| Saint Alphonsus Regional Medical Center Inc | |
|
1055 N Curtis Rd Boise ID 83706 | |
| (208) 367-4148 | |
| (208) 322-9560 |
| Full Name | Saint Alphonsus Regional Medical Center Inc |
|---|---|
| Speciality | Psychologist |
| Location | 1055 N Curtis Rd, Boise, Idaho |
| Authorized Official Name and Position | Brian Checketts (CFO) |
| Authorized Official Contact | 2083677347 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Saint Alphonsus Regional Medical Center Inc 1055 N Curtis Rd Boise ID 83706-1309 Ph: (208) 367-4148 | Saint Alphonsus Regional Medical Center Inc 1055 N Curtis Rd Boise ID 83706 Ph: (208) 367-4148 |
| NPI Number | 1649357716 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 06/16/2025 |
| Certification Date | 06/16/2025 |
| Medicare PECOS PAC ID | 3476462359 |
|---|---|
| Medicare Enrollment ID | O20040204001036 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649357716 | NPI | - | NPPES |
| 002266100 | Medicaid | ID | |
| 805068500 | Medicaid | ID | |
| 002267500 | Medicaid | ID |
| Provider Name | Walter Louis Seale |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1720033459 PECOS PAC ID: 5890693048 Enrollment ID: I20031223000868 |
| Provider Name | Jack C Chaffin |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1104867662 PECOS PAC ID: 8325932577 Enrollment ID: I20040210000424 |
| Provider Name | Robert L Petersen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043229685 PECOS PAC ID: 2365336492 Enrollment ID: I20040210001003 |
| Provider Name | Louis A Roser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497715866 PECOS PAC ID: 8729070404 Enrollment ID: I20040416001232 |
| Provider Name | George R Lyons |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386630465 PECOS PAC ID: 6901891886 Enrollment ID: I20040419001544 |
| Provider Name | Arthur C Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063402097 PECOS PAC ID: 3678563434 Enrollment ID: I20040513001228 |
| Provider Name | Angeline S Devitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659324358 PECOS PAC ID: 1951391457 Enrollment ID: I20040517000378 |
| Provider Name | Michael Roach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528004389 PECOS PAC ID: 3072503416 Enrollment ID: I20040517000731 |
| Provider Name | Michael S Womack |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912950338 PECOS PAC ID: 3870584022 Enrollment ID: I20040518001337 |
| Provider Name | Matthew S Brown |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508809914 PECOS PAC ID: 7315928496 Enrollment ID: I20040525001417 |
| Provider Name | Lisa M Hunt |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1225066103 PECOS PAC ID: 0244211159 Enrollment ID: I20040526001499 |
| Provider Name | Stan A Eisele |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306886767 PECOS PAC ID: 2668457946 Enrollment ID: I20040621001692 |
| Provider Name | Jonathan L Bowman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497703169 PECOS PAC ID: 1658358098 Enrollment ID: I20040702000417 |
| Provider Name | Steven C Von Flue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871553248 PECOS PAC ID: 0345210969 Enrollment ID: I20040729001084 |
| Provider Name | Margaret L Widener |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1063454437 PECOS PAC ID: 0345213849 Enrollment ID: I20040813000465 |
| Provider Name | Christina M Knutson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1649212119 PECOS PAC ID: 7911966197 Enrollment ID: I20041004001016 |
| Provider Name | David Christensen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922041961 PECOS PAC ID: 1052370913 Enrollment ID: I20041006000816 |
| Provider Name | Norman J East |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1518005701 PECOS PAC ID: 2769442169 Enrollment ID: I20041012000867 |
| Provider Name | Kathleen M Scanlan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972545465 PECOS PAC ID: 9739148222 Enrollment ID: I20041014000902 |
| Provider Name | Mark G Parent |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1558301515 PECOS PAC ID: 6709846462 Enrollment ID: I20041016000168 |
| Provider Name | Andrew S Pierson |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1992760664 PECOS PAC ID: 3476520321 Enrollment ID: I20041020001125 |
| Provider Name | Scott D Lossmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720032725 PECOS PAC ID: 7911960653 Enrollment ID: I20041104000530 |
| Provider Name | Robert Kenneth Perko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043261803 PECOS PAC ID: 9133184286 Enrollment ID: I20041130000903 |
| Provider Name | Naya N Antink |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811942816 PECOS PAC ID: 6608832878 Enrollment ID: I20041209000088 |
| Provider Name | Sheila Giffen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013957802 PECOS PAC ID: 7012966922 Enrollment ID: I20050119000182 |
| Provider Name | Charles C Novak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770511743 PECOS PAC ID: 0042261174 Enrollment ID: I20050207000568 |
| Provider Name | Kenneth John Gramyk |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598778136 PECOS PAC ID: 9436105905 Enrollment ID: I20050328000842 |
| Provider Name | Robert F Calhoun |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376697946 PECOS PAC ID: 2668408139 Enrollment ID: I20050715000430 |
| Provider Name | Angella Zieba |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730131905 PECOS PAC ID: 9830126416 Enrollment ID: I20050726000264 |
| Provider Name | Steven L Writer |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1811942543 PECOS PAC ID: 9032140843 Enrollment ID: I20050822000955 |
| Provider Name | Katherine E Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225066707 PECOS PAC ID: 1456377910 Enrollment ID: I20051024000599 |
| Provider Name | Richard Martin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285698571 PECOS PAC ID: 8123064755 Enrollment ID: I20051115000758 |
| Provider Name | Benjamin N Bish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770514051 PECOS PAC ID: 8325067424 Enrollment ID: I20051117000790 |
| Provider Name | Edward J Kim |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1396785531 PECOS PAC ID: 6709808181 Enrollment ID: I20051229000044 |
| Provider Name | Virginia P Haviland |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235148131 PECOS PAC ID: 3173546017 Enrollment ID: I20060106000324 |
| Provider Name | Susan M Mcmullen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932160447 PECOS PAC ID: 9335153014 Enrollment ID: I20060201000919 |
| Provider Name | Nancy C Kois |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1356397491 PECOS PAC ID: 0446262083 Enrollment ID: I20060622000076 |
| Provider Name | Jason M Quinn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710978036 PECOS PAC ID: 9638129349 Enrollment ID: I20061130000390 |
| Provider Name | James Gardner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730275876 PECOS PAC ID: 8628986452 Enrollment ID: I20061205000135 |
| Provider Name | Laura Lynne Asaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003916636 PECOS PAC ID: 1951302371 Enrollment ID: I20070126000353 |
| Provider Name | Gabriel M Garber |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1588632830 PECOS PAC ID: 4688632953 Enrollment ID: I20070221000566 |
| Provider Name | Tanya S Krafft |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1356370563 PECOS PAC ID: 5496763781 Enrollment ID: I20070221000581 |
| Provider Name | Emily D Ruprecht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518059534 PECOS PAC ID: 4587767165 Enrollment ID: I20070320000411 |
| Provider Name | A Miranda |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1669565669 PECOS PAC ID: 3870526429 Enrollment ID: I20070531000399 |
| Provider Name | Richard M Lee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588692933 PECOS PAC ID: 5092814707 Enrollment ID: I20070621000103 |
| Provider Name | Shane A Andrew |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1356308316 PECOS PAC ID: 6507961836 Enrollment ID: I20070730000338 |
| Provider Name | Melanie Vanderpol |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1003017799 PECOS PAC ID: 5294826103 Enrollment ID: I20070807000594 |
| Provider Name | Michael B Aldous |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386616431 PECOS PAC ID: 1658375142 Enrollment ID: I20070814000426 |
| Provider Name | Stuart Austin Black |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053351361 PECOS PAC ID: 0244233146 Enrollment ID: I20070828000794 |
| Provider Name | David J Kelly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194862417 PECOS PAC ID: 0840251740 Enrollment ID: I20070905000047 |
| Provider Name | Anne P Burgess |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194767178 PECOS PAC ID: 4880787563 Enrollment ID: I20070911000905 |
| Provider Name | William Laitinen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598792863 PECOS PAC ID: 7113010786 Enrollment ID: I20070912000728 |
| Provider Name | Todd R Palmer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568595270 PECOS PAC ID: 5799870457 Enrollment ID: I20070926001162 |
| Provider Name | David P Hightower |
|---|---|
| Provider Type | Practitioner - Undersea And Hyperbaric Medicine |
| Provider Identifiers | NPI Number: 1720089527 PECOS PAC ID: 5294791737 Enrollment ID: I20070928000179 |
| Provider Name | Ajit S Deol |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508898099 PECOS PAC ID: 3173503737 Enrollment ID: I20071114000357 |
| Provider Name | Scott A Shappard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649275587 PECOS PAC ID: 9830288612 Enrollment ID: I20071130000631 |
| Provider Name | Holly D Swensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386672012 PECOS PAC ID: 1355430893 Enrollment ID: I20071205000458 |
| Provider Name | Kae E Leinberger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811197874 PECOS PAC ID: 0941383780 Enrollment ID: I20080216000035 |
| Provider Name | Mary E River |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1205882743 PECOS PAC ID: 2264517069 Enrollment ID: I20080304000307 |
| Provider Name | Diana Menchaca |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184787764 PECOS PAC ID: 5092891333 Enrollment ID: I20080326000666 |
| Provider Name | Shauna T Williams |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1821150285 PECOS PAC ID: 4385720507 Enrollment ID: I20080327000451 |
| Provider Name | John J Kiehl |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902940570 PECOS PAC ID: 7911085170 Enrollment ID: I20080429000333 |
| Provider Name | Shana L Tubach |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205879483 PECOS PAC ID: 4082792247 Enrollment ID: I20080429000345 |
| Provider Name | Brandon G Isaacs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801833645 PECOS PAC ID: 4284617036 Enrollment ID: I20080514000513 |
| Provider Name | Ryan D Heyborne |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659573889 PECOS PAC ID: 0345312088 Enrollment ID: I20080711000509 |
| Provider Name | Daniel S Knorpp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538214184 PECOS PAC ID: 5890896658 Enrollment ID: I20080717000223 |
| Provider Name | Mark Burriesci |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831397835 PECOS PAC ID: 8921171737 Enrollment ID: I20080725000602 |
| Provider Name | Amanda M Draper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477719433 PECOS PAC ID: 0042386864 Enrollment ID: I20080902000535 |
| Provider Name | Christian G Zimmerman |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1407874068 PECOS PAC ID: 0345139176 Enrollment ID: I20080905000598 |
| Provider Name | John C Freeman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437279031 PECOS PAC ID: 3577639699 Enrollment ID: I20080913000052 |
| Provider Name | David G Babbel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861434961 PECOS PAC ID: 1951391275 Enrollment ID: I20081231000208 |
| Provider Name | Michael A Codina |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1871540708 PECOS PAC ID: 2062492226 Enrollment ID: I20090106000611 |
| Provider Name | Jared T Rye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457596413 PECOS PAC ID: 6406919646 Enrollment ID: I20090114000070 |
| Provider Name | Juliana L Digiosia |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144335332 PECOS PAC ID: 1153473962 Enrollment ID: I20090708000642 |
| Provider Name | Christopher C Wyatt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649487430 PECOS PAC ID: 7416009345 Enrollment ID: I20090723000328 |
| Provider Name | Sarah M Hollopeter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144243619 PECOS PAC ID: 6103829122 Enrollment ID: I20090822000151 |
| Provider Name | Christopher B Hirose |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1437111267 PECOS PAC ID: 7012988926 Enrollment ID: I20090824000645 |
| Provider Name | Robin D Sebastian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568559029 PECOS PAC ID: 9537214242 Enrollment ID: I20090902000150 |
| Provider Name | Karl N Watts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578591053 PECOS PAC ID: 1052382520 Enrollment ID: I20090902000737 |
| Provider Name | Marcel A Goldberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801837141 PECOS PAC ID: 8729026810 Enrollment ID: I20090910000647 |
| Provider Name | Christie A Julian |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801072129 PECOS PAC ID: 3779639851 Enrollment ID: I20090914000789 |
| Provider Name | Lisa M Nelson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1194840397 PECOS PAC ID: 2668545773 Enrollment ID: I20091013000504 |
| Provider Name | Elizabeth Prier |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306983689 PECOS PAC ID: 1951449354 Enrollment ID: I20091104000649 |
| Provider Name | Paula G Carvalho |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1255432910 PECOS PAC ID: 3375687163 Enrollment ID: I20100217000319 |
| Provider Name | Jennifer L Nordquist |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437489895 PECOS PAC ID: 1557406394 Enrollment ID: I20100304000888 |
| Provider Name | Richard Aguilar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932198967 PECOS PAC ID: 6901902162 Enrollment ID: I20100315000905 |
| Provider Name | Antonio R Velardi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1558435107 PECOS PAC ID: 7810946183 Enrollment ID: I20100415000621 |
| Provider Name | Joel Swanson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013956705 PECOS PAC ID: 1759361678 Enrollment ID: I20100522000043 |
| Provider Name | Ryan J Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114053014 PECOS PAC ID: 7113000282 Enrollment ID: I20100701000171 |
| Provider Name | Jackie J Whitesell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346367984 PECOS PAC ID: 4587718176 Enrollment ID: I20100714000994 |
| Provider Name | Rourke M Yeakley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790723286 PECOS PAC ID: 4688632342 Enrollment ID: I20100715001023 |
| Provider Name | Kerry P Pulver |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1376596247 PECOS PAC ID: 8426180936 Enrollment ID: I20100720000240 |
| Provider Name | Alex Johnson |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1417081399 PECOS PAC ID: 0345332433 Enrollment ID: I20100813000831 |
| Provider Name | Rebecca L Mccaffrey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215193263 PECOS PAC ID: 2668506577 Enrollment ID: I20100813000858 |
| Provider Name | Brigitta S Lavergne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164596557 PECOS PAC ID: 1759316151 Enrollment ID: I20100814000146 |
| Provider Name | Clarence W Blea |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558312199 PECOS PAC ID: 9537293956 Enrollment ID: I20100819000989 |
| Provider Name | Karl J Schultheiss |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1265478325 PECOS PAC ID: 5799819157 Enrollment ID: I20100820000302 |
| Provider Name | Michael O Sant |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1861478752 PECOS PAC ID: 4385656446 Enrollment ID: I20100825001070 |
| Provider Name | Jennifer L Gray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700927902 PECOS PAC ID: 6406816982 Enrollment ID: I20100908000766 |
| Provider Name | Allen C Han |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801825724 PECOS PAC ID: 7810081684 Enrollment ID: I20100920000783 |
| Provider Name | Andrea Axtell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922298678 PECOS PAC ID: 2860687191 Enrollment ID: I20101112000382 |
| Provider Name | Hansel Ashby |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548213457 PECOS PAC ID: 4587749569 Enrollment ID: I20101201000643 |
| Provider Name | Vaun J Archibald |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417937517 PECOS PAC ID: 8921295189 Enrollment ID: I20101214000586 |
| Provider Name | Jason M Ellison |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740231455 PECOS PAC ID: 5496943565 Enrollment ID: I20101216000645 |
| Provider Name | Jennifer E Biggerstaff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861690745 PECOS PAC ID: 5193904225 Enrollment ID: I20110121000481 |
| Provider Name | Kristine M Reinhardt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639490006 PECOS PAC ID: 5092994145 Enrollment ID: I20110121000726 |
| Provider Name | Rory R Ramsey |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1174634737 PECOS PAC ID: 4789602640 Enrollment ID: I20110222000518 |
| Provider Name | Jane K Spencer |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1962709550 PECOS PAC ID: 3375725765 Enrollment ID: I20110307000226 |
| Provider Name | Sarah D Palmer |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1619274727 PECOS PAC ID: 9032392394 Enrollment ID: I20110323000727 |
| Provider Name | Heather E Nichols |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144246950 PECOS PAC ID: 2668656166 Enrollment ID: I20110407000300 |
| Provider Name | Jenifer L Barry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164673968 PECOS PAC ID: 7810181880 Enrollment ID: I20110421000396 |
| Provider Name | Stefani A Westerberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417256736 PECOS PAC ID: 2860677150 Enrollment ID: I20110502000386 |
| Provider Name | Jennifer A Southard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023216538 PECOS PAC ID: 4385812429 Enrollment ID: I20110716000009 |
| Provider Name | Joseph P Brooks |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1457323693 PECOS PAC ID: 5193878056 Enrollment ID: I20110728000407 |
| Provider Name | Steven G Moser |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831396449 PECOS PAC ID: 2860660214 Enrollment ID: I20110729000499 |
| Provider Name | Anil S Patel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1356350664 PECOS PAC ID: 5294793584 Enrollment ID: I20110829000503 |
| Provider Name | John Foote |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1154310597 PECOS PAC ID: 0941269070 Enrollment ID: I20110922000218 |
| Provider Name | Robert B Buxton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073778098 PECOS PAC ID: 3779625512 Enrollment ID: I20111003000432 |
| Provider Name | Helen A Napier |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801867817 PECOS PAC ID: 2769665215 Enrollment ID: I20111004000734 |
| Provider Name | Merle L Keller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265609929 PECOS PAC ID: 7810040706 Enrollment ID: I20111013000459 |
| Provider Name | Jeri K Spencer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285940965 PECOS PAC ID: 4587859418 Enrollment ID: I20111116000596 |
| Provider Name | Jeremey S Cureton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053698167 PECOS PAC ID: 0840465332 Enrollment ID: I20111212000676 |
| Provider Name | Daniela Grigore |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295998862 PECOS PAC ID: 8628244928 Enrollment ID: I20120109000861 |
| Provider Name | Thomas Earl Goodwin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1649208851 PECOS PAC ID: 5799865192 Enrollment ID: I20120313000401 |
| Provider Name | Gerard P Connor |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1669470274 PECOS PAC ID: 5294756540 Enrollment ID: I20120604000017 |
| Provider Name | Kylee M Domby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124398458 PECOS PAC ID: 9335304435 Enrollment ID: I20120622000038 |
| Provider Name | Kimberly Judd |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619018470 PECOS PAC ID: 5092961482 Enrollment ID: I20120820000544 |
| Provider Name | Preston S Omer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831304526 PECOS PAC ID: 6103073598 Enrollment ID: I20120820000644 |
| Provider Name | Shashi Ajmani |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740255504 PECOS PAC ID: 6103901970 Enrollment ID: I20120822000717 |
| Provider Name | Coire C Weathers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437319662 PECOS PAC ID: 4385891993 Enrollment ID: I20120904000092 |
| Provider Name | Mark B Cheney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659504314 PECOS PAC ID: 0648427138 Enrollment ID: I20120906000548 |
| Provider Name | Megan C Mccarren |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1841490950 PECOS PAC ID: 1759550718 Enrollment ID: I20121005000667 |
| Provider Name | Michael E Graff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689603219 PECOS PAC ID: 8820084916 Enrollment ID: I20121030000484 |
| Provider Name | Robyn M Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790034312 PECOS PAC ID: 6305097460 Enrollment ID: I20121119000512 |
| Provider Name | Heidi E Shields |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053406488 PECOS PAC ID: 3274627989 Enrollment ID: I20121120000498 |
| Provider Name | D'nicole Livingston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508133679 PECOS PAC ID: 1355593245 Enrollment ID: I20121128000102 |
| Provider Name | Cindy K Horrocks |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1992059125 PECOS PAC ID: 0840443743 Enrollment ID: I20121228000357 |
| Provider Name | Christy E Bayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760796296 PECOS PAC ID: 8123271871 Enrollment ID: I20130109000407 |
| Provider Name | Marjorie C Rich |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1558664755 PECOS PAC ID: 1557514833 Enrollment ID: I20130117000335 |
| Provider Name | Jessica L Butterfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730432352 PECOS PAC ID: 1355594557 Enrollment ID: I20130122000547 |
| Provider Name | Sara B Thomson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1356316509 PECOS PAC ID: 8527206788 Enrollment ID: I20130529000505 |
| Provider Name | Alison Shearer |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396898482 PECOS PAC ID: 5991944043 Enrollment ID: I20130620000444 |
| Provider Name | Lynn M Dammarell |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1073959193 PECOS PAC ID: 1759520869 Enrollment ID: I20130621000377 |
| Provider Name | Forrest R Fredline |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245493840 PECOS PAC ID: 5092955054 Enrollment ID: I20130716000203 |
| Provider Name | Britani R Hill |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275718595 PECOS PAC ID: 9638357304 Enrollment ID: I20130723000934 |
| Provider Name | Lukas T Clark |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659519593 PECOS PAC ID: 7810138393 Enrollment ID: I20130725000468 |
| Provider Name | Robert W Chalmers |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114973708 PECOS PAC ID: 0941287817 Enrollment ID: I20130909000615 |
| Provider Name | Martha Clinton Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417268574 PECOS PAC ID: 7214174184 Enrollment ID: I20130912000401 |
| Provider Name | Mark O Moore |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1821261918 PECOS PAC ID: 0143464651 Enrollment ID: I20130924000575 |
| Provider Name | Sarah R Staller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336450402 PECOS PAC ID: 9537306402 Enrollment ID: I20130925000951 |
| Provider Name | Lindsay Rachel Sales |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1720248040 PECOS PAC ID: 3870727167 Enrollment ID: I20130927000149 |
| Provider Name | Chelsea M Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255773909 PECOS PAC ID: 6002041720 Enrollment ID: I20131104001567 |
| Provider Name | Abhilash K Desai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366519084 PECOS PAC ID: 4789644824 Enrollment ID: I20131105000805 |
| Provider Name | Jason S Southwick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538412382 PECOS PAC ID: 7315173747 Enrollment ID: I20131113001499 |
| Provider Name | William T Edwards |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679745590 PECOS PAC ID: 6608041041 Enrollment ID: I20131220001325 |
| Provider Name | Amanda D King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790053338 PECOS PAC ID: 1052549581 Enrollment ID: I20140108001361 |
| Provider Name | Guillermo M Guzman Trevino |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881828010 PECOS PAC ID: 0345386330 Enrollment ID: I20140121001636 |
| Provider Name | Jennifer J King |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235214586 PECOS PAC ID: 5698667020 Enrollment ID: I20140228000270 |
| Provider Name | Shirley E Van Zandt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700076312 PECOS PAC ID: 0446473748 Enrollment ID: I20140513001602 |
| Provider Name | Katherine L Devlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366620825 PECOS PAC ID: 3274617618 Enrollment ID: I20140521002387 |
| Provider Name | Robert A Swensen |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1225354244 PECOS PAC ID: 5395968739 Enrollment ID: I20140603001534 |
| Provider Name | Robert G Ingram |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427074384 PECOS PAC ID: 5294711602 Enrollment ID: I20140611002220 |
| Provider Name | Jeremy J Stockett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578859146 PECOS PAC ID: 7214152602 Enrollment ID: I20140626001802 |
| Provider Name | Sara Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285057976 PECOS PAC ID: 0840415261 Enrollment ID: I20140627000062 |
| Provider Name | Erik N Meyers |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598828378 PECOS PAC ID: 5496970691 Enrollment ID: I20140702000172 |
| Provider Name | Erik S Linn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487949475 PECOS PAC ID: 3173740628 Enrollment ID: I20140807001071 |
| Provider Name | Amos Haley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154733244 PECOS PAC ID: 7618194002 Enrollment ID: I20140807002417 |
| Provider Name | Joshua D Holweger |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1417102930 PECOS PAC ID: 0840430799 Enrollment ID: I20140809000095 |
| Provider Name | Michael Wheaton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871588632 PECOS PAC ID: 0244457349 Enrollment ID: I20140813002953 |
| Provider Name | Bradley G Bishop |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316258510 PECOS PAC ID: 6204079924 Enrollment ID: I20140825001980 |
| Provider Name | Jacob B Jones |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104113562 PECOS PAC ID: 1850519273 Enrollment ID: I20140827001029 |
| Provider Name | Harold G Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356320915 PECOS PAC ID: 7416928064 Enrollment ID: I20140905001361 |
| Provider Name | Olawale O Olaniyi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881973899 PECOS PAC ID: 6406075688 Enrollment ID: I20140922000000 |
| Provider Name | Linsey Etherington |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1336309434 PECOS PAC ID: 4486886462 Enrollment ID: I20140923000692 |
| Provider Name | Margot Vloka |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1174517775 PECOS PAC ID: 6608881743 Enrollment ID: I20150109000779 |
| Provider Name | Ginger A Jensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174895353 PECOS PAC ID: 2365760600 Enrollment ID: I20150416000550 |
| Provider Name | Michael E Rich |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1972759124 PECOS PAC ID: 4082938188 Enrollment ID: I20150701000621 |
| Provider Name | Darin Jurgensmeier |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1952537060 PECOS PAC ID: 2961623319 Enrollment ID: I20150703000062 |
| Provider Name | Katherine L Ball |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427314475 PECOS PAC ID: 6204148968 Enrollment ID: I20150709000006 |
| Provider Name | Ranan G Spolar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093121337 PECOS PAC ID: 9537472329 Enrollment ID: I20150722006362 |
| Provider Name | Clara Riji Anil |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043578818 PECOS PAC ID: 7810214533 Enrollment ID: I20150730014196 |
| Provider Name | Shae H Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669588315 PECOS PAC ID: 2163444811 Enrollment ID: I20150731017109 |
| Provider Name | Jessica Ziebarth |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1467747618 PECOS PAC ID: 6507170420 Enrollment ID: I20150805007091 |
| Provider Name | Kevin John Whitehead |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255421848 PECOS PAC ID: 9032004502 Enrollment ID: I20150805007186 |
| Provider Name | Van Ngoc Hoang |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215293139 PECOS PAC ID: 9133445091 Enrollment ID: I20150820012076 |
| Provider Name | Jee Hur |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053555326 PECOS PAC ID: 5890944656 Enrollment ID: I20150826001554 |
| Provider Name | Benedict J Taylor |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1831355957 PECOS PAC ID: 0840485090 Enrollment ID: I20150909002663 |
| Provider Name | Amber Taylor |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902154149 PECOS PAC ID: 5496062010 Enrollment ID: I20150915001624 |
| Provider Name | John M Pilcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982071940 PECOS PAC ID: 6406163799 Enrollment ID: I20150918001507 |
| Provider Name | Jennifer Kienlen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255706461 PECOS PAC ID: 2365746997 Enrollment ID: I20160202001795 |
| Provider Name | Daniel K Arrington |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396065165 PECOS PAC ID: 6103070107 Enrollment ID: I20160302002511 |
| Provider Name | Houng K Chea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285971747 PECOS PAC ID: 2466686936 Enrollment ID: I20160404002327 |
| Provider Name | Emily R Squyer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467618223 PECOS PAC ID: 1658515507 Enrollment ID: I20160609002306 |
| Provider Name | Mitchell A Mendenhall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881033256 PECOS PAC ID: 5496997942 Enrollment ID: I20160620001525 |
| Provider Name | Nathan Z Hicks |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1144667817 PECOS PAC ID: 1355668252 Enrollment ID: I20160624001002 |
| Provider Name | Brenton D Baldwin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649610528 PECOS PAC ID: 9739405606 Enrollment ID: I20160630001904 |
| Provider Name | Melissa M Agoudemos |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518175579 PECOS PAC ID: 1456547447 Enrollment ID: I20160718002095 |
| Provider Name | Ondrej Choutka |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1265651566 PECOS PAC ID: 4688843824 Enrollment ID: I20160722000926 |
| Provider Name | Adam R Schwind |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831539220 PECOS PAC ID: 5597081448 Enrollment ID: I20160725001004 |
| Provider Name | Derek E Kunz |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1760740708 PECOS PAC ID: 0446575591 Enrollment ID: I20160725002188 |
| Provider Name | Shahla Walizada |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205272986 PECOS PAC ID: 7315231693 Enrollment ID: I20160809002452 |
| Provider Name | Kara M Kuntz |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1891057246 PECOS PAC ID: 0345470282 Enrollment ID: I20160809002853 |
| Provider Name | Alexandra N Meier |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1619234622 PECOS PAC ID: 0446575856 Enrollment ID: I20160810001022 |
| Provider Name | Samantha P Meshack Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922240498 PECOS PAC ID: 0749459329 Enrollment ID: I20160817002175 |
| Provider Name | Bobby Chawla |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1598956963 PECOS PAC ID: 3072785633 Enrollment ID: I20160817002380 |
| Provider Name | Jenny Lee Doty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215360631 PECOS PAC ID: 5890080923 Enrollment ID: I20160829000231 |
| Provider Name | Jennifer S Stock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689750614 PECOS PAC ID: 7416993373 Enrollment ID: I20160830002255 |
| Provider Name | Erin M Welch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619230844 PECOS PAC ID: 6800016189 Enrollment ID: I20160922001014 |
| Provider Name | Carolyn G Mcfarlane |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679802987 PECOS PAC ID: 4082848700 Enrollment ID: I20160929001673 |
| Provider Name | Sherri Siegel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447707120 PECOS PAC ID: 6901194307 Enrollment ID: I20161018002983 |
| Provider Name | Kindra S Miiller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659787273 PECOS PAC ID: 5597981969 Enrollment ID: I20161025000767 |
| Provider Name | Jennifer A Hofstra |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003079120 PECOS PAC ID: 9335272475 Enrollment ID: I20161122000675 |
| Provider Name | Rebekah G Fayette |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1043690175 PECOS PAC ID: 6406162841 Enrollment ID: I20161215002288 |
| Provider Name | Omar E Wever-pinzon |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1205926250 PECOS PAC ID: 6002902905 Enrollment ID: I20161227001736 |
| Provider Name | Elizabeth Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801074232 PECOS PAC ID: 2769568989 Enrollment ID: I20170120000858 |
| Provider Name | Matthew R Nelson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1376622985 PECOS PAC ID: 6204908023 Enrollment ID: I20170405002209 |
| Provider Name | Nancy N Keegan-ovando |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215279153 PECOS PAC ID: 4385961929 Enrollment ID: I20170417001190 |
| Provider Name | Shasta M Slavkovsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932640968 PECOS PAC ID: 3779860184 Enrollment ID: I20170511001153 |
| Provider Name | Vanessa M Schultz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396040028 PECOS PAC ID: 0446491880 Enrollment ID: I20170512000387 |
| Provider Name | Sig-linda Jacobson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033291323 PECOS PAC ID: 5698869980 Enrollment ID: I20170522002259 |
| Provider Name | Cameron J Allen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730594185 PECOS PAC ID: 4284850215 Enrollment ID: I20170524001125 |
| Provider Name | Kathy Watkins |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1659322261 PECOS PAC ID: 6002183738 Enrollment ID: I20170530001652 |
| Provider Name | Jessica D Eilert |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427477090 PECOS PAC ID: 4880963354 Enrollment ID: I20170627002446 |
| Provider Name | Jessica Riordan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790028405 PECOS PAC ID: 3375784879 Enrollment ID: I20170628003204 |
| Provider Name | Ryan L Pettit |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487092292 PECOS PAC ID: 8224257241 Enrollment ID: I20170630002023 |
| Provider Name | Laura E Fink |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487094108 PECOS PAC ID: 0143463026 Enrollment ID: I20170713000835 |
| Provider Name | Lisa M Parrillo |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1659663482 PECOS PAC ID: 8820394281 Enrollment ID: I20170807002060 |
| Provider Name | Jeffrey Christian Walker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609167063 PECOS PAC ID: 3870743347 Enrollment ID: I20170914002144 |
| Provider Name | Ann Elizabeth Knierim |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1346402757 PECOS PAC ID: 5092956326 Enrollment ID: I20170914003303 |
| Provider Name | Matthew T Genther |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548784606 PECOS PAC ID: 1153695119 Enrollment ID: I20170914003608 |
| Provider Name | Cara N Sullivan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912347303 PECOS PAC ID: 0941526800 Enrollment ID: I20170916000632 |
| Provider Name | Jill A Konrad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396261129 PECOS PAC ID: 1052686086 Enrollment ID: I20171002001479 |
| Provider Name | Lena M Pascual |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134657042 PECOS PAC ID: 1355617275 Enrollment ID: I20171020001928 |
| Provider Name | Jordan D Nugent |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902224645 PECOS PAC ID: 3274853189 Enrollment ID: I20171128003019 |
| Provider Name | Tess Weidner |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1861861841 PECOS PAC ID: 6709143639 Enrollment ID: I20171201001425 |
| Provider Name | Kurt E Kracaw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285723460 PECOS PAC ID: 1557545407 Enrollment ID: I20171227000694 |
| Provider Name | Michael J Twomey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073924239 PECOS PAC ID: 6608192562 Enrollment ID: I20180201002682 |
| Provider Name | David A Wald |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1205859535 PECOS PAC ID: 7315939972 Enrollment ID: I20180212001995 |
| Provider Name | Jessica Lynn Kroll |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861798548 PECOS PAC ID: 3173819679 Enrollment ID: I20180321002168 |
| Provider Name | Kellie R Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992206742 PECOS PAC ID: 7214290261 Enrollment ID: I20180404002306 |
| Provider Name | Dixie J Skinner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659876399 PECOS PAC ID: 8729342225 Enrollment ID: I20180509002341 |
| Provider Name | Michelle L Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982062857 PECOS PAC ID: 2961709621 Enrollment ID: I20180525001166 |
| Provider Name | Jeffrey J Heslop |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1144544644 PECOS PAC ID: 0244541522 Enrollment ID: I20180531002304 |
| Provider Name | Jenny J Jin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1235493206 PECOS PAC ID: 7416102132 Enrollment ID: I20180619000825 |
| Provider Name | Mary T Walters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477042802 PECOS PAC ID: 4284980608 Enrollment ID: I20180627001570 |
| Provider Name | Eli Harris |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1235472531 PECOS PAC ID: 5294954095 Enrollment ID: I20180628000600 |
| Provider Name | Jeffery A Reese |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588084453 PECOS PAC ID: 0042529703 Enrollment ID: I20180706000531 |
| Provider Name | Annis W Vargas |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023404811 PECOS PAC ID: 2365722717 Enrollment ID: I20180719003913 |
| Provider Name | Sheev I Dattani |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1760903363 PECOS PAC ID: 6002189693 Enrollment ID: I20180725003808 |
| Provider Name | Tracye J Lawyer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1003170325 PECOS PAC ID: 5496071169 Enrollment ID: I20180727001720 |
| Provider Name | Travis John Clyde |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457700262 PECOS PAC ID: 7214229095 Enrollment ID: I20180727002448 |
| Provider Name | Christopher A Reising |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285699165 PECOS PAC ID: 4688625874 Enrollment ID: I20180806003441 |
| Provider Name | Nathan Kellis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942688627 PECOS PAC ID: 7810200169 Enrollment ID: I20180817003205 |
| Provider Name | Daniel Allan Bridger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710121926 PECOS PAC ID: 2466695531 Enrollment ID: I20180928000964 |
| Provider Name | Joshua Chong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326431198 PECOS PAC ID: 2163721762 Enrollment ID: I20181029001100 |
| Provider Name | Caleb Patee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780078857 PECOS PAC ID: 5193001790 Enrollment ID: I20181029001777 |
| Provider Name | Alvin P Perry |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427316942 PECOS PAC ID: 1254577711 Enrollment ID: I20181113002154 |
| Provider Name | Carl Ciplinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003397076 PECOS PAC ID: 6305190968 Enrollment ID: I20181116002345 |
| Provider Name | Donraphael Wynn |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396188751 PECOS PAC ID: 1951627124 Enrollment ID: I20181213001134 |
| Provider Name | Daniel L Meltzer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1275681256 PECOS PAC ID: 6800920836 Enrollment ID: I20181213002797 |
| Provider Name | Linda K Walker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053467852 PECOS PAC ID: 7315978095 Enrollment ID: I20190205001543 |
| Provider Name | Katherine Q Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760951537 PECOS PAC ID: 2062750748 Enrollment ID: I20190205003623 |
| Provider Name | Erin Bohn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063983153 PECOS PAC ID: 3870831233 Enrollment ID: I20190208002153 |
| Provider Name | Brianna Ashley Cracolice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639640402 PECOS PAC ID: 3173862661 Enrollment ID: I20190227002443 |
| Provider Name | Tina M Bossolono-williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891264545 PECOS PAC ID: 9638418031 Enrollment ID: I20190301001302 |
| Provider Name | Danielle Bores |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1053877555 PECOS PAC ID: 9537402797 Enrollment ID: I20190510001386 |
| Provider Name | Jessica A Evert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003015124 PECOS PAC ID: 5496823338 Enrollment ID: I20190521002797 |
| Provider Name | Jessica Spring Snuffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609334127 PECOS PAC ID: 8921331802 Enrollment ID: I20190607001133 |
| Provider Name | Ian Z Qureshi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1871934547 PECOS PAC ID: 4183903990 Enrollment ID: I20190719000513 |
| Provider Name | Nicholas R Homer |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1447612262 PECOS PAC ID: 7719261577 Enrollment ID: I20190726001805 |
| Provider Name | Alexandra M Nielsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588124838 PECOS PAC ID: 1355678442 Enrollment ID: I20190813000603 |
| Provider Name | Colin A Lyness |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093126229 PECOS PAC ID: 5496062267 Enrollment ID: I20190826001994 |
| Provider Name | Jeffrey Weese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689226177 PECOS PAC ID: 6204165723 Enrollment ID: I20190909003897 |
| Provider Name | Nicholas W Hodgman |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1164439725 PECOS PAC ID: 1153472006 Enrollment ID: I20190912001093 |
| Provider Name | Laura E Tedrick |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528453552 PECOS PAC ID: 7517271984 Enrollment ID: I20190913001723 |
| Provider Name | Karissa D Keenan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316333107 PECOS PAC ID: 5698054153 Enrollment ID: I20191001003513 |
| Provider Name | Danielle L Miller |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790131472 PECOS PAC ID: 4789979907 Enrollment ID: I20191015002277 |
| Provider Name | Shane N Mccauley |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1083603229 PECOS PAC ID: 6103158183 Enrollment ID: I20191023003438 |
| Provider Name | Emily C Corrigan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316081722 PECOS PAC ID: 0345414074 Enrollment ID: I20191029003691 |
| Provider Name | Victoria R Byrne |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124476205 PECOS PAC ID: 0749543239 Enrollment ID: I20191031001109 |
| Provider Name | Justin Fowler |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386835585 PECOS PAC ID: 3971746058 Enrollment ID: I20191114003338 |
| Provider Name | Alysha K Schlack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144886516 PECOS PAC ID: 0840622437 Enrollment ID: I20191120001738 |
| Provider Name | Dawn R Doepke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447612098 PECOS PAC ID: 9638502834 Enrollment ID: I20191202001096 |
| Provider Name | Sandra Messmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891273652 PECOS PAC ID: 7810241643 Enrollment ID: I20191204001538 |
| Provider Name | Renee Zubin Parsons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518508506 PECOS PAC ID: 6406289289 Enrollment ID: I20191220002311 |
| Provider Name | Debra L Burleigh-gilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124333927 PECOS PAC ID: 2961678255 Enrollment ID: I20191223001901 |
| Provider Name | Megan Lenkersdorfer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477197036 PECOS PAC ID: 7315371770 Enrollment ID: I20191231000646 |
| Provider Name | Denise Peruski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043730278 PECOS PAC ID: 6305117656 Enrollment ID: I20200106001290 |
| Provider Name | Rachelle C. Friesen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629622758 PECOS PAC ID: 5890121032 Enrollment ID: I20200205002951 |
| Provider Name | Kari Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134127640 PECOS PAC ID: 6002845153 Enrollment ID: I20200212002253 |
| Provider Name | Cassandra R Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760025142 PECOS PAC ID: 2668809484 Enrollment ID: I20200228002065 |
| Provider Name | Danielle Lauren Hynds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932748522 PECOS PAC ID: 5890123145 Enrollment ID: I20200319001467 |
| Provider Name | Jeffrey M Low |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1407884141 PECOS PAC ID: 1658540299 Enrollment ID: I20200401003528 |
| Provider Name | Maria Palmquist |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942369285 PECOS PAC ID: 6002992047 Enrollment ID: I20200406000546 |
| Provider Name | Billy Galligar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689053118 PECOS PAC ID: 8527374719 Enrollment ID: I20200407003419 |
| Provider Name | Daniel C Prior |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942568118 PECOS PAC ID: 7618225756 Enrollment ID: I20200410001694 |
| Provider Name | Zachary A Weiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932557782 PECOS PAC ID: 6507159340 Enrollment ID: I20200420001331 |
| Provider Name | Daniel B Simmons |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386903359 PECOS PAC ID: 2961620752 Enrollment ID: I20200508000681 |
| Provider Name | Wesley D Pidcock |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1013335157 PECOS PAC ID: 8820340672 Enrollment ID: I20200508001598 |
| Provider Name | Crystal A Larson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982990453 PECOS PAC ID: 2062669955 Enrollment ID: I20200511001707 |
| Provider Name | Aaron Newton |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1538507520 PECOS PAC ID: 2860749504 Enrollment ID: I20200610002653 |
| Provider Name | Jessica Councell |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1982230710 PECOS PAC ID: 9133541303 Enrollment ID: I20200616001613 |
| Provider Name | Elizabeth V Saarel |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1780763250 PECOS PAC ID: 5698673184 Enrollment ID: I20200618001294 |
| Provider Name | Christine Eden |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1609208610 PECOS PAC ID: 9032465257 Enrollment ID: I20200622002701 |
| Provider Name | Brennan Anderson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609222355 PECOS PAC ID: 2668766247 Enrollment ID: I20200625002278 |
| Provider Name | Joseph Aloysius Walsh |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1063674505 PECOS PAC ID: 0749406619 Enrollment ID: I20200629001026 |
| Provider Name | Benjamin M Stewart |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174934327 PECOS PAC ID: 4385951656 Enrollment ID: I20200629002226 |
| Provider Name | Megan Brands |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760003438 PECOS PAC ID: 1951724764 Enrollment ID: I20200713002787 |
| Provider Name | Lauren Franklin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528593381 PECOS PAC ID: 1951671668 Enrollment ID: I20200716003130 |
| Provider Name | Aaron Dunham |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1033504147 PECOS PAC ID: 9638470461 Enrollment ID: I20200720002273 |
| Provider Name | Melissa Arnold |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700105921 PECOS PAC ID: 1658515234 Enrollment ID: I20200721004210 |
| Provider Name | Zahra Mathura |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1053575860 PECOS PAC ID: 4183867286 Enrollment ID: I20200724001968 |
| Provider Name | James Donald Mcgregor |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1093165912 PECOS PAC ID: 7719270479 Enrollment ID: I20200817003439 |
| Provider Name | Ian P Hotchkiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174063036 PECOS PAC ID: 6507136595 Enrollment ID: I20200831002022 |
| Provider Name | John E Lattin |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1477949261 PECOS PAC ID: 0547577090 Enrollment ID: I20200903001827 |
| Provider Name | Kyle R. Yorgason |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1629223110 PECOS PAC ID: 2466634829 Enrollment ID: I20200903003017 |
| Provider Name | Patrick Coleman |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1326045428 PECOS PAC ID: 7810891447 Enrollment ID: I20200909002726 |
| Provider Name | Alysse Michele Weber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255957403 PECOS PAC ID: 2769800424 Enrollment ID: I20200911000882 |
| Provider Name | Elke Marie Swakhammer |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437525995 PECOS PAC ID: 7618247206 Enrollment ID: I20200922001836 |
| Provider Name | Leila Khaddour |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1750797486 PECOS PAC ID: 7214152032 Enrollment ID: I20200923002434 |
| Provider Name | Erin M Felt |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1972128395 PECOS PAC ID: 0941629562 Enrollment ID: I20201001001038 |
| Provider Name | Wesley C Jones |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841603941 PECOS PAC ID: 3173819380 Enrollment ID: I20201008003326 |
| Provider Name | Madison Beatty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457887507 PECOS PAC ID: 3476893637 Enrollment ID: I20201009002554 |
| Provider Name | Michael Benedict Schneider |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457399560 PECOS PAC ID: 0143294926 Enrollment ID: I20201019002827 |
| Provider Name | Ryan Townsend |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285077701 PECOS PAC ID: 6709102866 Enrollment ID: I20201021001135 |
| Provider Name | Adam J Schatz |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1316331705 PECOS PAC ID: 1759626682 Enrollment ID: I20201031000041 |
| Provider Name | Carmen Salyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811522949 PECOS PAC ID: 1759792856 Enrollment ID: I20201120001667 |
| Provider Name | Aixa D Espinosa-morales |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851449938 PECOS PAC ID: 5092987651 Enrollment ID: I20201208002702 |
| Provider Name | Fernando A Riveron |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1568493427 PECOS PAC ID: 6103909148 Enrollment ID: I20201218002287 |
| Provider Name | Drew Stanley Miiller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093316721 PECOS PAC ID: 7416360813 Enrollment ID: I20210104000330 |
| Provider Name | Leana Guerin |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1750591483 PECOS PAC ID: 8729111612 Enrollment ID: I20210104000353 |
| Provider Name | Aaron D Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841444759 PECOS PAC ID: 4880882448 Enrollment ID: I20210106002112 |
| Provider Name | Robert Farivar |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1588866354 PECOS PAC ID: 1951472083 Enrollment ID: I20210111002455 |
| Provider Name | Dominique Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487054730 PECOS PAC ID: 6800017534 Enrollment ID: I20210205002219 |
| Provider Name | Nathan Mason |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396953196 PECOS PAC ID: 7911053525 Enrollment ID: I20210222003038 |
| Provider Name | Chrysanthe Kepas Eastman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427650266 PECOS PAC ID: 8628484920 Enrollment ID: I20210322002696 |
| Provider Name | Jonelle Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770175614 PECOS PAC ID: 1052728235 Enrollment ID: I20210406001395 |
| Provider Name | Camille Berriochoa |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1992148332 PECOS PAC ID: 2567764400 Enrollment ID: I20210420002052 |
| Provider Name | Kathryn Garrity Hughes |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1902828213 PECOS PAC ID: 0042479834 Enrollment ID: I20210420002213 |
| Provider Name | Garhett J Ulmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619562295 PECOS PAC ID: 0840609061 Enrollment ID: I20210429000875 |
| Provider Name | Ashley Bennett |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1326252545 PECOS PAC ID: 8921296690 Enrollment ID: I20210506003133 |
| Provider Name | Adam Grimaldi |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1730422296 PECOS PAC ID: 4284933979 Enrollment ID: I20210604002554 |
| Provider Name | Erin C Grosslight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518330281 PECOS PAC ID: 4981974672 Enrollment ID: I20210609002036 |
| Provider Name | Jenni Kay Jensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285226084 PECOS PAC ID: 2264832310 Enrollment ID: I20210611001427 |
| Provider Name | Brian Wong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124474960 PECOS PAC ID: 1052711884 Enrollment ID: I20210615002502 |
| Provider Name | Anne Riffle |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043212079 PECOS PAC ID: 8921096355 Enrollment ID: I20210621002605 |
| Provider Name | Erik Valenti |
|---|---|
| Provider Type | Practitioner - Epileptologists |
| Provider Identifiers | NPI Number: 1407276223 PECOS PAC ID: 0244539393 Enrollment ID: I20210623003723 |
| Provider Name | Vanessa Irene Bizimana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801008305 PECOS PAC ID: 2062813850 Enrollment ID: I20210630003472 |
| Provider Name | Dana Karlsberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588828891 PECOS PAC ID: 5496893166 Enrollment ID: I20210702000000 |
| Provider Name | Jared Joffer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912394719 PECOS PAC ID: 8527379601 Enrollment ID: I20210706001877 |
| Provider Name | Taylor Lara |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1063808806 PECOS PAC ID: 2567770027 Enrollment ID: I20210721001099 |
| Provider Name | Nathaniel Orland Staley |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316392137 PECOS PAC ID: 1153724604 Enrollment ID: I20210721004149 |
| Provider Name | Leah Gleaves Stockton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477813780 PECOS PAC ID: 1557652625 Enrollment ID: I20210723002905 |
| Provider Name | Anthony Dinallo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205193760 PECOS PAC ID: 9436494929 Enrollment ID: I20210726003752 |
| Provider Name | John Goforth |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912432550 PECOS PAC ID: 2163790627 Enrollment ID: I20210727002017 |
| Provider Name | Kendra Coonse |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699181214 PECOS PAC ID: 4385860428 Enrollment ID: I20210804000311 |
| Provider Name | Brandon Denney |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1811383524 PECOS PAC ID: 1951705110 Enrollment ID: I20210810002180 |
| Provider Name | Samantha Ann Parnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356921423 PECOS PAC ID: 2567866478 Enrollment ID: I20210813001089 |
| Provider Name | Shawna Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871197533 PECOS PAC ID: 5698170751 Enrollment ID: I20210827000841 |
| Provider Name | Alexander Espinoza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164620522 PECOS PAC ID: 7911976931 Enrollment ID: I20210827002767 |
| Provider Name | Erin Reilly |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1528455896 PECOS PAC ID: 3274853262 Enrollment ID: I20210830001863 |
| Provider Name | Timothy Borup |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801380118 PECOS PAC ID: 3577807809 Enrollment ID: I20210830002683 |
| Provider Name | Evan Schlager |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1982051686 PECOS PAC ID: 9436443611 Enrollment ID: I20210831003529 |
| Provider Name | Jose Gude |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063432292 PECOS PAC ID: 5092719336 Enrollment ID: I20210909001608 |
| Provider Name | Jackie Schalk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841868239 PECOS PAC ID: 1759787021 Enrollment ID: I20210913000334 |
| Provider Name | Graham Hall |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1730317090 PECOS PAC ID: 6204147010 Enrollment ID: I20210913000960 |
| Provider Name | Jerrell Sims |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1689101768 PECOS PAC ID: 2769752138 Enrollment ID: I20210915003382 |
| Provider Name | Sara M Nehring |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1609037993 PECOS PAC ID: 8820268790 Enrollment ID: I20211018001225 |
| Provider Name | Leah Beech |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679244156 PECOS PAC ID: 6507254661 Enrollment ID: I20211022001956 |
| Provider Name | Daniel Mueller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760917454 PECOS PAC ID: 3476823279 Enrollment ID: I20211101000713 |
| Provider Name | Jason Williams |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1609225762 PECOS PAC ID: 9234417205 Enrollment ID: I20211102002425 |
| Provider Name | Majla Husic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083379119 PECOS PAC ID: 1951790906 Enrollment ID: I20211111002575 |
| Provider Name | Brian J Coates |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578769683 PECOS PAC ID: 3274789417 Enrollment ID: I20211129002456 |
| Provider Name | Tricia Sloan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649936576 PECOS PAC ID: 7719377092 Enrollment ID: I20211130001524 |
| Provider Name | Joanne Do Anderson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821539248 PECOS PAC ID: 2668891839 Enrollment ID: I20220114000665 |
| Provider Name | Maureen Newman |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1003006768 PECOS PAC ID: 9032168018 Enrollment ID: I20220125002165 |
| Provider Name | Amy M Aldrich |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285840298 PECOS PAC ID: 8628145000 Enrollment ID: I20220127001935 |
| Provider Name | Kiley Alyse Zeitler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528710613 PECOS PAC ID: 5890188734 Enrollment ID: I20220217000186 |
| Provider Name | Angela Rae Larkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871249474 PECOS PAC ID: 0345636452 Enrollment ID: I20220329001766 |
| Provider Name | Willow Detzer Brasher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548913064 PECOS PAC ID: 4183010515 Enrollment ID: I20220411002004 |
| Provider Name | Cassie Nicole Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104573112 PECOS PAC ID: 7911394127 Enrollment ID: I20220418001162 |
| Provider Name | Johnson Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326798232 PECOS PAC ID: 2668869157 Enrollment ID: I20220502001998 |
| Provider Name | Jennifer Marie Weiss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578823639 PECOS PAC ID: 3678960077 Enrollment ID: I20220504001515 |
| Provider Name | Brandon J Leroy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194364273 PECOS PAC ID: 1355779679 Enrollment ID: I20220518001990 |
| Provider Name | Jasmine Marie Streight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538819982 PECOS PAC ID: 9537546130 Enrollment ID: I20220520001435 |
| Provider Name | Jacob Hall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659834000 PECOS PAC ID: 3274860051 Enrollment ID: I20220524002963 |
| Provider Name | Bridget Cholewa |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790273506 PECOS PAC ID: 9931463825 Enrollment ID: I20220525000712 |
| Provider Name | Thomas Hanff |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1578867370 PECOS PAC ID: 0244548873 Enrollment ID: I20220525002214 |
| Provider Name | Amanda Rose Bledsoe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558027532 PECOS PAC ID: 2062890874 Enrollment ID: I20220607002989 |
| Provider Name | Jordan Resnick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255864682 PECOS PAC ID: 5092132308 Enrollment ID: I20220616002538 |
| Provider Name | Patrick Liebel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356723944 PECOS PAC ID: 9537457544 Enrollment ID: I20220618000220 |
| Provider Name | Melissa L Young |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386767333 PECOS PAC ID: 5799165288 Enrollment ID: I20220629003618 |
| Provider Name | Rosie Jasper |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1942399068 PECOS PAC ID: 9830295922 Enrollment ID: I20220705002189 |
| Provider Name | Melisa A Schwartz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841921392 PECOS PAC ID: 6103206099 Enrollment ID: I20220709000238 |
| Provider Name | Edward Mark Hatrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982107736 PECOS PAC ID: 3577827914 Enrollment ID: I20220725000176 |
| Provider Name | Anne Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235799743 PECOS PAC ID: 4688092638 Enrollment ID: I20220801000482 |
| Provider Name | Derek Kohlhase |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407410830 PECOS PAC ID: 5193052645 Enrollment ID: I20220803002492 |
| Provider Name | Patricia Billingsley Dushku |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932604543 PECOS PAC ID: 5991188500 Enrollment ID: I20220815002413 |
| Provider Name | Spencer Craven |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992169452 PECOS PAC ID: 1153616230 Enrollment ID: I20220816000783 |
| Provider Name | Christopher Desutter |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1104473883 PECOS PAC ID: 0547590549 Enrollment ID: I20220826000987 |
| Provider Name | Kyirsty J Bower |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740679356 PECOS PAC ID: 6103230123 Enrollment ID: I20220830002184 |
| Provider Name | Hannah Jacopian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386378586 PECOS PAC ID: 6204211303 Enrollment ID: I20220909001228 |
| Provider Name | Matthew Abraham |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588927891 PECOS PAC ID: 7315189842 Enrollment ID: I20220913002996 |
| Provider Name | Kristine Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598927931 PECOS PAC ID: 1557535952 Enrollment ID: I20220919001991 |
| Provider Name | Cedric Eduardo Munoz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538556337 PECOS PAC ID: 7719286343 Enrollment ID: I20220926001814 |
| Provider Name | April Grant |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104111707 PECOS PAC ID: 5890943591 Enrollment ID: I20220928000275 |
| Provider Name | Dakota Sechena |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790412294 PECOS PAC ID: 6406232313 Enrollment ID: I20220929003496 |
| Provider Name | Joanna Catherine Dziewa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699409540 PECOS PAC ID: 9638555287 Enrollment ID: I20221005000126 |
| Provider Name | Ronald Weiss |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1871548990 PECOS PAC ID: 9830176007 Enrollment ID: I20221010002924 |
| Provider Name | Sophia Elizabeth Airhart |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1427379825 PECOS PAC ID: 7810299369 Enrollment ID: I20221016000014 |
| Provider Name | Catharine A Wilfong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205561248 PECOS PAC ID: 8820464712 Enrollment ID: I20221018001174 |
| Provider Name | Jonathan Vaux |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1194137968 PECOS PAC ID: 0749515609 Enrollment ID: I20221028002222 |
| Provider Name | Camille S Mellijor-figg |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1477995454 PECOS PAC ID: 7416221916 Enrollment ID: I20221118000952 |
| Provider Name | Keren Genstler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396190153 PECOS PAC ID: 1557696861 Enrollment ID: I20221128002736 |
| Provider Name | Daniel Broderick |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487141990 PECOS PAC ID: 6103175344 Enrollment ID: I20221129000192 |
| Provider Name | Beba Kajdic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417675869 PECOS PAC ID: 6608244330 Enrollment ID: I20221130000619 |
| Provider Name | Amalia Geller |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1932399243 PECOS PAC ID: 0749368678 Enrollment ID: I20221205003249 |
| Provider Name | Megan Nan Hamilton Gorman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992428577 PECOS PAC ID: 7719356914 Enrollment ID: I20221209002528 |
| Provider Name | Majda Tabakovic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316675416 PECOS PAC ID: 6002285889 Enrollment ID: I20221219000595 |
| Provider Name | Craig Stagg |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1568670842 PECOS PAC ID: 1153229349 Enrollment ID: I20221220000260 |
| Provider Name | Tracy Lyon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548686751 PECOS PAC ID: 6002031820 Enrollment ID: I20221228002808 |
| Provider Name | Yujean Han |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1154611010 PECOS PAC ID: 9537390877 Enrollment ID: I20221228002910 |
| Provider Name | Jaime Nicacio |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1245314608 PECOS PAC ID: 0648357954 Enrollment ID: I20230103000526 |
| Provider Name | Joanna Darakjy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184349458 PECOS PAC ID: 3274903570 Enrollment ID: I20230103000645 |
| Provider Name | Carsten Ritter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982869343 PECOS PAC ID: 2961674296 Enrollment ID: I20230116000927 |
| Provider Name | Ravindra N Nallamothu |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1265764781 PECOS PAC ID: 4789877796 Enrollment ID: I20230117001154 |
| Provider Name | Samantha A Booth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609585199 PECOS PAC ID: 5597924563 Enrollment ID: I20230117001546 |
| Provider Name | Anthony Ferrante |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811421662 PECOS PAC ID: 9739583261 Enrollment ID: I20230209002205 |
| Provider Name | Mark Thomas Pyburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871206789 PECOS PAC ID: 4385017524 Enrollment ID: I20230308002434 |
| Provider Name | Brigette Marie Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225792021 PECOS PAC ID: 6901270552 Enrollment ID: I20230321002584 |
| Provider Name | Brian Adams |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1144492943 PECOS PAC ID: 7315251253 Enrollment ID: I20230323001380 |
| Provider Name | Irshan A Rajput |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144458944 PECOS PAC ID: 4981847647 Enrollment ID: I20230403000140 |
| Provider Name | Heather Rose Tresidder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184323917 PECOS PAC ID: 5799150355 Enrollment ID: I20230412002476 |
| Provider Name | Lacey Harrington |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1174987176 PECOS PAC ID: 1254668965 Enrollment ID: I20230427002219 |
| Provider Name | Geoffrey Hall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205334539 PECOS PAC ID: 2668838053 Enrollment ID: I20230509001680 |
| Provider Name | Daniela Maria Schneider-aguilera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689370157 PECOS PAC ID: 3274999529 Enrollment ID: I20230511003466 |
| Provider Name | Tylie Danielle Roman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740981943 PECOS PAC ID: 5092171231 Enrollment ID: I20230515001240 |
| Provider Name | Robert Shanks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861029159 PECOS PAC ID: 3870923568 Enrollment ID: I20230605002323 |
| Provider Name | Nurudeen Ibrahim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417655713 PECOS PAC ID: 6204293988 Enrollment ID: I20230612002192 |
| Provider Name | Kara Denby |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285053892 PECOS PAC ID: 7315240983 Enrollment ID: I20230613001467 |
| Provider Name | Laura Burlingame-lee |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811262439 PECOS PAC ID: 3577885763 Enrollment ID: I20230621001925 |
| Provider Name | Rachel Koch |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629497037 PECOS PAC ID: 6406159904 Enrollment ID: I20230626001200 |
| Provider Name | Briana Osbon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073970208 PECOS PAC ID: 9032577788 Enrollment ID: I20230628000638 |
| Provider Name | Danielle Marie Fowler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053007831 PECOS PAC ID: 4385002062 Enrollment ID: I20230628001947 |
| Provider Name | Tasneem Hasan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801393566 PECOS PAC ID: 9739423823 Enrollment ID: I20230629002539 |
| Provider Name | Hasan Faheem Dani |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1902337066 PECOS PAC ID: 6608144860 Enrollment ID: I20230629003123 |
| Provider Name | Rachael Steiner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861995185 PECOS PAC ID: 1456693530 Enrollment ID: I20230630000528 |
| Provider Name | Sean Stringham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588292734 PECOS PAC ID: 0345663829 Enrollment ID: I20230706001195 |
| Provider Name | Louis Eubank |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639604275 PECOS PAC ID: 0547525818 Enrollment ID: I20230713000222 |
| Provider Name | David Zarkou |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1659659001 PECOS PAC ID: 8729205018 Enrollment ID: I20230713003331 |
| Provider Name | Jason Lee Harmon |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1083177935 PECOS PAC ID: 1951761550 Enrollment ID: I20230713004209 |
| Provider Name | Wade Willis Muncey |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1619408838 PECOS PAC ID: 4183002785 Enrollment ID: I20230714001435 |
| Provider Name | Jayson Lavie |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689087009 PECOS PAC ID: 5991924227 Enrollment ID: I20230717003381 |
| Provider Name | Quentin Doperalski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780096032 PECOS PAC ID: 4082934120 Enrollment ID: I20230718002838 |
| Provider Name | Deanna Rachel Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982398038 PECOS PAC ID: 0547620825 Enrollment ID: I20230718003053 |
| Provider Name | Avinash Patil |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720291024 PECOS PAC ID: 5496885915 Enrollment ID: I20230720003701 |
| Provider Name | Russell Hamilton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952785362 PECOS PAC ID: 7416264379 Enrollment ID: I20230724001764 |
| Provider Name | Evan Joyce |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1801250808 PECOS PAC ID: 8022374552 Enrollment ID: I20230801003311 |
| Provider Name | Daniel Bechtold |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1124548730 PECOS PAC ID: 1254711807 Enrollment ID: I20230810001386 |
| Provider Name | Ana Siler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255671350 PECOS PAC ID: 1850534017 Enrollment ID: I20230814003189 |
| Provider Name | Louis Zhang |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1952843757 PECOS PAC ID: 8527342922 Enrollment ID: I20230816002891 |
| Provider Name | Hugo Cesar Araujo Lino |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760914345 PECOS PAC ID: 5597127712 Enrollment ID: I20230818002571 |
| Provider Name | Chrystie Osborne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669843652 PECOS PAC ID: 3173901600 Enrollment ID: I20230908002536 |
| Provider Name | Sarah Lombardo |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1972862894 PECOS PAC ID: 5597997205 Enrollment ID: I20230908002919 |
| Provider Name | Corydon Siffring |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1891728887 PECOS PAC ID: 7517964398 Enrollment ID: I20230913000591 |
| Provider Name | Kim Mcgrath |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619599347 PECOS PAC ID: 4385067883 Enrollment ID: I20230918001519 |
| Provider Name | Alanna Russo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053884783 PECOS PAC ID: 5597008078 Enrollment ID: I20230920003369 |
| Provider Name | Susan Elena Hill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427462142 PECOS PAC ID: 8628422581 Enrollment ID: I20230926002075 |
| Provider Name | Karen Yunuen Vest |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245934959 PECOS PAC ID: 3375997083 Enrollment ID: I20230929000531 |
| Provider Name | Marlin Mills |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164481156 PECOS PAC ID: 8325232630 Enrollment ID: I20231003001232 |
| Provider Name | Sarah Cheree Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033895065 PECOS PAC ID: 1557716883 Enrollment ID: I20231006000606 |
| Provider Name | Christopher Hults |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760477533 PECOS PAC ID: 2961649538 Enrollment ID: I20231006002232 |
| Provider Name | Aaron Hoblet |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1982768560 PECOS PAC ID: 8820252075 Enrollment ID: I20231009000472 |
| Provider Name | Elizabeth Anne Anderson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1497438543 PECOS PAC ID: 9234584491 Enrollment ID: I20231009002777 |
| Provider Name | Leonardo Brasiliense |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1689052664 PECOS PAC ID: 5799037487 Enrollment ID: I20231011003302 |
| Provider Name | Jenna Humphrey Hogan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275899379 PECOS PAC ID: 0749663136 Enrollment ID: I20231026004117 |
| Provider Name | Janessa Waterman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346933405 PECOS PAC ID: 5698121424 Enrollment ID: I20231030003020 |
| Provider Name | Autumn Rose Rauchwerk |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1235918285 PECOS PAC ID: 6901252592 Enrollment ID: I20231102003106 |
| Provider Name | Erin Katherine Wonenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689360240 PECOS PAC ID: 1052768470 Enrollment ID: I20231107002098 |
| Provider Name | David Abel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609858224 PECOS PAC ID: 2163556770 Enrollment ID: I20231108001983 |
| Provider Name | Jeffrey Boyle |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841296696 PECOS PAC ID: 1254323967 Enrollment ID: I20231108003194 |
| Provider Name | Marshall Snow |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1891112389 PECOS PAC ID: 1951635143 Enrollment ID: I20231109001415 |
| Provider Name | Linda Gasser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871805390 PECOS PAC ID: 3870857709 Enrollment ID: I20231116000226 |
| Provider Name | Christine Elwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346860996 PECOS PAC ID: 8527415223 Enrollment ID: I20231116001732 |
| Provider Name | Tiffeny Stees |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609466952 PECOS PAC ID: 2365890019 Enrollment ID: I20231120000551 |
| Provider Name | Kenneth Madsen |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1164412862 PECOS PAC ID: 2769402403 Enrollment ID: I20231120002255 |
| Provider Name | Mehrdad Asadifar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508816810 PECOS PAC ID: 6901074749 Enrollment ID: I20231122002705 |
| Provider Name | Christopher Chen |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1851603674 PECOS PAC ID: 6608017744 Enrollment ID: I20231128002525 |
| Provider Name | Amir Gendy |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1124361019 PECOS PAC ID: 4880913763 Enrollment ID: I20231201002088 |
| Provider Name | Jaime L Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821249905 PECOS PAC ID: 9537216676 Enrollment ID: I20231207004127 |
| Provider Name | Elias Samaha |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1134535693 PECOS PAC ID: 2365763208 Enrollment ID: I20231212003764 |
| Provider Name | Leah Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730692989 PECOS PAC ID: 9032540141 Enrollment ID: I20231215003345 |
| Provider Name | Ekaterina Alex Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093580581 PECOS PAC ID: 6709235617 Enrollment ID: I20231218000204 |
| Provider Name | Jordan Simpson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114346749 PECOS PAC ID: 8426377805 Enrollment ID: I20231218000367 |
| Provider Name | Deanne Degreaffenreidte |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124350830 PECOS PAC ID: 0042348062 Enrollment ID: I20231220002397 |
| Provider Name | Teresa Melina Lucas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588444665 PECOS PAC ID: 7618327263 Enrollment ID: I20231222002185 |
| Provider Name | Scott Gilmore |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457705642 PECOS PAC ID: 8628360062 Enrollment ID: I20231228000603 |
| Provider Name | Muhammad Beg |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1508077298 PECOS PAC ID: 3870630197 Enrollment ID: I20240102002876 |
| Provider Name | Penelope D Barnes |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1518042340 PECOS PAC ID: 9830107374 Enrollment ID: I20240106000188 |
| Provider Name | David Hak |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942290341 PECOS PAC ID: 0547272619 Enrollment ID: I20240109004912 |
| Provider Name | Kevin T Stephan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1942228259 PECOS PAC ID: 3375532153 Enrollment ID: I20240118001840 |
| Provider Name | Jennifer Hall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417022559 PECOS PAC ID: 0143599852 Enrollment ID: I20240119002763 |
| Provider Name | Katherine Homer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1790167757 PECOS PAC ID: 0547579716 Enrollment ID: I20240122001944 |
| Provider Name | William Christopher Egolf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083296461 PECOS PAC ID: 6709239965 Enrollment ID: I20240124003344 |
| Provider Name | Karen Caputo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205160611 PECOS PAC ID: 4486793726 Enrollment ID: I20240128000025 |
| Provider Name | David Tompkins |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1679596696 PECOS PAC ID: 0840356200 Enrollment ID: I20240129004625 |
| Provider Name | Martha Mooney |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1902872203 PECOS PAC ID: 2466405188 Enrollment ID: I20240201002944 |
| Provider Name | Alexander David Malloy |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1174886824 PECOS PAC ID: 2668805680 Enrollment ID: I20240206001403 |
| Provider Name | Mary Crow |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1164425211 PECOS PAC ID: 8022021757 Enrollment ID: I20240208003188 |
| Provider Name | Casey Margaret Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235754128 PECOS PAC ID: 3870936586 Enrollment ID: I20240209002002 |
| Provider Name | Bethany Kendall Maze |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053180976 PECOS PAC ID: 0749623312 Enrollment ID: I20240210000572 |
| Provider Name | James E Allen |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1730175290 PECOS PAC ID: 9436061025 Enrollment ID: I20240222003215 |
| Provider Name | Alyssa B Allsop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487222022 PECOS PAC ID: 8820433378 Enrollment ID: I20240223003736 |
| Provider Name | Mary Meacham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265207534 PECOS PAC ID: 4688011364 Enrollment ID: I20240318003374 |
| Provider Name | Joseph Zachariah |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1649293895 PECOS PAC ID: 9133137227 Enrollment ID: I20240322002178 |
| Provider Name | Chantal Brooke Chambers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891577284 PECOS PAC ID: 8921445974 Enrollment ID: I20240326001793 |
| Provider Name | Vikram Palkar |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1376947135 PECOS PAC ID: 8022381722 Enrollment ID: I20240401002958 |
| Provider Name | Amina Goodwin |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1669618302 PECOS PAC ID: 3678715174 Enrollment ID: I20240401003005 |
| Provider Name | Darla J. Buffa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982301644 PECOS PAC ID: 3971941212 Enrollment ID: I20240404002999 |
| Provider Name | Jeremy Conklin |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1700830882 PECOS PAC ID: 7517109614 Enrollment ID: I20240405001523 |
| Provider Name | Katherine Passafiume |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841890993 PECOS PAC ID: 0648683714 Enrollment ID: I20240409001492 |
| Provider Name | Steven Khalil |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1245452606 PECOS PAC ID: 1052406345 Enrollment ID: I20240410001728 |
| Provider Name | Nina E Nwoko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689261679 PECOS PAC ID: 7416363445 Enrollment ID: I20240410002887 |
| Provider Name | Gary Benedetti |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1598746604 PECOS PAC ID: 0941218887 Enrollment ID: I20240411000986 |
| Provider Name | Bryan P Mathieson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205022555 PECOS PAC ID: 3476620238 Enrollment ID: I20240412000731 |
| Provider Name | Matthew Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548651094 PECOS PAC ID: 7719388420 Enrollment ID: I20240423004449 |
| Provider Name | Gretchen Renae Winter |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1235498049 PECOS PAC ID: 2769622844 Enrollment ID: I20240426000742 |
| Provider Name | Sarah Shewayish |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1689936437 PECOS PAC ID: 8123340205 Enrollment ID: I20240430002660 |
| Provider Name | Karson Kalian |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1699262527 PECOS PAC ID: 2062764475 Enrollment ID: I20240501002003 |
| Provider Name | Julie Huau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962975219 PECOS PAC ID: 2769881267 Enrollment ID: I20240501002200 |
| Provider Name | Julie L. Wynne |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1336115401 PECOS PAC ID: 6406812858 Enrollment ID: I20240502001793 |
| Provider Name | Bruce Lee Whitaker |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790923969 PECOS PAC ID: 0446437131 Enrollment ID: I20240502002367 |
| Provider Name | Martine Nicole Troy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114371895 PECOS PAC ID: 8729378765 Enrollment ID: I20240503003429 |
| Provider Name | Hope Cranston D Amato |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1821033069 PECOS PAC ID: 3577573344 Enrollment ID: I20240507002552 |
| Provider Name | Sarah Carter |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487889796 PECOS PAC ID: 6204053416 Enrollment ID: I20240511000420 |
| Provider Name | Kevin J Pugh |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1043204704 PECOS PAC ID: 4284607250 Enrollment ID: I20240514001092 |
| Provider Name | Caleb James Mentzer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285920223 PECOS PAC ID: 8628217023 Enrollment ID: I20240528002468 |
| Provider Name | Therese Duane |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1427131598 PECOS PAC ID: 0244369833 Enrollment ID: I20240528002970 |
| Provider Name | Justin Blaty |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548766835 PECOS PAC ID: 8022355460 Enrollment ID: I20240529002775 |
| Provider Name | Kenneth Squires |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649706326 PECOS PAC ID: 0446529242 Enrollment ID: I20240530001672 |
| Provider Name | Laura Ann O'brien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982459467 PECOS PAC ID: 0042752131 Enrollment ID: I20240604003347 |
| Provider Name | Xavier Al-mateen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033738505 PECOS PAC ID: 1557784907 Enrollment ID: I20240605003948 |
| Provider Name | Stephanie Freeman |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1497732135 PECOS PAC ID: 8729989918 Enrollment ID: I20240605004214 |
| Provider Name | Cole Daniel Szymkiewicz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972368595 PECOS PAC ID: 1850833732 Enrollment ID: I20240606002622 |
| Provider Name | Philip Anderson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154997104 PECOS PAC ID: 8729487152 Enrollment ID: I20240607001553 |
| Provider Name | Kahdi Udobi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1205935624 PECOS PAC ID: 8921131897 Enrollment ID: I20240609000180 |
| Provider Name | Andrew Thomas Nilsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538747712 PECOS PAC ID: 6305388851 Enrollment ID: I20240612000588 |
| Provider Name | Jessica Michelle Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164140281 PECOS PAC ID: 4789126186 Enrollment ID: I20240612002560 |
| Provider Name | Kelly Block |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740786631 PECOS PAC ID: 4688061187 Enrollment ID: I20240613001733 |
| Provider Name | Petar Igic |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1053365494 PECOS PAC ID: 9638182801 Enrollment ID: I20240614001257 |
| Provider Name | Nicole Gaylene St Germain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295588374 PECOS PAC ID: 3971046277 Enrollment ID: I20240614001691 |
| Provider Name | Jane Elizabeth Bigelow |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043715782 PECOS PAC ID: 5092258897 Enrollment ID: I20240621000912 |
| Provider Name | William Kogler |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1629572839 PECOS PAC ID: 2365984713 Enrollment ID: I20240625002009 |
| Provider Name | Taylor Wolfe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194302976 PECOS PAC ID: 8628487428 Enrollment ID: I20240625004079 |
| Provider Name | Felix Vladimir |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1962472993 PECOS PAC ID: 6406823483 Enrollment ID: I20240626000798 |
| Provider Name | Choosak D Burr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588998447 PECOS PAC ID: 6204971617 Enrollment ID: I20240627001573 |
| Provider Name | Krystine Spiess |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1962701524 PECOS PAC ID: 2860616786 Enrollment ID: I20240701003303 |
| Provider Name | Daniel Frank Rivera |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164912507 PECOS PAC ID: 4082952957 Enrollment ID: I20240705002821 |
| Provider Name | Loren Black |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972008373 PECOS PAC ID: 4981954773 Enrollment ID: I20240716002020 |
| Provider Name | Emily Dickerson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669871398 PECOS PAC ID: 6608278650 Enrollment ID: I20240717002816 |
| Provider Name | Nicole M Randel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710555974 PECOS PAC ID: 6305247024 Enrollment ID: I20240718003876 |
| Provider Name | Joseph Helm |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1184067837 PECOS PAC ID: 5698094043 Enrollment ID: I20240718004939 |
| Provider Name | Bryce J. Parkinson |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1013477652 PECOS PAC ID: 4688110950 Enrollment ID: I20240723001470 |
| Provider Name | Srikanth Seethala |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1982803292 PECOS PAC ID: 1850425109 Enrollment ID: I20240730003808 |
| Provider Name | Trista Manon Kovach |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659583243 PECOS PAC ID: 8325585714 Enrollment ID: I20240802001988 |
| Provider Name | Jesse Mcchane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083297287 PECOS PAC ID: 1759783780 Enrollment ID: I20240806001024 |
| Provider Name | Edward Davila |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972545143 PECOS PAC ID: 7517970973 Enrollment ID: I20240806004184 |
| Provider Name | Ryley Mcpeters |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730543646 PECOS PAC ID: 1658670922 Enrollment ID: I20240812002100 |
| Provider Name | Megan Ann Schwehr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073196283 PECOS PAC ID: 8325440357 Enrollment ID: I20240814000814 |
| Provider Name | Scott Gregory Bird |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1992200331 PECOS PAC ID: 0244633246 Enrollment ID: I20240820000494 |
| Provider Name | Gail Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831587740 PECOS PAC ID: 6204148943 Enrollment ID: I20240820004478 |
| Provider Name | Ali Kimyaghalam |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1922455146 PECOS PAC ID: 4587033998 Enrollment ID: I20240823002349 |
| Provider Name | Courtney Scott Isaacs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083294227 PECOS PAC ID: 8820468937 Enrollment ID: I20240905003665 |
| Provider Name | Scott John |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1821382839 PECOS PAC ID: 7719123207 Enrollment ID: I20240909003942 |
| Provider Name | Ethan Taub |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1295002285 PECOS PAC ID: 5597905455 Enrollment ID: I20240910001370 |
| Provider Name | David W Silvestre |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1619315967 PECOS PAC ID: 1456665769 Enrollment ID: I20240911000646 |
| Provider Name | Jeremiah Nielson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699891374 PECOS PAC ID: 9436314010 Enrollment ID: I20240911004777 |
| Provider Name | Robert Jordan Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588494959 PECOS PAC ID: 7810437134 Enrollment ID: I20240912002138 |
| Provider Name | Joseph Graham |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1578638383 PECOS PAC ID: 1052367901 Enrollment ID: I20240912002152 |
| Provider Name | Hannah Elsevier |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1063875862 PECOS PAC ID: 4789920745 Enrollment ID: I20240913002943 |
| Provider Name | Murtuza Habeeb |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1881897205 PECOS PAC ID: 0345370664 Enrollment ID: I20240918000860 |
| Provider Name | Jared Anthony Belsher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174717870 PECOS PAC ID: 5193266054 Enrollment ID: I20240918003188 |
| Provider Name | George Samaan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255794756 PECOS PAC ID: 9234400128 Enrollment ID: I20240926004015 |
| Provider Name | Giovanna Cantor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144777350 PECOS PAC ID: 6204104599 Enrollment ID: I20240927001790 |
| Provider Name | Michelle Christopher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033523196 PECOS PAC ID: 3779702394 Enrollment ID: I20240930002795 |
| Provider Name | Timo Hakkarainen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1568604304 PECOS PAC ID: 7012219439 Enrollment ID: I20241014004256 |
| Provider Name | Henrik Manassarians |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1598798795 PECOS PAC ID: 4486658911 Enrollment ID: I20241016004214 |
| Provider Name | Kelsey Lynne Rogers |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1417785932 PECOS PAC ID: 3870025554 Enrollment ID: I20241018003030 |
| Provider Name | Taylor Brown |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881191088 PECOS PAC ID: 1456698885 Enrollment ID: I20241024002170 |
| Provider Name | David Krason |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1932166675 PECOS PAC ID: 5395739015 Enrollment ID: I20241105001486 |
| Provider Name | Jamie Pacheco |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1427450352 PECOS PAC ID: 9931422045 Enrollment ID: I20241106001564 |
| Provider Name | Sugat Patel |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1518947233 PECOS PAC ID: 7810996451 Enrollment ID: I20241120001887 |
| Provider Name | Allison J N Harriott |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1023247871 PECOS PAC ID: 6709028616 Enrollment ID: I20241121004201 |
| Provider Name | Benjamin Andersen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871322750 PECOS PAC ID: 1456886605 Enrollment ID: I20241125001067 |
| Provider Name | Andrew Dysart |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1821674995 PECOS PAC ID: 1557761418 Enrollment ID: I20241127001914 |
| Provider Name | Eric Wattenburg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194791640 PECOS PAC ID: 1658426663 Enrollment ID: I20241202003039 |
| Provider Name | Scott Sorge |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093211765 PECOS PAC ID: 8921487570 Enrollment ID: I20241203002944 |
| Provider Name | Thomas Kasprowicz |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1144664491 PECOS PAC ID: 1951541762 Enrollment ID: I20241206002941 |
| Provider Name | Elizabeth Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851698781 PECOS PAC ID: 6507393105 Enrollment ID: I20241220000807 |
| Provider Name | Xiuqing Ru |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1679508790 PECOS PAC ID: 7012976731 Enrollment ID: I20241227003051 |
| Provider Name | Jose Antonio Coronado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720802218 PECOS PAC ID: 6002343001 Enrollment ID: I20250102000907 |
| Provider Name | Charli Kinser |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598488959 PECOS PAC ID: 3274901483 Enrollment ID: I20250103001068 |
| Provider Name | Patrick J Lindsay |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1851949598 PECOS PAC ID: 7810229150 Enrollment ID: I20250113003148 |
| Provider Name | Alison Brann |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1801328687 PECOS PAC ID: 3870967284 Enrollment ID: I20250116003315 |
| Provider Name | Antonette Lynn Harvill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073897849 PECOS PAC ID: 0143485615 Enrollment ID: I20250123002043 |
| Provider Name | Eric T Choi |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1306863865 PECOS PAC ID: 3971632431 Enrollment ID: I20250128004523 |
| Provider Name | Belinda Estolia Dalrymple-gamboa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841575560 PECOS PAC ID: 7911363429 Enrollment ID: I20250130000416 |
| Provider Name | Daniel Christopher Ketterer |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1134393796 PECOS PAC ID: 5193955771 Enrollment ID: I20250205002321 |
| Provider Name | Allen Wong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508817214 PECOS PAC ID: 4981794229 Enrollment ID: I20250205002573 |
| Provider Name | Daniella Cristina Molinari |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1477238699 PECOS PAC ID: 0547790289 Enrollment ID: I20250210002745 |
| Provider Name | Amanda Lavallee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720148091 PECOS PAC ID: 1557554151 Enrollment ID: I20250210003344 |
| Provider Name | Jennifer Fish |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104663475 PECOS PAC ID: 8820528433 Enrollment ID: I20250212001713 |
| Provider Name | Danielle Dombrowski |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1285997338 PECOS PAC ID: 8123450814 Enrollment ID: I20250213000986 |
| Provider Name | Aaron Robert Calvano |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1609497551 PECOS PAC ID: 7416477484 Enrollment ID: I20250220001557 |
| Provider Name | Ramona Mullinax |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447694930 PECOS PAC ID: 2062650864 Enrollment ID: I20250224000776 |
| Provider Name | Paul Sarkaria |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1902463300 PECOS PAC ID: 7315392362 Enrollment ID: I20250225003489 |
| Provider Name | Stephanie Jan Bowles |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093027377 PECOS PAC ID: 5597285148 Enrollment ID: I20250226000697 |
| Provider Name | Michael Silva |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1205029998 PECOS PAC ID: 0446233027 Enrollment ID: I20250228001843 |
| Provider Name | Samuel Phillip Luque |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710178876 PECOS PAC ID: 2466818018 Enrollment ID: I20250305000695 |
| Provider Name | Craig Laudicina |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134502586 PECOS PAC ID: 9133585771 Enrollment ID: I20250307001655 |
| Provider Name | Ivan Martinez Avalos |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1114411865 PECOS PAC ID: 8921448614 Enrollment ID: I20250318003630 |
| Provider Name | Marc Papantonio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770847469 PECOS PAC ID: 1456873256 Enrollment ID: I20250321001080 |
| Provider Name | Alessandra Longoria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093529406 PECOS PAC ID: 0345762902 Enrollment ID: I20250324002305 |
| Provider Name | Connie B Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114206042 PECOS PAC ID: 9638322779 Enrollment ID: I20250328001800 |
| Provider Name | Michael Nizzi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700802055 PECOS PAC ID: 5193701944 Enrollment ID: I20250331002357 |
| Provider Name | Tavniah Leigh Betts |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1144588898 PECOS PAC ID: 7618490574 Enrollment ID: I20250401001972 |
| Provider Name | Jonathan Scoville |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1427412444 PECOS PAC ID: 6204192750 Enrollment ID: I20250422002533 |
| Provider Name | John Md Kodatt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083354039 PECOS PAC ID: 9234590076 Enrollment ID: I20250424003205 |
| Provider Name | Victoria O'brien |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275023855 PECOS PAC ID: 9032655956 Enrollment ID: I20250428002276 |
| Provider Name | Stephen Cooper |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1730706185 PECOS PAC ID: 2163847294 Enrollment ID: I20250520001872 |
Boise Behavioral Medicine Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7227 W Potomac Dr, Boise, ID 83704 Phone: 208-314-1770 | |
Saint Alphonsus Regional Medical Center Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 131 Allumbaugh St, Boise, ID 83704 Phone: 208-367-3069 Fax: 208-367-3002 | |
Living Well, Inc, Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6003 W Overland Rd, Suite 101, Boise, ID 83709 Phone: 208-322-2412 Fax: 208-345-2077 | |
Continual Wellness Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1915 N 33rd St, Boise, ID 83703 Phone: 208-340-6270 | |
Cda Solution Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10080 W Smoke Ranch Dr, Boise, ID 83709 Phone: 208-703-6004 | |
Commonplace Wellness Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 500 W Bannock St, Boise, ID 83702 Phone: 208-906-5878 | |
Arrowleaf Counseling Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 413 N Allumbaugh St Ste 101, Boise, ID 83704 Phone: 208-954-5594 Fax: 208-954-5598 |