| Holzer Clinic, Llc | |
|
100 Jackson Pike, Gallipolis, OH 45631-1560 | |
| (740) 446-5385 | |
| (740) 446-5310 |
| Full Name | Holzer Clinic, Llc |
|---|---|
| Type | Facility |
| Speciality | Clinic/center - Multi-specialty |
| Location | 100 Jackson Pike, Gallipolis, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508817248 | NPI | - | NPPES |
| 4046428 | Medicaid | OH | |
| 0006817002 | Medicaid | WV |
| Provider Name | John Sacco |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1336133685 PECOS PAC ID: 7214849686 Enrollment ID: I20031119000861 |
| Provider Name | Benjamin Goldman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831194109 PECOS PAC ID: 6800790908 Enrollment ID: I20031120000836 |
| Provider Name | Daniel J Hoffman |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1669464376 PECOS PAC ID: 5799689857 Enrollment ID: I20031121000069 |
| Provider Name | John R Kashubeck |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396702155 PECOS PAC ID: 6800798786 Enrollment ID: I20040122000011 |
| Provider Name | Marla G Haller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407951452 PECOS PAC ID: 2769385012 Enrollment ID: I20040202000664 |
| Provider Name | Naeem Akhtar Ali |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1073525309 PECOS PAC ID: 4688569247 Enrollment ID: I20040220000979 |
| Provider Name | Nitin Yogendra Bhatt |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1801809256 PECOS PAC ID: 7810883105 Enrollment ID: I20040224000812 |
| Provider Name | Edward A Dachowski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962478404 PECOS PAC ID: 0749171783 Enrollment ID: I20040322000298 |
| Provider Name | Martha Rachedi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295712784 PECOS PAC ID: 6204829351 Enrollment ID: I20040406000162 |
| Provider Name | Philip T Diaz |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1114930476 PECOS PAC ID: 0547255879 Enrollment ID: I20040416000946 |
| Provider Name | William A Ramsey |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1083655500 PECOS PAC ID: 8921096538 Enrollment ID: I20040503001525 |
| Provider Name | Margaret J Lionberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497709893 PECOS PAC ID: 8820088370 Enrollment ID: I20040516000000 |
| Provider Name | Christopher Bennet Clark |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1639123995 PECOS PAC ID: 5698766277 Enrollment ID: I20040521000678 |
| Provider Name | James J Sardo |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1992750145 PECOS PAC ID: 4880676675 Enrollment ID: I20040607000033 |
| Provider Name | Aundrea Jill Tipton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518975945 PECOS PAC ID: 7517940596 Enrollment ID: I20040610000957 |
| Provider Name | Robert Duane Mullins |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295792422 PECOS PAC ID: 7214910900 Enrollment ID: I20040611001527 |
| Provider Name | Vasantha Kumar |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1124084959 PECOS PAC ID: 8921083239 Enrollment ID: I20040622001271 |
| Provider Name | Aref Mahmoud Abou Amro |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1740266717 PECOS PAC ID: 3779568894 Enrollment ID: I20040622001707 |
| Provider Name | Edwin Hissa |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1124051081 PECOS PAC ID: 2264322858 Enrollment ID: I20040819001041 |
| Provider Name | Darren S Wamsley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407899792 PECOS PAC ID: 5294708673 Enrollment ID: I20040920000115 |
| Provider Name | Douglas Damien Massick |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1881666287 PECOS PAC ID: 9436119104 Enrollment ID: I20041017000002 |
| Provider Name | Syed Ashfaq Hussain Najeed |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1972560662 PECOS PAC ID: 3779545694 Enrollment ID: I20041102000621 |
| Provider Name | Raul J Gagucas |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1144273053 PECOS PAC ID: 0840253712 Enrollment ID: I20041111000092 |
| Provider Name | Choudhary Rayani |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1376596692 PECOS PAC ID: 7618924812 Enrollment ID: I20050331000037 |
| Provider Name | Stephen C Shy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598737991 PECOS PAC ID: 4789631987 Enrollment ID: I20050331000056 |
| Provider Name | Vijay Adusumilli |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487615647 PECOS PAC ID: 3375524754 Enrollment ID: I20050602000198 |
| Provider Name | Kevin R Bargmeyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467407874 PECOS PAC ID: 0446294961 Enrollment ID: I20050615000961 |
| Provider Name | Timothy Michael Peasak |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720142391 PECOS PAC ID: 0446242549 Enrollment ID: I20050802001399 |
| Provider Name | Khai T Vu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316912199 PECOS PAC ID: 9931125655 Enrollment ID: I20051021000043 |
| Provider Name | Robert Scott Bradley |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1194740266 PECOS PAC ID: 4385662915 Enrollment ID: I20051102000859 |
| Provider Name | Jared A Sheets |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023059227 PECOS PAC ID: 0941221907 Enrollment ID: I20051219000189 |
| Provider Name | Vinod Kunar Patwa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609811132 PECOS PAC ID: 1850312927 Enrollment ID: I20051221000093 |
| Provider Name | Imran Tasleem Minhas |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942288402 PECOS PAC ID: 7315960341 Enrollment ID: I20060105000364 |
| Provider Name | Jozefa M Hernon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336173533 PECOS PAC ID: 9638188105 Enrollment ID: I20060411000391 |
| Provider Name | Matthew C Exline |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1518918283 PECOS PAC ID: 3173536422 Enrollment ID: I20060803000237 |
| Provider Name | Danielle Theresa Cappelletti |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255362927 PECOS PAC ID: 7012912173 Enrollment ID: I20060922000443 |
| Provider Name | Jerome E Stasek |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1689642597 PECOS PAC ID: 4880690031 Enrollment ID: I20061011000035 |
| Provider Name | David G Johnson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235131848 PECOS PAC ID: 2668471855 Enrollment ID: I20061218000107 |
| Provider Name | Donald Michael Roach |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1376626507 PECOS PAC ID: 3870593551 Enrollment ID: I20070102000464 |
| Provider Name | John R Ellison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669427118 PECOS PAC ID: 1052371242 Enrollment ID: I20070314000178 |
| Provider Name | Khawaja K Hamid |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1326085374 PECOS PAC ID: 3375512361 Enrollment ID: I20070322000371 |
| Provider Name | Daniel Black |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1598719882 PECOS PAC ID: 3173624806 Enrollment ID: I20070725000644 |
| Provider Name | David V Blevins |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427002732 PECOS PAC ID: 0345201505 Enrollment ID: I20070725000655 |
| Provider Name | Mark G Christopher |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1699729913 PECOS PAC ID: 2668432857 Enrollment ID: I20070726000498 |
| Provider Name | Glenn A Fisher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245283621 PECOS PAC ID: 8921068107 Enrollment ID: I20070727000360 |
| Provider Name | Lyndon B Gaines |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225075260 PECOS PAC ID: 6507825999 Enrollment ID: I20070727000497 |
| Provider Name | Glen P Imlay |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1053364828 PECOS PAC ID: 1759342736 Enrollment ID: I20070730000570 |
| Provider Name | Nicolette M Jones |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1114974110 PECOS PAC ID: 9436128592 Enrollment ID: I20070730000639 |
| Provider Name | Il Hyong Kim |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396782314 PECOS PAC ID: 0648230003 Enrollment ID: I20070730000864 |
| Provider Name | Laurel A Kirkhart |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376583476 PECOS PAC ID: 1951360304 Enrollment ID: I20070731000315 |
| Provider Name | Ajay K Kottapalli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174560148 PECOS PAC ID: 3274502364 Enrollment ID: I20070731000360 |
| Provider Name | Phillip B Long |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770520330 PECOS PAC ID: 7517936461 Enrollment ID: I20070731000540 |
| Provider Name | Santpal S Mavi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1770534497 PECOS PAC ID: 9133198237 Enrollment ID: I20070801000444 |
| Provider Name | Michael C Myers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831139138 PECOS PAC ID: 6507835352 Enrollment ID: I20070801000707 |
| Provider Name | Bruce Pennington |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396785424 PECOS PAC ID: 5193794964 Enrollment ID: I20070801000827 |
| Provider Name | Kelly J Roush Icenhower |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1629018320 PECOS PAC ID: 4789775909 Enrollment ID: I20070802000213 |
| Provider Name | Dean A Siciliano |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699715300 PECOS PAC ID: 8022087808 Enrollment ID: I20070802000438 |
| Provider Name | Neesha Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063432771 PECOS PAC ID: 6406947670 Enrollment ID: I20070802000557 |
| Provider Name | Scott E Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275586695 PECOS PAC ID: 9638147572 Enrollment ID: I20070802000570 |
| Provider Name | Rodney Barry Stout |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1184668253 PECOS PAC ID: 5991774069 Enrollment ID: I20070802000626 |
| Provider Name | Jon M Sullivan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053341370 PECOS PAC ID: 9830168806 Enrollment ID: I20070803000587 |
| Provider Name | Robert T Townsend |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1861418493 PECOS PAC ID: 9032200035 Enrollment ID: I20070806000480 |
| Provider Name | William R Watts |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679500698 PECOS PAC ID: 2668464926 Enrollment ID: I20070806000589 |
| Provider Name | Louis Wickas |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1104861806 PECOS PAC ID: 7618068636 Enrollment ID: I20070806000612 |
| Provider Name | Shyam Bhakta |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1417094780 PECOS PAC ID: 5890887905 Enrollment ID: I20070822000083 |
| Provider Name | Gregory C Kloehn |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1740269711 PECOS PAC ID: 6002905866 Enrollment ID: I20071130000426 |
| Provider Name | Kelly Cremeans |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497937296 PECOS PAC ID: 3375624760 Enrollment ID: I20080110000714 |
| Provider Name | Patricia Lynne Debruin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083696215 PECOS PAC ID: 7517048028 Enrollment ID: I20080122000507 |
| Provider Name | Kimberly S Starks |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1033398219 PECOS PAC ID: 6800979394 Enrollment ID: I20080206000532 |
| Provider Name | Ming Zeng |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1275522435 PECOS PAC ID: 4789768912 Enrollment ID: I20080227000332 |
| Provider Name | Stephen S Henry |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1104845924 PECOS PAC ID: 3375644875 Enrollment ID: I20080320000610 |
| Provider Name | Mathew J Cosenza |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1356323000 PECOS PAC ID: 3072547744 Enrollment ID: I20080409000169 |
| Provider Name | Tammy Ball |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780855072 PECOS PAC ID: 2466530811 Enrollment ID: I20080424000714 |
| Provider Name | David B Grimm |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003906421 PECOS PAC ID: 5890793459 Enrollment ID: I20080506000189 |
| Provider Name | Seth Andrew Kearney |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1669492930 PECOS PAC ID: 2163426362 Enrollment ID: I20080617000506 |
| Provider Name | Troy Allen Schaffernocker |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1043434640 PECOS PAC ID: 1658442637 Enrollment ID: I20080618000685 |
| Provider Name | Glen Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124168406 PECOS PAC ID: 7517030117 Enrollment ID: I20080715000534 |
| Provider Name | Nathan Brummel |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1720203417 PECOS PAC ID: 9335213479 Enrollment ID: I20080807000196 |
| Provider Name | Loretta L Lauder |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1710903398 PECOS PAC ID: 9133295215 Enrollment ID: I20080915000314 |
| Provider Name | Jeri S Kitchen |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1073764775 PECOS PAC ID: 1951461508 Enrollment ID: I20081129000053 |
| Provider Name | Christopher Todd Marazon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700803699 PECOS PAC ID: 6204992100 Enrollment ID: I20090302000187 |
| Provider Name | Kyle Edward Mccausland |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932297934 PECOS PAC ID: 2264404433 Enrollment ID: I20090325000780 |
| Provider Name | Susan Fox-kuhner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265683163 PECOS PAC ID: 6406911288 Enrollment ID: I20090519000510 |
| Provider Name | Clyde J Rorrer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811944804 PECOS PAC ID: 2365348257 Enrollment ID: I20090520000053 |
| Provider Name | Diana Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295971661 PECOS PAC ID: 7113076027 Enrollment ID: I20090526000429 |
| Provider Name | Scott C Blair |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1922004399 PECOS PAC ID: 1759331317 Enrollment ID: I20090623000111 |
| Provider Name | Emily E Amin |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1689890071 PECOS PAC ID: 9830240092 Enrollment ID: I20090629000290 |
| Provider Name | Robert Lucas |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1780917302 PECOS PAC ID: 3375680820 Enrollment ID: I20091102000435 |
| Provider Name | Julie C Lew |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1932305273 PECOS PAC ID: 6002999547 Enrollment ID: I20091130000412 |
| Provider Name | Christopher A Lyons |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750612412 PECOS PAC ID: 8921143918 Enrollment ID: I20100302000423 |
| Provider Name | Amy B Hanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124251715 PECOS PAC ID: 8123157229 Enrollment ID: I20100528000126 |
| Provider Name | Shana A Vore |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144424698 PECOS PAC ID: 7719011055 Enrollment ID: I20100823000284 |
| Provider Name | Sheila Whiteley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629227798 PECOS PAC ID: 4082808613 Enrollment ID: I20101028000027 |
| Provider Name | Stephen Craig Kincaid |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1700958279 PECOS PAC ID: 8022205194 Enrollment ID: I20101215000611 |
| Provider Name | Amanda N Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164724787 PECOS PAC ID: 3375724628 Enrollment ID: I20110221000527 |
| Provider Name | Jamie Shaw Huffman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922318815 PECOS PAC ID: 4587840335 Enrollment ID: I20110512000565 |
| Provider Name | Lawand Saadulla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801009451 PECOS PAC ID: 0749313096 Enrollment ID: I20110624000416 |
| Provider Name | Sandra L Troester |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881986834 PECOS PAC ID: 5496923666 Enrollment ID: I20110714000685 |
| Provider Name | Jacob A Stollard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740574805 PECOS PAC ID: 7618145574 Enrollment ID: I20110719000808 |
| Provider Name | Nathan A Clark |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1588898373 PECOS PAC ID: 1153590468 Enrollment ID: I20110802000816 |
| Provider Name | Amy N Hendrix |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720288228 PECOS PAC ID: 2264601202 Enrollment ID: I20110809000707 |
| Provider Name | Adam D Ritchie |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356541858 PECOS PAC ID: 3678743101 Enrollment ID: I20110819000124 |
| Provider Name | Katherine J Kiger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790013720 PECOS PAC ID: 6305018797 Enrollment ID: I20111006000677 |
| Provider Name | Joanna Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073894242 PECOS PAC ID: 3173795929 Enrollment ID: I20111020000499 |
| Provider Name | David B Nash |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1578628400 PECOS PAC ID: 3274610746 Enrollment ID: I20120215000502 |
| Provider Name | Lauren F Goodman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1730303322 PECOS PAC ID: 1456515717 Enrollment ID: I20120618000257 |
| Provider Name | Michael Black |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588892194 PECOS PAC ID: 3870788177 Enrollment ID: I20120720000026 |
| Provider Name | Robert J Day |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558504837 PECOS PAC ID: 6507012606 Enrollment ID: I20120806000359 |
| Provider Name | Amanda N Mcconnell-mack |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740424076 PECOS PAC ID: 8729235619 Enrollment ID: I20120828000832 |
| Provider Name | Christy D Massie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972858843 PECOS PAC ID: 9436306115 Enrollment ID: I20120831000362 |
| Provider Name | Carlton W Herald |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053302836 PECOS PAC ID: 9739087867 Enrollment ID: I20130424000315 |
| Provider Name | Zena K Jalloh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083841357 PECOS PAC ID: 8123265535 Enrollment ID: I20130502000175 |
| Provider Name | Julio C Galindo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508144064 PECOS PAC ID: 8820239601 Enrollment ID: I20130719000512 |
| Provider Name | Vincent G Esguerra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598084220 PECOS PAC ID: 3779724539 Enrollment ID: I20130722000255 |
| Provider Name | Steven D. Conley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063673085 PECOS PAC ID: 7214176064 Enrollment ID: I20130723001056 |
| Provider Name | David M Smith |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689777070 PECOS PAC ID: 5092612358 Enrollment ID: I20130731000825 |
| Provider Name | Carleen Risaliti Spitzer |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1073832606 PECOS PAC ID: 2365683232 Enrollment ID: I20130801000453 |
| Provider Name | Robin M. Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598197618 PECOS PAC ID: 0446485890 Enrollment ID: I20131021001304 |
| Provider Name | Benjamin J Tishman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942508577 PECOS PAC ID: 3375778582 Enrollment ID: I20131024000348 |
| Provider Name | Theodore T Tanke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760788020 PECOS PAC ID: 9830339076 Enrollment ID: I20131113001121 |
| Provider Name | Elizabeth R Bolin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093144115 PECOS PAC ID: 4880824960 Enrollment ID: I20140312000416 |
| Provider Name | Christy L Walter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801859160 PECOS PAC ID: 2062479504 Enrollment ID: I20140327001947 |
| Provider Name | Sonal R Pannu |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1275751844 PECOS PAC ID: 3476609124 Enrollment ID: I20140327001983 |
| Provider Name | Charlotte Rose Barnhart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902128358 PECOS PAC ID: 3173755352 Enrollment ID: I20140423000525 |
| Provider Name | Katherine Holter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093139958 PECOS PAC ID: 9537384961 Enrollment ID: I20140627000552 |
| Provider Name | Michael J Wert |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1053636308 PECOS PAC ID: 9133360894 Enrollment ID: I20140709001832 |
| Provider Name | David T Rossi |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417377409 PECOS PAC ID: 2961628086 Enrollment ID: I20140725002376 |
| Provider Name | Jason J Cox |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1407088982 PECOS PAC ID: 1052538139 Enrollment ID: I20140813002179 |
| Provider Name | Megan G Lunsford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063811560 PECOS PAC ID: 7012138126 Enrollment ID: I20141014001892 |
| Provider Name | Karen Green |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659669646 PECOS PAC ID: 5294967170 Enrollment ID: I20141029000478 |
| Provider Name | Bobbi J. Lundy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609279363 PECOS PAC ID: 6002138146 Enrollment ID: I20141201001296 |
| Provider Name | Christine Pearl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194128561 PECOS PAC ID: 2264754225 Enrollment ID: I20141201002144 |
| Provider Name | Adam R Alley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356609390 PECOS PAC ID: 2961641642 Enrollment ID: I20141216001650 |
| Provider Name | Jonathan A Hess |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063770014 PECOS PAC ID: 7012156227 Enrollment ID: I20141216002424 |
| Provider Name | Tina M Perkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427453703 PECOS PAC ID: 9133442379 Enrollment ID: I20141219001360 |
| Provider Name | Rebecca J Stump |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164821930 PECOS PAC ID: 1355665225 Enrollment ID: I20150123002019 |
| Provider Name | Ali R Imani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285921858 PECOS PAC ID: 8325290760 Enrollment ID: I20150209002158 |
| Provider Name | Jeremy C Cuzzourt |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1013948694 PECOS PAC ID: 1153334487 Enrollment ID: I20150223001474 |
| Provider Name | Meredith Fallon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780071258 PECOS PAC ID: 1951622349 Enrollment ID: I20150610002633 |
| Provider Name | Muchun Tsai |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1285900845 PECOS PAC ID: 3870734585 Enrollment ID: I20150716002027 |
| Provider Name | Eugenia Kay Mccoy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003295270 PECOS PAC ID: 8022322080 Enrollment ID: I20150804005103 |
| Provider Name | Tina Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093191298 PECOS PAC ID: 1951619188 Enrollment ID: I20151007002250 |
| Provider Name | Susan L Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942678529 PECOS PAC ID: 9537479084 Enrollment ID: I20151112001488 |
| Provider Name | Chelsea Caldwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922470798 PECOS PAC ID: 3678873809 Enrollment ID: I20151119002259 |
| Provider Name | Heather Dawn Hartley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316322217 PECOS PAC ID: 7315247475 Enrollment ID: I20151123001304 |
| Provider Name | Brianne Willis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457723389 PECOS PAC ID: 9335440635 Enrollment ID: I20151210000641 |
| Provider Name | Julie L Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518336098 PECOS PAC ID: 6800197476 Enrollment ID: I20151228000389 |
| Provider Name | Joshua A Englert |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1881746584 PECOS PAC ID: 1658530662 Enrollment ID: I20160107000140 |
| Provider Name | Joellen Quillen |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1780011148 PECOS PAC ID: 0143522938 Enrollment ID: I20160111002577 |
| Provider Name | Chelsea Schott |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1558747469 PECOS PAC ID: 2961705298 Enrollment ID: I20160120002600 |
| Provider Name | Gretchen Hammond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467840975 PECOS PAC ID: 8325350267 Enrollment ID: I20160129001381 |
| Provider Name | Sherri Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447625033 PECOS PAC ID: 5496059313 Enrollment ID: I20160212000570 |
| Provider Name | Sarah A Leger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659764918 PECOS PAC ID: 1153641873 Enrollment ID: I20160317000392 |
| Provider Name | Suzanna Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861852139 PECOS PAC ID: 1355630658 Enrollment ID: I20160510000179 |
| Provider Name | John P Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508228412 PECOS PAC ID: 7517972573 Enrollment ID: I20160614000543 |
| Provider Name | Tammy Caudill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699139931 PECOS PAC ID: 3072805191 Enrollment ID: I20160711002393 |
| Provider Name | Tammy L Smathers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457708711 PECOS PAC ID: 6406149996 Enrollment ID: I20160720002892 |
| Provider Name | Stephanie Dewitt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063791689 PECOS PAC ID: 1254635212 Enrollment ID: I20160804001126 |
| Provider Name | Mohamedlatif Saiyad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619233061 PECOS PAC ID: 6002100955 Enrollment ID: I20160816000558 |
| Provider Name | Lynn A Fussner |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1548581200 PECOS PAC ID: 2163694266 Enrollment ID: I20160829001700 |
| Provider Name | Brittany Spencer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710338736 PECOS PAC ID: 3375839269 Enrollment ID: I20160831002850 |
| Provider Name | Tiffany Boggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073961678 PECOS PAC ID: 9335435577 Enrollment ID: I20160914001040 |
| Provider Name | Deron Hammack |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194963769 PECOS PAC ID: 9638363203 Enrollment ID: I20160920001771 |
| Provider Name | Rajesh Rajan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1154642098 PECOS PAC ID: 0941446645 Enrollment ID: I20160920002549 |
| Provider Name | Junyang Gong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801021183 PECOS PAC ID: 6406135763 Enrollment ID: I20161109002704 |
| Provider Name | Glenn Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093265837 PECOS PAC ID: 1456631902 Enrollment ID: I20161129002543 |
| Provider Name | Amber Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639629835 PECOS PAC ID: 3971883802 Enrollment ID: I20161209001180 |
| Provider Name | Ben O'kelly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912295338 PECOS PAC ID: 8527348432 Enrollment ID: I20161212002136 |
| Provider Name | David Paul Peasak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316987001 PECOS PAC ID: 9335137074 Enrollment ID: I20170105000032 |
| Provider Name | Paul Edmond Cowsar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245488410 PECOS PAC ID: 9032141106 Enrollment ID: I20170119000095 |
| Provider Name | Amy Parke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447557400 PECOS PAC ID: 8022390046 Enrollment ID: I20170126000679 |
| Provider Name | Robert Idzakovich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275994048 PECOS PAC ID: 6608159892 Enrollment ID: I20170214001381 |
| Provider Name | Tina Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326583196 PECOS PAC ID: 8820371743 Enrollment ID: I20170220000198 |
| Provider Name | Aasia Butt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053721803 PECOS PAC ID: 7719261999 Enrollment ID: I20170307002567 |
| Provider Name | Kelly Painter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699219469 PECOS PAC ID: 2264716380 Enrollment ID: I20170308001678 |
| Provider Name | Crystal Ferguson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497299770 PECOS PAC ID: 2668522871 Enrollment ID: I20170309001297 |
| Provider Name | Matthew Dawson |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1003159021 PECOS PAC ID: 9638475122 Enrollment ID: I20170720001340 |
| Provider Name | Angela Cox |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962825075 PECOS PAC ID: 2769612597 Enrollment ID: I20170724003191 |
| Provider Name | Clyde Jay Rorrer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255775235 PECOS PAC ID: 1759651771 Enrollment ID: I20170725001908 |
| Provider Name | Dustin L Peaytt |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609303437 PECOS PAC ID: 4587934203 Enrollment ID: I20170727003107 |
| Provider Name | Brian Torski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164709770 PECOS PAC ID: 5890934467 Enrollment ID: I20170809002612 |
| Provider Name | Jeffery D Kim |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1265725535 PECOS PAC ID: 3577702935 Enrollment ID: I20170810003580 |
| Provider Name | Nirav Parekh |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1053687053 PECOS PAC ID: 6406156611 Enrollment ID: I20170811002738 |
| Provider Name | Thomas Rittinger |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639242381 PECOS PAC ID: 2466351127 Enrollment ID: I20170814002959 |
| Provider Name | Ronald Brownfield |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730125766 PECOS PAC ID: 6507829769 Enrollment ID: I20170815004417 |
| Provider Name | Jennifer M. Calafato |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215353388 PECOS PAC ID: 0244534766 Enrollment ID: I20170828004184 |
| Provider Name | Zachary Orion Bosley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952717571 PECOS PAC ID: 2567762990 Enrollment ID: I20170906001555 |
| Provider Name | Tracy R Copley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114451143 PECOS PAC ID: 3577836634 Enrollment ID: I20170912001339 |
| Provider Name | Charles Zierenberg Garcia |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1801025200 PECOS PAC ID: 6103111448 Enrollment ID: I20170915003248 |
| Provider Name | Christina A Hively |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568980803 PECOS PAC ID: 4880968361 Enrollment ID: I20170921002806 |
| Provider Name | Emily L Ward |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629030218 PECOS PAC ID: 2264466184 Enrollment ID: I20170921003385 |
| Provider Name | Matthew J Comeau |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154345478 PECOS PAC ID: 9931495371 Enrollment ID: I20171128002040 |
| Provider Name | Lesley Newell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720591373 PECOS PAC ID: 1557620622 Enrollment ID: I20180117002328 |
| Provider Name | Ronald L Tawney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578062188 PECOS PAC ID: 2668734658 Enrollment ID: I20180403002533 |
| Provider Name | Rosanna Dillard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477052066 PECOS PAC ID: 4880957240 Enrollment ID: I20180417001875 |
| Provider Name | Samantha J Yelley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386050375 PECOS PAC ID: 7517220718 Enrollment ID: I20180423001711 |
| Provider Name | Kelsey L Black |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1538555768 PECOS PAC ID: 4789984592 Enrollment ID: I20180502000227 |
| Provider Name | Jarrod Gilmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982108718 PECOS PAC ID: 7113282773 Enrollment ID: I20180531002012 |
| Provider Name | Timothy D Webb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154721645 PECOS PAC ID: 1254628704 Enrollment ID: I20180626003681 |
| Provider Name | Kyle R Stinehart |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1437544681 PECOS PAC ID: 2961711460 Enrollment ID: I20180629002507 |
| Provider Name | Alexis A Cunningham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477937829 PECOS PAC ID: 4587912019 Enrollment ID: I20180731002604 |
| Provider Name | Jonathan Mathis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063890200 PECOS PAC ID: 0244540086 Enrollment ID: I20180802000620 |
| Provider Name | Ronnie Dale Roach |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1437232097 PECOS PAC ID: 2365466828 Enrollment ID: I20180806002944 |
| Provider Name | Emiley Niccole Houser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205321551 PECOS PAC ID: 8921358508 Enrollment ID: I20180830003639 |
| Provider Name | Antony Valentine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679956262 PECOS PAC ID: 1254637648 Enrollment ID: I20181001001746 |
| Provider Name | Elizabeth Nicole Butcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629558804 PECOS PAC ID: 5597000943 Enrollment ID: I20181213000834 |
| Provider Name | Tanya Danielle Mullins |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356798094 PECOS PAC ID: 0840578258 Enrollment ID: I20181214002507 |
| Provider Name | Karrie Joanne Lansing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497223192 PECOS PAC ID: 8921345927 Enrollment ID: I20190129003400 |
| Provider Name | Cynthia Dawn Jefferson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1194280321 PECOS PAC ID: 6406196203 Enrollment ID: I20190313002830 |
| Provider Name | Bridget Wilburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588133730 PECOS PAC ID: 6608117890 Enrollment ID: I20190417000499 |
| Provider Name | David A Kantorowitz |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1316959646 PECOS PAC ID: 3173416518 Enrollment ID: I20190418001298 |
| Provider Name | Nourhan Elmonoufy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700232360 PECOS PAC ID: 4587958186 Enrollment ID: I20190520002026 |
| Provider Name | Hannah Davidson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1538723283 PECOS PAC ID: 1658604046 Enrollment ID: I20190618002044 |
| Provider Name | Derrick D. Herman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1063755205 PECOS PAC ID: 0143459990 Enrollment ID: I20190627002069 |
| Provider Name | Joseph Stanley Bednash |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1114293677 PECOS PAC ID: 2264787456 Enrollment ID: I20190718003410 |
| Provider Name | Angela F Duhl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396245783 PECOS PAC ID: 6901947829 Enrollment ID: I20190719001774 |
| Provider Name | Jamie Mcgee |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922667740 PECOS PAC ID: 7517293210 Enrollment ID: I20190801000790 |
| Provider Name | Avraham Z. Cooper |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1871931501 PECOS PAC ID: 2860700309 Enrollment ID: I20190808002691 |
| Provider Name | Douglas M Poe |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457744435 PECOS PAC ID: 4385933613 Enrollment ID: I20190813003727 |
| Provider Name | Charles J Bishop |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1023428653 PECOS PAC ID: 2365779253 Enrollment ID: I20190815001597 |
| Provider Name | Melissa J Nibert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134789217 PECOS PAC ID: 8921336421 Enrollment ID: I20190821004137 |
| Provider Name | Marcello Delonardo Migliore |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457742314 PECOS PAC ID: 8426368127 Enrollment ID: I20190830002959 |
| Provider Name | Andrea Rae Roush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487206421 PECOS PAC ID: 0547599409 Enrollment ID: I20190903001589 |
| Provider Name | Andrew Martin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467848556 PECOS PAC ID: 3476806621 Enrollment ID: I20190916000240 |
| Provider Name | George Boutros |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609867423 PECOS PAC ID: 1759358591 Enrollment ID: I20191007003621 |
| Provider Name | Kristin Michele Lydick |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1588229090 PECOS PAC ID: 1052644689 Enrollment ID: I20191010000897 |
| Provider Name | Adrien J Brutus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740634963 PECOS PAC ID: 5496048597 Enrollment ID: I20191025002056 |
| Provider Name | Hannah Rose Bachtel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477105674 PECOS PAC ID: 1759714017 Enrollment ID: I20191127002415 |
| Provider Name | Jeffrey C Horowitz |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1619059524 PECOS PAC ID: 6204803208 Enrollment ID: I20191223001269 |
| Provider Name | Farah A Jama |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881056034 PECOS PAC ID: 3870883572 Enrollment ID: I20200117002300 |
| Provider Name | Kayla Spotts |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588295216 PECOS PAC ID: 3971930363 Enrollment ID: I20200225000594 |
| Provider Name | Agnes A Enrico-simon |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003910670 PECOS PAC ID: 3870526007 Enrollment ID: I20200320002552 |
| Provider Name | Mahija Kottapalli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366511271 PECOS PAC ID: 2163496985 Enrollment ID: I20200423003115 |
| Provider Name | Ernest Mckenzie |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548218993 PECOS PAC ID: 6800054875 Enrollment ID: I20200505003216 |
| Provider Name | Arindam Ghosh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184069791 PECOS PAC ID: 3173837119 Enrollment ID: I20200506002597 |
| Provider Name | John Brandenburg |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1912131079 PECOS PAC ID: 7719155639 Enrollment ID: I20200515001765 |
| Provider Name | Westley Cameron Mullins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093247348 PECOS PAC ID: 5496025835 Enrollment ID: I20200616003170 |
| Provider Name | Jennica N Johns |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1649615212 PECOS PAC ID: 0840429593 Enrollment ID: I20200629002776 |
| Provider Name | Randy Jackson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407470719 PECOS PAC ID: 4183047327 Enrollment ID: I20200707002719 |
| Provider Name | Arindam Singha |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1891114864 PECOS PAC ID: 9739406497 Enrollment ID: I20200707003347 |
| Provider Name | Elie L Homsy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1205178332 PECOS PAC ID: 0042447211 Enrollment ID: I20200714000904 |
| Provider Name | Jing G. Wang |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1891236733 PECOS PAC ID: 6709120603 Enrollment ID: I20200716003658 |
| Provider Name | Megan E Conroy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1104269851 PECOS PAC ID: 4981037579 Enrollment ID: I20200723002529 |
| Provider Name | Stella B Ogake |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1326468695 PECOS PAC ID: 2567752967 Enrollment ID: I20200730000391 |
| Provider Name | Jacob Pessia |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093248478 PECOS PAC ID: 8224388277 Enrollment ID: I20200813002025 |
| Provider Name | Katherine Ernst Frank |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285096453 PECOS PAC ID: 5799072427 Enrollment ID: I20200818003672 |
| Provider Name | Joseph Hossein Esmaeili |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124569330 PECOS PAC ID: 5597184556 Enrollment ID: I20200924003422 |
| Provider Name | Melissa D Burris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780299560 PECOS PAC ID: 2769802180 Enrollment ID: I20201022004004 |
| Provider Name | Robin Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245794049 PECOS PAC ID: 2567872682 Enrollment ID: I20201030002352 |
| Provider Name | Casey Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902412422 PECOS PAC ID: 0648680678 Enrollment ID: I20201103002182 |
| Provider Name | Christina D Richendollar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407451503 PECOS PAC ID: 2365855624 Enrollment ID: I20210105001311 |
| Provider Name | Brenda Jo Mershon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710597224 PECOS PAC ID: 9931428257 Enrollment ID: I20210122002533 |
| Provider Name | Vivek Verma |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1780926022 PECOS PAC ID: 8527308618 Enrollment ID: I20210127003428 |
| Provider Name | Erica Ryan Hersman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891398988 PECOS PAC ID: 1951715150 Enrollment ID: I20210129001226 |
| Provider Name | Marie Alyson Lear |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114388501 PECOS PAC ID: 8729493960 Enrollment ID: I20210219001511 |
| Provider Name | Amy Michelle Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134718182 PECOS PAC ID: 8426464801 Enrollment ID: I20210309003300 |
| Provider Name | Amy Maggard |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235686585 PECOS PAC ID: 8325456197 Enrollment ID: I20210415000604 |
| Provider Name | Rebecca Michelle Rankin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588244917 PECOS PAC ID: 3274932959 Enrollment ID: I20210528002474 |
| Provider Name | Lisa Dawn Stepp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801474622 PECOS PAC ID: 9537569280 Enrollment ID: I20210616003589 |
| Provider Name | Jonathan E Lackner |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1699790857 PECOS PAC ID: 2163503657 Enrollment ID: I20210616003685 |
| Provider Name | Nirpeksh Jain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649794603 PECOS PAC ID: 2264766443 Enrollment ID: I20210622001455 |
| Provider Name | Kevin Ho |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1194136101 PECOS PAC ID: 3375843113 Enrollment ID: I20210708000635 |
| Provider Name | Saad S Chaudhry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255836698 PECOS PAC ID: 6507113529 Enrollment ID: I20210721003482 |
| Provider Name | Robert Christopher Bowers |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841725058 PECOS PAC ID: 6709130800 Enrollment ID: I20210804001517 |
| Provider Name | Unknown Ul Hafeez Ul Hassan |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1891194957 PECOS PAC ID: 4183028731 Enrollment ID: I20210804003302 |
| Provider Name | Arthur Waverly Huntley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750871646 PECOS PAC ID: 3173860111 Enrollment ID: I20210805003586 |
| Provider Name | Stefanie K Wolf |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689028656 PECOS PAC ID: 7416240106 Enrollment ID: I20210810001989 |
| Provider Name | Brian Plants |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1841279361 PECOS PAC ID: 2365415361 Enrollment ID: I20210820002270 |
| Provider Name | Adriane Breshea Eastman-esmaeili |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1376030577 PECOS PAC ID: 8820494750 Enrollment ID: I20210901001302 |
| Provider Name | Susan M Kerns |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184085409 PECOS PAC ID: 6103182639 Enrollment ID: I20211116002036 |
| Provider Name | Jordon March |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1679009831 PECOS PAC ID: 8224427869 Enrollment ID: I20211227000459 |
| Provider Name | Chad Ball |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629628565 PECOS PAC ID: 2567895667 Enrollment ID: I20220114002277 |
| Provider Name | Harry R Parvey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326157454 PECOS PAC ID: 7214998244 Enrollment ID: I20220217002887 |
| Provider Name | Basem Alsarraj |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124381942 PECOS PAC ID: 3173820891 Enrollment ID: I20220228002387 |
| Provider Name | Angela Faith Ball |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386399863 PECOS PAC ID: 4385039742 Enrollment ID: I20220322000200 |
| Provider Name | Kiley Cosgrove |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073265518 PECOS PAC ID: 5294120689 Enrollment ID: I20220322001400 |
| Provider Name | Richard Ryan Dennison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881340180 PECOS PAC ID: 5496141210 Enrollment ID: I20220404002642 |
| Provider Name | Evelyn Corinne Stumbo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225618036 PECOS PAC ID: 9335535863 Enrollment ID: I20220408000475 |
| Provider Name | Fred Reed |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1396231833 PECOS PAC ID: 5496008641 Enrollment ID: I20220412001355 |
| Provider Name | Mohamed Suliman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912496514 PECOS PAC ID: 1951654078 Enrollment ID: I20220531001948 |
| Provider Name | Angela Faith Arnold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053055202 PECOS PAC ID: 3375923592 Enrollment ID: I20220706002334 |
| Provider Name | Joseph R Avila |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437475233 PECOS PAC ID: 9436392024 Enrollment ID: I20220711003738 |
| Provider Name | Chidoziri Conrad Nwokoro |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043751183 PECOS PAC ID: 3678843927 Enrollment ID: I20220720001157 |
| Provider Name | Tasha A Kashubeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528538832 PECOS PAC ID: 0749661684 Enrollment ID: I20220722002113 |
| Provider Name | Aron Hart |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770046724 PECOS PAC ID: 2466782172 Enrollment ID: I20220725000628 |
| Provider Name | Elena Hindh Noor Kwon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366563249 PECOS PAC ID: 5698824522 Enrollment ID: I20220802000765 |
| Provider Name | Gregory J Eisinger |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1689758500 PECOS PAC ID: 0446577548 Enrollment ID: I20220817001614 |
| Provider Name | Joshua Hall |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245896539 PECOS PAC ID: 2466835004 Enrollment ID: I20220817001762 |
| Provider Name | John Odackal |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1093177511 PECOS PAC ID: 2860785664 Enrollment ID: I20220817003003 |
| Provider Name | Jonathan Sedeyn |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851704217 PECOS PAC ID: 2264864297 Enrollment ID: I20220915000460 |
| Provider Name | Robert Onion |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1740778026 PECOS PAC ID: 4880947027 Enrollment ID: I20220915002541 |
| Provider Name | Milad Modarresi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1205367000 PECOS PAC ID: 3870978554 Enrollment ID: I20220915003464 |
| Provider Name | Brianna Purnell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568098630 PECOS PAC ID: 3577948801 Enrollment ID: I20220922000716 |
| Provider Name | Chelsea D Shepherd |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326577230 PECOS PAC ID: 5799051793 Enrollment ID: I20220928002751 |
| Provider Name | Sydney Stoops |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710640149 PECOS PAC ID: 6800272436 Enrollment ID: I20221004003103 |
| Provider Name | Breanna Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003556747 PECOS PAC ID: 7517333099 Enrollment ID: I20221025002382 |
| Provider Name | Courtney Michelle Abfall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528798261 PECOS PAC ID: 1254707623 Enrollment ID: I20221026002956 |
| Provider Name | Amy Nichole Mcfall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639802838 PECOS PAC ID: 6608243498 Enrollment ID: I20221108002076 |
| Provider Name | Kerry Dill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053032706 PECOS PAC ID: 0042687857 Enrollment ID: I20221108002579 |
| Provider Name | Jessica L Marcum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023742590 PECOS PAC ID: 6406224625 Enrollment ID: I20221119000104 |
| Provider Name | Courtney Marie Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649995994 PECOS PAC ID: 8224406111 Enrollment ID: I20221128000676 |
| Provider Name | Patrick E Ballard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982854980 PECOS PAC ID: 8729251103 Enrollment ID: I20230131002678 |
| Provider Name | Michael P Iannetti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396949889 PECOS PAC ID: 0547455784 Enrollment ID: I20230206002025 |
| Provider Name | Khadijeh Zarkoob |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1295705630 PECOS PAC ID: 1153343207 Enrollment ID: I20230207001244 |
| Provider Name | Brandon Lasseter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861104218 PECOS PAC ID: 8527430032 Enrollment ID: I20230209002587 |
| Provider Name | Alexandria Kincaid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518665868 PECOS PAC ID: 2567835879 Enrollment ID: I20230308000901 |
| Provider Name | Marwan Farhan Jarmakani |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1972572386 PECOS PAC ID: 4688754377 Enrollment ID: I20230308001209 |
| Provider Name | Jonna L Rice |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1790728087 PECOS PAC ID: 2365331709 Enrollment ID: I20230324000741 |
| Provider Name | Ian J Orozco |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1477688307 PECOS PAC ID: 8820180359 Enrollment ID: I20230324001363 |
| Provider Name | Vonda Kay Adkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205536919 PECOS PAC ID: 2163887043 Enrollment ID: I20230427002529 |
| Provider Name | Stanley Perecko |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255563474 PECOS PAC ID: 0143417295 Enrollment ID: I20230512001669 |
| Provider Name | Amarin Suriyakhamhaengwongse |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1477089316 PECOS PAC ID: 4183002256 Enrollment ID: I20230515001469 |
| Provider Name | Monica Jean Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912522442 PECOS PAC ID: 5294191953 Enrollment ID: I20230523000188 |
| Provider Name | Stephanie M. Yates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508555483 PECOS PAC ID: 7517324395 Enrollment ID: I20230609001680 |
| Provider Name | Matthew Shy-szuan Huang |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1013302579 PECOS PAC ID: 5698086130 Enrollment ID: I20230629002617 |
| Provider Name | Carissa Pessia |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1558873661 PECOS PAC ID: 9133487556 Enrollment ID: I20230711000246 |
| Provider Name | Robert Weaver |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750022554 PECOS PAC ID: 6305205105 Enrollment ID: I20230711001388 |
| Provider Name | Victoria Suzanne Howell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124711056 PECOS PAC ID: 0648630442 Enrollment ID: I20230712000774 |
| Provider Name | Mohammed Ali |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811540800 PECOS PAC ID: 5991126401 Enrollment ID: I20230719001082 |
| Provider Name | Daniel Argotte Vilchez |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1316329824 PECOS PAC ID: 2062701568 Enrollment ID: I20230721002210 |
| Provider Name | Kathleen Mccauley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558998633 PECOS PAC ID: 7214358837 Enrollment ID: I20230822002657 |
| Provider Name | Ethan Stephens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932723020 PECOS PAC ID: 1850713702 Enrollment ID: I20230822003040 |
| Provider Name | Andrea Merry-sperry |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609397926 PECOS PAC ID: 6103191705 Enrollment ID: I20230901003013 |
| Provider Name | Kelci Wanat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518742378 PECOS PAC ID: 9638533342 Enrollment ID: I20230914000471 |
| Provider Name | Lorie Lynn Siders |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1669019501 PECOS PAC ID: 3375979495 Enrollment ID: I20231006001280 |
| Provider Name | Adeniyi Ajenifuja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164805982 PECOS PAC ID: 2264788835 Enrollment ID: I20231009003042 |
| Provider Name | Megan Midkiff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578102778 PECOS PAC ID: 0446680581 Enrollment ID: I20231012001112 |
| Provider Name | Lou Potter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457530289 PECOS PAC ID: 4284789066 Enrollment ID: I20231012002314 |
| Provider Name | Kameron Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225718935 PECOS PAC ID: 9537514229 Enrollment ID: I20231016002612 |
| Provider Name | Taylor Renea Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053197699 PECOS PAC ID: 6507212883 Enrollment ID: I20231023001678 |
| Provider Name | John B Harley |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1619939295 PECOS PAC ID: 0244253532 Enrollment ID: I20231108002335 |
| Provider Name | Corey Johnson |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1811422900 PECOS PAC ID: 0143566521 Enrollment ID: I20231116002872 |
| Provider Name | Olusola Olubowale |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962923805 PECOS PAC ID: 9638593031 Enrollment ID: I20231121002234 |
| Provider Name | Omer Sheikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700373313 PECOS PAC ID: 0840649158 Enrollment ID: I20231212003159 |
| Provider Name | Tamara Martinez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851746739 PECOS PAC ID: 5597176370 Enrollment ID: I20231219002338 |
| Provider Name | Louis Gerena |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1588013221 PECOS PAC ID: 4082967922 Enrollment ID: I20240124001801 |
| Provider Name | Cathalene Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679342380 PECOS PAC ID: 4183067895 Enrollment ID: I20240209002228 |
| Provider Name | Cassandra K Walker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366940355 PECOS PAC ID: 7214381524 Enrollment ID: I20240216002905 |
| Provider Name | Adrienne Mays Kingston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457589079 PECOS PAC ID: 6305093055 Enrollment ID: I20240220002803 |
| Provider Name | Earl Michael Famularcano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407074867 PECOS PAC ID: 1355437997 Enrollment ID: I20240228004390 |
| Mailing Address | Practice Location Address |
|---|---|
| Holzer Clinic, Llc 90 Jackson Pike, Gallipolis, OH 45631-1560 Ph: (740) 446-5385 | Holzer Clinic, Llc 100 Jackson Pike, Gallipolis, OH 45631-1560 Ph: (740) 446-5385 |