| Providence Medical Group | |
|
101 W 8th Ave Mother Gamelin Center 3rd Floor Spokane WA 99204-2307 | |
| (509) 474-2072 | |
| Not Available |
| Full Name | Providence Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 101 W 8th Ave, Spokane, Washington |
| Authorized Official Name and Position | Donald W Anderson (ASSISTANT SECRETARY OF ENROLLMENTS) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Medical Group Po Box 421 Liberty Lake WA 99019-0421 Ph: () - | Providence Medical Group 101 W 8th Ave Mother Gamelin Center 3rd Floor Spokane WA 99204-2307 Ph: (509) 474-2072 |
| NPI Number | 1194099390 |
|---|---|
| Provider Enumeration Date | 03/06/2012 |
| Last Update Date | 02/08/2024 |
| Certification Date | 02/08/2024 |
| Medicare PECOS PAC ID | 0345139929 |
|---|---|
| Medicare Enrollment ID | O20040311001453 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194099390 | NPI | - | NPPES |
| Provider Name | William F Reed |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437167566 PECOS PAC ID: 7719891951 Enrollment ID: I20031113000117 |
| Provider Name | Gregory P Macdonald |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508890872 PECOS PAC ID: 7214841527 Enrollment ID: I20031119000314 |
| Provider Name | Susan D Frankovich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174516702 PECOS PAC ID: 5698670651 Enrollment ID: I20031203000321 |
| Provider Name | Leo Eugene Obermiller |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1528159316 PECOS PAC ID: 2163320011 Enrollment ID: I20031230000218 |
| Provider Name | Joseph D Phaneuf |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053413153 PECOS PAC ID: 9335041789 Enrollment ID: I20040126000063 |
| Provider Name | Keith A Morton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568564664 PECOS PAC ID: 3577465939 Enrollment ID: I20040126000085 |
| Provider Name | Sean D Hurley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477655579 PECOS PAC ID: 4587566948 Enrollment ID: I20040126000141 |
| Provider Name | Laura Janelle Wills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265424402 PECOS PAC ID: 1153224647 Enrollment ID: I20040130001093 |
| Provider Name | Michael C Kerkering |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881602910 PECOS PAC ID: 2860484185 Enrollment ID: I20040330000700 |
| Provider Name | Daniel T Yang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649372756 PECOS PAC ID: 4880686310 Enrollment ID: I20040402000271 |
| Provider Name | Michael M Mccarthy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1619061389 PECOS PAC ID: 4183619471 Enrollment ID: I20040416000612 |
| Provider Name | Robert J Maurer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346222759 PECOS PAC ID: 7719972819 Enrollment ID: I20040419000163 |
| Provider Name | Radica Z Alicic |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780667642 PECOS PAC ID: 0941299598 Enrollment ID: I20040508000435 |
| Provider Name | Richard Jensen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699728022 PECOS PAC ID: 8628067287 Enrollment ID: I20040510000022 |
| Provider Name | Stephen Murray |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1427011394 PECOS PAC ID: 1456340801 Enrollment ID: I20040510001591 |
| Provider Name | James A Numata |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396811220 PECOS PAC ID: 9436140050 Enrollment ID: I20040521000930 |
| Provider Name | Paul E Russell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437229218 PECOS PAC ID: 1153312681 Enrollment ID: I20040521001108 |
| Provider Name | Andrew T Howlett |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1639145618 PECOS PAC ID: 5294718540 Enrollment ID: I20040609000500 |
| Provider Name | Benjamin C Ling |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1710932579 PECOS PAC ID: 1052394251 Enrollment ID: I20040609000903 |
| Provider Name | Paul R Larsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720189749 PECOS PAC ID: 5597749358 Enrollment ID: I20040617001041 |
| Provider Name | Camtu M Thai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518950682 PECOS PAC ID: 2264419514 Enrollment ID: I20040702001251 |
| Provider Name | Sima G Issen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932211083 PECOS PAC ID: 7810975760 Enrollment ID: I20040708000855 |
| Provider Name | Joseph T Michels |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326031584 PECOS PAC ID: 2264410968 Enrollment ID: I20040709000584 |
| Provider Name | John N Klim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962494831 PECOS PAC ID: 5991783623 Enrollment ID: I20040709000803 |
| Provider Name | Glen R Stream |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265425326 PECOS PAC ID: 3476462060 Enrollment ID: I20040709000867 |
| Provider Name | Carol H Wysham |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1457344541 PECOS PAC ID: 4284612623 Enrollment ID: I20040712000665 |
| Provider Name | Tim P Lovell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1326030743 PECOS PAC ID: 4284612649 Enrollment ID: I20040712000768 |
| Provider Name | David R Fregeau |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962494393 PECOS PAC ID: 6305824798 Enrollment ID: I20040712001015 |
| Provider Name | Michael S Wukelic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477546554 PECOS PAC ID: 7416935689 Enrollment ID: I20040713000906 |
| Provider Name | Jeff L Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558353201 PECOS PAC ID: 7517946676 Enrollment ID: I20040714000635 |
| Provider Name | Rita M Snow |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114984531 PECOS PAC ID: 8224017025 Enrollment ID: I20040715000882 |
| Provider Name | Megan M Bristow |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255321618 PECOS PAC ID: 0143209957 Enrollment ID: I20040715000933 |
| Provider Name | Henry Mroch |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1245324219 PECOS PAC ID: 7214916840 Enrollment ID: I20040716001139 |
| Provider Name | Richard Parker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477698918 PECOS PAC ID: 0941289433 Enrollment ID: I20040719000037 |
| Provider Name | Timothy W Powell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982697090 PECOS PAC ID: 5294714671 Enrollment ID: I20040719000742 |
| Provider Name | Carijean Queen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679566996 PECOS PAC ID: 3072592450 Enrollment ID: I20040719000768 |
| Provider Name | Philip C Delich |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1407858889 PECOS PAC ID: 8224018940 Enrollment ID: I20040722001372 |
| Provider Name | Rebecca G Gallaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831181510 PECOS PAC ID: 5496735912 Enrollment ID: I20040723000750 |
| Provider Name | Amy J Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306848379 PECOS PAC ID: 9537149018 Enrollment ID: I20040723001158 |
| Provider Name | Debra R Gore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306984646 PECOS PAC ID: 7012987019 Enrollment ID: I20040728000207 |
| Provider Name | Anne M Montgomery |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477658102 PECOS PAC ID: 4981674785 Enrollment ID: I20040729000116 |
| Provider Name | Heather M Brennan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043292808 PECOS PAC ID: 5597736918 Enrollment ID: I20040802000210 |
| Provider Name | Geoffry S Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578655866 PECOS PAC ID: 8426029646 Enrollment ID: I20040803000142 |
| Provider Name | Judy A Benson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922081884 PECOS PAC ID: 1951372986 Enrollment ID: I20040804000005 |
| Provider Name | Darryl K Potyk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992780654 PECOS PAC ID: 0840261871 Enrollment ID: I20040804000025 |
| Provider Name | Benjamin Hsu |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1164401444 PECOS PAC ID: 0143110502 Enrollment ID: I20040804000056 |
| Provider Name | Judy G Swanson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447235650 PECOS PAC ID: 4486625423 Enrollment ID: I20040804000091 |
| Provider Name | Mary L Gilbert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699864603 PECOS PAC ID: 7315918257 Enrollment ID: I20040804000152 |
| Provider Name | Laurie Summers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073583670 PECOS PAC ID: 2163493362 Enrollment ID: I20040804000431 |
| Provider Name | Jeremy D Graham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093767303 PECOS PAC ID: 4688645575 Enrollment ID: I20040804000525 |
| Provider Name | Julia S Doyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891767190 PECOS PAC ID: 5395717797 Enrollment ID: I20040806000869 |
| Provider Name | Kelley M Mathia |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891783924 PECOS PAC ID: 3971575978 Enrollment ID: I20040811000009 |
| Provider Name | Griffith E Liang |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1891737748 PECOS PAC ID: 7416920574 Enrollment ID: I20040817000466 |
| Provider Name | Svetlana F Cox |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467418384 PECOS PAC ID: 6103892617 Enrollment ID: I20040907000764 |
| Provider Name | Jennifer A Troiano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073547378 PECOS PAC ID: 5890763502 Enrollment ID: I20040921000507 |
| Provider Name | Madeleine M Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558561829 PECOS PAC ID: 2062471543 Enrollment ID: I20041008001235 |
| Provider Name | Timothy W Bax |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255303301 PECOS PAC ID: 4082697941 Enrollment ID: I20041028000247 |
| Provider Name | Paul H Lin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528030665 PECOS PAC ID: 3870480239 Enrollment ID: I20041104000656 |
| Provider Name | Damanjeet S Chugh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366492944 PECOS PAC ID: 8224092473 Enrollment ID: I20041117000261 |
| Provider Name | Peter L Weitzman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801885660 PECOS PAC ID: 6901890250 Enrollment ID: I20041130000985 |
| Provider Name | David P Gruber |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1700824554 PECOS PAC ID: 5597666776 Enrollment ID: I20041229000847 |
| Provider Name | John J Brandabur |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1568493997 PECOS PAC ID: 8628036019 Enrollment ID: I20050103000239 |
| Provider Name | Alfonso Oliva |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1093728784 PECOS PAC ID: 4082666797 Enrollment ID: I20050210000507 |
| Provider Name | Brandon N Ong |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013968072 PECOS PAC ID: 2466405535 Enrollment ID: I20050301000473 |
| Provider Name | Richard Mattis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821040247 PECOS PAC ID: 7113964958 Enrollment ID: I20050413000155 |
| Provider Name | Melanie K Bergman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902892987 PECOS PAC ID: 9436199783 Enrollment ID: I20050505001249 |
| Provider Name | Timothy Dee Maughan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1346282373 PECOS PAC ID: 7719916873 Enrollment ID: I20050809000437 |
| Provider Name | Corrine L Bresko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447247499 PECOS PAC ID: 1557390523 Enrollment ID: I20050810000263 |
| Provider Name | Ronald L Ortiz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659473759 PECOS PAC ID: 1355371261 Enrollment ID: I20050819000168 |
| Provider Name | Cecilia M Lauder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487729315 PECOS PAC ID: 0941231740 Enrollment ID: I20050822000860 |
| Provider Name | Jennifer Robin Messinger |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538152418 PECOS PAC ID: 7113958034 Enrollment ID: I20050830000609 |
| Provider Name | Charles C Anderson |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1316990666 PECOS PAC ID: 0446284467 Enrollment ID: I20050920000580 |
| Provider Name | Carl Garabedian |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083666127 PECOS PAC ID: 1850325820 Enrollment ID: I20050920000973 |
| Provider Name | Sandra L Schilling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104811033 PECOS PAC ID: 7911922034 Enrollment ID: I20051007000634 |
| Provider Name | Nelson Chow |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1427142470 PECOS PAC ID: 8022034776 Enrollment ID: I20051021000258 |
| Provider Name | Krishna M Malireddi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1780778746 PECOS PAC ID: 0143266247 Enrollment ID: I20051024000492 |
| Provider Name | Traci Ann Satterfield |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528056744 PECOS PAC ID: 8426074972 Enrollment ID: I20051024000534 |
| Provider Name | April S Hume |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326055831 PECOS PAC ID: 2567480775 Enrollment ID: I20051107000346 |
| Provider Name | Ednea A Simon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174604425 PECOS PAC ID: 9335160340 Enrollment ID: I20051216000671 |
| Provider Name | Clinton D Hubbard |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912997370 PECOS PAC ID: 7810919149 Enrollment ID: I20051229000431 |
| Provider Name | Janet Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467675892 PECOS PAC ID: 4880618636 Enrollment ID: I20060119000172 |
| Provider Name | Kathrine R Tuttle |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1740399492 PECOS PAC ID: 6204840903 Enrollment ID: I20060202000109 |
| Provider Name | Elhami Hannan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1093803884 PECOS PAC ID: 9638124100 Enrollment ID: I20060321000259 |
| Provider Name | Jonathan M Nickoloff |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891742664 PECOS PAC ID: 2163430638 Enrollment ID: I20060324000052 |
| Provider Name | Siting S S Chen |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1689662587 PECOS PAC ID: 4183634504 Enrollment ID: I20060501000326 |
| Provider Name | Paul C Thorne |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003840398 PECOS PAC ID: 3173533221 Enrollment ID: I20060503000556 |
| Provider Name | John F Floyd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114913621 PECOS PAC ID: 0840201026 Enrollment ID: I20060601000300 |
| Provider Name | Adam H Juviler |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1396792073 PECOS PAC ID: 4880606623 Enrollment ID: I20060619000243 |
| Provider Name | Maria H Janout |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1922052737 PECOS PAC ID: 3971572181 Enrollment ID: I20060627000250 |
| Provider Name | Allen R Skidmore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053306100 PECOS PAC ID: 9638182751 Enrollment ID: I20060713000043 |
| Provider Name | Donald S Howard |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1376590778 PECOS PAC ID: 1658383732 Enrollment ID: I20060809000462 |
| Provider Name | Jamil Abou Harb |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891712980 PECOS PAC ID: 5193721611 Enrollment ID: I20061005000581 |
| Provider Name | Megan A Hoefer |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1306941109 PECOS PAC ID: 6608872122 Enrollment ID: I20061005000602 |
| Provider Name | Jess M Schultz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366461097 PECOS PAC ID: 4284631276 Enrollment ID: I20061106000200 |
| Provider Name | Ponrat Pakpreo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023050200 PECOS PAC ID: 6901827658 Enrollment ID: I20061211000485 |
| Provider Name | Derrick R Havin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467563304 PECOS PAC ID: 1557361920 Enrollment ID: I20070109000156 |
| Provider Name | Todd R Ewert |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861471385 PECOS PAC ID: 1254232002 Enrollment ID: I20070213000128 |
| Provider Name | Kari L Jones |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295841989 PECOS PAC ID: 2466477781 Enrollment ID: I20070213000465 |
| Provider Name | Kristen Lee Winther |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821140591 PECOS PAC ID: 9234231606 Enrollment ID: I20070305000065 |
| Provider Name | Christopher S Famy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043329840 PECOS PAC ID: 7113023672 Enrollment ID: I20070501000159 |
| Provider Name | Lisa L Randall |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1558459685 PECOS PAC ID: 5890891162 Enrollment ID: I20070502000486 |
| Provider Name | Mehrdad Farahmand |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629066733 PECOS PAC ID: 8820194921 Enrollment ID: I20070507000466 |
| Provider Name | Jody M Hechtman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871518456 PECOS PAC ID: 7719914530 Enrollment ID: I20070508000034 |
| Provider Name | Vicki Bolton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811928187 PECOS PAC ID: 8022115930 Enrollment ID: I20070529000317 |
| Provider Name | William S Stovall |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992819049 PECOS PAC ID: 6204934185 Enrollment ID: I20070531000586 |
| Provider Name | Ramon G Canto |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1386632487 PECOS PAC ID: 0345349833 Enrollment ID: I20070625000356 |
| Provider Name | Mihaela Cosma |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1215915103 PECOS PAC ID: 9032175419 Enrollment ID: I20070629000167 |
| Provider Name | Michael J Reznicek |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760568760 PECOS PAC ID: 0749389849 Enrollment ID: I20070629000304 |
| Provider Name | Lisa D Stiller |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1982751319 PECOS PAC ID: 9830298967 Enrollment ID: I20070629000499 |
| Provider Name | Wendy Kay Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346346509 PECOS PAC ID: 8325148166 Enrollment ID: I20070710000394 |
| Provider Name | Kathleen M Manion |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376613422 PECOS PAC ID: 6305947599 Enrollment ID: I20070718000119 |
| Provider Name | Tanya Keeble |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619000569 PECOS PAC ID: 1153422605 Enrollment ID: I20070727000215 |
| Provider Name | Neda T Cyprova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467580985 PECOS PAC ID: 8426156571 Enrollment ID: I20070730000581 |
| Provider Name | Elizabeth Duran |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073663522 PECOS PAC ID: 2163513136 Enrollment ID: I20070806000163 |
| Provider Name | Alina I Peffer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871796326 PECOS PAC ID: 2860583887 Enrollment ID: I20070809000334 |
| Provider Name | Jeremiah M Clinton |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1578575734 PECOS PAC ID: 4981795572 Enrollment ID: I20070810000756 |
| Provider Name | Carmen V Mcdermott |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982713665 PECOS PAC ID: 9739271354 Enrollment ID: I20070827000649 |
| Provider Name | Christopher M Kishiyama |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477609147 PECOS PAC ID: 6800988361 Enrollment ID: I20070828001102 |
| Provider Name | Amy R Occhino |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629081286 PECOS PAC ID: 4880786342 Enrollment ID: I20070828001110 |
| Provider Name | Elizabeth M Jansen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013086693 PECOS PAC ID: 3274637442 Enrollment ID: I20070907000130 |
| Provider Name | Jason G Ruzicka |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346440930 PECOS PAC ID: 3274626270 Enrollment ID: I20070907000159 |
| Provider Name | Sheila D Smith |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487859708 PECOS PAC ID: 7911090519 Enrollment ID: I20070912000164 |
| Provider Name | Edward D Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780672725 PECOS PAC ID: 5395830111 Enrollment ID: I20071009000077 |
| Provider Name | Bernard E Currigan |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1275521379 PECOS PAC ID: 6901992338 Enrollment ID: I20071017000471 |
| Provider Name | Robert Cooper |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1114902905 PECOS PAC ID: 4688760630 Enrollment ID: I20071022000663 |
| Provider Name | Ryan Nachreiner |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1104874569 PECOS PAC ID: 5698662856 Enrollment ID: I20071126000358 |
| Provider Name | James W Watkins |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316134158 PECOS PAC ID: 6305936956 Enrollment ID: I20071219000522 |
| Provider Name | Carol R Guthrie |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992813141 PECOS PAC ID: 5698760072 Enrollment ID: I20080115000184 |
| Provider Name | Cynthia R Murphy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184826125 PECOS PAC ID: 2466533047 Enrollment ID: I20080122000242 |
| Provider Name | Arpan Waghray |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801088794 PECOS PAC ID: 5597847459 Enrollment ID: I20080130000729 |
| Provider Name | Deborah A Montowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093703100 PECOS PAC ID: 1951486018 Enrollment ID: I20080313000240 |
| Provider Name | Mary Foutz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275708240 PECOS PAC ID: 2668542929 Enrollment ID: I20080529000738 |
| Provider Name | Jonathan Carlson |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1922219500 PECOS PAC ID: 4284704842 Enrollment ID: I20080609000433 |
| Provider Name | Patrick J Shannon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538157433 PECOS PAC ID: 9537246996 Enrollment ID: I20080618000490 |
| Provider Name | Kristi A Rice |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851321327 PECOS PAC ID: 6709957368 Enrollment ID: I20080625000542 |
| Provider Name | Sanjit K Dutta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881610038 PECOS PAC ID: 1456325349 Enrollment ID: I20080721000793 |
| Provider Name | Julie A Ulloa Michaelis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346267036 PECOS PAC ID: 7618973728 Enrollment ID: I20080721000800 |
| Provider Name | Amy G Burns |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518070341 PECOS PAC ID: 0840363644 Enrollment ID: I20080725000553 |
| Provider Name | Karina M Dierks |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184747388 PECOS PAC ID: 7113091976 Enrollment ID: I20080729000165 |
| Provider Name | Martha Dobbins Odegard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447361019 PECOS PAC ID: 2264508274 Enrollment ID: I20080827000321 |
| Provider Name | Deborah L Fertakis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710015110 PECOS PAC ID: 0446326326 Enrollment ID: I20080829000309 |
| Provider Name | Sandra Friendshuh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467562413 PECOS PAC ID: 7214039676 Enrollment ID: I20080925000150 |
| Provider Name | Michele J Greenwood |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1396912085 PECOS PAC ID: 5294893137 Enrollment ID: I20081022000409 |
| Provider Name | Betty A Gilchrist |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1659547909 PECOS PAC ID: 2264590058 Enrollment ID: I20081023000156 |
| Provider Name | Linda L J Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467501817 PECOS PAC ID: 1557339587 Enrollment ID: I20081031000344 |
| Provider Name | Pamela A Polensky Bonser |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1689841371 PECOS PAC ID: 7719046895 Enrollment ID: I20081104000405 |
| Provider Name | Monica Marton Popovici |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437326626 PECOS PAC ID: 4385705763 Enrollment ID: I20081203000653 |
| Provider Name | Gary G Gularte |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174665913 PECOS PAC ID: 1456413301 Enrollment ID: I20081231000119 |
| Provider Name | Marylynn Bernard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457344152 PECOS PAC ID: 3971585647 Enrollment ID: I20090112000262 |
| Provider Name | Christopher Tullis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578600342 PECOS PAC ID: 3274699772 Enrollment ID: I20090309000366 |
| Provider Name | Randall Volk |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538205794 PECOS PAC ID: 2163588666 Enrollment ID: I20090309000393 |
| Provider Name | John E Chapin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245246990 PECOS PAC ID: 1355423567 Enrollment ID: I20090323000394 |
| Provider Name | Michael J Doherty |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033299953 PECOS PAC ID: 5799833075 Enrollment ID: I20090423000797 |
| Provider Name | Lindsey A Dunham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093886061 PECOS PAC ID: 6800865031 Enrollment ID: I20090429000595 |
| Provider Name | Salil J Manek |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467573600 PECOS PAC ID: 9032163118 Enrollment ID: I20090602000094 |
| Provider Name | Sarah Wilhelm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265450324 PECOS PAC ID: 7416988746 Enrollment ID: I20090611000437 |
| Provider Name | Livia A Foley |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1740414325 PECOS PAC ID: 6901957257 Enrollment ID: I20090625000556 |
| Provider Name | Karen M Wildman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861439770 PECOS PAC ID: 8729155445 Enrollment ID: I20090722000087 |
| Provider Name | Vijayakumar K Reddy |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1932391547 PECOS PAC ID: 1557415601 Enrollment ID: I20090824000731 |
| Provider Name | Christina M Gerhardt |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639225246 PECOS PAC ID: 3971659145 Enrollment ID: I20090914000538 |
| Provider Name | Katherine B Reed |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1396919569 PECOS PAC ID: 8729134598 Enrollment ID: I20090918000508 |
| Provider Name | Ruth E Cockley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992962740 PECOS PAC ID: 1153477492 Enrollment ID: I20090928000784 |
| Provider Name | William O Wheeler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134150758 PECOS PAC ID: 6406802107 Enrollment ID: I20091021000282 |
| Provider Name | Bryan K Stamm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447246574 PECOS PAC ID: 8123017035 Enrollment ID: I20091201000681 |
| Provider Name | Robert D Wigert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215994587 PECOS PAC ID: 8123054806 Enrollment ID: I20091208000086 |
| Provider Name | Kimberly L Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073849410 PECOS PAC ID: 1355481748 Enrollment ID: I20091215000675 |
| Provider Name | Christiana B Pierce |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558491738 PECOS PAC ID: 5294875308 Enrollment ID: I20091222000324 |
| Provider Name | Harold K Cathcart |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1104815935 PECOS PAC ID: 9638163983 Enrollment ID: I20091228000606 |
| Provider Name | Russell S Vanderwilde |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1871562967 PECOS PAC ID: 8123019775 Enrollment ID: I20091230000481 |
| Provider Name | Elizabeth A Grosen |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1235125220 PECOS PAC ID: 7214824572 Enrollment ID: I20091230000557 |
| Provider Name | Okechukwu N Ojogho |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972535128 PECOS PAC ID: 6103988878 Enrollment ID: I20100105000577 |
| Provider Name | Rimma Barko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598997827 PECOS PAC ID: 4688714082 Enrollment ID: I20100111000356 |
| Provider Name | Daniel J Dionne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386693307 PECOS PAC ID: 0941236616 Enrollment ID: I20100112000679 |
| Provider Name | Kathleen M Schatz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912100496 PECOS PAC ID: 5597807362 Enrollment ID: I20100118000192 |
| Provider Name | Nalini Gupta |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194809111 PECOS PAC ID: 6507908167 Enrollment ID: I20100120000014 |
| Provider Name | Louisa V Lavy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366454175 PECOS PAC ID: 8729122783 Enrollment ID: I20100215000759 |
| Provider Name | Robin L Mitchell |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1295732212 PECOS PAC ID: 3971515594 Enrollment ID: I20100216000253 |
| Provider Name | David W Little |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396743043 PECOS PAC ID: 0244242865 Enrollment ID: I20100216000291 |
| Provider Name | Craig R Barrow |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1265539944 PECOS PAC ID: 9537102363 Enrollment ID: I20100224000943 |
| Provider Name | Gregory T Carter |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1073531695 PECOS PAC ID: 0143355255 Enrollment ID: I20100315000719 |
| Provider Name | Vivian M Moise |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1801954722 PECOS PAC ID: 6406747260 Enrollment ID: I20100324000501 |
| Provider Name | Sandra L Tidwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366404337 PECOS PAC ID: 1951437235 Enrollment ID: I20100325000497 |
| Provider Name | Michael J Cruz |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1083665145 PECOS PAC ID: 4789710799 Enrollment ID: I20100330000191 |
| Provider Name | Jeffrey D Bunn |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1760432868 PECOS PAC ID: 6204962228 Enrollment ID: I20100330000236 |
| Provider Name | Michael J Olds |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1730130808 PECOS PAC ID: 6406769041 Enrollment ID: I20100330000381 |
| Provider Name | David Shawn Malone |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1881644086 PECOS PAC ID: 4284760224 Enrollment ID: I20100330000485 |
| Provider Name | Robert B Kerr |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386736007 PECOS PAC ID: 6800923020 Enrollment ID: I20100420000880 |
| Provider Name | Audrey R Brantz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477661239 PECOS PAC ID: 5395872923 Enrollment ID: I20100429001010 |
| Provider Name | William Thomas Page |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205875879 PECOS PAC ID: 5890846885 Enrollment ID: I20100511000436 |
| Provider Name | Angela D Trobaugh Latrario |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215924782 PECOS PAC ID: 9739219155 Enrollment ID: I20100611000206 |
| Provider Name | Gary A Kelsberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790707362 PECOS PAC ID: 5890722367 Enrollment ID: I20100624000037 |
| Provider Name | Judy L Felgenhauer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386631059 PECOS PAC ID: 3274664727 Enrollment ID: I20100626000445 |
| Provider Name | April M Mckenna |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1417945528 PECOS PAC ID: 9335226794 Enrollment ID: I20100702000311 |
| Provider Name | Emily A Williams |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1386755957 PECOS PAC ID: 6305979964 Enrollment ID: I20100803000454 |
| Provider Name | Chad K Wheeler |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1932210580 PECOS PAC ID: 8527191105 Enrollment ID: I20100803000673 |
| Provider Name | Vanessa C Julsen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467616177 PECOS PAC ID: 0941346019 Enrollment ID: I20100818001276 |
| Provider Name | Trace J Julsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962663898 PECOS PAC ID: 7618024779 Enrollment ID: I20100820000673 |
| Provider Name | Tiffany L Jenson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1174506802 PECOS PAC ID: 2860516481 Enrollment ID: I20100902000502 |
| Provider Name | Craig M Smentek |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043324106 PECOS PAC ID: 5395830442 Enrollment ID: I20100914000276 |
| Provider Name | Dominique Kristina Grant |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164587259 PECOS PAC ID: 2567587215 Enrollment ID: I20100917000526 |
| Provider Name | Jennifer J Battaglia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235117367 PECOS PAC ID: 1153329065 Enrollment ID: I20101015000562 |
| Provider Name | Jiten D Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689895211 PECOS PAC ID: 8022201219 Enrollment ID: I20101020000653 |
| Provider Name | Wendy L Eastman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538335252 PECOS PAC ID: 6507059342 Enrollment ID: I20101025000789 |
| Provider Name | Sarabjit Kaur Atwal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881928414 PECOS PAC ID: 4880888072 Enrollment ID: I20101102000188 |
| Provider Name | Chelsey Jane Oneill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487978904 PECOS PAC ID: 6800080003 Enrollment ID: I20101102000308 |
| Provider Name | Kam Fun Pang |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104020783 PECOS PAC ID: 0840389334 Enrollment ID: I20101102001472 |
| Provider Name | Stacey A Rietze |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1144235003 PECOS PAC ID: 2567656671 Enrollment ID: I20101103000215 |
| Provider Name | Kimberly G Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851303465 PECOS PAC ID: 6800080789 Enrollment ID: I20101104000893 |
| Provider Name | Kristina H H Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184733636 PECOS PAC ID: 6103718747 Enrollment ID: I20101110000661 |
| Provider Name | Michael J Ryan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1760568414 PECOS PAC ID: 5193886802 Enrollment ID: I20101207000570 |
| Provider Name | David B Ramey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578771853 PECOS PAC ID: 8527191485 Enrollment ID: I20101213000486 |
| Provider Name | Lindsay D Milks |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1518271659 PECOS PAC ID: 9739376856 Enrollment ID: I20101214001335 |
| Provider Name | Stefanos Intzes |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558426908 PECOS PAC ID: 0042408387 Enrollment ID: I20101230000488 |
| Provider Name | Henry L Arguinchona |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1740228170 PECOS PAC ID: 3577592526 Enrollment ID: I20110105001094 |
| Provider Name | Joshua Jones |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548361009 PECOS PAC ID: 5395844591 Enrollment ID: I20110107000627 |
| Provider Name | Stacy C Bebee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568765253 PECOS PAC ID: 6800076753 Enrollment ID: I20110209000515 |
| Provider Name | William Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346291812 PECOS PAC ID: 2466361662 Enrollment ID: I20110217000291 |
| Provider Name | Arman K Mohsenian |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1326344672 PECOS PAC ID: 7416139761 Enrollment ID: I20110308000976 |
| Provider Name | Rebecca D Mallo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1225295397 PECOS PAC ID: 8224211982 Enrollment ID: I20110318000114 |
| Provider Name | Jody L Sabatino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093765182 PECOS PAC ID: 6901089309 Enrollment ID: I20110322001046 |
| Provider Name | Nitin V Sajnani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730285594 PECOS PAC ID: 3476608050 Enrollment ID: I20110328000892 |
| Provider Name | Dani L Fergen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164720488 PECOS PAC ID: 2466636089 Enrollment ID: I20110406000337 |
| Provider Name | Karl K Stranberg |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1306139779 PECOS PAC ID: 4981882511 Enrollment ID: I20110629000352 |
| Provider Name | Anna Barber |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427169093 PECOS PAC ID: 3173622149 Enrollment ID: I20110810000620 |
| Provider Name | Douglas R Barber |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477520005 PECOS PAC ID: 7911066907 Enrollment ID: I20110810000629 |
| Provider Name | Tyler J Baker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972764074 PECOS PAC ID: 3072782853 Enrollment ID: I20110811000807 |
| Provider Name | Jonathan F Kalisvaart |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1013196864 PECOS PAC ID: 1658540448 Enrollment ID: I20110811000893 |
| Provider Name | Bryan Sean Mitchell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376552976 PECOS PAC ID: 8820270564 Enrollment ID: I20110823000122 |
| Provider Name | Catalina M Draghici |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255524930 PECOS PAC ID: 2961672704 Enrollment ID: I20110902000345 |
| Provider Name | Sarah Hammil |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700063187 PECOS PAC ID: 9739257726 Enrollment ID: I20110902000625 |
| Provider Name | Pragya Rai |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972719813 PECOS PAC ID: 3779754684 Enrollment ID: I20110927000075 |
| Provider Name | Laura S Fralich |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1417118514 PECOS PAC ID: 0749452191 Enrollment ID: I20111007000553 |
| Provider Name | Elizabeth Locascio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679772362 PECOS PAC ID: 8729163068 Enrollment ID: I20111013000109 |
| Provider Name | Kristin A Edgehouse |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922200286 PECOS PAC ID: 8921139783 Enrollment ID: I20111020000778 |
| Provider Name | Monica M Zherebtsov |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811284599 PECOS PAC ID: 8527231265 Enrollment ID: I20111025000837 |
| Provider Name | Debra J Fuller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093095663 PECOS PAC ID: 1759554793 Enrollment ID: I20111108000049 |
| Provider Name | Brieanne Catherine Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699050575 PECOS PAC ID: 9931373941 Enrollment ID: I20111130000668 |
| Provider Name | Shea E Mcmanus |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730135690 PECOS PAC ID: 4981782547 Enrollment ID: I20120105000388 |
| Provider Name | Katie L Gomez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003190331 PECOS PAC ID: 2365618758 Enrollment ID: I20120106000286 |
| Provider Name | Joshua A Beers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376771584 PECOS PAC ID: 5991971277 Enrollment ID: I20120109000606 |
| Provider Name | Denise R Pounds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073752606 PECOS PAC ID: 5597932889 Enrollment ID: I20120127000564 |
| Provider Name | Alison Houchin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598043564 PECOS PAC ID: 2163689266 Enrollment ID: I20120201000310 |
| Provider Name | Aixa D Espinosa-morales |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851449938 PECOS PAC ID: 5092987651 Enrollment ID: I20120202000201 |
| Provider Name | James W Jordan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1417156993 PECOS PAC ID: 3870675002 Enrollment ID: I20120329000427 |
| Provider Name | Karee Lynn Ledeboer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831464015 PECOS PAC ID: 4789846296 Enrollment ID: I20120430000411 |
| Provider Name | William T Magee |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1235333188 PECOS PAC ID: 8729178769 Enrollment ID: I20120502000162 |
| Provider Name | Kavitha C Chaganur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174778401 PECOS PAC ID: 0648433516 Enrollment ID: I20120514000395 |
| Provider Name | April A Estelle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386925949 PECOS PAC ID: 9739342585 Enrollment ID: I20120515000544 |
| Provider Name | Ingrid L Olaru |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437319373 PECOS PAC ID: 8426193814 Enrollment ID: I20120522000788 |
| Provider Name | Jolene E Aubert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639442072 PECOS PAC ID: 3577728047 Enrollment ID: I20120706000580 |
| Provider Name | Cyril Kuriakose |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1255536181 PECOS PAC ID: 2062683725 Enrollment ID: I20120719000641 |
| Provider Name | Lance R Varns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962583534 PECOS PAC ID: 2567618523 Enrollment ID: I20120807000206 |
| Provider Name | Todd M Schoenberger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275888026 PECOS PAC ID: 3375791668 Enrollment ID: I20120911000469 |
| Provider Name | Kelly J Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073844403 PECOS PAC ID: 9830348861 Enrollment ID: I20121005000424 |
| Provider Name | Jennifer Shannon Niemi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598054249 PECOS PAC ID: 1254581622 Enrollment ID: I20121019000291 |
| Provider Name | Saneer Basnett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508015173 PECOS PAC ID: 0941450209 Enrollment ID: I20121022000621 |
| Provider Name | Christopher M Behne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699905935 PECOS PAC ID: 6204086564 Enrollment ID: I20121022000639 |
| Provider Name | Mitchell Van Tippetts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093942799 PECOS PAC ID: 0547410813 Enrollment ID: I20121022000674 |
| Provider Name | Eashen M Liu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1891954475 PECOS PAC ID: 0446400717 Enrollment ID: I20121022000686 |
| Provider Name | Janelle M Clauser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669631008 PECOS PAC ID: 5799819181 Enrollment ID: I20121024000632 |
| Provider Name | Hisam S Goueli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639382906 PECOS PAC ID: 3870644776 Enrollment ID: I20121030000555 |
| Provider Name | Colleen E Zimmerman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780812180 PECOS PAC ID: 7416108097 Enrollment ID: I20121107000371 |
| Provider Name | Casey R Doggett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730412669 PECOS PAC ID: 9335390921 Enrollment ID: I20121107000482 |
| Provider Name | Shamit D Tailor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104089432 PECOS PAC ID: 1153594585 Enrollment ID: I20121112000507 |
| Provider Name | Stephen Jebaraj Pakkianathan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1124227566 PECOS PAC ID: 5597938829 Enrollment ID: I20121129000605 |
| Provider Name | Adam M Sanborn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366485633 PECOS PAC ID: 0547412504 Enrollment ID: I20121220000438 |
| Provider Name | Michael P Johnston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346485372 PECOS PAC ID: 2961655840 Enrollment ID: I20121228000082 |
| Provider Name | Catherine Tsai |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356337935 PECOS PAC ID: 9638342249 Enrollment ID: I20130211000329 |
| Provider Name | Brett M Eckenrod |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497066211 PECOS PAC ID: 7416101720 Enrollment ID: I20130213000264 |
| Provider Name | Chad Harbour |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1124230479 PECOS PAC ID: 3971655549 Enrollment ID: I20130411000526 |
| Provider Name | Ravi Sivasankara Menon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326160177 PECOS PAC ID: 2062572142 Enrollment ID: I20130605000091 |
| Provider Name | Benjamin Atkinson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023256237 PECOS PAC ID: 4183802945 Enrollment ID: I20130620000086 |
| Provider Name | Chong Cheever |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295063683 PECOS PAC ID: 2860533031 Enrollment ID: I20130722000248 |
| Provider Name | Gabor C Mezei |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841520731 PECOS PAC ID: 8325179914 Enrollment ID: I20130808000086 |
| Provider Name | Dinesh Ratti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104137306 PECOS PAC ID: 4183867294 Enrollment ID: I20130821000177 |
| Provider Name | Jennifer M Plymale |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265456008 PECOS PAC ID: 2466544424 Enrollment ID: I20130822000097 |
| Provider Name | Jeremy Michael Cope |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134431505 PECOS PAC ID: 2961645270 Enrollment ID: I20130905000014 |
| Provider Name | Juan C. Mejia |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588848428 PECOS PAC ID: 1951562032 Enrollment ID: I20130905000157 |
| Provider Name | Rebecca Raluca Teona Muntean |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1003071598 PECOS PAC ID: 9234372509 Enrollment ID: I20130905000794 |
| Provider Name | Nelio Guzman Aguayo |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1124266184 PECOS PAC ID: 5092959106 Enrollment ID: I20130911000330 |
| Provider Name | Kerstin A Uhder |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558537621 PECOS PAC ID: 7911038138 Enrollment ID: I20130913000170 |
| Provider Name | Clara L Peck |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659563526 PECOS PAC ID: 6002985264 Enrollment ID: I20130917000070 |
| Provider Name | Jasdeep Kaur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831415538 PECOS PAC ID: 1355594425 Enrollment ID: I20130930000306 |
| Provider Name | Ruxandra M Costa |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588770093 PECOS PAC ID: 4284695024 Enrollment ID: I20131003000014 |
| Provider Name | Rebecca Knuth |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659531390 PECOS PAC ID: 3476788837 Enrollment ID: I20131021001619 |
| Provider Name | Amy A Eddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508179482 PECOS PAC ID: 7618102088 Enrollment ID: I20131022000064 |
| Provider Name | Megan C Bisbee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760818629 PECOS PAC ID: 8224264551 Enrollment ID: I20131115000197 |
| Provider Name | Lynn Sander |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1992139083 PECOS PAC ID: 6305072927 Enrollment ID: I20131203001947 |
| Provider Name | Katie Marie Kasunick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285063644 PECOS PAC ID: 9133356918 Enrollment ID: I20131227000113 |
| Provider Name | Sally Ann Delger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518393396 PECOS PAC ID: 2567690159 Enrollment ID: I20140103001041 |
| Provider Name | Tamara L Simmerman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124187505 PECOS PAC ID: 4486883220 Enrollment ID: I20140127001510 |
| Provider Name | Brian L Simmerman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972661437 PECOS PAC ID: 4587893243 Enrollment ID: I20140129001996 |
| Provider Name | Rachael A Witham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487917548 PECOS PAC ID: 2163651720 Enrollment ID: I20140131001475 |
| Provider Name | Ann M Roberts |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154489722 PECOS PAC ID: 7911136379 Enrollment ID: I20140205000129 |
| Provider Name | Jonathan M Ziegler |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1598192726 PECOS PAC ID: 0244469245 Enrollment ID: I20140218000423 |
| Provider Name | Laura Kathleen Elias |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437572773 PECOS PAC ID: 5991936205 Enrollment ID: I20140331001806 |
| Provider Name | Mary K Wagner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427040203 PECOS PAC ID: 2668432626 Enrollment ID: I20140410001504 |
| Provider Name | Shane Carson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710917299 PECOS PAC ID: 4183857428 Enrollment ID: I20140512001508 |
| Provider Name | Cindy K Hollenbaugh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699705160 PECOS PAC ID: 5294968541 Enrollment ID: I20140512001853 |
| Provider Name | Nishant Puri |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1922207471 PECOS PAC ID: 1951434836 Enrollment ID: I20140605001935 |
| Provider Name | Kang Zhang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023304359 PECOS PAC ID: 1658595509 Enrollment ID: I20140616000433 |
| Provider Name | Alison Elizabeth Goodman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710118369 PECOS PAC ID: 2466677737 Enrollment ID: I20140628000139 |
| Provider Name | Jo Persoon-gundy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467758581 PECOS PAC ID: 3971736570 Enrollment ID: I20140702000604 |
| Provider Name | Robert E Lichfield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568725695 PECOS PAC ID: 5799900932 Enrollment ID: I20140702001443 |
| Provider Name | Elise C Willis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487953683 PECOS PAC ID: 6800011602 Enrollment ID: I20140711001158 |
| Provider Name | Kristine Theresa Coons |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013293422 PECOS PAC ID: 4688813728 Enrollment ID: I20140719000054 |
| Provider Name | Jake Harley Choiniere |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578882452 PECOS PAC ID: 4688890155 Enrollment ID: I20140721000051 |
| Provider Name | Laura A Bonneau |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1447414479 PECOS PAC ID: 6608019187 Enrollment ID: I20140731000200 |
| Provider Name | Joseph D Mickelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578769816 PECOS PAC ID: 8224284526 Enrollment ID: I20140811002731 |
| Provider Name | William R Schmitt |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1912155136 PECOS PAC ID: 8022155811 Enrollment ID: I20140815001232 |
| Provider Name | Joshua E Drumm |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1720394521 PECOS PAC ID: 3072743772 Enrollment ID: I20141003001949 |
| Provider Name | Lynn M Mcclatchey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811989940 PECOS PAC ID: 7416177886 Enrollment ID: I20141007000983 |
| Provider Name | Hayley M Stewart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851612733 PECOS PAC ID: 6204158413 Enrollment ID: I20141125000860 |
| Provider Name | Kirandeep Gill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902016306 PECOS PAC ID: 2961695804 Enrollment ID: I20141126000417 |
| Provider Name | Lesley N Bobek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922202787 PECOS PAC ID: 0244377802 Enrollment ID: I20141216000708 |
| Provider Name | Catherine Annabel Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093145567 PECOS PAC ID: 8729202452 Enrollment ID: I20141223001633 |
| Provider Name | Maureen K Beardslee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801232301 PECOS PAC ID: 5991028607 Enrollment ID: I20150106000257 |
| Provider Name | Nicolle Benz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356322580 PECOS PAC ID: 1456322890 Enrollment ID: I20150117000241 |
| Provider Name | Kitti Kaiboriboon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912062035 PECOS PAC ID: 4284731027 Enrollment ID: I20150130000742 |
| Provider Name | Jordan Storhaug |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194088237 PECOS PAC ID: 3678897253 Enrollment ID: I20150130002352 |
| Provider Name | Rilla Westermeyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710240817 PECOS PAC ID: 4082939558 Enrollment ID: I20150205000637 |
| Provider Name | Alma Isela Chavez |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1508905522 PECOS PAC ID: 1850417957 Enrollment ID: I20150218000463 |
| Provider Name | Stephanie Gering |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568725661 PECOS PAC ID: 4082939806 Enrollment ID: I20150218001710 |
| Provider Name | Elizabeth M Stuhlmiller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477816502 PECOS PAC ID: 6305162009 Enrollment ID: I20150223001484 |
| Provider Name | Angella R Julagay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659763951 PECOS PAC ID: 0446577068 Enrollment ID: I20150319001439 |
| Provider Name | Adnan Rizvi |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1669482154 PECOS PAC ID: 2062416928 Enrollment ID: I20150325002509 |
| Provider Name | Jennifer Mays Suk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366536062 PECOS PAC ID: 7618294745 Enrollment ID: I20150327002636 |
| Provider Name | David Goshorn |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1043464373 PECOS PAC ID: 3274771548 Enrollment ID: I20150422000709 |
| Provider Name | Stacy M Rush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649663063 PECOS PAC ID: 1658690375 Enrollment ID: I20150430002614 |
| Provider Name | Shannon Brodersen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396938916 PECOS PAC ID: 0941529044 Enrollment ID: I20150511002284 |
| Provider Name | Seyed Ali Gaskari |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1124259155 PECOS PAC ID: 3678893773 Enrollment ID: I20150513000432 |
| Provider Name | Ann K Seltman |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1912098641 PECOS PAC ID: 7416902630 Enrollment ID: I20150514002973 |
| Provider Name | Satya Venkata Subramanyam Malladi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1790902088 PECOS PAC ID: 6406082015 Enrollment ID: I20150520001262 |
| Provider Name | Shelby R Rush |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144290586 PECOS PAC ID: 5698665198 Enrollment ID: I20150601000423 |
| Provider Name | Haendel Adrian Munoz Vega |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1225343486 PECOS PAC ID: 1658692678 Enrollment ID: I20150603000231 |
| Provider Name | Luke Xiaoli Zhan |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1043524481 PECOS PAC ID: 1052632882 Enrollment ID: I20150605000457 |
| Provider Name | Nathaniel Whitney |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1730356346 PECOS PAC ID: 5597918649 Enrollment ID: I20150608001199 |
| Provider Name | Kunal Shah |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1285878868 PECOS PAC ID: 9638490188 Enrollment ID: I20150612001038 |
| Provider Name | Dana L Baumgartner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356732960 PECOS PAC ID: 5193036713 Enrollment ID: I20150623001106 |
| Provider Name | Daniel J Rodgers |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1255719670 PECOS PAC ID: 8426360967 Enrollment ID: I20150711000113 |
| Provider Name | Kelly Grieves |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013969401 PECOS PAC ID: 8921072273 Enrollment ID: I20150713000611 |
| Provider Name | Inah Kim |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1376707224 PECOS PAC ID: 4789850199 Enrollment ID: I20150713002782 |
| Provider Name | Marc Schillios |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386730844 PECOS PAC ID: 4284947300 Enrollment ID: I20150720000554 |
| Provider Name | Lisa Koch |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003811712 PECOS PAC ID: 8022321819 Enrollment ID: I20150722006221 |
| Provider Name | Lacie Bland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013271386 PECOS PAC ID: 9133433774 Enrollment ID: I20150727002832 |
| Provider Name | Sarah Hess |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588951248 PECOS PAC ID: 2062643638 Enrollment ID: I20150729009640 |
| Provider Name | Chia Chun Hsu |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1518162072 PECOS PAC ID: 8628124815 Enrollment ID: I20150730010645 |
| Provider Name | Dara H Christante |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013116003 PECOS PAC ID: 6901076124 Enrollment ID: I20150806011010 |
| Provider Name | Julie Patrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629464292 PECOS PAC ID: 1658685334 Enrollment ID: I20150810000800 |
| Provider Name | Sarah Grisier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962884577 PECOS PAC ID: 0648585265 Enrollment ID: I20150811005793 |
| Provider Name | Chad M Turner |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1467687673 PECOS PAC ID: 4284873746 Enrollment ID: I20150812007295 |
| Provider Name | Tiffany Ludka-gaulke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518115393 PECOS PAC ID: 0547419913 Enrollment ID: I20150814013940 |
| Provider Name | Mark Ernest Gaulke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972709129 PECOS PAC ID: 8325235831 Enrollment ID: I20150825003426 |
| Provider Name | Anneke Van Sloten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285016139 PECOS PAC ID: 8224344403 Enrollment ID: I20150902002419 |
| Provider Name | Danielle Wald Baker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093194649 PECOS PAC ID: 1456668607 Enrollment ID: I20150921000963 |
| Provider Name | Caitlin E Shino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427424381 PECOS PAC ID: 0547578387 Enrollment ID: I20150929000935 |
| Provider Name | Douglas Hammerstrom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316998354 PECOS PAC ID: 8628028586 Enrollment ID: I20151005000295 |
| Provider Name | Roxanna Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427156165 PECOS PAC ID: 9931131307 Enrollment ID: I20151103000807 |
| Provider Name | Katherine Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881845931 PECOS PAC ID: 7719297514 Enrollment ID: I20151106001396 |
| Provider Name | Aileen Marie Hetrick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427343169 PECOS PAC ID: 5698075810 Enrollment ID: I20151119002146 |
| Provider Name | Mallory M Beale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174969661 PECOS PAC ID: 1254632763 Enrollment ID: I20151228001870 |
| Provider Name | Kathy T Kinderman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730551201 PECOS PAC ID: 1153624655 Enrollment ID: I20160115001284 |
| Provider Name | Katrina Maren Schmell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437481769 PECOS PAC ID: 3971760901 Enrollment ID: I20160304001838 |
| Provider Name | Pushapdeep K Brar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699097279 PECOS PAC ID: 0244400109 Enrollment ID: I20160407000847 |
| Provider Name | Michael A Brooks |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356570550 PECOS PAC ID: 8426367152 Enrollment ID: I20160505000453 |
| Provider Name | Richard Carlson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396035994 PECOS PAC ID: 9537462049 Enrollment ID: I20160509001431 |
| Provider Name | Kelly Wurzel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174880454 PECOS PAC ID: 1850604992 Enrollment ID: I20160509002246 |
| Provider Name | Ian Barton May |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790129930 PECOS PAC ID: 1557660842 Enrollment ID: I20160509002318 |
| Provider Name | Nathaniel R Miller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336310945 PECOS PAC ID: 3870897176 Enrollment ID: I20160512001047 |
| Provider Name | Nathaniel Lee Atkin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1134358344 PECOS PAC ID: 4688828981 Enrollment ID: I20160520001449 |
| Provider Name | Jessica Craddock |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154614469 PECOS PAC ID: 9739405101 Enrollment ID: I20160523002062 |
| Provider Name | Leah Berry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134472368 PECOS PAC ID: 1850681735 Enrollment ID: I20160606001106 |
| Provider Name | John Wurzel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538426812 PECOS PAC ID: 6204155237 Enrollment ID: I20160616002600 |
| Provider Name | Timothy Jordan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669442612 PECOS PAC ID: 3678864717 Enrollment ID: I20160621002533 |
| Provider Name | Benjamin Howie |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1154584969 PECOS PAC ID: 4284926502 Enrollment ID: I20160707000671 |
| Provider Name | David M Brown |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952691354 PECOS PAC ID: 2860710647 Enrollment ID: I20160708002108 |
| Provider Name | Kara Elizabeth Mackenzie |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1487944021 PECOS PAC ID: 3375769045 Enrollment ID: I20160713000652 |
| Provider Name | Vanessa J Gray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417240250 PECOS PAC ID: 8527286517 Enrollment ID: I20160713000871 |
| Provider Name | Kyle Benton Varner |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174961734 PECOS PAC ID: 1254624349 Enrollment ID: I20160727001153 |
| Provider Name | Eric M Tyler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447518808 PECOS PAC ID: 8224277306 Enrollment ID: I20160803002111 |
| Provider Name | Kristin Jean Johnson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942644182 PECOS PAC ID: 9931321767 Enrollment ID: I20160804000425 |
| Provider Name | Michael Barsotti |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619930211 PECOS PAC ID: 8123294642 Enrollment ID: I20160805001467 |
| Provider Name | Jeremy Robert Nicolarsen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891946778 PECOS PAC ID: 3971746496 Enrollment ID: I20160808002023 |
| Provider Name | Sarah Hill |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346428463 PECOS PAC ID: 0648446716 Enrollment ID: I20160809003018 |
| Provider Name | Jonathan M Morrill |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1043519440 PECOS PAC ID: 2062737653 Enrollment ID: I20160812000737 |
| Provider Name | Janelle D Sousa |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1548402308 PECOS PAC ID: 6800180910 Enrollment ID: I20160812001226 |
| Provider Name | Meghann Stenersen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245471028 PECOS PAC ID: 2860661154 Enrollment ID: I20160815002310 |
| Provider Name | Tarvinder Singh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225327091 PECOS PAC ID: 0840505251 Enrollment ID: I20160817001266 |
| Provider Name | Virginie Achim |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1598085383 PECOS PAC ID: 2567789738 Enrollment ID: I20160825000388 |
| Provider Name | Heidi Huppert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821449570 PECOS PAC ID: 7911292040 Enrollment ID: I20160829000097 |
| Provider Name | Anisha Boetel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073871646 PECOS PAC ID: 4981905205 Enrollment ID: I20160906000931 |
| Provider Name | Kristin Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720439045 PECOS PAC ID: 9133415664 Enrollment ID: I20160909001749 |
| Provider Name | Terece Hahn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336592203 PECOS PAC ID: 7618264359 Enrollment ID: I20160923001953 |
| Provider Name | Laura Spence |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912141250 PECOS PAC ID: 3678739752 Enrollment ID: I20160926001320 |
| Provider Name | Mary Ann Arndt |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1750458329 PECOS PAC ID: 0446313464 Enrollment ID: I20160926002168 |
| Provider Name | Caitlin Allen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124462478 PECOS PAC ID: 9133342017 Enrollment ID: I20160926002333 |
| Provider Name | Allison A Lambert |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1649439209 PECOS PAC ID: 4183875255 Enrollment ID: I20161013001694 |
| Provider Name | Shristi Kunwar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497043319 PECOS PAC ID: 1355569435 Enrollment ID: I20161024001034 |
| Provider Name | Levi O Estes |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1790076305 PECOS PAC ID: 6901106004 Enrollment ID: I20161025002723 |
| Provider Name | Thomas Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265981450 PECOS PAC ID: 0749568582 Enrollment ID: I20161028000813 |
| Provider Name | Gordon W Dowds |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1134115710 PECOS PAC ID: 4789747833 Enrollment ID: I20161228000734 |
| Provider Name | Maxswell A Hackett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518419738 PECOS PAC ID: 2567743768 Enrollment ID: I20161230000794 |
| Provider Name | Jana Eileen Stuckrath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851833669 PECOS PAC ID: 1153602149 Enrollment ID: I20170105002400 |
| Provider Name | Douglas A Valenta |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851553879 PECOS PAC ID: 4688728181 Enrollment ID: I20170119001307 |
| Provider Name | Elizabeth T Walz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609817261 PECOS PAC ID: 5597796375 Enrollment ID: I20170124000468 |
| Provider Name | Kamala Renee Keller Brickey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396283602 PECOS PAC ID: 0143504027 Enrollment ID: I20170222000586 |
| Provider Name | Andrew D Rontal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063657328 PECOS PAC ID: 7911150065 Enrollment ID: I20170223002188 |
| Provider Name | Lisa R Yanase |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851384937 PECOS PAC ID: 1052343167 Enrollment ID: I20170223002540 |
| Provider Name | Hannah R Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912443128 PECOS PAC ID: 8628352721 Enrollment ID: I20170309002712 |
| Provider Name | Amanda Rafter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700222890 PECOS PAC ID: 3577848274 Enrollment ID: I20170320002466 |
| Provider Name | Ashley Ann Baggott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053856443 PECOS PAC ID: 6709162647 Enrollment ID: I20170407001947 |
| Provider Name | Kirk Lee Stewart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790126340 PECOS PAC ID: 3375829146 Enrollment ID: I20170410001241 |
| Provider Name | Rachel Franklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588102107 PECOS PAC ID: 0042596249 Enrollment ID: I20170424000147 |
| Provider Name | Bradley Cook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770957854 PECOS PAC ID: 4587965504 Enrollment ID: I20170424002091 |
| Provider Name | Lisa Catherine Shawen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972043784 PECOS PAC ID: 9931486032 Enrollment ID: I20170427000648 |
| Provider Name | Franchette T Pascual |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245491711 PECOS PAC ID: 6305094889 Enrollment ID: I20170504000698 |
| Provider Name | Chelsie L Diaz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346550704 PECOS PAC ID: 9537473970 Enrollment ID: I20170517001420 |
| Provider Name | Dawn Dewitt Talbot |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114467891 PECOS PAC ID: 3375811664 Enrollment ID: I20170608002743 |
| Provider Name | Frank Jackson |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1548604200 PECOS PAC ID: 1557583838 Enrollment ID: I20170615002619 |
| Provider Name | Deepika Gupta |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1457616443 PECOS PAC ID: 4587984273 Enrollment ID: I20170619000869 |
| Provider Name | Joseph F Tkacik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457693558 PECOS PAC ID: 7618110040 Enrollment ID: I20170622002117 |
| Provider Name | Cicely W White |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407831167 PECOS PAC ID: 0941578595 Enrollment ID: I20170622002210 |
| Provider Name | Yi Mao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629327986 PECOS PAC ID: 0547538118 Enrollment ID: I20170622002818 |
| Provider Name | Nicole Breen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841605433 PECOS PAC ID: 3870862980 Enrollment ID: I20170705003392 |
| Provider Name | Caleb C Holtzer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124438338 PECOS PAC ID: 0143599100 Enrollment ID: I20170706002177 |
| Provider Name | Joseph David Nickolas Freeburg |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174898381 PECOS PAC ID: 7012224298 Enrollment ID: I20170706002670 |
| Provider Name | Amy Martin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417377284 PECOS PAC ID: 5597034421 Enrollment ID: I20170707001776 |
| Provider Name | Hela Kelsch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740600550 PECOS PAC ID: 2062781917 Enrollment ID: I20170707002510 |
| Provider Name | Reilly Kuehn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720379050 PECOS PAC ID: 6709012768 Enrollment ID: I20170712004064 |
| Provider Name | Natasha Sparrow |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326308339 PECOS PAC ID: 9931411600 Enrollment ID: I20170802001726 |
| Provider Name | Lacy Dawn Irwin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558781211 PECOS PAC ID: 1951672229 Enrollment ID: I20170804000211 |
| Provider Name | Justin Eberly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558579946 PECOS PAC ID: 4789709932 Enrollment ID: I20170810000952 |
| Provider Name | Corey White |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154610814 PECOS PAC ID: 2961723663 Enrollment ID: I20170811001881 |
| Provider Name | Kelly Glidewell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821444704 PECOS PAC ID: 8325310592 Enrollment ID: I20170823000995 |
| Provider Name | Kendra Hansonl |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235651811 PECOS PAC ID: 6800168998 Enrollment ID: I20170824001643 |
| Provider Name | David Hudon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366862369 PECOS PAC ID: 2668761206 Enrollment ID: I20170828004529 |
| Provider Name | David G Stoddard |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1629398706 PECOS PAC ID: 3870765043 Enrollment ID: I20170829000912 |
| Provider Name | Katheryn Hudon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821418815 PECOS PAC ID: 4183997703 Enrollment ID: I20170901002509 |
| Provider Name | Kai L Sharbono |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174801328 PECOS PAC ID: 5395036552 Enrollment ID: I20170912002781 |
| Provider Name | Jessemae Lynn Welsh |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1194950295 PECOS PAC ID: 6901196773 Enrollment ID: I20170913000968 |
| Provider Name | Sherry Marie Baker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427478692 PECOS PAC ID: 7214202308 Enrollment ID: I20170928002566 |
| Provider Name | Eric D Prince |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770843658 PECOS PAC ID: 2567752777 Enrollment ID: I20171002003734 |
| Provider Name | Cindi Marie Warburton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649605361 PECOS PAC ID: 8022243260 Enrollment ID: I20171011003272 |
| Provider Name | Daniel J Gilsdorf |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760758189 PECOS PAC ID: 4385876143 Enrollment ID: I20171017001793 |
| Provider Name | Ashley B Henderson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508201807 PECOS PAC ID: 6002173374 Enrollment ID: I20171122001863 |
| Provider Name | Kathryn Benson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720084213 PECOS PAC ID: 1850357104 Enrollment ID: I20171128001783 |
| Provider Name | Ansley Autumn Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396115549 PECOS PAC ID: 0244597755 Enrollment ID: I20171207002033 |
| Provider Name | James Winegart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902324445 PECOS PAC ID: 8325306038 Enrollment ID: I20171228002229 |
| Provider Name | Joseph Robert Perry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134354244 PECOS PAC ID: 8426285917 Enrollment ID: I20180110002318 |
| Provider Name | Tara Teresa Flores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447536685 PECOS PAC ID: 8325215957 Enrollment ID: I20180116001606 |
| Provider Name | David John Joosten |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902884869 PECOS PAC ID: 2961761820 Enrollment ID: I20180122003289 |
| Provider Name | Brandi A Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316328461 PECOS PAC ID: 4183924939 Enrollment ID: I20180131001883 |
| Provider Name | Sarah L. Dugan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629267067 PECOS PAC ID: 0143416883 Enrollment ID: I20180302001487 |
| Provider Name | Ryan Massoud |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023495512 PECOS PAC ID: 1759646300 Enrollment ID: I20180531001454 |
| Provider Name | Kimberlyn B Wellman |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1669961355 PECOS PAC ID: 2365707825 Enrollment ID: I20180604001660 |
| Provider Name | Abdelrahman Fouad Ahmed Beltagy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013250216 PECOS PAC ID: 0840592572 Enrollment ID: I20180615002091 |
| Provider Name | Rachael Gray Massoud |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336536887 PECOS PAC ID: 1658626502 Enrollment ID: I20180616000003 |
| Provider Name | Usman Ajaz |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1912261025 PECOS PAC ID: 1658661020 Enrollment ID: I20180618002335 |
| Provider Name | Erik Keith Loraas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265871578 PECOS PAC ID: 5395031793 Enrollment ID: I20180626002316 |
| Provider Name | Steven Klopsch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104213743 PECOS PAC ID: 4880940204 Enrollment ID: I20180627001725 |
| Provider Name | Sarah Joan Newton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033506308 PECOS PAC ID: 0143576579 Enrollment ID: I20180627002257 |
| Provider Name | Michelle A Gupta |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033343298 PECOS PAC ID: 4284980392 Enrollment ID: I20180703001381 |
| Provider Name | Nicholas Warren Auble |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366838435 PECOS PAC ID: 7911253554 Enrollment ID: I20180711003357 |
| Provider Name | Sara M'lis Clark |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346484276 PECOS PAC ID: 4082937511 Enrollment ID: I20180717000281 |
| Provider Name | Stephanie Posten |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669869889 PECOS PAC ID: 1658687991 Enrollment ID: I20180718000645 |
| Provider Name | Alicia S Fuhrman |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1063832004 PECOS PAC ID: 0547484164 Enrollment ID: I20180723001321 |
| Provider Name | Katie Phung Huynh |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1720390412 PECOS PAC ID: 5698095958 Enrollment ID: I20180726000598 |
| Provider Name | Derek R Fletcher |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1427204098 PECOS PAC ID: 6507149812 Enrollment ID: I20180731002461 |
| Provider Name | Holly Eckhart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275042491 PECOS PAC ID: 1355699067 Enrollment ID: I20180810002651 |
| Provider Name | Anna P Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245726363 PECOS PAC ID: 0042568701 Enrollment ID: I20180813001562 |
| Provider Name | Heidi Lynn Shovell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720468267 PECOS PAC ID: 7810246576 Enrollment ID: I20180814002952 |
| Provider Name | Jessica Anne Lundgren |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922494301 PECOS PAC ID: 3779833504 Enrollment ID: I20180829000934 |
| Provider Name | Jacquelyn Nicol Victoroff |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1093102287 PECOS PAC ID: 3072863372 Enrollment ID: I20180907000778 |
| Provider Name | Tasha Marenbach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285926816 PECOS PAC ID: 1951579176 Enrollment ID: I20180920002924 |
| Provider Name | Jill Michelle Neiman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851778070 PECOS PAC ID: 6305158478 Enrollment ID: I20180921000549 |
| Provider Name | Andre D Shaffer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1275899635 PECOS PAC ID: 8820381171 Enrollment ID: I20180924000450 |
| Provider Name | Mayank Arora |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174703151 PECOS PAC ID: 1759576978 Enrollment ID: I20180928002501 |
| Provider Name | Carrie Leslie Corwin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649539487 PECOS PAC ID: 6608168489 Enrollment ID: I20181029001184 |
| Provider Name | Lisa Tisch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144753088 PECOS PAC ID: 5092083923 Enrollment ID: I20181112001508 |
| Provider Name | Michael D Goodman |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1528008620 PECOS PAC ID: 0941197867 Enrollment ID: I20181119002969 |
| Provider Name | Stephenie Marie Matosich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548502586 PECOS PAC ID: 0840585261 Enrollment ID: I20181203000371 |
| Provider Name | Kerry P Gould |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205313467 PECOS PAC ID: 2567707607 Enrollment ID: I20181218003841 |
| Provider Name | Meghan L Meyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740766450 PECOS PAC ID: 5395081400 Enrollment ID: I20190110002078 |
| Provider Name | Michelle M Hagan |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1922321520 PECOS PAC ID: 2860739984 Enrollment ID: I20190128003513 |
| Provider Name | Timothy Burnette Naomi |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1861442071 PECOS PAC ID: 5597720060 Enrollment ID: I20190211001525 |
| Provider Name | Heidi Elizabeth Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124412937 PECOS PAC ID: 6507106549 Enrollment ID: I20190328003111 |
| Provider Name | Caitlin Anne Snider |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1669947818 PECOS PAC ID: 8820339823 Enrollment ID: I20190401000165 |
| Provider Name | Shira Y Albert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063817831 PECOS PAC ID: 4385985191 Enrollment ID: I20190404000646 |
| Provider Name | Riley Allen Mccorkle |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1790254969 PECOS PAC ID: 5395086623 Enrollment ID: I20190413000164 |
| Provider Name | Lesley Anne Portugal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023498532 PECOS PAC ID: 7012267057 Enrollment ID: I20190422002136 |
| Provider Name | Bridget Z Duffy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568591923 PECOS PAC ID: 0840341749 Enrollment ID: I20190513000671 |
| Provider Name | Jeffrey Patrick Dawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427539766 PECOS PAC ID: 5294078390 Enrollment ID: I20190513001197 |
| Provider Name | Darcia Lynn Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336617414 PECOS PAC ID: 0042543381 Enrollment ID: I20190531001359 |
| Provider Name | Alison C. Spaniol |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396030771 PECOS PAC ID: 0042543969 Enrollment ID: I20190610000038 |
| Provider Name | Ashley Diana Lundgren |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1942695192 PECOS PAC ID: 6002149937 Enrollment ID: I20190610000666 |
| Provider Name | Michael Edward Haws |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336568484 PECOS PAC ID: 8123351582 Enrollment ID: I20190618000522 |
| Provider Name | Justin Michael Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649633041 PECOS PAC ID: 1557652914 Enrollment ID: I20190619002423 |
| Provider Name | Kristin Michelle Comstock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528445368 PECOS PAC ID: 2961707203 Enrollment ID: I20190627003033 |
| Provider Name | Chayene Albuquerque |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285976803 PECOS PAC ID: 5991948341 Enrollment ID: I20190702001377 |
| Provider Name | Melissa Marie Claflin-hubbard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568025518 PECOS PAC ID: 5294060786 Enrollment ID: I20190703002196 |
| Provider Name | Sama Kamal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992168561 PECOS PAC ID: 1658606538 Enrollment ID: I20190715002420 |
| Provider Name | Bryan Robert Anderson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578828224 PECOS PAC ID: 5496064685 Enrollment ID: I20190717004140 |
| Provider Name | Leela Diana Farr |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1346403482 PECOS PAC ID: 6901046291 Enrollment ID: I20190719002403 |
| Provider Name | Christopher E Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346892858 PECOS PAC ID: 9234465576 Enrollment ID: I20190724003886 |
| Provider Name | Casey Christopher Denton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932563384 PECOS PAC ID: 7012294119 Enrollment ID: I20190725002865 |
| Provider Name | Kevin Costa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932555315 PECOS PAC ID: 8628365830 Enrollment ID: I20190726001564 |
| Provider Name | Lucas A Salg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841684289 PECOS PAC ID: 4981995917 Enrollment ID: I20190726002234 |
| Provider Name | Bennett Cole Gladden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336501022 PECOS PAC ID: 4880987783 Enrollment ID: I20190730003410 |
| Provider Name | Donald Merwin Ericson |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1477796944 PECOS PAC ID: 9638318116 Enrollment ID: I20190813000000 |
| Provider Name | Luis Eduardo Rendon Cantu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427459759 PECOS PAC ID: 6800123753 Enrollment ID: I20190814004148 |
| Provider Name | Katherine Elizabeth Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114585346 PECOS PAC ID: 3173851722 Enrollment ID: I20190821001805 |
| Provider Name | Jane S Tschang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568881985 PECOS PAC ID: 0345578852 Enrollment ID: I20190821004759 |
| Provider Name | Daniel John Koster |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558715946 PECOS PAC ID: 3072806173 Enrollment ID: I20190822002746 |
| Provider Name | Angela Joan Van Atta Slick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346635935 PECOS PAC ID: 5890008700 Enrollment ID: I20190823001484 |
| Provider Name | Elizabeth Newell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659638021 PECOS PAC ID: 5991934713 Enrollment ID: I20190826003037 |
| Provider Name | Kaelin Kristin Whitcomb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215596465 PECOS PAC ID: 3870821945 Enrollment ID: I20190827004084 |
| Provider Name | Lisa Claire Matelich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366837510 PECOS PAC ID: 1759673965 Enrollment ID: I20190902000003 |
| Provider Name | James F Wang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962829093 PECOS PAC ID: 7012232655 Enrollment ID: I20190910002212 |
| Provider Name | Daniel Cole Sessions |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679691620 PECOS PAC ID: 4385826395 Enrollment ID: I20190911002287 |
| Provider Name | Hannah E Qualls |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1619234135 PECOS PAC ID: 9739482605 Enrollment ID: I20190916000223 |
| Provider Name | Victoria Perkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760041271 PECOS PAC ID: 0345579389 Enrollment ID: I20190917000963 |
| Provider Name | Natalya S Wolter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952963449 PECOS PAC ID: 0648500322 Enrollment ID: I20190923002142 |
| Provider Name | Jennifer Pasko |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548550874 PECOS PAC ID: 7315182185 Enrollment ID: I20190927003178 |
| Provider Name | Alexander Lee Telis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1114260510 PECOS PAC ID: 9537394812 Enrollment ID: I20191008003725 |
| Provider Name | Hannah D. Jones |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1811541527 PECOS PAC ID: 4880925692 Enrollment ID: I20191009001638 |
| Provider Name | Alexander James Doud |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1932593423 PECOS PAC ID: 2264749712 Enrollment ID: I20191014001567 |
| Provider Name | Jennifer C Colvin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770997934 PECOS PAC ID: 9335448372 Enrollment ID: I20191031003129 |
| Provider Name | Natalie Rose Brulotte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912398199 PECOS PAC ID: 5092034256 Enrollment ID: I20191113003573 |
| Provider Name | Michael Jon Sokoloff |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962457549 PECOS PAC ID: 2769658368 Enrollment ID: I20191125000202 |
| Provider Name | Rhiannon A Armstrong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366090110 PECOS PAC ID: 8921431206 Enrollment ID: I20191126002584 |
| Provider Name | Christopher J Pannucci |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1083737738 PECOS PAC ID: 0345562856 Enrollment ID: I20191127001529 |
| Provider Name | Shelby Mae Gordon |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1538702774 PECOS PAC ID: 4284067729 Enrollment ID: I20191213001443 |
| Provider Name | Carson Van Sanford |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669869574 PECOS PAC ID: 9537471149 Enrollment ID: I20191216000256 |
| Provider Name | Georgina De La Garza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518316611 PECOS PAC ID: 7719245158 Enrollment ID: I20191223000071 |
| Provider Name | Erica En Jia Li |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285989137 PECOS PAC ID: 3870809395 Enrollment ID: I20191223001262 |
| Provider Name | Amil Rafiq |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669785804 PECOS PAC ID: 4880812452 Enrollment ID: I20191226001504 |
| Provider Name | Sarah Christine Davison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235552308 PECOS PAC ID: 2365876190 Enrollment ID: I20200102001002 |
| Provider Name | Lonika Sood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063642981 PECOS PAC ID: 4183870389 Enrollment ID: I20200116001360 |
| Provider Name | Fatima Ajaz |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1477731461 PECOS PAC ID: 2466691373 Enrollment ID: I20200128000706 |
| Provider Name | Maggie Mary Bulger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518504711 PECOS PAC ID: 3577999176 Enrollment ID: I20200130000027 |
| Provider Name | Erin Janea Perry |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1477953156 PECOS PAC ID: 8224464615 Enrollment ID: I20200203001964 |
| Provider Name | Ivy Barnard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578630372 PECOS PAC ID: 8426139163 Enrollment ID: I20200205002879 |
| Provider Name | Teale M Zeller |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1811536485 PECOS PAC ID: 3476989344 Enrollment ID: I20200212002908 |
| Provider Name | George Lopez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578588752 PECOS PAC ID: 9638172034 Enrollment ID: I20200224000997 |
| Provider Name | Erin Rose Holland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194368134 PECOS PAC ID: 5597192443 Enrollment ID: I20200305001726 |
| Provider Name | Richard J Montandon |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1164650198 PECOS PAC ID: 0941426829 Enrollment ID: I20200317001072 |
| Provider Name | Anthony Charles Mccanta |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730277658 PECOS PAC ID: 1153593108 Enrollment ID: I20200323003600 |
| Provider Name | Karlee Nicole Bundrock |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1467087254 PECOS PAC ID: 8022448943 Enrollment ID: I20200416002952 |
| Provider Name | Colleen Marie Marty Coleman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720320062 PECOS PAC ID: 1759605983 Enrollment ID: I20200422002690 |
| Provider Name | Sumant Arora |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1134535560 PECOS PAC ID: 3779897517 Enrollment ID: I20200424001096 |
| Provider Name | Nicholas Riordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629600648 PECOS PAC ID: 1052741360 Enrollment ID: I20200428000427 |
| Provider Name | Marcella Joy Day Staaben |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174152060 PECOS PAC ID: 7113358193 Enrollment ID: I20200506002444 |
| Provider Name | Aradhna Seth |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1073933107 PECOS PAC ID: 0244501963 Enrollment ID: I20200527003355 |
| Provider Name | Carol L Hough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255996674 PECOS PAC ID: 7911235528 Enrollment ID: I20200531000027 |
| Provider Name | Yiping Li |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1699032961 PECOS PAC ID: 2163655713 Enrollment ID: I20200601002118 |
| Provider Name | Eric Jemison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881128353 PECOS PAC ID: 0648517359 Enrollment ID: I20200603001213 |
| Provider Name | Nicholas Edward Calvo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972958593 PECOS PAC ID: 4183918279 Enrollment ID: I20200625001046 |
| Provider Name | Patricia Janelle Ferguson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497377238 PECOS PAC ID: 6204258981 Enrollment ID: I20200625002087 |
| Provider Name | Ryan W Farnsworth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457709727 PECOS PAC ID: 5496047201 Enrollment ID: I20200626001724 |
| Provider Name | Lyda E Nicodemus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376168336 PECOS PAC ID: 9638592405 Enrollment ID: I20200707000558 |
| Provider Name | Joshua Geeming Lee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992182885 PECOS PAC ID: 3971868696 Enrollment ID: I20200713003381 |
| Provider Name | Nicholas George Cowley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043742646 PECOS PAC ID: 9133543648 Enrollment ID: I20200716002752 |
| Provider Name | Helen Z Zhang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053774000 PECOS PAC ID: 6103117619 Enrollment ID: I20200720000436 |
| Provider Name | Kelli Marie Geiger Mcentee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952755274 PECOS PAC ID: 6800210246 Enrollment ID: I20200720000489 |
| Provider Name | Hanbing Wang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679927784 PECOS PAC ID: 3779907522 Enrollment ID: I20200727001289 |
| Provider Name | Kayla Marie Fix |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710411947 PECOS PAC ID: 3870918410 Enrollment ID: I20200730000880 |
| Provider Name | Christopher A Meadows |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1205280211 PECOS PAC ID: 2668752577 Enrollment ID: I20200804001266 |
| Provider Name | Devyn Irene Szwec |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700230216 PECOS PAC ID: 3173816253 Enrollment ID: I20200804003676 |
| Provider Name | Samantha Kate Mathews-klebes |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1871977454 PECOS PAC ID: 4284982489 Enrollment ID: I20200805003078 |
| Provider Name | Meghan Chelise Tanner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033641451 PECOS PAC ID: 7416373774 Enrollment ID: I20200817003359 |
| Provider Name | Kyle Yuichi Ogami |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801276571 PECOS PAC ID: 9638471626 Enrollment ID: I20200819003829 |
| Provider Name | Molly Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073044863 PECOS PAC ID: 7810311537 Enrollment ID: I20200824001452 |
| Provider Name | Michael Meng Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558757757 PECOS PAC ID: 9335424449 Enrollment ID: I20200827002834 |
| Provider Name | Derek Ting Yu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568889731 PECOS PAC ID: 5991068363 Enrollment ID: I20200903003199 |
| Provider Name | Jarod Patrick Mcateer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992947634 PECOS PAC ID: 5092035220 Enrollment ID: I20200914000448 |
| Provider Name | Ashleigh M Solak |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1871105221 PECOS PAC ID: 7214355742 Enrollment ID: I20200916000760 |
| Provider Name | Molly Kaitlin Webber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821529702 PECOS PAC ID: 7113343187 Enrollment ID: I20200916003055 |
| Provider Name | Tonya M Holstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407177157 PECOS PAC ID: 6305013707 Enrollment ID: I20200917003166 |
| Provider Name | Cheryl Swanson Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346856986 PECOS PAC ID: 1254751852 Enrollment ID: I20201021000578 |
| Provider Name | Alcia Delaney Edwards-richards |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689815573 PECOS PAC ID: 0941502439 Enrollment ID: I20201030000280 |
| Provider Name | Calvin B Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386023596 PECOS PAC ID: 5496068546 Enrollment ID: I20201112002237 |
| Provider Name | Michael Kristopher Don Woodruff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871082990 PECOS PAC ID: 7012329287 Enrollment ID: I20201211000619 |
| Provider Name | Thomas Lowell Fernandes |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1205114162 PECOS PAC ID: 0345652343 Enrollment ID: I20201216001432 |
| Provider Name | Logan Andrew Villarreal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689164188 PECOS PAC ID: 3476965492 Enrollment ID: I20201216002174 |
| Provider Name | Adrian S Dryden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487037172 PECOS PAC ID: 1850608407 Enrollment ID: I20201223002262 |
| Provider Name | Sarah A Jeffrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336585827 PECOS PAC ID: 3173766243 Enrollment ID: I20201228001170 |
| Provider Name | Justin Lange |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386022507 PECOS PAC ID: 9739491267 Enrollment ID: I20201231001252 |
| Provider Name | Michelle Drobny |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124432505 PECOS PAC ID: 4789979451 Enrollment ID: I20210122000428 |
| Provider Name | Steven Bruce Fishberger |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225002587 PECOS PAC ID: 5890734040 Enrollment ID: I20210126001318 |
| Provider Name | Pennie Lyn Schultz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912054339 PECOS PAC ID: 5193914232 Enrollment ID: I20210127000326 |
| Provider Name | Scott J Tetz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437529773 PECOS PAC ID: 3072927052 Enrollment ID: I20210203000607 |
| Provider Name | Jeremy Edward Stevens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063919843 PECOS PAC ID: 0941614812 Enrollment ID: I20210204001446 |
| Provider Name | James Michael Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245828227 PECOS PAC ID: 1759796352 Enrollment ID: I20210211003386 |
| Provider Name | Gary A Hurst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114951647 PECOS PAC ID: 7416998026 Enrollment ID: I20210217002169 |
| Provider Name | Sean Zohorsky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639601529 PECOS PAC ID: 7214342542 Enrollment ID: I20210219000802 |
| Provider Name | James R Fisk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881162162 PECOS PAC ID: 5799190641 Enrollment ID: I20210226001611 |
| Provider Name | Michael R Coe |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1295730802 PECOS PAC ID: 5890730014 Enrollment ID: I20210302001952 |
| Provider Name | Nathaniel L Crumet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487970125 PECOS PAC ID: 8022251479 Enrollment ID: I20210309002706 |
| Provider Name | Alexandra M Schmidt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043575574 PECOS PAC ID: 4183032022 Enrollment ID: I20210414001946 |
| Provider Name | Clare P Bear |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477982601 PECOS PAC ID: 4880002385 Enrollment ID: I20210422001143 |
| Provider Name | Casey M Hay |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053607523 PECOS PAC ID: 3678707320 Enrollment ID: I20210512001303 |
| Provider Name | Jean W Ruth |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760821490 PECOS PAC ID: 8123321874 Enrollment ID: I20210513001536 |
| Provider Name | Shaina Marie Bass |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033792528 PECOS PAC ID: 3678982022 Enrollment ID: I20210514001398 |
| Provider Name | Mildred O Bay |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679528178 PECOS PAC ID: 6608275797 Enrollment ID: I20210521001028 |
| Provider Name | Michael James Stewart |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053775767 PECOS PAC ID: 1052710746 Enrollment ID: I20210601000276 |
| Provider Name | Jennifer Louise Laycock |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1427491489 PECOS PAC ID: 4284033853 Enrollment ID: I20210602000590 |
| Provider Name | Dean Paul Lorimer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669859823 PECOS PAC ID: 0345640207 Enrollment ID: I20210614003366 |
| Provider Name | Jose Gomez Bautista |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508354010 PECOS PAC ID: 4587064209 Enrollment ID: I20210616002430 |
| Provider Name | Sergei Ivanov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457732950 PECOS PAC ID: 6608148580 Enrollment ID: I20210622000804 |
| Provider Name | Jennifer M Emery |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134552094 PECOS PAC ID: 8123396280 Enrollment ID: I20210625000172 |
| Provider Name | Travis Hughes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851889166 PECOS PAC ID: 4880095900 Enrollment ID: I20210628001380 |
| Provider Name | Benjamin M Carpenter |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1851724249 PECOS PAC ID: 7719250406 Enrollment ID: I20210628003010 |
| Provider Name | Eric Edward Desmarais |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174045967 PECOS PAC ID: 4981005840 Enrollment ID: I20210629002658 |
| Provider Name | Patrick L Kunkel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558850354 PECOS PAC ID: 2163823717 Enrollment ID: I20210702000926 |
| Provider Name | Zaid Diken |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134569148 PECOS PAC ID: 8123307295 Enrollment ID: I20210712000587 |
| Provider Name | Edwin Andre De Kock |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1134653348 PECOS PAC ID: 6002218179 Enrollment ID: I20210712003208 |
| Provider Name | Shannon Lee Riggs |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942878053 PECOS PAC ID: 8224430004 Enrollment ID: I20210715003873 |
| Provider Name | Erika L Garbrecht |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1164765632 PECOS PAC ID: 8729214028 Enrollment ID: I20210721001847 |
| Provider Name | Beth Ann Bremer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629645296 PECOS PAC ID: 7113320516 Enrollment ID: I20210722002183 |
| Provider Name | William Lou |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710340161 PECOS PAC ID: 9830481241 Enrollment ID: I20210723003232 |
| Provider Name | James D Calamia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588158166 PECOS PAC ID: 1052643913 Enrollment ID: I20210726000859 |
| Provider Name | Louis Zhang |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1952843757 PECOS PAC ID: 8527342922 Enrollment ID: I20210726002808 |
| Provider Name | Brent Ashby Mcginty |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1245645639 PECOS PAC ID: 6204053119 Enrollment ID: I20210727001458 |
| Provider Name | Richard James Deppisch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932609864 PECOS PAC ID: 6204170236 Enrollment ID: I20210803000464 |
| Provider Name | Megan Weyrauch |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962176800 PECOS PAC ID: 8123422532 Enrollment ID: I20210806002363 |
| Provider Name | Phoebe Ruth Ortman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154991107 PECOS PAC ID: 9234533597 Enrollment ID: I20210809001526 |
| Provider Name | Stephanie Michelle Biggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447867098 PECOS PAC ID: 9335551597 Enrollment ID: I20210812001385 |
| Provider Name | Nancy C Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851943765 PECOS PAC ID: 1254735293 Enrollment ID: I20210812001535 |
| Provider Name | Kamran A Karim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821520461 PECOS PAC ID: 1557774775 Enrollment ID: I20210812002724 |
| Provider Name | Aaron R Canfield |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144674029 PECOS PAC ID: 9739583709 Enrollment ID: I20210812002873 |
| Provider Name | Sean Robert Hayes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619516812 PECOS PAC ID: 3072940253 Enrollment ID: I20210819003091 |
| Provider Name | Tyson M Vandehey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962856641 PECOS PAC ID: 7315342953 Enrollment ID: I20210820000327 |
| Provider Name | Tiffany Fernandez-neel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497246128 PECOS PAC ID: 6204231772 Enrollment ID: I20210820002320 |
| Provider Name | Richard W Carson |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1114929668 PECOS PAC ID: 8224008560 Enrollment ID: I20210824001477 |
| Provider Name | Caitlin Alyssa Klamper |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003347543 PECOS PAC ID: 9638574056 Enrollment ID: I20210824001663 |
| Provider Name | Scott Bradley Bradeen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609228139 PECOS PAC ID: 0143567677 Enrollment ID: I20210826002344 |
| Provider Name | Launa Marie Lister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679857833 PECOS PAC ID: 8628245669 Enrollment ID: I20210910002625 |
| Provider Name | Maria Teresa Dellino |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487145389 PECOS PAC ID: 9537565817 Enrollment ID: I20210913000923 |
| Provider Name | Arun Kottarathara |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1568852838 PECOS PAC ID: 9436429800 Enrollment ID: I20210922001800 |
| Provider Name | Steven J Healan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811275944 PECOS PAC ID: 2062725500 Enrollment ID: I20210922002614 |
| Provider Name | Ashley Marie Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538735048 PECOS PAC ID: 8820495518 Enrollment ID: I20210922003132 |
| Provider Name | Zubair Saeed Zafar |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1174930051 PECOS PAC ID: 7416227897 Enrollment ID: I20210927002093 |
| Provider Name | Nicole Marie Hardy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205110095 PECOS PAC ID: 1052609849 Enrollment ID: I20210929002633 |
| Provider Name | Molly Elizabeth Dahl |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235559048 PECOS PAC ID: 0345581518 Enrollment ID: I20210930002827 |
| Provider Name | Nicholas Gerard Berger |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1518200666 PECOS PAC ID: 9032438510 Enrollment ID: I20211001000948 |
| Provider Name | Irene H Zoesch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568791036 PECOS PAC ID: 2264669688 Enrollment ID: I20211006000868 |
| Provider Name | Karanpreet Kaur Khahera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053808972 PECOS PAC ID: 8224436050 Enrollment ID: I20211008002130 |
| Provider Name | Barbara Jacobs |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1275981706 PECOS PAC ID: 5294029849 Enrollment ID: I20211013002778 |
| Provider Name | Sara J Stryker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609542356 PECOS PAC ID: 3971901372 Enrollment ID: I20211015001875 |
| Provider Name | Hunter S Oliver-allen |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1255759320 PECOS PAC ID: 0941592810 Enrollment ID: I20211026002634 |
| Provider Name | Kathryn W Jones |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1871732537 PECOS PAC ID: 3971657552 Enrollment ID: I20211026003191 |
| Provider Name | Coralyn Jill Alexander |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194713487 PECOS PAC ID: 8123210754 Enrollment ID: I20211029001797 |
| Provider Name | Ann Alexander Abraham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376938514 PECOS PAC ID: 2466790399 Enrollment ID: I20211109001621 |
| Provider Name | John Martin Stogin |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1235191297 PECOS PAC ID: 5799793410 Enrollment ID: I20211109002426 |
| Provider Name | Annie Petit-homme |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508528464 PECOS PAC ID: 3476942491 Enrollment ID: I20211112002343 |
| Provider Name | Casey P Collins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134680374 PECOS PAC ID: 9537559067 Enrollment ID: I20211124000333 |
| Provider Name | Jared Dean Evans |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1306927892 PECOS PAC ID: 1850781022 Enrollment ID: I20211201002608 |
| Provider Name | Jennifer L Gaston |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205395548 PECOS PAC ID: 3779973896 Enrollment ID: I20211203002587 |
| Provider Name | Neill Mears |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1740694603 PECOS PAC ID: 6507166428 Enrollment ID: I20211215002664 |
| Provider Name | Robert P Waugh |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1003950569 PECOS PAC ID: 7113043183 Enrollment ID: I20211215002745 |
| Provider Name | Billie Jo Schwalbe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578220349 PECOS PAC ID: 5496146573 Enrollment ID: I20211228001167 |
| Provider Name | Andrew Anderson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164803912 PECOS PAC ID: 3274836960 Enrollment ID: I20220107001455 |
| Provider Name | Sophia Kathryn Dunlap |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1366034977 PECOS PAC ID: 9032501523 Enrollment ID: I20220112002537 |
| Provider Name | Jeffery Givens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003890732 PECOS PAC ID: 2961487962 Enrollment ID: I20220124000242 |
| Provider Name | Divyanshoo Kohli |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1649569393 PECOS PAC ID: 2860706868 Enrollment ID: I20220315000615 |
| Provider Name | Krystal Ann Colwill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285206185 PECOS PAC ID: 1456746015 Enrollment ID: I20220316004135 |
| Provider Name | Katrina Joy Whipple |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255088845 PECOS PAC ID: 8628465630 Enrollment ID: I20220421001280 |
| Provider Name | Hui Quan Katie Zhang |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1871956912 PECOS PAC ID: 7416334768 Enrollment ID: I20220506002054 |
| Provider Name | Emily A Piekenbrock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891255386 PECOS PAC ID: 2466830757 Enrollment ID: I20220526002778 |
| Provider Name | Dylan S Mogk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720540784 PECOS PAC ID: 0244572691 Enrollment ID: I20220607002179 |
| Provider Name | Timothy W Hayes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255996492 PECOS PAC ID: 6204214943 Enrollment ID: I20220608001194 |
| Provider Name | Kaitlund R Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922662592 PECOS PAC ID: 9931588472 Enrollment ID: I20220614000951 |
| Provider Name | Taylor K Stewart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790245165 PECOS PAC ID: 2365821774 Enrollment ID: I20220615000912 |
| Provider Name | Brittany Ann Urso |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1427545433 PECOS PAC ID: 0244561124 Enrollment ID: I20220624002362 |
| Provider Name | Carol Eileen Johansen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881154847 PECOS PAC ID: 4789065053 Enrollment ID: I20220718002124 |
| Provider Name | Nasir Khan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1285061226 PECOS PAC ID: 4385939974 Enrollment ID: I20220720000864 |
| Provider Name | Meghana Srinivas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871049809 PECOS PAC ID: 4284904293 Enrollment ID: I20220726003823 |
| Provider Name | Carrie E. Laborde |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043367907 PECOS PAC ID: 9436305331 Enrollment ID: I20220804002917 |
| Provider Name | Nathan Campbell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356799290 PECOS PAC ID: 4981086071 Enrollment ID: I20220805002504 |
| Provider Name | Silvia Paola Russo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194258491 PECOS PAC ID: 0143602102 Enrollment ID: I20220808001605 |
| Provider Name | Richard Jesse Durrance |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598128670 PECOS PAC ID: 9739424078 Enrollment ID: I20220808003259 |
| Provider Name | Erica J Lay |
|---|---|
| Provider Type | Practitioner - Medical Genetics And Genomics |
| Provider Identifiers | NPI Number: 1588196463 PECOS PAC ID: 4082004320 Enrollment ID: I20220809001696 |
| Provider Name | Ariana Kamaliazad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982268777 PECOS PAC ID: 9739562422 Enrollment ID: I20220812001039 |
| Provider Name | Matthew Berger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417343773 PECOS PAC ID: 3476800111 Enrollment ID: I20220812002505 |
| Provider Name | Bryan Gregory Takisaki |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518521178 PECOS PAC ID: 5698158145 Enrollment ID: I20220816000765 |
| Provider Name | Soo Young Kwon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497199210 PECOS PAC ID: 2365686474 Enrollment ID: I20220816003257 |
| Provider Name | Austin Montgomery Brekke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083346050 PECOS PAC ID: 9739562778 Enrollment ID: I20220824000157 |
| Provider Name | Matthew L Coons |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750946042 PECOS PAC ID: 3870977333 Enrollment ID: I20220901000012 |
| Provider Name | Stanley A Lee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700339892 PECOS PAC ID: 5092199570 Enrollment ID: I20220901000738 |
| Provider Name | Carolyn Black |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1871984237 PECOS PAC ID: 8022355650 Enrollment ID: I20220906001883 |
| Provider Name | Clare Regina Gallagher |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1235790650 PECOS PAC ID: 7416367545 Enrollment ID: I20220913000741 |
| Provider Name | Melissa R Braid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568026961 PECOS PAC ID: 5890022446 Enrollment ID: I20220916002491 |
| Provider Name | Puneet Dhillon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710413539 PECOS PAC ID: 5496025389 Enrollment ID: I20220919003074 |
| Provider Name | Shelly Haferkamp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417418443 PECOS PAC ID: 8224413745 Enrollment ID: I20220920002728 |
| Provider Name | Kayli R Gimarc |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1164942868 PECOS PAC ID: 9739459926 Enrollment ID: I20220922002195 |
| Provider Name | Clare Frances Cozza |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588331102 PECOS PAC ID: 9537544762 Enrollment ID: I20220923001139 |
| Provider Name | Hilary A Lott |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033294194 PECOS PAC ID: 2466838560 Enrollment ID: I20220927001724 |
| Provider Name | Justin Woods |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861889354 PECOS PAC ID: 7810304565 Enrollment ID: I20221004000302 |
| Provider Name | Azmina Zieman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265895023 PECOS PAC ID: 0840581468 Enrollment ID: I20221024001500 |
| Provider Name | Kyle J Edwards |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417215351 PECOS PAC ID: 1254562127 Enrollment ID: I20221024001813 |
| Provider Name | Diane Marie Kovac |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902177850 PECOS PAC ID: 2466820659 Enrollment ID: I20221118001592 |
| Provider Name | Courtney A Lyle |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1275670549 PECOS PAC ID: 3577727940 Enrollment ID: I20221122000721 |
| Provider Name | Iulius S Grecu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144724683 PECOS PAC ID: 6507235991 Enrollment ID: I20221206003340 |
| Provider Name | James Monroe Stryker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831820562 PECOS PAC ID: 9234508409 Enrollment ID: I20221209001140 |
| Provider Name | Harshwant Grover |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639605454 PECOS PAC ID: 9638449564 Enrollment ID: I20230110002035 |
| Provider Name | Anna E Denton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003331539 PECOS PAC ID: 7315213790 Enrollment ID: I20230130002454 |
| Provider Name | Jenna Lois Ludwig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518673276 PECOS PAC ID: 1355713876 Enrollment ID: I20230209003110 |
| Provider Name | Morgan Sandhu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801376744 PECOS PAC ID: 7517210495 Enrollment ID: I20230217001443 |
| Provider Name | Seyedmahdi Pahlavani |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1841789419 PECOS PAC ID: 3375893084 Enrollment ID: I20230217001538 |
| Provider Name | Joel A Glidewell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609588466 PECOS PAC ID: 8820461601 Enrollment ID: I20230224002401 |
| Provider Name | Cedar James Neary |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144678103 PECOS PAC ID: 9032582580 Enrollment ID: I20230302002153 |
| Provider Name | James Cameron Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992264220 PECOS PAC ID: 1557734001 Enrollment ID: I20230302002232 |
| Provider Name | Samuel Lawrence Holley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447719489 PECOS PAC ID: 8527431048 Enrollment ID: I20230303001949 |
| Provider Name | Syed Hassan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1063638989 PECOS PAC ID: 7416191739 Enrollment ID: I20230303002271 |
| Provider Name | Hazel D Brogdon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396232666 PECOS PAC ID: 6800269002 Enrollment ID: I20230309002049 |
| Provider Name | Savannah Marie Patterson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427685841 PECOS PAC ID: 6800260951 Enrollment ID: I20230313002568 |
| Provider Name | Melony Burns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750047510 PECOS PAC ID: 2163897141 Enrollment ID: I20230404002354 |
| Provider Name | Trisha Leonard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174841571 PECOS PAC ID: 9234504291 Enrollment ID: I20230405002448 |
| Provider Name | Daniel J Yang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033746581 PECOS PAC ID: 4284009937 Enrollment ID: I20230411000950 |
| Provider Name | April Jean Walter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164072567 PECOS PAC ID: 6608204417 Enrollment ID: I20230412002719 |
| Provider Name | Elizabeth Tomer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053063842 PECOS PAC ID: 9537525936 Enrollment ID: I20230509001903 |
| Provider Name | Ashutosh Mahajan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1932140183 PECOS PAC ID: 6507896776 Enrollment ID: I20230510002388 |
| Provider Name | Michael Phillip Kinney |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144857012 PECOS PAC ID: 1759747058 Enrollment ID: I20230511000968 |
| Provider Name | Allison Nicole Cohen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427685908 PECOS PAC ID: 7214393412 Enrollment ID: I20230512002314 |
| Provider Name | Seth Allen Dotson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164041901 PECOS PAC ID: 0547627770 Enrollment ID: I20230605000110 |
| Provider Name | Sarah Knight |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881183853 PECOS PAC ID: 4880051994 Enrollment ID: I20230606000506 |
| Provider Name | Cayce Nicole Martin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245859263 PECOS PAC ID: 1951768092 Enrollment ID: I20230606001550 |
| Provider Name | Eric Wien |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952806804 PECOS PAC ID: 5496144503 Enrollment ID: I20230606001670 |
| Provider Name | Jenna Speltz Hennessey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699394569 PECOS PAC ID: 5991162935 Enrollment ID: I20230606001838 |
| Provider Name | Claire O Brutocao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912566274 PECOS PAC ID: 8426385279 Enrollment ID: I20230608001034 |
| Provider Name | Samuel James Beck |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720402993 PECOS PAC ID: 7719271410 Enrollment ID: I20230619001301 |
| Provider Name | Jared S Maybee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184078065 PECOS PAC ID: 9234561242 Enrollment ID: I20230621001153 |
| Provider Name | Phillip Andrew Choi |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1801250121 PECOS PAC ID: 5496113565 Enrollment ID: I20230621003449 |
| Provider Name | Tasha K Marchand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275200123 PECOS PAC ID: 9436518917 Enrollment ID: I20230630000758 |
| Provider Name | Emily H Huschart |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457732638 PECOS PAC ID: 5092116483 Enrollment ID: I20230630000981 |
| Provider Name | Roger Bentley |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1174817258 PECOS PAC ID: 6709186505 Enrollment ID: I20230703002871 |
| Provider Name | Katherine E Sloop |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376171611 PECOS PAC ID: 4284093550 Enrollment ID: I20230705000694 |
| Provider Name | Daniel S Davidson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639853914 PECOS PAC ID: 0345609673 Enrollment ID: I20230705003214 |
| Provider Name | Kelsi Cook |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073906699 PECOS PAC ID: 8921465279 Enrollment ID: I20230706001346 |
| Provider Name | Richa Mahajan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730396656 PECOS PAC ID: 4385784859 Enrollment ID: I20230707000206 |
| Provider Name | Glen Aaron Hester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346925419 PECOS PAC ID: 5395104210 Enrollment ID: I20230710002173 |
| Provider Name | Mashette Syrkin-nikolau |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811421779 PECOS PAC ID: 0244699197 Enrollment ID: I20230710003197 |
| Provider Name | Jennifer Glatt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982109500 PECOS PAC ID: 9335508126 Enrollment ID: I20230711004584 |
| Provider Name | Oksana Nimkevych |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1053644567 PECOS PAC ID: 2163643545 Enrollment ID: I20230714002833 |
| Provider Name | Kevin Arthur Mcnamee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437771169 PECOS PAC ID: 6507289006 Enrollment ID: I20230717002036 |
| Provider Name | Kelsie Marie Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740818954 PECOS PAC ID: 6002276474 Enrollment ID: I20230717002209 |
| Provider Name | Benjamin W Mitchell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982233219 PECOS PAC ID: 5193185171 Enrollment ID: I20230721003266 |
| Provider Name | Monita Poudyal |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1205805470 PECOS PAC ID: 9133139223 Enrollment ID: I20230726002305 |
| Provider Name | Brigette Christine Karagie Schuman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538797857 PECOS PAC ID: 8325409022 Enrollment ID: I20230727002455 |
| Provider Name | Jessica Dear |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467196238 PECOS PAC ID: 4981065356 Enrollment ID: I20230801003536 |
| Provider Name | Naaman Joseph Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487335964 PECOS PAC ID: 8820450273 Enrollment ID: I20230816002633 |
| Provider Name | Dara Lynn Horn |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629457593 PECOS PAC ID: 2567783020 Enrollment ID: I20230828001483 |
| Provider Name | Stephanie Tjho |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952798670 PECOS PAC ID: 7517244874 Enrollment ID: I20230829001223 |
| Provider Name | Brandon M White |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396988069 PECOS PAC ID: 9234592890 Enrollment ID: I20230829004369 |
| Provider Name | Oluwatoyin F Bamgbola |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851369334 PECOS PAC ID: 9335163393 Enrollment ID: I20230830002362 |
| Provider Name | Stevanie Junae Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598441248 PECOS PAC ID: 0244694297 Enrollment ID: I20230911001032 |
| Provider Name | Karly Michelle Clark |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760014450 PECOS PAC ID: 4789048620 Enrollment ID: I20230912001008 |
| Provider Name | Anwar Khokhar |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1477661825 PECOS PAC ID: 6709848344 Enrollment ID: I20231002000788 |
| Provider Name | Jennifer Zimmerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972282044 PECOS PAC ID: 1557716941 Enrollment ID: I20231004002072 |
| Provider Name | Jami Hoff |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093027476 PECOS PAC ID: 3678928884 Enrollment ID: I20231009000767 |
| Provider Name | Shannon Leah Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083498919 PECOS PAC ID: 7719332857 Enrollment ID: I20231010003552 |
| Provider Name | Lincoln John Round |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730968561 PECOS PAC ID: 0244685394 Enrollment ID: I20231010003754 |
| Provider Name | Chelsea Taylor Bremer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184113052 PECOS PAC ID: 9739534504 Enrollment ID: I20231013002060 |
| Provider Name | Randi Lynn Hankins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679701783 PECOS PAC ID: 1456707728 Enrollment ID: I20231023001443 |
| Provider Name | Clifford W Hall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184006389 PECOS PAC ID: 3476869033 Enrollment ID: I20231106002445 |
| Provider Name | Cassandra Marie Sauther |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154959534 PECOS PAC ID: 0446670277 Enrollment ID: I20231122003110 |
| Provider Name | Magdalena Garbacz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427612514 PECOS PAC ID: 6608104344 Enrollment ID: I20231206003572 |
| Provider Name | Jennifer Cooney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538791447 PECOS PAC ID: 9436587854 Enrollment ID: I20240103003245 |
| Provider Name | Katelynn Houger |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1972172831 PECOS PAC ID: 8921459959 Enrollment ID: I20240103004741 |
| Provider Name | Jessica N Douglass |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1508538711 PECOS PAC ID: 7810348729 Enrollment ID: I20240104002931 |
| Provider Name | Anthony Robert Gaspar |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1912475575 PECOS PAC ID: 1557712916 Enrollment ID: I20240110001249 |
| Provider Name | Katherine Lizbeth Morris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053940502 PECOS PAC ID: 8022469329 Enrollment ID: I20240111001505 |
| Provider Name | Haris Farooq Murad |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1972944247 PECOS PAC ID: 9931493418 Enrollment ID: I20240112004334 |
| Provider Name | Pong Xiong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922654532 PECOS PAC ID: 8729430889 Enrollment ID: I20240115000966 |
| Provider Name | Peter Franz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790363778 PECOS PAC ID: 3870945835 Enrollment ID: I20240116002107 |
| Provider Name | Sydney Joan Lindgren |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508176959 PECOS PAC ID: 3072965862 Enrollment ID: I20240117002395 |
| Provider Name | Kasey M Bailey-vanhook |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346717238 PECOS PAC ID: 8729430186 Enrollment ID: I20240122001763 |
| Provider Name | Leanne Kathleen Troop-dasgupta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104698489 PECOS PAC ID: 0547612905 Enrollment ID: I20240122001771 |
| Provider Name | Lauren Johnson |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1346636644 PECOS PAC ID: 0547530552 Enrollment ID: I20240122003546 |
| Provider Name | Stephanie Metzger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609420942 PECOS PAC ID: 5092045591 Enrollment ID: I20240125000826 |
| Provider Name | Jocelyn Cayla Mccornack |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013594209 PECOS PAC ID: 0143673970 Enrollment ID: I20240129002522 |
| Provider Name | Lydia Fazzio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770986176 PECOS PAC ID: 0749503993 Enrollment ID: I20240209002193 |
| Provider Name | Joshua Thomas Westby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457942955 PECOS PAC ID: 8123463361 Enrollment ID: I20240228000866 |
| Provider Name | Amy Stuart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619748746 PECOS PAC ID: 4587000732 Enrollment ID: I20240310000086 |
Cynthea Cunninghamm Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 323 W 15th Ave, Spokane, WA 99203 Phone: 509-838-3221 | |
Pennyfarthing Applied Behavior Analysis Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 707 W 7th Ave Ste 200, Spokane, WA 99204 Phone: 509-850-1080 Fax: 509-461-2532 | |
C.r.e.w. Behavioral Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3928 N Howard St, Spokane, WA 99205 Phone: 509-862-0707 | |
Mide Integrative Therapies Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1516 W Riverside Ave Ste 208, Spokane, WA 99201 Phone: 707-337-6721 | |
New Perspectives Behavior, Pllp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 222 W Mission Ave Ste 245, Spokane, WA 99201 Phone: 509-590-0047 Fax: 509-590-1437 | |
Arc Professional Counseling Service Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6821 N Country Homes Blvd Ste 201, Spokane, WA 99208 Phone: 509-558-7559 | |
Inward Love Therapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9631 N Nevada St Ste 311, Spokane, WA 99218 Phone: 509-496-7439 |