| Mercy Health Physicians Kentucky Specialty Care Llc | |
|
1530 Lone Oak Rd Paducah KY 42003-7901 | |
| (888) 696-3541 | |
| Not Available |
| Full Name | Mercy Health Physicians Kentucky Specialty Care Llc |
|---|---|
| Speciality | Surgery |
| Location | 1530 Lone Oak Rd, Paducah, Kentucky |
| Authorized Official Name and Position | Kimberly Ralston (SYSTEM DIRECTOR) |
| Authorized Official Contact | 4199965119 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Health Physicians Kentucky Specialty Care Llc Po Box 639983 Cincinnati OH 45263-9983 Ph: () - | Mercy Health Physicians Kentucky Specialty Care Llc 1530 Lone Oak Rd Paducah KY 42003-7901 Ph: (888) 696-3541 |
| NPI Number | 1700408093 |
|---|---|
| Provider Enumeration Date | 05/11/2020 |
| Last Update Date | 12/19/2023 |
| Certification Date | 12/19/2023 |
| Medicare PECOS PAC ID | 1456777069 |
|---|---|
| Medicare Enrollment ID | O20200813001096 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700408093 | NPI | - | NPPES |
| Provider Name | William E Hogancamp |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164432613 PECOS PAC ID: 5799678082 Enrollment ID: I20040419000090 |
| Provider Name | Frederic C. Park |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821189002 PECOS PAC ID: 1355339326 Enrollment ID: I20041108000382 |
| Provider Name | Teresa Lynn Moss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780792937 PECOS PAC ID: 9032168448 Enrollment ID: I20050112000887 |
| Provider Name | Daniell B Hill |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1801980644 PECOS PAC ID: 0749223881 Enrollment ID: I20050609000005 |
| Provider Name | David P Hall |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831180942 PECOS PAC ID: 9234168824 Enrollment ID: I20050804000123 |
| Provider Name | David Andrew Meyer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811957459 PECOS PAC ID: 8729050604 Enrollment ID: I20051207000063 |
| Provider Name | Kyli W Koenigsmark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376549543 PECOS PAC ID: 7012939192 Enrollment ID: I20060104000110 |
| Provider Name | William L Skinner |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1376657254 PECOS PAC ID: 9032125935 Enrollment ID: I20060302000051 |
| Provider Name | Vernon W Duncan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487606984 PECOS PAC ID: 8921010612 Enrollment ID: I20060621000021 |
| Provider Name | Ginny A Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699726596 PECOS PAC ID: 1254343858 Enrollment ID: I20060623000199 |
| Provider Name | Mohamad R Abul-khoudoud |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1396710091 PECOS PAC ID: 0941298178 Enrollment ID: I20061211000349 |
| Provider Name | Niranjan Siva |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154330157 PECOS PAC ID: 2769489087 Enrollment ID: I20070305000197 |
| Provider Name | Scott J. Sanders |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1972669422 PECOS PAC ID: 5597740977 Enrollment ID: I20070607000670 |
| Provider Name | Jehanzeb Khan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164445417 PECOS PAC ID: 0244330025 Enrollment ID: I20070709000437 |
| Provider Name | Shiraz K Patel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1699759449 PECOS PAC ID: 9436058286 Enrollment ID: I20070830000258 |
| Provider Name | Tara L Lykins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184810541 PECOS PAC ID: 6103913330 Enrollment ID: I20071105000010 |
| Provider Name | Darrell B Leslie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588741755 PECOS PAC ID: 6507951761 Enrollment ID: I20080317000474 |
| Provider Name | Shanna M Leslie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730278920 PECOS PAC ID: 8325133580 Enrollment ID: I20080402000073 |
| Provider Name | Gordon C Dugan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558531657 PECOS PAC ID: 8628156858 Enrollment ID: I20080429000060 |
| Provider Name | James P Orourke |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1144226598 PECOS PAC ID: 3577642917 Enrollment ID: I20080509000335 |
| Provider Name | Gary Bodnarchuk |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033196084 PECOS PAC ID: 4284664681 Enrollment ID: I20080530000057 |
| Provider Name | Cynthia A Bowman-stroud |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912045527 PECOS PAC ID: 2466523592 Enrollment ID: I20080618000187 |
| Provider Name | Jason D Banister |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1336218031 PECOS PAC ID: 6305910845 Enrollment ID: I20080801000244 |
| Provider Name | Sarah E Mizuguchi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902937584 PECOS PAC ID: 0840358453 Enrollment ID: I20081027000549 |
| Provider Name | Robin M Floyd |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518988682 PECOS PAC ID: 9436218765 Enrollment ID: I20081031000408 |
| Provider Name | Lonnie J Bargo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306000591 PECOS PAC ID: 9436219870 Enrollment ID: I20081115000016 |
| Provider Name | Ramakrishna Venkatesh |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1548286768 PECOS PAC ID: 1759446792 Enrollment ID: I20090209000059 |
| Provider Name | Samantha L Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558514570 PECOS PAC ID: 7517014715 Enrollment ID: I20090403000397 |
| Provider Name | James H Long |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881763100 PECOS PAC ID: 6103973789 Enrollment ID: I20090416000751 |
| Provider Name | Joseph M Pittard |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1629147574 PECOS PAC ID: 6709933120 Enrollment ID: I20090421000698 |
| Provider Name | William Zinn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912984238 PECOS PAC ID: 2062460694 Enrollment ID: I20090428000557 |
| Provider Name | Jimmy E Couch |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932281904 PECOS PAC ID: 4789734880 Enrollment ID: I20090611000341 |
| Provider Name | Brian S Kern |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1124231824 PECOS PAC ID: 1355401381 Enrollment ID: I20090801000044 |
| Provider Name | Robert Caturano |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376540625 PECOS PAC ID: 5395659643 Enrollment ID: I20091007000530 |
| Provider Name | Sharon L Dicicco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821249301 PECOS PAC ID: 2365588092 Enrollment ID: I20091009000081 |
| Provider Name | Kelly R Derington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083847404 PECOS PAC ID: 0345389847 Enrollment ID: I20091123000104 |
| Provider Name | Millicent Gay Kadner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174859409 PECOS PAC ID: 5294877007 Enrollment ID: I20100116000004 |
| Provider Name | Harold L Halfhill |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407842651 PECOS PAC ID: 3476689852 Enrollment ID: I20100325000420 |
| Provider Name | Patrick K Ellison |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1184626244 PECOS PAC ID: 6901933803 Enrollment ID: I20100426000210 |
| Provider Name | Wendell Wright |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1962483941 PECOS PAC ID: 4082742168 Enrollment ID: I20100511000525 |
| Provider Name | Meghan Ashley Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881924611 PECOS PAC ID: 6305974148 Enrollment ID: I20100514000475 |
| Provider Name | Patricia Ann Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578880456 PECOS PAC ID: 3173654605 Enrollment ID: I20100628000824 |
| Provider Name | Amanda Ellen Wagner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235457359 PECOS PAC ID: 7416071402 Enrollment ID: I20100827000187 |
| Provider Name | Daniel Howard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1336136514 PECOS PAC ID: 6002808060 Enrollment ID: I20100917000360 |
| Provider Name | Catherine N Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629387972 PECOS PAC ID: 6901092063 Enrollment ID: I20101201000565 |
| Provider Name | Deborah Lynn Bray |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1134433931 PECOS PAC ID: 5698962231 Enrollment ID: I20101209000061 |
| Provider Name | Jenny J Franke |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1437112893 PECOS PAC ID: 5698826444 Enrollment ID: I20110215000855 |
| Provider Name | Binor B Said |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952359697 PECOS PAC ID: 6305811464 Enrollment ID: I20110308000009 |
| Provider Name | Linda M Dall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417277229 PECOS PAC ID: 7012199045 Enrollment ID: I20110311000099 |
| Provider Name | Tara L Crumble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801195466 PECOS PAC ID: 3678751500 Enrollment ID: I20110624000148 |
| Provider Name | Rebecca Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285957308 PECOS PAC ID: 0547439093 Enrollment ID: I20110817000943 |
| Provider Name | Gregory D Kingston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689710899 PECOS PAC ID: 5698833531 Enrollment ID: I20120131000871 |
| Provider Name | Heidi Atkinson Davies |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063788479 PECOS PAC ID: 6901068543 Enrollment ID: I20120427000299 |
| Provider Name | Tammy J Vaughan |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1992064091 PECOS PAC ID: 5092979096 Enrollment ID: I20120601000394 |
| Provider Name | Sabrina Talbott Browning |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548399249 PECOS PAC ID: 0446414478 Enrollment ID: I20120604000192 |
| Provider Name | Spencer E Romine |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1659535409 PECOS PAC ID: 8921254459 Enrollment ID: I20120815000662 |
| Provider Name | Van M Woeltz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447269451 PECOS PAC ID: 1951308279 Enrollment ID: I20130311000115 |
| Provider Name | Brandi L Stacy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760722144 PECOS PAC ID: 8022253921 Enrollment ID: I20130325000529 |
| Provider Name | Adriana Troutman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083725246 PECOS PAC ID: 6608011275 Enrollment ID: I20130402000379 |
| Provider Name | Rachel S Lowdenback |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174841357 PECOS PAC ID: 6507009065 Enrollment ID: I20130830000695 |
| Provider Name | Amy R Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932532934 PECOS PAC ID: 2365686789 Enrollment ID: I20130924000771 |
| Provider Name | Sara Lynnea Cederstrand |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1447457247 PECOS PAC ID: 8820232101 Enrollment ID: I20130926000838 |
| Provider Name | David J Mauterer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306854963 PECOS PAC ID: 9537283924 Enrollment ID: I20140206001648 |
| Provider Name | Jason Shou |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245479054 PECOS PAC ID: 9638361272 Enrollment ID: I20140521001134 |
| Provider Name | Lee A Lutes |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1295092732 PECOS PAC ID: 7214157130 Enrollment ID: I20140927000293 |
| Provider Name | Lindsey Jo Lund |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578791018 PECOS PAC ID: 7517115116 Enrollment ID: I20141016001065 |
| Provider Name | Farah Brown |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871595736 PECOS PAC ID: 5294784856 Enrollment ID: I20141211001880 |
| Provider Name | Leslie N Weitlauf |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760888523 PECOS PAC ID: 1456674282 Enrollment ID: I20141230002037 |
| Provider Name | Tejal Lalaji |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225003320 PECOS PAC ID: 3577526524 Enrollment ID: I20150127000289 |
| Provider Name | Ross Jones |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1083856041 PECOS PAC ID: 8921243171 Enrollment ID: I20150818006188 |
| Provider Name | Miriam D Slatter Hall |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952566788 PECOS PAC ID: 8527216373 Enrollment ID: I20150824001151 |
| Provider Name | Austin Alexander Beck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245641273 PECOS PAC ID: 8022324631 Enrollment ID: I20150827001171 |
| Provider Name | Shay Lynn Kirk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003121393 PECOS PAC ID: 6002123825 Enrollment ID: I20150910002954 |
| Provider Name | Francis Alouysious Fraser |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1164457198 PECOS PAC ID: 3678640190 Enrollment ID: I20150917000614 |
| Provider Name | Amanda F Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902273535 PECOS PAC ID: 9739498577 Enrollment ID: I20151019001892 |
| Provider Name | Catherine Lee Reimnitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194112755 PECOS PAC ID: 1254633498 Enrollment ID: I20160215000448 |
| Provider Name | Regina Dawn Wilkerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346606860 PECOS PAC ID: 4789983586 Enrollment ID: I20160429000109 |
| Provider Name | Wederson Marcos Claudino |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1588977391 PECOS PAC ID: 7416249131 Enrollment ID: I20160715001369 |
| Provider Name | Jonathan D Couch |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1689808107 PECOS PAC ID: 0244544484 Enrollment ID: I20160722002191 |
| Provider Name | Carol Grigsby Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346323227 PECOS PAC ID: 7315230331 Enrollment ID: I20160727002324 |
| Provider Name | Karen Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215390117 PECOS PAC ID: 1456645233 Enrollment ID: I20160803000187 |
| Provider Name | Hope R Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922482587 PECOS PAC ID: 7315234382 Enrollment ID: I20161011001601 |
| Provider Name | Felicia Marie Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508314212 PECOS PAC ID: 8527356948 Enrollment ID: I20161017002930 |
| Provider Name | Cheryl Vinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164964870 PECOS PAC ID: 7810278942 Enrollment ID: I20170104002122 |
| Provider Name | Gregory Mccord |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1720116924 PECOS PAC ID: 6507953320 Enrollment ID: I20170206002749 |
| Provider Name | Courtney Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538604657 PECOS PAC ID: 8921381302 Enrollment ID: I20170208002840 |
| Provider Name | Charles W Scowcroft |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750336863 PECOS PAC ID: 6709059488 Enrollment ID: I20170228002420 |
| Provider Name | Kari Dubosque |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235496191 PECOS PAC ID: 3476864166 Enrollment ID: I20170310002068 |
| Provider Name | Sharlotte Ashley Sargent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821538745 PECOS PAC ID: 7517244015 Enrollment ID: I20170511000035 |
| Provider Name | Derek W Savells |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316267818 PECOS PAC ID: 7911145727 Enrollment ID: I20170517001312 |
| Provider Name | Tiffany Lynn Cates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790225977 PECOS PAC ID: 3971870734 Enrollment ID: I20170525002647 |
| Provider Name | Ryan Tyler Beck |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1184912909 PECOS PAC ID: 0143460550 Enrollment ID: I20170801002728 |
| Provider Name | Elizabeth Nicole Garrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194236521 PECOS PAC ID: 6800162678 Enrollment ID: I20171023001218 |
| Provider Name | Stewart Gilbert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487636445 PECOS PAC ID: 7012981285 Enrollment ID: I20171106003183 |
| Provider Name | Anand P Lalaji |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649245747 PECOS PAC ID: 7416928734 Enrollment ID: I20171116001695 |
| Provider Name | Eric L Lo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1497782023 PECOS PAC ID: 8123193208 Enrollment ID: I20171212003043 |
| Provider Name | Hannah Kate Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669987814 PECOS PAC ID: 4183982028 Enrollment ID: I20171221002182 |
| Provider Name | Maria Jean Sprunger |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1346591914 PECOS PAC ID: 2163717117 Enrollment ID: I20180206001806 |
| Provider Name | Svetlana Famina |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053792515 PECOS PAC ID: 8921368127 Enrollment ID: I20180208001063 |
| Provider Name | Shelly Ray Balliet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184126260 PECOS PAC ID: 2567724289 Enrollment ID: I20180316001377 |
| Provider Name | Kay Delphia Taylor |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1245293711 PECOS PAC ID: 5193792307 Enrollment ID: I20180613003348 |
| Provider Name | Kimberly J Lovell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265922330 PECOS PAC ID: 9739435751 Enrollment ID: I20180705002379 |
| Provider Name | Allison Price Simons |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427317254 PECOS PAC ID: 9638311426 Enrollment ID: I20180724002471 |
| Provider Name | Alice Ann Higdon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1326488891 PECOS PAC ID: 1557619491 Enrollment ID: I20180808002868 |
| Provider Name | Jason Gregory Patton |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1578826061 PECOS PAC ID: 5496994311 Enrollment ID: I20180821001472 |
| Provider Name | Randall M Scott |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811476864 PECOS PAC ID: 2264781079 Enrollment ID: I20180827002871 |
| Provider Name | Clinton Kaufman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134566805 PECOS PAC ID: 2860621968 Enrollment ID: I20180906001644 |
| Provider Name | Eugene Owsley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245573963 PECOS PAC ID: 4688946577 Enrollment ID: I20180912002077 |
| Provider Name | Timothy J. Mcdermott |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1972613487 PECOS PAC ID: 0547325425 Enrollment ID: I20180918002669 |
| Provider Name | Michael Mensah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1205218948 PECOS PAC ID: 3678876182 Enrollment ID: I20180919004306 |
| Provider Name | Kelly M Ray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497239750 PECOS PAC ID: 8426302555 Enrollment ID: I20181108001356 |
| Provider Name | Gregory Szych |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1841268521 PECOS PAC ID: 4688655467 Enrollment ID: I20181109000584 |
| Provider Name | David Powers |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1932410370 PECOS PAC ID: 6204196538 Enrollment ID: I20181109001530 |
| Provider Name | Abbas Chamsuddin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578539557 PECOS PAC ID: 0446150262 Enrollment ID: I20181126003946 |
| Provider Name | Dawn Leighann Benefiel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609392406 PECOS PAC ID: 8527302082 Enrollment ID: I20181211000168 |
| Provider Name | Lanita Dawson-jones |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740248483 PECOS PAC ID: 6103716857 Enrollment ID: I20190207002137 |
| Provider Name | Anil John Mani |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1881688018 PECOS PAC ID: 4587687082 Enrollment ID: I20190208003130 |
| Provider Name | Brian Thomas Farrell |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1073766150 PECOS PAC ID: 4688827744 Enrollment ID: I20190315001396 |
| Provider Name | Lingaiah Chandrashekar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1013934710 PECOS PAC ID: 4082658778 Enrollment ID: I20190320003263 |
| Provider Name | Cessinee Nicole Thornton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174097794 PECOS PAC ID: 5193066744 Enrollment ID: I20190408002090 |
| Provider Name | Victoria Ivanukoff |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1598095929 PECOS PAC ID: 1153562293 Enrollment ID: I20190411001861 |
| Provider Name | Cody Sexton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053884361 PECOS PAC ID: 7810221082 Enrollment ID: I20190620003524 |
| Provider Name | Umberto Gaetano Fontana |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1033111315 PECOS PAC ID: 0749326601 Enrollment ID: I20190621002579 |
| Provider Name | Bryan Jeremy Glaenzer |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1568805406 PECOS PAC ID: 9830324771 Enrollment ID: I20190625001709 |
| Provider Name | John E Pierce |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487016564 PECOS PAC ID: 0446542245 Enrollment ID: I20190716003442 |
| Provider Name | Lauren Deanne Mcclain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417415993 PECOS PAC ID: 3577899053 Enrollment ID: I20190722000778 |
| Provider Name | Jessica Dale Gossom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316507981 PECOS PAC ID: 5193052371 Enrollment ID: I20190809002881 |
| Provider Name | Victor Bykov |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396757829 PECOS PAC ID: 5496720013 Enrollment ID: I20190910003090 |
| Provider Name | Kristin Gaffney |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1720241318 PECOS PAC ID: 2163556523 Enrollment ID: I20191214000239 |
| Provider Name | Kayla Hendley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326685066 PECOS PAC ID: 1052745874 Enrollment ID: I20200102000731 |
| Provider Name | Patrick Basu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1053396572 PECOS PAC ID: 0143260646 Enrollment ID: I20200110002114 |
| Provider Name | George Ethan Smith |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346898103 PECOS PAC ID: 3870920358 Enrollment ID: I20200221001763 |
| Provider Name | Megan Danielle Mcdowell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598390148 PECOS PAC ID: 6709216476 Enrollment ID: I20200420003120 |
| Provider Name | Britany Nicole Walters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639790991 PECOS PAC ID: 3375964216 Enrollment ID: I20200602001840 |
| Provider Name | Ashton B Downing |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1538675707 PECOS PAC ID: 1355762956 Enrollment ID: I20200608001953 |
| Provider Name | Bobbie Lee Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720699010 PECOS PAC ID: 3870913452 Enrollment ID: I20201020003820 |
| Provider Name | Christina Michelle Thweatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578170718 PECOS PAC ID: 2668883968 Enrollment ID: I20201117002377 |
| Provider Name | Amanda R Raether |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801429428 PECOS PAC ID: 4688085228 Enrollment ID: I20201202003013 |
| Provider Name | Jonathon Blake Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215535919 PECOS PAC ID: 5193137578 Enrollment ID: I20201208002292 |
| Provider Name | Lindita Coku |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1134394745 PECOS PAC ID: 9830356963 Enrollment ID: I20210202001692 |
| Provider Name | Edward Snyder |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083792873 PECOS PAC ID: 6204994296 Enrollment ID: I20210315001470 |
| Provider Name | Rawel S Randhawa |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1689781361 PECOS PAC ID: 4789602715 Enrollment ID: I20210315002560 |
| Provider Name | Mohammad N Khan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1295778215 PECOS PAC ID: 3476538760 Enrollment ID: I20210318002420 |
| Provider Name | Steven Millmond |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851365944 PECOS PAC ID: 6204730013 Enrollment ID: I20210319001939 |
| Provider Name | John I Young |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114218963 PECOS PAC ID: 7618114729 Enrollment ID: I20210322001879 |
| Provider Name | Shelby A Rollings-gough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629677117 PECOS PAC ID: 0446667703 Enrollment ID: I20210402000238 |
| Provider Name | Amjad A Safvi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093707457 PECOS PAC ID: 7012809650 Enrollment ID: I20210601002755 |
| Provider Name | Simone A Fearon |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255522801 PECOS PAC ID: 2668535014 Enrollment ID: I20210629001512 |
| Provider Name | Patricia Silva |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730158635 PECOS PAC ID: 7618926197 Enrollment ID: I20210715002840 |
| Provider Name | Holly Kimberlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053982918 PECOS PAC ID: 1456753102 Enrollment ID: I20210716002492 |
| Provider Name | James T Frencher |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386039758 PECOS PAC ID: 8022449941 Enrollment ID: I20210827000574 |
| Provider Name | Gregory L Thalken |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861547317 PECOS PAC ID: 9830333541 Enrollment ID: I20210827001486 |
| Provider Name | Neil Anand |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508271149 PECOS PAC ID: 8325380900 Enrollment ID: I20210827002814 |
| Provider Name | Artin Aharonian |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992740187 PECOS PAC ID: 8224098942 Enrollment ID: I20210827002944 |
| Provider Name | Michael V Klein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205826237 PECOS PAC ID: 5698708998 Enrollment ID: I20210830001384 |
| Provider Name | Leonard Morneau |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376937722 PECOS PAC ID: 5193125219 Enrollment ID: I20210830001515 |
| Provider Name | Ravinder S Sohal |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740244466 PECOS PAC ID: 3779541974 Enrollment ID: I20210830001521 |
| Provider Name | Robert Farrell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952386476 PECOS PAC ID: 8628971801 Enrollment ID: I20210830001763 |
| Provider Name | Shareef M Riad |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417111477 PECOS PAC ID: 0042353336 Enrollment ID: I20210830002456 |
| Provider Name | Zachary S Roeder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326305483 PECOS PAC ID: 4688802655 Enrollment ID: I20210830002813 |
| Provider Name | Olufolajimi Obembe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164630117 PECOS PAC ID: 7315097367 Enrollment ID: I20210830002937 |
| Provider Name | Michael D Karachalios |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013142348 PECOS PAC ID: 6305149733 Enrollment ID: I20210830003448 |
| Provider Name | Jill Furubayashi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457587073 PECOS PAC ID: 7517186224 Enrollment ID: I20210830003484 |
| Provider Name | Kambrie Y Kato |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235424284 PECOS PAC ID: 7911290069 Enrollment ID: I20210831000915 |
| Provider Name | Theresa M Yuh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265523930 PECOS PAC ID: 3173576154 Enrollment ID: I20210831003721 |
| Provider Name | Irada Ibrahim-zada |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1265842991 PECOS PAC ID: 7719298512 Enrollment ID: I20210909002492 |
| Provider Name | Archana C Lucchesi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225108533 PECOS PAC ID: 6709871346 Enrollment ID: I20210913002929 |
| Provider Name | Latisha Dawn Mcclain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497358899 PECOS PAC ID: 0547667743 Enrollment ID: I20210929003691 |
| Provider Name | Kenna J Williams |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770571853 PECOS PAC ID: 6800873035 Enrollment ID: I20211118002162 |
| Provider Name | Robert S Poston |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1467493700 PECOS PAC ID: 9739263468 Enrollment ID: I20211209002794 |
| Provider Name | Mary Burkeen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710642350 PECOS PAC ID: 7618368069 Enrollment ID: I20211220002120 |
| Provider Name | Kaley N Bebout |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750908299 PECOS PAC ID: 6103217369 Enrollment ID: I20211222001774 |
| Provider Name | Alisyn M Brann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497415210 PECOS PAC ID: 7113319781 Enrollment ID: I20220112001267 |
| Provider Name | Ali E Lampert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467113118 PECOS PAC ID: 5799177226 Enrollment ID: I20220113001282 |
| Provider Name | Willie Charles Harrison |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1447227087 PECOS PAC ID: 7416270426 Enrollment ID: I20220127000478 |
| Provider Name | Reginald Sandy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972504629 PECOS PAC ID: 6103974167 Enrollment ID: I20220129000350 |
| Provider Name | Jonathan L Chadwick |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1215019179 PECOS PAC ID: 7214175074 Enrollment ID: I20220211000770 |
| Provider Name | Thomas A Williams |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1932194966 PECOS PAC ID: 1355366352 Enrollment ID: I20220506002076 |
| Provider Name | Ryan Jean Baptiste |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497997050 PECOS PAC ID: 4587789326 Enrollment ID: I20220706003807 |
| Provider Name | Eric Ledermann |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871722801 PECOS PAC ID: 1557585247 Enrollment ID: I20220708001601 |
| Provider Name | Gabriel Ionescu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750315628 PECOS PAC ID: 9133126485 Enrollment ID: I20220715002292 |
| Provider Name | Tuan G Nguyen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477660983 PECOS PAC ID: 3375526593 Enrollment ID: I20220726000959 |
| Provider Name | Ethan Pace Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124551809 PECOS PAC ID: 3072841493 Enrollment ID: I20220826003195 |
| Provider Name | Mark A Byard |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1043205164 PECOS PAC ID: 3274597794 Enrollment ID: I20220830004262 |
| Provider Name | Samantha Ann Barrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225769391 PECOS PAC ID: 8527442623 Enrollment ID: I20220908000257 |
| Provider Name | Satyam Veean |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447785480 PECOS PAC ID: 3779856653 Enrollment ID: I20220928000335 |
| Provider Name | Russell S Weinstein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992788459 PECOS PAC ID: 4587641261 Enrollment ID: I20221010001943 |
| Provider Name | Rachel Faye Gardiner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609597434 PECOS PAC ID: 5092184556 Enrollment ID: I20221206001937 |
| Provider Name | Mario C Giudici |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558341073 PECOS PAC ID: 8527967710 Enrollment ID: I20230104001955 |
| Provider Name | Ryan A Frederiksen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922260033 PECOS PAC ID: 0446431753 Enrollment ID: I20230105001674 |
| Provider Name | Shota Yamamoto |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609165356 PECOS PAC ID: 6901170067 Enrollment ID: I20230105001938 |
| Provider Name | Shannon E Bownds |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518911726 PECOS PAC ID: 6901817386 Enrollment ID: I20230105001994 |
| Provider Name | Lincoln Rameshbhai Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639130198 PECOS PAC ID: 5395821193 Enrollment ID: I20230106001179 |
| Provider Name | Stephen Johnston |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730525841 PECOS PAC ID: 0042574048 Enrollment ID: I20230106001532 |
| Provider Name | Linda Kang Armstrong |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285841916 PECOS PAC ID: 4486816105 Enrollment ID: I20230106002463 |
| Provider Name | Matthew D. Hermann |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477990521 PECOS PAC ID: 0345482212 Enrollment ID: I20230111000770 |
| Provider Name | David A Zelman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346526829 PECOS PAC ID: 4688890460 Enrollment ID: I20230111001489 |
| Provider Name | Falgun Harish Chokshi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851501126 PECOS PAC ID: 1355519661 Enrollment ID: I20230125003177 |
| Provider Name | Bassem M Samaan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679740302 PECOS PAC ID: 8224271945 Enrollment ID: I20230126002739 |
| Provider Name | Stephanie Anne Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780396572 PECOS PAC ID: 0749652311 Enrollment ID: I20230207003513 |
| Provider Name | Ahmed A. Farag |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659722361 PECOS PAC ID: 0941594840 Enrollment ID: I20230208001519 |
| Provider Name | Matthew Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962074898 PECOS PAC ID: 5395140727 Enrollment ID: I20230301000927 |
| Provider Name | Heramb K Singh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023074127 PECOS PAC ID: 1355247925 Enrollment ID: I20230315000536 |
| Provider Name | Palam Annamalai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972529584 PECOS PAC ID: 5698776144 Enrollment ID: I20230320000252 |
| Provider Name | Erin Cantrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154080935 PECOS PAC ID: 1850765496 Enrollment ID: I20230321002393 |
| Provider Name | Brijesh V Reddy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174780621 PECOS PAC ID: 5092970921 Enrollment ID: I20230322002417 |
| Provider Name | Elliot Landau |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902151038 PECOS PAC ID: 4587924204 Enrollment ID: I20230323000979 |
| Provider Name | Aldo C Ruffolo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235124561 PECOS PAC ID: 1951339142 Enrollment ID: I20230404000551 |
| Provider Name | George Radich |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720026669 PECOS PAC ID: 8325041700 Enrollment ID: I20230421001491 |
| Provider Name | Harry Brown |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902007339 PECOS PAC ID: 1658463658 Enrollment ID: I20230427002745 |
| Provider Name | Marvin F Pinzon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518947522 PECOS PAC ID: 7810893203 Enrollment ID: I20230508000923 |
| Provider Name | Johnathan Hays |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366654162 PECOS PAC ID: 5698825867 Enrollment ID: I20230508001502 |
| Provider Name | Thaddeus D Hollingsworth |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750776183 PECOS PAC ID: 6103248588 Enrollment ID: I20230509002165 |
| Provider Name | Clarence Findley |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1962644310 PECOS PAC ID: 2062685753 Enrollment ID: I20230518001280 |
| Provider Name | Anna-reid L Malone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750053195 PECOS PAC ID: 8022475334 Enrollment ID: I20230601000243 |
| Provider Name | Murray H Shapiro |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578790267 PECOS PAC ID: 9234359639 Enrollment ID: I20230712004201 |
| Provider Name | Kailey E Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275210726 PECOS PAC ID: 7618337221 Enrollment ID: I20230714000292 |
| Provider Name | Luan Cong Tran |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619967650 PECOS PAC ID: 3072706407 Enrollment ID: I20230717000933 |
| Provider Name | Faryab Frank Lohrasbi |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1982660437 PECOS PAC ID: 0941371363 Enrollment ID: I20230822000332 |
| Provider Name | Lisa N Adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891055893 PECOS PAC ID: 5890165104 Enrollment ID: I20230901002289 |
| Provider Name | Jonathan Lazzara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144580085 PECOS PAC ID: 3476876632 Enrollment ID: I20230901002607 |
| Provider Name | Emily Hahn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306214101 PECOS PAC ID: 5092015412 Enrollment ID: I20230905001518 |
| Provider Name | Kristina Delco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831869627 PECOS PAC ID: 8325423932 Enrollment ID: I20230905002682 |
| Provider Name | Roberta Allen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730437179 PECOS PAC ID: 7012264815 Enrollment ID: I20230905002865 |
| Provider Name | Melissa Hinkel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972229474 PECOS PAC ID: 0244608958 Enrollment ID: I20230906000552 |
| Provider Name | Yisela Barragan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285112532 PECOS PAC ID: 4486067915 Enrollment ID: I20230906001396 |
| Provider Name | Lauren Wahba |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770214520 PECOS PAC ID: 1557747003 Enrollment ID: I20230906002496 |
| Provider Name | Christel Earles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043887128 PECOS PAC ID: 7214308410 Enrollment ID: I20230911000294 |
| Provider Name | Jeremy Babb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255966875 PECOS PAC ID: 9032573993 Enrollment ID: I20230911002037 |
| Provider Name | Lindsay Manning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700268836 PECOS PAC ID: 8224346846 Enrollment ID: I20230911003629 |
| Provider Name | Joel Dey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053815167 PECOS PAC ID: 3375899305 Enrollment ID: I20230912000530 |
| Provider Name | Nancy Madenyika |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659794683 PECOS PAC ID: 7416249800 Enrollment ID: I20230912001115 |
| Provider Name | Marjorie Combellick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831504364 PECOS PAC ID: 9537386560 Enrollment ID: I20230912002758 |
| Provider Name | John A Barringer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780272138 PECOS PAC ID: 8820496102 Enrollment ID: I20230912003556 |
| Provider Name | Nancy Schmelzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558890657 PECOS PAC ID: 9537430301 Enrollment ID: I20230912004076 |
| Provider Name | Denayer Mueller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902431810 PECOS PAC ID: 9032549753 Enrollment ID: I20230913000966 |
| Provider Name | Megan Mulligan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629783774 PECOS PAC ID: 7113399189 Enrollment ID: I20230913001169 |
| Provider Name | Patricia E Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801304423 PECOS PAC ID: 8527328830 Enrollment ID: I20230913001947 |
| Provider Name | Daniel Leon Rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104530914 PECOS PAC ID: 4688038342 Enrollment ID: I20230913002735 |
| Provider Name | Nadine Sheray Graham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518495878 PECOS PAC ID: 8820483571 Enrollment ID: I20230913004065 |
| Provider Name | Melisa Gilliam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649516337 PECOS PAC ID: 5890155287 Enrollment ID: I20230918001810 |
| Provider Name | Katie Bergin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790446698 PECOS PAC ID: 4385000835 Enrollment ID: I20231003001937 |
| Provider Name | Ashley Danielle Sharp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356035315 PECOS PAC ID: 3375999154 Enrollment ID: I20231031001174 |
| Provider Name | Kevin P Carmen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558565358 PECOS PAC ID: 9234276353 Enrollment ID: I20231109000560 |
| Provider Name | Thanh Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447241666 PECOS PAC ID: 2466435011 Enrollment ID: I20231122000973 |
| Provider Name | Hemang Panchal |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1508155144 PECOS PAC ID: 2860725678 Enrollment ID: I20231207003174 |
| Provider Name | Portia Lynn Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043961063 PECOS PAC ID: 6002267002 Enrollment ID: I20240103003917 |
| Provider Name | Felicia Humphrey |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1144511833 PECOS PAC ID: 6709005960 Enrollment ID: I20240209002330 |
| Provider Name | Andre Bobo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437299724 PECOS PAC ID: 6507818333 Enrollment ID: I20240212002590 |
| Provider Name | Hanisha Manickavasagan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437539640 PECOS PAC ID: 8820499577 Enrollment ID: I20240226003241 |
| Provider Name | Crystal Kingcade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811496631 PECOS PAC ID: 3375977226 Enrollment ID: I20240228003718 |
Summit Mental Wellness And Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4630 Village Square Dr, Suite 202, Paducah, KY 42001 Phone: 270-777-4490 Fax: 866-824-4022 | |
Laurie K. Ballew Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 657 Lone Oak Rd Ste 2, Paducah, KY 42003 Phone: 270-558-4174 Fax: 270-534-5753 | |
Psychological Associates Of Paducah, Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2315 Broadway St, Paducah, KY 42001 Phone: 270-442-8785 Fax: 270-443-1784 | |
Millstone Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4001 Hansen Rd, Paducah, KY 42001 Phone: 270-554-9216 Fax: 270-554-8732 | |
Integrated Psychological Services Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 413 Broadway St Unit A, Paducah, KY 42001 Phone: 618-727-1913 | |
Purchase Neurology Psc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 225 Medical Center Drive, Suite 402, Paducah, KY 42003 Phone: 270-441-4400 Fax: 270-441-4409 | |
Crossroads Treatment Centers Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 327 Coleman Rd, Paducah, KY 42001 Phone: 800-805-6989 |