| Advantage Health/saint Mary's Medical Group | |
|
245 State St Se Grand Rapids MI 49503-4328 | |
| (616) 685-8050 | |
| (616) 685-1850 |
| Full Name | Advantage Health/saint Mary's Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 245 State St Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | David Blair (MD/CMO) |
| Authorized Official Contact | 6166851808 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advantage Health/saint Mary's Medical Group 245 State St Se Grand Rapids MI 49503-4328 Ph: (616) 685-1808 | Advantage Health/saint Mary's Medical Group 245 State St Se Grand Rapids MI 49503-4328 Ph: (616) 685-8050 |
| NPI Number | 1376862151 |
|---|---|
| Provider Enumeration Date | 05/19/2010 |
| Last Update Date | 02/05/2015 |
| Medicare PECOS PAC ID | 4082807961 |
|---|---|
| Medicare Enrollment ID | O20101023000279 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376862151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Scott S Russo |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942298369 PECOS PAC ID: 6507760527 Enrollment ID: I20031121000488 |
| Provider Name | Peter Jl Jebson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1760578553 PECOS PAC ID: 4880599448 Enrollment ID: I20031205000452 |
| Provider Name | James P Twesten Otoole |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1174599344 PECOS PAC ID: 5193623825 Enrollment ID: I20031219000437 |
| Provider Name | Michelle C Klanke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851361802 PECOS PAC ID: 4981502887 Enrollment ID: I20031230000375 |
| Provider Name | Neil C Colegrove |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962455188 PECOS PAC ID: 0749181642 Enrollment ID: I20040114000684 |
| Provider Name | James M Kane |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1710090469 PECOS PAC ID: 8729973342 Enrollment ID: I20040223000129 |
| Provider Name | Stephen Winston |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1376509158 PECOS PAC ID: 2365338316 Enrollment ID: I20040302000672 |
| Provider Name | Eugene M Tay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275589863 PECOS PAC ID: 1759278963 Enrollment ID: I20040302001200 |
| Provider Name | Ho See C Chan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588617914 PECOS PAC ID: 5597653154 Enrollment ID: I20040306000050 |
| Provider Name | An G Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629024880 PECOS PAC ID: 4385532845 Enrollment ID: I20040306000144 |
| Provider Name | Rhoda Valdez Beltran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255382891 PECOS PAC ID: 5890683361 Enrollment ID: I20040306000172 |
| Provider Name | Denise D Gregory |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336195007 PECOS PAC ID: 2961390869 Enrollment ID: I20040310000670 |
| Provider Name | Lynn S Hedeman |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1497836282 PECOS PAC ID: 3577469865 Enrollment ID: I20040316001379 |
| Provider Name | Jaroslaw Mateuszczyk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003997230 PECOS PAC ID: 0941191134 Enrollment ID: I20040324001668 |
| Provider Name | Venkata R Jasty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184661670 PECOS PAC ID: 6608861844 Enrollment ID: I20040417000267 |
| Provider Name | Michael W Method |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1437153913 PECOS PAC ID: 5991794398 Enrollment ID: I20040511000365 |
| Provider Name | Margaret Rabish |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336230481 PECOS PAC ID: 3870582141 Enrollment ID: I20040512000691 |
| Provider Name | Jean B Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265488688 PECOS PAC ID: 0244211589 Enrollment ID: I20040525000254 |
| Provider Name | Kelly A O'sullivan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750332474 PECOS PAC ID: 1052392305 Enrollment ID: I20040525000344 |
| Provider Name | Troy D Silvernale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699855908 PECOS PAC ID: 8921089715 Enrollment ID: I20040527000374 |
| Provider Name | John E Vanschagen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144276411 PECOS PAC ID: 5698759140 Enrollment ID: I20040614001309 |
| Provider Name | David E Thompson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1972612919 PECOS PAC ID: 1658355532 Enrollment ID: I20040617000345 |
| Provider Name | Randall S Kuntzman |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1558471284 PECOS PAC ID: 0648254532 Enrollment ID: I20040617000429 |
| Provider Name | Jeffrey B Casamento |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1780607044 PECOS PAC ID: 9638154032 Enrollment ID: I20040621000913 |
| Provider Name | Paul N Rodriguez |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1790709996 PECOS PAC ID: 1951386358 Enrollment ID: I20040621000950 |
| Provider Name | Gregory L Miller |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306831185 PECOS PAC ID: 2961487038 Enrollment ID: I20040622001386 |
| Provider Name | Roger A Shammas |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346235595 PECOS PAC ID: 3375528094 Enrollment ID: I20040622001411 |
| Provider Name | Jayne E Courts |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518931500 PECOS PAC ID: 4486630241 Enrollment ID: I20040624000948 |
| Provider Name | Maureen B Pawloski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770574220 PECOS PAC ID: 1456337740 Enrollment ID: I20040628000457 |
| Provider Name | Leslie A Neuman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730146119 PECOS PAC ID: 3274511878 Enrollment ID: I20040709001372 |
| Provider Name | Jurgen Luders |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1609891704 PECOS PAC ID: 2860471810 Enrollment ID: I20040714001292 |
| Provider Name | Steve R Klafeta |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1033140868 PECOS PAC ID: 6800875451 Enrollment ID: I20040716000493 |
| Provider Name | Min Zhu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679513667 PECOS PAC ID: 7012996507 Enrollment ID: I20040719000056 |
| Provider Name | Gregory Pellizzon |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1932190345 PECOS PAC ID: 7719967850 Enrollment ID: I20040721000335 |
| Provider Name | William M Ahrens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417994088 PECOS PAC ID: 9032183504 Enrollment ID: I20040820000796 |
| Provider Name | Jaret A Beane |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972537876 PECOS PAC ID: 6901870419 Enrollment ID: I20040820001019 |
| Provider Name | Marc A Travis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497708366 PECOS PAC ID: 0648245886 Enrollment ID: I20040831000786 |
| Provider Name | Janine K Van Noord |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144276908 PECOS PAC ID: 0143297044 Enrollment ID: I20040910001039 |
| Provider Name | Kari R Formsma |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073572830 PECOS PAC ID: 3577530328 Enrollment ID: I20040913000467 |
| Provider Name | Marc Alan Hoeksema |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942202254 PECOS PAC ID: 2668440454 Enrollment ID: I20040920000855 |
| Provider Name | Timothy D Henne |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1730125428 PECOS PAC ID: 3577532829 Enrollment ID: I20041001001091 |
| Provider Name | Nasser Elsouri |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1609885151 PECOS PAC ID: 5395704704 Enrollment ID: I20041008001479 |
| Provider Name | Robert F Cali |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1750324794 PECOS PAC ID: 5991772857 Enrollment ID: I20041025000788 |
| Provider Name | Cornelius Robens |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538158688 PECOS PAC ID: 7214999036 Enrollment ID: I20041103000101 |
| Provider Name | David T Rispler |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1518901560 PECOS PAC ID: 1456326834 Enrollment ID: I20041104000653 |
| Provider Name | Pamela K Wirth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073566071 PECOS PAC ID: 5294799375 Enrollment ID: I20041118000062 |
| Provider Name | Noel Bell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1942249628 PECOS PAC ID: 2264498823 Enrollment ID: I20041206000296 |
| Provider Name | Patricia Reis Vanbaren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407809726 PECOS PAC ID: 1850357179 Enrollment ID: I20041208000096 |
| Provider Name | Wendy S Balivet |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972511400 PECOS PAC ID: 9133187776 Enrollment ID: I20041229000170 |
| Provider Name | Emily Adele Gualtieri-riley |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1124092275 PECOS PAC ID: 4486603529 Enrollment ID: I20050117000036 |
| Provider Name | Richard W Martin |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1215924642 PECOS PAC ID: 5991778359 Enrollment ID: I20050127000808 |
| Provider Name | Danette Clare Taylor |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1376624296 PECOS PAC ID: 1254383623 Enrollment ID: I20050214000574 |
| Provider Name | Kenneth W Beroza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760539803 PECOS PAC ID: 8921051509 Enrollment ID: I20050223000487 |
| Provider Name | Andrew John Livingston |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1689624017 PECOS PAC ID: 4688629587 Enrollment ID: I20050314000731 |
| Provider Name | Sajid Hussain |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073545133 PECOS PAC ID: 7719934546 Enrollment ID: I20050405000205 |
| Provider Name | Mark William Newberry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013962216 PECOS PAC ID: 0244287894 Enrollment ID: I20050405001306 |
| Provider Name | Steven N Triesenberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588645139 PECOS PAC ID: 7810888005 Enrollment ID: I20050504000395 |
| Provider Name | Steven J Dupuis |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1518906130 PECOS PAC ID: 2769422971 Enrollment ID: I20050506000531 |
| Provider Name | Jennifer G Hemingway |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275597635 PECOS PAC ID: 1254371461 Enrollment ID: I20050506000562 |
| Provider Name | Michael C Mccully |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790749042 PECOS PAC ID: 4486694601 Enrollment ID: I20050506000601 |
| Provider Name | Rebecca Jawahir Sypniewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326138900 PECOS PAC ID: 2163463886 Enrollment ID: I20050512000638 |
| Provider Name | Robert George Riekse |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1225081672 PECOS PAC ID: 6507800323 Enrollment ID: I20050613001293 |
| Provider Name | Tim Lenters |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1649211368 PECOS PAC ID: 1658360243 Enrollment ID: I20050616000576 |
| Provider Name | Rudolph O Addy |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1003839168 PECOS PAC ID: 8022053669 Enrollment ID: I20050623000450 |
| Provider Name | Prerana A Manohar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265423651 PECOS PAC ID: 1052356474 Enrollment ID: I20050624000972 |
| Provider Name | Wayne E Vanderkolk |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821094129 PECOS PAC ID: 6901842061 Enrollment ID: I20050629000845 |
| Provider Name | Mark J Ivey |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1962450981 PECOS PAC ID: 4981631884 Enrollment ID: I20050725000080 |
| Provider Name | Jeffrey J Vanwingen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053349993 PECOS PAC ID: 1153359450 Enrollment ID: I20050728000566 |
| Provider Name | Todd J Shomin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578635058 PECOS PAC ID: 6305874611 Enrollment ID: I20050728000683 |
| Provider Name | Gerald G Durfee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821040858 PECOS PAC ID: 5799714127 Enrollment ID: I20050805000811 |
| Provider Name | Amy Henne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104879592 PECOS PAC ID: 6507895828 Enrollment ID: I20050808000451 |
| Provider Name | James A Foote |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255372504 PECOS PAC ID: 8022047356 Enrollment ID: I20050808000487 |
| Provider Name | Lawrence R Hall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104994359 PECOS PAC ID: 2961431085 Enrollment ID: I20050809000928 |
| Provider Name | Erik W Kooyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700830684 PECOS PAC ID: 0345146726 Enrollment ID: I20050822000739 |
| Provider Name | Srinivas K Janardan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1770588279 PECOS PAC ID: 5597723726 Enrollment ID: I20050910000224 |
| Provider Name | Jay B Morrow |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1215932710 PECOS PAC ID: 8426080417 Enrollment ID: I20050910000237 |
| Provider Name | Lisa K Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366498131 PECOS PAC ID: 9830122878 Enrollment ID: I20050912000430 |
| Provider Name | Behrooz Shabahang |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1417980707 PECOS PAC ID: 7012992746 Enrollment ID: I20050914000695 |
| Provider Name | Mark A Fredrickson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356426712 PECOS PAC ID: 9739113770 Enrollment ID: I20050922000802 |
| Provider Name | Francis Hinsberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275574105 PECOS PAC ID: 5698709202 Enrollment ID: I20050922001150 |
| Provider Name | Thomas B Foster |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033183371 PECOS PAC ID: 1153356423 Enrollment ID: I20051005000876 |
| Provider Name | Hasan Shanawani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285643163 PECOS PAC ID: 3072580158 Enrollment ID: I20051021000702 |
| Provider Name | Rachel Noelle Dillbeck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275586356 PECOS PAC ID: 1456378652 Enrollment ID: I20051027000384 |
| Provider Name | Heather Joann Romero |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285680082 PECOS PAC ID: 9830112978 Enrollment ID: I20060104000582 |
| Provider Name | Robert John Fontana |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1700968237 PECOS PAC ID: 9234152026 Enrollment ID: I20060106000748 |
| Provider Name | Joseph M Corey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891884763 PECOS PAC ID: 4284658733 Enrollment ID: I20060123000982 |
| Provider Name | Shannon K English |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609820711 PECOS PAC ID: 1557335932 Enrollment ID: I20060126000800 |
| Provider Name | Jeffrey Andrew Hess |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1184679896 PECOS PAC ID: 9032123252 Enrollment ID: I20060126000827 |
| Provider Name | Mary J Niemeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477530475 PECOS PAC ID: 0446264154 Enrollment ID: I20060202000250 |
| Provider Name | Alden H Dykstra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427083757 PECOS PAC ID: 7911925078 Enrollment ID: I20060207000339 |
| Provider Name | Mary Br Clifton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255493086 PECOS PAC ID: 8224080452 Enrollment ID: I20060209000116 |
| Provider Name | Pamela K Van Dusen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700832995 PECOS PAC ID: 0244246460 Enrollment ID: I20060227000059 |
| Provider Name | Andola C Mathis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417994997 PECOS PAC ID: 6305852369 Enrollment ID: I20060228000495 |
| Provider Name | Laura Lynn Ackerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063449585 PECOS PAC ID: 2567479827 Enrollment ID: I20060310000245 |
| Provider Name | Zamir Gani Podgorica |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366416463 PECOS PAC ID: 7416966569 Enrollment ID: I20060418000371 |
| Provider Name | Shelley Lynn Freimark |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1386641892 PECOS PAC ID: 5890686760 Enrollment ID: I20060531000187 |
| Provider Name | Michael C Bishop |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316920614 PECOS PAC ID: 0648259663 Enrollment ID: I20060614000039 |
| Provider Name | Jaime Jo Halverson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447205273 PECOS PAC ID: 2062424385 Enrollment ID: I20060630000278 |
| Provider Name | Sasko Gjorgjievski |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558316356 PECOS PAC ID: 3577576065 Enrollment ID: I20060731000199 |
| Provider Name | Jane D Visser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518913961 PECOS PAC ID: 6901819499 Enrollment ID: I20060731000224 |
| Provider Name | Anita R Avery |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346293693 PECOS PAC ID: 5597778993 Enrollment ID: I20060802000244 |
| Provider Name | James P Passinault |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1225081490 PECOS PAC ID: 6406859347 Enrollment ID: I20060816000098 |
| Provider Name | Stephen Delapp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649298837 PECOS PAC ID: 0547263329 Enrollment ID: I20060816000523 |
| Provider Name | Geron D Turke |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003849308 PECOS PAC ID: 7315940194 Enrollment ID: I20060816000562 |
| Provider Name | Kevin R Kane |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477599207 PECOS PAC ID: 5395717623 Enrollment ID: I20060823000114 |
| Provider Name | Daniel K Borreson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245211796 PECOS PAC ID: 9739106568 Enrollment ID: I20060830000397 |
| Provider Name | Stanley R Sherman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831171826 PECOS PAC ID: 8527964923 Enrollment ID: I20060830000435 |
| Provider Name | John H Healey |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1578509303 PECOS PAC ID: 3577535806 Enrollment ID: I20060831000286 |
| Provider Name | Thomas E Hilts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306899935 PECOS PAC ID: 2264436419 Enrollment ID: I20060831000297 |
| Provider Name | Louis J Nykamp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053383919 PECOS PAC ID: 6608779962 Enrollment ID: I20060901000054 |
| Provider Name | Brian J Decker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801809157 PECOS PAC ID: 9335143429 Enrollment ID: I20060901000170 |
| Provider Name | Melissa M Winger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265453005 PECOS PAC ID: 3173527280 Enrollment ID: I20060901000332 |
| Provider Name | Frances G Chames |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902858608 PECOS PAC ID: 8820092950 Enrollment ID: I20060905000071 |
| Provider Name | Michael John Dejong |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609857143 PECOS PAC ID: 1254358096 Enrollment ID: I20060905000232 |
| Provider Name | Michael C Leahy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1922080910 PECOS PAC ID: 6608893441 Enrollment ID: I20060905000330 |
| Provider Name | Nasir A Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194779124 PECOS PAC ID: 3577567536 Enrollment ID: I20060905000430 |
| Provider Name | Kevin D Mcbride |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629024583 PECOS PAC ID: 2769486745 Enrollment ID: I20060906000014 |
| Provider Name | Brian J Stewart |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154377935 PECOS PAC ID: 9739119868 Enrollment ID: I20060906000021 |
| Provider Name | Ruggero Battan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1134150147 PECOS PAC ID: 0840294831 Enrollment ID: I20060906000033 |
| Provider Name | Philip J Baty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518918499 PECOS PAC ID: 3375547367 Enrollment ID: I20060906000050 |
| Provider Name | Jill K Bultje |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568414241 PECOS PAC ID: 7719981703 Enrollment ID: I20060906000072 |
| Provider Name | Peter S Ritsema |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235185067 PECOS PAC ID: 2163426156 Enrollment ID: I20060906000084 |
| Provider Name | Jonathan J Krieger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255385142 PECOS PAC ID: 7517961519 Enrollment ID: I20060906000202 |
| Provider Name | Fredric A Reyelts |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1285687467 PECOS PAC ID: 9234133232 Enrollment ID: I20060906000217 |
| Provider Name | Adriana S Tanner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386684256 PECOS PAC ID: 5294639928 Enrollment ID: I20060906000453 |
| Provider Name | Liton S Mecano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831142306 PECOS PAC ID: 1153325014 Enrollment ID: I20060907000095 |
| Provider Name | Steven R Ashmead |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710931704 PECOS PAC ID: 2769486620 Enrollment ID: I20060907000117 |
| Provider Name | Sally L Kliphuis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114979929 PECOS PAC ID: 8022012996 Enrollment ID: I20060907000216 |
| Provider Name | Rhonda L Mejeur |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790738193 PECOS PAC ID: 4587668330 Enrollment ID: I20060908000353 |
| Provider Name | Kerry L Gorsuch |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952332769 PECOS PAC ID: 3678577475 Enrollment ID: I20060911000185 |
| Provider Name | Sejal P Bennett |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508881616 PECOS PAC ID: 9931103736 Enrollment ID: I20060911000195 |
| Provider Name | Mark L Jary |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467407049 PECOS PAC ID: 1557365350 Enrollment ID: I20060911000213 |
| Provider Name | David E Blair |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518910900 PECOS PAC ID: 9638162456 Enrollment ID: I20060911000233 |
| Provider Name | Gerald S Witherell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114970126 PECOS PAC ID: 0840294658 Enrollment ID: I20060911000291 |
| Provider Name | Joseph S Polizzi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538115357 PECOS PAC ID: 6901800713 Enrollment ID: I20060911000319 |
| Provider Name | Ronald S Duemler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679524284 PECOS PAC ID: 0143224964 Enrollment ID: I20060911000358 |
| Provider Name | Kimberly G Turke |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1083667968 PECOS PAC ID: 4385648062 Enrollment ID: I20060912000177 |
| Provider Name | Mark L Joseph |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033164744 PECOS PAC ID: 5890799399 Enrollment ID: I20060913000530 |
| Provider Name | John H Schneider |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588689210 PECOS PAC ID: 8123023611 Enrollment ID: I20060915000087 |
| Provider Name | Heather N Bunting |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881645422 PECOS PAC ID: 4183629686 Enrollment ID: I20060915000130 |
| Provider Name | Jody L Banister |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881647501 PECOS PAC ID: 8325043821 Enrollment ID: I20060915000149 |
| Provider Name | Bryan E Hull |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639124324 PECOS PAC ID: 0749285245 Enrollment ID: I20060915000175 |
| Provider Name | Helen Patricia Scott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043266844 PECOS PAC ID: 3072518588 Enrollment ID: I20060915000218 |
| Provider Name | Mohammad I Saleh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992751739 PECOS PAC ID: 6608871116 Enrollment ID: I20060915000229 |
| Provider Name | Constance M Leahy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164477204 PECOS PAC ID: 6406851955 Enrollment ID: I20060915000515 |
| Provider Name | Mark T Spoolstra |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1912953662 PECOS PAC ID: 6709881188 Enrollment ID: I20060918000178 |
| Provider Name | Daniel R Harro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790730505 PECOS PAC ID: 8527063916 Enrollment ID: I20060918000292 |
| Provider Name | Paul D Harris |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1033144266 PECOS PAC ID: 6406851898 Enrollment ID: I20060918000312 |
| Provider Name | Geoffrey A Sandman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1760481782 PECOS PAC ID: 4587669973 Enrollment ID: I20060918000321 |
| Provider Name | Gregory J Vanwienen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194771972 PECOS PAC ID: 1759386147 Enrollment ID: I20060918000335 |
| Provider Name | John A Cavacece |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093768244 PECOS PAC ID: 3375548761 Enrollment ID: I20060918000347 |
| Provider Name | Laurie J Daum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457302184 PECOS PAC ID: 8820093214 Enrollment ID: I20060918000354 |
| Provider Name | Kevin T Foley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750335865 PECOS PAC ID: 5890790299 Enrollment ID: I20060918000380 |
| Provider Name | Terrence P Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124056643 PECOS PAC ID: 6204848492 Enrollment ID: I20060921000541 |
| Provider Name | Paul C Elsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073567178 PECOS PAC ID: 6002811072 Enrollment ID: I20060926000057 |
| Provider Name | Barbara Elizabeth Stanford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063438844 PECOS PAC ID: 7416952130 Enrollment ID: I20061002000047 |
| Provider Name | Brian A Buckler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154344398 PECOS PAC ID: 7810993409 Enrollment ID: I20061004000270 |
| Provider Name | Nnaemeka Ekekwe Egwuatu |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1588686695 PECOS PAC ID: 3971539982 Enrollment ID: I20061012000494 |
| Provider Name | Trisha L Zylstra |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134223779 PECOS PAC ID: 6002813581 Enrollment ID: I20061025000533 |
| Provider Name | Jennifer M Lachapell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396773594 PECOS PAC ID: 6305844481 Enrollment ID: I20061128000323 |
| Provider Name | Robert E Reneker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972529014 PECOS PAC ID: 9739188525 Enrollment ID: I20061205000174 |
| Provider Name | Rafael E Bilbao |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164565974 PECOS PAC ID: 1850495136 Enrollment ID: I20070326000416 |
| Provider Name | Channing E Finkbeiner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225050701 PECOS PAC ID: 6608970447 Enrollment ID: I20070403000551 |
| Provider Name | Minerva A Galang |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1467510933 PECOS PAC ID: 1355445016 Enrollment ID: I20070406000091 |
| Provider Name | Emilie M Collins |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1104942085 PECOS PAC ID: 7315047370 Enrollment ID: I20070705000518 |
| Provider Name | Marc Ydenberg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912928110 PECOS PAC ID: 7810097797 Enrollment ID: I20070706000069 |
| Provider Name | Aaron T Eggebeen |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1629194352 PECOS PAC ID: 8022118421 Enrollment ID: I20070714000040 |
| Provider Name | Jamie L Caughran |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215156336 PECOS PAC ID: 9931200532 Enrollment ID: I20070726000543 |
| Provider Name | David Robert Meyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487875076 PECOS PAC ID: 9234221227 Enrollment ID: I20070822000903 |
| Provider Name | Maha Ayashi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134257694 PECOS PAC ID: 7416040787 Enrollment ID: I20070831000151 |
| Provider Name | Alexander W Runowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154439339 PECOS PAC ID: 3779677851 Enrollment ID: I20070920000113 |
| Provider Name | Alanna J Wiarda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306067053 PECOS PAC ID: 0446345045 Enrollment ID: I20070927000332 |
| Provider Name | Lisa J Kinsey Callaway |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821105982 PECOS PAC ID: 0042226896 Enrollment ID: I20071004000184 |
| Provider Name | Christopher C Glisson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932254745 PECOS PAC ID: 9032204953 Enrollment ID: I20071005000739 |
| Provider Name | Wendy A Falkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932311057 PECOS PAC ID: 8820184435 Enrollment ID: I20071012000137 |
| Provider Name | Jeffery L Chamberlain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790905214 PECOS PAC ID: 8224124789 Enrollment ID: I20071012000681 |
| Provider Name | Jayaseeli Bastin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437365897 PECOS PAC ID: 4981791878 Enrollment ID: I20071024000239 |
| Provider Name | Tami L Nysse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104005560 PECOS PAC ID: 3577643543 Enrollment ID: I20080103000097 |
| Provider Name | Julie M Bourbonnais |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1487781795 PECOS PAC ID: 5092895631 Enrollment ID: I20080108000628 |
| Provider Name | Stephen C Dalm |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114028255 PECOS PAC ID: 2769562255 Enrollment ID: I20080109000792 |
| Provider Name | Sayeema Daudi |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1174731046 PECOS PAC ID: 9234210295 Enrollment ID: I20080115000838 |
| Provider Name | Tricia L Mueller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558589374 PECOS PAC ID: 8224114558 Enrollment ID: I20080326000597 |
| Provider Name | Chad A Friend |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396952065 PECOS PAC ID: 6305918533 Enrollment ID: I20080707000245 |
| Provider Name | Courtney A Soubliere |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1275748121 PECOS PAC ID: 2264505205 Enrollment ID: I20080723000755 |
| Provider Name | Mario M Cesario |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124093679 PECOS PAC ID: 7517853112 Enrollment ID: I20080802000045 |
| Provider Name | Melanie L Ranta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316990757 PECOS PAC ID: 9436224789 Enrollment ID: I20080820000646 |
| Provider Name | Karen B Foley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295854842 PECOS PAC ID: 3274609557 Enrollment ID: I20080910000587 |
| Provider Name | Rachel M Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598849796 PECOS PAC ID: 9234206152 Enrollment ID: I20080918000474 |
| Provider Name | Stacyann Steen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699768820 PECOS PAC ID: 1658272042 Enrollment ID: I20081118000581 |
| Provider Name | Dandrea M Heeres |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548480197 PECOS PAC ID: 6901966035 Enrollment ID: I20081119000818 |
| Provider Name | Kipp L Chillag |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518931245 PECOS PAC ID: 1052471844 Enrollment ID: I20081124000666 |
| Provider Name | Hari Sree Conjeevaram |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1831271360 PECOS PAC ID: 9537254230 Enrollment ID: I20081212000583 |
| Provider Name | James D Hudson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881649598 PECOS PAC ID: 2567524101 Enrollment ID: I20081216000554 |
| Provider Name | Randal S Baker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104867480 PECOS PAC ID: 3173687704 Enrollment ID: I20090127000438 |
| Provider Name | Paul R Kemmeter |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548217946 PECOS PAC ID: 8628132255 Enrollment ID: I20090128000371 |
| Provider Name | Laura M Doherty |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629123435 PECOS PAC ID: 2062578073 Enrollment ID: I20090226000576 |
| Provider Name | Eryn C Quinn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568427763 PECOS PAC ID: 6204853617 Enrollment ID: I20090323000286 |
| Provider Name | Julia K Walters |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1467636811 PECOS PAC ID: 1557418456 Enrollment ID: I20090410000161 |
| Provider Name | Raymond J Jaglowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538192935 PECOS PAC ID: 9537217260 Enrollment ID: I20090506000237 |
| Provider Name | Susan E Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275773574 PECOS PAC ID: 4789733163 Enrollment ID: I20090513000479 |
| Provider Name | Terri Lynn Bott-kothari |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1558386607 PECOS PAC ID: 0648342998 Enrollment ID: I20090528000618 |
| Provider Name | Daniel J Rupke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447394879 PECOS PAC ID: 3274697131 Enrollment ID: I20090609000327 |
| Provider Name | Michael S Jakubowski |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1104863646 PECOS PAC ID: 0244387660 Enrollment ID: I20090709000610 |
| Provider Name | Susan M Terrell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891903480 PECOS PAC ID: 3577616952 Enrollment ID: I20090803000196 |
| Provider Name | Terence A Hambleton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306901632 PECOS PAC ID: 4688727977 Enrollment ID: I20090804000518 |
| Provider Name | Laura M Bennington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841473998 PECOS PAC ID: 8628121811 Enrollment ID: I20090805000738 |
| Provider Name | Patrick J Fitzgibbon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902025760 PECOS PAC ID: 6406909498 Enrollment ID: I20090810000293 |
| Provider Name | Anna A Papes |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679791784 PECOS PAC ID: 8426102401 Enrollment ID: I20090811000475 |
| Provider Name | Kelly S Wiersema |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902023575 PECOS PAC ID: 3678627437 Enrollment ID: I20090813000700 |
| Provider Name | Muhammad U Farooq |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598945156 PECOS PAC ID: 8729132857 Enrollment ID: I20090824000545 |
| Provider Name | Andrew P Jameson |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1770781890 PECOS PAC ID: 7012062003 Enrollment ID: I20090826000831 |
| Provider Name | Nicholas J Schneider |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841312949 PECOS PAC ID: 2062567910 Enrollment ID: I20090828000534 |
| Provider Name | Kyle A Rasikas |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1114034162 PECOS PAC ID: 4082515366 Enrollment ID: I20090904000422 |
| Provider Name | Jillaine Ruppel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780816520 PECOS PAC ID: 9931255106 Enrollment ID: I20090914000607 |
| Provider Name | Jeffrey H Kramer |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1306889100 PECOS PAC ID: 9234275686 Enrollment ID: I20091015000285 |
| Provider Name | Derek T Nagle |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942413844 PECOS PAC ID: 9335286103 Enrollment ID: I20091027000752 |
| Provider Name | Marie W Vanderlinde |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467456129 PECOS PAC ID: 7911049796 Enrollment ID: I20100115000698 |
| Provider Name | Gwen Marie Brandt |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1316093529 PECOS PAC ID: 7911049713 Enrollment ID: I20100115000813 |
| Provider Name | Herman C Sullivan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528008281 PECOS PAC ID: 6608954649 Enrollment ID: I20100305000394 |
| Provider Name | Susan K Owen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871820514 PECOS PAC ID: 6204962020 Enrollment ID: I20100331000948 |
| Provider Name | Eric C Bouwens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336143965 PECOS PAC ID: 4981733664 Enrollment ID: I20100519000474 |
| Provider Name | Rick D Saier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750459285 PECOS PAC ID: 6002946233 Enrollment ID: I20100614000682 |
| Provider Name | Mark G Kanitz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023036563 PECOS PAC ID: 2769513639 Enrollment ID: I20100622000462 |
| Provider Name | Ann M Knapp |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457377483 PECOS PAC ID: 6204967201 Enrollment ID: I20100707000458 |
| Provider Name | Ashley Desrocher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104147792 PECOS PAC ID: 2062545742 Enrollment ID: I20100802000435 |
| Provider Name | Elizabeth L Neubig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043263544 PECOS PAC ID: 2567595887 Enrollment ID: I20100806000014 |
| Provider Name | Sherry Kuo |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1184839011 PECOS PAC ID: 6709919004 Enrollment ID: I20100806000866 |
| Provider Name | Emily E Dietrich |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053533646 PECOS PAC ID: 2567596158 Enrollment ID: I20100818000566 |
| Provider Name | Jannah H Thompson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1104089986 PECOS PAC ID: 6305997867 Enrollment ID: I20100819000637 |
| Provider Name | Cheryl A Sisco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831416478 PECOS PAC ID: 5496889990 Enrollment ID: I20100819000687 |
| Provider Name | Matthew P Biersack |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396944971 PECOS PAC ID: 2264557560 Enrollment ID: I20100909000924 |
| Provider Name | William Henry Baer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184731333 PECOS PAC ID: 0143236992 Enrollment ID: I20100916000449 |
| Provider Name | David Hoffius |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689628596 PECOS PAC ID: 4385836402 Enrollment ID: I20101007001096 |
| Provider Name | John T Morris |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1982819611 PECOS PAC ID: 7416149208 Enrollment ID: I20101012000818 |
| Provider Name | Glenes J Hamersma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841242898 PECOS PAC ID: 6305039983 Enrollment ID: I20101015000673 |
| Provider Name | Soumya C Madala |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1043334527 PECOS PAC ID: 8325231590 Enrollment ID: I20101020000466 |
| Provider Name | Karen D Fujii |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083648463 PECOS PAC ID: 9436342482 Enrollment ID: I20101021001433 |
| Provider Name | Gary L Martzke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922053057 PECOS PAC ID: 8426241449 Enrollment ID: I20101022000804 |
| Provider Name | Markian Iwaszko |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1659380939 PECOS PAC ID: 0143224006 Enrollment ID: I20101102000370 |
| Provider Name | Yvan Rodrigues |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487973103 PECOS PAC ID: 5890980114 Enrollment ID: I20101112000348 |
| Provider Name | Joanne L Jepsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063742518 PECOS PAC ID: 6406041516 Enrollment ID: I20101115001310 |
| Provider Name | Dennis S Vanwormer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336129568 PECOS PAC ID: 2860689973 Enrollment ID: I20101214001305 |
| Provider Name | Theodor Asgeirsson |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1255480067 PECOS PAC ID: 7416145511 Enrollment ID: I20101215001056 |
| Provider Name | Ashley Nicole Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760792444 PECOS PAC ID: 2668660432 Enrollment ID: I20101221000093 |
| Provider Name | Carlos Weiss |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1609880616 PECOS PAC ID: 4385642024 Enrollment ID: I20101228000573 |
| Provider Name | Carey A Krause |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467408229 PECOS PAC ID: 5092904169 Enrollment ID: I20110105001292 |
| Provider Name | Michael J Post |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1841307154 PECOS PAC ID: 0244246411 Enrollment ID: I20110215001090 |
| Provider Name | Keith Vanoosterhout |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1851329957 PECOS PAC ID: 4587748223 Enrollment ID: I20110225000847 |
| Provider Name | Anthony M Foster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578585964 PECOS PAC ID: 7416139043 Enrollment ID: I20110303000271 |
| Provider Name | William C Granger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689982159 PECOS PAC ID: 3779767280 Enrollment ID: I20110407000489 |
| Provider Name | Kourtnee J Naylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689964397 PECOS PAC ID: 5395922272 Enrollment ID: I20110601000461 |
| Provider Name | Bruce Lee Whitaker |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790923969 PECOS PAC ID: 0446437131 Enrollment ID: I20110606000706 |
| Provider Name | Arashdeep K Litt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386807139 PECOS PAC ID: 5395922512 Enrollment ID: I20110615000406 |
| Provider Name | Alexandra Marie Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730482860 PECOS PAC ID: 8921286055 Enrollment ID: I20110620000670 |
| Provider Name | Jessica L Keto |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356569933 PECOS PAC ID: 0345428678 Enrollment ID: I20110708000523 |
| Provider Name | Uchebike N Nwankwo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962690073 PECOS PAC ID: 7719155498 Enrollment ID: I20110725000227 |
| Provider Name | Joanna Haveman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801080684 PECOS PAC ID: 3779751359 Enrollment ID: I20110726000639 |
| Provider Name | Ebony R Hoskins |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1659398667 PECOS PAC ID: 2163691965 Enrollment ID: I20110812000178 |
| Provider Name | Bryan J Pack |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1295944239 PECOS PAC ID: 8527255991 Enrollment ID: I20110817000177 |
| Provider Name | Kristina N Karanec |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053503748 PECOS PAC ID: 3274703418 Enrollment ID: I20110826000276 |
| Provider Name | Sameh Fs Dwaikat |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609182567 PECOS PAC ID: 4082884911 Enrollment ID: I20110831000493 |
| Provider Name | Eyad I Abu Isa |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1396861936 PECOS PAC ID: 3476724907 Enrollment ID: I20110914000074 |
| Provider Name | Madhuri Kakarala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538281647 PECOS PAC ID: 3072784412 Enrollment ID: I20110915000640 |
| Provider Name | Ronel N Santos |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548453343 PECOS PAC ID: 6800969692 Enrollment ID: I20111006000280 |
| Provider Name | Joel A Green |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760600639 PECOS PAC ID: 7618149055 Enrollment ID: I20111007000464 |
| Provider Name | Baljit Deol |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1417908278 PECOS PAC ID: 6608776497 Enrollment ID: I20111111000664 |
| Provider Name | Qasim Omran |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1861773491 PECOS PAC ID: 9638345226 Enrollment ID: I20120103000536 |
| Provider Name | Iain G Charnley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467680439 PECOS PAC ID: 2961662663 Enrollment ID: I20120404000048 |
| Provider Name | Rodica Bejganeanu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558628438 PECOS PAC ID: 1850553611 Enrollment ID: I20120424000656 |
| Provider Name | Abdur Rehman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427280965 PECOS PAC ID: 4587828090 Enrollment ID: I20120613000619 |
| Provider Name | Sheila X Wang |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225262967 PECOS PAC ID: 3678737095 Enrollment ID: I20120615000319 |
| Provider Name | Aaron E Hampton |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255569653 PECOS PAC ID: 6901060268 Enrollment ID: I20120618000263 |
| Provider Name | Gerard A Rudy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598031940 PECOS PAC ID: 5395909519 Enrollment ID: I20120619000307 |
| Provider Name | Eric J Mitchell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205031036 PECOS PAC ID: 8022273531 Enrollment ID: I20120709000392 |
| Provider Name | Erica Ann Austin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477715076 PECOS PAC ID: 2668638719 Enrollment ID: I20120718000467 |
| Provider Name | Mary K Kline |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174751945 PECOS PAC ID: 9931365848 Enrollment ID: I20120720000604 |
| Provider Name | Gabriel Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801024872 PECOS PAC ID: 3375709074 Enrollment ID: I20120725000144 |
| Provider Name | Andrea M Wolf |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508078544 PECOS PAC ID: 5092961268 Enrollment ID: I20120804000083 |
| Provider Name | Erik Michael Ratchford |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1003013392 PECOS PAC ID: 9931355088 Enrollment ID: I20120806000885 |
| Provider Name | David C Shen |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1114120771 PECOS PAC ID: 3173623550 Enrollment ID: I20120824000468 |
| Provider Name | Josefina D Shen |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1477726917 PECOS PAC ID: 9335270685 Enrollment ID: I20120831000427 |
| Provider Name | Kimberly R Resseguie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083975478 PECOS PAC ID: 9931356540 Enrollment ID: I20120904000066 |
| Provider Name | Vinayak Anand Manohar |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1306855242 PECOS PAC ID: 5890799746 Enrollment ID: I20120910000435 |
| Provider Name | Joanna M Olewicz |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790954097 PECOS PAC ID: 4981890217 Enrollment ID: I20120926000407 |
| Provider Name | Megan J Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154686608 PECOS PAC ID: 5698924199 Enrollment ID: I20120926000784 |
| Provider Name | Janet R Hostetler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447236765 PECOS PAC ID: 9830111558 Enrollment ID: I20121005000489 |
| Provider Name | Joshua B Koenig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275828683 PECOS PAC ID: 0749439792 Enrollment ID: I20121005000687 |
| Provider Name | Kyle C Cuneo |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1740464627 PECOS PAC ID: 3577712389 Enrollment ID: I20121010000379 |
| Provider Name | Jose M Pimiento |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1063670487 PECOS PAC ID: 3870635162 Enrollment ID: I20121011000173 |
| Provider Name | Shanna B Williams |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245416775 PECOS PAC ID: 1759530504 Enrollment ID: I20121011000200 |
| Provider Name | Margaret A Szarowicz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649546912 PECOS PAC ID: 8224289764 Enrollment ID: I20121110000111 |
| Provider Name | David L Nyenhuis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902836372 PECOS PAC ID: 5092790790 Enrollment ID: I20121208000025 |
| Provider Name | Adam Michael Peterik |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1609089101 PECOS PAC ID: 1850484924 Enrollment ID: I20121213000285 |
| Provider Name | Mary Jo Richard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427303452 PECOS PAC ID: 0941453674 Enrollment ID: I20130109000207 |
| Provider Name | Nichole E Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528338142 PECOS PAC ID: 8022263680 Enrollment ID: I20130305000275 |
| Provider Name | Nirali S Bora |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811000953 PECOS PAC ID: 8921153289 Enrollment ID: I20130305000356 |
| Provider Name | Katherine R Elenbaas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326349671 PECOS PAC ID: 0749435196 Enrollment ID: I20130309000014 |
| Provider Name | Viswanadh R Vegesna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417280017 PECOS PAC ID: 3678726684 Enrollment ID: I20130402000013 |
| Provider Name | Mckensay Elisabeth Heinonen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437495967 PECOS PAC ID: 0345486601 Enrollment ID: I20130412000020 |
| Provider Name | Monica Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184808263 PECOS PAC ID: 6608012349 Enrollment ID: I20130424000904 |
| Provider Name | Susan D Blackburn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649512484 PECOS PAC ID: 3870730161 Enrollment ID: I20130503000456 |
| Provider Name | Luke A Caldwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386949436 PECOS PAC ID: 8123265386 Enrollment ID: I20130507000132 |
| Provider Name | Sreevalli Attili |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518193259 PECOS PAC ID: 8921257437 Enrollment ID: I20130517000459 |
| Provider Name | Kathryn Born |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689608036 PECOS PAC ID: 2163420324 Enrollment ID: I20130710000342 |
| Provider Name | Belal Hegazy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205103793 PECOS PAC ID: 5092956409 Enrollment ID: I20130729000123 |
| Provider Name | David Cullen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841501418 PECOS PAC ID: 3678714862 Enrollment ID: I20130731000303 |
| Provider Name | Christopher E Morgan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992967061 PECOS PAC ID: 7719129485 Enrollment ID: I20130808000286 |
| Provider Name | Kara Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194160986 PECOS PAC ID: 8325280050 Enrollment ID: I20130809000027 |
| Provider Name | Benjamin L Harper |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1609073287 PECOS PAC ID: 5890938559 Enrollment ID: I20130827000945 |
| Provider Name | Andrew R Fras |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1639328834 PECOS PAC ID: 7719137009 Enrollment ID: I20130909000783 |
| Provider Name | Anca Tanase |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497920292 PECOS PAC ID: 3476626235 Enrollment ID: I20130930000551 |
| Provider Name | Dustin G Nowacek |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699934604 PECOS PAC ID: 8426282609 Enrollment ID: I20130930000606 |
| Provider Name | Brian W Scheeringa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245473784 PECOS PAC ID: 9335373273 Enrollment ID: I20131009000901 |
| Provider Name | Vita R Eizans |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679703839 PECOS PAC ID: 5991930372 Enrollment ID: I20131022000392 |
| Provider Name | Armand B Tanase |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1154594356 PECOS PAC ID: 2860565629 Enrollment ID: I20131022001254 |
| Provider Name | Janice L Walcott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669414645 PECOS PAC ID: 6305071614 Enrollment ID: I20131022001644 |
| Provider Name | Richard E Sadowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821258393 PECOS PAC ID: 6305030354 Enrollment ID: I20131023001619 |
| Provider Name | Tena E Landers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366887812 PECOS PAC ID: 5193950152 Enrollment ID: I20131028001979 |
| Provider Name | Adrianne Jabaay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205276219 PECOS PAC ID: 7012142698 Enrollment ID: I20131107000719 |
| Provider Name | Curtis R Weaver |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1548382773 PECOS PAC ID: 8527294057 Enrollment ID: I20131111001672 |
| Provider Name | Sara Vanderzwaag |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093149759 PECOS PAC ID: 9537395009 Enrollment ID: I20131112001390 |
| Provider Name | Mohammad J Poostizadeh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1417193087 PECOS PAC ID: 4284860693 Enrollment ID: I20131113000663 |
| Provider Name | Eric Geiser |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1316007503 PECOS PAC ID: 9335154111 Enrollment ID: I20131113001176 |
| Provider Name | Jessica S Grevenstuk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588098685 PECOS PAC ID: 2567698996 Enrollment ID: I20131113001290 |
| Provider Name | Erin E Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427379916 PECOS PAC ID: 6204072622 Enrollment ID: I20131113001941 |
| Provider Name | Brooke M Cudney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497188668 PECOS PAC ID: 4789810854 Enrollment ID: I20131119001505 |
| Provider Name | Christian B Vanderkaay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730493792 PECOS PAC ID: 1759517857 Enrollment ID: I20131120000311 |
| Provider Name | Kristine Todd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841628690 PECOS PAC ID: 3678701232 Enrollment ID: I20140107000059 |
| Provider Name | Alan M Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083935894 PECOS PAC ID: 3971763145 Enrollment ID: I20140113001136 |
| Provider Name | Barbara A Pickut |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104255611 PECOS PAC ID: 7113155391 Enrollment ID: I20140115000584 |
| Provider Name | Joshua I Greenberg |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1780831255 PECOS PAC ID: 2769639772 Enrollment ID: I20140304002005 |
| Provider Name | Kimberly L Lanning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164843009 PECOS PAC ID: 2668602939 Enrollment ID: I20140306000359 |
| Provider Name | Jessica Hedeman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639310196 PECOS PAC ID: 5597996843 Enrollment ID: I20140329000293 |
| Provider Name | Tanya L Vreeke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134230832 PECOS PAC ID: 9234272303 Enrollment ID: I20140402001193 |
| Provider Name | Lindsey Elie Heathman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770838708 PECOS PAC ID: 4981852084 Enrollment ID: I20140403001829 |
| Provider Name | Kimberly Barrows |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083666101 PECOS PAC ID: 2860408689 Enrollment ID: I20140407001408 |
| Provider Name | Raigan Burkall Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205097227 PECOS PAC ID: 3779740295 Enrollment ID: I20140509000576 |
| Provider Name | Afriyie Makel Gray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477842904 PECOS PAC ID: 6305069519 Enrollment ID: I20140515001201 |
| Provider Name | Crystal A Zilo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134483340 PECOS PAC ID: 7012130164 Enrollment ID: I20140519001682 |
| Provider Name | Christopher Michael Morelli |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1063653798 PECOS PAC ID: 4183861339 Enrollment ID: I20140521001259 |
| Provider Name | Christopher R Shoemaker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184911836 PECOS PAC ID: 5698919553 Enrollment ID: I20140605002053 |
| Provider Name | Patricia L Fick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457639361 PECOS PAC ID: 7911136973 Enrollment ID: I20140630000632 |
| Provider Name | Rebecca H Klesmith |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164718029 PECOS PAC ID: 8022252758 Enrollment ID: I20140701000288 |
| Provider Name | Trevor C Wu |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346652492 PECOS PAC ID: 0840415543 Enrollment ID: I20140715000086 |
| Provider Name | Alicia A Boone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700170032 PECOS PAC ID: 3375769771 Enrollment ID: I20140721001229 |
| Provider Name | Rebecca E Schra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942615513 PECOS PAC ID: 5395961478 Enrollment ID: I20140725000855 |
| Provider Name | Nishant Kalra |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1316146236 PECOS PAC ID: 3072605807 Enrollment ID: I20140801001559 |
| Provider Name | Timothy Byon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538456298 PECOS PAC ID: 9234373077 Enrollment ID: I20140804000354 |
| Provider Name | Moiz Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174803357 PECOS PAC ID: 8123245792 Enrollment ID: I20140806000922 |
| Provider Name | Blake W Miller |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1952564130 PECOS PAC ID: 7618194465 Enrollment ID: I20140819000750 |
| Provider Name | Emily Olenzek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740571306 PECOS PAC ID: 1254559016 Enrollment ID: I20140820002234 |
| Provider Name | Brianna Kilner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548587231 PECOS PAC ID: 3678711314 Enrollment ID: I20140822001196 |
| Provider Name | Frigga Jacob |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508153263 PECOS PAC ID: 6305072604 Enrollment ID: I20140905002074 |
| Provider Name | Melanie G Taylor |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1134363419 PECOS PAC ID: 8628297322 Enrollment ID: I20140911000481 |
| Provider Name | Stephanie D Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417208463 PECOS PAC ID: 8628220092 Enrollment ID: I20140915002331 |
| Provider Name | Mohammad Wisam Sakbani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689952228 PECOS PAC ID: 0143471003 Enrollment ID: I20140917000607 |
| Provider Name | Cyprian Alphius Gardine |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1659583888 PECOS PAC ID: 3971602327 Enrollment ID: I20140922000342 |
| Provider Name | Beth S Stevenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225464555 PECOS PAC ID: 6002040698 Enrollment ID: I20141002001530 |
| Provider Name | Albert Ho |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710165030 PECOS PAC ID: 6103099957 Enrollment ID: I20141029002460 |
| Provider Name | Ann M Wiltshire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629353974 PECOS PAC ID: 2163696543 Enrollment ID: I20141106001819 |
| Provider Name | George J Ghuneim |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1881034791 PECOS PAC ID: 9133363369 Enrollment ID: I20141119000931 |
| Provider Name | Sarah M Rich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346644861 PECOS PAC ID: 5496077174 Enrollment ID: I20141208001873 |
| Provider Name | Lawrence Allen Robillard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396731790 PECOS PAC ID: 7517139280 Enrollment ID: I20141212000272 |
| Provider Name | Tracy D Slone |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104878495 PECOS PAC ID: 5294912408 Enrollment ID: I20141216000269 |
| Provider Name | Alysha Kirkwood |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063698033 PECOS PAC ID: 4082883178 Enrollment ID: I20141222001461 |
| Provider Name | Kari Jo Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184024481 PECOS PAC ID: 6608199567 Enrollment ID: I20141229001101 |
| Provider Name | Debra Dominiak Rinck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760872790 PECOS PAC ID: 3971828294 Enrollment ID: I20150209001552 |
| Provider Name | Jacques Green |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841482791 PECOS PAC ID: 1850616020 Enrollment ID: I20150210001341 |
| Provider Name | Meagon Ann Oliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992103667 PECOS PAC ID: 6800111592 Enrollment ID: I20150223000932 |
| Provider Name | Emily Joy Keen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588064638 PECOS PAC ID: 8325364029 Enrollment ID: I20150223001393 |
| Provider Name | Cynthia Ann Betterly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508254426 PECOS PAC ID: 2163748781 Enrollment ID: I20150225002450 |
| Provider Name | Grace Hoffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336531607 PECOS PAC ID: 9234457813 Enrollment ID: I20150410000602 |
| Provider Name | Kathleen R Everitt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841677895 PECOS PAC ID: 7810217981 Enrollment ID: I20150514000159 |
| Provider Name | Abbas Ali Jowkar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760501662 PECOS PAC ID: 4183725765 Enrollment ID: I20150521000186 |
| Provider Name | Christopher M Goshgarian |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821318379 PECOS PAC ID: 2365674959 Enrollment ID: I20150521000209 |
| Provider Name | Mustafizur R Choudhury |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1073877999 PECOS PAC ID: 7810130424 Enrollment ID: I20150521000321 |
| Provider Name | Theresa Starr |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1255357794 PECOS PAC ID: 7214917350 Enrollment ID: I20150521001230 |
| Provider Name | Jessica Gibbie |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821384108 PECOS PAC ID: 0648409342 Enrollment ID: I20150527001254 |
| Provider Name | Rebecca M Osbourne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568758704 PECOS PAC ID: 7719120716 Enrollment ID: I20150611002366 |
| Provider Name | Andre Hollingsworth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801184247 PECOS PAC ID: 8921235961 Enrollment ID: I20150615001915 |
| Provider Name | Jill K Onesti |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1063674497 PECOS PAC ID: 2860620218 Enrollment ID: I20150615002535 |
| Provider Name | Sajid Mehmood |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467444950 PECOS PAC ID: 2860450095 Enrollment ID: I20150617003098 |
| Provider Name | Benjamin Willenbring |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902160385 PECOS PAC ID: 6103137054 Enrollment ID: I20150618000732 |
| Provider Name | Christopher Meeusen |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1730476086 PECOS PAC ID: 4880823384 Enrollment ID: I20150618002260 |
| Provider Name | David Charles Henderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720427404 PECOS PAC ID: 9830333723 Enrollment ID: I20150708001907 |
| Provider Name | Sarah Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194089672 PECOS PAC ID: 4981848850 Enrollment ID: I20150710001112 |
| Provider Name | Jeremy Bushman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1699088906 PECOS PAC ID: 8820227309 Enrollment ID: I20150716000745 |
| Provider Name | Katherine Leigh Burton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457790149 PECOS PAC ID: 2163657651 Enrollment ID: I20150717000403 |
| Provider Name | Stephanie Downing |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174834055 PECOS PAC ID: 6002039708 Enrollment ID: I20150721000467 |
| Provider Name | Christine Olree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396756326 PECOS PAC ID: 3577539022 Enrollment ID: I20150722003465 |
| Provider Name | Matthew J Rossing |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1043268436 PECOS PAC ID: 2466456215 Enrollment ID: I20150803002117 |
| Provider Name | Clara Vanderweide |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558744797 PECOS PAC ID: 7517271364 Enrollment ID: I20150806011901 |
| Provider Name | Nicole Markiewicz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073997698 PECOS PAC ID: 4385958081 Enrollment ID: I20150807014142 |
| Provider Name | Melissa Kurek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902289655 PECOS PAC ID: 3577877281 Enrollment ID: I20150807014424 |
| Provider Name | Michael Terrell |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1366822553 PECOS PAC ID: 9931413622 Enrollment ID: I20150810001166 |
| Provider Name | Fahed Sabagh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932421179 PECOS PAC ID: 5698080141 Enrollment ID: I20150813009857 |
| Provider Name | Eric T Slavin |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1518194034 PECOS PAC ID: 0143486258 Enrollment ID: I20150824000563 |
| Provider Name | Maggi Ann Forgue |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861781783 PECOS PAC ID: 5597998922 Enrollment ID: I20150902000145 |
| Provider Name | Alison Aubry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538536966 PECOS PAC ID: 6103133772 Enrollment ID: I20150915000200 |
| Provider Name | Faith Van Oss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598140303 PECOS PAC ID: 0648587907 Enrollment ID: I20150918000388 |
| Provider Name | Lucy Ledesma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114395803 PECOS PAC ID: 7810204922 Enrollment ID: I20150922000297 |
| Provider Name | Renee Sirois |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659740678 PECOS PAC ID: 4486962339 Enrollment ID: I20150928000025 |
| Provider Name | Margaret F Vandewater |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902275506 PECOS PAC ID: 5294043642 Enrollment ID: I20151005000725 |
| Provider Name | Kimberly A Hybels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609259837 PECOS PAC ID: 3779892880 Enrollment ID: I20151012000880 |
| Provider Name | Brandi Ross-douglas |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1588779904 PECOS PAC ID: 0941205876 Enrollment ID: I20151124000341 |
| Provider Name | Anamaria B Bondici |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1942524020 PECOS PAC ID: 8729237086 Enrollment ID: I20160113000575 |
| Provider Name | Antione J Trent |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346673274 PECOS PAC ID: 9335442805 Enrollment ID: I20160118000910 |
| Provider Name | Ashley Therasse |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1265665988 PECOS PAC ID: 7719103308 Enrollment ID: I20160122000244 |
| Provider Name | Lindsay J Maul |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1851642748 PECOS PAC ID: 3072767037 Enrollment ID: I20160201002408 |
| Provider Name | David Hakopian |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1851651673 PECOS PAC ID: 7719286251 Enrollment ID: I20160504001291 |
| Provider Name | Lee Patrick Heeringa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972869048 PECOS PAC ID: 5193032597 Enrollment ID: I20160601000529 |
| Provider Name | Therese Angelica Fermo Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295040855 PECOS PAC ID: 3375787252 Enrollment ID: I20160601001177 |
| Provider Name | Oluwaseun Davies |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1164779179 PECOS PAC ID: 6002127990 Enrollment ID: I20160617000746 |
| Provider Name | Chad Mills Shelner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497102800 PECOS PAC ID: 8325339492 Enrollment ID: I20160621000175 |
| Provider Name | Virginia Stoll-tyrrell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518128255 PECOS PAC ID: 9335279546 Enrollment ID: I20160624000137 |
| Provider Name | Angela R Andrews |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659636595 PECOS PAC ID: 6608177480 Enrollment ID: I20160706001029 |
| Provider Name | David Michael Ehrhardt |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710255575 PECOS PAC ID: 7214229574 Enrollment ID: I20160706001632 |
| Provider Name | Cameron Patthanacharoenphon |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1073834339 PECOS PAC ID: 9931337243 Enrollment ID: I20160711000724 |
| Provider Name | Michelle Catherine Kosovec |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1578859542 PECOS PAC ID: 3173752938 Enrollment ID: I20160711001791 |
| Provider Name | Christopher James Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205276383 PECOS PAC ID: 3274852975 Enrollment ID: I20160712000748 |
| Provider Name | Catherine Davis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730529645 PECOS PAC ID: 6406099902 Enrollment ID: I20160714000840 |
| Provider Name | Laura Wicksall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710390372 PECOS PAC ID: 3779875539 Enrollment ID: I20160714001934 |
| Provider Name | Marian Mocanu |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1770768038 PECOS PAC ID: 4385784602 Enrollment ID: I20160719001465 |
| Provider Name | Megan Ann Yee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760822068 PECOS PAC ID: 2961646781 Enrollment ID: I20160720000490 |
| Provider Name | Vinh Ho |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952740334 PECOS PAC ID: 6709020746 Enrollment ID: I20160721000841 |
| Provider Name | Brandon Andrew Francis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154588267 PECOS PAC ID: 7012200553 Enrollment ID: I20160721001404 |
| Provider Name | Andrea L Buras |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1609130392 PECOS PAC ID: 2062705049 Enrollment ID: I20160728001161 |
| Provider Name | Paul Andrew Trowbridge |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205098803 PECOS PAC ID: 3870807993 Enrollment ID: I20160802000219 |
| Provider Name | Jean C Talsma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144660200 PECOS PAC ID: 0840583639 Enrollment ID: I20160802000442 |
| Provider Name | Kimberly Harper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902258627 PECOS PAC ID: 7315231016 Enrollment ID: I20160803001005 |
| Provider Name | Joshua T Nicholson |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1487916599 PECOS PAC ID: 2264726918 Enrollment ID: I20160803002502 |
| Provider Name | Joel Nathan Phillips |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639462039 PECOS PAC ID: 8921230699 Enrollment ID: I20160809000944 |
| Provider Name | Maria Hassan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104230960 PECOS PAC ID: 6709002553 Enrollment ID: I20160809001656 |
| Provider Name | Jarrad Montie Utter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942614185 PECOS PAC ID: 6608096813 Enrollment ID: I20160810000063 |
| Provider Name | Emily Sheng |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154663938 PECOS PAC ID: 0547565566 Enrollment ID: I20160810000661 |
| Provider Name | Orena J Kirchner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073966628 PECOS PAC ID: 0345534483 Enrollment ID: I20160811001788 |
| Provider Name | David Scott Jasperse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609119544 PECOS PAC ID: 8921327321 Enrollment ID: I20160815000957 |
| Provider Name | James Scott Fitzgerald |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891037248 PECOS PAC ID: 5193020915 Enrollment ID: I20160816000059 |
| Provider Name | Emily Carole Johnson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023374048 PECOS PAC ID: 1052614542 Enrollment ID: I20160816001480 |
| Provider Name | Aileen Elizabeth M Ampil Antonio |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982991683 PECOS PAC ID: 7214221191 Enrollment ID: I20160816001533 |
| Provider Name | Eric Joseph Krebill |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659667624 PECOS PAC ID: 8022246958 Enrollment ID: I20160817003409 |
| Provider Name | Tomasz Stankiewicz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346654944 PECOS PAC ID: 0345546925 Enrollment ID: I20160818000499 |
| Provider Name | Margaret Bader |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710330212 PECOS PAC ID: 7416242144 Enrollment ID: I20160819001821 |
| Provider Name | Brandon Robert Mancini |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1366731838 PECOS PAC ID: 1456662675 Enrollment ID: I20160826000287 |
| Provider Name | Matthew Schoeck |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548535719 PECOS PAC ID: 2466747555 Enrollment ID: I20160829002032 |
| Provider Name | Jonathan Rouwhorst |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508120122 PECOS PAC ID: 9133438633 Enrollment ID: I20160902000717 |
| Provider Name | Michelle E Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730538489 PECOS PAC ID: 5799071395 Enrollment ID: I20160908000549 |
| Provider Name | Rachel Marie Lettinga |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558700484 PECOS PAC ID: 8820384233 Enrollment ID: I20160912001601 |
| Provider Name | Alex Gilde |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548674625 PECOS PAC ID: 7517182132 Enrollment ID: I20160922001236 |
| Provider Name | Tiffany D Rebandt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467905133 PECOS PAC ID: 8628365368 Enrollment ID: I20160923002279 |
| Provider Name | Leda Theres Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780133694 PECOS PAC ID: 4587942727 Enrollment ID: I20161024000691 |
| Provider Name | Elizabeth Marie Schmidt |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1851652077 PECOS PAC ID: 1254647936 Enrollment ID: I20161110000312 |
| Provider Name | Ethan Braden Morrical |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376954917 PECOS PAC ID: 6204115306 Enrollment ID: I20161114000100 |
| Provider Name | Autumn Elizabeth Dangl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205388493 PECOS PAC ID: 5294014288 Enrollment ID: I20161115001268 |
| Provider Name | Hani Murad |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1982610069 PECOS PAC ID: 4880730357 Enrollment ID: I20161229000459 |
| Provider Name | Sara C Kirchhoff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760914535 PECOS PAC ID: 0446537633 Enrollment ID: I20170425001504 |
| Provider Name | Mohamed E Ghonimy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821437427 PECOS PAC ID: 0446548101 Enrollment ID: I20170509001931 |
| Provider Name | Andrea Christine Morse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932634623 PECOS PAC ID: 3476820853 Enrollment ID: I20170607000330 |
| Provider Name | Andrew Stanley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639583495 PECOS PAC ID: 4880819176 Enrollment ID: I20170706002947 |
| Provider Name | Anne Elizabeth Jordan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689088825 PECOS PAC ID: 6709006091 Enrollment ID: I20170711001291 |
| Provider Name | Patrick Abraham Pavwoski |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1073953881 PECOS PAC ID: 4385954577 Enrollment ID: I20170718001604 |
| Provider Name | Steven Ritter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023548344 PECOS PAC ID: 5496025819 Enrollment ID: I20170718002158 |
| Provider Name | Morgan A Daul |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295148690 PECOS PAC ID: 3072730258 Enrollment ID: I20170720002506 |
| Provider Name | Martin Aramburu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063831634 PECOS PAC ID: 2264715986 Enrollment ID: I20170724001117 |
| Provider Name | Camille Ryan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306250543 PECOS PAC ID: 9032339338 Enrollment ID: I20170724001513 |
| Provider Name | Shauna S Stark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609303676 PECOS PAC ID: 1658641543 Enrollment ID: I20170726000950 |
| Provider Name | Pritha Chitagi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811316813 PECOS PAC ID: 4385940063 Enrollment ID: I20170726002677 |
| Provider Name | Maram Attiq |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790104792 PECOS PAC ID: 5496056582 Enrollment ID: I20170727001079 |
| Provider Name | Karri Macmillan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467865188 PECOS PAC ID: 0749409944 Enrollment ID: I20170728001227 |
| Provider Name | Ashraf Mostafa |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396976080 PECOS PAC ID: 4486952348 Enrollment ID: I20170802001594 |
| Provider Name | Mitchell Sydloski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760896906 PECOS PAC ID: 9638399926 Enrollment ID: I20170803000713 |
| Provider Name | Laura J Hickman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881116457 PECOS PAC ID: 0042581845 Enrollment ID: I20170811001000 |
| Provider Name | Courtney C Thenn |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1346654803 PECOS PAC ID: 7012137185 Enrollment ID: I20170817001887 |
| Provider Name | Andrea Landon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104238484 PECOS PAC ID: 7618193855 Enrollment ID: I20170908001812 |
| Provider Name | John Andrew Carr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821471509 PECOS PAC ID: 7810200755 Enrollment ID: I20170911000753 |
| Provider Name | Matthew Aaron Falkiewicz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447631411 PECOS PAC ID: 7810200631 Enrollment ID: I20170911001840 |
| Provider Name | Nicholas Blank |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275914244 PECOS PAC ID: 4789997511 Enrollment ID: I20170926002522 |
| Provider Name | Elizabeth A Hess |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467709345 PECOS PAC ID: 2466727268 Enrollment ID: I20171004001878 |
| Provider Name | Benjamin John Borton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740799451 PECOS PAC ID: 6406122571 Enrollment ID: I20171018001315 |
| Provider Name | Lara Mae Dengerink-vantil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679023501 PECOS PAC ID: 3971879875 Enrollment ID: I20171020000961 |
| Provider Name | Michael Vanderlaan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1396183653 PECOS PAC ID: 4880837855 Enrollment ID: I20180102000275 |
| Provider Name | Jennifer Ann Gole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962910943 PECOS PAC ID: 5799045274 Enrollment ID: I20180131002373 |
| Provider Name | Lesli Casten |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992089965 PECOS PAC ID: 6103087234 Enrollment ID: I20180221000600 |
| Provider Name | Sara Beth Grevers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780183699 PECOS PAC ID: 6800157348 Enrollment ID: I20180226002665 |
| Provider Name | Carrie Ann Holland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043418189 PECOS PAC ID: 3971653304 Enrollment ID: I20180424000108 |
| Provider Name | Derek Paul Bergsma |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1467728428 PECOS PAC ID: 3375810328 Enrollment ID: I20180523000242 |
| Provider Name | Ishrat Jahan |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1982976247 PECOS PAC ID: 3476818816 Enrollment ID: I20180605002838 |
| Provider Name | Christopher J Murphy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1114285558 PECOS PAC ID: 4486873627 Enrollment ID: I20180612002239 |
| Provider Name | David Alan Elliott |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1497044085 PECOS PAC ID: 2860647591 Enrollment ID: I20180613002396 |
| Provider Name | Jaclyn Reckow |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144717604 PECOS PAC ID: 9537414065 Enrollment ID: I20180625000182 |
| Provider Name | Adam C Henke |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588003040 PECOS PAC ID: 8820227630 Enrollment ID: I20180709002132 |
| Provider Name | Marc Arenas |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1871908970 PECOS PAC ID: 0547480840 Enrollment ID: I20180710000831 |
| Provider Name | Audrey Kay Sanders |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518377746 PECOS PAC ID: 7315232048 Enrollment ID: I20180710000860 |
| Provider Name | Ryan D Kuefler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902210925 PECOS PAC ID: 1456577519 Enrollment ID: I20180710000968 |
| Provider Name | Rebecca Smith Tang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598101115 PECOS PAC ID: 4385884543 Enrollment ID: I20180711002329 |
| Provider Name | Ryan Scott Brooks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306228473 PECOS PAC ID: 4789997016 Enrollment ID: I20180713000048 |
| Provider Name | Rada R Brooks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891175907 PECOS PAC ID: 4284938101 Enrollment ID: I20180713000073 |
| Provider Name | Kathryn Therese Kozminski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457732422 PECOS PAC ID: 0143533968 Enrollment ID: I20180806000560 |
| Provider Name | Paul Michael Kiger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659635647 PECOS PAC ID: 3971852831 Enrollment ID: I20180827000690 |
| Provider Name | Ahmet S Tunceroglu |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1578806352 PECOS PAC ID: 6305196098 Enrollment ID: I20180829004111 |
| Provider Name | Dana M Stewart |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1588939433 PECOS PAC ID: 8123322633 Enrollment ID: I20180904002057 |
| Provider Name | Meghan Jon Freund |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811301831 PECOS PAC ID: 1456577527 Enrollment ID: I20180906003510 |
| Provider Name | Ryan B Dick-perez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982962783 PECOS PAC ID: 7719295872 Enrollment ID: I20180920000978 |
| Provider Name | Melissa Marie Halverson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558887174 PECOS PAC ID: 3870850100 Enrollment ID: I20181009000490 |
| Provider Name | Concepcion R Diaz-arrastia |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104986553 PECOS PAC ID: 3072666320 Enrollment ID: I20181030000109 |
| Provider Name | Paul Dieleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003263450 PECOS PAC ID: 0446504922 Enrollment ID: I20181120001056 |
| Provider Name | Julie Renee Hews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447729967 PECOS PAC ID: 9638414030 Enrollment ID: I20181212002484 |
| Provider Name | Seema Azher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669815890 PECOS PAC ID: 7214254051 Enrollment ID: I20190108002236 |
| Provider Name | Leah Carpenter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194297077 PECOS PAC ID: 1456697796 Enrollment ID: I20190108002332 |
| Provider Name | Kevin Fitzgerald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487152633 PECOS PAC ID: 0749529386 Enrollment ID: I20190226003457 |
| Provider Name | Melissa Devroy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073913398 PECOS PAC ID: 1052651601 Enrollment ID: I20190319001940 |
| Provider Name | Nicole Steffen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639560204 PECOS PAC ID: 6608116983 Enrollment ID: I20190325000148 |
| Provider Name | Heather Marie Coots |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316404148 PECOS PAC ID: 5698015865 Enrollment ID: I20190326001293 |
| Provider Name | Christina A Eller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053897595 PECOS PAC ID: 8022368794 Enrollment ID: I20190418001228 |
| Provider Name | Colleen E Tillema |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720503329 PECOS PAC ID: 9335412790 Enrollment ID: I20190424000702 |
| Provider Name | Peter Lenhart |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831170646 PECOS PAC ID: 1052408713 Enrollment ID: I20190509002138 |
| Provider Name | Danielle J. Armstrong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548721665 PECOS PAC ID: 5395078109 Enrollment ID: I20190611001165 |
| Provider Name | Jana Baatenburg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720438872 PECOS PAC ID: 1557659752 Enrollment ID: I20190712002222 |
| Provider Name | Emily Schipper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184074239 PECOS PAC ID: 7012205214 Enrollment ID: I20190712002242 |
| Provider Name | Abiy T Nigatu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952697252 PECOS PAC ID: 7416279641 Enrollment ID: I20190712002271 |
| Provider Name | Mary Vincent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447811401 PECOS PAC ID: 8022343029 Enrollment ID: I20190712002306 |
| Provider Name | Patrick Tyrrell |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891154621 PECOS PAC ID: 5395070395 Enrollment ID: I20190712002334 |
| Provider Name | Lara Baatenburg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336590843 PECOS PAC ID: 3476841677 Enrollment ID: I20190712002379 |
| Provider Name | Gabriella Marie Rubino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538515648 PECOS PAC ID: 5294098026 Enrollment ID: I20190726002401 |
| Provider Name | Ariel Eduardo Mejia Sanchez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831543313 PECOS PAC ID: 9335429786 Enrollment ID: I20190729003654 |
| Provider Name | Benjamin Matthew Strong |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1174865174 PECOS PAC ID: 1557698297 Enrollment ID: I20190803000150 |
| Provider Name | Megan Amber Deboer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447810569 PECOS PAC ID: 0840527511 Enrollment ID: I20190805001090 |
| Provider Name | Caleb Walters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427409937 PECOS PAC ID: 7214225432 Enrollment ID: I20190808002167 |
| Provider Name | Ryan Burmeister |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922450246 PECOS PAC ID: 8022302967 Enrollment ID: I20190815001975 |
| Provider Name | Andrea Lynn Eastway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467005165 PECOS PAC ID: 1456689454 Enrollment ID: I20190829001800 |
| Provider Name | Kory Allen Eastway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326691791 PECOS PAC ID: 4981932886 Enrollment ID: I20190829001949 |
| Provider Name | Amanda L Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154772663 PECOS PAC ID: 4486942554 Enrollment ID: I20190829003449 |
| Provider Name | Joel David Stracke |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558624189 PECOS PAC ID: 1153564943 Enrollment ID: I20190830000208 |
| Provider Name | Shawn Patrick Reidy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013438886 PECOS PAC ID: 2860763372 Enrollment ID: I20190905000336 |
| Provider Name | Tarajo Lynn Hanrahan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295256063 PECOS PAC ID: 6507137015 Enrollment ID: I20190910000123 |
| Provider Name | Melissa Kirvan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447768270 PECOS PAC ID: 4284964107 Enrollment ID: I20190919000785 |
| Provider Name | Joseph Paul Urbanski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497116453 PECOS PAC ID: 4082046586 Enrollment ID: I20191122000259 |
| Provider Name | Katelyn Van Allsburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063058345 PECOS PAC ID: 4587097084 Enrollment ID: I20191212003140 |
| Provider Name | Rebecca L Veneklase |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245882703 PECOS PAC ID: 1456785013 Enrollment ID: I20200107002720 |
| Provider Name | Tara Marie Steketee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225677990 PECOS PAC ID: 4183059348 Enrollment ID: I20200115002584 |
| Provider Name | Ryan Kelting |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598027708 PECOS PAC ID: 3072828615 Enrollment ID: I20200117001572 |
| Provider Name | Christina Glewen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598265670 PECOS PAC ID: 6002244100 Enrollment ID: I20200324003052 |
| Provider Name | Kevin Hengeveld |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699315747 PECOS PAC ID: 0840628806 Enrollment ID: I20200325002032 |
| Provider Name | Elizabeth Joy Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790248250 PECOS PAC ID: 0749619062 Enrollment ID: I20200407001722 |
| Provider Name | Mary M Cherrette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225679491 PECOS PAC ID: 1759710817 Enrollment ID: I20200411000220 |
| Provider Name | David Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982266193 PECOS PAC ID: 8022448299 Enrollment ID: I20200501000325 |
| Provider Name | Joseph Evans |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1699054874 PECOS PAC ID: 1658671714 Enrollment ID: I20200616001168 |
| Provider Name | Delphia Catina Croff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447886692 PECOS PAC ID: 2365864550 Enrollment ID: I20200616002503 |
| Provider Name | Hussain Aboud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902046246 PECOS PAC ID: 5890965834 Enrollment ID: I20200616003320 |
| Provider Name | Brandon Dale Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568087948 PECOS PAC ID: 2860814779 Enrollment ID: I20200623001893 |
| Provider Name | Ericka Musa Robles |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730619990 PECOS PAC ID: 0749551265 Enrollment ID: I20200702001298 |
| Provider Name | Brittany Palazzolo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497398374 PECOS PAC ID: 5597188755 Enrollment ID: I20200706002863 |
| Provider Name | Hussam Shaker |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861807315 PECOS PAC ID: 2860618626 Enrollment ID: I20200708001160 |
| Provider Name | Anita Olga Bell |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1326494907 PECOS PAC ID: 3173947439 Enrollment ID: I20200720001190 |
| Provider Name | Dexter R Mckellar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336633742 PECOS PAC ID: 0840548103 Enrollment ID: I20200724002043 |
| Provider Name | Trisha Kay Bank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023627429 PECOS PAC ID: 0042637738 Enrollment ID: I20200826001565 |
| Provider Name | Amber Lynn Vanderwagen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508321662 PECOS PAC ID: 9931528858 Enrollment ID: I20200925002532 |
| Provider Name | Andrew John Kepplinger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184151623 PECOS PAC ID: 0749600781 Enrollment ID: I20201013003320 |
| Provider Name | Ramon Anel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1467547711 PECOS PAC ID: 2769377423 Enrollment ID: I20201117000619 |
| Provider Name | Samuel Woods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184274086 PECOS PAC ID: 0042622706 Enrollment ID: I20201222001547 |
| Provider Name | Hiba Hadid |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1497097539 PECOS PAC ID: 0840422788 Enrollment ID: I20210210001339 |
| Provider Name | Allison Jean Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780272211 PECOS PAC ID: 6800201203 Enrollment ID: I20210217001462 |
| Provider Name | Afsheen Masood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548666373 PECOS PAC ID: 1658658984 Enrollment ID: I20210217002975 |
| Provider Name | Nicole P Falatic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457986069 PECOS PAC ID: 2365857315 Enrollment ID: I20210224002722 |
| Provider Name | Gabriella Keefe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821673492 PECOS PAC ID: 1153738711 Enrollment ID: I20210325002575 |
| Provider Name | James Hull |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1548441827 PECOS PAC ID: 9133369556 Enrollment ID: I20210325002697 |
| Provider Name | Angela J Ghuneim |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265814370 PECOS PAC ID: 0345550505 Enrollment ID: I20210401000837 |
| Provider Name | Fawaz Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477786598 PECOS PAC ID: 9436305992 Enrollment ID: I20210420001013 |
| Provider Name | Dustin Taylor Harmon |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1801215058 PECOS PAC ID: 1759684665 Enrollment ID: I20210603001442 |
| Provider Name | Elysha A Keener |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861076465 PECOS PAC ID: 5799185575 Enrollment ID: I20210616000715 |
| Provider Name | Joshua C Haeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942878632 PECOS PAC ID: 3476953928 Enrollment ID: I20210621001921 |
| Provider Name | Lindsay Jade Robell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861873903 PECOS PAC ID: 6507166311 Enrollment ID: I20210624002950 |
| Provider Name | Michael Essenmacher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457845075 PECOS PAC ID: 8921356262 Enrollment ID: I20210712000110 |
| Provider Name | Drew Jorgensen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356787790 PECOS PAC ID: 1052549474 Enrollment ID: I20210712000453 |
| Provider Name | Gabrielle Elizabeth Barringer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255825873 PECOS PAC ID: 4981952462 Enrollment ID: I20210712000535 |
| Provider Name | Bradley Christiansen |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1356846703 PECOS PAC ID: 1052667177 Enrollment ID: I20210712000588 |
| Provider Name | Anita Eapen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740643196 PECOS PAC ID: 8123312725 Enrollment ID: I20210714000152 |
| Provider Name | Margaret Elizabeth Whicker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1568873156 PECOS PAC ID: 7214239417 Enrollment ID: I20210802002253 |
| Provider Name | Abdel Rahman A Omer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1356607626 PECOS PAC ID: 1850605866 Enrollment ID: I20210824000170 |
| Provider Name | Osama Hadid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275995250 PECOS PAC ID: 0042509473 Enrollment ID: I20210825001010 |
| Provider Name | Seo Hyun Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689247348 PECOS PAC ID: 2567868433 Enrollment ID: I20210901002988 |
| Provider Name | Amber Marva Lindeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689347932 PECOS PAC ID: 0941606461 Enrollment ID: I20210909000752 |
| Provider Name | Karma Albert Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548842545 PECOS PAC ID: 0143618025 Enrollment ID: I20211026001630 |
| Provider Name | Jamal Fisher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497148175 PECOS PAC ID: 2668861642 Enrollment ID: I20211112000951 |
| Provider Name | Lindsay Marie Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417610981 PECOS PAC ID: 3971993361 Enrollment ID: I20211129000422 |
| Provider Name | Hayley Marie Amsbaugh |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407515950 PECOS PAC ID: 0244620813 Enrollment ID: I20211214002468 |
| Provider Name | Rebecca Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326701160 PECOS PAC ID: 2466843057 Enrollment ID: I20211215000425 |
| Provider Name | Amanda J Covell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295333938 PECOS PAC ID: 6204229024 Enrollment ID: I20220131001115 |
| Provider Name | Alayna A Stratton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992398689 PECOS PAC ID: 5092108399 Enrollment ID: I20220209001922 |
| Provider Name | Samuel A Maluil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245662436 PECOS PAC ID: 5991092934 Enrollment ID: I20220228001652 |
| Provider Name | Vanessa Martinez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437643756 PECOS PAC ID: 5799029013 Enrollment ID: I20220314001566 |
| Provider Name | Muhannad Kassawat |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023266533 PECOS PAC ID: 3274698436 Enrollment ID: I20220406001483 |
| Provider Name | Anne Lihau-n'kanza |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1730127788 PECOS PAC ID: 9133149966 Enrollment ID: I20220420000739 |
| Provider Name | Jennifer J Droski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013444868 PECOS PAC ID: 5496142358 Enrollment ID: I20220422000937 |
| Provider Name | Daniel J Denooyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932509726 PECOS PAC ID: 0446647317 Enrollment ID: I20220422001151 |
| Provider Name | Laura B Dewit |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679214233 PECOS PAC ID: 5395132211 Enrollment ID: I20220425000447 |
| Provider Name | Teresa M Mann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073885901 PECOS PAC ID: 1759778582 Enrollment ID: I20220426002856 |
| Provider Name | Alexander J Ghuneim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740843713 PECOS PAC ID: 9739415241 Enrollment ID: I20220510000506 |
| Provider Name | Taylor Cordonnier |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1689010266 PECOS PAC ID: 8426297979 Enrollment ID: I20220516000632 |
| Provider Name | Tzvi Neuman |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1114187119 PECOS PAC ID: 8628192937 Enrollment ID: I20220526002048 |
| Provider Name | Brent Gustafson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841850997 PECOS PAC ID: 0345577219 Enrollment ID: I20220607001989 |
| Provider Name | Steveny Grieve |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659735595 PECOS PAC ID: 4688968837 Enrollment ID: I20220613000152 |
| Provider Name | Allison Harriott |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023247871 PECOS PAC ID: 6709028616 Enrollment ID: I20220615002381 |
| Provider Name | Miriam Adrianson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700441300 PECOS PAC ID: 0042545436 Enrollment ID: I20220706003645 |
| Provider Name | Aisha Davis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023405073 PECOS PAC ID: 3678886991 Enrollment ID: I20220713003651 |
| Provider Name | Jennifer Alexandra Novak |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1093242737 PECOS PAC ID: 6608257084 Enrollment ID: I20220715002195 |
| Provider Name | Caitlin Blackmer Sturr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437891900 PECOS PAC ID: 7214318047 Enrollment ID: I20220725002881 |
| Provider Name | Aubri Rush |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497312110 PECOS PAC ID: 6406284389 Enrollment ID: I20220802000885 |
| Provider Name | Maritza Scarlet Baez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952767220 PECOS PAC ID: 2860779451 Enrollment ID: I20220802001438 |
| Provider Name | Emily Geerlings |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225698475 PECOS PAC ID: 6002143971 Enrollment ID: I20220803002652 |
| Provider Name | Brett Levesseur |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720572340 PECOS PAC ID: 8921356288 Enrollment ID: I20220811000572 |
| Provider Name | Bess Marie Connors |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528412517 PECOS PAC ID: 0749578144 Enrollment ID: I20220812002893 |
| Provider Name | Charles Franklin Gloster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790231793 PECOS PAC ID: 9830487800 Enrollment ID: I20220818001092 |
| Provider Name | Michael R Johnson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1730422791 PECOS PAC ID: 3779893839 Enrollment ID: I20220912000772 |
| Provider Name | Michael Crowder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669953246 PECOS PAC ID: 4486998945 Enrollment ID: I20220922002837 |
| Provider Name | Shelby L Vanhouten |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942830963 PECOS PAC ID: 8921483116 Enrollment ID: I20220926000195 |
| Provider Name | Katherine Swords |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720642622 PECOS PAC ID: 0941632582 Enrollment ID: I20221108001023 |
| Provider Name | Agnes A Bacon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457020810 PECOS PAC ID: 7113395740 Enrollment ID: I20221201001945 |
| Provider Name | Emily Rose Vidri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093422172 PECOS PAC ID: 9032588595 Enrollment ID: I20221206001711 |
| Provider Name | Carleen M Riley-mercado |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427646983 PECOS PAC ID: 6305215518 Enrollment ID: I20221210000056 |
| Provider Name | Becky Purkaple |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174979900 PECOS PAC ID: 2668768326 Enrollment ID: I20230111001927 |
| Provider Name | Bhuvaneshwari Dakshinamoorthy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881122562 PECOS PAC ID: 1153759568 Enrollment ID: I20230306002326 |
| Provider Name | Whitney Elvera Boss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982318069 PECOS PAC ID: 5698149359 Enrollment ID: I20230320001312 |
| Provider Name | Conrad Kozlowski |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1710479399 PECOS PAC ID: 1355721341 Enrollment ID: I20230426001852 |
| Provider Name | Michael Paul Meyers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740807205 PECOS PAC ID: 2860816857 Enrollment ID: I20230510001674 |
| Provider Name | Joshua Michael Corriveau |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225693054 PECOS PAC ID: 4981061314 Enrollment ID: I20230531000397 |
| Provider Name | Tara Couturier |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1386361590 PECOS PAC ID: 2668839739 Enrollment ID: I20230605002353 |
| Provider Name | Thomas Stanley Wenzlick |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1740700459 PECOS PAC ID: 7214206341 Enrollment ID: I20230612002168 |
| Provider Name | Kendra K Vander Sluis-kallemeyn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548952039 PECOS PAC ID: 0446618763 Enrollment ID: I20230620000361 |
| Provider Name | Desiree D Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134764228 PECOS PAC ID: 6204294150 Enrollment ID: I20230625000101 |
| Provider Name | Chester Wilson |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1548245772 PECOS PAC ID: 8325020811 Enrollment ID: I20230629002447 |
| Provider Name | Lucy R Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851922405 PECOS PAC ID: 7012376494 Enrollment ID: I20230703001073 |
| Provider Name | Stephany Zahl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679199178 PECOS PAC ID: 8820411721 Enrollment ID: I20230714001753 |
| Provider Name | Alexander Turin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1922426626 PECOS PAC ID: 2062712011 Enrollment ID: I20230715000122 |
| Provider Name | Erin Marie Holcomb |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801374830 PECOS PAC ID: 7113270018 Enrollment ID: I20230804001122 |
| Provider Name | Matthew J Haley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1073007381 PECOS PAC ID: 8729332127 Enrollment ID: I20230807002515 |
| Provider Name | Jonathan Prest |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730539511 PECOS PAC ID: 8224329990 Enrollment ID: I20230816000673 |
| Provider Name | David Joseph Doud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538785738 PECOS PAC ID: 0941624944 Enrollment ID: I20230818003120 |
| Provider Name | Jonathan S Shaw |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356672794 PECOS PAC ID: 7214291079 Enrollment ID: I20230830001808 |
| Provider Name | Sudha Penumala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437635984 PECOS PAC ID: 4486907508 Enrollment ID: I20230901003485 |
| Provider Name | Paul Filip Ziedins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114311321 PECOS PAC ID: 1951764117 Enrollment ID: I20230906000517 |
| Provider Name | Amanda Wood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528628674 PECOS PAC ID: 9739416603 Enrollment ID: I20230914000887 |
| Provider Name | Bryn Joelle Pape |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1558855544 PECOS PAC ID: 4082080296 Enrollment ID: I20231002002494 |
| Provider Name | Somer L Bareman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700663200 PECOS PAC ID: 9133575228 Enrollment ID: I20231025003594 |
| Provider Name | Julie Blossom-hartley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689194631 PECOS PAC ID: 5698006880 Enrollment ID: I20231027003314 |
| Provider Name | Roxanne Kyriakakis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598285173 PECOS PAC ID: 5991077216 Enrollment ID: I20231107000406 |
| Provider Name | Hisham Gibriel Bakhiet Elkhider |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831610815 PECOS PAC ID: 2961772884 Enrollment ID: I20231108002225 |
| Provider Name | Megan Marie Michelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811697758 PECOS PAC ID: 6800243767 Enrollment ID: I20231114003019 |
| Provider Name | Timothy Jon Buning |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851617708 PECOS PAC ID: 2567810849 Enrollment ID: I20231127002714 |
| Provider Name | Mohammad A S A Hasan |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1053966465 PECOS PAC ID: 0446606370 Enrollment ID: I20231226000332 |
| Provider Name | Haider Mahdi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134383508 PECOS PAC ID: 6002061181 Enrollment ID: I20240129001564 |
Gastroenterology Specialist Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1179 E Paris Ave Se Ste 200, Grand Rapids, MI 49546 Phone: 616-975-9100 Fax: 616-975-1161 | |
Mfb Professional Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1155 E. Paris, Ste 200, Grand Rapids, MI 49546 Phone: 616-233-3480 Fax: 616-233-3481 | |
American Current Care Of Michigan Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 933 Three Mile Road, Suite 110, Grand Rapids, MI 49544 Phone: 616-785-2619 Fax: 616-785-2623 | |
Patient One Care, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1740 28th St Se, Grand Rapids, MI 49508 Phone: 616-323-3999 Fax: 616-552-1618 | |
Elite Health, Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 310 Fulton St E, Suite A, Grand Rapids, MI 49503 Phone: 616-644-1423 Fax: 616-773-1291 | |
Cherry Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Cherry St Se, Grand Rapids, MI 49503 Phone: 616-965-8200 | |
Dr Asif Azeem Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1200 East Paris Ave Se, Ste 8, Grand Rapids, MI 49546 Phone: 616-942-6230 Fax: 616-942-6270 |