| Southcentral Foundation | |
|
10 Dnr Road Mcgrath AK 99627 | |
| (907) 524-3299 | |
| Not Available |
| Full Name | Southcentral Foundation |
|---|---|
| Speciality | Clinic/Center |
| Location | 10 Dnr Road, Mcgrath, Alaska |
| Authorized Official Name and Position | Ronald Lee Olson (EXECUTIVE VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 9077294939 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southcentral Foundation Po Box 35198 Seattle WA 98124-5198 Ph: () - | Southcentral Foundation 10 Dnr Road Mcgrath AK 99627 Ph: (907) 524-3299 |
| NPI Number | 1780614263 |
|---|---|
| Provider Enumeration Date | 07/03/2006 |
| Last Update Date | 09/15/2023 |
| Certification Date | 09/15/2023 |
| Medicare PECOS PAC ID | 5496663627 |
|---|---|
| Medicare Enrollment ID | O20051027000416 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780614263 | NPI | - | NPPES |
| 1000855 | Medicaid | AK | |
| 1021095 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 20467 (Alaska) | Primary |
| Provider Name | Susannah Q Olnes |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649358896 PECOS PAC ID: 9335045400 Enrollment ID: I20031209001103 |
| Provider Name | Lynette R Dziuk |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1629033527 PECOS PAC ID: 8729986948 Enrollment ID: I20031226000171 |
| Provider Name | Laurie E Dahms |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245285964 PECOS PAC ID: 2466443916 Enrollment ID: I20040521001239 |
| Provider Name | Tamara Lynne Russell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699722975 PECOS PAC ID: 3476532235 Enrollment ID: I20040715000632 |
| Provider Name | Sarah J Taygan |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1689787137 PECOS PAC ID: 8628048485 Enrollment ID: I20040728001576 |
| Provider Name | Alex C Orten |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518912849 PECOS PAC ID: 2769445717 Enrollment ID: I20041110000546 |
| Provider Name | Bethany R Berry |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1699722959 PECOS PAC ID: 3577528132 Enrollment ID: I20041123000164 |
| Provider Name | Christine A Tan Cadogan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992815468 PECOS PAC ID: 6103882287 Enrollment ID: I20041209000894 |
| Provider Name | Regan A Ramsey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669582169 PECOS PAC ID: 9931167103 Enrollment ID: I20041221000216 |
| Provider Name | Daniel C Griffis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063499010 PECOS PAC ID: 3678523818 Enrollment ID: I20050126000368 |
| Provider Name | Sarah A Stienbarger |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427150549 PECOS PAC ID: 9931153327 Enrollment ID: I20050309000155 |
| Provider Name | Claudia A Phillips |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164476800 PECOS PAC ID: 5698688562 Enrollment ID: I20050310000900 |
| Provider Name | Eric L Noble |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487764973 PECOS PAC ID: 3173567419 Enrollment ID: I20050616000926 |
| Provider Name | Karen C Nelson |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1457381881 PECOS PAC ID: 0840228235 Enrollment ID: I20050727000805 |
| Provider Name | Annalissa T. Ogena |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437269925 PECOS PAC ID: 0648161471 Enrollment ID: I20051020000524 |
| Provider Name | Cindy D Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851346779 PECOS PAC ID: 4385662709 Enrollment ID: I20051103001173 |
| Provider Name | Elize J Rumley |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1750414579 PECOS PAC ID: 3274551981 Enrollment ID: I20051110000362 |
| Provider Name | Aryeh L Levenson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245303650 PECOS PAC ID: 7214944461 Enrollment ID: I20060503000751 |
| Provider Name | Benjamin A Garnett |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164435327 PECOS PAC ID: 3375540164 Enrollment ID: I20061109000312 |
| Provider Name | Steve J Tierney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376650242 PECOS PAC ID: 4183726789 Enrollment ID: I20070228000652 |
| Provider Name | Glenda H Grawe |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417925363 PECOS PAC ID: 9537122882 Enrollment ID: I20070306000123 |
| Provider Name | Kenneth J Norris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841276102 PECOS PAC ID: 5395849558 Enrollment ID: I20070327000620 |
| Provider Name | Scott D Mitchell |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245334465 PECOS PAC ID: 5092815738 Enrollment ID: I20070711000353 |
| Provider Name | Susan Mermelstein |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1841315124 PECOS PAC ID: 2062509086 Enrollment ID: I20071107000329 |
| Provider Name | Robin L Molsberry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922111434 PECOS PAC ID: 8921189440 Enrollment ID: I20080122000616 |
| Provider Name | Erin Callahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215131156 PECOS PAC ID: 5698851558 Enrollment ID: I20080318000758 |
| Provider Name | June I Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396858114 PECOS PAC ID: 9032297304 Enrollment ID: I20080428000248 |
| Provider Name | Anna M Stafford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023236395 PECOS PAC ID: 7719050871 Enrollment ID: I20080722000749 |
| Provider Name | Cheryl E Bays Goodman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548343353 PECOS PAC ID: 1850467226 Enrollment ID: I20080909000287 |
| Provider Name | Amie C Wu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205947629 PECOS PAC ID: 0042378010 Enrollment ID: I20081020000347 |
| Provider Name | John G Rosenfeld |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891726659 PECOS PAC ID: 9830258045 Enrollment ID: I20081103000495 |
| Provider Name | Clifford C Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457503823 PECOS PAC ID: 5890851737 Enrollment ID: I20090302000519 |
| Provider Name | Kathleen L Healy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811990575 PECOS PAC ID: 7719044163 Enrollment ID: I20090330000384 |
| Provider Name | Daniel L Nagoda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649423948 PECOS PAC ID: 9234288549 Enrollment ID: I20090515000422 |
| Provider Name | Michael P Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790947349 PECOS PAC ID: 9234106501 Enrollment ID: I20090519000655 |
| Provider Name | Sandi Angevine |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548488455 PECOS PAC ID: 3870550767 Enrollment ID: I20090629000061 |
| Provider Name | Laurie E Zimmer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477678506 PECOS PAC ID: 0547394140 Enrollment ID: I20100818000742 |
| Provider Name | Bruce C Stockhouse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689781643 PECOS PAC ID: 5991839227 Enrollment ID: I20100823000135 |
| Provider Name | Neil J Murphy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598878019 PECOS PAC ID: 4082738638 Enrollment ID: I20100902000903 |
| Provider Name | Patricia J Mcloughlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841413317 PECOS PAC ID: 4688798093 Enrollment ID: I20100907000760 |
| Provider Name | Christopher Piromalli |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1861615932 PECOS PAC ID: 1658563846 Enrollment ID: I20101006000525 |
| Provider Name | Michelle A Tschida |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1790016293 PECOS PAC ID: 1759414634 Enrollment ID: I20101203000477 |
| Provider Name | Melissa G Shein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982726485 PECOS PAC ID: 8527255652 Enrollment ID: I20101215000157 |
| Provider Name | Sarah T Truitt |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811971427 PECOS PAC ID: 2365413937 Enrollment ID: I20110331000151 |
| Provider Name | Christopher Wightman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740337864 PECOS PAC ID: 7810038098 Enrollment ID: I20110401000202 |
| Provider Name | Nazly Mofidi |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467648873 PECOS PAC ID: 8325223407 Enrollment ID: I20110505000274 |
| Provider Name | Anne L White |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790895274 PECOS PAC ID: 3375729460 Enrollment ID: I20110526000229 |
| Provider Name | Robin Zigler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831396118 PECOS PAC ID: 5991981086 Enrollment ID: I20110526000255 |
| Provider Name | Amy C Schumacher |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366552820 PECOS PAC ID: 9335326420 Enrollment ID: I20110526000285 |
| Provider Name | Danise Ann Petticrew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952359200 PECOS PAC ID: 2466622121 Enrollment ID: I20110907001173 |
| Provider Name | Kathryn Jacques |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245470210 PECOS PAC ID: 9133391220 Enrollment ID: I20111014000169 |
| Provider Name | Marah Gotcsik |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275723108 PECOS PAC ID: 7810170958 Enrollment ID: I20111114000550 |
| Provider Name | Laurie E Fenderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962625921 PECOS PAC ID: 9032123310 Enrollment ID: I20111221000757 |
| Provider Name | Benjamin P Westley |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1083867592 PECOS PAC ID: 2264600501 Enrollment ID: I20120411000240 |
| Provider Name | Ryan T Mcwilliams |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1013966977 PECOS PAC ID: 4789688193 Enrollment ID: I20120507000642 |
| Provider Name | Shiloh N Small |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871758813 PECOS PAC ID: 1153587829 Enrollment ID: I20120724000861 |
| Provider Name | Roger N Fox |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316172000 PECOS PAC ID: 1759552813 Enrollment ID: I20121003000349 |
| Provider Name | Sarah M Dobbs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548510282 PECOS PAC ID: 4789833658 Enrollment ID: I20121009000724 |
| Provider Name | Amy K Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932442597 PECOS PAC ID: 9234379645 Enrollment ID: I20130709000095 |
| Provider Name | David M Lessens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710111398 PECOS PAC ID: 4789846742 Enrollment ID: I20140206001309 |
| Provider Name | John Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1881018653 PECOS PAC ID: 7012131808 Enrollment ID: I20140618000399 |
| Provider Name | Randall C Zernzach |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730175662 PECOS PAC ID: 9931324514 Enrollment ID: I20140716000576 |
| Provider Name | Ashley L Voigt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215292909 PECOS PAC ID: 3173740388 Enrollment ID: I20140812002239 |
| Provider Name | Daniel Tieva |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639464050 PECOS PAC ID: 5890932792 Enrollment ID: I20140917001663 |
| Provider Name | Jennifer Sass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487057196 PECOS PAC ID: 8426371535 Enrollment ID: I20141222001597 |
| Provider Name | Zachary P Paulson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710388608 PECOS PAC ID: 7012233661 Enrollment ID: I20150226000917 |
| Provider Name | James K. Parietti |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831209451 PECOS PAC ID: 8527159052 Enrollment ID: I20150624001035 |
| Provider Name | Brittany R Haley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598152142 PECOS PAC ID: 7719299411 Enrollment ID: I20150709001351 |
| Provider Name | Matthew S Ubedei |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1962681171 PECOS PAC ID: 3971720954 Enrollment ID: I20150710001908 |
| Provider Name | Angel M. Husher |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548693831 PECOS PAC ID: 4385871532 Enrollment ID: I20150716001220 |
| Provider Name | Raul Angeles |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285017194 PECOS PAC ID: 7911213418 Enrollment ID: I20150828001296 |
| Provider Name | Theresa Bartoldus |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1871991661 PECOS PAC ID: 9931417029 Enrollment ID: I20151009002263 |
| Provider Name | Melissa Rs Tondre |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295034536 PECOS PAC ID: 7618108762 Enrollment ID: I20151015000130 |
| Provider Name | Kassy J Swanson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609128941 PECOS PAC ID: 1153630603 Enrollment ID: I20151022002500 |
| Provider Name | Luanna L Beauchamp |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740224286 PECOS PAC ID: 0749211720 Enrollment ID: I20151106000277 |
| Provider Name | Marissa Gonzalez James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811312721 PECOS PAC ID: 5597998682 Enrollment ID: I20151119001624 |
| Provider Name | Margaret E Carlson Cosentino |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1568722197 PECOS PAC ID: 3375868029 Enrollment ID: I20160205000129 |
| Provider Name | Mackenzie C Slater |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730409418 PECOS PAC ID: 1254594815 Enrollment ID: I20160219000825 |
| Provider Name | Molly Rothmeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639238652 PECOS PAC ID: 0547458309 Enrollment ID: I20160421000227 |
| Provider Name | Jennifer L Scholl |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1669457362 PECOS PAC ID: 6305731449 Enrollment ID: I20160602000514 |
| Provider Name | Logan J Duerksen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407260268 PECOS PAC ID: 7517182314 Enrollment ID: I20160628000138 |
| Provider Name | Marie Gessel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710151196 PECOS PAC ID: 4587989181 Enrollment ID: I20160721001211 |
| Provider Name | Elisabeth M Harding |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316387541 PECOS PAC ID: 6507159431 Enrollment ID: I20160729000262 |
| Provider Name | Paige Ann Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982051728 PECOS PAC ID: 0749574325 Enrollment ID: I20160804000502 |
| Provider Name | Kristen M Stille |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801078100 PECOS PAC ID: 2769644467 Enrollment ID: I20160830000338 |
| Provider Name | Reinou Sybrecht Groen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740540517 PECOS PAC ID: 3072800119 Enrollment ID: I20160917000203 |
| Provider Name | Linda Ann Hodson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689732661 PECOS PAC ID: 3779651476 Enrollment ID: I20160922000191 |
| Provider Name | Rose N Laignel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609139997 PECOS PAC ID: 1254633936 Enrollment ID: I20160926000519 |
| Provider Name | Christine Amy Hallas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538614722 PECOS PAC ID: 8820386469 Enrollment ID: I20161013001571 |
| Provider Name | Sean M Franey |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1750838843 PECOS PAC ID: 9335427350 Enrollment ID: I20161026001910 |
| Provider Name | Wendi Suzette Alejandre |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1891233136 PECOS PAC ID: 3971888355 Enrollment ID: I20170327002427 |
| Provider Name | David C Ogilbee |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811311970 PECOS PAC ID: 5496032609 Enrollment ID: I20170425002600 |
| Provider Name | Dustin Bergerson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588947055 PECOS PAC ID: 2668740549 Enrollment ID: I20170617000046 |
| Provider Name | Alati M Wasson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225447915 PECOS PAC ID: 7810266780 Enrollment ID: I20170708000037 |
| Provider Name | Michael J Nasenbeny |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578974119 PECOS PAC ID: 6507171634 Enrollment ID: I20170824000314 |
| Provider Name | Anna Jo Pfahl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083033435 PECOS PAC ID: 9234403338 Enrollment ID: I20170927002623 |
| Provider Name | Micah W Willis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659567832 PECOS PAC ID: 5294804597 Enrollment ID: I20170929001950 |
| Provider Name | Jennifer R Perkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528478716 PECOS PAC ID: 7719290865 Enrollment ID: I20171003004997 |
| Provider Name | Maria Cristy Murray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538607403 PECOS PAC ID: 0143597500 Enrollment ID: I20171010000515 |
| Provider Name | Kathryn A Paulson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1790957827 PECOS PAC ID: 9537425723 Enrollment ID: I20171103000305 |
| Provider Name | Tirza A Cannon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275842510 PECOS PAC ID: 1759607013 Enrollment ID: I20171107001045 |
| Provider Name | Melodie K Isgro |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1528094968 PECOS PAC ID: 9830166933 Enrollment ID: I20171107001103 |
| Provider Name | Robyn Amonda Mette |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1689184483 PECOS PAC ID: 0042576753 Enrollment ID: I20171114001053 |
| Provider Name | Adam J Tudor |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1881084754 PECOS PAC ID: 5294054730 Enrollment ID: I20171206002950 |
| Provider Name | Alina Nicole Schneider |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780793448 PECOS PAC ID: 6507058682 Enrollment ID: I20171211001155 |
| Provider Name | Calvin W Gabel |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1053660084 PECOS PAC ID: 1456502178 Enrollment ID: I20171214000255 |
| Provider Name | Sarah E Ferroni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679081889 PECOS PAC ID: 4789944539 Enrollment ID: I20180216000375 |
| Provider Name | Virginia Elizabeth Hunter |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1215291208 PECOS PAC ID: 4880903970 Enrollment ID: I20180801001430 |
| Provider Name | Christina Rodriguez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255621165 PECOS PAC ID: 7416189139 Enrollment ID: I20180815001155 |
| Provider Name | Alexandra Wegner |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639684616 PECOS PAC ID: 5597014613 Enrollment ID: I20180823001143 |
| Provider Name | Valerie Laine Unrein |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1841708435 PECOS PAC ID: 7012267578 Enrollment ID: I20180904000988 |
| Provider Name | Susan Lynn Steffans |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1326298175 PECOS PAC ID: 6406989326 Enrollment ID: I20180906002655 |
| Provider Name | Crystal Anne Sharon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326277013 PECOS PAC ID: 0446423917 Enrollment ID: I20181016000798 |
| Provider Name | Elizabeth C Turgeon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013966795 PECOS PAC ID: 0547158503 Enrollment ID: I20181017000600 |
| Provider Name | Anjali Dhir Madeira |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1508343153 PECOS PAC ID: 4789938457 Enrollment ID: I20181115001214 |
| Provider Name | Katherine Weathers |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508274820 PECOS PAC ID: 3870714876 Enrollment ID: I20181120000617 |
| Provider Name | Kendra Lorraine Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386143501 PECOS PAC ID: 1456605732 Enrollment ID: I20181127000650 |
| Provider Name | Rebecca Rae Weicht |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295091239 PECOS PAC ID: 7214167006 Enrollment ID: I20190205002280 |
| Provider Name | Jamie Ann Popham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841513389 PECOS PAC ID: 2668712969 Enrollment ID: I20190325000743 |
| Provider Name | Christine Maura Daly |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649380684 PECOS PAC ID: 9133124373 Enrollment ID: I20190416000937 |
| Provider Name | Regina Marie Swanson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1205230026 PECOS PAC ID: 7315261179 Enrollment ID: I20190509000607 |
| Provider Name | Dana L Webster-smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326407479 PECOS PAC ID: 7911230164 Enrollment ID: I20190604000581 |
| Provider Name | Jessica Ruth Moreland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063817526 PECOS PAC ID: 6507199387 Enrollment ID: I20190611000161 |
| Provider Name | Karl Alu Tieva |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497044507 PECOS PAC ID: 3779705793 Enrollment ID: I20190628001142 |
| Provider Name | Tarah Ruth Desatoff |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1497317168 PECOS PAC ID: 1557698511 Enrollment ID: I20190814000048 |
| Provider Name | Toni May Kehaulani Taylor |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1609420538 PECOS PAC ID: 2163750506 Enrollment ID: I20190823000716 |
| Provider Name | Colleen Slate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922246503 PECOS PAC ID: 0547317125 Enrollment ID: I20190826000564 |
| Provider Name | Dwight A Parker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457713612 PECOS PAC ID: 1254697782 Enrollment ID: I20190918002669 |
| Provider Name | Jolie A Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225683709 PECOS PAC ID: 9931431491 Enrollment ID: I20191101001508 |
| Provider Name | Jonathan Eden Benaknin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992987655 PECOS PAC ID: 0143493106 Enrollment ID: I20191121000726 |
| Provider Name | Alfred Swanson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932550738 PECOS PAC ID: 3375836141 Enrollment ID: I20200121001918 |
| Provider Name | Tracey L Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306247796 PECOS PAC ID: 4284926254 Enrollment ID: I20200128000038 |
| Provider Name | Allison Michelle Hillen |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1356964662 PECOS PAC ID: 4183046105 Enrollment ID: I20200622000767 |
| Provider Name | Janelle N Nakea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033603261 PECOS PAC ID: 1759610322 Enrollment ID: I20200728002615 |
| Provider Name | Shahid Abbas Zaidi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851370084 PECOS PAC ID: 4789866138 Enrollment ID: I20200826002121 |
| Provider Name | Amanda L Ruff |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1043859127 PECOS PAC ID: 9335567312 Enrollment ID: I20200909000278 |
| Provider Name | Tanya Darlene Sena |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770898025 PECOS PAC ID: 6709296791 Enrollment ID: I20201103000558 |
| Provider Name | Katie Michelle Millican |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1871986745 PECOS PAC ID: 3870881907 Enrollment ID: I20201214002928 |
| Provider Name | Allison Phillips Moe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447857875 PECOS PAC ID: 8426461690 Enrollment ID: I20210107000286 |
| Provider Name | Carlos A Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023590023 PECOS PAC ID: 3476966334 Enrollment ID: I20210113002704 |
| Provider Name | Lisa Kay Stimpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558986521 PECOS PAC ID: 6709292998 Enrollment ID: I20210315000114 |
| Provider Name | Shelley Foley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417585902 PECOS PAC ID: 9335559038 Enrollment ID: I20210409000375 |
| Provider Name | Laura Crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588163794 PECOS PAC ID: 4688938210 Enrollment ID: I20210428000150 |
| Provider Name | Sarah Keeley Sjostedt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437671039 PECOS PAC ID: 8022380690 Enrollment ID: I20210622001476 |
| Provider Name | Kimberly Fleming |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1780111559 PECOS PAC ID: 3375877285 Enrollment ID: I20210701001028 |
| Provider Name | Theresa K Kennon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962523530 PECOS PAC ID: 1759324171 Enrollment ID: I20210712000926 |
| Provider Name | Kaveri Bharti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912514647 PECOS PAC ID: 6103229653 Enrollment ID: I20210722000058 |
| Provider Name | Cherie L. Wagahoft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497015838 PECOS PAC ID: 9335542695 Enrollment ID: I20210723001090 |
| Provider Name | Luigia Rosella Goodman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205306420 PECOS PAC ID: 8224457353 Enrollment ID: I20210728000180 |
| Provider Name | Rachel Perry |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1821556036 PECOS PAC ID: 0042613010 Enrollment ID: I20210728002348 |
| Provider Name | Emily Margaret Reilly |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063916815 PECOS PAC ID: 8527315779 Enrollment ID: I20210804000187 |
| Provider Name | Mary Elizabeth Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265074454 PECOS PAC ID: 9133554462 Enrollment ID: I20210813002022 |
| Provider Name | Sara Joy Risi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710319496 PECOS PAC ID: 1951799782 Enrollment ID: I20211028001120 |
| Provider Name | Julia Swayne |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1710499942 PECOS PAC ID: 9537429881 Enrollment ID: I20211103001383 |
| Provider Name | Matthew Gerard Pascual |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1477059079 PECOS PAC ID: 3375931785 Enrollment ID: I20211103002185 |
| Provider Name | Mary Mcquilkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518361898 PECOS PAC ID: 1254642838 Enrollment ID: I20220223001382 |
| Provider Name | Autumn M'rinn Tinajero |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1649766478 PECOS PAC ID: 2769733849 Enrollment ID: I20220413000354 |
| Provider Name | Lindsey Ellise Wilkens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043986714 PECOS PAC ID: 8022495035 Enrollment ID: I20220512002261 |
| Provider Name | Paul Andrew Young |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922532472 PECOS PAC ID: 1456623859 Enrollment ID: I20220712001499 |
| Provider Name | William H Freeman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1104997881 PECOS PAC ID: 8729143938 Enrollment ID: I20220714003348 |
| Provider Name | Gabriella Emilia Timuscuk |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912676909 PECOS PAC ID: 7113308651 Enrollment ID: I20220715000236 |
| Provider Name | Kayla Skye Rowe |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1487388732 PECOS PAC ID: 3870975360 Enrollment ID: I20220730000317 |
| Provider Name | Thomas Anthony Robinson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1184199754 PECOS PAC ID: 0143555763 Enrollment ID: I20220810001472 |
| Provider Name | Cara L Wolfe |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1235878166 PECOS PAC ID: 7719360494 Enrollment ID: I20220812000585 |
| Provider Name | Rachelle S Yang |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972252898 PECOS PAC ID: 6204219959 Enrollment ID: I20220813000488 |
| Provider Name | Bethany N Neubarth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124511043 PECOS PAC ID: 5799116463 Enrollment ID: I20220823003361 |
| Provider Name | Mendy Ann Southard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336644947 PECOS PAC ID: 7416331020 Enrollment ID: I20220831002080 |
| Provider Name | Christian Michael Pankhurst |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1740917145 PECOS PAC ID: 4981088218 Enrollment ID: I20220905000228 |
| Provider Name | Megan S. Aspelund |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184111817 PECOS PAC ID: 2163810029 Enrollment ID: I20220909001848 |
| Provider Name | Martha Jane Moore |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1053418921 PECOS PAC ID: 0143368126 Enrollment ID: I20220927001704 |
| Provider Name | Jessica Leigh Akin |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1003497702 PECOS PAC ID: 6204212244 Enrollment ID: I20220929000041 |
| Provider Name | Mallory Lorraine Reeves |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1295451136 PECOS PAC ID: 5395111736 Enrollment ID: I20221026001137 |
| Provider Name | Corrie Leigh Poelman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912403858 PECOS PAC ID: 3870849300 Enrollment ID: I20221027000208 |
| Provider Name | Erika Leigh Pierce |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1154860781 PECOS PAC ID: 6608152970 Enrollment ID: I20221109000590 |
| Provider Name | Sarah Switzer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912281460 PECOS PAC ID: 4880061555 Enrollment ID: I20221109002011 |
| Provider Name | Estrella Molle |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619479748 PECOS PAC ID: 9032587316 Enrollment ID: I20221117000231 |
| Provider Name | Valerie Louise Schmitz |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1376878991 PECOS PAC ID: 5890163901 Enrollment ID: I20221122000242 |
| Provider Name | Jacob Burns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285359711 PECOS PAC ID: 7012386121 Enrollment ID: I20221213000796 |
| Provider Name | Tina Elaine Audie |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477947679 PECOS PAC ID: 8729392139 Enrollment ID: I20230118000609 |
| Provider Name | Rebekah Grace Briscoe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861481210 PECOS PAC ID: 9133301500 Enrollment ID: I20230119000846 |
| Provider Name | Thomas Robert Harding |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194837336 PECOS PAC ID: 8527075787 Enrollment ID: I20230119003096 |
| Provider Name | Desiree Lynn Hilborn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578184693 PECOS PAC ID: 5597186403 Enrollment ID: I20230215000401 |
| Provider Name | Jazmin Nicole Taylor |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437709235 PECOS PAC ID: 1456723626 Enrollment ID: I20230216001197 |
| Provider Name | Raina Pasiewicz |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1033816905 PECOS PAC ID: 0446623045 Enrollment ID: I20230301002713 |
| Provider Name | Jordan Nicole Spargo |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1669907093 PECOS PAC ID: 2668845892 Enrollment ID: I20230308002340 |
| Provider Name | Samantha Maloney |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1104582501 PECOS PAC ID: 4688048499 Enrollment ID: I20230317002016 |
| Provider Name | Priscilla Marble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588304554 PECOS PAC ID: 2961876511 Enrollment ID: I20230321002732 |
| Provider Name | James Stephen Roberts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669874541 PECOS PAC ID: 4688968084 Enrollment ID: I20230615000079 |
| Provider Name | Jasmine Ardeshir Hamid |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1851679716 PECOS PAC ID: 2062719685 Enrollment ID: I20230710001365 |
| Provider Name | James Aubrey Underwood |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629634563 PECOS PAC ID: 2567824212 Enrollment ID: I20230814001094 |
| Provider Name | Brian E Thomas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174601652 PECOS PAC ID: 0547150443 Enrollment ID: I20230814002419 |
| Provider Name | Michele L Hines |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194797191 PECOS PAC ID: 2668456815 Enrollment ID: I20230816000609 |
| Provider Name | Carly Craig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295356178 PECOS PAC ID: 7113340324 Enrollment ID: I20230822000633 |
| Provider Name | Holli Blake |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417518143 PECOS PAC ID: 7719340652 Enrollment ID: I20230825000942 |
| Provider Name | Andrea Farmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588141741 PECOS PAC ID: 5496095929 Enrollment ID: I20230905002051 |
| Provider Name | Anne Gray |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093876674 PECOS PAC ID: 1052683703 Enrollment ID: I20230906000037 |
| Provider Name | Yiwei Pan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912783929 PECOS PAC ID: 1254785462 Enrollment ID: I20230921002478 |
| Provider Name | Rebekah Villalon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356718738 PECOS PAC ID: 1355795048 Enrollment ID: I20230928003886 |
| Provider Name | Emily Cutting Sanchez |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669749610 PECOS PAC ID: 6305290958 Enrollment ID: I20230929003001 |
| Provider Name | Jolene Danielle Sletten |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1801362132 PECOS PAC ID: 9638523046 Enrollment ID: I20231003002151 |
| Provider Name | Laura Spano |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1134708431 PECOS PAC ID: 4486009941 Enrollment ID: I20231018002871 |
| Provider Name | Thor J Wocasek |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326197989 PECOS PAC ID: 3870941354 Enrollment ID: I20231121003190 |
| Provider Name | Arielle Joanna Niederer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669102216 PECOS PAC ID: 4385092675 Enrollment ID: I20231127003255 |
| Provider Name | Lara Church |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043280449 PECOS PAC ID: 8628236759 Enrollment ID: I20231201002393 |
| Provider Name | Phillip Mendoza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760681761 PECOS PAC ID: 7416081625 Enrollment ID: I20231205001269 |
| Provider Name | Bahiyyih Young |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124577499 PECOS PAC ID: 4981052438 Enrollment ID: I20231207000900 |
| Provider Name | Erik Shamus Sooy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083017818 PECOS PAC ID: 1759730377 Enrollment ID: I20231207003706 |
| Provider Name | Troy Edward Wolcoff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457605206 PECOS PAC ID: 2769831254 Enrollment ID: I20231208002636 |
| Provider Name | Heather Skelton-frye |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760016158 PECOS PAC ID: 6002264389 Enrollment ID: I20231228001493 |
| Provider Name | Santhia Lisa Rose |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1194305730 PECOS PAC ID: 3476954843 Enrollment ID: I20240228001643 |
| Provider Name | Brent Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952830226 PECOS PAC ID: 6901137199 Enrollment ID: I20240304000228 |
| Provider Name | Mackenzie Moses |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598321895 PECOS PAC ID: 9032554647 Enrollment ID: I20240305001046 |
| Provider Name | Kathleen Rutherford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275949034 PECOS PAC ID: 4486031788 Enrollment ID: I20240320002894 |
| Provider Name | Rebecca Elizabeth Widmer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194381434 PECOS PAC ID: 6305283441 Enrollment ID: I20240325001804 |
| Provider Name | Cassie Stenehjem |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093239378 PECOS PAC ID: 3779920798 Enrollment ID: I20240326000915 |
| Provider Name | Kim Trevino |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659910032 PECOS PAC ID: 6204274608 Enrollment ID: I20240404001118 |
| Provider Name | Torrance Fishburn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609347525 PECOS PAC ID: 2961840368 Enrollment ID: I20240404001413 |
| Provider Name | Janet Lynn Wilkinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912130238 PECOS PAC ID: 1557403813 Enrollment ID: I20240408001572 |
| Provider Name | Sierra Rose Stevens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114062270 PECOS PAC ID: 0749624484 Enrollment ID: I20240410003095 |
| Provider Name | Rachel Adams Minick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821859026 PECOS PAC ID: 9537505904 Enrollment ID: I20240411000976 |
| Provider Name | Elizabeth Tahirih Young-ortiz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790078251 PECOS PAC ID: 8224477120 Enrollment ID: I20240411001773 |
| Provider Name | Kimberly Cassie Wood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073005237 PECOS PAC ID: 2769821693 Enrollment ID: I20240411003323 |
| Provider Name | Veronica Spearing |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891919866 PECOS PAC ID: 0345404828 Enrollment ID: I20240422000476 |
| Provider Name | Keri Lynn Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407216831 PECOS PAC ID: 1153629787 Enrollment ID: I20240422002237 |
| Provider Name | Amanda Marie Barlow |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841678521 PECOS PAC ID: 3375983596 Enrollment ID: I20240503002795 |
| Provider Name | Miyuki Sato-yazaki |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487881033 PECOS PAC ID: 5698116531 Enrollment ID: I20240509002704 |
| Provider Name | Mallory Wetherington |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053050443 PECOS PAC ID: 1557702149 Enrollment ID: I20240514002125 |
| Provider Name | Julia K Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740339761 PECOS PAC ID: 2163592056 Enrollment ID: I20240521002221 |
| Provider Name | Kim Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518721554 PECOS PAC ID: 3971045956 Enrollment ID: I20240605002359 |
| Provider Name | Kathryn Patricia Pennington |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1336265511 PECOS PAC ID: 5496949703 Enrollment ID: I20240607000180 |
| Provider Name | Joel Renna |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124404850 PECOS PAC ID: 0244772077 Enrollment ID: I20240609000000 |
| Provider Name | Augustine Graham O'malley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962022558 PECOS PAC ID: 2163844804 Enrollment ID: I20240611000024 |
| Provider Name | Heather Lee Tichenor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184257511 PECOS PAC ID: 9537601034 Enrollment ID: I20240612002408 |
| Provider Name | Cydni Marie Shearer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1477397966 PECOS PAC ID: 9032653084 Enrollment ID: I20240701002861 |
| Provider Name | Kristerra Yawea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154897429 PECOS PAC ID: 3971849365 Enrollment ID: I20240703000635 |
| Provider Name | Lucas Allen Rowley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225129828 PECOS PAC ID: 0749728046 Enrollment ID: I20240819000561 |
| Provider Name | Alexandria Vincent |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1881287100 PECOS PAC ID: 8022556232 Enrollment ID: I20240820000761 |
| Provider Name | Maria Zarif |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073132593 PECOS PAC ID: 6709325764 Enrollment ID: I20240822002420 |
| Provider Name | Tyler Ryan Stoltz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700236049 PECOS PAC ID: 3476836826 Enrollment ID: I20240822002591 |
| Provider Name | Hannah G Stoltz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295395689 PECOS PAC ID: 6709325616 Enrollment ID: I20240823000016 |
| Provider Name | Lindsey Christine Wagner |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1699510156 PECOS PAC ID: 4880133461 Enrollment ID: I20240827002956 |
| Provider Name | Kirsten Marie Petron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902421118 PECOS PAC ID: 9234670142 Enrollment ID: I20240919000227 |
| Provider Name | Kimberly Mitcham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720451297 PECOS PAC ID: 1153623665 Enrollment ID: I20240919000448 |
| Provider Name | Anjoilyn Ladrido Vreeland |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669235750 PECOS PAC ID: 7012458631 Enrollment ID: I20240924000636 |
| Provider Name | Christian Wilfred Thomas Garrett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831626225 PECOS PAC ID: 9537690680 Enrollment ID: I20241001001643 |
| Provider Name | Inga Irene Runstrom |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1235968538 PECOS PAC ID: 5193257012 Enrollment ID: I20241017000224 |
| Provider Name | Anna Katrena Sappah |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598327074 PECOS PAC ID: 8022461680 Enrollment ID: I20241021003535 |
| Provider Name | Eli Alexander Woods Oates |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487765186 PECOS PAC ID: 0244381705 Enrollment ID: I20241022000560 |
| Provider Name | Margaret Power |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255968533 PECOS PAC ID: 5698196111 Enrollment ID: I20241023000151 |
| Provider Name | Heather Corrine Waite |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1629646773 PECOS PAC ID: 8426581885 Enrollment ID: I20241024001171 |
| Provider Name | Collin Thomas Atkinson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942754742 PECOS PAC ID: 0143508275 Enrollment ID: I20241105001605 |
| Provider Name | Emily Atton |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1588182745 PECOS PAC ID: 4183089758 Enrollment ID: I20241111002043 |
| Provider Name | Elizabeth Linxwiler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043779838 PECOS PAC ID: 8820478175 Enrollment ID: I20241114000024 |
| Provider Name | Ara Dadivanyan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962029306 PECOS PAC ID: 2567999030 Enrollment ID: I20241223000057 |
| Provider Name | Fulani Noni Sutherland |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184127664 PECOS PAC ID: 9739616152 Enrollment ID: I20241226001025 |
| Provider Name | Margaret Elizabeth Van Huystee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669184321 PECOS PAC ID: 8820525918 Enrollment ID: I20250101000054 |
| Provider Name | Madeline Rosenberger |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1790591014 PECOS PAC ID: 2466980487 Enrollment ID: I20250103001977 |
| Provider Name | Lisa Diane Rapallo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437341997 PECOS PAC ID: 8325577018 Enrollment ID: I20250124002167 |
| Provider Name | Troy Mcgill |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083636088 PECOS PAC ID: 8729269436 Enrollment ID: I20250130001931 |
| Provider Name | David Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922703818 PECOS PAC ID: 2264896166 Enrollment ID: I20250130002607 |
| Provider Name | Ariel Nicole Moilanen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801400494 PECOS PAC ID: 9830619121 Enrollment ID: I20250217002109 |
| Provider Name | Joseph Elendil Piper |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1861102337 PECOS PAC ID: 3476073248 Enrollment ID: I20250224001599 |
| Provider Name | Amber Marie Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558947796 PECOS PAC ID: 7618497405 Enrollment ID: I20250224002603 |
| Provider Name | Evelyn Patricia Mujica-larson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508149766 PECOS PAC ID: 8123548799 Enrollment ID: I20250226001134 |
| Provider Name | Rachel Debauche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508697749 PECOS PAC ID: 0244750784 Enrollment ID: I20250227000297 |
| Provider Name | Megan Hayes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336611698 PECOS PAC ID: 6406192053 Enrollment ID: I20250228000058 |
| Provider Name | Maria Ann Rollins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689971756 PECOS PAC ID: 0446771653 Enrollment ID: I20250304003140 |
Southcentral Foundation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Dnr Road, Mcgrath, AK 99627 Phone: 907-524-3299 |