| Ssm Cardinal Glennon Childrens Hospital | |
|
1 Saint Elizabeth Blvd O Fallon IL 62269-1099 | |
| (618) 234-2120 | |
| Not Available |
| Full Name | Ssm Cardinal Glennon Childrens Hospital |
|---|---|
| Speciality | Pediatrics |
| Location | 1 Saint Elizabeth Blvd, O Fallon, Illinois |
| Authorized Official Name and Position | Karen Rewerts (VP FINANCE) |
| Authorized Official Contact | 3149892034 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ssm Cardinal Glennon Childrens Hospital 1145 Corporate Lake Dr Saint Louis MO 63132-2907 Ph: (314) 989-6843 | Ssm Cardinal Glennon Childrens Hospital 1 Saint Elizabeth Blvd O Fallon IL 62269-1099 Ph: (618) 234-2120 |
| NPI Number | 1174577670 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 09/30/2020 |
| Certification Date | 08/24/2020 |
| Medicare PECOS PAC ID | 7012828163 |
|---|---|
| Medicare Enrollment ID | O20031231000604 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174577670 | NPI | - | NPPES |
| 540155801 | Medicaid | MO |
| Provider Name | Mohamad Al-hosni |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053351338 PECOS PAC ID: 5799680278 Enrollment ID: I20031208000054 |
| Provider Name | Timothy W Staed |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134175847 PECOS PAC ID: 6608761150 Enrollment ID: I20040216000495 |
| Provider Name | Brent E Cully |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114921533 PECOS PAC ID: 1850282898 Enrollment ID: I20040322000286 |
| Provider Name | Connie D Anderson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073619334 PECOS PAC ID: 8527950641 Enrollment ID: I20040325000617 |
| Provider Name | Friederike Helene Kreisel |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1962428185 PECOS PAC ID: 5991798878 Enrollment ID: I20040406001270 |
| Provider Name | Zafar Rehmani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487629754 PECOS PAC ID: 0143205567 Enrollment ID: I20040621001116 |
| Provider Name | Megan Elizabeth Mcdonald |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164470779 PECOS PAC ID: 7012983620 Enrollment ID: I20040904000061 |
| Provider Name | Carl A Freeman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629172846 PECOS PAC ID: 2163484395 Enrollment ID: I20041101000183 |
| Provider Name | Nadeem D Parkar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235121013 PECOS PAC ID: 2365491016 Enrollment ID: I20050119001092 |
| Provider Name | Mark C Eddy |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1760596126 PECOS PAC ID: 5890745699 Enrollment ID: I20050129000048 |
| Provider Name | Jason C Gutting |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205851755 PECOS PAC ID: 9739133240 Enrollment ID: I20050308000842 |
| Provider Name | Deborah J Yersky |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588609127 PECOS PAC ID: 8921045394 Enrollment ID: I20050418000136 |
| Provider Name | Donna R Halloran |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003826520 PECOS PAC ID: 3577599042 Enrollment ID: I20050715000421 |
| Provider Name | Kristin Anne Leland |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013968213 PECOS PAC ID: 2567497795 Enrollment ID: I20050927000903 |
| Provider Name | Angela Misuraco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114901279 PECOS PAC ID: 4385669381 Enrollment ID: I20051010000159 |
| Provider Name | Alejandro Mendez Castillo |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1649255076 PECOS PAC ID: 2567361322 Enrollment ID: I20051012001212 |
| Provider Name | Medhat M Osman |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1932117819 PECOS PAC ID: 5698793545 Enrollment ID: I20051109000335 |
| Provider Name | Michelle C Sineff |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316939838 PECOS PAC ID: 0749209427 Enrollment ID: I20051114000002 |
| Provider Name | Emanuel J Vlastos |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710913306 PECOS PAC ID: 7214941913 Enrollment ID: I20060202000102 |
| Provider Name | Daniel J Naughton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548202062 PECOS PAC ID: 7012920804 Enrollment ID: I20060720000429 |
| Provider Name | Matthew A Broom |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114967767 PECOS PAC ID: 2163427451 Enrollment ID: I20060920000044 |
| Provider Name | Thomas M Bender |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649278789 PECOS PAC ID: 4587662630 Enrollment ID: I20061128000133 |
| Provider Name | Julie R Ferguson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689602781 PECOS PAC ID: 9739281056 Enrollment ID: I20070216000629 |
| Provider Name | David S Brink |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1922054196 PECOS PAC ID: 4981706116 Enrollment ID: I20070424000458 |
| Provider Name | Rolanda A Gott |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588617559 PECOS PAC ID: 9931206489 Enrollment ID: I20070518000116 |
| Provider Name | Carole A Vogler |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1063465466 PECOS PAC ID: 3476650656 Enrollment ID: I20070523000160 |
| Provider Name | Gene M Labarge |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740294149 PECOS PAC ID: 9234237488 Enrollment ID: I20070612000172 |
| Provider Name | Tracy M Tomlinson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700091709 PECOS PAC ID: 8325146335 Enrollment ID: I20070614000069 |
| Provider Name | Shahida R Naseer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336159854 PECOS PAC ID: 4486752490 Enrollment ID: I20070614000093 |
| Provider Name | Douglas C Rivard |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1891842365 PECOS PAC ID: 3779683909 Enrollment ID: I20070718000773 |
| Provider Name | Martin N Reis |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1205802154 PECOS PAC ID: 8527159805 Enrollment ID: I20070801000593 |
| Provider Name | Jennifer S Ladage |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477642106 PECOS PAC ID: 9335233303 Enrollment ID: I20070921000015 |
| Provider Name | Kevin R Mahoney |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386745115 PECOS PAC ID: 2466548466 Enrollment ID: I20071023000173 |
| Provider Name | Stefanee Lynann Keth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912195868 PECOS PAC ID: 8224125331 Enrollment ID: I20071106000189 |
| Provider Name | Cathy L Gross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730128943 PECOS PAC ID: 8628158474 Enrollment ID: I20080105000045 |
| Provider Name | Richard L Obrien |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1366414575 PECOS PAC ID: 9537246970 Enrollment ID: I20080409000232 |
| Provider Name | Jenny L Furtak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720265077 PECOS PAC ID: 1850470923 Enrollment ID: I20080501000236 |
| Provider Name | Tonya L Williams |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336368679 PECOS PAC ID: 2567541881 Enrollment ID: I20080512000214 |
| Provider Name | Thomas D Myles |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598773475 PECOS PAC ID: 0648341602 Enrollment ID: I20080618000469 |
| Provider Name | Shulamit M Portnoy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033115589 PECOS PAC ID: 2860565140 Enrollment ID: I20080719000027 |
| Provider Name | Abigail M Sharamitaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992982342 PECOS PAC ID: 0345316063 Enrollment ID: I20080904000076 |
| Provider Name | Dorothea J Mostello |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841208725 PECOS PAC ID: 4082780713 Enrollment ID: I20080904000189 |
| Provider Name | Neil J Mardis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104949304 PECOS PAC ID: 5496822579 Enrollment ID: I20080916000554 |
| Provider Name | Douglas E Coplen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1972529295 PECOS PAC ID: 2769559699 Enrollment ID: I20080919000050 |
| Provider Name | Jeffrey Craver |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1629035886 PECOS PAC ID: 0749358802 Enrollment ID: I20081003000043 |
| Provider Name | Ece I Akduman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700894557 PECOS PAC ID: 8224106257 Enrollment ID: I20081009000708 |
| Provider Name | Debra K Quick |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1659578011 PECOS PAC ID: 0244308740 Enrollment ID: I20081010000470 |
| Provider Name | Ricardo Sarli |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1457420408 PECOS PAC ID: 5395631550 Enrollment ID: I20081022000070 |
| Provider Name | Matthew A Pieper |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598920647 PECOS PAC ID: 8527127547 Enrollment ID: I20081106000028 |
| Provider Name | Karen A Caudill |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699728667 PECOS PAC ID: 7810057338 Enrollment ID: I20081113000453 |
| Provider Name | Dave A Harris |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1952379380 PECOS PAC ID: 4880759885 Enrollment ID: I20090206000366 |
| Provider Name | Michael R Kenney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073569349 PECOS PAC ID: 6002972577 Enrollment ID: I20090309000058 |
| Provider Name | Elizabeth S Obrien |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831276427 PECOS PAC ID: 1557427978 Enrollment ID: I20090309000642 |
| Provider Name | Donna R Manley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407977887 PECOS PAC ID: 4880742436 Enrollment ID: I20090508000228 |
| Provider Name | Jessica R Luitjohan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730381716 PECOS PAC ID: 4587758685 Enrollment ID: I20090707000661 |
| Provider Name | Jamie S Sutherell |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1477760585 PECOS PAC ID: 9335291772 Enrollment ID: I20090716000346 |
| Provider Name | Nadim Kanafani |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396761524 PECOS PAC ID: 2769535491 Enrollment ID: I20090728000884 |
| Provider Name | Erica J Traxel |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1235266024 PECOS PAC ID: 4385798859 Enrollment ID: I20090818000424 |
| Provider Name | Kimberly A Twyman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508942921 PECOS PAC ID: 5890849186 Enrollment ID: I20090820000880 |
| Provider Name | Pamela B Witthohn |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588873855 PECOS PAC ID: 0345396131 Enrollment ID: I20090921000082 |
| Provider Name | Timothy P Zinkus |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992995039 PECOS PAC ID: 3173678489 Enrollment ID: I20091016000277 |
| Provider Name | Melissa E Lowe |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1881749232 PECOS PAC ID: 5799823035 Enrollment ID: I20091106000487 |
| Provider Name | Amer Alshekhlee |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1255328100 PECOS PAC ID: 0648375931 Enrollment ID: I20100305000025 |
| Provider Name | Gilad A Gross |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619995354 PECOS PAC ID: 1658416383 Enrollment ID: I20100305000781 |
| Provider Name | Levent Akduman |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1245344605 PECOS PAC ID: 2860529260 Enrollment ID: I20100415000881 |
| Provider Name | Heidi M Sallee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568473007 PECOS PAC ID: 8022146620 Enrollment ID: I20100430000694 |
| Provider Name | Mary S Heaney |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043220296 PECOS PAC ID: 2567590169 Enrollment ID: I20100430000714 |
| Provider Name | Jay E Noffsinger |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033130588 PECOS PAC ID: 1557499167 Enrollment ID: I20100430000730 |
| Provider Name | John J Puetz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508811068 PECOS PAC ID: 4183752264 Enrollment ID: I20100511000515 |
| Provider Name | Dana J Aronin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467639781 PECOS PAC ID: 2961532197 Enrollment ID: I20100614000621 |
| Provider Name | Jaye M Shyken |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972619302 PECOS PAC ID: 5799815635 Enrollment ID: I20100618000872 |
| Provider Name | Jay Crockett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275577850 PECOS PAC ID: 1254463045 Enrollment ID: I20100714000342 |
| Provider Name | Catherine J Reese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720236284 PECOS PAC ID: 9638201353 Enrollment ID: I20100715000862 |
| Provider Name | Lauren E Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679717417 PECOS PAC ID: 7012040017 Enrollment ID: I20100728000138 |
| Provider Name | Rebecca Kathryn Phelps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881925337 PECOS PAC ID: 2365575123 Enrollment ID: I20100729000944 |
| Provider Name | Yihua Zhou |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255457271 PECOS PAC ID: 4880727254 Enrollment ID: I20100805000505 |
| Provider Name | Chetana M Reddy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093738916 PECOS PAC ID: 1759415367 Enrollment ID: I20100818000864 |
| Provider Name | Mehrdad John Sehi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407801442 PECOS PAC ID: 2163498759 Enrollment ID: I20100818000958 |
| Provider Name | Richard C Callison |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326253832 PECOS PAC ID: 3173696853 Enrollment ID: I20100825000894 |
| Provider Name | Stacey E Woodrome |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689852253 PECOS PAC ID: 5698967214 Enrollment ID: I20101014000073 |
| Provider Name | Cristiana F Teodorescu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902964323 PECOS PAC ID: 3173716172 Enrollment ID: I20101022000666 |
| Provider Name | Christopher R Wangard |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023127396 PECOS PAC ID: 9436343837 Enrollment ID: I20101029000845 |
| Provider Name | Kenneth A Haller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679584304 PECOS PAC ID: 5496943581 Enrollment ID: I20101215000959 |
| Provider Name | Michelle L Phillips |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295909992 PECOS PAC ID: 5890868541 Enrollment ID: I20110112000882 |
| Provider Name | Joan K Zawin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205912037 PECOS PAC ID: 9739171109 Enrollment ID: I20110131000446 |
| Provider Name | Elizabeth Elaine Merritt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558337519 PECOS PAC ID: 5890977839 Enrollment ID: I20110311000164 |
| Provider Name | Barbara A Braddock |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1184811887 PECOS PAC ID: 9931385465 Enrollment ID: I20110518000655 |
| Provider Name | Amanda S Mcintyre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205126679 PECOS PAC ID: 6406033323 Enrollment ID: I20110602000027 |
| Provider Name | Mujahida Baram |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407018336 PECOS PAC ID: 9234308123 Enrollment ID: I20110810000469 |
| Provider Name | Miguel A Guzman |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1093926602 PECOS PAC ID: 4082884390 Enrollment ID: I20110824000309 |
| Provider Name | Ashley A Borawski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487934642 PECOS PAC ID: 8729250014 Enrollment ID: I20111010000461 |
| Provider Name | Grace F Spinner |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1457628224 PECOS PAC ID: 9638336266 Enrollment ID: I20120208000911 |
| Provider Name | Felicia L Harvey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033145982 PECOS PAC ID: 2163683574 Enrollment ID: I20120411000787 |
| Provider Name | Meghan P Holland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679848584 PECOS PAC ID: 9133381916 Enrollment ID: I20120425000112 |
| Provider Name | Katherine J Robbins |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1073792727 PECOS PAC ID: 6002094539 Enrollment ID: I20120515000334 |
| Provider Name | Kristin N Wilmes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265706337 PECOS PAC ID: 6709040330 Enrollment ID: I20120612000449 |
| Provider Name | Vilaas S Shetty |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164577540 PECOS PAC ID: 1557526522 Enrollment ID: I20120626000572 |
| Provider Name | Bennett Gray |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376637132 PECOS PAC ID: 0244131191 Enrollment ID: I20120720000567 |
| Provider Name | Yosef Greenspon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942364690 PECOS PAC ID: 3577665090 Enrollment ID: I20120727000738 |
| Provider Name | Jennifer A Craig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669698338 PECOS PAC ID: 5698931095 Enrollment ID: I20120731000205 |
| Provider Name | Katherine M Childress |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619130010 PECOS PAC ID: 9830345784 Enrollment ID: I20120808000350 |
| Provider Name | Margaret A Eschete |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225068000 PECOS PAC ID: 7911098942 Enrollment ID: I20120824000454 |
| Provider Name | Cortney L Button |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538348016 PECOS PAC ID: 3173771276 Enrollment ID: I20120914000361 |
| Provider Name | Deborah C Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639384506 PECOS PAC ID: 4688822612 Enrollment ID: I20120918000203 |
| Provider Name | Kenisha Bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811295850 PECOS PAC ID: 6709035611 Enrollment ID: I20121010000214 |
| Provider Name | Rebecca L Hunt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376785352 PECOS PAC ID: 1557511250 Enrollment ID: I20121015000376 |
| Provider Name | Austin M Dalrymple |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770718579 PECOS PAC ID: 9234389834 Enrollment ID: I20121017000024 |
| Provider Name | Jennifer L Brickler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386816130 PECOS PAC ID: 9931350485 Enrollment ID: I20121112000017 |
| Provider Name | Amanda L Parsley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770719171 PECOS PAC ID: 4284885732 Enrollment ID: I20121112000042 |
| Provider Name | Anne Marie Gildehaus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760719249 PECOS PAC ID: 0446401459 Enrollment ID: I20121120000482 |
| Provider Name | Stephanie L Rader |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184952525 PECOS PAC ID: 3870745797 Enrollment ID: I20121128000514 |
| Provider Name | Kimberly A Stieglitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386767879 PECOS PAC ID: 7214189133 Enrollment ID: I20121128000527 |
| Provider Name | Colleen M Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417155383 PECOS PAC ID: 4789733957 Enrollment ID: I20121205000241 |
| Provider Name | Lisa M Schrock |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821218637 PECOS PAC ID: 5193977601 Enrollment ID: I20121208000030 |
| Provider Name | Kirubahara Vaheesan |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1982891271 PECOS PAC ID: 1658460332 Enrollment ID: I20130220000439 |
| Provider Name | Danielle M Carpenter |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1376743088 PECOS PAC ID: 0941446207 Enrollment ID: I20130411000578 |
| Provider Name | Amy E Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518208107 PECOS PAC ID: 3072752534 Enrollment ID: I20130613000736 |
| Provider Name | Emily R Daut |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285912253 PECOS PAC ID: 6305086323 Enrollment ID: I20130715000582 |
| Provider Name | Kelby B Napier |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124299730 PECOS PAC ID: 0244471878 Enrollment ID: I20130724000877 |
| Provider Name | Razi Muzaffar |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1518159466 PECOS PAC ID: 9830331826 Enrollment ID: I20130802000857 |
| Provider Name | Sameer Devchandbhai Gadani |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1013110477 PECOS PAC ID: 4789746280 Enrollment ID: I20130827000180 |
| Provider Name | Laura Vricella |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316150907 PECOS PAC ID: 5092846006 Enrollment ID: I20131022002140 |
| Provider Name | Stephen B Huebner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730479676 PECOS PAC ID: 8022265099 Enrollment ID: I20131025000431 |
| Provider Name | Maya E Moody |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659682946 PECOS PAC ID: 6305071317 Enrollment ID: I20131029001274 |
| Provider Name | Lauren V Delashmit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205188364 PECOS PAC ID: 0143457267 Enrollment ID: I20131217001837 |
| Provider Name | Sylvia A Poe-velasco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700144623 PECOS PAC ID: 4587892328 Enrollment ID: I20140124000685 |
| Provider Name | Tessia N Childs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164776415 PECOS PAC ID: 2365671526 Enrollment ID: I20140210001429 |
| Provider Name | Elizabeth A Brennan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093022246 PECOS PAC ID: 6002045929 Enrollment ID: I20140218001094 |
| Provider Name | Tara M Budetti |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285811059 PECOS PAC ID: 1052541307 Enrollment ID: I20140305002176 |
| Provider Name | Cora E Orphe Harris |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992859433 PECOS PAC ID: 8123259124 Enrollment ID: I20140314000763 |
| Provider Name | Kelly M Schober |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437186996 PECOS PAC ID: 2567694631 Enrollment ID: I20140404000611 |
| Provider Name | Karen Moser |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1760635478 PECOS PAC ID: 5991937211 Enrollment ID: I20140418000467 |
| Provider Name | Ting Y Tao |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144484601 PECOS PAC ID: 5092939355 Enrollment ID: I20140609000193 |
| Provider Name | Amy C Zimmermann |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1093925588 PECOS PAC ID: 7719101526 Enrollment ID: I20140618001373 |
| Provider Name | Robert J Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215350095 PECOS PAC ID: 8527283514 Enrollment ID: I20140708000321 |
| Provider Name | Mary M Henry |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1144283136 PECOS PAC ID: 7719140888 Enrollment ID: I20140710000907 |
| Provider Name | Lauren Rhae Draper |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043500416 PECOS PAC ID: 5890911127 Enrollment ID: I20140723001064 |
| Provider Name | Morgan A Baldwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295023836 PECOS PAC ID: 6406075696 Enrollment ID: I20140930001516 |
| Provider Name | Stephanie R Griesenauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730595711 PECOS PAC ID: 1456571090 Enrollment ID: I20141003000433 |
| Provider Name | Stephanie B Theut |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114077062 PECOS PAC ID: 4688770142 Enrollment ID: I20141003001306 |
| Provider Name | Brenton D Reading |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356556112 PECOS PAC ID: 9537389978 Enrollment ID: I20141006002426 |
| Provider Name | Barbara J Huelsmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568701886 PECOS PAC ID: 3375764723 Enrollment ID: I20141028001336 |
| Provider Name | Megan Gibbons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558765362 PECOS PAC ID: 7810119096 Enrollment ID: I20141104002149 |
| Provider Name | Elisa R Pincus |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548569734 PECOS PAC ID: 1254653488 Enrollment ID: I20141125001493 |
| Provider Name | Dawn M Spell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427452762 PECOS PAC ID: 5890017420 Enrollment ID: I20141209001822 |
| Provider Name | Heather J Mchughs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982984837 PECOS PAC ID: 3577888213 Enrollment ID: I20150220001442 |
| Provider Name | Dina R Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225150675 PECOS PAC ID: 3173779543 Enrollment ID: I20150223001530 |
| Provider Name | Brandy R Friemel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760888614 PECOS PAC ID: 8921324484 Enrollment ID: I20150302000204 |
| Provider Name | L R Scherer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154391142 PECOS PAC ID: 8729092176 Enrollment ID: I20150421001895 |
| Provider Name | Melanie A Hussey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134511132 PECOS PAC ID: 8325367139 Enrollment ID: I20150429000943 |
| Provider Name | Daniel K Holt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033420112 PECOS PAC ID: 6608005756 Enrollment ID: I20150504001270 |
| Provider Name | Deborah Goldberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326338849 PECOS PAC ID: 9436479318 Enrollment ID: I20150515001096 |
| Provider Name | Mark Miller Shuldberg |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1881905164 PECOS PAC ID: 8628398351 Enrollment ID: I20150521000157 |
| Provider Name | Sarah Starnes |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1215165410 PECOS PAC ID: 3274853825 Enrollment ID: I20150521000797 |
| Provider Name | Christopher Q Buchanan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952691404 PECOS PAC ID: 1456671635 Enrollment ID: I20150529001436 |
| Provider Name | Ann Ovbiye Idemundia |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235233545 PECOS PAC ID: 2860468071 Enrollment ID: I20150810001531 |
| Provider Name | Jennifer Kathryn Sehn |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1720372709 PECOS PAC ID: 6800053273 Enrollment ID: I20150908002582 |
| Provider Name | Wambui Waruingi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033313143 PECOS PAC ID: 4688808694 Enrollment ID: I20150914000476 |
| Provider Name | Jennifer G Ray |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437478476 PECOS PAC ID: 4385878743 Enrollment ID: I20151001001829 |
| Provider Name | Kathleen A Rinehart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326429275 PECOS PAC ID: 3779891221 Enrollment ID: I20151001002625 |
| Provider Name | Katherine E Gruenkemeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770723132 PECOS PAC ID: 5698084176 Enrollment ID: I20151023000841 |
| Provider Name | Timothy Walton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669423976 PECOS PAC ID: 4880903384 Enrollment ID: I20151023001661 |
| Provider Name | Anne C Walentik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174813133 PECOS PAC ID: 5890004121 Enrollment ID: I20151027001835 |
| Provider Name | Carl K Callahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750755849 PECOS PAC ID: 9830490788 Enrollment ID: I20151217001519 |
| Provider Name | Katherine E Milhouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407223647 PECOS PAC ID: 1456654078 Enrollment ID: I20160114001966 |
| Provider Name | Maureen M Mercier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396101135 PECOS PAC ID: 7517262074 Enrollment ID: I20160219002009 |
| Provider Name | Allison R Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114390663 PECOS PAC ID: 6305142787 Enrollment ID: I20160310001808 |
| Provider Name | Keith J Pereira |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1992092258 PECOS PAC ID: 1759690126 Enrollment ID: I20160318001302 |
| Provider Name | Kevin M Scharff |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780637553 PECOS PAC ID: 7517944267 Enrollment ID: I20160321001081 |
| Provider Name | Katherine E Schwetye |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1962780155 PECOS PAC ID: 4385934983 Enrollment ID: I20160610000885 |
| Provider Name | Michael J Schildz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427492024 PECOS PAC ID: 4587966973 Enrollment ID: I20160718000667 |
| Provider Name | Judith A Mead |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942273156 PECOS PAC ID: 1951347376 Enrollment ID: I20160815002230 |
| Provider Name | Debra W Emery |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356898928 PECOS PAC ID: 8527354877 Enrollment ID: I20160913000470 |
| Provider Name | Jessica Kesterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922455336 PECOS PAC ID: 7517254881 Enrollment ID: I20160930000147 |
| Provider Name | Laura R Slamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235529389 PECOS PAC ID: 9234427279 Enrollment ID: I20161007000104 |
| Provider Name | Douglas P Blackall |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1891885380 PECOS PAC ID: 0840192274 Enrollment ID: I20161024001102 |
| Provider Name | Anu R French |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386699767 PECOS PAC ID: 4082992904 Enrollment ID: I20161027002569 |
| Provider Name | Kelly K Devous |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710359047 PECOS PAC ID: 8527346196 Enrollment ID: I20161102001101 |
| Provider Name | Sarah K Burrus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033450697 PECOS PAC ID: 0648558221 Enrollment ID: I20161102001381 |
| Provider Name | Carmen Valero-aracama |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1962950816 PECOS PAC ID: 9234418799 Enrollment ID: I20161128001860 |
| Provider Name | Jessica L Meyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659823854 PECOS PAC ID: 9335429562 Enrollment ID: I20161206000887 |
| Provider Name | Judith D Brusatti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346695939 PECOS PAC ID: 4385924448 Enrollment ID: I20161206002422 |
| Provider Name | Jennifer M Burford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871045716 PECOS PAC ID: 7315227410 Enrollment ID: I20161208000849 |
| Provider Name | Lillian G Mcdonagh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669833174 PECOS PAC ID: 4789964487 Enrollment ID: I20161215002092 |
| Provider Name | Brianna Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174985493 PECOS PAC ID: 1658651351 Enrollment ID: I20161215002231 |
| Provider Name | Michelle L.j. Black |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356714893 PECOS PAC ID: 3375823982 Enrollment ID: I20161216000664 |
| Provider Name | Katherine R Forrester |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265775571 PECOS PAC ID: 7315249752 Enrollment ID: I20161216001627 |
| Provider Name | Qamar U Zaman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497036552 PECOS PAC ID: 9436451861 Enrollment ID: I20161219001581 |
| Provider Name | Karen H Pugh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629412481 PECOS PAC ID: 3476855925 Enrollment ID: I20161228000066 |
| Provider Name | Neil F Rebbe |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386627404 PECOS PAC ID: 4082995147 Enrollment ID: I20170103001290 |
| Provider Name | Chauncey D Tarrant |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154646156 PECOS PAC ID: 4486937091 Enrollment ID: I20170206001151 |
| Provider Name | Elinor F Hancock |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285743229 PECOS PAC ID: 6002193265 Enrollment ID: I20170426001485 |
| Provider Name | Emad Allam |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649566480 PECOS PAC ID: 4082916432 Enrollment ID: I20170509002419 |
| Provider Name | Margaret R Chen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356752679 PECOS PAC ID: 3971805326 Enrollment ID: I20170510002823 |
| Provider Name | Jennifer L Heithaus |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639468135 PECOS PAC ID: 3072815448 Enrollment ID: I20170608002235 |
| Provider Name | Samantha S Rohe |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568881746 PECOS PAC ID: 5294037750 Enrollment ID: I20170615000972 |
| Provider Name | Kelly F Hinman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831636000 PECOS PAC ID: 9931478872 Enrollment ID: I20170707002230 |
| Provider Name | Timothy C Lackey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679529382 PECOS PAC ID: 8628348109 Enrollment ID: I20170714002849 |
| Provider Name | Zachary P Englert |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306073614 PECOS PAC ID: 7113226374 Enrollment ID: I20170728002133 |
| Provider Name | Jennifer L Orbe |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629498555 PECOS PAC ID: 3678875101 Enrollment ID: I20170728002429 |
| Provider Name | Kathryn E Jackson |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1568697035 PECOS PAC ID: 9638486491 Enrollment ID: I20170731000467 |
| Provider Name | Jerome L Kao |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1306131974 PECOS PAC ID: 1355583709 Enrollment ID: I20170803002558 |
| Provider Name | Joseph E Muenster |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104246230 PECOS PAC ID: 6800168311 Enrollment ID: I20170817003866 |
| Provider Name | Elizabeth A Suba |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1891216123 PECOS PAC ID: 3476825738 Enrollment ID: I20170821003224 |
| Provider Name | Michelle Papachrisanthou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225019664 PECOS PAC ID: 8527331891 Enrollment ID: I20170907003344 |
| Provider Name | Kia S Lannaman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164786166 PECOS PAC ID: 6608172150 Enrollment ID: I20170907003562 |
| Provider Name | Sarah J Rollin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841304953 PECOS PAC ID: 6204837032 Enrollment ID: I20170920002947 |
| Provider Name | Namrata N Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841636867 PECOS PAC ID: 7810261450 Enrollment ID: I20170921000744 |
| Provider Name | William Robert Carter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912905563 PECOS PAC ID: 9830337286 Enrollment ID: I20170928002122 |
| Provider Name | Sandeep Madan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871523035 PECOS PAC ID: 8224067269 Enrollment ID: I20171025003260 |
| Provider Name | Joan T Murray |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942257225 PECOS PAC ID: 1456617513 Enrollment ID: I20171107001460 |
| Provider Name | Michael W Czajka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912941451 PECOS PAC ID: 3577829068 Enrollment ID: I20171116001757 |
| Provider Name | Kristy N Wienstroer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124530340 PECOS PAC ID: 3577820604 Enrollment ID: I20171128002632 |
| Provider Name | Amy E Mcalister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053822254 PECOS PAC ID: 6103183025 Enrollment ID: I20171201001159 |
| Provider Name | Ericka L Rutledge |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215448527 PECOS PAC ID: 6204195563 Enrollment ID: I20180111001567 |
| Provider Name | Shaheen I Umar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942466156 PECOS PAC ID: 6002008828 Enrollment ID: I20180305000323 |
| Provider Name | Mary Hoff |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730689100 PECOS PAC ID: 6608137765 Enrollment ID: I20180306001694 |
| Provider Name | Tiffany S Harold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083120208 PECOS PAC ID: 5890057350 Enrollment ID: I20180320003462 |
| Provider Name | Timothy M Phillips |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1992724595 PECOS PAC ID: 0143408252 Enrollment ID: I20180601002177 |
| Provider Name | Christopher A Brownsworth |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255628103 PECOS PAC ID: 8426282765 Enrollment ID: I20180614000721 |
| Provider Name | Perry C Morocco |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518357235 PECOS PAC ID: 2365744802 Enrollment ID: I20180628002083 |
| Provider Name | Jennifer A Aleshire |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447647243 PECOS PAC ID: 8820390289 Enrollment ID: I20180706001074 |
| Provider Name | Ali A Jamal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184980716 PECOS PAC ID: 0042514085 Enrollment ID: I20180709000210 |
| Provider Name | Michel J Adonis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497190854 PECOS PAC ID: 5991096380 Enrollment ID: I20180716000954 |
| Provider Name | Afsheen K Sherwani |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1174887921 PECOS PAC ID: 8123321007 Enrollment ID: I20180716002266 |
| Provider Name | Shannon M Grabosch |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1003136151 PECOS PAC ID: 3678792744 Enrollment ID: I20180723001874 |
| Provider Name | Damian R Lafitte |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568857027 PECOS PAC ID: 0648575662 Enrollment ID: I20180802002643 |
| Provider Name | Shamseldeen Y Mahmoud |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023438835 PECOS PAC ID: 0446521967 Enrollment ID: I20180810002865 |
| Provider Name | Ritu Bordia |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992064521 PECOS PAC ID: 9335365790 Enrollment ID: I20180823002272 |
| Provider Name | Paula A Casey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629107958 PECOS PAC ID: 0042390288 Enrollment ID: I20180828003696 |
| Provider Name | Amanda Rae Rohlfing |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083092365 PECOS PAC ID: 3779834023 Enrollment ID: I20180925003448 |
| Provider Name | Deporres Cormier |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801151881 PECOS PAC ID: 4385995505 Enrollment ID: I20180926002511 |
| Provider Name | Brian T Mcginn |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447683487 PECOS PAC ID: 4284955030 Enrollment ID: I20181128002586 |
| Provider Name | Amna Qureshi |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1437462918 PECOS PAC ID: 9537305396 Enrollment ID: I20181226002236 |
| Provider Name | John T Culhane |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821105628 PECOS PAC ID: 7911982467 Enrollment ID: I20181226002293 |
| Provider Name | Sherri S Besmer |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1922448976 PECOS PAC ID: 4385980648 Enrollment ID: I20190108003149 |
| Provider Name | Gillian Sloane Mayersohn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265917884 PECOS PAC ID: 4183960263 Enrollment ID: I20190110000785 |
| Provider Name | James A Thorp |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679511539 PECOS PAC ID: 8921104431 Enrollment ID: I20190114000319 |
| Provider Name | Anna M Shinneman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265901904 PECOS PAC ID: 1254670383 Enrollment ID: I20190306002828 |
| Provider Name | Sandra M Steele Rendon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740744499 PECOS PAC ID: 9537409818 Enrollment ID: I20190325000022 |
| Provider Name | Elyse A Shaw Ellis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255744785 PECOS PAC ID: 0749404135 Enrollment ID: I20190422000218 |
| Provider Name | Daniela Hermelin |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1396159091 PECOS PAC ID: 2961705017 Enrollment ID: I20190501000571 |
| Provider Name | Khang T Nguyen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568717114 PECOS PAC ID: 0840523890 Enrollment ID: I20190606002773 |
| Provider Name | Chen-wen C Heh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467449629 PECOS PAC ID: 6507885670 Enrollment ID: I20190617002326 |
| Provider Name | Jason R Bell |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1275899155 PECOS PAC ID: 5698077998 Enrollment ID: I20190627000656 |
| Provider Name | Luke J Weaver |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639532831 PECOS PAC ID: 8022305200 Enrollment ID: I20190819000407 |
| Provider Name | Vivian M Hathuc |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1073809182 PECOS PAC ID: 3577876044 Enrollment ID: I20191028002658 |
| Provider Name | Maria T Cabonce |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1417092941 PECOS PAC ID: 2961734678 Enrollment ID: I20191030001379 |
| Provider Name | Johanna B Lowell |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1750941589 PECOS PAC ID: 7810229226 Enrollment ID: I20191104001542 |
| Provider Name | Caryn E Yeager |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487166260 PECOS PAC ID: 3678905213 Enrollment ID: I20191119003222 |
| Provider Name | Julie A Thorne |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1821658659 PECOS PAC ID: 8022440676 Enrollment ID: I20191120000237 |
| Provider Name | Sherwin S Chan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023274677 PECOS PAC ID: 5991138158 Enrollment ID: I20191203001132 |
| Provider Name | Manish K Kotecha |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346496528 PECOS PAC ID: 1951447564 Enrollment ID: I20191203001157 |
| Provider Name | Julie M Mcalister |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1639214182 PECOS PAC ID: 6800229980 Enrollment ID: I20191203002082 |
| Provider Name | Grace Saeko Mitchell |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1295964666 PECOS PAC ID: 0345484861 Enrollment ID: I20191211001810 |
| Provider Name | Omar Maatouk |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720428915 PECOS PAC ID: 8325316458 Enrollment ID: I20191211001836 |
| Provider Name | Jason F Tobler |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1538305362 PECOS PAC ID: 4284872482 Enrollment ID: I20191211002506 |
| Provider Name | Heather A Berigan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700205184 PECOS PAC ID: 3971805433 Enrollment ID: I20200109001860 |
| Provider Name | Shannon W Longshore |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043292386 PECOS PAC ID: 2961636766 Enrollment ID: I20200123000596 |
| Provider Name | Keatyn Mcvietty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669019964 PECOS PAC ID: 0749617629 Enrollment ID: I20200305002811 |
| Provider Name | David Anthony Rodeberg |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124120290 PECOS PAC ID: 9537168653 Enrollment ID: I20200310002338 |
| Provider Name | Zoe M Preis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073150017 PECOS PAC ID: 3971931734 Enrollment ID: I20200310002393 |
| Provider Name | Zaria C Murrell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730130303 PECOS PAC ID: 4082657887 Enrollment ID: I20200312001121 |
| Provider Name | Jamal Al Taani |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1083819593 PECOS PAC ID: 7012002314 Enrollment ID: I20200317002491 |
| Provider Name | Brian S Dunoski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083933584 PECOS PAC ID: 4284758939 Enrollment ID: I20200323002826 |
| Provider Name | Laura N Dinneen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861466096 PECOS PAC ID: 7214366251 Enrollment ID: I20200326002230 |
| Provider Name | Amy N Dahl |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720200124 PECOS PAC ID: 4789862004 Enrollment ID: I20200402003212 |
| Provider Name | Kay L North |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1679503528 PECOS PAC ID: 2860821303 Enrollment ID: I20200403000339 |
| Provider Name | Erin Opfer |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1790764124 PECOS PAC ID: 1557790011 Enrollment ID: I20200403001036 |
| Provider Name | Mary C Monahan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558992826 PECOS PAC ID: 2769811918 Enrollment ID: I20200409000752 |
| Provider Name | Aimee Elizabeth Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982243721 PECOS PAC ID: 8921438763 Enrollment ID: I20200420001289 |
| Provider Name | Silvia Carnes |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1730379751 PECOS PAC ID: 1951731660 Enrollment ID: I20200421001296 |
| Provider Name | Mary K Riner |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1316137227 PECOS PAC ID: 5193155802 Enrollment ID: I20200421001533 |
| Provider Name | Chelsea Elaine Bertelsmann |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1558712547 PECOS PAC ID: 8729418439 Enrollment ID: I20200421001543 |
| Provider Name | Radu Serban |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1114231479 PECOS PAC ID: 3577705789 Enrollment ID: I20200505002694 |
| Provider Name | Bartholomew J Kane |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093839789 PECOS PAC ID: 6002982444 Enrollment ID: I20200507000696 |
| Provider Name | Ali A Malik |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1225391592 PECOS PAC ID: 1355611617 Enrollment ID: I20200509000225 |
| Provider Name | Mark C Stovroff |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750380689 PECOS PAC ID: 7810060308 Enrollment ID: I20200519001914 |
| Provider Name | Yasmine Astrid Fehr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134627730 PECOS PAC ID: 4385065234 Enrollment ID: I20200601001021 |
| Provider Name | Katherine Lynn-funkhouser Leger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144871658 PECOS PAC ID: 8426470774 Enrollment ID: I20200616000439 |
| Provider Name | Colleen Walsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497980387 PECOS PAC ID: 6901229491 Enrollment ID: I20200630002323 |
| Provider Name | Heather Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659904233 PECOS PAC ID: 4981029246 Enrollment ID: I20200803002700 |
| Provider Name | Leslie J Davis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083145601 PECOS PAC ID: 0244509438 Enrollment ID: I20200811003631 |
| Provider Name | Christopher John Blewett |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477524502 PECOS PAC ID: 1850490459 Enrollment ID: I20200812002589 |
| Provider Name | Elizabeth M Noonan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154852598 PECOS PAC ID: 1153699046 Enrollment ID: I20200819001479 |
| Provider Name | Grace Aurore Nicksa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528242294 PECOS PAC ID: 6507167301 Enrollment ID: I20200819003037 |
| Provider Name | Shin Miyata |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1538319959 PECOS PAC ID: 3375862782 Enrollment ID: I20200902001631 |
| Provider Name | Emily Michelle Ahmad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871875104 PECOS PAC ID: 1850710567 Enrollment ID: I20200930000569 |
| Provider Name | Rachel Marie Berkovich |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912167933 PECOS PAC ID: 1557500444 Enrollment ID: I20200930000873 |
| Provider Name | Janet W Kwan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598314213 PECOS PAC ID: 2961813985 Enrollment ID: I20201125002250 |
| Provider Name | Richard Scott Herman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972750289 PECOS PAC ID: 6305032988 Enrollment ID: I20210112000947 |
| Provider Name | Xavier Packianathan |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1669692059 PECOS PAC ID: 0345327623 Enrollment ID: I20210115000782 |
| Provider Name | Emily Orscheln |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356631444 PECOS PAC ID: 2567600141 Enrollment ID: I20210129002224 |
| Provider Name | Robert H Strashun |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720082324 PECOS PAC ID: 3870909328 Enrollment ID: I20210308000943 |
| Provider Name | Angela Nicole Lewis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508246778 PECOS PAC ID: 0244541779 Enrollment ID: I20210408002669 |
| Provider Name | Melissa Claire Gibson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1386234805 PECOS PAC ID: 9436567807 Enrollment ID: I20210423001202 |
| Provider Name | Johnston Fite |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760865984 PECOS PAC ID: 8224452586 Enrollment ID: I20210517002121 |
| Provider Name | Dale Katherine Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477781987 PECOS PAC ID: 1355567728 Enrollment ID: I20210528001026 |
| Provider Name | Emily Price |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285145367 PECOS PAC ID: 7911308333 Enrollment ID: I20210623001200 |
| Provider Name | Jessenia Guerrero |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1447646021 PECOS PAC ID: 1557762721 Enrollment ID: I20210624003246 |
| Provider Name | John Thomas Buelter |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548766405 PECOS PAC ID: 2062814528 Enrollment ID: I20210707001795 |
| Provider Name | Alexandra Elizabeth Bush-kaufman |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1538736574 PECOS PAC ID: 4082017744 Enrollment ID: I20210720000335 |
| Provider Name | Kaleigh Adrian |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225521644 PECOS PAC ID: 2466709233 Enrollment ID: I20210810001653 |
| Provider Name | Nabiha N Awan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902303555 PECOS PAC ID: 7810242997 Enrollment ID: I20210812001956 |
| Provider Name | Hayden W Head |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144401126 PECOS PAC ID: 2264558618 Enrollment ID: I20210818000713 |
| Provider Name | Alyssa Ann Faust |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720610355 PECOS PAC ID: 3971900416 Enrollment ID: I20210924002714 |
| Provider Name | Rachel Ruth Dunston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083383087 PECOS PAC ID: 6103224175 Enrollment ID: I20211005001964 |
| Provider Name | Jordan Ann Mondt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417610601 PECOS PAC ID: 2163810128 Enrollment ID: I20211022002364 |
| Provider Name | Kelly A Lucash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073289690 PECOS PAC ID: 8527457951 Enrollment ID: I20211105000584 |
| Provider Name | Jaime Renee Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992467625 PECOS PAC ID: 8123417417 Enrollment ID: I20211108000283 |
| Provider Name | Alexandra Marie Vohs |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043822711 PECOS PAC ID: 6305236969 Enrollment ID: I20211214001677 |
| Provider Name | Aditi Hendi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508127283 PECOS PAC ID: 9537306311 Enrollment ID: I20220104001541 |
| Provider Name | Lauren Burke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487314316 PECOS PAC ID: 5496147472 Enrollment ID: I20220125001669 |
| Provider Name | Kortny Dusek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770234734 PECOS PAC ID: 7618360975 Enrollment ID: I20220209000364 |
| Provider Name | Lori Paige Balchik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063054716 PECOS PAC ID: 7810380185 Enrollment ID: I20220209000640 |
| Provider Name | Christopher Keup |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861607665 PECOS PAC ID: 7517356165 Enrollment ID: I20220217000963 |
| Provider Name | Kelly Kapp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194472928 PECOS PAC ID: 7911392766 Enrollment ID: I20220315001238 |
| Provider Name | Laura Holzum |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770870776 PECOS PAC ID: 5991945784 Enrollment ID: I20220329001353 |
| Provider Name | Justin A. Sobrino |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396058871 PECOS PAC ID: 7618275926 Enrollment ID: I20220405000671 |
| Provider Name | Anastasia Lindsey Wexler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376028530 PECOS PAC ID: 8729330741 Enrollment ID: I20220518001878 |
| Provider Name | Hannah Rose Holtmeyer |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1487236568 PECOS PAC ID: 5890173256 Enrollment ID: I20220526001137 |
| Provider Name | Melissa Paige Harkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477293967 PECOS PAC ID: 9739567488 Enrollment ID: I20220608001253 |
| Provider Name | Peter Winningham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811239296 PECOS PAC ID: 5395046189 Enrollment ID: I20220609001482 |
| Provider Name | Rita Wyrebek |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831574326 PECOS PAC ID: 7113223850 Enrollment ID: I20220617000205 |
| Provider Name | Amanda Groebl Judilla |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225324569 PECOS PAC ID: 7315326584 Enrollment ID: I20220617000982 |
| Provider Name | Crystal Rochell Lucas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558093179 PECOS PAC ID: 7517349269 Enrollment ID: I20220728000672 |
| Provider Name | Maxwell Wallace |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588195267 PECOS PAC ID: 5890063788 Enrollment ID: I20220728002583 |
| Provider Name | Viet Le |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033504006 PECOS PAC ID: 1456667831 Enrollment ID: I20220805000561 |
| Provider Name | Mohammed A Siddiqui |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1508228669 PECOS PAC ID: 8820382328 Enrollment ID: I20220809001212 |
| Provider Name | Matthew Minnette |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114486115 PECOS PAC ID: 4880929637 Enrollment ID: I20220816001598 |
| Provider Name | Brian J Glen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043779044 PECOS PAC ID: 5698009793 Enrollment ID: I20220818002881 |
| Provider Name | Dazialee Goodwin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194491480 PECOS PAC ID: 4385028323 Enrollment ID: I20220825000887 |
| Provider Name | Carmen Fabiola Paredes Saenz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1649650722 PECOS PAC ID: 1951786607 Enrollment ID: I20220915001912 |
| Provider Name | Candace Danielle Benford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679205140 PECOS PAC ID: 9436535895 Enrollment ID: I20221007002695 |
| Provider Name | Ian Washington |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1568186203 PECOS PAC ID: 6901272947 Enrollment ID: I20221017002778 |
| Provider Name | Katherine Cecilia Wilson |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1801528195 PECOS PAC ID: 0042688590 Enrollment ID: I20221115001156 |
| Provider Name | Emily Madelyn Hollenkamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770735219 PECOS PAC ID: 0244609485 Enrollment ID: I20221212000555 |
| Provider Name | Kelsey J Lonergan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871126391 PECOS PAC ID: 1254700271 Enrollment ID: I20221214002523 |
| Provider Name | Sucheta Thekkedam |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639429897 PECOS PAC ID: 8325317571 Enrollment ID: I20221215002612 |
| Provider Name | Molly Kathleen Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164132700 PECOS PAC ID: 7517337264 Enrollment ID: I20221221002566 |
| Provider Name | Nedra Lynn Tanksley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265037428 PECOS PAC ID: 8921478231 Enrollment ID: I20230103001029 |
| Provider Name | Smruthi Sanath Kumar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750510640 PECOS PAC ID: 0244553733 Enrollment ID: I20230127001253 |
| Provider Name | Tiffany Marie Riffle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881309714 PECOS PAC ID: 1355713124 Enrollment ID: I20230206001089 |
| Provider Name | Jason Garnreiter |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790988962 PECOS PAC ID: 4789830944 Enrollment ID: I20230227001786 |
| Provider Name | Megan E Bush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205542586 PECOS PAC ID: 3971976523 Enrollment ID: I20230301000434 |
| Provider Name | Michelle Roberta White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609573823 PECOS PAC ID: 9436515830 Enrollment ID: I20230509001950 |
| Provider Name | Yoon Young Cho |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598299463 PECOS PAC ID: 2264813997 Enrollment ID: I20230510001277 |
| Provider Name | Laura Nicole Becker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023478344 PECOS PAC ID: 5698132108 Enrollment ID: I20230526001482 |
| Provider Name | Courtney Kovachevich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710688072 PECOS PAC ID: 3870950207 Enrollment ID: I20230531000464 |
| Provider Name | Emily Marie Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659061893 PECOS PAC ID: 0244697480 Enrollment ID: I20230605000302 |
| Provider Name | Christine Reitz |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1790487239 PECOS PAC ID: 7719352400 Enrollment ID: I20230613002262 |
| Provider Name | Julie Ann Steinberg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467972562 PECOS PAC ID: 1355709239 Enrollment ID: I20230626000842 |
| Provider Name | Leighia Mcghee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720750367 PECOS PAC ID: 7911396080 Enrollment ID: I20230630000453 |
| Provider Name | Aniruddh Setya |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1588914857 PECOS PAC ID: 2961756606 Enrollment ID: I20230710003588 |
| Provider Name | Erika Milbner Gotway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902505795 PECOS PAC ID: 4789043670 Enrollment ID: I20230711000511 |
| Provider Name | Alan Conrad Hauser |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134617160 PECOS PAC ID: 2062767874 Enrollment ID: I20230721001643 |
| Provider Name | Caitlin Swatek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225713696 PECOS PAC ID: 2466813654 Enrollment ID: I20230803004201 |
| Provider Name | Avner Meoded |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528479631 PECOS PAC ID: 5193001782 Enrollment ID: I20230804000515 |
| Provider Name | Brittany Ramos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609552850 PECOS PAC ID: 0941662837 Enrollment ID: I20230809001268 |
| Provider Name | Jenna Rebecca Berger |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659909026 PECOS PAC ID: 5395107031 Enrollment ID: I20230814000647 |
| Provider Name | Spenser Saville Hayward |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811496060 PECOS PAC ID: 3577945286 Enrollment ID: I20230918000855 |
| Provider Name | Kimberly R Hall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801305008 PECOS PAC ID: 3072967959 Enrollment ID: I20230926002995 |
| Provider Name | Grace Elise Monterubio |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982481222 PECOS PAC ID: 4688029051 Enrollment ID: I20231006000459 |
| Provider Name | Faith Wright |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1649959347 PECOS PAC ID: 4981059912 Enrollment ID: I20231011003810 |
| Provider Name | Josni Joseph |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932987393 PECOS PAC ID: 1355796103 Enrollment ID: I20231016000337 |
| Provider Name | Basheer Lotfi-fard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659598860 PECOS PAC ID: 4284829938 Enrollment ID: I20231026001837 |
| Provider Name | Elizabeth R Downey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740304948 PECOS PAC ID: 6800242736 Enrollment ID: I20231027002144 |
| Provider Name | Karthikeyan Vadakantharai Parameswaran |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194132662 PECOS PAC ID: 6103275979 Enrollment ID: I20231206001221 |
| Provider Name | Dean Trigg |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1427015833 PECOS PAC ID: 8224060439 Enrollment ID: I20231206002572 |
| Provider Name | Deanna Ronne |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1811535552 PECOS PAC ID: 5395197701 Enrollment ID: I20240122003605 |
| Provider Name | Amber Louise Oberlin |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1336849983 PECOS PAC ID: 0941653711 Enrollment ID: I20240129000644 |
| Provider Name | Cayce Hess |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1437921269 PECOS PAC ID: 1557705647 Enrollment ID: I20240216001091 |
| Provider Name | Daniel E Goldenberg |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295226132 PECOS PAC ID: 7719237429 Enrollment ID: I20240228003782 |
| Provider Name | Kathleen Anne Mckean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801657556 PECOS PAC ID: 1456797984 Enrollment ID: I20240307000198 |
| Provider Name | Emily Caufield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619515384 PECOS PAC ID: 8325484611 Enrollment ID: I20240308001939 |
| Provider Name | Sierra Jacquelynn Wineinger |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1770104283 PECOS PAC ID: 1557721941 Enrollment ID: I20240309000208 |
| Provider Name | Jesse B Garwood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265925010 PECOS PAC ID: 1951657113 Enrollment ID: I20240326002765 |
| Provider Name | Mary Brown Montgomery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114704996 PECOS PAC ID: 9032558762 Enrollment ID: I20240415001975 |
| Provider Name | Connor Corcoran |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205298593 PECOS PAC ID: 1355636861 Enrollment ID: I20240416004182 |
| Provider Name | Kristen Lynn Mueller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790549855 PECOS PAC ID: 2961842646 Enrollment ID: I20240429000891 |
| Provider Name | Vinod Alluri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548279870 PECOS PAC ID: 1254336357 Enrollment ID: I20240514002260 |
| Provider Name | David A Simon |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1306290374 PECOS PAC ID: 5496001141 Enrollment ID: I20240521002332 |
| Provider Name | Alyssa Mclellan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326803511 PECOS PAC ID: 9133561640 Enrollment ID: I20240530000166 |
| Provider Name | Carli J Elliott |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1972360741 PECOS PAC ID: 9739621400 Enrollment ID: I20240610001456 |
| Provider Name | Andrea Cassimatis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518710359 PECOS PAC ID: 5597209445 Enrollment ID: I20240702002383 |
| Provider Name | Astrid Herard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255598512 PECOS PAC ID: 0345435186 Enrollment ID: I20240729003539 |
| Provider Name | Ashley Shepard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194110197 PECOS PAC ID: 3577867092 Enrollment ID: I20240807002472 |
| Provider Name | Jordan Schaefer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629816962 PECOS PAC ID: 3375081508 Enrollment ID: I20240819002313 |
| Provider Name | Katie Elizabeth Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063250538 PECOS PAC ID: 9335687466 Enrollment ID: I20240820001894 |
| Provider Name | Julie Ann Bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912749532 PECOS PAC ID: 3577001619 Enrollment ID: I20240820002546 |
| Provider Name | Jagoda Siembida |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518428507 PECOS PAC ID: 6507305596 Enrollment ID: I20240821004824 |
| Provider Name | Angela Rahn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366289019 PECOS PAC ID: 0143769034 Enrollment ID: I20240822004028 |
| Provider Name | Kathleen A Judkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922074988 PECOS PAC ID: 1557800323 Enrollment ID: I20240823002800 |
| Provider Name | Haley Loyet |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467039800 PECOS PAC ID: 9931640141 Enrollment ID: I20240916000865 |
| Provider Name | Austin Brooke Weshinskey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801679360 PECOS PAC ID: 0749721314 Enrollment ID: I20240923002573 |
| Provider Name | Christina Renee Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114752607 PECOS PAC ID: 2062953482 Enrollment ID: I20240925000573 |
| Provider Name | Megan Mccollum |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649838327 PECOS PAC ID: 2466853064 Enrollment ID: I20241002000707 |
| Provider Name | Alaina Mcculla |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1073347456 PECOS PAC ID: 1850823121 Enrollment ID: I20241011003271 |
| Provider Name | Christina Nelson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1972337277 PECOS PAC ID: 7911430087 Enrollment ID: I20241028002290 |
| Provider Name | Michael Cerullo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649345026 PECOS PAC ID: 8123045648 Enrollment ID: I20241129000287 |
| Provider Name | Natalie Drury |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1003636457 PECOS PAC ID: 9739615436 Enrollment ID: I20241204003657 |
| Provider Name | Lauren G Hacker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063233781 PECOS PAC ID: 4688100696 Enrollment ID: I20241212004007 |
| Provider Name | Ramneesh Baweja |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548525413 PECOS PAC ID: 8729344874 Enrollment ID: I20241216003059 |
| Provider Name | Taha Ansari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538512629 PECOS PAC ID: 0749515948 Enrollment ID: I20241217000351 |
| Provider Name | Christian Maria Jackson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578142980 PECOS PAC ID: 1557898475 Enrollment ID: I20241217001056 |
| Provider Name | Amber Pollard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609694025 PECOS PAC ID: 4688101348 Enrollment ID: I20241219003051 |
| Provider Name | Lauro Amezcua-patino |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659364396 PECOS PAC ID: 1153385273 Enrollment ID: I20250122002444 |
| Provider Name | Laura Jean Cordonnier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992266993 PECOS PAC ID: 1658727482 Enrollment ID: I20250129003162 |
| Provider Name | Ashley Rose Prevallet |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1558192401 PECOS PAC ID: 3971033184 Enrollment ID: I20250203003152 |
| Provider Name | Andrea Hendricks |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1366284952 PECOS PAC ID: 4284164401 Enrollment ID: I20250203003514 |
| Provider Name | Georgia Haas |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1548023393 PECOS PAC ID: 7315467891 Enrollment ID: I20250227001615 |
| Provider Name | Vijay Phalgoo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538323951 PECOS PAC ID: 9931326097 Enrollment ID: I20250301000074 |
| Provider Name | Seth Jonathan Brownridge |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962550319 PECOS PAC ID: 3779004031 Enrollment ID: I20250304001179 |
| Provider Name | Kelsey Bruns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124849666 PECOS PAC ID: 0143741389 Enrollment ID: I20250305000136 |
| Provider Name | Alice Mckinzie |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720025075 PECOS PAC ID: 7012261167 Enrollment ID: I20250313000519 |
| Provider Name | Katherine Anne Johnson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1205477825 PECOS PAC ID: 8628590957 Enrollment ID: I20250317001843 |
| Provider Name | Kathryn Helen Kranbuhl |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629041884 PECOS PAC ID: 1658896352 Enrollment ID: I20250415002854 |
| Provider Name | Caydren Jones |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1750181947 PECOS PAC ID: 2567987431 Enrollment ID: I20250423002104 |
| Provider Name | Catalina Draghici |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255524930 PECOS PAC ID: 2961672704 Enrollment ID: I20250502001128 |
| Provider Name | Courtney Maxey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457169286 PECOS PAC ID: 5597283028 Enrollment ID: I20250519000604 |
| Provider Name | Brittney Danielle Byrth |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457910747 PECOS PAC ID: 4183133127 Enrollment ID: I20250602002700 |
| Provider Name | Yashar Fard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649746272 PECOS PAC ID: 0345665352 Enrollment ID: I20250604003826 |
Alliance Counseling Services Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8 Eagle Ctr Ste 4, O Fallon, IL 62269 Phone: 618-792-8256 | |
Larose Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7 Eagle Ctr Ste 2b, O Fallon, IL 62269 Phone: 618-342-7511 | |
Dwilson Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 640 Pierce Blvd Ste 200, O Fallon, IL 62269 Phone: 618-406-2490 | |
Leia Stein Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 785 Wall St Ste 200, O Fallon, IL 62269 Phone: 618-670-9069 | |
Coping With Choices Therapy Group Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1151 Boulder Creek Drive, Apt 104, O Fallon, IL 62269 Phone: 618-825-8173 | |
Precision Tms Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 640 Pierce Blvd Ste 100, O Fallon, IL 62269 Phone: 314-881-8671 Fax: 314-279-3199 |