| Behavioral Health Center | |
|
4579 S Eason Blvd Ste A Tupelo MS 38801-6539 | |
| (662) 377-3161 | |
| (662) 377-2993 |
| Full Name | Behavioral Health Center |
|---|---|
| Speciality | Psychologist |
| Location | 4579 S Eason Blvd Ste A, Tupelo, Mississippi |
| Authorized Official Name and Position | Gerald Wages (COO) |
| Authorized Official Contact | 6623773161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Health Center 450 E President Ave Tupelo MS 38801-5599 Ph: (662) 377-4685 | Behavioral Health Center 4579 S Eason Blvd Ste A Tupelo MS 38801-6539 Ph: (662) 377-3161 |
| NPI Number | 1972608347 |
|---|---|
| Provider Enumeration Date | 09/13/2006 |
| Last Update Date | 03/17/2015 |
| Medicare PECOS PAC ID | 9931010600 |
|---|---|
| Medicare Enrollment ID | O20040413000541 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972608347 | NPI | - | NPPES |
| CA5810 | Other | MS | RAILROAD MEDICARE |
| 09015893 | Medicaid | MS | |
| C02674 | Other | MS | MEDICARE GROUP NUMBER |
| CJ3596 | Other | MS | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | James Riddell Lewis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821038407 PECOS PAC ID: 0143122127 Enrollment ID: I20040121000594 |
| Provider Name | Brian Estes |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154402782 PECOS PAC ID: 5799678504 Enrollment ID: I20040205000546 |
| Provider Name | William B Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720022973 PECOS PAC ID: 2365436060 Enrollment ID: I20040414000896 |
| Provider Name | Joseph M Alexander |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942248208 PECOS PAC ID: 8729073291 Enrollment ID: I20040415000934 |
| Provider Name | Robert N Stewart |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1932165073 PECOS PAC ID: 6901892090 Enrollment ID: I20040423000301 |
| Provider Name | Rebecca Cagle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689776999 PECOS PAC ID: 1456348895 Enrollment ID: I20040428000675 |
| Provider Name | Dana S Mann |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1649389453 PECOS PAC ID: 1658360276 Enrollment ID: I20040510000503 |
| Provider Name | Sandra A Marlin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679590434 PECOS PAC ID: 5092705525 Enrollment ID: I20040515000488 |
| Provider Name | Kimberly L Remmers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821014804 PECOS PAC ID: 4082604525 Enrollment ID: I20040515000503 |
| Provider Name | Charles E Dalton |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1720004914 PECOS PAC ID: 7214928050 Enrollment ID: I20040520001102 |
| Provider Name | William R Edmonson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1528031077 PECOS PAC ID: 6002897246 Enrollment ID: I20040525001096 |
| Provider Name | John W Allen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801868666 PECOS PAC ID: 8224010186 Enrollment ID: I20040603001151 |
| Provider Name | Jaime R Ungo |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1275599656 PECOS PAC ID: 7214914092 Enrollment ID: I20040630000308 |
| Provider Name | David H Witty |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1114984374 PECOS PAC ID: 3072590884 Enrollment ID: I20040630000482 |
| Provider Name | Sidney K Pace |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003855784 PECOS PAC ID: 4284611799 Enrollment ID: I20040702000082 |
| Provider Name | Robert K Rogers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1720005200 PECOS PAC ID: 2264419456 Enrollment ID: I20040706000965 |
| Provider Name | Lewis T Rogers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750309191 PECOS PAC ID: 7719965664 Enrollment ID: I20040708000861 |
| Provider Name | Cheryl A Sanders |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427148428 PECOS PAC ID: 2567440431 Enrollment ID: I20040708001029 |
| Provider Name | Melanie Marweg |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215953401 PECOS PAC ID: 0840278149 Enrollment ID: I20040713000273 |
| Provider Name | William Mc Comb |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043235047 PECOS PAC ID: 7911977095 Enrollment ID: I20040727001088 |
| Provider Name | Gregory Hurd |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1225054422 PECOS PAC ID: 2769455484 Enrollment ID: I20040819000416 |
| Provider Name | Paschal Wilson |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1619975521 PECOS PAC ID: 2466427554 Enrollment ID: I20040901000314 |
| Provider Name | John Payne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760451991 PECOS PAC ID: 1052388782 Enrollment ID: I20040913001074 |
| Provider Name | Shannon C Fryery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407895725 PECOS PAC ID: 3476522004 Enrollment ID: I20040929001138 |
| Provider Name | Brian E Condit |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1174570881 PECOS PAC ID: 2163402975 Enrollment ID: I20041013001242 |
| Provider Name | Brady David Russell |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942266341 PECOS PAC ID: 5698735215 Enrollment ID: I20041018000451 |
| Provider Name | Donna B Pritchard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063612422 PECOS PAC ID: 2163487083 Enrollment ID: I20041119000702 |
| Provider Name | Rachel C Hardy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285614115 PECOS PAC ID: 3678539491 Enrollment ID: I20041203000366 |
| Provider Name | William Ray Reed |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1235171091 PECOS PAC ID: 5698736957 Enrollment ID: I20041207000836 |
| Provider Name | Eniola O Otuseso |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962451757 PECOS PAC ID: 6608836952 Enrollment ID: I20041216000662 |
| Provider Name | Keven L Barber |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982632014 PECOS PAC ID: 8426016866 Enrollment ID: I20041230000663 |
| Provider Name | Debbie E Kelley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962518373 PECOS PAC ID: 0244298578 Enrollment ID: I20050103000583 |
| Provider Name | Donald Carter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043245244 PECOS PAC ID: 0941268270 Enrollment ID: I20050103000608 |
| Provider Name | Bradley W Jones |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013939370 PECOS PAC ID: 6608824990 Enrollment ID: I20050104000060 |
| Provider Name | Mary C White |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689696262 PECOS PAC ID: 7810945011 Enrollment ID: I20050104000971 |
| Provider Name | Michael R Benge |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467479964 PECOS PAC ID: 7012965221 Enrollment ID: I20050104001046 |
| Provider Name | Maria V Valdez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679678312 PECOS PAC ID: 0941251789 Enrollment ID: I20050209000285 |
| Provider Name | Summer P Swinney |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336165521 PECOS PAC ID: 1850338906 Enrollment ID: I20050411001101 |
| Provider Name | Sandra A Waters |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902813009 PECOS PAC ID: 3971541939 Enrollment ID: I20050420000593 |
| Provider Name | Jennifer A Little |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043238488 PECOS PAC ID: 4486695434 Enrollment ID: I20050519000601 |
| Provider Name | David A Reed |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1093826349 PECOS PAC ID: 0648216929 Enrollment ID: I20050708000285 |
| Provider Name | Elbert A White |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1811954324 PECOS PAC ID: 0648206359 Enrollment ID: I20050714000159 |
| Provider Name | Saleem A Ali |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801989124 PECOS PAC ID: 2860422003 Enrollment ID: I20050817000203 |
| Provider Name | Malinda Mallory Prewitt |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1710941315 PECOS PAC ID: 5294765392 Enrollment ID: I20050818000333 |
| Provider Name | Penneye M Holder |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063492023 PECOS PAC ID: 5799718862 Enrollment ID: I20050919000353 |
| Provider Name | Raymond R Arriola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265404214 PECOS PAC ID: 2466487475 Enrollment ID: I20050928001059 |
| Provider Name | Benton Mcmillon Wheeler |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1760415608 PECOS PAC ID: 4385669928 Enrollment ID: I20051012000637 |
| Provider Name | Stace Beard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1225063423 PECOS PAC ID: 0244257236 Enrollment ID: I20051028000617 |
| Provider Name | Brent E Boyett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235211129 PECOS PAC ID: 2668460759 Enrollment ID: I20051121000774 |
| Provider Name | Jeffrey Avery |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598717076 PECOS PAC ID: 3375550908 Enrollment ID: I20060307000547 |
| Provider Name | Holli A Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225008576 PECOS PAC ID: 3476563933 Enrollment ID: I20060427000499 |
| Provider Name | Molly Hester-conway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851331805 PECOS PAC ID: 6800808320 Enrollment ID: I20060628000193 |
| Provider Name | Andrew H Kellum |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1427055185 PECOS PAC ID: 1951305549 Enrollment ID: I20060913000406 |
| Provider Name | Julian B Hill |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1598762247 PECOS PAC ID: 2466456058 Enrollment ID: I20060913000443 |
| Provider Name | Harold H Batson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609835420 PECOS PAC ID: 5991700759 Enrollment ID: I20060929000048 |
| Provider Name | Peter M Mccormick |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770505356 PECOS PAC ID: 1456357847 Enrollment ID: I20061006000416 |
| Provider Name | Bernadine C Dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902914716 PECOS PAC ID: 6103823141 Enrollment ID: I20061103000389 |
| Provider Name | Dennis E Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245279918 PECOS PAC ID: 6406854959 Enrollment ID: I20061117000315 |
| Provider Name | James C Brand |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194808279 PECOS PAC ID: 1850393810 Enrollment ID: I20070205000645 |
| Provider Name | David J Chisholm |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1942383492 PECOS PAC ID: 1153323837 Enrollment ID: I20070208000588 |
| Provider Name | Jennifer B Stanton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952477168 PECOS PAC ID: 5395844799 Enrollment ID: I20070626000576 |
| Provider Name | Jacqueline A Fraiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629199633 PECOS PAC ID: 3577656669 Enrollment ID: I20070905000713 |
| Provider Name | Gayla R Estes |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982813077 PECOS PAC ID: 2961599592 Enrollment ID: I20071030000212 |
| Provider Name | Vanessa Winter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932397908 PECOS PAC ID: 6901996750 Enrollment ID: I20071217000355 |
| Provider Name | Greg R Parham |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1144419987 PECOS PAC ID: 9638252018 Enrollment ID: I20080207000546 |
| Provider Name | Amanda H Bagwell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710176532 PECOS PAC ID: 7719060003 Enrollment ID: I20080211000011 |
| Provider Name | Courtney D Stringer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497944235 PECOS PAC ID: 9931282233 Enrollment ID: I20080211000041 |
| Provider Name | Raymond P Boykin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1649450602 PECOS PAC ID: 3870677875 Enrollment ID: I20080229000205 |
| Provider Name | David A Vance |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528236890 PECOS PAC ID: 4981774783 Enrollment ID: I20080605000598 |
| Provider Name | Julia E Lucius |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1033377767 PECOS PAC ID: 3274607544 Enrollment ID: I20080805000081 |
| Provider Name | Shelley Gaggini |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1437317583 PECOS PAC ID: 2466527353 Enrollment ID: I20080812000209 |
| Provider Name | Jeanne R Benson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982648382 PECOS PAC ID: 7012083256 Enrollment ID: I20080911000463 |
| Provider Name | Marissa O Cruz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316108756 PECOS PAC ID: 7315014362 Enrollment ID: I20080917000583 |
| Provider Name | Stacey S George |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477799708 PECOS PAC ID: 1759443922 Enrollment ID: I20081222000618 |
| Provider Name | Sara P Tate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518111723 PECOS PAC ID: 2365504545 Enrollment ID: I20081222000662 |
| Provider Name | Xiaohong Si |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801089347 PECOS PAC ID: 8921158833 Enrollment ID: I20090616000365 |
| Provider Name | Becky A Adams |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245489947 PECOS PAC ID: 5890847677 Enrollment ID: I20090709000459 |
| Provider Name | Paul M Perry |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1689614513 PECOS PAC ID: 7113952953 Enrollment ID: I20090826000809 |
| Provider Name | Nicholas R Barron |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1205161080 PECOS PAC ID: 5294878518 Enrollment ID: I20100208000659 |
| Provider Name | Summer A Palmer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1942459631 PECOS PAC ID: 4688717994 Enrollment ID: I20100209000627 |
| Provider Name | David S Talton |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1629078746 PECOS PAC ID: 1951336569 Enrollment ID: I20100215000628 |
| Provider Name | Terry W Pinson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629049846 PECOS PAC ID: 0648314609 Enrollment ID: I20100215000751 |
| Provider Name | Charles Gregory Pigott |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487625703 PECOS PAC ID: 0941343123 Enrollment ID: I20100216000881 |
| Provider Name | John M Matthews |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891754057 PECOS PAC ID: 5193869048 Enrollment ID: I20100216000909 |
| Provider Name | Robert J Derveloy |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1689674707 PECOS PAC ID: 9830233626 Enrollment ID: I20100217000310 |
| Provider Name | Vishal Sachdev |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1538169503 PECOS PAC ID: 6002988995 Enrollment ID: I20100218000563 |
| Provider Name | Danny L Sanders |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760453997 PECOS PAC ID: 9234274259 Enrollment ID: I20100302000718 |
| Provider Name | Wanderful E Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407833221 PECOS PAC ID: 3476698374 Enrollment ID: I20100303000517 |
| Provider Name | Marianne Barnes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962440230 PECOS PAC ID: 5193850782 Enrollment ID: I20100324000926 |
| Provider Name | Michelle M Turba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912963471 PECOS PAC ID: 9234266883 Enrollment ID: I20100429001226 |
| Provider Name | Derreck F Menefee |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275502403 PECOS PAC ID: 3971631383 Enrollment ID: I20100505000802 |
| Provider Name | Charles M King |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1538137989 PECOS PAC ID: 3678601093 Enrollment ID: I20100505000856 |
| Provider Name | Max R Taylor |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1225094261 PECOS PAC ID: 1557459955 Enrollment ID: I20100511001021 |
| Provider Name | Vanessa R Williams |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1174850721 PECOS PAC ID: 5496883480 Enrollment ID: I20100512000752 |
| Provider Name | Eric Lewis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1043229990 PECOS PAC ID: 5799752234 Enrollment ID: I20100512001026 |
| Provider Name | Carl G Bevering |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1215909171 PECOS PAC ID: 8022146950 Enrollment ID: I20100513000264 |
| Provider Name | Louis Rosa |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1275597288 PECOS PAC ID: 3072641927 Enrollment ID: I20100513000447 |
| Provider Name | Richard Hendrick |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770559841 PECOS PAC ID: 0042348724 Enrollment ID: I20100518000132 |
| Provider Name | Karen A Hughes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780622035 PECOS PAC ID: 9032249206 Enrollment ID: I20100615000199 |
| Provider Name | Terry R Perrine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033157391 PECOS PAC ID: 9234269424 Enrollment ID: I20100615000408 |
| Provider Name | Lisa H Hodge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366774622 PECOS PAC ID: 7113050931 Enrollment ID: I20100730000599 |
| Provider Name | William Scot Bell |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104808856 PECOS PAC ID: 8628102803 Enrollment ID: I20100811000112 |
| Provider Name | Samuel Newell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962495192 PECOS PAC ID: 6608934674 Enrollment ID: I20100903000298 |
| Provider Name | Mark H Fletcher |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225021371 PECOS PAC ID: 5890810170 Enrollment ID: I20100909000657 |
| Provider Name | Angela F Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699774810 PECOS PAC ID: 5395861637 Enrollment ID: I20100924000017 |
| Provider Name | Heather A Hancock |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1821120072 PECOS PAC ID: 7911078316 Enrollment ID: I20101004001147 |
| Provider Name | James M Orender |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1538263058 PECOS PAC ID: 0648212282 Enrollment ID: I20101013000836 |
| Provider Name | Charlotte R Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174843742 PECOS PAC ID: 0840484275 Enrollment ID: I20101029001136 |
| Provider Name | Benton E Kilman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144457284 PECOS PAC ID: 7214124882 Enrollment ID: I20101208000610 |
| Provider Name | Mary A Britton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104137942 PECOS PAC ID: 5294922894 Enrollment ID: I20101208000930 |
| Provider Name | Cheryl Gladney |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366401465 PECOS PAC ID: 8729277249 Enrollment ID: I20110113000747 |
| Provider Name | Lauren E Abel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003125873 PECOS PAC ID: 2860671104 Enrollment ID: I20110202000054 |
| Provider Name | Patrick W Abel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497064265 PECOS PAC ID: 7012106305 Enrollment ID: I20110202000106 |
| Provider Name | Kevin C Harbour |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1508903626 PECOS PAC ID: 0648450833 Enrollment ID: I20110204000406 |
| Provider Name | Lisa P Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124161849 PECOS PAC ID: 5294827077 Enrollment ID: I20110323000506 |
| Provider Name | Harminder K Atwal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134427719 PECOS PAC ID: 9537343579 Enrollment ID: I20110415000127 |
| Provider Name | Justin C Graff |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427041664 PECOS PAC ID: 4082898986 Enrollment ID: I20110418000118 |
| Provider Name | Carrie Loftiss |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598954125 PECOS PAC ID: 6608058540 Enrollment ID: I20110418000636 |
| Provider Name | Sherry Lynn Finn Gaskin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811289564 PECOS PAC ID: 0840477261 Enrollment ID: I20110610000340 |
| Provider Name | Leslie R Villarrubia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861605560 PECOS PAC ID: 2769665322 Enrollment ID: I20110707000203 |
| Provider Name | Katie M Gann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508154501 PECOS PAC ID: 0547439762 Enrollment ID: I20110804000382 |
| Provider Name | Keli Np Ballard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174818389 PECOS PAC ID: 6305015439 Enrollment ID: I20110808000147 |
| Provider Name | Mary Cook |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821319146 PECOS PAC ID: 3678698834 Enrollment ID: I20110822000324 |
| Provider Name | Robert Coleman Mceachern |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1164413407 PECOS PAC ID: 0840370268 Enrollment ID: I20110913000051 |
| Provider Name | Tandalaya Meoshye Traylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578851325 PECOS PAC ID: 5799956082 Enrollment ID: I20110916000358 |
| Provider Name | Hannah Driggers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013985225 PECOS PAC ID: 5698679421 Enrollment ID: I20110921000593 |
| Provider Name | Tammy L Pelegrin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073893624 PECOS PAC ID: 3072786441 Enrollment ID: I20111031000270 |
| Provider Name | Lauren H Cook |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1023391927 PECOS PAC ID: 6901079276 Enrollment ID: I20111101000733 |
| Provider Name | Santrise Goree |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770760357 PECOS PAC ID: 1456524305 Enrollment ID: I20111109000540 |
| Provider Name | Regena B Rowan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1811270093 PECOS PAC ID: 2860665718 Enrollment ID: I20111109000587 |
| Provider Name | Monda K Lamb |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164706578 PECOS PAC ID: 9931373677 Enrollment ID: I20111115000770 |
| Provider Name | Babadele Oyedepo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1225267305 PECOS PAC ID: 6406021468 Enrollment ID: I20111202000669 |
| Provider Name | Noel V Garcia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053322842 PECOS PAC ID: 3476533480 Enrollment ID: I20120202000889 |
| Provider Name | Richard Comer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053618710 PECOS PAC ID: 0042478166 Enrollment ID: I20120221000665 |
| Provider Name | Khaled Rikabi |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1851375489 PECOS PAC ID: 4284895905 Enrollment ID: I20120405000291 |
| Provider Name | Marcus E Ueltschey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447278528 PECOS PAC ID: 2365605276 Enrollment ID: I20120511000301 |
| Provider Name | Celeste M Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386919199 PECOS PAC ID: 1658534417 Enrollment ID: I20120515000651 |
| Provider Name | Melinda L Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285910653 PECOS PAC ID: 0941463442 Enrollment ID: I20120521000270 |
| Provider Name | Paul W Bradley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154577088 PECOS PAC ID: 3779749098 Enrollment ID: I20120731000526 |
| Provider Name | Charles Meeks |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699900159 PECOS PAC ID: 4082864079 Enrollment ID: I20121029000607 |
| Provider Name | Sarah C Ashmore |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003165960 PECOS PAC ID: 5395996805 Enrollment ID: I20121109000411 |
| Provider Name | Morgan L Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952609802 PECOS PAC ID: 5092969832 Enrollment ID: I20130204000269 |
| Provider Name | Cynthia H Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679820799 PECOS PAC ID: 9931353372 Enrollment ID: I20130212000117 |
| Provider Name | Vivian A Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649549858 PECOS PAC ID: 1355587494 Enrollment ID: I20130417000026 |
| Provider Name | Stephen K Beeman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982999314 PECOS PAC ID: 8921244831 Enrollment ID: I20130419000497 |
| Provider Name | Edith W Faulkner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134460736 PECOS PAC ID: 8921159120 Enrollment ID: I20130701000096 |
| Provider Name | Jiahuai Tan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1578891503 PECOS PAC ID: 4082855598 Enrollment ID: I20130725000854 |
| Provider Name | Corey Brown |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1487944617 PECOS PAC ID: 8224281019 Enrollment ID: I20130731000215 |
| Provider Name | Ashley S Henson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144669649 PECOS PAC ID: 0042454134 Enrollment ID: I20130911000122 |
| Provider Name | Jessica S Lilley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093912479 PECOS PAC ID: 8325282379 Enrollment ID: I20130913000294 |
| Provider Name | Bradley A Boldizar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215258702 PECOS PAC ID: 4082849344 Enrollment ID: I20131023000976 |
| Provider Name | William S Darsey |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1689961914 PECOS PAC ID: 2264667203 Enrollment ID: I20131030000373 |
| Provider Name | Robbie L Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881946465 PECOS PAC ID: 4082849534 Enrollment ID: I20131108001368 |
| Provider Name | Vernon A Rayford |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053548545 PECOS PAC ID: 8527226687 Enrollment ID: I20131227000138 |
| Provider Name | Ashley Carpenter Gilliland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104253699 PECOS PAC ID: 2466680053 Enrollment ID: I20140103001084 |
| Provider Name | Justin M Brewer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366628059 PECOS PAC ID: 9537399498 Enrollment ID: I20140221000075 |
| Provider Name | Lindsay E Everett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700210424 PECOS PAC ID: 0345470902 Enrollment ID: I20140226000991 |
| Provider Name | Lori L Barkley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588095251 PECOS PAC ID: 7719118108 Enrollment ID: I20140328000202 |
| Provider Name | Cheri M Harbour |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619133485 PECOS PAC ID: 2062645641 Enrollment ID: I20140506001409 |
| Provider Name | Feras Jeradeh-boursoulian |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881910677 PECOS PAC ID: 8224254248 Enrollment ID: I20140729000998 |
| Provider Name | Imad Tahboub |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669468336 PECOS PAC ID: 9436142866 Enrollment ID: I20140923000274 |
| Provider Name | Lan Zhou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881953693 PECOS PAC ID: 8426278441 Enrollment ID: I20140925000947 |
| Provider Name | Lakesha J Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437561982 PECOS PAC ID: 5092935304 Enrollment ID: I20141009001077 |
| Provider Name | Angela Blake Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538589601 PECOS PAC ID: 4183844202 Enrollment ID: I20141013000297 |
| Provider Name | Joseph Stinson |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1962641704 PECOS PAC ID: 6800118928 Enrollment ID: I20141201000589 |
| Provider Name | William L Cauthen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417186347 PECOS PAC ID: 3274855739 Enrollment ID: I20141211001579 |
| Provider Name | Robert Wilder Bradsher |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891094272 PECOS PAC ID: 4183873409 Enrollment ID: I20141230001268 |
| Provider Name | Amanda Blackmon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1083995518 PECOS PAC ID: 8921279142 Enrollment ID: I20150210000478 |
| Provider Name | Marlana Huffstatler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477955177 PECOS PAC ID: 7113242116 Enrollment ID: I20150216000960 |
| Provider Name | Scott Gibson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639569320 PECOS PAC ID: 3476879057 Enrollment ID: I20150225001059 |
| Provider Name | David V Pizzimenti |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265517056 PECOS PAC ID: 3173552189 Enrollment ID: I20150504000344 |
| Provider Name | Jonathan D Richmond |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1184819583 PECOS PAC ID: 2062538770 Enrollment ID: I20150612001419 |
| Provider Name | Leonidas Arapos |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932340379 PECOS PAC ID: 7618001561 Enrollment ID: I20150616000856 |
| Provider Name | Viswanath Gajula |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710113998 PECOS PAC ID: 7416262662 Enrollment ID: I20150817001836 |
| Provider Name | Devin C Fancher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588046155 PECOS PAC ID: 1052627445 Enrollment ID: I20150831002137 |
| Provider Name | Frank A Osei |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437309028 PECOS PAC ID: 9032426622 Enrollment ID: I20150915000860 |
| Provider Name | Raghavendran G Gajagowni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588942460 PECOS PAC ID: 9436468014 Enrollment ID: I20151021002839 |
| Provider Name | Amanda G Balof |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1144698994 PECOS PAC ID: 7618287590 Enrollment ID: I20151104002412 |
| Provider Name | Terry Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740659960 PECOS PAC ID: 4183934524 Enrollment ID: I20151113002004 |
| Provider Name | Terry J Burgess |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609244342 PECOS PAC ID: 1052621307 Enrollment ID: I20151117001420 |
| Provider Name | Khushboo K Agrawal |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1184853913 PECOS PAC ID: 2264666163 Enrollment ID: I20151124001283 |
| Provider Name | Lisa D Foley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801009592 PECOS PAC ID: 2466671110 Enrollment ID: I20151215001554 |
| Provider Name | Christopher L Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215304696 PECOS PAC ID: 7416258546 Enrollment ID: I20151215001707 |
| Provider Name | Christina G Shelton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083004022 PECOS PAC ID: 6002117736 Enrollment ID: I20151222000862 |
| Provider Name | Kayla E Hood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447622196 PECOS PAC ID: 0446552665 Enrollment ID: I20160105002526 |
| Provider Name | Sara A Silver |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780824714 PECOS PAC ID: 3072752567 Enrollment ID: I20160120002786 |
| Provider Name | Kevin M Silver |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1982934311 PECOS PAC ID: 2668617408 Enrollment ID: I20160201000965 |
| Provider Name | April Mccain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043685498 PECOS PAC ID: 8426353939 Enrollment ID: I20160222001367 |
| Provider Name | Stephanie Stegall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518341072 PECOS PAC ID: 7416252374 Enrollment ID: I20160302000068 |
| Provider Name | Kellie J Thornton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851757413 PECOS PAC ID: 9537466487 Enrollment ID: I20160321002303 |
| Provider Name | Chelsea Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285095687 PECOS PAC ID: 4789981291 Enrollment ID: I20160329001164 |
| Provider Name | Anna Heaton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427425958 PECOS PAC ID: 8224335658 Enrollment ID: I20160329002385 |
| Provider Name | Louise Cristo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649635921 PECOS PAC ID: 3274832332 Enrollment ID: I20160425001833 |
| Provider Name | Renee Walters |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942645486 PECOS PAC ID: 1557650322 Enrollment ID: I20160518000066 |
| Provider Name | Philip F Huq |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558785022 PECOS PAC ID: 1658675921 Enrollment ID: I20160518000882 |
| Provider Name | Lindsey Hinton |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1841580065 PECOS PAC ID: 8729229364 Enrollment ID: I20160617001158 |
| Provider Name | James M Lewis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558609545 PECOS PAC ID: 8921253204 Enrollment ID: I20160621001011 |
| Provider Name | Rhonda Von Strahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992177463 PECOS PAC ID: 1254622350 Enrollment ID: I20160621001321 |
| Provider Name | Samantha L Houston |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1568729457 PECOS PAC ID: 9537451976 Enrollment ID: I20160706000763 |
| Provider Name | Thomas E Craig |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720163066 PECOS PAC ID: 9537265038 Enrollment ID: I20160712002266 |
| Provider Name | Candyce Little |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609228642 PECOS PAC ID: 6002109907 Enrollment ID: I20160801000061 |
| Provider Name | Mary Horn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093165805 PECOS PAC ID: 1850684630 Enrollment ID: I20160802000046 |
| Provider Name | Benjamin Hinton |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1417248501 PECOS PAC ID: 0446400899 Enrollment ID: I20160804000053 |
| Provider Name | Jason Dean Stacy |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1154559961 PECOS PAC ID: 7315262623 Enrollment ID: I20160804001225 |
| Provider Name | Yahya M Kurdi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346582178 PECOS PAC ID: 1052540341 Enrollment ID: I20160816000245 |
| Provider Name | Renata Palasiewicz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962745737 PECOS PAC ID: 7911217260 Enrollment ID: I20160818001433 |
| Provider Name | Kayle M Patterson Dampeer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1295132025 PECOS PAC ID: 4880911742 Enrollment ID: I20160914002266 |
| Provider Name | Christina Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679930929 PECOS PAC ID: 2365721727 Enrollment ID: I20161108001616 |
| Provider Name | Robin Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669922670 PECOS PAC ID: 6305125626 Enrollment ID: I20161109001409 |
| Provider Name | Mary R Yates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629449798 PECOS PAC ID: 7012296288 Enrollment ID: I20161110000716 |
| Provider Name | Starla Horton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518412691 PECOS PAC ID: 8729368261 Enrollment ID: I20161129002090 |
| Provider Name | Mohammed Zaman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215126032 PECOS PAC ID: 4284882895 Enrollment ID: I20170105001208 |
| Provider Name | Warner Huh |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1043257173 PECOS PAC ID: 9830152131 Enrollment ID: I20170130001221 |
| Provider Name | Charles A Leath |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1255313193 PECOS PAC ID: 7618908971 Enrollment ID: I20170131000430 |
| Provider Name | John Straughn |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1043262777 PECOS PAC ID: 5597660027 Enrollment ID: I20170216000455 |
| Provider Name | Kirk A Caddell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952690224 PECOS PAC ID: 4385862416 Enrollment ID: I20170222002410 |
| Provider Name | Sheri L Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891233300 PECOS PAC ID: 9335423730 Enrollment ID: I20170303000033 |
| Provider Name | Jessica Wallace Shelton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316391055 PECOS PAC ID: 9739463761 Enrollment ID: I20170310001239 |
| Provider Name | Dorothy Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457896417 PECOS PAC ID: 4981989498 Enrollment ID: I20170324001318 |
| Provider Name | Chut Sombutmai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649320987 PECOS PAC ID: 4284807413 Enrollment ID: I20170327002585 |
| Provider Name | John R Speights |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255743464 PECOS PAC ID: 4688992092 Enrollment ID: I20170404001827 |
| Provider Name | Angel Isabelle Justice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487104675 PECOS PAC ID: 0042596892 Enrollment ID: I20170411001389 |
| Provider Name | Lori Forrester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205249471 PECOS PAC ID: 9739307893 Enrollment ID: I20170515000263 |
| Provider Name | Toni Burnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396286209 PECOS PAC ID: 7911274626 Enrollment ID: I20170601000485 |
| Provider Name | Montianna Bingham |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346445665 PECOS PAC ID: 7315116514 Enrollment ID: I20170614002181 |
| Provider Name | Demetrio Prota Martinez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508206558 PECOS PAC ID: 6901177146 Enrollment ID: I20170805000217 |
| Provider Name | Lisa-gaye Camille Thomas |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427336528 PECOS PAC ID: 4587935556 Enrollment ID: I20170809002426 |
| Provider Name | Vakeshea Shannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700308806 PECOS PAC ID: 6709159577 Enrollment ID: I20170830002846 |
| Provider Name | April D Carter |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1083024558 PECOS PAC ID: 3274759634 Enrollment ID: I20170927001573 |
| Provider Name | Jenna Mordecai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336699578 PECOS PAC ID: 3971878364 Enrollment ID: I20171011002111 |
| Provider Name | Casey Hargett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487187068 PECOS PAC ID: 1355617895 Enrollment ID: I20171027000341 |
| Provider Name | Cody G Stroupe |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780095901 PECOS PAC ID: 1456647502 Enrollment ID: I20171205001914 |
| Provider Name | Angela Christine Middleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124382593 PECOS PAC ID: 3971756875 Enrollment ID: I20171213001009 |
| Provider Name | Daniel L Hollowell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710499751 PECOS PAC ID: 3577821834 Enrollment ID: I20171215000249 |
| Provider Name | Jessica Crittenden Glidewell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639689656 PECOS PAC ID: 9032478979 Enrollment ID: I20180122002286 |
| Provider Name | Timothy J Murphy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851752307 PECOS PAC ID: 4385903038 Enrollment ID: I20180125002222 |
| Provider Name | Maegan Gilliland Flynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548770563 PECOS PAC ID: 9739449208 Enrollment ID: I20180131002164 |
| Provider Name | Teresa Ann Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043720071 PECOS PAC ID: 4284994799 Enrollment ID: I20180201000427 |
| Provider Name | Shelley Marie Hamblin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053821793 PECOS PAC ID: 0840550091 Enrollment ID: I20180207002097 |
| Provider Name | Kelli Mcgee Plunk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265942288 PECOS PAC ID: 8921368960 Enrollment ID: I20180212002095 |
| Provider Name | Holly Poland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346754793 PECOS PAC ID: 0446511455 Enrollment ID: I20180307000824 |
| Provider Name | Patricia Kloser |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1801988787 PECOS PAC ID: 9537328760 Enrollment ID: I20180404002250 |
| Provider Name | Vemana Jampala |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1538509385 PECOS PAC ID: 4587950274 Enrollment ID: I20180419002059 |
| Provider Name | Jessica Floyd |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386888113 PECOS PAC ID: 3779729868 Enrollment ID: I20180517002912 |
| Provider Name | Tina King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013330109 PECOS PAC ID: 6204191141 Enrollment ID: I20180524002540 |
| Provider Name | Amy S Price |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790881274 PECOS PAC ID: 4183989031 Enrollment ID: I20180525000292 |
| Provider Name | Yelena G Vidgop |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336300771 PECOS PAC ID: 0941444095 Enrollment ID: I20180607000583 |
| Provider Name | Theresa B. Sevilis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407111461 PECOS PAC ID: 6608191911 Enrollment ID: I20180612003103 |
| Provider Name | Patricia Colon-garcia |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427157270 PECOS PAC ID: 0446356216 Enrollment ID: I20180625001869 |
| Provider Name | Jayce Miskel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265819825 PECOS PAC ID: 6901115146 Enrollment ID: I20180703000949 |
| Provider Name | Lori D Mize |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285129197 PECOS PAC ID: 5698022143 Enrollment ID: I20180716002150 |
| Provider Name | Katherine Colleen Riordan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689832107 PECOS PAC ID: 8224174354 Enrollment ID: I20180723001346 |
| Provider Name | David K. Hahn |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053625459 PECOS PAC ID: 7911217724 Enrollment ID: I20180724003521 |
| Provider Name | Megan Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922599752 PECOS PAC ID: 5597012377 Enrollment ID: I20180725001177 |
| Provider Name | Federico Mariano Canavosio |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679721393 PECOS PAC ID: 4587801576 Enrollment ID: I20180814000875 |
| Provider Name | Janice R Driskell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649756271 PECOS PAC ID: 1153670633 Enrollment ID: I20180816000383 |
| Provider Name | Jessica Marie Hychko |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629323613 PECOS PAC ID: 0547510307 Enrollment ID: I20180829002213 |
| Provider Name | Julie P Wilson |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1790759215 PECOS PAC ID: 5294760682 Enrollment ID: I20180905001436 |
| Provider Name | Harsha Ghatge Nagaraja |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568606259 PECOS PAC ID: 5496983009 Enrollment ID: I20180921002576 |
| Provider Name | Adham Samy Kamel Elsayed Elokda |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225264526 PECOS PAC ID: 9739357609 Enrollment ID: I20180925001563 |
| Provider Name | Sabrina S Vance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306324637 PECOS PAC ID: 9032461249 Enrollment ID: I20181016001179 |
| Provider Name | Amber Bailey Googe |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255725818 PECOS PAC ID: 9739496571 Enrollment ID: I20181020000280 |
| Provider Name | Cody Do Davis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629463674 PECOS PAC ID: 8123397551 Enrollment ID: I20181023002834 |
| Provider Name | Vivian Marie Suarez Gonzalez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801107388 PECOS PAC ID: 7618145830 Enrollment ID: I20181107000061 |
| Provider Name | Sarah Melissa Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871068338 PECOS PAC ID: 9537413711 Enrollment ID: I20181107002612 |
| Provider Name | Deidre Redd |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1306995865 PECOS PAC ID: 1658397658 Enrollment ID: I20181108000277 |
| Provider Name | Rebecca Diane Cody |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1265425763 PECOS PAC ID: 1759373962 Enrollment ID: I20181112002238 |
| Provider Name | Kellie Grove |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811472681 PECOS PAC ID: 2062766959 Enrollment ID: I20181113000098 |
| Provider Name | Stephanie Glover |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902381775 PECOS PAC ID: 8022362821 Enrollment ID: I20181114001502 |
| Provider Name | Jason R Sebesto |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861786246 PECOS PAC ID: 0749416238 Enrollment ID: I20181114002879 |
| Provider Name | Meghan Alford Luter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013357276 PECOS PAC ID: 0840516084 Enrollment ID: I20181114003268 |
| Provider Name | April Leann Gilreath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811464548 PECOS PAC ID: 3870847395 Enrollment ID: I20181119001911 |
| Provider Name | Marian Boykin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497223317 PECOS PAC ID: 1759625940 Enrollment ID: I20181128002585 |
| Provider Name | Lori Leigh Wiygul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205314770 PECOS PAC ID: 7012251218 Enrollment ID: I20181128003092 |
| Provider Name | Tiffany Ann Gillespie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972084895 PECOS PAC ID: 6901140029 Enrollment ID: I20181130000765 |
| Provider Name | Geetanjali Vajapey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740523935 PECOS PAC ID: 5799087441 Enrollment ID: I20181207000255 |
| Provider Name | Lori Blansett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851868533 PECOS PAC ID: 6204170780 Enrollment ID: I20181211000870 |
| Provider Name | Kayla Nicole Worthey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063994267 PECOS PAC ID: 4486991403 Enrollment ID: I20190130000206 |
| Provider Name | James B Manley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184197584 PECOS PAC ID: 0345588703 Enrollment ID: I20190208002061 |
| Provider Name | Ram Narayan Kaveer Nandigam |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881856078 PECOS PAC ID: 9335303569 Enrollment ID: I20190218002640 |
| Provider Name | Vahid Behravan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871722520 PECOS PAC ID: 6507189123 Enrollment ID: I20190507000473 |
| Provider Name | Phillipa Jean Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235531658 PECOS PAC ID: 3870836869 Enrollment ID: I20190514002615 |
| Provider Name | Hollie Waldron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316500887 PECOS PAC ID: 0840533725 Enrollment ID: I20190516000564 |
| Provider Name | Joaquin A Hidalgo |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1063777472 PECOS PAC ID: 5698090991 Enrollment ID: I20190621000579 |
| Provider Name | Elie Jose Checo Heinsen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467764381 PECOS PAC ID: 9739322884 Enrollment ID: I20190702000399 |
| Provider Name | Paige A Nabors |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396200408 PECOS PAC ID: 4587999149 Enrollment ID: I20190718001703 |
| Provider Name | Joshua Calcote |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811340201 PECOS PAC ID: 5698069623 Enrollment ID: I20190729003057 |
| Provider Name | Mahesh Bhatt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881018166 PECOS PAC ID: 8022230952 Enrollment ID: I20190730004022 |
| Provider Name | Justin C Malone |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710537592 PECOS PAC ID: 0648502823 Enrollment ID: I20191022001394 |
| Provider Name | Syed Ali Akhtar Tirmizi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619320439 PECOS PAC ID: 9830421890 Enrollment ID: I20191024002959 |
| Provider Name | Laura May Dowdy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831743780 PECOS PAC ID: 7416289111 Enrollment ID: I20191030001259 |
| Provider Name | Raymond Seay |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811264062 PECOS PAC ID: 3678890746 Enrollment ID: I20191104001994 |
| Provider Name | Haritha N Abbott |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1326699075 PECOS PAC ID: 6305278391 Enrollment ID: I20191113002097 |
| Provider Name | Eurieka Shumpert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083186563 PECOS PAC ID: 0244663243 Enrollment ID: I20191205001096 |
| Provider Name | Haller Jackson Smith |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1104183938 PECOS PAC ID: 2860642691 Enrollment ID: I20191212002306 |
| Provider Name | Charles O Olisa |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265582837 PECOS PAC ID: 9436215019 Enrollment ID: I20200116000643 |
| Provider Name | Darrion Prewitt |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841284445 PECOS PAC ID: 8729091822 Enrollment ID: I20200218001166 |
| Provider Name | Kathyrn Smith Hilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093287773 PECOS PAC ID: 7315374535 Enrollment ID: I20200228001547 |
| Provider Name | Amanda N Kovarik |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710362041 PECOS PAC ID: 8628388113 Enrollment ID: I20200303002266 |
| Provider Name | Justin Salerian |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316208705 PECOS PAC ID: 1658658695 Enrollment ID: I20200313001284 |
| Provider Name | Shubhangi Chumble |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881684074 PECOS PAC ID: 6305844242 Enrollment ID: I20200324002731 |
| Provider Name | Usman Ayub Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346658416 PECOS PAC ID: 5395174874 Enrollment ID: I20200403001976 |
| Provider Name | Uyi-oghosa Idemudia |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629065131 PECOS PAC ID: 3173555885 Enrollment ID: I20200406002981 |
| Provider Name | Caitlin Maree Defazio Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437622909 PECOS PAC ID: 5395175145 Enrollment ID: I20200420001847 |
| Provider Name | Demareo Webb |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1588003479 PECOS PAC ID: 6800181801 Enrollment ID: I20200611000759 |
| Provider Name | Jhoclay See |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558776401 PECOS PAC ID: 5496045676 Enrollment ID: I20200615000286 |
| Provider Name | Neha Patil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568874790 PECOS PAC ID: 0749578359 Enrollment ID: I20200619001758 |
| Provider Name | Drew Blackstock |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1841532819 PECOS PAC ID: 0547482739 Enrollment ID: I20200623001721 |
| Provider Name | Benjamin Duke Spencer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316588858 PECOS PAC ID: 8820410665 Enrollment ID: I20200624000211 |
| Provider Name | Jesse Lee Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326689860 PECOS PAC ID: 8527481605 Enrollment ID: I20200708000816 |
| Provider Name | Joao Mc-oneil Plancher |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700142668 PECOS PAC ID: 9638317837 Enrollment ID: I20200709000794 |
| Provider Name | Waqas Israr Gilani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386039683 PECOS PAC ID: 8325461114 Enrollment ID: I20200713001893 |
| Provider Name | Sam Kumar Saha |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629394390 PECOS PAC ID: 3870733181 Enrollment ID: I20200724002461 |
| Provider Name | Amy Robinson Doyle |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710034673 PECOS PAC ID: 3173597267 Enrollment ID: I20200729000855 |
| Provider Name | Neil J Patel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295155364 PECOS PAC ID: 5193076578 Enrollment ID: I20200813003433 |
| Provider Name | Neetu Dhadwal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962842492 PECOS PAC ID: 4183852270 Enrollment ID: I20200818002272 |
| Provider Name | Erin L Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205473253 PECOS PAC ID: 0042636987 Enrollment ID: I20200821002179 |
| Provider Name | Rajachendra Tumma |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043657455 PECOS PAC ID: 7810110079 Enrollment ID: I20200916000880 |
| Provider Name | Cynthia Lynne Dimauro |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1942231337 PECOS PAC ID: 1254424146 Enrollment ID: I20200924002776 |
| Provider Name | Joshua Todd Mendelson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265641070 PECOS PAC ID: 8921139023 Enrollment ID: I20200925002137 |
| Provider Name | Meilani Hasmin Mapa |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1063600872 PECOS PAC ID: 3678655149 Enrollment ID: I20200929001049 |
| Provider Name | Jennifer L Kennard |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1275912065 PECOS PAC ID: 1153637491 Enrollment ID: I20201005000119 |
| Provider Name | Sandro James Corti |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538503131 PECOS PAC ID: 4789953696 Enrollment ID: I20201006000069 |
| Provider Name | Andrew D Ballard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1538775317 PECOS PAC ID: 7315366531 Enrollment ID: I20201007001288 |
| Provider Name | Robert F Adams |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1205443348 PECOS PAC ID: 5991124125 Enrollment ID: I20201007001565 |
| Provider Name | Justin Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619574738 PECOS PAC ID: 4486073665 Enrollment ID: I20201008000341 |
| Provider Name | Murtaza Amir |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508971920 PECOS PAC ID: 4688602915 Enrollment ID: I20201012001369 |
| Provider Name | Benjamin H Johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1457958282 PECOS PAC ID: 7012337579 Enrollment ID: I20201021003251 |
| Provider Name | Maria Aguilar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518924190 PECOS PAC ID: 9133130156 Enrollment ID: I20201028000406 |
| Provider Name | Matthew T Hester |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972102275 PECOS PAC ID: 2163832262 Enrollment ID: I20201030001418 |
| Provider Name | Lauren A Hester |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265031561 PECOS PAC ID: 6204246366 Enrollment ID: I20201102001492 |
| Provider Name | Todd Gunnar Holmes |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1588720544 PECOS PAC ID: 4981627924 Enrollment ID: I20201106002534 |
| Provider Name | Mark Mitchell Mcdonald |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366837429 PECOS PAC ID: 6709156334 Enrollment ID: I20201130000579 |
| Provider Name | Sui Li |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992026371 PECOS PAC ID: 0345554929 Enrollment ID: I20201229000020 |
| Provider Name | Hsiong Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912165374 PECOS PAC ID: 1456548601 Enrollment ID: I20210112001275 |
| Provider Name | Hollie Moffatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962013664 PECOS PAC ID: 6608289459 Enrollment ID: I20210115001156 |
| Provider Name | Mariecken V Fowler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548200116 PECOS PAC ID: 4688602758 Enrollment ID: I20210203000647 |
| Provider Name | Aimee Marie Settlemires |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578159877 PECOS PAC ID: 7012321029 Enrollment ID: I20210203001834 |
| Provider Name | Morgan Patrylo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972946002 PECOS PAC ID: 4880948959 Enrollment ID: I20210203002060 |
| Provider Name | Christina Marie Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154913895 PECOS PAC ID: 6709292386 Enrollment ID: I20210305000319 |
| Provider Name | Amanda Hanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083257315 PECOS PAC ID: 8921414095 Enrollment ID: I20210316000420 |
| Provider Name | Carol Annette Quain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437407368 PECOS PAC ID: 0143637918 Enrollment ID: I20210322002699 |
| Provider Name | Eric Street |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891906657 PECOS PAC ID: 2365859584 Enrollment ID: I20210405001697 |
| Provider Name | Charles R Robertson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619073103 PECOS PAC ID: 8921415167 Enrollment ID: I20210406000021 |
| Provider Name | Marlana Lee Mcfarland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730796376 PECOS PAC ID: 3971910076 Enrollment ID: I20210407000381 |
| Provider Name | Van D Stone |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770689267 PECOS PAC ID: 7810304987 Enrollment ID: I20210408000446 |
| Provider Name | Jennifer L Grisham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952406589 PECOS PAC ID: 1153739032 Enrollment ID: I20210413002357 |
| Provider Name | Sandra Allison Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134671126 PECOS PAC ID: 5496163388 Enrollment ID: I20210413003039 |
| Provider Name | Kacie C. Hollimon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619531662 PECOS PAC ID: 9830507482 Enrollment ID: I20210420000869 |
| Provider Name | Carl Andrew Ballard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386243574 PECOS PAC ID: 3577971019 Enrollment ID: I20210421001587 |
| Provider Name | Lauren Parrish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073092326 PECOS PAC ID: 1153730114 Enrollment ID: I20210504002880 |
| Provider Name | Brian Sorace |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639565997 PECOS PAC ID: 9032426697 Enrollment ID: I20210505002801 |
| Provider Name | Katie Meyer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235596107 PECOS PAC ID: 9133413404 Enrollment ID: I20210512000097 |
| Provider Name | Tao Tong |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942401815 PECOS PAC ID: 2961558168 Enrollment ID: I20210517000306 |
| Provider Name | Lorianne Elizabeth Avino |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306898762 PECOS PAC ID: 6305859919 Enrollment ID: I20210521001751 |
| Provider Name | Amanda Paige Michael |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104459742 PECOS PAC ID: 4486053212 Enrollment ID: I20210528000206 |
| Provider Name | Birenkumar Rajandrakumar Patel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679900062 PECOS PAC ID: 0547533788 Enrollment ID: I20210630002411 |
| Provider Name | Nicole Sherice Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003443458 PECOS PAC ID: 3779985569 Enrollment ID: I20210715004314 |
| Provider Name | Keila Carolina Romero Barreto |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174987648 PECOS PAC ID: 8022346089 Enrollment ID: I20210719003196 |
| Provider Name | Zeenat Shameem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669960589 PECOS PAC ID: 0143577205 Enrollment ID: I20210722000939 |
| Provider Name | John Neill |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1114330180 PECOS PAC ID: 4789900143 Enrollment ID: I20210728001934 |
| Provider Name | Fermina Alia Pirmohamed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508138314 PECOS PAC ID: 9133369754 Enrollment ID: I20210813000372 |
| Provider Name | Benzion Chaim Yitzchok Blech |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538515465 PECOS PAC ID: 9638461056 Enrollment ID: I20210818004021 |
| Provider Name | Stanley Garken Lue |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003017427 PECOS PAC ID: 6204005648 Enrollment ID: I20210903000959 |
| Provider Name | Jodilyn Allred Ferguson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225701394 PECOS PAC ID: 0143626531 Enrollment ID: I20210910000290 |
| Provider Name | Robert Myers |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700248937 PECOS PAC ID: 7416356324 Enrollment ID: I20210910001679 |
| Provider Name | Georgy Cherkassky |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760827778 PECOS PAC ID: 7416197702 Enrollment ID: I20210914001602 |
| Provider Name | Tanya Sanderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457907248 PECOS PAC ID: 1951707140 Enrollment ID: I20210914001899 |
| Provider Name | Morgan Elizabeth Figurelle |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801241260 PECOS PAC ID: 8729373642 Enrollment ID: I20210915003816 |
| Provider Name | Abhi H Kapuria |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730542812 PECOS PAC ID: 8820493935 Enrollment ID: I20210915004071 |
| Provider Name | Caitlin Clark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750776290 PECOS PAC ID: 4284937095 Enrollment ID: I20210917000182 |
| Provider Name | Billy R Carstens |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1447342738 PECOS PAC ID: 0042250904 Enrollment ID: I20210920003526 |
| Provider Name | Nina Grace Bradley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750692422 PECOS PAC ID: 6709025505 Enrollment ID: I20210928001673 |
| Provider Name | Jenna R Kanter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063737302 PECOS PAC ID: 1850514456 Enrollment ID: I20210929003637 |
| Provider Name | Colby A. Richardson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558724799 PECOS PAC ID: 2567866973 Enrollment ID: I20211011002747 |
| Provider Name | Kristi Patricia Gill |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750514261 PECOS PAC ID: 6406080811 Enrollment ID: I20211104000964 |
| Provider Name | Claudine Brown |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871989343 PECOS PAC ID: 3577800432 Enrollment ID: I20211104001103 |
| Provider Name | Ricky Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063779213 PECOS PAC ID: 6901039734 Enrollment ID: I20211116003067 |
| Provider Name | Darshana Pritesh Amin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407901382 PECOS PAC ID: 4082750468 Enrollment ID: I20211117002647 |
| Provider Name | Philippe Gerard Douyon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306169487 PECOS PAC ID: 3072755396 Enrollment ID: I20211119001692 |
| Provider Name | Satinder Kaur Grewal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386085546 PECOS PAC ID: 7618229436 Enrollment ID: I20211119002026 |
| Provider Name | Andrew Novick |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316568728 PECOS PAC ID: 7315335361 Enrollment ID: I20211122000507 |
| Provider Name | Melanie Bush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376150920 PECOS PAC ID: 9739570383 Enrollment ID: I20211215002543 |
| Provider Name | Yu-hsuan Liao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063868677 PECOS PAC ID: 9133523350 Enrollment ID: I20211217002209 |
| Provider Name | James Anthony Welker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568423440 PECOS PAC ID: 2466423538 Enrollment ID: I20220111000854 |
| Provider Name | Linda Y. Jiang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427476456 PECOS PAC ID: 3678870276 Enrollment ID: I20220113001481 |
| Provider Name | Mylie Kate Beane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194497032 PECOS PAC ID: 3274925243 Enrollment ID: I20220125001335 |
| Provider Name | Akira Keyana Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972110963 PECOS PAC ID: 6002208915 Enrollment ID: I20220126000497 |
| Provider Name | Amanda Jeanette Hulsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447922364 PECOS PAC ID: 0749673580 Enrollment ID: I20220131001582 |
| Provider Name | Kalisa Deann Mickell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013504067 PECOS PAC ID: 7719370402 Enrollment ID: I20220201001225 |
| Provider Name | Rebecca Erin Mckinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124781240 PECOS PAC ID: 9830582956 Enrollment ID: I20220211001442 |
| Provider Name | Melinda K Osborn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508486804 PECOS PAC ID: 0143613117 Enrollment ID: I20220216000100 |
| Provider Name | Brent Lee Hallmark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093313397 PECOS PAC ID: 0446643308 Enrollment ID: I20220217000989 |
| Provider Name | Brandon Turnage |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124682323 PECOS PAC ID: 6507273729 Enrollment ID: I20220217002925 |
| Provider Name | Tanya Underwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366062572 PECOS PAC ID: 5799170767 Enrollment ID: I20220310000808 |
| Provider Name | Lucinda Dobbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639824543 PECOS PAC ID: 0648665547 Enrollment ID: I20220310002499 |
| Provider Name | Wendi Kulin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043411333 PECOS PAC ID: 5193857647 Enrollment ID: I20220315002879 |
| Provider Name | Rachel Stephens Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184371452 PECOS PAC ID: 2466847090 Enrollment ID: I20220318000072 |
| Provider Name | James Andry |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205192838 PECOS PAC ID: 6002119633 Enrollment ID: I20220330000005 |
| Provider Name | Steven Gangloff |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952756058 PECOS PAC ID: 4587951637 Enrollment ID: I20220404000868 |
| Provider Name | Ramachandram Avusula |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639519069 PECOS PAC ID: 8426365669 Enrollment ID: I20220405000588 |
| Provider Name | Meera Satish Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700534971 PECOS PAC ID: 1557758554 Enrollment ID: I20220421000780 |
| Provider Name | Anant Shenoy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194998005 PECOS PAC ID: 5991855140 Enrollment ID: I20220512000513 |
| Provider Name | Jimmy Windham |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1699208918 PECOS PAC ID: 4486931516 Enrollment ID: I20220607001695 |
| Provider Name | Evan F Garner |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1043654312 PECOS PAC ID: 7618117482 Enrollment ID: I20220714000824 |
| Provider Name | Saurabh Khurana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851656292 PECOS PAC ID: 3072807155 Enrollment ID: I20220716000059 |
| Provider Name | Ravi Yarlagadda |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679531636 PECOS PAC ID: 7911975560 Enrollment ID: I20220811001139 |
| Provider Name | Lakshmi Mukundan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619137015 PECOS PAC ID: 6800111303 Enrollment ID: I20220815002341 |
| Provider Name | Foluke Adeola Akinyemi |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1356515654 PECOS PAC ID: 6608268438 Enrollment ID: I20220819000227 |
| Provider Name | Jennifer Grace Lindsey |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1457913543 PECOS PAC ID: 7517341522 Enrollment ID: I20220824003609 |
| Provider Name | Monico Banez |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962479451 PECOS PAC ID: 6406996008 Enrollment ID: I20220829000628 |
| Provider Name | Felix G Rivera-perez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003078692 PECOS PAC ID: 4981755733 Enrollment ID: I20220910000085 |
| Provider Name | Nicholas Anthony Ressa |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366974867 PECOS PAC ID: 8921370404 Enrollment ID: I20220910000607 |
| Provider Name | Kimberly Faye Goss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720695190 PECOS PAC ID: 7618352634 Enrollment ID: I20220912002552 |
| Provider Name | Lakeysha Nichelle Weatherspoon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871157198 PECOS PAC ID: 7618352527 Enrollment ID: I20220913003056 |
| Provider Name | Donnie Lovell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710602776 PECOS PAC ID: 9931576048 Enrollment ID: I20221102002077 |
| Provider Name | Srijana Zarkou |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649482340 PECOS PAC ID: 3779617139 Enrollment ID: I20221110001396 |
| Provider Name | Joshua A Mascagni |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518683119 PECOS PAC ID: 8921475526 Enrollment ID: I20221111000766 |
| Provider Name | Jimmy Diep Nguyen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1285815605 PECOS PAC ID: 5799837621 Enrollment ID: I20221114001616 |
| Provider Name | Taylor B Michelletti |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528784915 PECOS PAC ID: 8527435007 Enrollment ID: I20221114001775 |
| Provider Name | Kristin Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922722883 PECOS PAC ID: 8921476359 Enrollment ID: I20221116001222 |
| Provider Name | Alice Claire Ellis Harrelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427772284 PECOS PAC ID: 5294103941 Enrollment ID: I20221130001367 |
| Provider Name | John Winestone |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1598933301 PECOS PAC ID: 0446420640 Enrollment ID: I20221206002711 |
| Provider Name | Angela Holloway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952901076 PECOS PAC ID: 3375912736 Enrollment ID: I20221207002657 |
| Provider Name | Jonathan Vinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164143087 PECOS PAC ID: 7315316312 Enrollment ID: I20221214001576 |
| Provider Name | Benjamin J Googe |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1124480215 PECOS PAC ID: 1759675705 Enrollment ID: I20230109003025 |
| Provider Name | Ryna Then |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427346303 PECOS PAC ID: 4587891080 Enrollment ID: I20230118000037 |
| Provider Name | Adam Mitchell Koss |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760801112 PECOS PAC ID: 2769604123 Enrollment ID: I20230131003145 |
| Provider Name | Mary Angela Eaton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255044269 PECOS PAC ID: 2365814886 Enrollment ID: I20230209003082 |
| Provider Name | Brandie Nicole Wise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134827488 PECOS PAC ID: 1557735545 Enrollment ID: I20230314001749 |
| Provider Name | Indre Gerlach |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740665066 PECOS PAC ID: 1052629557 Enrollment ID: I20230322001626 |
| Provider Name | Neil G Jhamb |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477787067 PECOS PAC ID: 4082852769 Enrollment ID: I20230417000427 |
| Provider Name | Indira De Jesus Alvelo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700074796 PECOS PAC ID: 2264651207 Enrollment ID: I20230422000118 |
| Provider Name | Patricia Kleinholz-owens |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629344882 PECOS PAC ID: 5496043440 Enrollment ID: I20230424000366 |
| Provider Name | Igor Alexandrovich Malenky |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740714054 PECOS PAC ID: 8820361330 Enrollment ID: I20230424002457 |
| Provider Name | Crystal Dawn Biffle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164122818 PECOS PAC ID: 9931566908 Enrollment ID: I20230606003443 |
| Provider Name | Raaj R Ghosal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366066698 PECOS PAC ID: 2860817293 Enrollment ID: I20230717001334 |
| Provider Name | Shaheryar Jafri |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033595830 PECOS PAC ID: 5597027649 Enrollment ID: I20230725003820 |
| Provider Name | Arvind Vasudevan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770503526 PECOS PAC ID: 2860414091 Enrollment ID: I20230727001008 |
| Provider Name | Emad Alghazo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174186662 PECOS PAC ID: 8527429216 Enrollment ID: I20230727001830 |
| Provider Name | Jason P Stabley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992713234 PECOS PAC ID: 8022904036 Enrollment ID: I20230801002868 |
| Provider Name | Lindsey Phyfer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902538895 PECOS PAC ID: 1254715048 Enrollment ID: I20230801003765 |
| Provider Name | Kristen Veal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821594789 PECOS PAC ID: 5698141604 Enrollment ID: I20230803000848 |
| Provider Name | Danoushka Loris Tememe |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255742227 PECOS PAC ID: 5294950812 Enrollment ID: I20230823001108 |
| Provider Name | Amit Jain |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1104350925 PECOS PAC ID: 9638456254 Enrollment ID: I20230825003418 |
| Provider Name | Paul Russell Roberts |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1902392939 PECOS PAC ID: 1951653245 Enrollment ID: I20230901002091 |
| Provider Name | Ravi Kumar Metai |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1912304585 PECOS PAC ID: 8022383017 Enrollment ID: I20230906002595 |
| Provider Name | Etienne Schonbach |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1073040580 PECOS PAC ID: 9739583774 Enrollment ID: I20230918000083 |
| Provider Name | David Cawthon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063587384 PECOS PAC ID: 2163480005 Enrollment ID: I20230921000522 |
| Provider Name | Stella Margaret Kidwell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184696122 PECOS PAC ID: 1456398056 Enrollment ID: I20230922003863 |
| Provider Name | Amit Keith Correa |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1710396486 PECOS PAC ID: 6608208160 Enrollment ID: I20230929000318 |
| Provider Name | Juan Jose Martin |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1265639777 PECOS PAC ID: 7810138153 Enrollment ID: I20231002000002 |
| Provider Name | Jose Augusto Henao Correa |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1487109260 PECOS PAC ID: 0648565135 Enrollment ID: I20231003000527 |
| Provider Name | James Lamb |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427411537 PECOS PAC ID: 8921362211 Enrollment ID: I20231005001997 |
| Provider Name | Levi Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952187494 PECOS PAC ID: 3476908062 Enrollment ID: I20231017003713 |
| Provider Name | Alison Daigle |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730476839 PECOS PAC ID: 9032338579 Enrollment ID: I20231018000793 |
| Provider Name | Kelly Milton |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770882458 PECOS PAC ID: 8729206099 Enrollment ID: I20231018001394 |
| Provider Name | Shao-hwa P Wei |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205062361 PECOS PAC ID: 7517278146 Enrollment ID: I20231023003651 |
| Provider Name | Katelyn Mitchell |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003471699 PECOS PAC ID: 2668860040 Enrollment ID: I20231025002623 |
| Provider Name | Nicholas Guy Ross |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396240040 PECOS PAC ID: 4082961131 Enrollment ID: I20231026002366 |
| Provider Name | Shannon Andrews |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1548559206 PECOS PAC ID: 4284859695 Enrollment ID: I20231108002353 |
| Provider Name | Parham J Zamani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184287427 PECOS PAC ID: 6800254327 Enrollment ID: I20231111000004 |
| Provider Name | Sudhin Kanabar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750373882 PECOS PAC ID: 2062590987 Enrollment ID: I20231111000104 |
| Provider Name | Cintasha Redmond |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639437452 PECOS PAC ID: 8628344728 Enrollment ID: I20231116000204 |
| Provider Name | Sarah Cleveland |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1831870054 PECOS PAC ID: 7315395605 Enrollment ID: I20231128000014 |
| Provider Name | Elizabeth A Kennedy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1871274084 PECOS PAC ID: 3779931068 Enrollment ID: I20231128000033 |
| Provider Name | Jamie Lee Morales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811642176 PECOS PAC ID: 0143679159 Enrollment ID: I20231214003629 |
| Provider Name | Carlos Eugenio Villar Cordova |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1417921321 PECOS PAC ID: 2163504614 Enrollment ID: I20231229000233 |
| Provider Name | Mallori Mcbryde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801671425 PECOS PAC ID: 8628429826 Enrollment ID: I20240112000657 |
| Provider Name | Clark Hunt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427597855 PECOS PAC ID: 1052763836 Enrollment ID: I20240117002110 |
| Provider Name | Sandra Holmes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649890336 PECOS PAC ID: 5698119022 Enrollment ID: I20240214000235 |
| Provider Name | Brittney Danielle Kelton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497516983 PECOS PAC ID: 1951745983 Enrollment ID: I20240219001015 |
| Provider Name | Joseph Duncan Read |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265208557 PECOS PAC ID: 4183068026 Enrollment ID: I20240219001993 |
| Provider Name | Teresa Kate Leslie Boitano |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1801250303 PECOS PAC ID: 3173819745 Enrollment ID: I20240226000026 |
| Provider Name | Chantelle Harry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285286898 PECOS PAC ID: 4385089507 Enrollment ID: I20240228000222 |
Heart To Heart Counseling Services,llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 813 Varsity Dr Ste 7, Tupelo, MS 38801 Phone: 662-523-3100 | |
Oceans Behavioral Hospital Of Tupelo, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4579 S Eason Blvd Ste B, Tupelo, MS 38801 Phone: 662-268-4418 Fax: 888-255-5803 | |
Landy Headache & Esthetics, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 311 S Gloster St Ste 103, Tupelo, MS 38801 Phone: 662-401-6400 | |
Betteryou Counseling And Consultant, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2161 Lana Lane, Tupelo, MS 38801 Phone: 662-321-2635 | |
Heale Counseling, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 302 S Spring St, Tupelo, MS 38804 Phone: 662-205-0098 | |
Rh Arise Venture Of Tupelo Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 777 Holly Hill Dr, Tupelo, MS 38801 Phone: 662-432-1221 | |
Melissa Ratliff, Lcsw Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 302 S Spring St, Tupelo, MS 38804 Phone: 662-841-8020 Fax: 662-841-8021 |