| Bsd - Mcgrath | |
|
10 Dnr Road Mcgrath AK 99627 | |
| (907) 524-3299 | |
| Not Available |
| Full Name | Bsd - Mcgrath |
|---|---|
| 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 |
|---|---|
| Bsd - Mcgrath Po Box 35198 Seattle WA 98124-5198 | Bsd - Mcgrath 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 | Ingrid M Carlson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457368722 PECOS PAC ID: 6103810049 Enrollment ID: I20040413000834 |
| 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 | 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 | Jasen R Thompson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033226998 PECOS PAC ID: 8628015997 Enrollment ID: I20050408000792 |
| 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 | Julie D Mueller |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831205665 PECOS PAC ID: 8527096759 Enrollment ID: I20050729000428 |
| Provider Name | Matthew J Hirschfeld |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679683213 PECOS PAC ID: 3072547124 Enrollment ID: I20050919001045 |
| Provider Name | Annalissa T. Ogena |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437269925 PECOS PAC ID: 0648161471 Enrollment ID: I20051020000524 |
| 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 | Thai G Verzone |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1679534721 PECOS PAC ID: 4183645203 Enrollment ID: I20051215000777 |
| Provider Name | Tamra Jean Wright |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1568680437 PECOS PAC ID: 8628085776 Enrollment ID: I20060314000498 |
| Provider Name | Jonathan P Casurella |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609959410 PECOS PAC ID: 9032127220 Enrollment ID: I20060329000731 |
| 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 | Katharine a Andre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023187580 PECOS PAC ID: 8820005598 Enrollment ID: I20061214000547 |
| Provider Name | Robin M Cope |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255498614 PECOS PAC ID: 0941302194 Enrollment ID: I20070219000750 |
| 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 Jewell Norris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841276102 PECOS PAC ID: 5395849558 Enrollment ID: I20070327000620 |
| Provider Name | James R Schmid |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437160496 PECOS PAC ID: 3072611300 Enrollment ID: I20070608000514 |
| Provider Name | Ruth S Alvarez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194815126 PECOS PAC ID: 6204931801 Enrollment ID: I20070626000802 |
| 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 | Stephanie L Eklund |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982617130 PECOS PAC ID: 4183724792 Enrollment ID: I20070711001015 |
| Provider Name | Jana L Linfield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669693560 PECOS PAC ID: 2466546346 Enrollment ID: I20070922000241 |
| Provider Name | Susan Mermelstein |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1841315124 PECOS PAC ID: 2062509086 Enrollment ID: I20071107000329 |
| Provider Name | Susan a Bryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568650950 PECOS PAC ID: 7618057407 Enrollment ID: I20080107000343 |
| Provider Name | Robin L Molsberry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922111434 PECOS PAC ID: 8921189440 Enrollment ID: I20080122000616 |
| Provider Name | Molly J Bartel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134302144 PECOS PAC ID: 9931283892 Enrollment ID: I20080301000092 |
| 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 | Verlyn L Corbett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811009962 PECOS PAC ID: 0941389308 Enrollment ID: I20080509000415 |
| Provider Name | Denise Ann Kolojejchick Coslett |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1265601363 PECOS PAC ID: 5799679692 Enrollment ID: I20080715000796 |
| Provider Name | Juanita H Luna-greene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407069388 PECOS PAC ID: 9436222882 Enrollment ID: I20080718000302 |
| 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 | Carla M Laos |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134278476 PECOS PAC ID: 5991865057 Enrollment ID: I20081119000157 |
| Provider Name | Lindsay L Wood |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1568637536 PECOS PAC ID: 0941362982 Enrollment ID: I20081229000369 |
| 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 | Emily Catherine Long |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891946943 PECOS PAC ID: 0244387512 Enrollment ID: I20090402000691 |
| Provider Name | Matthew J Malouf |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1629214226 PECOS PAC ID: 5496802076 Enrollment ID: I20090416000725 |
| 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 | Amber R Beardslee |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1407089162 PECOS PAC ID: 3971649948 Enrollment ID: I20091005000473 |
| Provider Name | Sue E Christiansen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1447267646 PECOS PAC ID: 2365580412 Enrollment ID: I20091110000299 |
| Provider Name | Julie M Castle |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407997356 PECOS PAC ID: 8022159342 Enrollment ID: I20100108000722 |
| Provider Name | Ferritha a Leoncio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831300268 PECOS PAC ID: 0648311969 Enrollment ID: I20100108000737 |
| Provider Name | Daniel J Hartman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114130903 PECOS PAC ID: 2860534922 Enrollment ID: I20100127000860 |
| Provider Name | Cathy a Desanto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497818181 PECOS PAC ID: 5799812780 Enrollment ID: I20100422001060 |
| Provider Name | Molly C Rutledge |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1861623266 PECOS PAC ID: 1850425083 Enrollment ID: I20100810000704 |
| 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 | Martha Cotten |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528170677 PECOS PAC ID: 9537181243 Enrollment ID: I20100826001072 |
| Provider Name | Clare Lattimore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558347989 PECOS PAC ID: 7214025550 Enrollment ID: I20100901000833 |
| Provider Name | Patricia J Mcloughlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841413317 PECOS PAC ID: 4688798093 Enrollment ID: I20100907000760 |
| Provider Name | Janet a Froeschle |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1306859566 PECOS PAC ID: 2668596099 Enrollment ID: I20100907001057 |
| Provider Name | Olegario X Carrillo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417946039 PECOS PAC ID: 8527057066 Enrollment ID: I20100927000270 |
| Provider Name | Katherine L Schneider |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033226063 PECOS PAC ID: 8628260064 Enrollment ID: I20101004001437 |
| 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 | Sherry D Nelson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528250826 PECOS PAC ID: 2365502226 Enrollment ID: I20110531000515 |
| Provider Name | Danise Ann Petticrew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952359200 PECOS PAC ID: 2466622121 Enrollment ID: I20110907001173 |
| Provider Name | Rachel Kerford Lescher |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043480643 PECOS PAC ID: 7517138480 Enrollment ID: I20110926000584 |
| 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 | Genevieve John |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1245482348 PECOS PAC ID: 8729262480 Enrollment ID: I20120423000526 |
| Provider Name | Ryan T Mcwilliams |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1013966977 PECOS PAC ID: 4789688193 Enrollment ID: I20120507000642 |
| Provider Name | Cordellia Sewall |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1295019248 PECOS PAC ID: 5799946844 Enrollment ID: I20120530000019 |
| Provider Name | Shiloh N Small |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871758813 PECOS PAC ID: 1153587829 Enrollment ID: I20120724000861 |
| Provider Name | Leanne K Komorowski |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700045648 PECOS PAC ID: 9234385030 Enrollment ID: I20120810000177 |
| 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 | Erin P Carrick |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1568712719 PECOS PAC ID: 9931352259 Enrollment ID: I20130116000296 |
| Provider Name | Amy Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932442597 PECOS PAC ID: 9234379645 Enrollment ID: I20130709000095 |
| Provider Name | Shane M Coleman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083819692 PECOS PAC ID: 5597933291 Enrollment ID: I20130716000445 |
| Provider Name | Christopher J Haupt-chronister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184067027 PECOS PAC ID: 0042451825 Enrollment ID: I20130719000473 |
| Provider Name | Matthew a Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437402278 PECOS PAC ID: 1052554896 Enrollment ID: I20130827000557 |
| Provider Name | Juliana Abreu |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083058408 PECOS PAC ID: 9234372863 Enrollment ID: I20130830000134 |
| Provider Name | Krista Mccoy Warner Cook |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1265787774 PECOS PAC ID: 5193954949 Enrollment ID: I20140128000335 |
| Provider Name | David M Lessens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710111398 PECOS PAC ID: 4789846742 Enrollment ID: I20140206001309 |
| Provider Name | Jon W Haney |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659618197 PECOS PAC ID: 1355571258 Enrollment ID: I20140219001977 |
| 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 | James W Henkelman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700056975 PECOS PAC ID: 3577639426 Enrollment ID: I20140908000728 |
| Provider Name | Diana Ray Weinstein |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083869416 PECOS PAC ID: 5597984476 Enrollment ID: I20140909001195 |
| Provider Name | Daniel Tieva |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639464050 PECOS PAC ID: 5890932792 Enrollment ID: I20140917001663 |
| Provider Name | Whitney E Elliott |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891006656 PECOS PAC ID: 8224272562 Enrollment ID: I20141013001176 |
| Provider Name | Anna D Frisby |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831431063 PECOS PAC ID: 7315168911 Enrollment ID: I20141023002492 |
| Provider Name | Georgia Kubic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235429655 PECOS PAC ID: 7911139761 Enrollment ID: I20141203000295 |
| Provider Name | Jennifer Sass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487057196 PECOS PAC ID: 8426371535 Enrollment ID: I20141222001597 |
| Provider Name | Kristi L. Murray |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1982877692 PECOS PAC ID: 9830166115 Enrollment ID: I20141222002530 |
| Provider Name | Allison Lindsey Critchlow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437392180 PECOS PAC ID: 7416120241 Enrollment ID: I20141229000151 |
| Provider Name | Melissa D Porter |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1295131415 PECOS PAC ID: 1052637709 Enrollment ID: I20150224001711 |
| 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 | Michael D. Dennis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356505820 PECOS PAC ID: 2466517032 Enrollment ID: I20150424000265 |
| 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 | Vinh Tran Tunley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205809878 PECOS PAC ID: 2466476304 Enrollment ID: I20150701001891 |
| Provider Name | Brian Thomas Boden |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316938673 PECOS PAC ID: 1052364858 Enrollment ID: I20150706001627 |
| 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 Beauchamp |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740224286 PECOS PAC ID: 0749211720 Enrollment ID: I20151106000277 |
| Provider Name | Patricia Capo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588862684 PECOS PAC ID: 1951571140 Enrollment ID: I20151119000431 |
| Provider Name | Marissa Gonzalez James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811312721 PECOS PAC ID: 5597998682 Enrollment ID: I20151119001624 |
| Provider Name | Carlene Boden |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235128349 PECOS PAC ID: 4880646785 Enrollment ID: I20160125001913 |
| Provider Name | Gilia M Degange |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740559491 PECOS PAC ID: 7517260599 Enrollment ID: I20160126000454 |
| 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 | Dana Damron |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093826828 PECOS PAC ID: 8921015363 Enrollment ID: I20160209000038 |
| Provider Name | Jordan Aimee Elizabeth Manelick |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1871903955 PECOS PAC ID: 1658675731 Enrollment ID: I20160210001371 |
| Provider Name | Mackenzie C Slater |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730409418 PECOS PAC ID: 1254594815 Enrollment ID: I20160219000825 |
| Provider Name | Jacquelyn K Russell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639156268 PECOS PAC ID: 4284722638 Enrollment ID: I20160316000239 |
| Provider Name | Terrin L Holliman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184055600 PECOS PAC ID: 2365671682 Enrollment ID: I20160412001004 |
| 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 | Robert Bidwell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1215915236 PECOS PAC ID: 5294016523 Enrollment ID: I20161229000124 |
| Provider Name | Patricia J Cushman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932272531 PECOS PAC ID: 2163655226 Enrollment ID: I20170214000855 |
| Provider Name | Lara Vanhoozer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972041069 PECOS PAC ID: 2961786991 Enrollment ID: I20170310001436 |
| 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 | 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 | Meera Davenport |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093113904 PECOS PAC ID: 1658655360 Enrollment ID: I20170728000493 |
| 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 | Rona Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164944229 PECOS PAC ID: 8022383090 Enrollment ID: I20171002003355 |
| Provider Name | Jennifer R Mulkey |
|---|---|
| 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 | Lilian K Ho |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659798114 PECOS PAC ID: 4981925476 Enrollment ID: I20171020000831 |
| Provider Name | Amber Nicole Langston |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437517877 PECOS PAC ID: 2961708805 Enrollment ID: I20171020002289 |
| Provider Name | Megan K Hallock |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346765708 PECOS PAC ID: 6709152192 Enrollment ID: I20171031001184 |
| 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 | Shannon Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679029953 PECOS PAC ID: 7719243625 Enrollment ID: I20171109001300 |
| Provider Name | Robyn Amonda Mette |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1689184483 PECOS PAC ID: 0042576753 Enrollment ID: I20171114001053 |
| Provider Name | Connie I Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538139027 PECOS PAC ID: 1355233313 Enrollment ID: I20171116002520 |
| Provider Name | Margaret Olin Hoffman David |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1497272447 PECOS PAC ID: 0941567903 Enrollment ID: I20171129000907 |
| 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 | Javier Fernando Festa |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1336495845 PECOS PAC ID: 6305096975 Enrollment ID: I20180227000257 |
| Provider Name | Erin E Lorencz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1649619651 PECOS PAC ID: 4587953062 Enrollment ID: I20180312000234 |
| Provider Name | William D Longworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912399486 PECOS PAC ID: 4082935697 Enrollment ID: I20180625003105 |
| 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 | Cameron a Karlsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316245509 PECOS PAC ID: 6305022518 Enrollment ID: I20180823002619 |
| 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 | Mary Elizabeth Velasco Anderson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912385840 PECOS PAC ID: 1052617370 Enrollment ID: I20180925001721 |
| Provider Name | Crystal Anne Sharon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326277013 PECOS PAC ID: 0446423917 Enrollment ID: I20181016000798 |
| Provider Name | Holly Michelle Fisk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457835795 PECOS PAC ID: 1557614914 Enrollment ID: I20181101000331 |
| Provider Name | Misty Rose Miranda |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1497230882 PECOS PAC ID: 3971856352 Enrollment ID: I20181101001332 |
| 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 | Terri Draper |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891085007 PECOS PAC ID: 5799039384 Enrollment ID: I20181119000505 |
| 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 | Joel L Cohen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700066560 PECOS PAC ID: 0244425692 Enrollment ID: I20190201000560 |
| Provider Name | Rebecca Rae Weicht |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295091239 PECOS PAC ID: 7214167006 Enrollment ID: I20190205002280 |
| Provider Name | Charlene Louise Difilippo |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1760814420 PECOS PAC ID: 0345588737 Enrollment ID: I20190211000212 |
| Provider Name | Christopher Dunaway |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1275011686 PECOS PAC ID: 9032458799 Enrollment ID: I20190225002786 |
| Provider Name | Kimberly Dahm |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316341142 PECOS PAC ID: 4284959198 Enrollment ID: I20190308001090 |
| 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 | Julia V Koval |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1053874388 PECOS PAC ID: 4183957178 Enrollment ID: I20190606000210 |
| 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 | Lauren Poulsen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1558640607 PECOS PAC ID: 5092986224 Enrollment ID: I20190718002671 |
| 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 | Richard Ellsasser |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497069389 PECOS PAC ID: 3375783566 Enrollment ID: I20190917002426 |
| Provider Name | Lindsay Mcauley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235613449 PECOS PAC ID: 7113257148 Enrollment ID: I20190918000470 |
| 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 | Stephanie Killingsworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629616487 PECOS PAC ID: 2163857947 Enrollment ID: I20200124002007 |
| Provider Name | Tracey L Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306247796 PECOS PAC ID: 4284926254 Enrollment ID: I20200128000038 |
| Provider Name | Hunter M Keys |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649696279 PECOS PAC ID: 2668697624 Enrollment ID: I20200206000136 |
| Provider Name | Alana Marie Wright |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1760965446 PECOS PAC ID: 5991131930 Enrollment ID: I20200211000324 |
| Provider Name | Brenda Wittman |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1255407854 PECOS PAC ID: 0042251217 Enrollment ID: I20200325002228 |
| Provider Name | Cheryl Hodges |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649465139 PECOS PAC ID: 2769532365 Enrollment ID: I20200422000156 |
| Provider Name | Cynthia Smith |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013098326 PECOS PAC ID: 3971504234 Enrollment ID: I20200519002255 |
| Provider Name | Erin S Huntley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154610194 PECOS PAC ID: 6103126875 Enrollment ID: I20200615002340 |
| 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 | Heather Hamilton |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1154947570 PECOS PAC ID: 2961825625 Enrollment ID: I20200714001186 |
| 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 | Morgan Taylor Noad |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649808221 PECOS PAC ID: 9638582992 Enrollment ID: I20210105001293 |
| 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 | Mykaela D Stuart |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457879140 PECOS PAC ID: 5698013712 Enrollment ID: I20210423000284 |
| Provider Name | Laura Crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588163794 PECOS PAC ID: 4688938210 Enrollment ID: I20210428000150 |
| Provider Name | John Michael Davis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346839149 PECOS PAC ID: 4385044676 Enrollment ID: I20210608001472 |
| Provider Name | Sarah Keeley Sjostedt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437671039 PECOS PAC ID: 8022380690 Enrollment ID: I20210622001476 |
| Provider Name | Paulette Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093943458 PECOS PAC ID: 7517194681 Enrollment ID: I20210630002292 |
| 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 | Peffin Lee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972964161 PECOS PAC ID: 6709174600 Enrollment ID: I20210706001727 |
| Provider Name | Ashley Reeder |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639218969 PECOS PAC ID: 7618071036 Enrollment ID: I20210707002977 |
| Provider Name | Theresa K Kennon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962523530 PECOS PAC ID: 1759324171 Enrollment ID: I20210712000926 |
| Provider Name | Shelly Rana Budde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538652748 PECOS PAC ID: 9830449784 Enrollment ID: I20210714000090 |
| 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 | Dorothy Chyung |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164798740 PECOS PAC ID: 5395046148 Enrollment ID: I20210728004172 |
| Provider Name | Emily Margaret Reilly |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063916815 PECOS PAC ID: 8527315779 Enrollment ID: I20210804000187 |
| Provider Name | David Sky Bridgman-packer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619473576 PECOS PAC ID: 4587911854 Enrollment ID: I20210813001661 |
| Provider Name | Mary Elizabeth Mildenberger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265074454 PECOS PAC ID: 9133554462 Enrollment ID: I20210813002022 |
| Provider Name | Andrew a Baber |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891344867 PECOS PAC ID: 8921406588 Enrollment ID: I20211012001655 |
| 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 | Ivarene Hurtado |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1881357960 PECOS PAC ID: 7012307952 Enrollment ID: I20211208000304 |
| Provider Name | Mary Mcquilkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518361898 PECOS PAC ID: 1254642838 Enrollment ID: I20220223001382 |
| Provider Name | Ashley Caprice Sockpick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740851815 PECOS PAC ID: 7315331535 Enrollment ID: I20220303000863 |
| Provider Name | Jay H Collier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174573216 PECOS PAC ID: 2365408952 Enrollment ID: I20220308001065 |
| 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 | Jessica Ellen Bury |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396061149 PECOS PAC ID: 7911124698 Enrollment ID: I20220418000569 |
| Provider Name | Lindsey Ellise Wilkens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043986714 PECOS PAC ID: 8022495035 Enrollment ID: I20220512002261 |
| Provider Name | Kelsey Sheridan Miller |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689241366 PECOS PAC ID: 0143614883 Enrollment ID: I20220708001146 |
| Provider Name | Paul Andrew Young |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922532472 PECOS PAC ID: 1456623859 Enrollment ID: I20220712001499 |
| Provider Name | Maram M Boutwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336652338 PECOS PAC ID: 8729469440 Enrollment ID: I20220713000140 |
| 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 | Frederick Victor Lief |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265744254 PECOS PAC ID: 2961884556 Enrollment ID: I20220728002633 |
| 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 | Tia Elizabeth Hale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124750963 PECOS PAC ID: 4981086014 Enrollment ID: I20220805000021 |
| Provider Name | Jonathan Hedges |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184001042 PECOS PAC ID: 1456631894 Enrollment ID: I20220809000590 |
| 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 | Sarah Helen Lyrata |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669995908 PECOS PAC ID: 3476936261 Enrollment ID: I20220811000674 |
| 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 | Timothy Cho Olson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154792620 PECOS PAC ID: 1658617345 Enrollment ID: I20220817000070 |
| 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 | Lisa Franklin Wesley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1306046818 PECOS PAC ID: 1456441641 Enrollment ID: I20220913000622 |
| Provider Name | Kristin Campbell |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1356853329 PECOS PAC ID: 4587920723 Enrollment ID: I20220922000594 |
| Provider Name | Sarah J Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700214749 PECOS PAC ID: 0446487920 Enrollment ID: I20220927000264 |
| Provider Name | Martha Jane Moore |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1053418921 PECOS PAC ID: 0143368126 Enrollment ID: I20220927001704 |
| Provider Name | Jacob Eby |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295112159 PECOS PAC ID: 3870914575 Enrollment ID: I20220927002201 |
| 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 | Margaret H Grinnell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568025567 PECOS PAC ID: 9638405061 Enrollment ID: I20221007002469 |
| Provider Name | Samantha Matteucci |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1730800087 PECOS PAC ID: 6305212416 Enrollment ID: I20221014000803 |
| 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 Barry |
|---|---|
| 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 | Gregory Hau |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1265191522 PECOS PAC ID: 0446627152 Enrollment ID: I20221110000014 |
| 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 | Jodi Casper |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1851039903 PECOS PAC ID: 0446628283 Enrollment ID: I20221129000061 |
| Provider Name | Brian Desmond |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1629708979 PECOS PAC ID: 1153790548 Enrollment ID: I20221206003256 |
| Provider Name | Jacob Burns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285359711 PECOS PAC ID: 7012386121 Enrollment ID: I20221213000796 |
| Provider Name | Dewayne Charles Lazenby |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073507364 PECOS PAC ID: 4284650540 Enrollment ID: I20221216000065 |
| Provider Name | Megan Ann Cho |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710649561 PECOS PAC ID: 0840660262 Enrollment ID: I20221229002083 |
| Provider Name | Melanie Thelen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609544121 PECOS PAC ID: 2769852615 Enrollment ID: I20230110002475 |
| Provider Name | Ciara Stoutenburgh |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1902140130 PECOS PAC ID: 8224408026 Enrollment ID: I20230111001802 |
| Provider Name | Tina Elaine Audie |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477947679 PECOS PAC ID: 8729392139 Enrollment ID: I20230118000609 |
| Provider Name | Bernadette E Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164883963 PECOS PAC ID: 4981902681 Enrollment ID: I20230118003129 |
| Provider Name | Julie Sachiko Hammatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295189041 PECOS PAC ID: 6709171408 Enrollment ID: I20230119000185 |
| 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 | Jessica Marie Lazar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407387186 PECOS PAC ID: 9638589419 Enrollment ID: I20230124000247 |
| Provider Name | Emily Jane Baker |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1821674748 PECOS PAC ID: 8123490844 Enrollment ID: I20230207000063 |
| 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 | Matthew Mau |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1427699222 PECOS PAC ID: 3678907805 Enrollment ID: I20230227001864 |
| 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 | Priscilla Marble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588304554 PECOS PAC ID: 2961876511 Enrollment ID: I20230321002732 |
| Provider Name | Lillie Demarest Bullock |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1285304600 PECOS PAC ID: 8224402763 Enrollment ID: I20230323000853 |
| Provider Name | Haley Ahna Cochran |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1548938335 PECOS PAC ID: 0840665881 Enrollment ID: I20230405001561 |
| Provider Name | Kimberly a King |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841390093 PECOS PAC ID: 3274628912 Enrollment ID: I20230410000625 |
| Provider Name | Dajan Lefuel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184338303 PECOS PAC ID: 3173998556 Enrollment ID: I20230418000237 |
| Provider Name | Tyler Laurence |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477116473 PECOS PAC ID: 5092041533 Enrollment ID: I20230425000736 |
| Provider Name | Morgan Bristol Whitfield |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346918430 PECOS PAC ID: 0446616619 Enrollment ID: I20230512000637 |
| Provider Name | Ashley Smith |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1548969413 PECOS PAC ID: 9032575279 Enrollment ID: I20230515001051 |
| 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 | Kelly Lindahl |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295413235 PECOS PAC ID: 0345601332 Enrollment ID: I20230808000345 |
| 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 | Timothy a Kocher |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265936207 PECOS PAC ID: 7810231958 Enrollment ID: I20230822001889 |
| 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 | Bradley Dayton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790126035 PECOS PAC ID: 3173987948 Enrollment ID: I20230912002642 |
| 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 | Ronald Kichura |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457341034 PECOS PAC ID: 9335560184 Enrollment ID: I20230927000519 |
| 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 | Andrew Watson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659859221 PECOS PAC ID: 1254789308 Enrollment ID: I20231129003007 |
| 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 | Miron B Tzou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952174609 PECOS PAC ID: 1254780042 Enrollment ID: I20231205002054 |
| 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 | David a Theuret |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740565936 PECOS PAC ID: 7810149697 Enrollment ID: I20231208002437 |
| 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 | Molly Rose Masters |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700380995 PECOS PAC ID: 2062861222 Enrollment ID: I20231213001306 |
| Provider Name | Jacob John |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821435751 PECOS PAC ID: 6204076425 Enrollment ID: I20231219000072 |
| Provider Name | Jeffery Grant Taylor |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366773376 PECOS PAC ID: 1759731367 Enrollment ID: I20231222000593 |
| 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 | Breanna Kilmartin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720679046 PECOS PAC ID: 3476903634 Enrollment ID: I20231229001775 |
| Provider Name | Sydney Fowler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407621717 PECOS PAC ID: 2466803606 Enrollment ID: I20240111003249 |
| Provider Name | Stephanie Chen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891006946 PECOS PAC ID: 9739307448 Enrollment ID: I20240205002758 |
| Provider Name | Emily L Wagner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760752232 PECOS PAC ID: 6901249127 Enrollment ID: I20240205002891 |
| Provider Name | Janelle Kaiser |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1215453683 PECOS PAC ID: 3375986474 Enrollment ID: I20240206001232 |
| Provider Name | Roderic Smith |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952362170 PECOS PAC ID: 0244509560 Enrollment ID: I20240222001176 |
| Provider Name | Michael Mallatt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1669409876 PECOS PAC ID: 3577455997 Enrollment ID: I20240222004342 |
| 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 | Samuel Castles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033730015 PECOS PAC ID: 1658796511 Enrollment ID: I20240306003171 |
| Provider Name | Rebecca Cleveland |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1518630391 PECOS PAC ID: 7416393798 Enrollment ID: I20240308001356 |
| 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 | Nicholas Mccarty |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1053788265 PECOS PAC ID: 9133401250 Enrollment ID: I20240326002318 |
| Provider Name | Rory B Ingram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225567431 PECOS PAC ID: 8820362908 Enrollment ID: I20240401002298 |
| Provider Name | Hunter James Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316671514 PECOS PAC ID: 9234577743 Enrollment ID: I20240403001766 |
| Provider Name | Kim Trevino |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659910032 PECOS PAC ID: 6204274608 Enrollment ID: I20240404001118 |
| 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 | 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 | Justin Doggett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366008252 PECOS PAC ID: 3173963873 Enrollment ID: I20240429001692 |
| 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 | Alonzo Martinez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922882836 PECOS PAC ID: 6305287020 Enrollment ID: I20240513002620 |
| 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 | Grant Robbins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053772392 PECOS PAC ID: 6608173331 Enrollment ID: I20240530002563 |
| 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 | Kelly Mahay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285482851 PECOS PAC ID: 0244774412 Enrollment ID: I20240628000444 |
| 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 | Hannah Marianne Sybil Deraedt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992580047 PECOS PAC ID: 8527505874 Enrollment ID: I20240805000096 |
| Provider Name | Emily Rose Waltemyer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811642804 PECOS PAC ID: 7618337387 Enrollment ID: I20240812000702 |
| Provider Name | Rachel Veronica Franzen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558623918 PECOS PAC ID: 4880132653 Enrollment ID: I20240813000231 |
| 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 | Lori C Hamilton |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1912338872 PECOS PAC ID: 8426289380 Enrollment ID: I20240911003152 |
| 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 | Parisa Salehi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689809121 PECOS PAC ID: 3971737222 Enrollment ID: I20240926000598 |
| 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 | Angela Gookin |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1629392915 PECOS PAC ID: 1456596410 Enrollment ID: I20241004002953 |
| 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 | Cassie Iutzi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053756346 PECOS PAC ID: 5597062067 Enrollment ID: I20241030000833 |
| 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 | Marlina Robinson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1306032321 PECOS PAC ID: 0547339095 Enrollment ID: I20241121000825 |
| Provider Name | Rebecca Snyder |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1780464719 PECOS PAC ID: 3476089392 Enrollment ID: I20241216000592 |
| Provider Name | Jennifer S Bracamontes |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942663190 PECOS PAC ID: 9638460793 Enrollment ID: I20241217002272 |
| 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 | Madeline Rosenberger |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1790591014 PECOS PAC ID: 2466980487 Enrollment ID: I20250103001977 |
| 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 | 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 | Trina Fowler |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1356122568 PECOS PAC ID: 9436671781 Enrollment ID: I20250317002429 |
| Provider Name | Boston Mcgahie |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1427746148 PECOS PAC ID: 2264954858 Enrollment ID: I20250324003280 |
| Provider Name | Holly Kathryn Maguire |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316589054 PECOS PAC ID: 9931622586 Enrollment ID: I20250325001528 |
| Provider Name | Hallie Bergwall |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1578374427 PECOS PAC ID: 7012430572 Enrollment ID: I20250326000953 |
| Provider Name | Enos Ngetich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396019188 PECOS PAC ID: 6800057001 Enrollment ID: I20250327002342 |
| Provider Name | Camille Noelle Clements |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1487227500 PECOS PAC ID: 5092239509 Enrollment ID: I20250407000948 |
| Provider Name | Sabrina Kay Hoppas |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1063997096 PECOS PAC ID: 7911421185 Enrollment ID: I20250409001029 |
| Provider Name | Brianna Michelle Aspelund |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902466824 PECOS PAC ID: 7810411790 Enrollment ID: I20250414000021 |
| Provider Name | Tara Ness |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285165035 PECOS PAC ID: 7618491598 Enrollment ID: I20250414000044 |
| Provider Name | Melissa Paige Begich |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194249557 PECOS PAC ID: 7618491440 Enrollment ID: I20250414001438 |
| Provider Name | Cheryl Lynn Kious |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326397266 PECOS PAC ID: 8123542982 Enrollment ID: I20250414002041 |
| Provider Name | Paulette Marie Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689959298 PECOS PAC ID: 1759806813 Enrollment ID: I20250422000683 |
| Provider Name | Stacy Ricketts |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1730352410 PECOS PAC ID: 7113085333 Enrollment ID: I20250428000944 |
| Provider Name | Johnathan Grant Wright |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316349392 PECOS PAC ID: 0547787632 Enrollment ID: I20250513000401 |
| Provider Name | Julia Rozier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720565336 PECOS PAC ID: 0648521757 Enrollment ID: I20250514001125 |
| Provider Name | Danielle Rae Gapinski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922459924 PECOS PAC ID: 5496273179 Enrollment ID: I20250516000586 |
| Provider Name | Heather M Harris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861913972 PECOS PAC ID: 9638697352 Enrollment ID: I20250516001643 |
| Provider Name | Natalia Dias |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659108454 PECOS PAC ID: 9335659622 Enrollment ID: I20250606000379 |
| Provider Name | Sarah Frenzel-lee |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528524204 PECOS PAC ID: 0648511683 Enrollment ID: I20250611004038 |
| Provider Name | Lisa Lindquist |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114278363 PECOS PAC ID: 7416172861 Enrollment ID: I20250616000114 |
| Provider Name | Araceli Cruz |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1932980612 PECOS PAC ID: 4688020902 Enrollment ID: I20250623002764 |
| Provider Name | Devry Birdsell |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1902615537 PECOS PAC ID: 0244744670 Enrollment ID: I20250708004353 |
| Provider Name | Taniesh Amon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396490405 PECOS PAC ID: 8022522457 Enrollment ID: I20250708004526 |
| Provider Name | Whitney Hannah Summers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821705732 PECOS PAC ID: 0345755310 Enrollment ID: I20250717001881 |
| Provider Name | Alison Jane Rigby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871948398 PECOS PAC ID: 0244526820 Enrollment ID: I20250724000094 |
| Provider Name | Chandler Gee |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376039644 PECOS PAC ID: 7810360922 Enrollment ID: I20250725000345 |
| Provider Name | Kristine Virginia Koliadko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558172791 PECOS PAC ID: 2062929318 Enrollment ID: I20250730002257 |
| Provider Name | Macey D Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295460558 PECOS PAC ID: 6002323383 Enrollment ID: I20250730002811 |
| Provider Name | Brittany Breeden |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1801552013 PECOS PAC ID: 8921485087 Enrollment ID: I20250731002703 |
| Provider Name | Fred Ledbetter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609453968 PECOS PAC ID: 4183132483 Enrollment ID: I20250806001125 |
| Provider Name | Shelbylee Rininger |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245712785 PECOS PAC ID: 6709121981 Enrollment ID: I20250807004270 |
| Provider Name | Karsen Cullen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184496200 PECOS PAC ID: 5395189963 Enrollment ID: I20250819000737 |
| Provider Name | Zoe Hotman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1275344772 PECOS PAC ID: 2668971375 Enrollment ID: I20250819003483 |
| Provider Name | Anne Cullings |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174007280 PECOS PAC ID: 7315390754 Enrollment ID: I20250820003323 |
| Provider Name | Hannah L Hayes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982260220 PECOS PAC ID: 6608377080 Enrollment ID: I20250828000299 |
| Provider Name | Rachael Marie Schoepke |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1720979263 PECOS PAC ID: 3779084835 Enrollment ID: I20250829001728 |
| Provider Name | Anneliese R Petersen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457092702 PECOS PAC ID: 4284014226 Enrollment ID: I20250902001282 |
| Provider Name | Mary E Gibbs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457010100 PECOS PAC ID: 6800398439 Enrollment ID: I20250904000853 |
| Provider Name | Irisa Devine |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437384583 PECOS PAC ID: 6002032935 Enrollment ID: I20250909000753 |
| Provider Name | James Hales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033091871 PECOS PAC ID: 7113421280 Enrollment ID: I20250920000284 |
| Provider Name | Sydney Henegan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215811211 PECOS PAC ID: 7416453592 Enrollment ID: I20250929003631 |
| Provider Name | Vanessa Marie Fernandez-miro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629718002 PECOS PAC ID: 8820595382 Enrollment ID: I20251009002596 |
| Provider Name | Monica L Byrd |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659937928 PECOS PAC ID: 2769979053 Enrollment ID: I20251011000070 |
| Provider Name | Natalie S Longley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689315939 PECOS PAC ID: 5395123145 Enrollment ID: I20251013000999 |
| Provider Name | Shane Ball |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922146307 PECOS PAC ID: 4385131929 Enrollment ID: I20251016001699 |
| Provider Name | Jessica Caitlyn Carlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437836806 PECOS PAC ID: 9830686294 Enrollment ID: I20251017002495 |
| Provider Name | Joshua Bearden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790358992 PECOS PAC ID: 8921404484 Enrollment ID: I20251021002674 |
| Provider Name | Nicole Domaschuk-jackson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346514718 PECOS PAC ID: 7113415191 Enrollment ID: I20251022000568 |
| Provider Name | Nikki a Linquist |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912253741 PECOS PAC ID: 3476041013 Enrollment ID: I20251024000582 |
| Provider Name | Shawn Darnell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598002206 PECOS PAC ID: 4486143112 Enrollment ID: I20251031001151 |
| Provider Name | Julie Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144941949 PECOS PAC ID: 7315437795 Enrollment ID: I20251104004485 |
| Provider Name | Angela Jean Plucker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568185866 PECOS PAC ID: 2961992912 Enrollment ID: I20251107000463 |
| Provider Name | Amanda Leigh Brucki |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750969101 PECOS PAC ID: 9537659594 Enrollment ID: I20251107000695 |
| Provider Name | Joel Brownell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083681506 PECOS PAC ID: 6901799782 Enrollment ID: I20251110003700 |
| Provider Name | Andrea Christina Miller |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1225756141 PECOS PAC ID: 0840781449 Enrollment ID: I20251111003930 |
| Provider Name | Saendy Jung |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801356688 PECOS PAC ID: 5597118638 Enrollment ID: I20251113001980 |
| Provider Name | Paulina C Altshuler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205397833 PECOS PAC ID: 8022348796 Enrollment ID: I20251122001210 |
| Provider Name | Tiara Danin Mcdougal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043948276 PECOS PAC ID: 8628561230 Enrollment ID: I20251203000157 |
| Provider Name | Eline I Cove |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316687668 PECOS PAC ID: 2365823028 Enrollment ID: I20251204000231 |
| Provider Name | Brenda a Byrd |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114527454 PECOS PAC ID: 9638662695 Enrollment ID: I20251208001295 |
| Provider Name | Brittany Derose |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1770270845 PECOS PAC ID: 3870088990 Enrollment ID: I20251216004171 |
| Provider Name | Jessica Depweg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861066573 PECOS PAC ID: 0446745418 Enrollment ID: I20251218000119 |
| Provider Name | Desiree Compton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801137989 PECOS PAC ID: 8325533268 Enrollment ID: I20251218002120 |
| Provider Name | Brian Cassidy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760919633 PECOS PAC ID: 7618462813 Enrollment ID: I20251224000572 |
| Provider Name | Cydney Fenton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497788921 PECOS PAC ID: 4385675909 Enrollment ID: I20260109001552 |
| Provider Name | Albert Mendiola Toves |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811653827 PECOS PAC ID: 9234615816 Enrollment ID: I20260114000432 |
| Provider Name | Anthony Privratsky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336726843 PECOS PAC ID: 8527442847 Enrollment ID: I20260114002841 |
| Provider Name | Delmi Cruz |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1366229577 PECOS PAC ID: 0547614174 Enrollment ID: I20260115002493 |
| Provider Name | Madelyne Bee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407213150 PECOS PAC ID: 3173000312 Enrollment ID: I20260120001925 |
| Provider Name | Ryan M Gleason |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841856622 PECOS PAC ID: 5294212742 Enrollment ID: I20260127001676 |
| Provider Name | Allison Lynn O'leary |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336883354 PECOS PAC ID: 6709364144 Enrollment ID: I20260128001993 |
| Provider Name | Julienne Heimerl |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366034159 PECOS PAC ID: 7517445786 Enrollment ID: I20260129001509 |
| Provider Name | Ronald Steven Wilmot |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245617711 PECOS PAC ID: 5698253888 Enrollment ID: I20260129002096 |
| Provider Name | Jastice Erlyne Medel Celario |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508559048 PECOS PAC ID: 0042798241 Enrollment ID: I20260129002427 |
| Provider Name | Heidi Renee Swift |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730551862 PECOS PAC ID: 1850695263 Enrollment ID: I20260203000849 |
| Provider Name | Gregory Semancik |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194882282 PECOS PAC ID: 8022278530 Enrollment ID: I20260204000026 |
| Provider Name | Sarah Dey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609028018 PECOS PAC ID: 1557840063 Enrollment ID: I20260205000609 |
| Provider Name | Tika Devi Chamlagai |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710656608 PECOS PAC ID: 4688153026 Enrollment ID: I20260206000475 |
| Provider Name | Brittany Wright |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215541743 PECOS PAC ID: 1456831569 Enrollment ID: I20260217003125 |
| Provider Name | Steven Monroe Wachter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780235978 PECOS PAC ID: 7214417039 Enrollment ID: I20260219000714 |
| Provider Name | Nicholas James Hurst |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073855763 PECOS PAC ID: 6406160654 Enrollment ID: I20260223001551 |
| Provider Name | Andrew Ashton |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255059820 PECOS PAC ID: 8628412004 Enrollment ID: I20260223001669 |
| Provider Name | Eric Salazar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992303481 PECOS PAC ID: 9436630969 Enrollment ID: I20260224000237 |
| Provider Name | Rebekah Bailey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245939354 PECOS PAC ID: 0042791394 Enrollment ID: I20260225000195 |
| Provider Name | April Nicole Hart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154984607 PECOS PAC ID: 3375025281 Enrollment ID: I20260228000185 |
| Provider Name | Barry Edward Andres |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689789497 PECOS PAC ID: 6002398302 Enrollment ID: I20260305002176 |
| Provider Name | Marisa Rae Goldfinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699433888 PECOS PAC ID: 0042680357 Enrollment ID: I20260311002034 |
| Provider Name | Megan Slaughter Varvoutis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831534734 PECOS PAC ID: 6204101637 Enrollment ID: I20260314000450 |
| Provider Name | Rebekah Ellen Keene |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750948071 PECOS PAC ID: 9931682085 Enrollment ID: I20260317001424 |
| Provider Name | Chad J Aubin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1962608869 PECOS PAC ID: 3274016340 Enrollment ID: I20260317002004 |
| Provider Name | Laura Knight |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932384245 PECOS PAC ID: 4688160146 Enrollment ID: I20260318000228 |
| Provider Name | Simon Michael White |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417807025 PECOS PAC ID: 2961986906 Enrollment ID: I20260318001846 |
| Provider Name | Glennis Ellen Henderson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033089693 PECOS PAC ID: 3870077621 Enrollment ID: I20260319003659 |
| Provider Name | Reginaldo Pomer Gregorio |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497099543 PECOS PAC ID: 9436370749 Enrollment ID: I20260324003431 |
| Provider Name | Mitchel Elling |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134092083 PECOS PAC ID: 6305320532 Enrollment ID: I20260325001742 |
| Provider Name | Melissa Dawley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386008340 PECOS PAC ID: 2163702150 Enrollment ID: I20260327002612 |
| Provider Name | Stephanie Jane Holcombe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396176459 PECOS PAC ID: 0749598902 Enrollment ID: I20260330002502 |
| Provider Name | Delroy a Duckworth |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003468810 PECOS PAC ID: 4981189719 Enrollment ID: I20260331000116 |
| Provider Name | Victoria Yu |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1891864385 PECOS PAC ID: 8921999848 Enrollment ID: I20260331002342 |
| Provider Name | Cautrese Alexander |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518205285 PECOS PAC ID: 3678048089 Enrollment ID: I20260413002686 |
| Provider Name | Darrel Foister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942047196 PECOS PAC ID: 1052859071 Enrollment ID: I20260420003725 |
| Provider Name | Jordan Blessing |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073907291 PECOS PAC ID: 4082916978 Enrollment ID: I20260501001078 |
| Provider Name | Leanne Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366159436 PECOS PAC ID: 1355824830 Enrollment ID: I20260511000965 |
| Provider Name | Jasmine Jenean Burton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407472095 PECOS PAC ID: 1658849377 Enrollment ID: I20260511002450 |
| Provider Name | Cynthia Mantey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073381562 PECOS PAC ID: 8426495474 Enrollment ID: I20260512001357 |
| Provider Name | Christina Lam |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1932168804 PECOS PAC ID: 8022067420 Enrollment ID: I20260615000430 |
| Provider Name | Susan Suzi Wallace |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124215256 PECOS PAC ID: 8628540135 Enrollment ID: I20260616002644 |
| Provider Name | Amanda Mae Rose |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134831357 PECOS PAC ID: 0143793489 Enrollment ID: I20260626003725 |
Mcgrath Regional Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Dnr Rd, Mcgrath, AK 99627 Phone: 907-729-4987 Fax: 907-729-8607 |
BH 1115- Mcgrath Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Dnr Road, Mcgrath, AK 99627 Phone: 907-524-3299 |