| Rockwood Clinic Ps | |
|
400 E 5th Ave Spokane WA 99202-1334 | |
| (509) 838-2531 | |
| (509) 455-5315 |
| Full Name | Rockwood Clinic Ps |
|---|---|
| Speciality | Internal Medicine |
| Location | 400 E 5th Ave, Spokane, Washington |
| Authorized Official Name and Position | Christopher Mcgoldrick (CFO) |
| Authorized Official Contact | 5093423709 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rockwood Clinic Ps Po Box 3649 Spokane WA 99220-3649 Ph: (509) 838-2531 | Rockwood Clinic Ps 400 E 5th Ave Spokane WA 99202-1334 Ph: (509) 838-2531 |
| NPI Number | 1417953787 |
|---|---|
| Provider Enumeration Date | 06/22/2005 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 8527976513 |
|---|---|
| Medicare Enrollment ID | O20031117000912 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417953787 | NPI | - | NPPES |
| 8064900200 | Medicaid | ID | |
| 7075310 | Medicaid | WA | |
| 003284100 | Medicaid | ID | |
| 2120004 | Medicaid | WA | |
| 407472 | Medicaid | MT | |
| 807640100 | Medicaid | ID | |
| 7014012 | Medicaid | WA |
| Provider Name | Onder Orgul |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1932123601 PECOS PAC ID: 2163320904 Enrollment ID: I20031230000630 |
| Provider Name | Tom J Koeske |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952393639 PECOS PAC ID: 2264334267 Enrollment ID: I20040121000742 |
| Provider Name | Ann K Brehmer |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1639164726 PECOS PAC ID: 0840186359 Enrollment ID: I20040223000929 |
| Provider Name | Charles B Hough |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811989163 PECOS PAC ID: 4880688399 Enrollment ID: I20040412000017 |
| Provider Name | Roger W Hanson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881723534 PECOS PAC ID: 4789679200 Enrollment ID: I20040415000592 |
| Provider Name | Randy E Goehring |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1780756478 PECOS PAC ID: 1658366455 Enrollment ID: I20040420000536 |
| Provider Name | Walter A Fernau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154313096 PECOS PAC ID: 9335139088 Enrollment ID: I20040514000328 |
| Provider Name | Deborah K Cavalieri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881766699 PECOS PAC ID: 6002807542 Enrollment ID: I20040521001152 |
| Provider Name | Corliss L Newman |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1760475073 PECOS PAC ID: 2264416742 Enrollment ID: I20040614000804 |
| Provider Name | Jody M Shanbour |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1619960770 PECOS PAC ID: 9739163205 Enrollment ID: I20040614001523 |
| Provider Name | Jedediah A Kaufman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1043228422 PECOS PAC ID: 3072591973 Enrollment ID: I20040708000490 |
| Provider Name | Mark R Bassett |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1619969045 PECOS PAC ID: 8527046440 Enrollment ID: I20040708000672 |
| Provider Name | Beth J Orenstein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821081142 PECOS PAC ID: 2860470796 Enrollment ID: I20040708000772 |
| Provider Name | Paul N Grubb |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568454817 PECOS PAC ID: 3870571730 Enrollment ID: I20040708000898 |
| Provider Name | Earl M Ryder |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1700879335 PECOS PAC ID: 3577541275 Enrollment ID: I20040709000548 |
| Provider Name | Joseph T Michels |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326031584 PECOS PAC ID: 2264410968 Enrollment ID: I20040709000584 |
| Provider Name | Paul E Myers |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063405272 PECOS PAC ID: 1759290349 Enrollment ID: I20040709000656 |
| Provider Name | Robert M Farner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154313088 PECOS PAC ID: 8224016969 Enrollment ID: I20040709000850 |
| Provider Name | Douglas Graham Wysham |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1275526360 PECOS PAC ID: 4385553973 Enrollment ID: I20040712000611 |
| Provider Name | Carol H Wysham |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1457344541 PECOS PAC ID: 4284612623 Enrollment ID: I20040712000665 |
| Provider Name | Richard A Frost |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1558353433 PECOS PAC ID: 8527046788 Enrollment ID: I20040713000816 |
| Provider Name | Charles W Laudenbach |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255324638 PECOS PAC ID: 0143138131 Enrollment ID: I20040713000854 |
| Provider Name | Jay L Wittenkeller |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1487647566 PECOS PAC ID: 1355329533 Enrollment ID: I20040713000960 |
| Provider Name | Samir Keblawi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790777472 PECOS PAC ID: 9739167933 Enrollment ID: I20040713001083 |
| Provider Name | Jeff L Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558353201 PECOS PAC ID: 7517946676 Enrollment ID: I20040714000635 |
| Provider Name | Janet K Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699768606 PECOS PAC ID: 1850370479 Enrollment ID: I20040716001065 |
| Provider Name | Richard A Bright |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619979358 PECOS PAC ID: 2567441199 Enrollment ID: I20040716001155 |
| Provider Name | Shani M Mcginnis |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1003809252 PECOS PAC ID: 4385623750 Enrollment ID: I20040719000691 |
| Provider Name | Timothy W Powell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982697090 PECOS PAC ID: 5294714671 Enrollment ID: I20040719000742 |
| Provider Name | Erin A Church |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891797353 PECOS PAC ID: 8325027733 Enrollment ID: I20040719000927 |
| Provider Name | Tamara K Grim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891787743 PECOS PAC ID: 0345229654 Enrollment ID: I20040719001005 |
| Provider Name | Ernest O Kanu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437261179 PECOS PAC ID: 2264411479 Enrollment ID: I20040720000139 |
| Provider Name | Chris L Bogarosh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700921004 PECOS PAC ID: 3870572084 Enrollment ID: I20040720000161 |
| Provider Name | Sarah E D Hulst |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033111414 PECOS PAC ID: 7416854666 Enrollment ID: I20040721000672 |
| Provider Name | Wayne B Venters |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1366435430 PECOS PAC ID: 4082694989 Enrollment ID: I20040721001571 |
| Provider Name | Mark E Didier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255333647 PECOS PAC ID: 8628058534 Enrollment ID: I20040721001655 |
| Provider Name | Darin P Eckert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073515458 PECOS PAC ID: 8224018148 Enrollment ID: I20040721001691 |
| Provider Name | Stephen Lewis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184616526 PECOS PAC ID: 8123008042 Enrollment ID: I20040721001698 |
| Provider Name | Brendan A Mielke |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1265425532 PECOS PAC ID: 2769462688 Enrollment ID: I20040721001704 |
| Provider Name | Steven R Laney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548356504 PECOS PAC ID: 9830179571 Enrollment ID: I20040722000927 |
| Provider Name | Philip C Delich |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1407858889 PECOS PAC ID: 8224018940 Enrollment ID: I20040722001372 |
| Provider Name | John L Musa |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1154314367 PECOS PAC ID: 5395725014 Enrollment ID: I20040722001380 |
| Provider Name | Mary B Sherwood |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1386637320 PECOS PAC ID: 2264412980 Enrollment ID: I20040722001401 |
| Provider Name | Mathew C Rawlins |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1801889928 PECOS PAC ID: 5496735003 Enrollment ID: I20040723000603 |
| Provider Name | Catherine A Lee |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1679565014 PECOS PAC ID: 9032199658 Enrollment ID: I20040723000685 |
| Provider Name | Rebecca G Gallaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831181510 PECOS PAC ID: 5496735912 Enrollment ID: I20040723000750 |
| Provider Name | Jonathan M Staben |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720071889 PECOS PAC ID: 3577543057 Enrollment ID: I20040723001110 |
| Provider Name | Amy J Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306848379 PECOS PAC ID: 9537149018 Enrollment ID: I20040723001158 |
| Provider Name | Tatiana Ponomarenko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619960937 PECOS PAC ID: 4880674365 Enrollment ID: I20040723001167 |
| Provider Name | Scott E Carlson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659373116 PECOS PAC ID: 7416927751 Enrollment ID: I20040726001422 |
| Provider Name | Mary L Gilbert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699864603 PECOS PAC ID: 7315918257 Enrollment ID: I20040804000152 |
| Provider Name | Debra Kontny |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1346276516 PECOS PAC ID: 1759343254 Enrollment ID: I20041027001013 |
| Provider Name | Julie B Loudon |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295805372 PECOS PAC ID: 7416994702 Enrollment ID: I20050411000815 |
| Provider Name | Julie M Iverson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508945205 PECOS PAC ID: 5092753780 Enrollment ID: I20050422000395 |
| Provider Name | Elizabeth J Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497800049 PECOS PAC ID: 4880633809 Enrollment ID: I20050428001126 |
| Provider Name | Timothy F Ahern |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932258829 PECOS PAC ID: 5698719128 Enrollment ID: I20050615000999 |
| Provider Name | Ronald D Moss |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699871269 PECOS PAC ID: 7810932787 Enrollment ID: I20050621001216 |
| Provider Name | Clint T Hauxwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205828159 PECOS PAC ID: 1052379781 Enrollment ID: I20050701000787 |
| Provider Name | Thomas F Heston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861447245 PECOS PAC ID: 7315974490 Enrollment ID: I20050728000172 |
| Provider Name | Louis W Cotterell |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1811994668 PECOS PAC ID: 8325079320 Enrollment ID: I20050830000387 |
| Provider Name | Madeleine C Geraghty |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902898877 PECOS PAC ID: 0143252635 Enrollment ID: I20050906000719 |
| Provider Name | Steven O Thomas |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1588691943 PECOS PAC ID: 7113951583 Enrollment ID: I20050924000247 |
| Provider Name | Timothy P Manson |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1780684316 PECOS PAC ID: 4385678754 Enrollment ID: I20050924000252 |
| Provider Name | Tamara Garduno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063440766 PECOS PAC ID: 1658305024 Enrollment ID: I20050924000261 |
| Provider Name | Peter J Hill |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1972531671 PECOS PAC ID: 8628003225 Enrollment ID: I20051003000562 |
| Provider Name | Hamed A Al-ghanim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124039938 PECOS PAC ID: 9638104128 Enrollment ID: I20051004000407 |
| Provider Name | Jose Jeffrey T Reasol |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033152855 PECOS PAC ID: 8527089200 Enrollment ID: I20051208000940 |
| Provider Name | Jennifer L Musa |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1376511329 PECOS PAC ID: 6709892060 Enrollment ID: I20060224000121 |
| Provider Name | Trent May |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1982799557 PECOS PAC ID: 3173530920 Enrollment ID: I20060320000353 |
| Provider Name | Michael E Coats |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1942237045 PECOS PAC ID: 1153331558 Enrollment ID: I20060501000170 |
| Provider Name | Adam Brown |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1992755417 PECOS PAC ID: 5092777458 Enrollment ID: I20060516000007 |
| Provider Name | Paul S Fontana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275582751 PECOS PAC ID: 1052321411 Enrollment ID: I20060601000084 |
| Provider Name | Teresa M Ogden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730143280 PECOS PAC ID: 1254319858 Enrollment ID: I20060824000069 |
| Provider Name | Eric R Anderson |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1295732030 PECOS PAC ID: 5597761973 Enrollment ID: I20061006000349 |
| Provider Name | Bradford A Nelson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1962466045 PECOS PAC ID: 5193721470 Enrollment ID: I20061010000164 |
| Provider Name | Todd E Bristow |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1538161369 PECOS PAC ID: 7810993102 Enrollment ID: I20061010000268 |
| Provider Name | Matthew T Gores |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1356333298 PECOS PAC ID: 2264438563 Enrollment ID: I20061010000379 |
| Provider Name | Jennifer L Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902916935 PECOS PAC ID: 2567468440 Enrollment ID: I20061017000323 |
| Provider Name | Steven J Nordeen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447232939 PECOS PAC ID: 1850398686 Enrollment ID: I20061108000516 |
| Provider Name | John K Naylor |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1467440727 PECOS PAC ID: 2163421355 Enrollment ID: I20061218000148 |
| Provider Name | Daniel R Coulston |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1437178266 PECOS PAC ID: 8426057613 Enrollment ID: I20061218000153 |
| Provider Name | Christopher J Gapen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932184033 PECOS PAC ID: 8921065343 Enrollment ID: I20070119000037 |
| Provider Name | Daniel H Stoop |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780680173 PECOS PAC ID: 6406857382 Enrollment ID: I20070119000080 |
| Provider Name | William Conrad Dir |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1376517268 PECOS PAC ID: 7315912136 Enrollment ID: I20070409000189 |
| Provider Name | Michael D Hixon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396850756 PECOS PAC ID: 3779689195 Enrollment ID: I20070501000690 |
| Provider Name | Tricia M Earhart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780605972 PECOS PAC ID: 8628176849 Enrollment ID: I20070611000638 |
| Provider Name | Gabriella Nicole Ghali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891826186 PECOS PAC ID: 7113028309 Enrollment ID: I20070718000135 |
| Provider Name | Michael C Brophy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1528055498 PECOS PAC ID: 0941301204 Enrollment ID: I20070731000239 |
| Provider Name | Neal J Peterson |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1033320817 PECOS PAC ID: 6002908126 Enrollment ID: I20070822000155 |
| Provider Name | Gretchen W Lasalle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497781926 PECOS PAC ID: 1254319213 Enrollment ID: I20070904000164 |
| Provider Name | Fiona E Dennison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841216587 PECOS PAC ID: 1254428097 Enrollment ID: I20071026000160 |
| Provider Name | Cynthia R Murphy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184826125 PECOS PAC ID: 2466533047 Enrollment ID: I20080122000242 |
| Provider Name | Samuel E Schneider |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700831823 PECOS PAC ID: 3678582707 Enrollment ID: I20080131000018 |
| Provider Name | Monica M Anselmetti |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356318000 PECOS PAC ID: 4789767369 Enrollment ID: I20080206000373 |
| Provider Name | Mohammed H Baccora |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1366567471 PECOS PAC ID: 7416909312 Enrollment ID: I20080430000309 |
| Provider Name | Gary Van Heuvelen |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1629060256 PECOS PAC ID: 4981591062 Enrollment ID: I20080710000150 |
| Provider Name | Byron E Wright |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972563930 PECOS PAC ID: 9234227141 Enrollment ID: I20080710000526 |
| Provider Name | Kelly M Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720293749 PECOS PAC ID: 8123191806 Enrollment ID: I20080715000229 |
| Provider Name | Sanjit K Dutta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881610038 PECOS PAC ID: 1456325349 Enrollment ID: I20080721000793 |
| Provider Name | Sarvesh S Thakur |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1295761328 PECOS PAC ID: 3779473244 Enrollment ID: I20080814000389 |
| Provider Name | Jon L Griffith |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1356333959 PECOS PAC ID: 2264329341 Enrollment ID: I20080828000577 |
| Provider Name | Donna S Longpre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093836850 PECOS PAC ID: 3274609003 Enrollment ID: I20080902000597 |
| Provider Name | Holland M Patterson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174742407 PECOS PAC ID: 6709952427 Enrollment ID: I20080904000072 |
| Provider Name | Esther Rawner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093999211 PECOS PAC ID: 1850467275 Enrollment ID: I20080909000701 |
| Provider Name | Jonathan David Spitz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194785014 PECOS PAC ID: 0244124733 Enrollment ID: I20080911000315 |
| Provider Name | Heidi Richardson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285843235 PECOS PAC ID: 2163515628 Enrollment ID: I20080911000361 |
| Provider Name | Ramon Anel |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1467547711 PECOS PAC ID: 2769377423 Enrollment ID: I20081009000781 |
| Provider Name | Janet L Collar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467406975 PECOS PAC ID: 3678579943 Enrollment ID: I20081020000096 |
| Provider Name | Narinderpal Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285796987 PECOS PAC ID: 0446352983 Enrollment ID: I20081031000254 |
| Provider Name | Benjamin C Hubbard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154588978 PECOS PAC ID: 1153480033 Enrollment ID: I20081106000660 |
| Provider Name | Marylynn Bernard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457344152 PECOS PAC ID: 3971585647 Enrollment ID: I20090112000262 |
| Provider Name | Joseph C Swiggum |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1467570259 PECOS PAC ID: 2163516550 Enrollment ID: I20090728000723 |
| Provider Name | Scott E Grosse |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1316978281 PECOS PAC ID: 2365583002 Enrollment ID: I20100104000372 |
| Provider Name | Rimma Barko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598997827 PECOS PAC ID: 4688714082 Enrollment ID: I20100111000356 |
| Provider Name | Joel R Galloway |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1538118062 PECOS PAC ID: 9537069190 Enrollment ID: I20100119000616 |
| Provider Name | Jennifer C Coles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861494320 PECOS PAC ID: 3375685019 Enrollment ID: I20100119000631 |
| Provider Name | Andrea Balazs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295721439 PECOS PAC ID: 4385786631 Enrollment ID: I20100125000369 |
| Provider Name | Christopher J Melich |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1447365457 PECOS PAC ID: 2668466913 Enrollment ID: I20100208000517 |
| Provider Name | Susanne M Ferro |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275626483 PECOS PAC ID: 1759485048 Enrollment ID: I20100302000189 |
| Provider Name | Bob Thong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538352802 PECOS PAC ID: 7315072360 Enrollment ID: I20100317000036 |
| Provider Name | Joseph Harcourt Acton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861452765 PECOS PAC ID: 8123924867 Enrollment ID: I20100416000204 |
| Provider Name | Taras P Kindrat |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326205980 PECOS PAC ID: 0345311411 Enrollment ID: I20100507000400 |
| Provider Name | Glenn P Gardner |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1932165321 PECOS PAC ID: 9436114550 Enrollment ID: I20100514000701 |
| Provider Name | Jonathan Grant Haymore |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1811191372 PECOS PAC ID: 4183756695 Enrollment ID: I20100720000231 |
| Provider Name | Trace J Julsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962663898 PECOS PAC ID: 7618024779 Enrollment ID: I20100820000673 |
| Provider Name | Jiten D Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689895211 PECOS PAC ID: 8022201219 Enrollment ID: I20101020000653 |
| Provider Name | Damon Sheneman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053522094 PECOS PAC ID: 3072707462 Enrollment ID: I20101029000712 |
| Provider Name | Elizabeth A Swift |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114233731 PECOS PAC ID: 6901090901 Enrollment ID: I20101103001295 |
| Provider Name | Marie F Brenden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932265071 PECOS PAC ID: 7214908912 Enrollment ID: I20101105000775 |
| Provider Name | Daniel V. Rodriguez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1720187651 PECOS PAC ID: 2163563537 Enrollment ID: I20101112000562 |
| Provider Name | Sarah Henn Hayward |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568774982 PECOS PAC ID: 4486849650 Enrollment ID: I20101112000956 |
| Provider Name | Craig Allen Lammers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679639272 PECOS PAC ID: 0941496327 Enrollment ID: I20101124000584 |
| Provider Name | Dan C Wilcox |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1912900994 PECOS PAC ID: 7719956606 Enrollment ID: I20101214001121 |
| Provider Name | Byron J Humble |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1053391508 PECOS PAC ID: 4880883347 Enrollment ID: I20110113001178 |
| Provider Name | Paige Mcreynolds |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649254947 PECOS PAC ID: 6507045762 Enrollment ID: I20110120000770 |
| Provider Name | Jennifer L Hickman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952541971 PECOS PAC ID: 0446293153 Enrollment ID: I20110131001014 |
| Provider Name | Veronica G Ruiz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407844004 PECOS PAC ID: 7416965934 Enrollment ID: I20110216000555 |
| Provider Name | Dani L Fergen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164720488 PECOS PAC ID: 2466636089 Enrollment ID: I20110406000337 |
| Provider Name | Joseph W Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013182179 PECOS PAC ID: 0648456798 Enrollment ID: I20110525000521 |
| Provider Name | Jared Wyrick |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1194938522 PECOS PAC ID: 9931387560 Enrollment ID: I20110629000402 |
| Provider Name | Conrad C Nievera |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346292018 PECOS PAC ID: 8325123318 Enrollment ID: I20110802000397 |
| Provider Name | Yu Lisa Shen-vasen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396044418 PECOS PAC ID: 2769651934 Enrollment ID: I20110803000785 |
| Provider Name | Beejay A Feliciano |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1235273632 PECOS PAC ID: 3173792322 Enrollment ID: I20110804000745 |
| Provider Name | Charles P Haigh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295788347 PECOS PAC ID: 3870597172 Enrollment ID: I20110831000195 |
| Provider Name | Marguerite Wayland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861622482 PECOS PAC ID: 3476723396 Enrollment ID: I20110901000775 |
| Provider Name | Sean Ian Sanchez |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1225207186 PECOS PAC ID: 2860533759 Enrollment ID: I20110901000781 |
| Provider Name | Valerie Ewert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861527574 PECOS PAC ID: 9234300831 Enrollment ID: I20110912000107 |
| Provider Name | Allan Heller |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1114196466 PECOS PAC ID: 9436218716 Enrollment ID: I20110913000454 |
| Provider Name | Satinder Singh |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1508013749 PECOS PAC ID: 8820150584 Enrollment ID: I20111004000407 |
| Provider Name | Elizabeth Locascio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679772362 PECOS PAC ID: 8729163068 Enrollment ID: I20111013000109 |
| Provider Name | Kristopher G Davies |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073766994 PECOS PAC ID: 8325193998 Enrollment ID: I20111107000481 |
| Provider Name | Muhammad F Tariq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093965899 PECOS PAC ID: 5294900700 Enrollment ID: I20111212000932 |
| Provider Name | Jihad O Arteh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174713846 PECOS PAC ID: 2567637093 Enrollment ID: I20111213000215 |
| Provider Name | Purvi S Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1225248735 PECOS PAC ID: 2567521578 Enrollment ID: I20111213000382 |
| Provider Name | Harjeet S Dhillon |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508076985 PECOS PAC ID: 4688739683 Enrollment ID: I20111222000184 |
| Provider Name | Adam A Lyko |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1659485332 PECOS PAC ID: 0345270047 Enrollment ID: I20120106000416 |
| Provider Name | Jon E Ween |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831482876 PECOS PAC ID: 0042486342 Enrollment ID: I20120109000801 |
| Provider Name | Ambalavanan Balasubramanian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184799066 PECOS PAC ID: 3779647169 Enrollment ID: I20120125000244 |
| Provider Name | Kiet A Ton |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558326371 PECOS PAC ID: 8628159845 Enrollment ID: I20120213000809 |
| Provider Name | Tonia L Baker |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1629386610 PECOS PAC ID: 5193911857 Enrollment ID: I20120301000270 |
| Provider Name | Carla M Williams |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235266503 PECOS PAC ID: 2567456395 Enrollment ID: I20120319000521 |
| Provider Name | William T Magee |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1235333188 PECOS PAC ID: 8729178769 Enrollment ID: I20120502000162 |
| Provider Name | Michael P Hubbell |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1932309135 PECOS PAC ID: 5698930733 Enrollment ID: I20120622000502 |
| Provider Name | Jon D Boyum |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194801357 PECOS PAC ID: 4880752039 Enrollment ID: I20120703000084 |
| Provider Name | Molly B Stapleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073870648 PECOS PAC ID: 8224294285 Enrollment ID: I20120719000638 |
| Provider Name | Shawkat K Kero |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1932106929 PECOS PAC ID: 9234266305 Enrollment ID: I20120807000488 |
| Provider Name | Caroline M Sebley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942443445 PECOS PAC ID: 9335395177 Enrollment ID: I20120809000335 |
| Provider Name | Sarah R King |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417022799 PECOS PAC ID: 1759428147 Enrollment ID: I20120821001082 |
| Provider Name | Aimee M Gence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255695300 PECOS PAC ID: 7416105903 Enrollment ID: I20120906000620 |
| Provider Name | Ravi K Kilaru |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1508823097 PECOS PAC ID: 5294908760 Enrollment ID: I20121019000416 |
| Provider Name | Shaluk Biswas |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1295080562 PECOS PAC ID: 1850541012 Enrollment ID: I20121024000252 |
| Provider Name | Vienna Loften |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447334230 PECOS PAC ID: 1254591662 Enrollment ID: I20121026000294 |
| Provider Name | Alon S Aharon |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1780617746 PECOS PAC ID: 9032006978 Enrollment ID: I20121110000156 |
| Provider Name | Jeffrey S Schack |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366559635 PECOS PAC ID: 6002067543 Enrollment ID: I20121110000158 |
| Provider Name | Shamit D Tailor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104089432 PECOS PAC ID: 1153594585 Enrollment ID: I20121112000507 |
| Provider Name | Elena V Olsen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629209002 PECOS PAC ID: 4486805744 Enrollment ID: I20121114000104 |
| Provider Name | Erin Baldwin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922333863 PECOS PAC ID: 5395996508 Enrollment ID: I20121116000499 |
| Provider Name | Erika R Klossner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841398062 PECOS PAC ID: 4284885328 Enrollment ID: I20121119000174 |
| Provider Name | Angela D Sankaran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891064895 PECOS PAC ID: 7113179961 Enrollment ID: I20121130000541 |
| Provider Name | Hassan Y Tehrani |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1770547572 PECOS PAC ID: 9931194370 Enrollment ID: I20130212000533 |
| Provider Name | Rhonda E Kelley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912243783 PECOS PAC ID: 1355589599 Enrollment ID: I20130530000438 |
| Provider Name | Anneliese C. Clow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952655045 PECOS PAC ID: 1951540475 Enrollment ID: I20130613000401 |
| Provider Name | Miguel Enrique Ordonez Castellanos |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1013168392 PECOS PAC ID: 6204073877 Enrollment ID: I20130620000377 |
| Provider Name | Ryan Barnes |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1992933881 PECOS PAC ID: 8123260601 Enrollment ID: I20130813000401 |
| Provider Name | Leigh T Moseman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962849760 PECOS PAC ID: 4981846474 Enrollment ID: I20130813000482 |
| Provider Name | Enkhtuyaa L Mueller |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1508917261 PECOS PAC ID: 5597801167 Enrollment ID: I20130829000459 |
| Provider Name | Andriy M Viter |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528371622 PECOS PAC ID: 8426292467 Enrollment ID: I20130913000267 |
| Provider Name | Kara L Holden |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841622495 PECOS PAC ID: 2769618206 Enrollment ID: I20131112000082 |
| Provider Name | Jonathan Weiser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699739862 PECOS PAC ID: 8022030857 Enrollment ID: I20131116000003 |
| Provider Name | Joseph R Barthelemy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1447567011 PECOS PAC ID: 5294960985 Enrollment ID: I20131220000787 |
| Provider Name | Karyn M Manor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992134332 PECOS PAC ID: 9537396494 Enrollment ID: I20131220001389 |
| Provider Name | Carlo Greg Demandante |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1528134517 PECOS PAC ID: 3971731928 Enrollment ID: I20140121000223 |
| Provider Name | Kendra Elizabeth Johnson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1235568338 PECOS PAC ID: 8628207917 Enrollment ID: I20140212001822 |
| Provider Name | Kyle W Sasser |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1750710968 PECOS PAC ID: 2961630934 Enrollment ID: I20140213001062 |
| Provider Name | Mistie L Varner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508287087 PECOS PAC ID: 1850521741 Enrollment ID: I20140219001774 |
| Provider Name | Mark A Mueller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295755288 PECOS PAC ID: 5890750509 Enrollment ID: I20140311001912 |
| Provider Name | Kenneth A Absalonson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811206998 PECOS PAC ID: 3678705670 Enrollment ID: I20140404001704 |
| Provider Name | Jo Prophet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184047508 PECOS PAC ID: 7214169234 Enrollment ID: I20140407000280 |
| Provider Name | Lindsay N Anderson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861822595 PECOS PAC ID: 0941432322 Enrollment ID: I20140417001199 |
| Provider Name | Charlotte N Pecht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447671680 PECOS PAC ID: 3274766290 Enrollment ID: I20140428002054 |
| Provider Name | Migdalia Merida |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770526766 PECOS PAC ID: 8729271762 Enrollment ID: I20140523000100 |
| Provider Name | Wilfrido Urueta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548311350 PECOS PAC ID: 9739226556 Enrollment ID: I20140604001126 |
| Provider Name | Jo Persoon-gundy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467758581 PECOS PAC ID: 3971736570 Enrollment ID: I20140702000604 |
| Provider Name | Lisa P Maestas |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1033114160 PECOS PAC ID: 1658331343 Enrollment ID: I20140703001624 |
| Provider Name | Kate S Statz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831492941 PECOS PAC ID: 1658512470 Enrollment ID: I20140712000097 |
| Provider Name | Sarah L Crow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548556889 PECOS PAC ID: 1254557853 Enrollment ID: I20140716001646 |
| Provider Name | Heidi W Eiseman |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1457659047 PECOS PAC ID: 9638395163 Enrollment ID: I20140718001273 |
| Provider Name | Robert U Glazier |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1699065052 PECOS PAC ID: 0648414250 Enrollment ID: I20140722000830 |
| Provider Name | Wen Zhong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356381537 PECOS PAC ID: 7810980752 Enrollment ID: I20140730002861 |
| Provider Name | Jared J Allred |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497902340 PECOS PAC ID: 6901047455 Enrollment ID: I20140731002550 |
| Provider Name | Bryce J Barker |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1184848814 PECOS PAC ID: 8729204409 Enrollment ID: I20140801002042 |
| Provider Name | Joseph D Mickelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578769816 PECOS PAC ID: 8224284526 Enrollment ID: I20140811002731 |
| Provider Name | Beaver Eller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760827372 PECOS PAC ID: 7113169335 Enrollment ID: I20140828000196 |
| Provider Name | Andrew Brendan Dill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215922182 PECOS PAC ID: 8921012139 Enrollment ID: I20141023002149 |
| Provider Name | Catherine Annabel Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093145567 PECOS PAC ID: 8729202452 Enrollment ID: I20141223001633 |
| Provider Name | Marta E Gorczyca |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1750669073 PECOS PAC ID: 9537482567 Enrollment ID: I20141226000479 |
| Provider Name | Kelli J Shannon |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1700283314 PECOS PAC ID: 0648594655 Enrollment ID: I20150122001990 |
| Provider Name | Gwen M Bernacki |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134319791 PECOS PAC ID: 5698090231 Enrollment ID: I20150203000204 |
| Provider Name | Gayle Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598779746 PECOS PAC ID: 5799847455 Enrollment ID: I20150304001251 |
| Provider Name | Cassandra A Mahan-richards |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1093767782 PECOS PAC ID: 3870487606 Enrollment ID: I20150313001995 |
| Provider Name | Catherine M Cairney |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114155306 PECOS PAC ID: 3072757210 Enrollment ID: I20150314000219 |
| Provider Name | John Joseph Perry |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1851321442 PECOS PAC ID: 8729075668 Enrollment ID: I20150407002165 |
| Provider Name | Manuela L Orban |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063801694 PECOS PAC ID: 8921327461 Enrollment ID: I20150505000138 |
| Provider Name | Sean R Hendrickson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225421159 PECOS PAC ID: 5294054656 Enrollment ID: I20150506001079 |
| Provider Name | Shelby R Rush |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144290586 PECOS PAC ID: 5698665198 Enrollment ID: I20150601000423 |
| Provider Name | Ashley M Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457746737 PECOS PAC ID: 1557682028 Enrollment ID: I20150609001861 |
| Provider Name | Jason Roos |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1205147659 PECOS PAC ID: 2365608189 Enrollment ID: I20150616002557 |
| Provider Name | Heather Anne Hartshorn |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003016163 PECOS PAC ID: 6800031840 Enrollment ID: I20150702001668 |
| 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 | Shawn M Baxter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174884688 PECOS PAC ID: 9133432255 Enrollment ID: I20150720000437 |
| Provider Name | Nicolas Villa Guillen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1265696553 PECOS PAC ID: 7113148651 Enrollment ID: I20150723007220 |
| Provider Name | Christopher Bateman Dewing |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477608875 PECOS PAC ID: 7113087693 Enrollment ID: I20150724011493 |
| Provider Name | Jeff M Pryor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790045045 PECOS PAC ID: 9436462082 Enrollment ID: I20150724012177 |
| Provider Name | Christopher K Yang |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1639480692 PECOS PAC ID: 5890927685 Enrollment ID: I20150810000393 |
| Provider Name | Chad M Turner |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1467687673 PECOS PAC ID: 4284873746 Enrollment ID: I20150812007295 |
| Provider Name | Meng Zhao |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1083848337 PECOS PAC ID: 0345489266 Enrollment ID: I20150812008519 |
| Provider Name | Joseph B Accursio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528400652 PECOS PAC ID: 4587894340 Enrollment ID: I20150827001281 |
| Provider Name | Mark Anthony C Cabrera |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1659524924 PECOS PAC ID: 6406989698 Enrollment ID: I20150829000008 |
| Provider Name | Christopher A Michaeles |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1225060684 PECOS PAC ID: 0244229839 Enrollment ID: I20150916001286 |
| Provider Name | Brian A Tennant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023499308 PECOS PAC ID: 3971810318 Enrollment ID: I20150916002671 |
| Provider Name | Teodulo T Vince Cruz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821035643 PECOS PAC ID: 9335107192 Enrollment ID: I20150922000577 |
| Provider Name | Keegan K Bench |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1801204144 PECOS PAC ID: 2264749340 Enrollment ID: I20150922002800 |
| Provider Name | Kelsey A White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083080238 PECOS PAC ID: 4789992561 Enrollment ID: I20150928001654 |
| Provider Name | Caitlin E Shino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427424381 PECOS PAC ID: 0547578387 Enrollment ID: I20150929000935 |
| Provider Name | Kenneth M Brantley |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1609825017 PECOS PAC ID: 6709885262 Enrollment ID: I20151006000167 |
| Provider Name | Veronica Navarro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356718829 PECOS PAC ID: 7113236480 Enrollment ID: I20151028000126 |
| Provider Name | Stephens Taylor |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1508841966 PECOS PAC ID: 9234031550 Enrollment ID: I20151116002085 |
| Provider Name | Jay Jahanmir |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407837347 PECOS PAC ID: 2163417619 Enrollment ID: I20151120001725 |
| Provider Name | Navpreet Sidhu |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1336303304 PECOS PAC ID: 5991006702 Enrollment ID: I20151221002675 |
| Provider Name | Tanya Jean D Karg |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1558774638 PECOS PAC ID: 6103043690 Enrollment ID: I20160104000554 |
| Provider Name | Kelly Lawrence |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396041679 PECOS PAC ID: 4082859459 Enrollment ID: I20160226002220 |
| Provider Name | Lisa M Ogrin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265899546 PECOS PAC ID: 1052618717 Enrollment ID: I20160323000835 |
| Provider Name | Pushapdeep K Brar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699097279 PECOS PAC ID: 0244400109 Enrollment ID: I20160407000847 |
| Provider Name | Donald D Storey |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1578921755 PECOS PAC ID: 7911205794 Enrollment ID: I20160411002272 |
| Provider Name | Megan L Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457718702 PECOS PAC ID: 3072811777 Enrollment ID: I20160413001474 |
| Provider Name | Olaseni Alexander Shoroye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053376509 PECOS PAC ID: 1557346418 Enrollment ID: I20160422000793 |
| Provider Name | Bradley W Hilliard-lythgoe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376984682 PECOS PAC ID: 0941247332 Enrollment ID: I20160426001220 |
| Provider Name | Josiah J Newton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215395397 PECOS PAC ID: 6901105816 Enrollment ID: I20160427001930 |
| Provider Name | Gurdev Singh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1376599431 PECOS PAC ID: 2365421393 Enrollment ID: I20160615002394 |
| Provider Name | Kerrin Michele Sorrie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982064507 PECOS PAC ID: 8325339666 Enrollment ID: I20160616002237 |
| Provider Name | Parth Joshi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649595372 PECOS PAC ID: 9436391182 Enrollment ID: I20160706001668 |
| Provider Name | Sami Amjad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760770788 PECOS PAC ID: 1951520576 Enrollment ID: I20160711000418 |
| Provider Name | Kyle Benton Varner |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174961734 PECOS PAC ID: 1254624349 Enrollment ID: I20160727001153 |
| Provider Name | Patricia Woods |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760614655 PECOS PAC ID: 6901071430 Enrollment ID: I20160728002520 |
| Provider Name | Christine V Guenther |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891132155 PECOS PAC ID: 5395046387 Enrollment ID: I20160812002009 |
| Provider Name | Carol Ann Kerr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225354400 PECOS PAC ID: 0042446478 Enrollment ID: I20160826002130 |
| Provider Name | Leonard Lacefield |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447590088 PECOS PAC ID: 2769777101 Enrollment ID: I20160920003006 |
| Provider Name | Jonathan Danaraj |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1518283845 PECOS PAC ID: 7810139920 Enrollment ID: I20160926002218 |
| Provider Name | David Bragin-sanchez |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1457364770 PECOS PAC ID: 8426018441 Enrollment ID: I20160929000660 |
| Provider Name | Ioan Nicolescu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053501452 PECOS PAC ID: 3274701552 Enrollment ID: I20161021001077 |
| Provider Name | Shristi Kunwar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497043319 PECOS PAC ID: 1355569435 Enrollment ID: I20161024001034 |
| Provider Name | Carolyn S Kay |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003172735 PECOS PAC ID: 5597043174 Enrollment ID: I20161102001247 |
| Provider Name | Dyston Madsen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275086811 PECOS PAC ID: 4385923499 Enrollment ID: I20161114000546 |
| Provider Name | Tiffany A Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033562442 PECOS PAC ID: 5890074892 Enrollment ID: I20161115001918 |
| Provider Name | Samantha Magby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871839449 PECOS PAC ID: 7810216595 Enrollment ID: I20161123001932 |
| Provider Name | Manuel Fonseca |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467902957 PECOS PAC ID: 8527348036 Enrollment ID: I20161129000826 |
| Provider Name | Kiira Tietjen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366992091 PECOS PAC ID: 3779863071 Enrollment ID: I20161202000652 |
| Provider Name | Worakarn Victor Ingkanisorn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669670972 PECOS PAC ID: 9032293949 Enrollment ID: I20161220001591 |
| Provider Name | Nydia Melendez-brugueras |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447263769 PECOS PAC ID: 8426023946 Enrollment ID: I20170105000608 |
| Provider Name | Christopher M Ramage |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598086688 PECOS PAC ID: 2466680772 Enrollment ID: I20170111002003 |
| Provider Name | Dennis M Klein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558312447 PECOS PAC ID: 6901882786 Enrollment ID: I20170118001150 |
| Provider Name | Erin R Medina |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902121932 PECOS PAC ID: 1557590213 Enrollment ID: I20170119001072 |
| Provider Name | Rhett Norris |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528051521 PECOS PAC ID: 0547543316 Enrollment ID: I20170202000872 |
| Provider Name | Roselyne Murugu Knopf |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033406715 PECOS PAC ID: 7618199480 Enrollment ID: I20170206001405 |
| Provider Name | Paula Eboli |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1043413438 PECOS PAC ID: 0840508982 Enrollment ID: I20170213000435 |
| Provider Name | Tejesh Srinivasa Reddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922312636 PECOS PAC ID: 3476797366 Enrollment ID: I20170217001846 |
| Provider Name | Barbara S Vaneeckhout |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982612479 PECOS PAC ID: 1254396401 Enrollment ID: I20170221001436 |
| Provider Name | John Ibarra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881606408 PECOS PAC ID: 2961407697 Enrollment ID: I20170222000552 |
| Provider Name | Matthew Vernon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649368986 PECOS PAC ID: 1355242264 Enrollment ID: I20170222001817 |
| Provider Name | Holly Hawks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144777673 PECOS PAC ID: 1658655105 Enrollment ID: I20170228001525 |
| Provider Name | Domonique Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023446101 PECOS PAC ID: 7214219757 Enrollment ID: I20170301001429 |
| Provider Name | Fola S Alade |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255771077 PECOS PAC ID: 7113201369 Enrollment ID: I20170307001337 |
| Provider Name | Chastity L Kolb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801209929 PECOS PAC ID: 6800108127 Enrollment ID: I20170308001293 |
| Provider Name | Jennifer May Matthews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740720093 PECOS PAC ID: 0042595225 Enrollment ID: I20170330002268 |
| Provider Name | Ashley Ann Baggott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053856443 PECOS PAC ID: 6709162647 Enrollment ID: I20170407001947 |
| Provider Name | Cara Wendel Wurst |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700916582 PECOS PAC ID: 8325037047 Enrollment ID: I20170421000553 |
| Provider Name | Malorie Marguerite Mahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194108340 PECOS PAC ID: 8224315478 Enrollment ID: I20170426000782 |
| Provider Name | Jose Vaz Carneiro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033106554 PECOS PAC ID: 0840397121 Enrollment ID: I20170426002162 |
| Provider Name | Lisa Catherine Shawen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972043784 PECOS PAC ID: 9931486032 Enrollment ID: I20170427000648 |
| Provider Name | Amber Renee Collier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184156572 PECOS PAC ID: 9638456759 Enrollment ID: I20170427001110 |
| Provider Name | Eric John Malsam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134316060 PECOS PAC ID: 6204999873 Enrollment ID: I20170503000330 |
| Provider Name | Randall J Johnson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417375866 PECOS PAC ID: 8426327404 Enrollment ID: I20170706002958 |
| Provider Name | Shelby N Apodaca |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457694390 PECOS PAC ID: 4981973716 Enrollment ID: I20170710002311 |
| Provider Name | Anna Edith Pruett |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881124584 PECOS PAC ID: 5496024051 Enrollment ID: I20170713000935 |
| Provider Name | Niba F Nchotu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366709792 PECOS PAC ID: 3274854153 Enrollment ID: I20170714002137 |
| Provider Name | Kathleen Marie Sacco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447622774 PECOS PAC ID: 1951671379 Enrollment ID: I20170718002553 |
| Provider Name | Nicholas Patrick Strasser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881033371 PECOS PAC ID: 9739304668 Enrollment ID: I20170719002464 |
| Provider Name | Tobiah Joel Cewe |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1043741952 PECOS PAC ID: 2466724984 Enrollment ID: I20170817004237 |
| Provider Name | Jessica Kaye Cewe |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891135158 PECOS PAC ID: 9830402783 Enrollment ID: I20170821001022 |
| Provider Name | Amrou Ali Idris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932528213 PECOS PAC ID: 9335448463 Enrollment ID: I20170823000001 |
| Provider Name | Alyssa Michelle Martsching |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1518323476 PECOS PAC ID: 5496040081 Enrollment ID: I20170830001476 |
| Provider Name | Netsanet Dessalegn Chalchisa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861812901 PECOS PAC ID: 1052684735 Enrollment ID: I20170830004004 |
| Provider Name | Jonathan Scott Allred |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376071878 PECOS PAC ID: 7517231293 Enrollment ID: I20170919001825 |
| Provider Name | Kristy Kay Whitney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184149890 PECOS PAC ID: 2365716453 Enrollment ID: I20170928002248 |
| Provider Name | Ian C. Riddock |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1669582870 PECOS PAC ID: 1759544356 Enrollment ID: I20170929003432 |
| Provider Name | Robert Arthur Egan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396771358 PECOS PAC ID: 9436184751 Enrollment ID: I20171002002120 |
| Provider Name | Kirsten Stacy Anderson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1730470238 PECOS PAC ID: 9830377027 Enrollment ID: I20171023002472 |
| Provider Name | Jacob George Kriegbaum |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1538689716 PECOS PAC ID: 3870869522 Enrollment ID: I20171024002339 |
| Provider Name | Lea Donelle Coville |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083630826 PECOS PAC ID: 8426051145 Enrollment ID: I20171031001143 |
| Provider Name | Samuil D Rafailov |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306107644 PECOS PAC ID: 4284990607 Enrollment ID: I20171116003217 |
| Provider Name | Brian Walcott |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1093975500 PECOS PAC ID: 7416115118 Enrollment ID: I20171117000701 |
| Provider Name | Daniel Shih |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790721967 PECOS PAC ID: 7315919156 Enrollment ID: I20171122001716 |
| Provider Name | Alexandra Marie Windhorn Shaver |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861734394 PECOS PAC ID: 1759600091 Enrollment ID: I20171122001953 |
| Provider Name | Lauri Ann Leahy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043418239 PECOS PAC ID: 0446306765 Enrollment ID: I20171215002352 |
| Provider Name | Soofia Salehi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508286352 PECOS PAC ID: 9931404886 Enrollment ID: I20171226000000 |
| Provider Name | Ahmed A Shalabi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558558320 PECOS PAC ID: 9234298381 Enrollment ID: I20171226001579 |
| Provider Name | Lindsey Renae Schwaderer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073027314 PECOS PAC ID: 4880953181 Enrollment ID: I20180112000460 |
| Provider Name | James Clement |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588089106 PECOS PAC ID: 6103135694 Enrollment ID: I20180112002286 |
| Provider Name | Brent C Morgan |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1710995949 PECOS PAC ID: 3274631528 Enrollment ID: I20180118001488 |
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 |