment ID: I20170913003631 |
| Provider Name | Jonathan Decker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619371937 PECOS PAC ID: 2567736317 Enrollment ID: I20170919000060 |
| Provider Name | Courtney W Bagayoko |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1235472176 PECOS PAC ID: 3577837772 Enrollment ID: I20170927002305 |
| Provider Name | Jerome Klein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851349500 PECOS PAC ID: 6800878851 Enrollment ID: I20171004003097 |
| Provider Name | Cynthia L Sherwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942554050 PECOS PAC ID: 3678718293 Enrollment ID: I20171005000060 |
| Provider Name | Emily Haskell |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255850327 PECOS PAC ID: 5991070633 Enrollment ID: I20171006000535 |
| Provider Name | Alan Reid Hay |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1710048061 PECOS PAC ID: 9234324245 Enrollment ID: I20171011000387 |
| Provider Name | David L Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891133369 PECOS PAC ID: 0345463774 Enrollment ID: I20171114002573 |
| Provider Name | Victor Sanoe Harrison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952621468 PECOS PAC ID: 5395981435 Enrollment ID: I20171115001047 |
| Provider Name | Connie I Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538139027 PECOS PAC ID: 1355233313 Enrollment ID: I20171116002520 |
| Provider Name | Donna M Paul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396916383 PECOS PAC ID: 8224162011 Enrollment ID: I20171120000682 |
| Provider Name | Brooke Reynolds |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598080830 PECOS PAC ID: 4587967039 Enrollment ID: I20171128000082 |
| Provider Name | Arlene F Foley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790867448 PECOS PAC ID: 6002805421 Enrollment ID: I20171128000864 |
| Provider Name | Amy B Thompson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457454704 PECOS PAC ID: 7012032816 Enrollment ID: I20171130000437 |
| Provider Name | Dawn Irene Hardwick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023481793 PECOS PAC ID: 0143510446 Enrollment ID: I20171205000459 |
| Provider Name | Kathleen M Myers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578644837 PECOS PAC ID: 2264329481 Enrollment ID: I20171206000231 |
| Provider Name | Daniel R Sparks |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063432201 PECOS PAC ID: 5395884829 Enrollment ID: I20171213000578 |
| Provider Name | Steven Edson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881656692 PECOS PAC ID: 4587650452 Enrollment ID: I20171214001015 |
| Provider Name | Lynn E Prysunka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720144520 PECOS PAC ID: 2062496797 Enrollment ID: I20171215000863 |
| Provider Name | John Edward Carey |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1689667115 PECOS PAC ID: 7012976095 Enrollment ID: I20171215000893 |
| Provider Name | David Emerson Good |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770786618 PECOS PAC ID: 3274615711 Enrollment ID: I20171220000708 |
| Provider Name | Drew Edward Baldwin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952415952 PECOS PAC ID: 0941374847 Enrollment ID: I20171220003007 |
| Provider Name | Joseph Charles Livengood |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518948447 PECOS PAC ID: 4688568181 Enrollment ID: I20171221000142 |
| Provider Name | Jacqueline Bolmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619236908 PECOS PAC ID: 1456514538 Enrollment ID: I20171229001159 |
| Provider Name | Michael Joseph Longo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1508838467 PECOS PAC ID: 2062542673 Enrollment ID: I20180102001000 |
| Provider Name | Sergey Shkurovich |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902070519 PECOS PAC ID: 9032261706 Enrollment ID: I20180110001411 |
| Provider Name | Alan Pratt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922046135 PECOS PAC ID: 7416981063 Enrollment ID: I20180111000437 |
| Provider Name | Priti B Ram |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043276397 PECOS PAC ID: 9638174477 Enrollment ID: I20180112001803 |
| Provider Name | Steven A Archibald |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083657134 PECOS PAC ID: 8729165493 Enrollment ID: I20180116000737 |
| Provider Name | Michael Frederick Bloss |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801854732 PECOS PAC ID: 5597728097 Enrollment ID: I20180116001356 |
| Provider Name | Albert Ybasco |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215900162 PECOS PAC ID: 3971587643 Enrollment ID: I20180116002236 |
| Provider Name | Kathryn R Wagner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043508617 PECOS PAC ID: 5092006486 Enrollment ID: I20180116002564 |
| Provider Name | Michael Cooney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811950231 PECOS PAC ID: 8224942974 Enrollment ID: I20180117001028 |
| Provider Name | Richard T Kaplan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265462980 PECOS PAC ID: 9638105844 Enrollment ID: I20180117001131 |
| Provider Name | Mary Jane Betterman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710962386 PECOS PAC ID: 9830104603 Enrollment ID: I20180118000715 |
| Provider Name | Glenn Mason |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922057025 PECOS PAC ID: 0941223804 Enrollment ID: I20180119000199 |
| Provider Name | Barbara A Newman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003808908 PECOS PAC ID: 6305025784 Enrollment ID: I20180122000377 |
| Provider Name | Amanda K Dutton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972588044 PECOS PAC ID: 9537262266 Enrollment ID: I20180122002429 |
| Provider Name | Kirsten A Menn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558509166 PECOS PAC ID: 5395922702 Enrollment ID: I20180123000737 |
| Provider Name | James Faliszek |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467568261 PECOS PAC ID: 0143116244 Enrollment ID: I20180124000180 |
| Provider Name | Charles Michael Roesel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124003389 PECOS PAC ID: 7113976382 Enrollment ID: I20180202001744 |
| Provider Name | Cindy Annette Rosenberger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841517539 PECOS PAC ID: 7911021084 Enrollment ID: I20180213000329 |
| Provider Name | Daphne Anne Solomon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861833303 PECOS PAC ID: 0941504914 Enrollment ID: I20180214002702 |
| Provider Name | Kristofor A Sargent |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912133588 PECOS PAC ID: 0840428249 Enrollment ID: I20180228000713 |
| Provider Name | Erin Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285813592 PECOS PAC ID: 0648531723 Enrollment ID: I20180306002476 |
| Provider Name | Monte F Zarlingo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992752067 PECOS PAC ID: 8022076934 Enrollment ID: I20180307000722 |
| Provider Name | Krishnan Kartha |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144325952 PECOS PAC ID: 7618038506 Enrollment ID: I20180309001125 |
| Provider Name | Joyce Camille Restad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750594818 PECOS PAC ID: 4183523426 Enrollment ID: I20180329000316 |
| Provider Name | Lisa Marie Lagrange |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316370927 PECOS PAC ID: 1052545233 Enrollment ID: I20180411002256 |
| Provider Name | David Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356622419 PECOS PAC ID: 8820261332 Enrollment ID: I20180412002331 |
| Provider Name | Danita N Koehler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750455150 PECOS PAC ID: 9638193659 Enrollment ID: I20180412002429 |
| Provider Name | Kelly Elizabeth Spittler |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1700388865 PECOS PAC ID: 5294098653 Enrollment ID: I20180417001703 |
| Provider Name | Kathleen C Rooney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932351871 PECOS PAC ID: 3173686094 Enrollment ID: I20180418002075 |
| Provider Name | Annmarie Campione |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205923521 PECOS PAC ID: 5395894091 Enrollment ID: I20180523000408 |
| Provider Name | Laurel I Skeek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487073813 PECOS PAC ID: 4385949882 Enrollment ID: I20180604001851 |
| Provider Name | Beverley A Blake O'doherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821166539 PECOS PAC ID: 3577514207 Enrollment ID: I20180702000814 |
| Provider Name | Saaransh R Desai |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093070138 PECOS PAC ID: 4587978184 Enrollment ID: I20180703002322 |
| Provider Name | Frederick James Anderson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861409740 PECOS PAC ID: 5395631758 Enrollment ID: I20180719000415 |
| Provider Name | Lucas Donald Schreiner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982085239 PECOS PAC ID: 0345546917 Enrollment ID: I20180807001672 |
| Provider Name | Vinod Gollapalli |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104055185 PECOS PAC ID: 7911294459 Enrollment ID: I20180813000809 |
| Provider Name | Buck Bania |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154685972 PECOS PAC ID: 6305082447 Enrollment ID: I20180829004336 |
| Provider Name | Kari Janece Defreest |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1316425291 PECOS PAC ID: 2961312699 Enrollment ID: I20180911000841 |
| Provider Name | Maureen A Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114190048 PECOS PAC ID: 6800960774 Enrollment ID: I20180911001981 |
| Provider Name | Melody M Shepherd |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578940284 PECOS PAC ID: 3870897689 Enrollment ID: I20180913000095 |
| Provider Name | Katherine Elizabeth Carroll |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1720569791 PECOS PAC ID: 3678823564 Enrollment ID: I20180914000998 |
| Provider Name | Jared Onder |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1316482953 PECOS PAC ID: 7012292063 Enrollment ID: I20180925003454 |
| Provider Name | Moniquea J Degan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205933884 PECOS PAC ID: 2668447202 Enrollment ID: I20181003003066 |
| Provider Name | Carol Altepeter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629305834 PECOS PAC ID: 6709138209 Enrollment ID: I20181011000715 |
| Provider Name | Matthew E Leither |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750769972 PECOS PAC ID: 5698087112 Enrollment ID: I20181015002776 |
| Provider Name | Rodney Warner Schaffer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821032350 PECOS PAC ID: 2567538853 Enrollment ID: I20181022000097 |
| Provider Name | Lisa Marie Antonio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679951438 PECOS PAC ID: 3072820760 Enrollment ID: I20181025000137 |
| Provider Name | Chelsea Phelps |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720580202 PECOS PAC ID: 2860746682 Enrollment ID: I20181114002352 |
| Provider Name | Jenilyn Lo |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881055655 PECOS PAC ID: 3678869385 Enrollment ID: I20181117000284 |
| Provider Name | James Lawrence Taggart |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730478538 PECOS PAC ID: 3678846540 Enrollment ID: I20181119003069 |
| Provider Name | Rayshal Spalding |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1891261996 PECOS PAC ID: 4385998871 Enrollment ID: I20181120001336 |
| Provider Name | Steven Scott Overman |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1437154309 PECOS PAC ID: 5991792103 Enrollment ID: I20190103000755 |
| Provider Name | Savannah Mallory Wilhite |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992128383 PECOS PAC ID: 6608191721 Enrollment ID: I20190107002537 |
| Provider Name | Kerry Dorius |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891741526 PECOS PAC ID: 9436048964 Enrollment ID: I20190117000313 |
| Provider Name | Kevin M. Kollins |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952563462 PECOS PAC ID: 5395932826 Enrollment ID: I20190118000074 |
| Provider Name | Dykes Maxwell Young |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699853234 PECOS PAC ID: 6507828753 Enrollment ID: I20190201000312 |
| Provider Name | Anita Matherley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184941486 PECOS PAC ID: 2365679263 Enrollment ID: I20190219001605 |
| Provider Name | Steven R Steinhubl |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1033123633 PECOS PAC ID: 6709863269 Enrollment ID: I20190304001362 |
| Provider Name | Thomas Anthony Lamperti |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1780673392 PECOS PAC ID: 0648170886 Enrollment ID: I20190306000628 |
| Provider Name | Mary A Wemple |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1033108188 PECOS PAC ID: 2567448897 Enrollment ID: I20190307002151 |
| Provider Name | Michael Young Han |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1063413144 PECOS PAC ID: 7719922822 Enrollment ID: I20190307002363 |
| Provider Name | Barbara J Fox |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1164430054 PECOS PAC ID: 4284521360 Enrollment ID: I20190308000925 |
| Provider Name | Ronald Martin Schlansky |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1558341727 PECOS PAC ID: 0244247245 Enrollment ID: I20190308001554 |
| Provider Name | Norman J Simon |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1932266897 PECOS PAC ID: 6406817386 Enrollment ID: I20190311000399 |
| Provider Name | Michael J Wolfe |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1346289865 PECOS PAC ID: 5991605156 Enrollment ID: I20190311000457 |
| Provider Name | Teresa A Marshall |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1932399425 PECOS PAC ID: 2961487392 Enrollment ID: I20190311000579 |
| Provider Name | Ling Zhou |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1912297110 PECOS PAC ID: 2860771698 Enrollment ID: I20190325000154 |
| Provider Name | Baruch Friedman |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1174591713 PECOS PAC ID: 5395776256 Enrollment ID: I20190402000195 |
| Provider Name | Meghan Eileen Greenfield |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1841581576 PECOS PAC ID: 2062731557 Enrollment ID: I20190402000470 |
| Provider Name | Rodney Vaught |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245209709 PECOS PAC ID: 5294729679 Enrollment ID: I20190403000346 |
| Provider Name | Ivan Medvedev |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1629236187 PECOS PAC ID: 8729103452 Enrollment ID: I20190404001167 |
| Provider Name | Vivek R Mehta |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1538501812 PECOS PAC ID: 9537481619 Enrollment ID: I20190416000969 |
| Provider Name | Jill S Cease |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245284249 PECOS PAC ID: 3971503269 Enrollment ID: I20190417000304 |
| Provider Name | Richard Fitzgerald Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902314511 PECOS PAC ID: 9931468725 Enrollment ID: I20190417000351 |
| Provider Name | Rachel Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588990915 PECOS PAC ID: 4688935380 Enrollment ID: I20190417000608 |
| Provider Name | Walter Argueta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508333717 PECOS PAC ID: 0749521854 Enrollment ID: I20190417001995 |
| Provider Name | Bruce M Palmer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1326110743 PECOS PAC ID: 4981937570 Enrollment ID: I20190613002450 |
| Provider Name | Carly Hall Haas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134678972 PECOS PAC ID: 5395024756 Enrollment ID: I20190614000237 |
| Provider Name | Richard Lewis Holt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558451302 PECOS PAC ID: 7416055595 Enrollment ID: I20190709001506 |
| Provider Name | Debra Brushafer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215939871 PECOS PAC ID: 9537323126 Enrollment ID: I20190716003345 |
| Provider Name | Mark Eliot Clyde |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1902840812 PECOS PAC ID: 7315942398 Enrollment ID: I20190717000295 |
| Provider Name | Carly Allen |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1528455722 PECOS PAC ID: 2961797857 Enrollment ID: I20190730000165 |
| Provider Name | Melissa Ann Dewolfe |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356545172 PECOS PAC ID: 9638390552 Enrollment ID: I20190730000464 |
| Provider Name | Casey Ploof |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255871034 PECOS PAC ID: 6305121617 Enrollment ID: I20190812003086 |
| Provider Name | Andrea Galaviz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851740211 PECOS PAC ID: 7810280427 Enrollment ID: I20190815000295 |
| Provider Name | Brianna Grigsby |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720435712 PECOS PAC ID: 4688965213 Enrollment ID: I20190815003071 |
| Provider Name | Norma Mary Furlong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528111721 PECOS PAC ID: 9133438260 Enrollment ID: I20190822003249 |
| Provider Name | Colleen Slate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922246503 PECOS PAC ID: 0547317125 Enrollment ID: I20190826000564 |
| Provider Name | Wayne Stuart Moss |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841501681 PECOS PAC ID: 0042444663 Enrollment ID: I20190826002566 |
| Provider Name | Andrew T Coletti |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255381109 PECOS PAC ID: 5294705836 Enrollment ID: I20190827000420 |
| Provider Name | Samuel Chase Werner |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1467866038 PECOS PAC ID: 4587929773 Enrollment ID: I20190828000418 |
| Provider Name | Krysta Byrnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073027942 PECOS PAC ID: 1456689314 Enrollment ID: I20190830000119 |
| Provider Name | Bryan James Wilson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1366860314 PECOS PAC ID: 7113148263 Enrollment ID: I20190913002260 |
| Provider Name | Donald Robert Teater |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699769224 PECOS PAC ID: 0749354470 Enrollment ID: I20190923002063 |
| Provider Name | Elysia Sophia Spencer |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1861831273 PECOS PAC ID: 5193940468 Enrollment ID: I20190926003340 |
| Provider Name | Ruthanne Reichert Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538278171 PECOS PAC ID: 6103977764 Enrollment ID: I20191002003228 |
| Provider Name | Javaneh Lyons |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1477969640 PECOS PAC ID: 2163724980 Enrollment ID: I20191016000023 |
| Provider Name | Joshua David Ring |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1487069696 PECOS PAC ID: 9133344997 Enrollment ID: I20191025001602 |
| Provider Name | Vincent T. Chan |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1194832592 PECOS PAC ID: 5597838417 Enrollment ID: I20191108000999 |
| Provider Name | Theresa Shelley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659626083 PECOS PAC ID: 5698100956 Enrollment ID: I20200114001703 |
| Provider Name | Kirk Alexander |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1720076367 PECOS PAC ID: 5092774240 Enrollment ID: I20200128000225 |
| Provider Name | Carolyn Larkin Taylor |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790844660 PECOS PAC ID: 3870489982 Enrollment ID: I20200306001712 |
| Provider Name | Calvin B Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386023596 PECOS PAC ID: 5496068546 Enrollment ID: I20200309001625 |
| Provider Name | Steven Han |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1013033190 PECOS PAC ID: 0345205241 Enrollment ID: I20200327003141 |
| Provider Name | Joel Lilly |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1104899137 PECOS PAC ID: 5496774481 Enrollment ID: I20200413002780 |
| Provider Name | Riley K O'connor |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1639708803 PECOS PAC ID: 0042640104 Enrollment ID: I20200414001425 |
| Provider Name | Kimberly C Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881148674 PECOS PAC ID: 1850674532 Enrollment ID: I20200506000110 |
| Provider Name | Erin Board |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346620861 PECOS PAC ID: 4688977614 Enrollment ID: I20200520003725 |
| Provider Name | Jennifer A Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821644808 PECOS PAC ID: 4587085766 Enrollment ID: I20200526000268 |
| Provider Name | Andrea Michelle Gibson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033568563 PECOS PAC ID: 8820419757 Enrollment ID: I20200602001414 |
| Provider Name | Terry Zahniser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205976198 PECOS PAC ID: 7012079411 Enrollment ID: I20200710002370 |
| Provider Name | John Andrew Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538462353 PECOS PAC ID: 6709209372 Enrollment ID: I20200715001110 |
| Provider Name | Sarah J Virnig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487180774 PECOS PAC ID: 3476822610 Enrollment ID: I20200819000154 |
| Provider Name | Anna Knisely |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1992937825 PECOS PAC ID: 7719287622 Enrollment ID: I20200908002351 |
| Provider Name | Laura Jean Wittmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295217289 PECOS PAC ID: 2466796537 Enrollment ID: I20200917001624 |
| Provider Name | Drew Clyde Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427583426 PECOS PAC ID: 4486072717 Enrollment ID: I20200917002121 |
| Provider Name | Corey White |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154610814 PECOS PAC ID: 2961723663 Enrollment ID: I20200922000707 |
| Provider Name | Kelsey Campolong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518499961 PECOS PAC ID: 9739457698 Enrollment ID: I20200922002357 |
| Provider Name | Richard B Stein |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477949857 PECOS PAC ID: 1557674975 Enrollment ID: I20200929002329 |
| Provider Name | Kyleen Luhrs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730610221 PECOS PAC ID: 3375817000 Enrollment ID: I20201006000250 |
| Provider Name | John Vantassel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063443638 PECOS PAC ID: 4183633225 Enrollment ID: I20201021001155 |
| Provider Name | John Yates Sealander |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164464178 PECOS PAC ID: 3476637448 Enrollment ID: I20201027001342 |
| Provider Name | Eric G Young |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366642290 PECOS PAC ID: 7618309949 Enrollment ID: I20201214002316 |
| Provider Name | Kathryn Salerno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255831681 PECOS PAC ID: 3870858160 Enrollment ID: I20201215000343 |
| Provider Name | Patricia Siza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619168028 PECOS PAC ID: 4385913516 Enrollment ID: I20201216000800 |
| Provider Name | Gregory Grant |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1154324812 PECOS PAC ID: 1153396635 Enrollment ID: I20201228002229 |
| Provider Name | Eric J Bowton |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1538169446 PECOS PAC ID: 1759280399 Enrollment ID: I20210104001946 |
| Provider Name | Maurice Yoskin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639137334 PECOS PAC ID: 4284718651 Enrollment ID: I20210108001230 |
| Provider Name | Theresa Noel Reynolds |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1609463868 PECOS PAC ID: 6305259078 Enrollment ID: I20210120000058 |
| Provider Name | Taylor M Miles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043665987 PECOS PAC ID: 5890032353 Enrollment ID: I20210210002254 |
| Provider Name | Tad Willis Buckingham |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992876056 PECOS PAC ID: 7719081421 Enrollment ID: I20210218002646 |
| Provider Name | Scott Rigdon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134371503 PECOS PAC ID: 6901965482 Enrollment ID: I20210219000095 |
| Provider Name | Madeline Nguyen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083058275 PECOS PAC ID: 8123398203 Enrollment ID: I20210301000178 |
| Provider Name | Nancy Isenberg |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700886157 PECOS PAC ID: 0446275135 Enrollment ID: I20210310001554 |
| Provider Name | Joan Sutcliffe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871597799 PECOS PAC ID: 7618868480 Enrollment ID: I20210331002492 |
| Provider Name | John Mignone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194834127 PECOS PAC ID: 1658506142 Enrollment ID: I20210408001322 |
| Provider Name | Karen Linnea Peterson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1518970235 PECOS PAC ID: 4880650043 Enrollment ID: I20210419000080 |
| Provider Name | Edward T Chen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396273132 PECOS PAC ID: 6103237987 Enrollment ID: I20210427000282 |
| Provider Name | Sean D Kalagher |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972715282 PECOS PAC ID: 4587810189 Enrollment ID: I20210429000270 |
| Provider Name | Lawrence Murphy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699846691 PECOS PAC ID: 0345233995 Enrollment ID: I20210429000541 |
| Provider Name | Eric J Kraemer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881621621 PECOS PAC ID: 1153429469 Enrollment ID: I20210506001225 |
| Provider Name | Kristen A Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124572540 PECOS PAC ID: 7416235627 Enrollment ID: I20210511000363 |
| Provider Name | Myra D Dimitrov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134548464 PECOS PAC ID: 2567724842 Enrollment ID: I20210521001286 |
| Provider Name | John Green |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1811240252 PECOS PAC ID: 4789836958 Enrollment ID: I20210524000769 |
| Provider Name | Mitra Jahangiri |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1528642675 PECOS PAC ID: 2264831221 Enrollment ID: I20210524001357 |
| Provider Name | Allen Meglin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437187473 PECOS PAC ID: 6204803562 Enrollment ID: I20210525000867 |
| Provider Name | Lissa C Sakata |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902193410 PECOS PAC ID: 8123249810 Enrollment ID: I20210526002999 |
| Provider Name | Santanu Biswas |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1639138944 PECOS PAC ID: 5698772994 Enrollment ID: I20210610000248 |
| Provider Name | Kaitlyn Marie Main |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972008399 PECOS PAC ID: 6709201304 Enrollment ID: I20210615000253 |
| Provider Name | Susan Renteria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881631786 PECOS PAC ID: 1153365739 Enrollment ID: I20210623000685 |
| Provider Name | Kerry H Sullivan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093717548 PECOS PAC ID: 7012064611 Enrollment ID: I20210706000415 |
| Provider Name | Reid Haflich |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659804862 PECOS PAC ID: 3173954997 Enrollment ID: I20210709000649 |
| Provider Name | Kateland Townley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689161960 PECOS PAC ID: 2163836057 Enrollment ID: I20210712000127 |
| Provider Name | Jonathan Motts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124550488 PECOS PAC ID: 1850678855 Enrollment ID: I20210728000301 |
| Provider Name | Elizabeth Litoff |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1437641545 PECOS PAC ID: 7517361751 Enrollment ID: I20210810001237 |
| Provider Name | George Banks |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1720449655 PECOS PAC ID: 6901105477 Enrollment ID: I20210812002226 |
| Provider Name | Carl N Schofield |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316945728 PECOS PAC ID: 5597727180 Enrollment ID: I20210818003507 |
| Provider Name | An Phan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154857373 PECOS PAC ID: 9335545839 Enrollment ID: I20210909000169 |
| Provider Name | Corey Cox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750814547 PECOS PAC ID: 5193093052 Enrollment ID: I20210915000792 |
| Provider Name | Jacob A Petrosky |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881959013 PECOS PAC ID: 9931351707 Enrollment ID: I20210915001241 |
| Provider Name | Fredrick Yost |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821059353 PECOS PAC ID: 6204851660 Enrollment ID: I20210923000830 |
| Provider Name | Denise Giroux |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1730671363 PECOS PAC ID: 2365875614 Enrollment ID: I20211018000533 |
| Provider Name | Evan Dannhardt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932558392 PECOS PAC ID: 4981992484 Enrollment ID: I20211019000878 |
| Provider Name | Caleb John Euhus |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477915296 PECOS PAC ID: 3971991118 Enrollment ID: I20211021000429 |
| Provider Name | Gabriella Robin Worden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053951962 PECOS PAC ID: 2769870138 Enrollment ID: I20211104000996 |
| Provider Name | Ian Merrill |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245350164 PECOS PAC ID: 9931291580 Enrollment ID: I20211116002593 |
| Provider Name | Jennie Rebecca Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801486410 PECOS PAC ID: 3476969577 Enrollment ID: I20220120000156 |
| Provider Name | Michael Lee Ettner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629061940 PECOS PAC ID: 1557496080 Enrollment ID: I20220124000402 |
| Provider Name | Audrey Conrad |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1619593449 PECOS PAC ID: 4183017544 Enrollment ID: I20220207001481 |
| Provider Name | Alicia Stettler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124561774 PECOS PAC ID: 9032529268 Enrollment ID: I20220222002294 |
| Provider Name | Lee Flowers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215290010 PECOS PAC ID: 0244476000 Enrollment ID: I20220224002074 |
| Provider Name | William R Bacon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609014489 PECOS PAC ID: 5294905386 Enrollment ID: I20220301001266 |
| Provider Name | Danielle Dues |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912242504 PECOS PAC ID: 2163706250 Enrollment ID: I20220303002204 |
| Provider Name | Lora Jae |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497389647 PECOS PAC ID: 5193156719 Enrollment ID: I20220310001500 |
| Provider Name | Erica Foster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053710582 PECOS PAC ID: 6901191006 Enrollment ID: I20220321002596 |
| Provider Name | Carol Goetz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255322764 PECOS PAC ID: 2567757875 Enrollment ID: I20220324000037 |
| Provider Name | Abigail Volmer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174031504 PECOS PAC ID: 1951636851 Enrollment ID: I20220328001033 |
| Provider Name | Alison Brazel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831648617 PECOS PAC ID: 8325433410 Enrollment ID: I20220329000332 |
| Provider Name | Jayme Schroeder |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215466081 PECOS PAC ID: 0345679882 Enrollment ID: I20220330000613 |
| Provider Name | Bonnie Dansby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528184322 PECOS PAC ID: 1557757564 Enrollment ID: I20220330002824 |
| Provider Name | Joshua D Boucher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316390990 PECOS PAC ID: 0042584138 Enrollment ID: I20220421000155 |
| Provider Name | Matthew T Usmiller |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1801543004 PECOS PAC ID: 4880081876 Enrollment ID: I20220421000485 |
| Provider Name | Guillermo Jimenez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154570984 PECOS PAC ID: 8921395617 Enrollment ID: I20220421000497 |
| Provider Name | Linda Holmes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760401327 PECOS PAC ID: 4385697663 Enrollment ID: I20220502000166 |
| Provider Name | Carmen S Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538612882 PECOS PAC ID: 4789971680 Enrollment ID: I20220524000731 |
| Provider Name | Jennifer Kujak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902016496 PECOS PAC ID: 0840361283 Enrollment ID: I20220608001015 |
| Provider Name | Leslie Defluiter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821565540 PECOS PAC ID: 7517207087 Enrollment ID: I20220616000601 |
| Provider Name | Meaghan Lamothe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326586991 PECOS PAC ID: 5799069324 Enrollment ID: I20220630001863 |
| Provider Name | Kristina Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801447826 PECOS PAC ID: 8426438201 Enrollment ID: I20220711002711 |
| Provider Name | Kathy Stepien |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598959314 PECOS PAC ID: 7517244395 Enrollment ID: I20220712000962 |
| Provider Name | Kela Bergren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962965038 PECOS PAC ID: 0446585327 Enrollment ID: I20220719002998 |
| Provider Name | Stephen Ellison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134782121 PECOS PAC ID: 8729314059 Enrollment ID: I20220720000178 |
| Provider Name | Bradley Wine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578126561 PECOS PAC ID: 0648505537 Enrollment ID: I20220726000380 |
| Provider Name | Samuel Baxter Steinbruegge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437628930 PECOS PAC ID: 3779965926 Enrollment ID: I20220804000173 |
| Provider Name | Michelle J Hinton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346717428 PECOS PAC ID: 2466794961 Enrollment ID: I20220815001545 |
| Provider Name | Nikolas Johs |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457914558 PECOS PAC ID: 1153654074 Enrollment ID: I20220822003104 |
| Provider Name | Lyndell Sue Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013951854 PECOS PAC ID: 4688611775 Enrollment ID: I20220824003681 |
| Provider Name | Matthew Markey-crimp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366903171 PECOS PAC ID: 3072842764 Enrollment ID: I20220909001436 |
| Provider Name | Zulema Aryssa Marquez |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1578154142 PECOS PAC ID: 9638554082 Enrollment ID: I20220921000667 |
| Provider Name | Kayla Janae Luhrs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538429964 PECOS PAC ID: 9638312705 Enrollment ID: I20220926002013 |
| Provider Name | Matthew Madden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417424854 PECOS PAC ID: 5890023808 Enrollment ID: I20221010001911 |
| Provider Name | John Chen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1750745121 PECOS PAC ID: 0042696742 Enrollment ID: I20221018001644 |
| Provider Name | Tenelle L Bragg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982296786 PECOS PAC ID: 9335515261 Enrollment ID: I20221018002919 |
| Provider Name | Travis Polston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578052882 PECOS PAC ID: 0941557508 Enrollment ID: I20221024000477 |
| Provider Name | Charles Jin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801966924 PECOS PAC ID: 1658329693 Enrollment ID: I20221109001500 |
| Provider Name | Marie Jeanne Lavigne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306438908 PECOS PAC ID: 8325416803 Enrollment ID: I20221115002445 |
| Provider Name | Ravinder S Sohal |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740244466 PECOS PAC ID: 3779541974 Enrollment ID: I20221209000929 |
| Provider Name | James Howard |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1457692121 PECOS PAC ID: 9739325812 Enrollment ID: I20221216000454 |
| Provider Name | Norwood W Knight Richardson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891700316 PECOS PAC ID: 6709789290 Enrollment ID: I20230103001461 |
| Provider Name | Janet Maurice |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598298069 PECOS PAC ID: 8022394683 Enrollment ID: I20230204000098 |
| Provider Name | Nina Mueller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124668595 PECOS PAC ID: 5395117303 Enrollment ID: I20230220002016 |
| Provider Name | Sarah E Hines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669707584 PECOS PAC ID: 7810300613 Enrollment ID: I20230303001635 |
| Provider Name | Piper Haney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457953515 PECOS PAC ID: 2668846551 Enrollment ID: I20230315002766 |
| Provider Name | Charlotte Bourdillon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972163889 PECOS PAC ID: 9931573367 Enrollment ID: I20230324002316 |
| Provider Name | Chadwick Densley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629430046 PECOS PAC ID: 0345635678 Enrollment ID: I20230327002017 |
| Provider Name | Kayla Mcmaster |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1093241580 PECOS PAC ID: 6800146705 Enrollment ID: I20230330003023 |
| Provider Name | Dawn King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407256712 PECOS PAC ID: 7810117934 Enrollment ID: I20230406001329 |
| Provider Name | Emily Rosenfeld |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861856122 PECOS PAC ID: 0749572881 Enrollment ID: I20230406001882 |
| Provider Name | Nicholas Newbury |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417214933 PECOS PAC ID: 1153611058 Enrollment ID: I20230414000083 |
| Provider Name | Cynthia Dennis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477765899 PECOS PAC ID: 6507174836 Enrollment ID: I20230530001316 |
| Provider Name | Ernst Hansch |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366428351 PECOS PAC ID: 2668548454 Enrollment ID: I20230609000382 |
| Provider Name | Sean Plank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528589777 PECOS PAC ID: 8527326198 Enrollment ID: I20230622003493 |
| Provider Name | Kathleen Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629080999 PECOS PAC ID: 6608817945 Enrollment ID: I20230627000035 |
| Provider Name | Margaret Curtis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619296837 PECOS PAC ID: 0941444822 Enrollment ID: I20230706002530 |
| Provider Name | Kyle Jurczyk |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1952092538 PECOS PAC ID: 2860852951 Enrollment ID: I20230720003625 |
| Provider Name | Ryan Wilson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1780070060 PECOS PAC ID: 6507158896 Enrollment ID: I20230801002084 |
| Provider Name | Tara Kathryn Fenske Farley |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1154013357 PECOS PAC ID: 1850752270 Enrollment ID: I20230802000833 |
| Provider Name | David Wong |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871584227 PECOS PAC ID: 9436193703 Enrollment ID: I20230829001155 |
| Provider Name | Jonathan Caudle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437658960 PECOS PAC ID: 5395080485 Enrollment ID: I20230906002801 |
| Provider Name | Lucy Goodson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255894101 PECOS PAC ID: 9830432657 Enrollment ID: I20230907003831 |
| Provider Name | Emily Harvey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710476023 PECOS PAC ID: 7517215080 Enrollment ID: I20230919004487 |
| Provider Name | Neal Keeshin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063494599 PECOS PAC ID: 6305869058 Enrollment ID: I20230928000133 |
| Provider Name | Amanda B Sorrill |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114128253 PECOS PAC ID: 9133516768 Enrollment ID: I20230929002421 |
| Provider Name | Ciara Ray |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1922632132 PECOS PAC ID: 1658740048 Enrollment ID: I20231002003245 |
| Provider Name | Sarah Beebe |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1821594805 PECOS PAC ID: 4880941830 Enrollment ID: I20231005000783 |
| Provider Name | Lisa Marie Benton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487933545 PECOS PAC ID: 5799956744 Enrollment ID: I20231005001509 |
| Provider Name | April Rose Coyle |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467729822 PECOS PAC ID: 0749635126 Enrollment ID: I20231005001728 |
| Provider Name | Thomas Orsini |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568415727 PECOS PAC ID: 4880669589 Enrollment ID: I20231010000443 |
| Provider Name | Jonathan Breslau |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942208699 PECOS PAC ID: 5890690754 Enrollment ID: I20231010002174 |
| Provider Name | Jessica Pyatt |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861787095 PECOS PAC ID: 7315189560 Enrollment ID: I20231010002202 |
| Provider Name | Jena Uvalle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407376098 PECOS PAC ID: 7517231459 Enrollment ID: I20231011002214 |
| Provider Name | Tyler Sherban |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255820072 PECOS PAC ID: 2961750450 Enrollment ID: I20231013003044 |
| Provider Name | Eva Fish |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1821667924 PECOS PAC ID: 0143675777 Enrollment ID: I20231017001027 |
| Provider Name | Mari-margaret Celeste Tydingco |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164186821 PECOS PAC ID: 4789039363 Enrollment ID: I20231017002930 |
| Provider Name | Elizabeth Hunt |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1942589783 PECOS PAC ID: 3274704267 Enrollment ID: I20231027001379 |
| Provider Name | Patricia Dawn Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881702231 PECOS PAC ID: 2466434360 Enrollment ID: I20231107001538 |
| Provider Name | Nicolette Womble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679911986 PECOS PAC ID: 9739320326 Enrollment ID: I20231108000878 |
| Provider Name | Samantha Hawkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528601358 PECOS PAC ID: 3577999119 Enrollment ID: I20231121001413 |
| Provider Name | Vanessa Hadley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629252044 PECOS PAC ID: 3779705611 Enrollment ID: I20231202000596 |
| Provider Name | Christiaan Collier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174164875 PECOS PAC ID: 4385077064 Enrollment ID: I20231205001981 |
| Provider Name | David Krakowski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730368721 PECOS PAC ID: 8325116148 Enrollment ID: I20231213000313 |
| Provider Name | Emily Sherwood |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1811654569 PECOS PAC ID: 0446634257 Enrollment ID: I20231218002309 |
| Provider Name | Ty Ovella |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730156498 PECOS PAC ID: 2769389980 Enrollment ID: I20231219003254 |
| Provider Name | Kenneth Macneal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487180519 PECOS PAC ID: 4880044056 Enrollment ID: I20231229002398 |
| Provider Name | Allison Rolf-mcmurren |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386201135 PECOS PAC ID: 5193176410 Enrollment ID: I20240110004035 |
| Provider Name | Amanda Underwood |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285046219 PECOS PAC ID: 2466677372 Enrollment ID: I20240116002902 |
| Provider Name | Olivia Salisbury Sinaiko |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629690789 PECOS PAC ID: 3971955774 Enrollment ID: I20240117002720 |
| Provider Name | Charissa Strope |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649628199 PECOS PAC ID: 1951754712 Enrollment ID: I20240129000215 |
| Provider Name | Trina Lee Williamson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386901833 PECOS PAC ID: 3779936455 Enrollment ID: I20240130000388 |
| Provider Name | Kala Maus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699264903 PECOS PAC ID: 3971851510 Enrollment ID: I20240131000198 |
| Provider Name | David Lubin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710503800 PECOS PAC ID: 2668825902 Enrollment ID: I20240202000122 |
| Provider Name | Kindra Robbins |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1104541705 PECOS PAC ID: 3577932482 Enrollment ID: I20240209001663 |
| Provider Name | David Shaw |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1033348792 PECOS PAC ID: 4880901784 Enrollment ID: I20240213000234 |
| Provider Name | Amber Chambers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023434511 PECOS PAC ID: 8527402783 Enrollment ID: I20240215004187 |
| Provider Name | Sonia Wiggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063676146 PECOS PAC ID: 0345315701 Enrollment ID: I20240226003381 |
| Provider Name | Sadie Elizabeth Meyer |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1841056447 PECOS PAC ID: 0446697197 Enrollment ID: I20240318002401 |
| Provider Name | Auston Douglas Eckert |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1396247367 PECOS PAC ID: 1759728348 Enrollment ID: I20240319000495 |
| Provider Name | Desiree Tricarico |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871069849 PECOS PAC ID: 7416378021 Enrollment ID: I20240321000032 |
| Provider Name | Aaron Christopher Fong |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689843161 PECOS PAC ID: 9234576380 Enrollment ID: I20240325002116 |
| Provider Name | Rory Ingram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225567431 PECOS PAC ID: 8820362908 Enrollment ID: I20240401002298 |
| Provider Name | Amanda Lowe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841853835 PECOS PAC ID: 2769718238 Enrollment ID: I20240405001352 |
| Provider Name | John Raasch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679024673 PECOS PAC ID: 5991143109 Enrollment ID: I20240409000025 |
| Provider Name | Tait Dalton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467698977 PECOS PAC ID: 5597954149 Enrollment ID: I20240411002405 |
| Provider Name | Michele Federico |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750412532 PECOS PAC ID: 5698114411 Enrollment ID: I20240412002544 |
| Provider Name | Zachary Forcade |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568959559 PECOS PAC ID: 1759638547 Enrollment ID: I20240415000286 |
| Provider Name | Joseph Roth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427090307 PECOS PAC ID: 1557310851 Enrollment ID: I20240415002635 |
| Provider Name | Deborah Carlisle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497993950 PECOS PAC ID: 5294038493 Enrollment ID: I20240416000715 |
| Provider Name | Soroosh Hashemi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437543386 PECOS PAC ID: 0143521682 Enrollment ID: I20240416003074 |
| Provider Name | Laura Prestidge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255938726 PECOS PAC ID: 3779993654 Enrollment ID: I20240419003230 |
| Provider Name | Jessica Steinsiek |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407370471 PECOS PAC ID: 4789927583 Enrollment ID: I20240429002124 |
| Provider Name | Stephen Rafferty |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1447359286 PECOS PAC ID: 4688772445 Enrollment ID: I20240507000780 |
| Provider Name | Amy Hertrick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750632311 PECOS PAC ID: 9830596857 Enrollment ID: I20240508001145 |
| Provider Name | Cornell Wells |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851658850 PECOS PAC ID: 8820317043 Enrollment ID: I20240508002814 |
| Provider Name | Lien Nguyen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023402914 PECOS PAC ID: 9830404417 Enrollment ID: I20240514003940 |
| Provider Name | Alexandra Lily Mcmurren |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053071837 PECOS PAC ID: 8224479647 Enrollment ID: I20240515003321 |
| Provider Name | Alison Powell |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1710753546 PECOS PAC ID: 5092156398 Enrollment ID: I20240517001895 |
| Provider Name | Jeanne Wescoat |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679594907 PECOS PAC ID: 4688670854 Enrollment ID: I20240521000914 |
| Provider Name | Alicia Kiger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629657374 PECOS PAC ID: 8022419613 Enrollment ID: I20240524000051 |
| Provider Name | Kim Hoang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477951028 PECOS PAC ID: 1355689175 Enrollment ID: I20240613002437 |