| Mosaic Medical Center - Maryville Physician Group | |
|
2016 S Main St Maryville MO 64468-2655 | |
| (660) 562-2525 | |
| Not Available |
| Full Name | Mosaic Medical Center - Maryville Physician Group |
|---|---|
| Speciality | Specialist |
| Location | 2016 S Main St, Maryville, Missouri |
| Authorized Official Name and Position | Dwight Carvell (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Contact | 8162730473 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mosaic Medical Center - Maryville Physician Group 2016 S Main St Maryville MO 64468-2655 Ph: (660) 562-2525 | Mosaic Medical Center - Maryville Physician Group 2016 S Main St Maryville MO 64468-2655 Ph: (660) 562-2525 |
| NPI Number | 1184189797 |
|---|---|
| Provider Enumeration Date | 02/07/2019 |
| Last Update Date | 12/19/2022 |
| Certification Date | 12/19/2022 |
| Medicare PECOS PAC ID | 3678813896 |
|---|---|
| Medicare Enrollment ID | O20190405001537 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184189797 | NPI | - | NPPES |
| Provider Name | Maria A Mendez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457397671 PECOS PAC ID: 9436054459 Enrollment ID: I20031203000568 |
| Provider Name | Sally A Bomar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043212228 PECOS PAC ID: 4183518855 Enrollment ID: I20040212000333 |
| Provider Name | Robert R Grant |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1790897908 PECOS PAC ID: 1052208030 Enrollment ID: I20040303000905 |
| Provider Name | Paul R Epp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770592461 PECOS PAC ID: 1052209889 Enrollment ID: I20040304001005 |
| Provider Name | Arvind K Sharma |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588776793 PECOS PAC ID: 7911896584 Enrollment ID: I20040311001420 |
| Provider Name | Aaron Bruce Koonce |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902844384 PECOS PAC ID: 2769373026 Enrollment ID: I20040324000733 |
| Provider Name | Kanti L Havaldar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588668297 PECOS PAC ID: 0446232490 Enrollment ID: I20040603000270 |
| Provider Name | Charles Edward Chatfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548238330 PECOS PAC ID: 2163495458 Enrollment ID: I20040830000690 |
| Provider Name | Brenda L Lafollette |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588632640 PECOS PAC ID: 6406822063 Enrollment ID: I20040903000982 |
| Provider Name | Timothy J Monahan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1457348203 PECOS PAC ID: 1355236076 Enrollment ID: I20040924000446 |
| Provider Name | Ricardo A Ramos |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568574770 PECOS PAC ID: 6800856477 Enrollment ID: I20041018000849 |
| Provider Name | Bridget R Robinson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1376569608 PECOS PAC ID: 5890758007 Enrollment ID: I20041109000580 |
| Provider Name | Scott A Wade |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639103583 PECOS PAC ID: 3173581410 Enrollment ID: I20050103000649 |
| Provider Name | Denise K Miller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508834078 PECOS PAC ID: 7416908819 Enrollment ID: I20050202000992 |
| Provider Name | Lung K Tan |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1205862778 PECOS PAC ID: 8921050071 Enrollment ID: I20050420000031 |
| Provider Name | Corey Alan Trease |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1154323913 PECOS PAC ID: 8729029897 Enrollment ID: I20050518001181 |
| Provider Name | Brent S Carlson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235130329 PECOS PAC ID: 2860396314 Enrollment ID: I20050609000571 |
| Provider Name | David W Oberkrom |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043217938 PECOS PAC ID: 6002850344 Enrollment ID: I20050616000906 |
| Provider Name | Jason Robert Bible |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1336110097 PECOS PAC ID: 7214973536 Enrollment ID: I20050707000990 |
| Provider Name | James J Jura |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588698948 PECOS PAC ID: 8224066022 Enrollment ID: I20050802001101 |
| Provider Name | Jason Keith Karns |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194794164 PECOS PAC ID: 0840225371 Enrollment ID: I20051003000879 |
| Provider Name | Sheena Drake |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245255983 PECOS PAC ID: 1254356058 Enrollment ID: I20051011000646 |
| Provider Name | Padmavathi Veligati |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992738744 PECOS PAC ID: 9739133745 Enrollment ID: I20051011000770 |
| Provider Name | William Steven Long |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457457764 PECOS PAC ID: 6800811464 Enrollment ID: I20051012000785 |
| Provider Name | Davin G Turner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235161605 PECOS PAC ID: 0840210803 Enrollment ID: I20051206000157 |
| Provider Name | Bryan R Green |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295791366 PECOS PAC ID: 2466474333 Enrollment ID: I20051221000027 |
| Provider Name | Patrick B Harr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174527873 PECOS PAC ID: 8527080092 Enrollment ID: I20051227000441 |
| Provider Name | Amrit Pal Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275589426 PECOS PAC ID: 9830105154 Enrollment ID: I20060223000652 |
| Provider Name | William L Gummelt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285670281 PECOS PAC ID: 8325050552 Enrollment ID: I20060706000415 |
| Provider Name | Dana L Mcdaniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295792547 PECOS PAC ID: 5395749790 Enrollment ID: I20060825000412 |
| Provider Name | Rony M Abou-jawde |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1548226541 PECOS PAC ID: 0648274043 Enrollment ID: I20060825000436 |
| Provider Name | Chau N Nguyen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881612414 PECOS PAC ID: 6507861432 Enrollment ID: I20060927000034 |
| Provider Name | Susan Watson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508837691 PECOS PAC ID: 1355250945 Enrollment ID: I20070125000089 |
| Provider Name | Steven P Freeman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679582506 PECOS PAC ID: 6204931660 Enrollment ID: I20070413000540 |
| Provider Name | Stacey Marie Monaco |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043283625 PECOS PAC ID: 7517063076 Enrollment ID: I20070501000142 |
| Provider Name | John T Symonds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922035070 PECOS PAC ID: 1153369814 Enrollment ID: I20070504000159 |
| Provider Name | Samantha J Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770707523 PECOS PAC ID: 6002913605 Enrollment ID: I20070516000069 |
| Provider Name | Peter T Phan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316998941 PECOS PAC ID: 6608871272 Enrollment ID: I20070711000398 |
| Provider Name | Eli N Denney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417161795 PECOS PAC ID: 4284727637 Enrollment ID: I20070830000760 |
| Provider Name | Rebecca Lynn Roberts |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447289178 PECOS PAC ID: 6608964242 Enrollment ID: I20071115000562 |
| Provider Name | David J Stahl |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1275502023 PECOS PAC ID: 3678667870 Enrollment ID: I20080617000680 |
| Provider Name | Mark D Snyder |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790778587 PECOS PAC ID: 1355417395 Enrollment ID: I20080827000633 |
| Provider Name | Lisa M Newman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1326074451 PECOS PAC ID: 7618908492 Enrollment ID: I20080929000259 |
| Provider Name | Lori J Snook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669477972 PECOS PAC ID: 1850459215 Enrollment ID: I20081029000354 |
| Provider Name | David A Blaker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770720716 PECOS PAC ID: 9032273354 Enrollment ID: I20090202000414 |
| Provider Name | Matthew R Corder |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336385814 PECOS PAC ID: 4082778162 Enrollment ID: I20090204000581 |
| Provider Name | Reggie E Maggard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972740082 PECOS PAC ID: 7113075383 Enrollment ID: I20090427000413 |
| Provider Name | Roger M Goldenberg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558345769 PECOS PAC ID: 5799737417 Enrollment ID: I20090518000478 |
| Provider Name | John D Owen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356343024 PECOS PAC ID: 1456431451 Enrollment ID: I20090605000057 |
| Provider Name | Pamela M Lotz |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1619105731 PECOS PAC ID: 8921153206 Enrollment ID: I20090910000329 |
| Provider Name | Loricia L Jenkins |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821214438 PECOS PAC ID: 5496853343 Enrollment ID: I20100108000347 |
| Provider Name | John R Bennett |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457330128 PECOS PAC ID: 0446392260 Enrollment ID: I20100116000144 |
| Provider Name | Kathryn A Stueve |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1265528475 PECOS PAC ID: 8325180821 Enrollment ID: I20100121000646 |
| Provider Name | Michael J Wurm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679578884 PECOS PAC ID: 7214079409 Enrollment ID: I20100127000050 |
| Provider Name | Mohan R Hindupur |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1184660938 PECOS PAC ID: 6204979099 Enrollment ID: I20100202000384 |
| Provider Name | Lisa G Distefano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003810789 PECOS PAC ID: 4183768427 Enrollment ID: I20100224000412 |
| Provider Name | Brian D Golightly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225032923 PECOS PAC ID: 8628112968 Enrollment ID: I20100224000425 |
| Provider Name | Michelle L Kempf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356345730 PECOS PAC ID: 9638204332 Enrollment ID: I20100319000695 |
| Provider Name | Martha R Mustion |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205830601 PECOS PAC ID: 3476689233 Enrollment ID: I20100331000329 |
| Provider Name | Deborah C Blachar |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1992774905 PECOS PAC ID: 5991833543 Enrollment ID: I20100503000497 |
| Provider Name | Kay F Beatty |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1700854783 PECOS PAC ID: 0143358796 Enrollment ID: I20100503000524 |
| Provider Name | Lorraine Dodson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619970761 PECOS PAC ID: 4587757380 Enrollment ID: I20100507000562 |
| Provider Name | Morris C Matthias |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427027028 PECOS PAC ID: 7810025285 Enrollment ID: I20100507000659 |
| Provider Name | Stacie A Fisher Biller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629393434 PECOS PAC ID: 8426186578 Enrollment ID: I20100511000150 |
| Provider Name | Shakila Tanjim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619198686 PECOS PAC ID: 5092801639 Enrollment ID: I20100805000374 |
| Provider Name | Karen M Fischer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295047504 PECOS PAC ID: 3678698040 Enrollment ID: I20100909000444 |
| Provider Name | Shannon A Engel |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1649220302 PECOS PAC ID: 1153398532 Enrollment ID: I20100917000986 |
| Provider Name | Michael Joseph |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437397247 PECOS PAC ID: 8123143641 Enrollment ID: I20100921000233 |
| Provider Name | David K Chou |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841432689 PECOS PAC ID: 3072706175 Enrollment ID: I20101021000700 |
| Provider Name | Rachelle D Motsinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568760361 PECOS PAC ID: 0042494098 Enrollment ID: I20110415000288 |
| Provider Name | Kathryn M Lang Smock |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1083810196 PECOS PAC ID: 4486825361 Enrollment ID: I20110926000652 |
| Provider Name | Casey R Wagner |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1750659777 PECOS PAC ID: 5395902563 Enrollment ID: I20120131000844 |
| Provider Name | Whitney D Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467721431 PECOS PAC ID: 5698935914 Enrollment ID: I20120323000532 |
| Provider Name | Frederick C Dimmel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497056808 PECOS PAC ID: 4880854124 Enrollment ID: I20120324000037 |
| Provider Name | Tracy L Howery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528333184 PECOS PAC ID: 0042471997 Enrollment ID: I20120419000723 |
| Provider Name | Lauren A Short |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548535198 PECOS PAC ID: 7315108131 Enrollment ID: I20120420000619 |
| Provider Name | Gregory J Ramirez |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295998987 PECOS PAC ID: 5991951733 Enrollment ID: I20120809000325 |
| Provider Name | Nicole R Cloutier |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114241668 PECOS PAC ID: 3971759408 Enrollment ID: I20120815000611 |
| Provider Name | Jonathan L Hill |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437310737 PECOS PAC ID: 3779730817 Enrollment ID: I20120824000679 |
| Provider Name | Jon T Gertken |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1669670501 PECOS PAC ID: 5991863656 Enrollment ID: I20120914000278 |
| Provider Name | Jason D Lightle |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588929210 PECOS PAC ID: 3971754706 Enrollment ID: I20121103000080 |
| Provider Name | Joseph F Banks |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1508063397 PECOS PAC ID: 0244481786 Enrollment ID: I20121110000090 |
| Provider Name | Ryan B Hunsel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730352832 PECOS PAC ID: 3173793338 Enrollment ID: I20121127000621 |
| Provider Name | Kelly D Mcfee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013273812 PECOS PAC ID: 8527210012 Enrollment ID: I20121207000365 |
| Provider Name | David Lloyd Ewing |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639283369 PECOS PAC ID: 2264436344 Enrollment ID: I20130419000332 |
| Provider Name | Ernesto Jose Negron |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841475845 PECOS PAC ID: 8628194347 Enrollment ID: I20130716000900 |
| Provider Name | Nicholas James Shields |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710323191 PECOS PAC ID: 9537301585 Enrollment ID: I20130805000365 |
| Provider Name | Abra Ann Woolard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194067991 PECOS PAC ID: 8224270012 Enrollment ID: I20130807000308 |
| Provider Name | Jonathan C Amspacher |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1154527190 PECOS PAC ID: 6103069687 Enrollment ID: I20130903000018 |
| Provider Name | Mahmoud B Said |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1053390096 PECOS PAC ID: 2466461629 Enrollment ID: I20130903000586 |
| Provider Name | Sonya L Bradford Varner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275973455 PECOS PAC ID: 5496998866 Enrollment ID: I20130904000369 |
| Provider Name | David Cole Sorley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841343365 PECOS PAC ID: 5496891764 Enrollment ID: I20130930000286 |
| Provider Name | Brian R Hendrickson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1053755504 PECOS PAC ID: 3173750460 Enrollment ID: I20131211001879 |
| Provider Name | Matthew A Parker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558537522 PECOS PAC ID: 5294912671 Enrollment ID: I20140116000209 |
| Provider Name | Justin A Simpson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447494463 PECOS PAC ID: 1658512736 Enrollment ID: I20140227000170 |
| Provider Name | Joshua C Matthias |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1104056076 PECOS PAC ID: 0143450676 Enrollment ID: I20140303001112 |
| Provider Name | Shelley M Merritt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023432333 PECOS PAC ID: 4688804081 Enrollment ID: I20140304002050 |
| Provider Name | Christopher Carpenter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1457772550 PECOS PAC ID: 3476783416 Enrollment ID: I20140313000311 |
| Provider Name | Misty D Langford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699198333 PECOS PAC ID: 0446481634 Enrollment ID: I20140402000304 |
| Provider Name | Daniel W Scherer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568612588 PECOS PAC ID: 0345304986 Enrollment ID: I20140521000559 |
| Provider Name | Amy C Law |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659791556 PECOS PAC ID: 1658594031 Enrollment ID: I20140604000437 |
| Provider Name | Laura M Kenny |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558589762 PECOS PAC ID: 4587747746 Enrollment ID: I20140612000310 |
| Provider Name | Ryan R Sturm |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548589245 PECOS PAC ID: 4385897503 Enrollment ID: I20140811002785 |
| Provider Name | Brandon L Seller |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1861812968 PECOS PAC ID: 5496972572 Enrollment ID: I20140813001939 |
| Provider Name | Nancy L Bruda |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1518915503 PECOS PAC ID: 7113002676 Enrollment ID: I20140814000514 |
| Provider Name | Jane M Jones |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023334042 PECOS PAC ID: 0941422380 Enrollment ID: I20141119001305 |
| Provider Name | Stephanie L Kramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447643051 PECOS PAC ID: 8628396017 Enrollment ID: I20150415000978 |
| Provider Name | Julian Jesus Nunez |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1528054996 PECOS PAC ID: 5496734543 Enrollment ID: I20150709002762 |
| Provider Name | William F Rippe |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1316235054 PECOS PAC ID: 3971730144 Enrollment ID: I20150717000341 |
| Provider Name | Matthew T Perry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689941668 PECOS PAC ID: 1850520586 Enrollment ID: I20150721000919 |
| Provider Name | Mychi Le |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1952539660 PECOS PAC ID: 3779717368 Enrollment ID: I20150819006879 |
| Provider Name | Megan K Augustine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558737874 PECOS PAC ID: 4385951383 Enrollment ID: I20150923000552 |
| Provider Name | Phyllis Eason |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174596746 PECOS PAC ID: 1355307075 Enrollment ID: I20160210001933 |
| Provider Name | Brian J Spinks |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538429360 PECOS PAC ID: 0840510574 Enrollment ID: I20160801001562 |
| Provider Name | Louis Jamtgaard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255696308 PECOS PAC ID: 6305075326 Enrollment ID: I20160802000981 |
| Provider Name | Peter A Dawson |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1407141492 PECOS PAC ID: 1951537489 Enrollment ID: I20160811000214 |
| Provider Name | Gopichand Pendurti |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1578798393 PECOS PAC ID: 9537458955 Enrollment ID: I20160912001024 |
| Provider Name | Crystal Renea Macaluso |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043656796 PECOS PAC ID: 6901104694 Enrollment ID: I20161212001987 |
| Provider Name | Steffan Libarnes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326376773 PECOS PAC ID: 6204085673 Enrollment ID: I20170303001189 |
| Provider Name | Estella M Myrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225577372 PECOS PAC ID: 7719261783 Enrollment ID: I20170313000755 |
| Provider Name | Allison Janell Barfuss-walter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265773766 PECOS PAC ID: 1951614833 Enrollment ID: I20170522001605 |
| Provider Name | William J Kinderknecht |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821407644 PECOS PAC ID: 6406154863 Enrollment ID: I20170707000913 |
| Provider Name | Benjamin M Kinderknecht |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1801217245 PECOS PAC ID: 8729358338 Enrollment ID: I20170713003490 |
| Provider Name | Khang D Le |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1073879011 PECOS PAC ID: 9739485418 Enrollment ID: I20170815001715 |
| Provider Name | James Gaunt |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1245670637 PECOS PAC ID: 5193044881 Enrollment ID: I20170911002375 |
| Provider Name | Craig Wiley Hirsch |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588083562 PECOS PAC ID: 0143521864 Enrollment ID: I20170925003524 |
| Provider Name | Bradley A Grier |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1750624235 PECOS PAC ID: 4789959040 Enrollment ID: I20171012001547 |
| Provider Name | Miranda Marie Floyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215452289 PECOS PAC ID: 2163700790 Enrollment ID: I20171128001624 |
| Provider Name | Christopher S Miller |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1982010609 PECOS PAC ID: 4688998404 Enrollment ID: I20171206001929 |
| Provider Name | Bryon K Vogt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619362720 PECOS PAC ID: 4688976764 Enrollment ID: I20180123001721 |
| Provider Name | Pegah V Harlan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821239922 PECOS PAC ID: 3971780941 Enrollment ID: I20180326000639 |
| Provider Name | Laura E Mcfadden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386161800 PECOS PAC ID: 2163787276 Enrollment ID: I20180521000131 |
| Provider Name | Albert J Giambrone |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194790956 PECOS PAC ID: 2769429356 Enrollment ID: I20180521001634 |
| Provider Name | Lisa Cox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366824039 PECOS PAC ID: 3779839733 Enrollment ID: I20180705000128 |
| Provider Name | Mahaletwork Yeshitela Assefa |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952781726 PECOS PAC ID: 0547572992 Enrollment ID: I20180711001601 |
| Provider Name | Evan Richard Slanczka |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245625375 PECOS PAC ID: 2466750120 Enrollment ID: I20180725003168 |
| Provider Name | Anthony Okechukwu Ezemba |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1336546084 PECOS PAC ID: 3274882774 Enrollment ID: I20180816001127 |
| Provider Name | Katelyn A Harris |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265827877 PECOS PAC ID: 9537475819 Enrollment ID: I20180820001074 |
| Provider Name | Jared N Norman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619330073 PECOS PAC ID: 9931491446 Enrollment ID: I20180910002954 |
| Provider Name | Andrea Rosewell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356784508 PECOS PAC ID: 4082857743 Enrollment ID: I20181129001350 |
| Provider Name | Kevin Tran |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588059190 PECOS PAC ID: 8426360546 Enrollment ID: I20181206000652 |
| Provider Name | Cali M Lloyd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487110789 PECOS PAC ID: 6002155140 Enrollment ID: I20190306003265 |
| Provider Name | Joseph B Weimholt |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1093241135 PECOS PAC ID: 0042581795 Enrollment ID: I20190710002979 |
| Provider Name | Brian Wright Roe |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396007894 PECOS PAC ID: 0648508275 Enrollment ID: I20190821000916 |
| Provider Name | Nicholas A. Kaup |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295112076 PECOS PAC ID: 1951608934 Enrollment ID: I20190821002485 |
| Provider Name | Sajjad Ahmad |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013359173 PECOS PAC ID: 0244522936 Enrollment ID: I20190911003179 |
| Provider Name | Allison Marie Voeks Roe |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1497015705 PECOS PAC ID: 7810283629 Enrollment ID: I20190919001611 |
| Provider Name | Lauren G Dozier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669022174 PECOS PAC ID: 3870925191 Enrollment ID: I20191107000560 |
| Provider Name | Alison Sporleder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275183055 PECOS PAC ID: 1850723123 Enrollment ID: I20191107002638 |
| Provider Name | Donna Ching |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780636670 PECOS PAC ID: 5698734960 Enrollment ID: I20191122000374 |
| Provider Name | Paula Goodridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982251856 PECOS PAC ID: 4981030889 Enrollment ID: I20200213001078 |
| Provider Name | Kristin A Cecil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932739620 PECOS PAC ID: 5698103380 Enrollment ID: I20200311001375 |
| Provider Name | Jodi Midiri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528454170 PECOS PAC ID: 2769788207 Enrollment ID: I20200423002868 |
| Provider Name | Kaylee A Messner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982239349 PECOS PAC ID: 7719318591 Enrollment ID: I20200511003019 |
| Provider Name | Sarah Ann Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942830872 PECOS PAC ID: 1658793427 Enrollment ID: I20200624001386 |
| Provider Name | Jeffery Richard Sturdivan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275081499 PECOS PAC ID: 6305268970 Enrollment ID: I20200629000305 |
| Provider Name | Rey Anthony Carandang |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1295265544 PECOS PAC ID: 2769752286 Enrollment ID: I20200804001048 |
| Provider Name | Sai Siva Ram Guduru |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700316528 PECOS PAC ID: 9537584776 Enrollment ID: I20200804002923 |
| Provider Name | John Weitlich |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1417339623 PECOS PAC ID: 8022326909 Enrollment ID: I20200807000804 |
| Provider Name | German Kamalov |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225259385 PECOS PAC ID: 9739360934 Enrollment ID: I20200807002193 |
| Provider Name | Amulya Dakka |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326569328 PECOS PAC ID: 6608292024 Enrollment ID: I20200817001761 |
| Provider Name | Ryan Harold Wyatt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346776242 PECOS PAC ID: 0143646299 Enrollment ID: I20200819002770 |
| Provider Name | Ion Volosenco |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801317508 PECOS PAC ID: 0143556837 Enrollment ID: I20200820000425 |
| Provider Name | Surabh Khanal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639602535 PECOS PAC ID: 1355615188 Enrollment ID: I20200821000409 |
| Provider Name | Uchechi Genevieve Ibe |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1447782099 PECOS PAC ID: 5193142578 Enrollment ID: I20200831001819 |
| Provider Name | Alan Anderson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003159005 PECOS PAC ID: 4082918883 Enrollment ID: I20200902002449 |
| Provider Name | Zachary Downs |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407241433 PECOS PAC ID: 1759634793 Enrollment ID: I20201112002908 |
| Provider Name | Adam Condra |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467816470 PECOS PAC ID: 5193010023 Enrollment ID: I20201223001250 |
| Provider Name | Jarret Gardner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144726837 PECOS PAC ID: 3072869577 Enrollment ID: I20210104001510 |
| Provider Name | Taylor R Ellis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1275144156 PECOS PAC ID: 2961822093 Enrollment ID: I20210423001760 |
| Provider Name | Patrick Brown |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083119614 PECOS PAC ID: 4880094960 Enrollment ID: I20210610002230 |
| Provider Name | Victoria Mulandi |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1144598657 PECOS PAC ID: 9638338312 Enrollment ID: I20210614001342 |
| Provider Name | Suzanne Renee Martell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912592536 PECOS PAC ID: 2365842812 Enrollment ID: I20210621001996 |
| Provider Name | Diti Ronvelia |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619464427 PECOS PAC ID: 3779831771 Enrollment ID: I20210712001801 |
| Provider Name | Annette Lyons |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912238171 PECOS PAC ID: 8123154507 Enrollment ID: I20210712001946 |
| Provider Name | Loren Olson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184613101 PECOS PAC ID: 4486611423 Enrollment ID: I20210713001953 |
| Provider Name | Zach Boal |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053805531 PECOS PAC ID: 0749534535 Enrollment ID: I20210720003084 |
| Provider Name | Elena Dimiceli |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528592060 PECOS PAC ID: 3577802776 Enrollment ID: I20210721003452 |
| Provider Name | Donald P Kingsley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568966919 PECOS PAC ID: 9537411822 Enrollment ID: I20210726001351 |
| Provider Name | Daniel Kolm |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811491012 PECOS PAC ID: 3779831029 Enrollment ID: I20210728001327 |
| Provider Name | Shane Kevin Giannetti |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295298651 PECOS PAC ID: 5890020499 Enrollment ID: I20210810002049 |
| Provider Name | Aadil Ahmed |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1528550357 PECOS PAC ID: 4082959697 Enrollment ID: I20210826002287 |
| Provider Name | Mercy Dickson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336643170 PECOS PAC ID: 5395091714 Enrollment ID: I20210830001797 |
| Provider Name | Derek Su |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679066765 PECOS PAC ID: 4082961230 Enrollment ID: I20210830002023 |
| Provider Name | Claire Christine Gregson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154943991 PECOS PAC ID: 0446656292 Enrollment ID: I20210902002679 |
| Provider Name | Samantha J Dearmon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1164913240 PECOS PAC ID: 4284982877 Enrollment ID: I20211011002238 |
| Provider Name | Chacy Anna Lancaster |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477050938 PECOS PAC ID: 4587991682 Enrollment ID: I20211110000577 |
| Provider Name | Chelsea Renea Ingino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053073262 PECOS PAC ID: 1456740810 Enrollment ID: I20211213001405 |
| Provider Name | Madison Emery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699373035 PECOS PAC ID: 2668865478 Enrollment ID: I20220131000658 |
| Provider Name | Sara Beth Henggeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609520733 PECOS PAC ID: 8022404086 Enrollment ID: I20220331001403 |
| Provider Name | Donald G Peghee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235221433 PECOS PAC ID: 6901808385 Enrollment ID: I20220421000228 |
| Provider Name | Allison Lahnanen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1861137614 PECOS PAC ID: 7810376688 Enrollment ID: I20220624001226 |
| Provider Name | Sarah Perdue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265914576 PECOS PAC ID: 4688927619 Enrollment ID: I20220707001304 |
| Provider Name | Zachary E Officer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407590375 PECOS PAC ID: 5193106375 Enrollment ID: I20220719002687 |
| Provider Name | Ronak Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871150136 PECOS PAC ID: 2264765908 Enrollment ID: I20220721002380 |
| Provider Name | Mohammad Nimer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710440193 PECOS PAC ID: 1355676461 Enrollment ID: I20220728001961 |
| Provider Name | Richard Wadsworth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790279511 PECOS PAC ID: 4981951035 Enrollment ID: I20220801001429 |
| Provider Name | Tyler Brown |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912387283 PECOS PAC ID: 4082969357 Enrollment ID: I20220801001696 |
| Provider Name | Kristopher Mitchell Short |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215671128 PECOS PAC ID: 4981087806 Enrollment ID: I20220810001102 |
| Provider Name | Nafis Islam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780146308 PECOS PAC ID: 6901131788 Enrollment ID: I20220811001448 |
| Provider Name | Michael Lunski |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1063875227 PECOS PAC ID: 0749575108 Enrollment ID: I20220825003111 |
| Provider Name | Olujimi Jegede |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1609396571 PECOS PAC ID: 8820368343 Enrollment ID: I20220830000750 |
| Provider Name | Warren Linnerooth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346700374 PECOS PAC ID: 9436533148 Enrollment ID: I20220830001966 |
| Provider Name | Mandalyn Mills |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548780844 PECOS PAC ID: 8527337252 Enrollment ID: I20220921001634 |
| Provider Name | James Lynch |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205327608 PECOS PAC ID: 3476809591 Enrollment ID: I20220922001038 |
| Provider Name | David De La Cruz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518463124 PECOS PAC ID: 9830446038 Enrollment ID: I20220923000964 |
| Provider Name | Paul Brungardt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386107936 PECOS PAC ID: 1254668445 Enrollment ID: I20220923002297 |
| Provider Name | Rachel Warnert |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609371814 PECOS PAC ID: 8820346604 Enrollment ID: I20221021000687 |
| Provider Name | David Nguyen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477112860 PECOS PAC ID: 3971970377 Enrollment ID: I20221027001067 |
| Provider Name | Bader Abdelhaleem Abuhazeem |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467098624 PECOS PAC ID: 7214304955 Enrollment ID: I20221109000835 |
| Provider Name | Nathan Noakes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891201869 PECOS PAC ID: 6305226713 Enrollment ID: I20221116002556 |
| Provider Name | Brent Eaton |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679815740 PECOS PAC ID: 5294007712 Enrollment ID: I20221206001939 |
| Provider Name | Kristine K Kramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326753682 PECOS PAC ID: 7113390766 Enrollment ID: I20230301000568 |
| Provider Name | Cassandra D Veale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740996495 PECOS PAC ID: 1951775568 Enrollment ID: I20230322002008 |
| Provider Name | Aleatha Hoff |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689038234 PECOS PAC ID: 0941583918 Enrollment ID: I20230412001414 |
| Provider Name | Sarah Pfeiffer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578907622 PECOS PAC ID: 6406157114 Enrollment ID: I20230507000035 |
| Provider Name | Braedyn R Mitchell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356044127 PECOS PAC ID: 2567822505 Enrollment ID: I20230721001471 |
| Provider Name | Cody Pollack |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518499607 PECOS PAC ID: 0547689317 Enrollment ID: I20230721001813 |
| Provider Name | Stevi Lee Dunlap |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568146322 PECOS PAC ID: 3779944566 Enrollment ID: I20230726001416 |
| Provider Name | Amber Dawn Lewis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740977248 PECOS PAC ID: 3678934478 Enrollment ID: I20230726001916 |
| Provider Name | Steyr Stubenrauch |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730879560 PECOS PAC ID: 4587026299 Enrollment ID: I20230811002685 |
| Provider Name | Haley N Simpson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982216354 PECOS PAC ID: 7416316187 Enrollment ID: I20230815001270 |
| Provider Name | Allison Kayla Delasalle |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992480024 PECOS PAC ID: 8729440284 Enrollment ID: I20230815002596 |
| Provider Name | Isaac Demke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487278750 PECOS PAC ID: 8426473950 Enrollment ID: I20230928003350 |
| Provider Name | Brent Allen Matthews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770261471 PECOS PAC ID: 1557716198 Enrollment ID: I20231017001287 |
| Provider Name | Paige Dosch |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871171256 PECOS PAC ID: 2365844883 Enrollment ID: I20231102003492 |
| Provider Name | Daniel Shashy Masin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003493669 PECOS PAC ID: 3072916691 Enrollment ID: I20231215001901 |
| Provider Name | Hayley E Gorman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255919270 PECOS PAC ID: 4385046804 Enrollment ID: I20231222001196 |
| Provider Name | Javier Loeza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437684123 PECOS PAC ID: 9234551292 Enrollment ID: I20240112002007 |
| Provider Name | Christopher Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356831705 PECOS PAC ID: 2163829748 Enrollment ID: I20240125000256 |
New Beginnings Counseling Center Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 318 North Main Street, Maryville, MO 64468 Phone: 660-562-3000 Fax: 660-562-3002 | |
New Beginnings Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 423 N Market St, Maryville, MO 64468 Phone: 660-562-3000 Fax: 660-562-3002 | |
Mosaic Behavioral Health - Maryville Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2016 S Main St, Maryville, MO 64468 Phone: 660-562-2600 Fax: 660-562-7943 | |
Ken Thom Counseling Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 W Cooper, Maryville, MO 64468 Phone: 660-562-2531 Fax: 660-562-3239 | |
Hallelujah Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1315 S Main St Ste C, Maryville, MO 64468 Phone: 660-223-1700 | |
Jacobson Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 W Edwards St, Maryville, MO 64468 Phone: 660-254-1812 |