| East Des Moines Family Care Center | |
|
840 E University Ave Des Moines IA 50316-2304 | |
| (515) 265-4211 | |
| (515) 309-5993 |
| Full Name | East Des Moines Family Care Center |
|---|---|
| Speciality | Family Medicine |
| Location | 840 E University Ave, Des Moines, Iowa |
| Authorized Official Name and Position | Michael J Dewerff (CFO) |
| Authorized Official Contact | 5152416507 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Des Moines Family Care Center 5409 Nw 88th St Suite 200 Johnston IA 50131-2949 Ph: (515) 362-5980 | East Des Moines Family Care Center 840 E University Ave Des Moines IA 50316-2304 Ph: (515) 265-4211 |
| NPI Number | 1104879576 |
|---|---|
| Provider Enumeration Date | 05/18/2006 |
| Last Update Date | 03/19/2019 |
| Medicare PECOS PAC ID | 1052229275 |
|---|---|
| Medicare Enrollment ID | O20040128001102 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104879576 | NPI | - | NPPES |
| 0096958 | Medicaid | IA | |
| CC7397 | Other | IA | RAILROAD MEDICARE GROUP |
| Provider Name | Eric D Haugen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063406940 PECOS PAC ID: 8426944968 Enrollment ID: I20040223001089 |
| Provider Name | Thomas E Benzoni |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245231448 PECOS PAC ID: 0648167924 Enrollment ID: I20040302000309 |
| Provider Name | Sea A Fey |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1972577450 PECOS PAC ID: 2668465527 Enrollment ID: I20040406001154 |
| Provider Name | Lynn M Rankin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710972823 PECOS PAC ID: 9335135615 Enrollment ID: I20040422000397 |
| Provider Name | Judy R Walker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407838618 PECOS PAC ID: 6002804176 Enrollment ID: I20040505001564 |
| Provider Name | Jennifer R Sleiter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740272855 PECOS PAC ID: 0941281554 Enrollment ID: I20040921000070 |
| Provider Name | Allison L Brown |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235127788 PECOS PAC ID: 2163490756 Enrollment ID: I20040921001227 |
| Provider Name | Charles R Dunlop |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215916523 PECOS PAC ID: 6507827318 Enrollment ID: I20041025000947 |
| Provider Name | Mark W Purtle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356315477 PECOS PAC ID: 1951353838 Enrollment ID: I20050218000615 |
| Provider Name | Dianne S Alber |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053481713 PECOS PAC ID: 5890723472 Enrollment ID: I20050804000007 |
| Provider Name | Laura L Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386620284 PECOS PAC ID: 9830120187 Enrollment ID: I20050825000970 |
| Provider Name | John M Koester |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811978646 PECOS PAC ID: 9739104456 Enrollment ID: I20051012000357 |
| Provider Name | Bryan L Folkers |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1952327728 PECOS PAC ID: 7012933112 Enrollment ID: I20051018000911 |
| Provider Name | Samir Y Alabsi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780662205 PECOS PAC ID: 4183645328 Enrollment ID: I20051215000066 |
| Provider Name | Julie L Anderson Suddarth |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245214436 PECOS PAC ID: 7416978655 Enrollment ID: I20051215000094 |
| Provider Name | Amy L Timmerman |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1629307012 PECOS PAC ID: 4385652585 Enrollment ID: I20060330000020 |
| Provider Name | Wook James Kim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124006770 PECOS PAC ID: 2264430362 Enrollment ID: I20061128000570 |
| Provider Name | Cory C Vaudt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184675159 PECOS PAC ID: 8123091691 Enrollment ID: I20070201000603 |
| Provider Name | Shehzad Kamran |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942247739 PECOS PAC ID: 7719081751 Enrollment ID: I20070330000117 |
| Provider Name | Susan A Hernandez |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1407931363 PECOS PAC ID: 7416053905 Enrollment ID: I20070430000275 |
| Provider Name | Wendy A Zadeh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194703074 PECOS PAC ID: 7517065667 Enrollment ID: I20070613000354 |
| Provider Name | Anish P Keshwani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093764615 PECOS PAC ID: 8426158585 Enrollment ID: I20070703000409 |
| Provider Name | Carla M Nester |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1538387873 PECOS PAC ID: 8729179973 Enrollment ID: I20070802000424 |
| Provider Name | Kathleen S Dewald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578755732 PECOS PAC ID: 8022102631 Enrollment ID: I20070913000249 |
| Provider Name | Kyriacos Panayides |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063634038 PECOS PAC ID: 4082708144 Enrollment ID: I20070919000936 |
| Provider Name | John M Tysklind |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1952471005 PECOS PAC ID: 9638241805 Enrollment ID: I20080702000633 |
| Provider Name | Tracy Laine Ekhardt |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265500383 PECOS PAC ID: 0840363115 Enrollment ID: I20080718000672 |
| Provider Name | Calvin J Hansen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639157373 PECOS PAC ID: 7810061934 Enrollment ID: I20080807000030 |
| Provider Name | Duangchai Narawong |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750376034 PECOS PAC ID: 1557437183 Enrollment ID: I20080905000395 |
| Provider Name | Katherine M Frush |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1821269333 PECOS PAC ID: 3274601877 Enrollment ID: I20081009000451 |
| Provider Name | Heather Smith Bueltel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609027234 PECOS PAC ID: 9032287578 Enrollment ID: I20081010000037 |
| Provider Name | Timothy T Hart |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1336121011 PECOS PAC ID: 8729148622 Enrollment ID: I20081121000736 |
| Provider Name | Nathan E Boonstra |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649250713 PECOS PAC ID: 9537221742 Enrollment ID: I20081223000254 |
| Provider Name | Robert J Isaak |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1619197464 PECOS PAC ID: 6507929783 Enrollment ID: I20090114000463 |
| Provider Name | John T Triantafyllos |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1720053705 PECOS PAC ID: 4688737877 Enrollment ID: I20090114000482 |
| Provider Name | Lisa Jayne Menzies |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356337273 PECOS PAC ID: 4183516669 Enrollment ID: I20090306000370 |
| Provider Name | Rebecca L Lachenmaier |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1821058322 PECOS PAC ID: 8527115880 Enrollment ID: I20090402000671 |
| Provider Name | Kathleen M Gradoville |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285626390 PECOS PAC ID: 4082761705 Enrollment ID: I20090416000143 |
| Provider Name | Marianka O Pille |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841443066 PECOS PAC ID: 5496804809 Enrollment ID: I20090514000120 |
| Provider Name | Jeffrey S Carstens |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1730265976 PECOS PAC ID: 0042285140 Enrollment ID: I20090515000090 |
| Provider Name | Ryan D Mccracken |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518169051 PECOS PAC ID: 1850440454 Enrollment ID: I20090529000475 |
| Provider Name | Debra J Bixler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720073083 PECOS PAC ID: 5193875185 Enrollment ID: I20090612000436 |
| Provider Name | Rachael K Sokol |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508903691 PECOS PAC ID: 2769578822 Enrollment ID: I20090715000114 |
| Provider Name | Sudhir C Kumar |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1417931700 PECOS PAC ID: 1355305475 Enrollment ID: I20090715000347 |
| Provider Name | Luann A Volkmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386636207 PECOS PAC ID: 9032262035 Enrollment ID: I20090807000331 |
| Provider Name | Jennifer Elizabeth Kintzle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427021617 PECOS PAC ID: 0941260673 Enrollment ID: I20091012000184 |
| Provider Name | Craig A Stark |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245212075 PECOS PAC ID: 9335286715 Enrollment ID: I20091019000143 |
| Provider Name | Bente Y Hoegsberg |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760427041 PECOS PAC ID: 9133266935 Enrollment ID: I20091112000072 |
| Provider Name | Leenu Mishra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588838841 PECOS PAC ID: 7618010687 Enrollment ID: I20100130000316 |
| Provider Name | Leonard Scott Richards |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548249311 PECOS PAC ID: 9436293164 Enrollment ID: I20100219000092 |
| Provider Name | Karen L Drake |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083688568 PECOS PAC ID: 5991849200 Enrollment ID: I20100224000136 |
| Provider Name | Robert D Rondinelli |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1679552327 PECOS PAC ID: 6800930140 Enrollment ID: I20100224000423 |
| Provider Name | Ernst F Hoffman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871665612 PECOS PAC ID: 1456496975 Enrollment ID: I20100308000646 |
| Provider Name | Michelle L Hunerdosse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578574687 PECOS PAC ID: 0648306720 Enrollment ID: I20100327000565 |
| Provider Name | Lisa A Veach |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1043217748 PECOS PAC ID: 5092842625 Enrollment ID: I20100429000924 |
| Provider Name | Lynn K Struck |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750369344 PECOS PAC ID: 3870620404 Enrollment ID: I20100429000964 |
| Provider Name | Roger L Harvey |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1235137845 PECOS PAC ID: 0941337570 Enrollment ID: I20100429000987 |
| Provider Name | Cornelius J Gucfa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942274626 PECOS PAC ID: 9032240015 Enrollment ID: I20100708000814 |
| Provider Name | Ken L Cheyne |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053305086 PECOS PAC ID: 8224162839 Enrollment ID: I20100818000824 |
| Provider Name | Leyla A Best Bandenay |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1003074931 PECOS PAC ID: 3577697879 Enrollment ID: I20100820000935 |
| Provider Name | Teresa P Monsod Borromeo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326236316 PECOS PAC ID: 7618092941 Enrollment ID: I20100910000035 |
| Provider Name | Amy E Shriver |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639225311 PECOS PAC ID: 7012032360 Enrollment ID: I20100910000264 |
| Provider Name | Jill M Jasper |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821058868 PECOS PAC ID: 8426058256 Enrollment ID: I20100910001129 |
| Provider Name | Gary A Yuille |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740344357 PECOS PAC ID: 0547385551 Enrollment ID: I20100914001344 |
| Provider Name | Christopher A Rokes |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1992037931 PECOS PAC ID: 3870618762 Enrollment ID: I20100915001041 |
| Provider Name | Lisa M Glantz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790967081 PECOS PAC ID: 8628193158 Enrollment ID: I20100921000316 |
| Provider Name | Michael L Line |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881779684 PECOS PAC ID: 9335242163 Enrollment ID: I20100921000853 |
| Provider Name | Wendy L Woods Swafford |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598812307 PECOS PAC ID: 3274658745 Enrollment ID: I20100921000872 |
| Provider Name | Debra Ann Downing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427376219 PECOS PAC ID: 5991821233 Enrollment ID: I20100924000064 |
| Provider Name | Megan L Overton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396926671 PECOS PAC ID: 4486770278 Enrollment ID: I20100929001189 |
| Provider Name | Teresa J Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811134455 PECOS PAC ID: 6305038407 Enrollment ID: I20101007000824 |
| Provider Name | Lisa M Jansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255644233 PECOS PAC ID: 8527253350 Enrollment ID: I20101105001209 |
| Provider Name | Catherine P Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750698833 PECOS PAC ID: 3779778394 Enrollment ID: I20101109000993 |
| Provider Name | Bradley J Riley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043298565 PECOS PAC ID: 7517152093 Enrollment ID: I20101110000191 |
| Provider Name | Jennifer N Blume |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407166473 PECOS PAC ID: 0244426377 Enrollment ID: I20101201000160 |
| Provider Name | Jodie R Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558696104 PECOS PAC ID: 1557558384 Enrollment ID: I20101206001284 |
| Provider Name | Carissa L Scheve |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790969715 PECOS PAC ID: 8527243021 Enrollment ID: I20110427000399 |
| Provider Name | Nicholas J Fustino |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891952552 PECOS PAC ID: 4284803917 Enrollment ID: I20110812000650 |
| Provider Name | Amy M Groen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821078940 PECOS PAC ID: 1456520915 Enrollment ID: I20110818000108 |
| Provider Name | Nathan R Noble |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407836513 PECOS PAC ID: 2860650751 Enrollment ID: I20120223000454 |
| Provider Name | Elizabeth A Mccleary |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1396041927 PECOS PAC ID: 4789844408 Enrollment ID: I20120404000286 |
| Provider Name | Kerri L Patton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457303653 PECOS PAC ID: 2567526023 Enrollment ID: I20120502000648 |
| Provider Name | Colette J Henningsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336413780 PECOS PAC ID: 1153584974 Enrollment ID: I20120515000257 |
| Provider Name | Leslie R Fenimore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134485998 PECOS PAC ID: 8527221647 Enrollment ID: I20120529000315 |
| Provider Name | Christopher Bernard Komanapalli |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1194894519 PECOS PAC ID: 8022201789 Enrollment ID: I20120706000275 |
| Provider Name | Dianne L Chapko |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1619114956 PECOS PAC ID: 1850547621 Enrollment ID: I20120809000770 |
| Provider Name | Janice A Landy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275507022 PECOS PAC ID: 7618007238 Enrollment ID: I20120820000622 |
| Provider Name | Travis E Kain |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477715738 PECOS PAC ID: 1052568151 Enrollment ID: I20120824000299 |
| Provider Name | Amy Moberg |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700012986 PECOS PAC ID: 5496902504 Enrollment ID: I20120824000330 |
| Provider Name | Clint R Hawthorne |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154559912 PECOS PAC ID: 2264681766 Enrollment ID: I20120926000756 |
| Provider Name | Alladdin Abosaida |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376777524 PECOS PAC ID: 1052561503 Enrollment ID: I20121018000752 |
| Provider Name | Maria S Ogden |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043286446 PECOS PAC ID: 1850542515 Enrollment ID: I20121107000037 |
| Provider Name | Kimberly L Burrier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184852311 PECOS PAC ID: 0840438156 Enrollment ID: I20130528000624 |
| Provider Name | Eduardo J Carlin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700080538 PECOS PAC ID: 8628211893 Enrollment ID: I20130909000256 |
| Provider Name | Cindy S Pontious |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770925935 PECOS PAC ID: 0648404848 Enrollment ID: I20131001000201 |
| Provider Name | Eduardo Sebastian Antezano |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1447363486 PECOS PAC ID: 3375783335 Enrollment ID: I20131015002073 |
| Provider Name | Jamie L Piotrowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013359132 PECOS PAC ID: 1951536820 Enrollment ID: I20131030001616 |
| Provider Name | Kristin R Schroeder |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336460310 PECOS PAC ID: 1658507652 Enrollment ID: I20131121001636 |
| Provider Name | Kang Yu K Lee Son |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1487083911 PECOS PAC ID: 8820226780 Enrollment ID: I20140122001881 |
| Provider Name | Lisa I Hardisty |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013112424 PECOS PAC ID: 9133317514 Enrollment ID: I20140205000706 |
| Provider Name | Leslie J Soyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790119170 PECOS PAC ID: 4284864828 Enrollment ID: I20140227001999 |
| Provider Name | Nicole A Wagaman |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1689011405 PECOS PAC ID: 8820229222 Enrollment ID: I20140328000479 |
| Provider Name | Michelle M Ewest |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215223847 PECOS PAC ID: 3173766953 Enrollment ID: I20140430001068 |
| Provider Name | Sarah M Seehase |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528360856 PECOS PAC ID: 8123269198 Enrollment ID: I20140506000821 |
| Provider Name | Amy M Ferguson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588976237 PECOS PAC ID: 6204064918 Enrollment ID: I20140606001899 |
| Provider Name | Arshin Sheybani |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1407082712 PECOS PAC ID: 6406093673 Enrollment ID: I20140702000611 |
| Provider Name | Kristin A Rice |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154529022 PECOS PAC ID: 0840424974 Enrollment ID: I20140708001668 |
| Provider Name | Christopher Alex S Kabriel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942596572 PECOS PAC ID: 8820231772 Enrollment ID: I20140722002391 |
| Provider Name | Melissa A Lipovac |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336554286 PECOS PAC ID: 8224256086 Enrollment ID: I20140820001917 |
| Provider Name | Kimberly N Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316356496 PECOS PAC ID: 8729206883 Enrollment ID: I20140902002072 |
| Provider Name | Nicholas H Kluesner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245599711 PECOS PAC ID: 5698913416 Enrollment ID: I20140905001842 |
| Provider Name | Tharwat Stewart Fouad Boulis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356501340 PECOS PAC ID: 9739245945 Enrollment ID: I20140916000719 |
| Provider Name | Alexander M Wittry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104110931 PECOS PAC ID: 5991945933 Enrollment ID: I20140918001441 |
| Provider Name | Ashlea A Lem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225446313 PECOS PAC ID: 5294954483 Enrollment ID: I20140922000486 |
| Provider Name | Danielle N Brodersen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407250830 PECOS PAC ID: 1355563768 Enrollment ID: I20141118002562 |
| Provider Name | Veena Ramachandran |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144495987 PECOS PAC ID: 0143544528 Enrollment ID: I20150112001935 |
| Provider Name | Anthony E Magalski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174508014 PECOS PAC ID: 6002837523 Enrollment ID: I20150210000927 |
| Provider Name | Kimberley Dawn Magalski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467438978 PECOS PAC ID: 6002822566 Enrollment ID: I20150210002140 |
| Provider Name | Rebecca Lynn Fox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265785083 PECOS PAC ID: 4082931100 Enrollment ID: I20150327002201 |
| Provider Name | David A Terrero Salcedo |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1013282953 PECOS PAC ID: 3072830983 Enrollment ID: I20150401002465 |
| Provider Name | Blake C Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245624626 PECOS PAC ID: 1658690458 Enrollment ID: I20150429000387 |
| Provider Name | Ratna P Gangi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1164653945 PECOS PAC ID: 7618298548 Enrollment ID: I20150604000650 |
| Provider Name | Jason M Misurac |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1205061900 PECOS PAC ID: 9739326141 Enrollment ID: I20150710000604 |
| Provider Name | Lindsey Koele-schmidt |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518194000 PECOS PAC ID: 6608189485 Enrollment ID: I20150722006091 |
| Provider Name | John Yung Netten |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356637896 PECOS PAC ID: 8921322546 Enrollment ID: I20150730010732 |
| Provider Name | Priscilla M Putzier |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962638031 PECOS PAC ID: 4587891122 Enrollment ID: I20150810000608 |
| Provider Name | Philip S Taber |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154613412 PECOS PAC ID: 6507171295 Enrollment ID: I20150810001506 |
| Provider Name | Eric D Meyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457584740 PECOS PAC ID: 1951533835 Enrollment ID: I20150903001996 |
| Provider Name | Austin T Baeth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750647400 PECOS PAC ID: 2264749514 Enrollment ID: I20150918000072 |
| Provider Name | Brianna M Schimp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629454293 PECOS PAC ID: 3577872456 Enrollment ID: I20151015000554 |
| Provider Name | Brooke N Johnson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013158955 PECOS PAC ID: 8426219296 Enrollment ID: I20151029002403 |
| Provider Name | Tara M Eastvold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326410499 PECOS PAC ID: 5496055717 Enrollment ID: I20151118001330 |
| Provider Name | Matthew T Edel |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1760773626 PECOS PAC ID: 4981929411 Enrollment ID: I20160204000864 |
| Provider Name | Lindsay D Barden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184007502 PECOS PAC ID: 8224334206 Enrollment ID: I20160317001080 |
| Provider Name | Gregory Samson |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1962690487 PECOS PAC ID: 3971740424 Enrollment ID: I20160321001726 |
| Provider Name | Shelley N Hancock |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528232899 PECOS PAC ID: 7810114659 Enrollment ID: I20160523002464 |
| Provider Name | Chase N Deobald |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346683539 PECOS PAC ID: 3577882430 Enrollment ID: I20160524000287 |
| Provider Name | Jonathan B Howe |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982967964 PECOS PAC ID: 2062645195 Enrollment ID: I20160606002136 |
| Provider Name | Audrey K Bush |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285074377 PECOS PAC ID: 5991930208 Enrollment ID: I20160609000348 |
| Provider Name | Abdur R Ayoob |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780962845 PECOS PAC ID: 3476777913 Enrollment ID: I20160609001268 |
| Provider Name | Mina A. Salib |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528365277 PECOS PAC ID: 7113196080 Enrollment ID: I20160617001080 |
| Provider Name | Padmanabhan Priyesh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1598078552 PECOS PAC ID: 9133355860 Enrollment ID: I20160623002127 |
| Provider Name | Scott Davison |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255770145 PECOS PAC ID: 0042444168 Enrollment ID: I20160627000881 |
| Provider Name | Samantha Lynne Mallory |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336375369 PECOS PAC ID: 6204092281 Enrollment ID: I20160628002754 |
| Provider Name | Mohammad Alsharabati |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174748180 PECOS PAC ID: 0749339539 Enrollment ID: I20160711001411 |
| Provider Name | Luke M Lowry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750728309 PECOS PAC ID: 5890939854 Enrollment ID: I20160824001798 |
| Provider Name | Anastasia M Marx |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073874335 PECOS PAC ID: 3577859677 Enrollment ID: I20160915000488 |
| Provider Name | Amanda Lizette Monroy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073068979 PECOS PAC ID: 9537457650 Enrollment ID: I20161005001597 |
| Provider Name | Autumn Schmoker |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1770031668 PECOS PAC ID: 9133408420 Enrollment ID: I20161109000225 |
| Provider Name | Rajeev R Fernando |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952651382 PECOS PAC ID: 6305159849 Enrollment ID: I20170217000173 |
| Provider Name | Amy M Yuska |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811372238 PECOS PAC ID: 6103100219 Enrollment ID: I20170308001479 |
| Provider Name | Debra J Borcherding |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659786820 PECOS PAC ID: 8224254966 Enrollment ID: I20170518002079 |
| Provider Name | Dan Y Shamir |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1558318188 PECOS PAC ID: 7618038555 Enrollment ID: I20170519001545 |
| Provider Name | Salim Hommeida |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730477407 PECOS PAC ID: 2466671912 Enrollment ID: I20170620000750 |
| Provider Name | Blaire L Garber |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1053840181 PECOS PAC ID: 1658641931 Enrollment ID: I20170719001717 |
| Provider Name | Brittany D Jensen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912340076 PECOS PAC ID: 9335458264 Enrollment ID: I20170814000929 |
| Provider Name | Abdulrahman Mohammed Abdulbaki |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1972701050 PECOS PAC ID: 3476725730 Enrollment ID: I20170927004321 |
| Provider Name | Christine M Schmitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154834638 PECOS PAC ID: 3173880416 Enrollment ID: I20171122000504 |
| Provider Name | Monica W Atkinson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093710212 PECOS PAC ID: 6800887100 Enrollment ID: I20171130000793 |
| Provider Name | Robert Gallegos |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1205870805 PECOS PAC ID: 2365436417 Enrollment ID: I20171207002287 |
| Provider Name | Katie M Dean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326550922 PECOS PAC ID: 4981962610 Enrollment ID: I20171229000313 |
| Provider Name | Khara J Keegan |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1801245204 PECOS PAC ID: 3678861978 Enrollment ID: I20180123000176 |
| Provider Name | Cara E Hollmer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750602546 PECOS PAC ID: 0143463109 Enrollment ID: I20180125002312 |
| Provider Name | Sarah Jones Ketter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013369107 PECOS PAC ID: 1658665856 Enrollment ID: I20180131000865 |
| Provider Name | Kelly Maxwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730687328 PECOS PAC ID: 4880955368 Enrollment ID: I20180223002440 |
| Provider Name | Hamzah Miltaha |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861656431 PECOS PAC ID: 7315169430 Enrollment ID: I20180307001312 |
| Provider Name | Rachael M Doty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003313750 PECOS PAC ID: 2163785502 Enrollment ID: I20180417000935 |
| Provider Name | Vishesh Kumar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679838700 PECOS PAC ID: 3476868589 Enrollment ID: I20180531002681 |
| Provider Name | Seenaiah Byreddy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831538065 PECOS PAC ID: 0749545325 Enrollment ID: I20180531002769 |
| Provider Name | Brooke L Knop |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1659877827 PECOS PAC ID: 5092070573 Enrollment ID: I20180604002722 |
| Provider Name | Dawn T Corriere |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1326410689 PECOS PAC ID: 4981901097 Enrollment ID: I20180609000138 |
| Provider Name | Nelson A Telles Garcia |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1922360726 PECOS PAC ID: 3870736499 Enrollment ID: I20180620001260 |
| Provider Name | Deepika Abbadi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1205191210 PECOS PAC ID: 2769779347 Enrollment ID: I20180627002647 |
| Provider Name | Andrew D Sims |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942681333 PECOS PAC ID: 7416262563 Enrollment ID: I20180725003946 |
| Provider Name | Cassie J Wagner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134523269 PECOS PAC ID: 0941558613 Enrollment ID: I20180813002055 |
| Provider Name | Sarah M Mechem |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1396125894 PECOS PAC ID: 2466767116 Enrollment ID: I20180910000830 |
| Provider Name | Sara L Johnson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1831616770 PECOS PAC ID: 5092081695 Enrollment ID: I20180919000548 |
| Provider Name | Lynna L Malloy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881174498 PECOS PAC ID: 0648521674 Enrollment ID: I20181001002113 |
| Provider Name | Andrew C Nordine |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811042781 PECOS PAC ID: 5496007452 Enrollment ID: I20181003000617 |
| Provider Name | Douglas A Gorney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427544162 PECOS PAC ID: 6305199399 Enrollment ID: I20181020000748 |
| Provider Name | Samantha J Specht |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982066593 PECOS PAC ID: 2264785112 Enrollment ID: I20181023003725 |
| Provider Name | Gregory A Kolb |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811378383 PECOS PAC ID: 7911251897 Enrollment ID: I20181112002067 |
| Provider Name | Bryan Landon Stocker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740631001 PECOS PAC ID: 4183918667 Enrollment ID: I20181116001301 |
| Provider Name | Melissa A Koch |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1518459643 PECOS PAC ID: 5991049900 Enrollment ID: I20181203001043 |
| Provider Name | Keegan Tucker Overbey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942775754 PECOS PAC ID: 6002151321 Enrollment ID: I20181214000656 |
| Provider Name | Orrin Probst |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043691942 PECOS PAC ID: 4789920687 Enrollment ID: I20190115000244 |
| Provider Name | Erin E Richardson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447519038 PECOS PAC ID: 1759521081 Enrollment ID: I20190121000003 |
| Provider Name | Amy L Lindgren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154403327 PECOS PAC ID: 0648372342 Enrollment ID: I20190212000132 |
| Provider Name | Sridevi S Ellickal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760740195 PECOS PAC ID: 6406194562 Enrollment ID: I20190214002503 |
| Provider Name | Lily Sutton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740687854 PECOS PAC ID: 7810212669 Enrollment ID: I20190405001708 |
| Provider Name | Amanda Hope Croxton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588920151 PECOS PAC ID: 8123266954 Enrollment ID: I20190417001365 |
| Provider Name | Mary Cannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144789694 PECOS PAC ID: 0345581427 Enrollment ID: I20190418001840 |
| Provider Name | Todd Sexton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407203037 PECOS PAC ID: 7517259963 Enrollment ID: I20190503002443 |
| Provider Name | John Jordan Melchert |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972922391 PECOS PAC ID: 9931326972 Enrollment ID: I20190711000363 |
| Provider Name | Joel P Waddell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174960793 PECOS PAC ID: 6204133606 Enrollment ID: I20190729002608 |
| Provider Name | Sierra J Walter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487215588 PECOS PAC ID: 7618205113 Enrollment ID: I20190821004279 |
| Provider Name | Chad W Becker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043679699 PECOS PAC ID: 4789931262 Enrollment ID: I20190829003586 |
| Provider Name | Jacob P Flinkman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306226790 PECOS PAC ID: 9830482421 Enrollment ID: I20190830000216 |
| Provider Name | Amy M Massey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679132591 PECOS PAC ID: 7113256496 Enrollment ID: I20190911003086 |
| Provider Name | Jamie M May |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821641564 PECOS PAC ID: 3971833534 Enrollment ID: I20190924002488 |
| Provider Name | Brian P Jennett |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205255114 PECOS PAC ID: 3274757620 Enrollment ID: I20190925000444 |
| Provider Name | Paul M Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538620844 PECOS PAC ID: 3678803996 Enrollment ID: I20190927003139 |
| Provider Name | Jessica L Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215581293 PECOS PAC ID: 9931439254 Enrollment ID: I20190927003157 |
| Provider Name | Ranjani Ananth |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376943175 PECOS PAC ID: 1951694330 Enrollment ID: I20190930003038 |
| Provider Name | Patria M Alba Aponte |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689942518 PECOS PAC ID: 7113219064 Enrollment ID: I20191017000603 |
| Provider Name | Laura C Mccarthy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184062457 PECOS PAC ID: 3779804588 Enrollment ID: I20191104001397 |
| Provider Name | Sarah Elizabeth Francis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760869374 PECOS PAC ID: 7719233816 Enrollment ID: I20191106001586 |
| Provider Name | Lane A Moser |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508247990 PECOS PAC ID: 0042525180 Enrollment ID: I20191108001812 |
| Provider Name | Jenny A Mackrill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205477684 PECOS PAC ID: 3779915343 Enrollment ID: I20191120001033 |
| Provider Name | Denise J Hoevelkamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447812102 PECOS PAC ID: 3779916119 Enrollment ID: I20191126000436 |
| Provider Name | Jeffrey C King |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962508218 PECOS PAC ID: 8729072277 Enrollment ID: I20191210001378 |
| Provider Name | Amy L Couchman |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1346882552 PECOS PAC ID: 8224462577 Enrollment ID: I20191219002779 |
| Provider Name | Jennifer L Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336799451 PECOS PAC ID: 4082049887 Enrollment ID: I20200125000209 |
| Provider Name | Addie M Hinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447713607 PECOS PAC ID: 8628404696 Enrollment ID: I20200211001490 |
| Provider Name | Christopher S Vara |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1659566479 PECOS PAC ID: 5597794149 Enrollment ID: I20200213002938 |
| Provider Name | Connie S Mccullick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013358787 PECOS PAC ID: 9436391687 Enrollment ID: I20200520000471 |
| Provider Name | Samuel R Schroeder |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1861871105 PECOS PAC ID: 5294047908 Enrollment ID: I20200617002723 |
| Provider Name | Jessica M Kruckenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194349258 PECOS PAC ID: 9638592173 Enrollment ID: I20200701000169 |
| Provider Name | Erica R Sloan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437782638 PECOS PAC ID: 4688097017 Enrollment ID: I20200702000113 |
| Provider Name | Courtney D Reints |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700417169 PECOS PAC ID: 7214350495 Enrollment ID: I20200707000351 |
| Provider Name | Erik A Adair |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356756175 PECOS PAC ID: 7911276589 Enrollment ID: I20200716001291 |
| Provider Name | Andrew W Fondell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093120263 PECOS PAC ID: 2062638703 Enrollment ID: I20200720000075 |
| Provider Name | Marie Danielle Leblanc |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972126894 PECOS PAC ID: 9537583257 Enrollment ID: I20200728000297 |
| Provider Name | Shivakrishna Kovi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821483843 PECOS PAC ID: 2567767189 Enrollment ID: I20200730001210 |
| Provider Name | Abby J Doering |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962025767 PECOS PAC ID: 5496170847 Enrollment ID: I20200803001721 |
| Provider Name | Maria Romero Alvarez |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1952784662 PECOS PAC ID: 2668898206 Enrollment ID: I20200804000812 |
| Provider Name | Nicholas B Loudas |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1043605140 PECOS PAC ID: 4981992435 Enrollment ID: I20200818003104 |
| Provider Name | Cassidy A Carr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871052472 PECOS PAC ID: 8022434208 Enrollment ID: I20200818003676 |
| Provider Name | Madan M Acharya |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1053609321 PECOS PAC ID: 6901100155 Enrollment ID: I20200821002669 |
| Provider Name | Lauren Hodgson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932717600 PECOS PAC ID: 9830517333 Enrollment ID: I20200915003467 |
| Provider Name | Tria Doner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982214318 PECOS PAC ID: 5395163455 Enrollment ID: I20200922001802 |
| Provider Name | Ashley L Thomson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740891696 PECOS PAC ID: 7012336183 Enrollment ID: I20200923002923 |
| Provider Name | Morgan F Halbur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679190227 PECOS PAC ID: 9830518596 Enrollment ID: I20200929002749 |
| Provider Name | Lynzee D Makowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992314108 PECOS PAC ID: 0648699108 Enrollment ID: I20201001002302 |
| Provider Name | Kyle M J Hickman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285040816 PECOS PAC ID: 4688995582 Enrollment ID: I20201013001806 |
| Provider Name | Kyle Lemasters |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396239034 PECOS PAC ID: 2860812443 Enrollment ID: I20201020003849 |
| Provider Name | Anem Kohli |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295121127 PECOS PAC ID: 0648568451 Enrollment ID: I20201029002218 |
| Provider Name | Miranda Carlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447858634 PECOS PAC ID: 0749690162 Enrollment ID: I20201113000212 |
| Provider Name | James Smith |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235271172 PECOS PAC ID: 8628054798 Enrollment ID: I20201124002377 |
| Provider Name | Tyler Fisher |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114213451 PECOS PAC ID: 8628370954 Enrollment ID: I20201214001061 |
| Provider Name | Ashley Ulsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548754237 PECOS PAC ID: 5092127639 Enrollment ID: I20201223001752 |
| Provider Name | Cara Jean Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821690223 PECOS PAC ID: 0547673022 Enrollment ID: I20201229002715 |
| Provider Name | Courtney Makus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720681554 PECOS PAC ID: 5294149951 Enrollment ID: I20210121000675 |
| Provider Name | Shannon O'brien |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1124167259 PECOS PAC ID: 7810050150 Enrollment ID: I20210127003373 |
| Provider Name | Mark Mankins |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1710271549 PECOS PAC ID: 3173761525 Enrollment ID: I20210303001360 |
| Provider Name | Courtney Cox-kozel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992395958 PECOS PAC ID: 1759797186 Enrollment ID: I20210310001559 |
| Provider Name | David Briceno Gomez |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1841547189 PECOS PAC ID: 0648503201 Enrollment ID: I20210316001131 |
| Provider Name | Kecia Lanae Keady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356930481 PECOS PAC ID: 8426465147 Enrollment ID: I20210325000813 |
| Provider Name | Rebekah Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699205682 PECOS PAC ID: 8921371394 Enrollment ID: I20210401001483 |
| Provider Name | Fedja Rochling |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1083664007 PECOS PAC ID: 6406999432 Enrollment ID: I20210602001444 |
| Provider Name | Ngoc Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023632502 PECOS PAC ID: 8022419639 Enrollment ID: I20210701003774 |
| Provider Name | Heidi A Nettrour |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770826125 PECOS PAC ID: 4082016373 Enrollment ID: I20210708002907 |
| Provider Name | Rebecca Rae Johansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003401449 PECOS PAC ID: 6608278478 Enrollment ID: I20210715003770 |
| Provider Name | Oscar Viteri Molina |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760739510 PECOS PAC ID: 2163779224 Enrollment ID: I20210722001803 |
| Provider Name | Kristian Luong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962076448 PECOS PAC ID: 1557764842 Enrollment ID: I20210723002178 |
| Provider Name | Marco Olivera-martinez |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1518125194 PECOS PAC ID: 5799851739 Enrollment ID: I20210728001215 |
| Provider Name | Joseph Longobardi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659805430 PECOS PAC ID: 4183995533 Enrollment ID: I20210805001139 |
| Provider Name | Laura Socwell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326427626 PECOS PAC ID: 5092029330 Enrollment ID: I20210816001254 |
| Provider Name | Teresa Munro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245800788 PECOS PAC ID: 4587069893 Enrollment ID: I20210825001839 |
| Provider Name | Gabriel D Lancaster |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649837253 PECOS PAC ID: 5193050201 Enrollment ID: I20210831000450 |
| Provider Name | Kathryn Bartlett |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568990869 PECOS PAC ID: 0840567426 Enrollment ID: I20210902000819 |
| Provider Name | Ashleigh Burt |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245722727 PECOS PAC ID: 3072919638 Enrollment ID: I20210907001448 |
| Provider Name | Patrick John Shaeffer |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1790214765 PECOS PAC ID: 3173892296 Enrollment ID: I20210916000378 |
| Provider Name | Dawn Louise Kerwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790358588 PECOS PAC ID: 7810394822 Enrollment ID: I20210917001122 |
| Provider Name | Sarah Elizabeth Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659045417 PECOS PAC ID: 4880092048 Enrollment ID: I20211004000138 |
| Provider Name | Gabrielle Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659045441 PECOS PAC ID: 4385042555 Enrollment ID: I20211004000391 |
| Provider Name | Jill E Bartlett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366015547 PECOS PAC ID: 7214335116 Enrollment ID: I20211007000428 |
| Provider Name | Allison K Kim |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538650809 PECOS PAC ID: 8527456813 Enrollment ID: I20211019000203 |
| Provider Name | Rachel M Archer |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1558036897 PECOS PAC ID: 7012305220 Enrollment ID: I20211020002017 |
| Provider Name | Kailey Rae Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073282570 PECOS PAC ID: 5395135156 Enrollment ID: I20211209001617 |
| Provider Name | Kelsey Nicole Madesen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306514237 PECOS PAC ID: 5496145203 Enrollment ID: I20211210000919 |
| Provider Name | Alvise F Bernabei |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588679013 PECOS PAC ID: 0941218507 Enrollment ID: I20211221002056 |
| Provider Name | Josie Michelle Rutherford |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1770249054 PECOS PAC ID: 8123410750 Enrollment ID: I20220111002465 |
| Provider Name | Sumita Gyawali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356001507 PECOS PAC ID: 8527451202 Enrollment ID: I20220201000757 |
| Provider Name | Mathieu Levesque |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639833601 PECOS PAC ID: 4385037035 Enrollment ID: I20220202000944 |
| Provider Name | Lindsey Steele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407523566 PECOS PAC ID: 8224421268 Enrollment ID: I20220215001466 |
| Provider Name | Sarah Doan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174016398 PECOS PAC ID: 3375938954 Enrollment ID: I20220317000739 |
| Provider Name | Kayla Lawrance |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1639610603 PECOS PAC ID: 8628489739 Enrollment ID: I20220318000659 |
| Provider Name | Jordyn Lee Wiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023688215 PECOS PAC ID: 5092101451 Enrollment ID: I20220412000559 |
| Provider Name | Margaret Koos |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952715427 PECOS PAC ID: 2163648049 Enrollment ID: I20220413001593 |
| Provider Name | Edward Rojas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154700268 PECOS PAC ID: 9133543754 Enrollment ID: I20220525001292 |
| Provider Name | Ahmad Alsalman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831645704 PECOS PAC ID: 4880980903 Enrollment ID: I20220613000557 |
| Provider Name | Akshay Khatri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003267170 PECOS PAC ID: 7810224953 Enrollment ID: I20220614001000 |
| Provider Name | Richard S Herman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972750289 PECOS PAC ID: 6305032988 Enrollment ID: I20220615002210 |
| Provider Name | Amanda Privitera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306455563 PECOS PAC ID: 4082094644 Enrollment ID: I20220629002411 |
| Provider Name | Jennifer Lynn Westly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619625902 PECOS PAC ID: 0042690414 Enrollment ID: I20220630002843 |
| Provider Name | Holly Kramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275836751 PECOS PAC ID: 8224283775 Enrollment ID: I20220705002468 |
| Provider Name | Meghan Ryan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093162075 PECOS PAC ID: 0143568493 Enrollment ID: I20220706002851 |
| Provider Name | Jennifer Loftus Nystrom |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326401068 PECOS PAC ID: 3870974348 Enrollment ID: I20220714001531 |
| Provider Name | Justine Pirozzi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518526904 PECOS PAC ID: 9133500697 Enrollment ID: I20220715000902 |
| Provider Name | Samantha Bonin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053056663 PECOS PAC ID: 0345621215 Enrollment ID: I20220724000003 |
| Provider Name | Grant C Perry |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245692417 PECOS PAC ID: 6002100872 Enrollment ID: I20220803000318 |
| Provider Name | Nicholas Ryan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548680937 PECOS PAC ID: 3274839493 Enrollment ID: I20220805002386 |
| Provider Name | Sara Jeglum |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1972126985 PECOS PAC ID: 6901204882 Enrollment ID: I20220805002588 |
| Provider Name | Erica Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053040584 PECOS PAC ID: 9830572569 Enrollment ID: I20220812002951 |
| Provider Name | Nicole Marie Bales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164155040 PECOS PAC ID: 8022490580 Enrollment ID: I20220822001653 |
| Provider Name | Kendall Stewardson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134681190 PECOS PAC ID: 6406183060 Enrollment ID: I20220916000201 |
| Provider Name | Kylie Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467172312 PECOS PAC ID: 6305222027 Enrollment ID: I20221004002421 |
| Provider Name | Faith Thompson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134788847 PECOS PAC ID: 3375919392 Enrollment ID: I20221017001785 |
| Provider Name | Wendelin Kreifels |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205299252 PECOS PAC ID: 5193017374 Enrollment ID: I20221024000156 |
| Provider Name | Nash Whitaker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346685641 PECOS PAC ID: 9032359963 Enrollment ID: I20221026000254 |
| Provider Name | Yosef Greenspon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942364690 PECOS PAC ID: 3577665090 Enrollment ID: I20221110001062 |
| Provider Name | Kelsie Scaringe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811667330 PECOS PAC ID: 8022416262 Enrollment ID: I20221208000199 |
| Provider Name | Stacey Stallman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700433497 PECOS PAC ID: 9335519750 Enrollment ID: I20221229002352 |
| Provider Name | Sylena Danielle Blanchard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194442129 PECOS PAC ID: 2062883572 Enrollment ID: I20230120000443 |
| Provider Name | Natalie Bridge |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992328439 PECOS PAC ID: 2668895434 Enrollment ID: I20230120001097 |
| Provider Name | Mackenzie Lees |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558076471 PECOS PAC ID: 5698146751 Enrollment ID: I20230127001360 |
| Provider Name | Michael Leinwand |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447230032 PECOS PAC ID: 9537192711 Enrollment ID: I20230130000490 |
| Provider Name | Caleb T Byers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699499731 PECOS PAC ID: 3779957121 Enrollment ID: I20230327000125 |
| Provider Name | Claire Murray |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609239953 PECOS PAC ID: 8729313713 Enrollment ID: I20230329002233 |
| Provider Name | Naftali Presser |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1124314919 PECOS PAC ID: 5496056335 Enrollment ID: I20230419001024 |
| Provider Name | Jerris-stephanie Okonkwo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710418959 PECOS PAC ID: 4284007394 Enrollment ID: I20230419001033 |
| Provider Name | Danielle N Weller |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427758622 PECOS PAC ID: 7416312616 Enrollment ID: I20230421001874 |
| Provider Name | Miranda Rebecca Temple |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740989920 PECOS PAC ID: 1254796097 Enrollment ID: I20230428002376 |
| Provider Name | Kelly Schifsky |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215375308 PECOS PAC ID: 4587899869 Enrollment ID: I20230504001111 |
| Provider Name | Justin C Bohrer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114155041 PECOS PAC ID: 7113163478 Enrollment ID: I20230523002293 |
| Provider Name | Saif Al-adwan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1851849848 PECOS PAC ID: 4789041187 Enrollment ID: I20230530002586 |
| Provider Name | Jeffrey Pence |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629063722 PECOS PAC ID: 6800184789 Enrollment ID: I20230606002441 |
| Provider Name | Beth Avery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811437809 PECOS PAC ID: 2264899095 Enrollment ID: I20230608002858 |
| Provider Name | Michael Ganey |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306967534 PECOS PAC ID: 7113953498 Enrollment ID: I20230613000614 |
| Provider Name | Wafic Itani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1700306024 PECOS PAC ID: 0345585279 Enrollment ID: I20230630000217 |
| Provider Name | Aubrey Anderson Reese |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124641766 PECOS PAC ID: 0345609715 Enrollment ID: I20230703000330 |
| Provider Name | Juan Arenas |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1225191703 PECOS PAC ID: 1456322411 Enrollment ID: I20230710003167 |
| Provider Name | Jessica Dotson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538521844 PECOS PAC ID: 3678845997 Enrollment ID: I20230718003652 |
| Provider Name | Crosby Rock |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1457849259 PECOS PAC ID: 7113252818 Enrollment ID: I20230718004186 |
| Provider Name | Aaron Ballantyne |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447521901 PECOS PAC ID: 9830403583 Enrollment ID: I20230724002267 |
| Provider Name | Ali Savage-hand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598442741 PECOS PAC ID: 5294197893 Enrollment ID: I20230814003602 |
| Provider Name | Walter Andrews |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700836046 PECOS PAC ID: 3971543836 Enrollment ID: I20230829000416 |
| Provider Name | Jessica May Graff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740967546 PECOS PAC ID: 0547623175 Enrollment ID: I20230830002699 |
| Provider Name | Matthew Alexander |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760895536 PECOS PAC ID: 3274750732 Enrollment ID: I20230830002910 |
| Provider Name | Arian Jahansouz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245856517 PECOS PAC ID: 6608299763 Enrollment ID: I20230907000582 |
| Provider Name | Eric D Polich |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558986844 PECOS PAC ID: 2365869104 Enrollment ID: I20230913002845 |
| Provider Name | Shilpi Relan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699018721 PECOS PAC ID: 7113356148 Enrollment ID: I20230915000596 |
| Provider Name | Collin James Thatcher |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245868017 PECOS PAC ID: 6103249032 Enrollment ID: I20230929000607 |
| Provider Name | Amy Elizabeth Blessing |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558095448 PECOS PAC ID: 0547615973 Enrollment ID: I20231004003645 |
| Provider Name | Serge B Pierrecharles |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1609167980 PECOS PAC ID: 3375850852 Enrollment ID: I20231019001362 |
| Provider Name | Dimitri Boreisha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164081584 PECOS PAC ID: 5890029250 Enrollment ID: I20231101001887 |
| Provider Name | Samuel Laney |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1861590358 PECOS PAC ID: 3678679115 Enrollment ID: I20231109002314 |
| Provider Name | Timothy Andrew Flynn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487281085 PECOS PAC ID: 6901254572 Enrollment ID: I20231121002565 |
| Provider Name | Brian R Rath |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912247909 PECOS PAC ID: 0446608871 Enrollment ID: I20231127000756 |
| Provider Name | John Mark Pool |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1134338114 PECOS PAC ID: 5496818395 Enrollment ID: I20231127001897 |
| Provider Name | Bailey Oermann |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417675786 PECOS PAC ID: 0244688513 Enrollment ID: I20231127002440 |
| Provider Name | Andrew Dentzau |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942984745 PECOS PAC ID: 5799133880 Enrollment ID: I20231130000700 |
| Provider Name | Megan Lee Simpson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437443025 PECOS PAC ID: 0547619637 Enrollment ID: I20231214002614 |
| Provider Name | Matthew Dennis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417211210 PECOS PAC ID: 2769625623 Enrollment ID: I20240104003695 |
| Provider Name | Rhonda Kay Idemmili |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700269370 PECOS PAC ID: 5395058382 Enrollment ID: I20240105000391 |
| Provider Name | Alexia Marie Chally |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558044412 PECOS PAC ID: 8022469816 Enrollment ID: I20240105001481 |
| Provider Name | Elizabeth Spooner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356329205 PECOS PAC ID: 9638488216 Enrollment ID: I20240105003284 |
| Provider Name | Emily Betsworth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477150803 PECOS PAC ID: 9739531260 Enrollment ID: I20240119001736 |
| Provider Name | Aradia Fu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578855631 PECOS PAC ID: 7214249952 Enrollment ID: I20240125004143 |
| Provider Name | Danielle Smith |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1679863542 PECOS PAC ID: 1951606979 Enrollment ID: I20240126003209 |
Mercy Ruan Neurology Clinic Central Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1111 6th Ave, East Tower Suite A100, Des Moines, IA 50314 Phone: 515-358-0011 Fax: 515-358-0099 | |
Multicultural Institute Of Therapeutic Excellence Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4313 University Ave, Des Moines, IA 50311 Phone: 515-802-2487 | |
Beyond Wellness Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 699 Walnut St Ste 400, Des Moines, IA 50309 Phone: 855-380-6136 | |
Unitypoint Health - Des Moines Iowa Methodist Medical Center Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 700 E University Ave, Des Moines, IA 50316 Phone: 515-263-5612 | |
The Healing Space Counseling Center, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3810 1/2 Douglas Ave, Des Moines, IA 50310 Phone: 515-423-2333 | |
Openloop Healthcare Partners Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 317 6th Ave Ste 400, Des Moines, IA 50309 Phone: 515-216-0962 | |
Child Guidance Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 808 5th Ave, Des Moines, IA 50309 Phone: 515-244-2267 |