| Boone Physician Services, LLC | |
|
1600 E Broadway Columbia MO 65201-5844 | |
| (573) 815-6245 | |
| (573) 815-8556 |
| Full Name | Boone Physician Services, LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 1600 E Broadway, Columbia, Missouri |
| Authorized Official Name and Position | Brian Lee Winn (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 5738153269 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boone Physician Services, LLC 1600 E Broadway Columbia MO 65201-5844 Ph: (573) 815-6245 | Boone Physician Services, LLC 1600 E Broadway Columbia MO 65201-5844 Ph: (573) 815-6245 |
| NPI Number | 1760893259 |
|---|---|
| Provider Enumeration Date | 05/19/2014 |
| Last Update Date | 03/15/2021 |
| Certification Date | 03/15/2021 |
| Medicare PECOS PAC ID | 6507090644 |
|---|---|
| Medicare Enrollment ID | O20131003000535 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760893259 | NPI | - | NPPES |
| DU1604 | Other | MO | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| Provider Name | Michael T Kinkade |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588774889 PECOS PAC ID: 3678468329 Enrollment ID: I20040220000297 |
| Provider Name | Paul Santiago |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1114945540 PECOS PAC ID: 1052304375 Enrollment ID: I20040405000387 |
| Provider Name | Michele L Williams |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629074703 PECOS PAC ID: 0244227031 Enrollment ID: I20040426000826 |
| Provider Name | Katherine Batton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932105384 PECOS PAC ID: 6800884123 Enrollment ID: I20040505000459 |
| Provider Name | Mark Haskell Monroe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740294396 PECOS PAC ID: 3173427440 Enrollment ID: I20041104000341 |
| Provider Name | Florence F Doman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699702035 PECOS PAC ID: 6800844473 Enrollment ID: I20050111000013 |
| Provider Name | Donald J Meyer |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1912990805 PECOS PAC ID: 6507816493 Enrollment ID: I20050214000189 |
| Provider Name | Derek D Bond |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114274503 PECOS PAC ID: 1355394164 Enrollment ID: I20050222000011 |
| Provider Name | John a Kesler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710070784 PECOS PAC ID: 3577506245 Enrollment ID: I20050603000233 |
| Provider Name | Alicia Lange |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871511154 PECOS PAC ID: 2961446794 Enrollment ID: I20050614000003 |
| Provider Name | Maxwell Lazinger |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306833405 PECOS PAC ID: 5193746188 Enrollment ID: I20051219000476 |
| Provider Name | Terry Jean Elwing |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346237435 PECOS PAC ID: 7416979406 Enrollment ID: I20051219000525 |
| Provider Name | Shane T Smith |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215968110 PECOS PAC ID: 2163444316 Enrollment ID: I20060206000038 |
| Provider Name | Kimberly a Kritzer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245261601 PECOS PAC ID: 0345259586 Enrollment ID: I20060417000107 |
| Provider Name | Lindsay a Bell |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1104874833 PECOS PAC ID: 6608887831 Enrollment ID: I20060531000220 |
| Provider Name | Terrence J Ryan |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1619925559 PECOS PAC ID: 2860404274 Enrollment ID: I20060630000135 |
| Provider Name | Charles P Bondurant |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1174515696 PECOS PAC ID: 2365454774 Enrollment ID: I20060630000171 |
| Provider Name | Todd M Ankenman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1386675676 PECOS PAC ID: 7315940434 Enrollment ID: I20060815000121 |
| Provider Name | Shaon D Fry |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558380659 PECOS PAC ID: 8224031349 Enrollment ID: I20060815000352 |
| Provider Name | Anne E Petersen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114968435 PECOS PAC ID: 5799788261 Enrollment ID: I20060823000286 |
| Provider Name | Richard Kenneth Capling |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265450217 PECOS PAC ID: 4183667058 Enrollment ID: I20060912000482 |
| Provider Name | Timothy R Soncasie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225058308 PECOS PAC ID: 9234134834 Enrollment ID: I20061003000174 |
| Provider Name | Sara E Crowder |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1285689687 PECOS PAC ID: 1658377510 Enrollment ID: I20061017000141 |
| Provider Name | Matthew G Struttmann |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1386676757 PECOS PAC ID: 2365449063 Enrollment ID: I20061020000511 |
| Provider Name | Holly M Boyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801985833 PECOS PAC ID: 5991706921 Enrollment ID: I20070118000150 |
| Provider Name | Paula J Mcmurtry |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1568467546 PECOS PAC ID: 7214030485 Enrollment ID: I20070308000005 |
| Provider Name | Michael L Quinlan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134122906 PECOS PAC ID: 7810094190 Enrollment ID: I20070601000426 |
| Provider Name | Siamac Vahabzadeh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568536514 PECOS PAC ID: 5890894893 Enrollment ID: I20070615000127 |
| Provider Name | Ronald R Renard |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164591921 PECOS PAC ID: 0042310666 Enrollment ID: I20070712000041 |
| Provider Name | Kevin D Halsey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942268206 PECOS PAC ID: 5698867125 Enrollment ID: I20070828000797 |
| Provider Name | Jane a Vaughan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699750091 PECOS PAC ID: 6204924558 Enrollment ID: I20071120000297 |
| Provider Name | Megha E Garg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871695049 PECOS PAC ID: 9234213075 Enrollment ID: I20080303000656 |
| Provider Name | Kelly Nickelson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871780155 PECOS PAC ID: 1759467723 Enrollment ID: I20080401000223 |
| Provider Name | Andrew J Getzoff |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538157755 PECOS PAC ID: 1052484326 Enrollment ID: I20080718000649 |
| Provider Name | Jennifer L Epperson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1356513667 PECOS PAC ID: 8123191947 Enrollment ID: I20080725000710 |
| Provider Name | Shahbaz a Riaz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992952113 PECOS PAC ID: 9436227444 Enrollment ID: I20081003000564 |
| Provider Name | Ricardo a Hernandez |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1225191380 PECOS PAC ID: 2668531955 Enrollment ID: I20081031000044 |
| Provider Name | Carolle Silney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922172956 PECOS PAC ID: 4082780564 Enrollment ID: I20090605000168 |
| Provider Name | Arthur R Petrie |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316064595 PECOS PAC ID: 0042375370 Enrollment ID: I20090721000178 |
| Provider Name | Scott T Graham |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1750300497 PECOS PAC ID: 9638223928 Enrollment ID: I20090820000864 |
| Provider Name | Kurtis L Lackland |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1316271679 PECOS PAC ID: 2961540422 Enrollment ID: I20091104000088 |
| Provider Name | George Prica |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578637567 PECOS PAC ID: 9638245111 Enrollment ID: I20091217000105 |
| Provider Name | Sean Hamlett |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1255379970 PECOS PAC ID: 5698785905 Enrollment ID: I20100109000045 |
| Provider Name | Richard J Mellitt |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1730171026 PECOS PAC ID: 4385785542 Enrollment ID: I20100109000281 |
| Provider Name | Denise Jean Freidel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154441822 PECOS PAC ID: 6901881176 Enrollment ID: I20100201000763 |
| Provider Name | Peggy Wanner-barjenbruch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326023185 PECOS PAC ID: 8921019571 Enrollment ID: I20100305000085 |
| Provider Name | Lisa M Byrd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013140847 PECOS PAC ID: 9830226935 Enrollment ID: I20100421000744 |
| Provider Name | Rebecca Kelley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023099579 PECOS PAC ID: 4385554658 Enrollment ID: I20100524000534 |
| Provider Name | Myles B Goble |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013028745 PECOS PAC ID: 3274666086 Enrollment ID: I20100730000506 |
| Provider Name | Jessica Dale Chaney |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1922310820 PECOS PAC ID: 0941334254 Enrollment ID: I20100820001076 |
| Provider Name | Megan D Forsee |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1891009353 PECOS PAC ID: 4082739230 Enrollment ID: I20100913000397 |
| Provider Name | Michael R Chicoine |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1346268984 PECOS PAC ID: 3678698644 Enrollment ID: I20100914000828 |
| Provider Name | Linda Jill Gamlin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770770059 PECOS PAC ID: 1658467832 Enrollment ID: I20100917000718 |
| Provider Name | Donald Carl Gerhardt |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619921673 PECOS PAC ID: 3274635990 Enrollment ID: I20100920000495 |
| Provider Name | Peter Jay Cleavinger |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1841244191 PECOS PAC ID: 9335108182 Enrollment ID: I20100920000516 |
| Provider Name | Nicolas Llorens |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1174575294 PECOS PAC ID: 3375645096 Enrollment ID: I20100920000536 |
| Provider Name | Byron T Critchfield |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1396727467 PECOS PAC ID: 5395861587 Enrollment ID: I20100924000835 |
| Provider Name | Marikay L Asberry |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699724351 PECOS PAC ID: 6507058393 Enrollment ID: I20101012000839 |
| Provider Name | Joshua Charles Frates |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912227190 PECOS PAC ID: 4183817653 Enrollment ID: I20101018000681 |
| Provider Name | Matthew P Cormier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831109347 PECOS PAC ID: 6901092170 Enrollment ID: I20101130000780 |
| Provider Name | Sheena Jose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710055389 PECOS PAC ID: 6507998424 Enrollment ID: I20110322000776 |
| Provider Name | Tonya a Linthacum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972636686 PECOS PAC ID: 4789852229 Enrollment ID: I20110727000532 |
| Provider Name | James M Koch |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164625794 PECOS PAC ID: 5193994796 Enrollment ID: I20110817000279 |
| Provider Name | Lisa Marie Prather Rollison |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417111337 PECOS PAC ID: 8527238492 Enrollment ID: I20110901000171 |
| Provider Name | Venkata Kenguva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497911374 PECOS PAC ID: 1456523612 Enrollment ID: I20111012000030 |
| Provider Name | Lindi B Binder |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1538442314 PECOS PAC ID: 1759554827 Enrollment ID: I20111105000025 |
| Provider Name | Rodney C Brownell |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1750325908 PECOS PAC ID: 5395787006 Enrollment ID: I20111219000038 |
| Provider Name | Rebecca K Hornbeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326346685 PECOS PAC ID: 5193986586 Enrollment ID: I20120411000567 |
| Provider Name | Jessica M Bender |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669670659 PECOS PAC ID: 6406019306 Enrollment ID: I20120511000241 |
| Provider Name | Sara M Revelle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124104831 PECOS PAC ID: 9335302264 Enrollment ID: I20120511000556 |
| Provider Name | Rachel B Hanson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1548539414 PECOS PAC ID: 3072777580 Enrollment ID: I20120613000681 |
| Provider Name | Joss Fernandez |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1235173642 PECOS PAC ID: 5395748875 Enrollment ID: I20120709000389 |
| Provider Name | Alexandre Makarian |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639321045 PECOS PAC ID: 7618123407 Enrollment ID: I20120810000030 |
| Provider Name | David T James |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033398771 PECOS PAC ID: 0941355697 Enrollment ID: I20120816000084 |
| Provider Name | Jason a Goodin |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1629165436 PECOS PAC ID: 4587810049 Enrollment ID: I20120816000099 |
| Provider Name | Adnan Z Choudhury |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669603486 PECOS PAC ID: 6507013679 Enrollment ID: I20120823000925 |
| Provider Name | Cheryl J Cawley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1750402525 PECOS PAC ID: 5496901142 Enrollment ID: I20120905000081 |
| Provider Name | Michael Dewayne Roach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740592435 PECOS PAC ID: 7719153279 Enrollment ID: I20121002000775 |
| Provider Name | Rahul Shekhar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184854663 PECOS PAC ID: 6709035405 Enrollment ID: I20121011000885 |
| Provider Name | Brandon J Glasgow |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063775997 PECOS PAC ID: 2466602958 Enrollment ID: I20121018000045 |
| Provider Name | Melissa Renee Koga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922356294 PECOS PAC ID: 1759532385 Enrollment ID: I20121108000100 |
| Provider Name | Rafael Marroquin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740419431 PECOS PAC ID: 3476704354 Enrollment ID: I20121127000681 |
| Provider Name | Elizabeth a Crews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710232905 PECOS PAC ID: 9830341593 Enrollment ID: I20121204000521 |
| Provider Name | Jacqueline Lea Beshears |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710239033 PECOS PAC ID: 9133372758 Enrollment ID: I20130110000277 |
| Provider Name | Mohammed Ahmed |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1538443791 PECOS PAC ID: 7315112992 Enrollment ID: I20130604000301 |
| Provider Name | Cathy J Cody |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225349111 PECOS PAC ID: 9830339704 Enrollment ID: I20130717000707 |
| Provider Name | Christian Andres Rojas Moreno |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1245492396 PECOS PAC ID: 1951544824 Enrollment ID: I20130823001139 |
| Provider Name | Aaron J Whiting |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225359573 PECOS PAC ID: 2860635356 Enrollment ID: I20130903000107 |
| Provider Name | Sonya S Addison |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1215199369 PECOS PAC ID: 3072756287 Enrollment ID: I20130906000359 |
| Provider Name | Catherine a Scheulen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710326210 PECOS PAC ID: 7113151614 Enrollment ID: I20131017000317 |
| Provider Name | Andrea Young Willer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790126399 PECOS PAC ID: 5597992578 Enrollment ID: I20131219000516 |
| Provider Name | Nathan Lee Granneman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689960171 PECOS PAC ID: 9436384542 Enrollment ID: I20140306000407 |
| Provider Name | Melinda Carol Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619399003 PECOS PAC ID: 5698905842 Enrollment ID: I20140307001528 |
| Provider Name | Reggie a Vaden |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1700983343 PECOS PAC ID: 5294622536 Enrollment ID: I20140425001393 |
| Provider Name | Tareq M Abu Salah |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1417914474 PECOS PAC ID: 0042476251 Enrollment ID: I20140513000399 |
| Provider Name | Housam E Soukieh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568422673 PECOS PAC ID: 1254482631 Enrollment ID: I20140904002142 |
| Provider Name | Jeremy William Briggs |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316364185 PECOS PAC ID: 7416968300 Enrollment ID: I20140909002315 |
| Provider Name | Erica H Salinas |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1396914321 PECOS PAC ID: 7214161116 Enrollment ID: I20140911001889 |
| Provider Name | Delali K Buatsi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275778649 PECOS PAC ID: 4082872346 Enrollment ID: I20141008000790 |
| Provider Name | Karen L Florio |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932405776 PECOS PAC ID: 9032397278 Enrollment ID: I20141021002542 |
| Provider Name | Abdalla M Oun |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992089619 PECOS PAC ID: 1456673474 Enrollment ID: I20141202002201 |
| Provider Name | Abby Marie Brunnert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679989800 PECOS PAC ID: 0446573232 Enrollment ID: I20141231001682 |
| Provider Name | Shelton C Blevins |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376951590 PECOS PAC ID: 9335466978 Enrollment ID: I20150319002352 |
| Provider Name | Wendell Nall |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1447306725 PECOS PAC ID: 6002128105 Enrollment ID: I20150702000172 |
| Provider Name | Kate L Grossman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1841452869 PECOS PAC ID: 7416127337 Enrollment ID: I20150702000201 |
| Provider Name | Rachel a Mallett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457730715 PECOS PAC ID: 1557673167 Enrollment ID: I20150709001965 |
| Provider Name | Joshua B Mongler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841551660 PECOS PAC ID: 1557595725 Enrollment ID: I20150710001502 |
| Provider Name | Benjamin Kuster |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376923730 PECOS PAC ID: 5193038230 Enrollment ID: I20150720001263 |
| Provider Name | Angela Schmitt |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578819140 PECOS PAC ID: 6709199375 Enrollment ID: I20150727000148 |
| Provider Name | Aruna Cheddi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053676197 PECOS PAC ID: 9133437833 Enrollment ID: I20150930000105 |
| Provider Name | Brittany a Kammerich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396157699 PECOS PAC ID: 7719295344 Enrollment ID: I20151001001635 |
| Provider Name | Lauren Nicole Obrien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790153922 PECOS PAC ID: 7810297264 Enrollment ID: I20151208000609 |
| Provider Name | Jonathan Daniel Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376915678 PECOS PAC ID: 4880995265 Enrollment ID: I20151209002463 |
| Provider Name | Garrel L Renick |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1114288495 PECOS PAC ID: 6406156454 Enrollment ID: I20160304001495 |
| Provider Name | Logan Frank |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356655104 PECOS PAC ID: 1557595204 Enrollment ID: I20160607002199 |
| Provider Name | Ursula Reusch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477633063 PECOS PAC ID: 4082614755 Enrollment ID: I20160712000627 |
| Provider Name | Chad P Zeglis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053751578 PECOS PAC ID: 4688808710 Enrollment ID: I20160729000486 |
| Provider Name | Steveny Grieve |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659735595 PECOS PAC ID: 4688968837 Enrollment ID: I20160810001742 |
| Provider Name | Elizabeth M Fagiolo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689038101 PECOS PAC ID: 8729373220 Enrollment ID: I20160823001912 |
| Provider Name | Mario Alejandro Tapia Gomez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851563787 PECOS PAC ID: 2668542374 Enrollment ID: I20160926000060 |
| Provider Name | Ashley Paige Makowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740631928 PECOS PAC ID: 5698054021 Enrollment ID: I20161108000641 |
| Provider Name | David C Streitman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083719637 PECOS PAC ID: 2466524103 Enrollment ID: I20161118000841 |
| Provider Name | Taylor Morgan Wesley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598209512 PECOS PAC ID: 3072894294 Enrollment ID: I20161230001698 |
| Provider Name | Farzin Fotouhi |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1679562920 PECOS PAC ID: 4385669076 Enrollment ID: I20170126002378 |
| Provider Name | Mindy Lou Doscher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003274440 PECOS PAC ID: 8224312657 Enrollment ID: I20170303000911 |
| Provider Name | Rubin Jit Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942615992 PECOS PAC ID: 9537466115 Enrollment ID: I20170724002911 |
| Provider Name | Michael D Williams |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750334470 PECOS PAC ID: 2769495514 Enrollment ID: I20170815000742 |
| Provider Name | Nicholas Madaffer |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1649535824 PECOS PAC ID: 5395978225 Enrollment ID: I20170831002756 |
| Provider Name | Patricia E Watson-adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578006714 PECOS PAC ID: 5092077198 Enrollment ID: I20180402000295 |
| Provider Name | Andres Bran Acevedo |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1821353509 PECOS PAC ID: 1658643267 Enrollment ID: I20180711001383 |
| Provider Name | Tochukwu Emmanuel Njepuome |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417337296 PECOS PAC ID: 9638480023 Enrollment ID: I20180712000670 |
| Provider Name | Jane Isabelle Foreman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699267047 PECOS PAC ID: 8820346109 Enrollment ID: I20180802000952 |
| Provider Name | John a Fernando |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487049250 PECOS PAC ID: 2567764723 Enrollment ID: I20180815001968 |
| Provider Name | Farhan Siddiq |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1740472745 PECOS PAC ID: 7214006618 Enrollment ID: I20180816001052 |
| Provider Name | Matthew James Freer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710372446 PECOS PAC ID: 5092026815 Enrollment ID: I20180824000811 |
| Provider Name | Steven Benjamin Carr |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1588989172 PECOS PAC ID: 4981954377 Enrollment ID: I20180905003292 |
| Provider Name | Stephanie Whitbey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043796444 PECOS PAC ID: 5395096077 Enrollment ID: I20180919001033 |
| Provider Name | Jamie D Markway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821588609 PECOS PAC ID: 5496007759 Enrollment ID: I20181015002262 |
| Provider Name | David F Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245492982 PECOS PAC ID: 8820333685 Enrollment ID: I20181222000468 |
| Provider Name | Rebecca Cates Shetley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689146060 PECOS PAC ID: 8729325816 Enrollment ID: I20190128002355 |
| Provider Name | Ndeye Marieme Ndiaye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972076743 PECOS PAC ID: 2668712472 Enrollment ID: I20190314000080 |
| Provider Name | Ahmad Abou Leila |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1861741126 PECOS PAC ID: 4183993546 Enrollment ID: I20190417000333 |
| Provider Name | Cody Marie Eckelkamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154988327 PECOS PAC ID: 4789919150 Enrollment ID: I20190709000476 |
| Provider Name | Taylor B Nelson |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1104230903 PECOS PAC ID: 6002032430 Enrollment ID: I20190710002536 |
| Provider Name | Crystelle Wiona Canuto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063076313 PECOS PAC ID: 9234465683 Enrollment ID: I20190724000138 |
| Provider Name | Muhammad Asghar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063862795 PECOS PAC ID: 3870860547 Enrollment ID: I20190729001313 |
| Provider Name | Ghulam Ghous |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003260787 PECOS PAC ID: 7810223641 Enrollment ID: I20190731001734 |
| Provider Name | Mustafa Alsaid Alkhreisat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205268588 PECOS PAC ID: 3678869153 Enrollment ID: I20190802002010 |
| Provider Name | Daniel W Lovinger |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598115693 PECOS PAC ID: 8123310091 Enrollment ID: I20190805000851 |
| Provider Name | Blake J Welschmeyer |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1154771178 PECOS PAC ID: 8224320106 Enrollment ID: I20190808003775 |
| Provider Name | Zahid Ijaz Tarar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922459056 PECOS PAC ID: 1355679507 Enrollment ID: I20190826002008 |
| Provider Name | Laneshia K Tague |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1619276136 PECOS PAC ID: 1355561762 Enrollment ID: I20190920001282 |
| Provider Name | Shambhu Bhagat |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1972954097 PECOS PAC ID: 1850645607 Enrollment ID: I20190924000407 |
| Provider Name | Rebekah C Bail |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023664562 PECOS PAC ID: 3678805785 Enrollment ID: I20191022003571 |
| Provider Name | Sarah Rene Mcbee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235790833 PECOS PAC ID: 8426481805 Enrollment ID: I20191126001906 |
| Provider Name | Kellie Marie Asher |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1598395691 PECOS PAC ID: 5597191395 Enrollment ID: I20200213001760 |
| Provider Name | Robin Elizabeth Howard-boyd |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1003435454 PECOS PAC ID: 2668802364 Enrollment ID: I20200421000877 |
| Provider Name | Phillip P Beck |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1700236882 PECOS PAC ID: 4981996857 Enrollment ID: I20200423003087 |
| Provider Name | Charlotte Lin Chang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578083515 PECOS PAC ID: 7618248568 Enrollment ID: I20200515001945 |
| Provider Name | Rachael N Brashears |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1427445493 PECOS PAC ID: 2668776303 Enrollment ID: I20200710002862 |
| Provider Name | Felix Nau Jr |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932632544 PECOS PAC ID: 5294005351 Enrollment ID: I20200721001367 |
| Provider Name | Emily Schroeder Webber |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356962039 PECOS PAC ID: 8325463037 Enrollment ID: I20200728003925 |
| Provider Name | Saqib Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376978064 PECOS PAC ID: 5294964250 Enrollment ID: I20200813002891 |
| Provider Name | Bethany R Mullinix |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336671023 PECOS PAC ID: 0648538694 Enrollment ID: I20200827002789 |
| Provider Name | Arooj Mohsin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821521386 PECOS PAC ID: 8527331297 Enrollment ID: I20201012000656 |
| Provider Name | Elizabeth Anne Snodgrass-stringer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588207310 PECOS PAC ID: 5395178149 Enrollment ID: I20201015003367 |
| Provider Name | Katelyn Foley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1366043630 PECOS PAC ID: 1850702952 Enrollment ID: I20201120002054 |
| Provider Name | Shannon Marie Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750995270 PECOS PAC ID: 4385056464 Enrollment ID: I20201214002424 |
| Provider Name | Bradley W Anderson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1649533878 PECOS PAC ID: 9830335793 Enrollment ID: I20201216002609 |
| Provider Name | Pamela Louise Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841806551 PECOS PAC ID: 8022423698 Enrollment ID: I20210211001701 |
| Provider Name | Kari Angela Jansing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124621289 PECOS PAC ID: 6406261726 Enrollment ID: I20210219000401 |
| Provider Name | Lauren Wood Breshears |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861887689 PECOS PAC ID: 0446667893 Enrollment ID: I20210331000675 |
| Provider Name | Hunter Douglas Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811580566 PECOS PAC ID: 4981013026 Enrollment ID: I20210503000602 |
| Provider Name | Sarah Larraine Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912571282 PECOS PAC ID: 5395145205 Enrollment ID: I20210615001669 |
| Provider Name | Syed Osama Hassan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245728492 PECOS PAC ID: 4981005477 Enrollment ID: I20210622000202 |
| Provider Name | Brandi Dawn Zey-thacker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679170047 PECOS PAC ID: 9032511183 Enrollment ID: I20210712002511 |
| Provider Name | Ashlee L Dougherty |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801416599 PECOS PAC ID: 3870996465 Enrollment ID: I20210720001577 |
| Provider Name | Joy Annette Wolfe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306345368 PECOS PAC ID: 8820491194 Enrollment ID: I20210723001360 |
| Provider Name | Elyssa Ann Gibbons |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1447923313 PECOS PAC ID: 3577967306 Enrollment ID: I20210802001200 |
| Provider Name | Alex Michael |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1750796603 PECOS PAC ID: 8921223090 Enrollment ID: I20210805003299 |
| Provider Name | Liza Suzanne Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386217388 PECOS PAC ID: 4880091990 Enrollment ID: I20210916000114 |
| Provider Name | Matthew Bryant Maasen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265006662 PECOS PAC ID: 8527465657 Enrollment ID: I20210916000925 |
| Provider Name | Grace Elizabeth Wilson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1750761532 PECOS PAC ID: 0244542660 Enrollment ID: I20210929003020 |
| Provider Name | Kearsta Courier |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144985888 PECOS PAC ID: 1850780842 Enrollment ID: I20211112001273 |
| Provider Name | Ashley Renee Walker-ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104385335 PECOS PAC ID: 3173851466 Enrollment ID: I20211115002281 |
| Provider Name | Jean Ricci Goodman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447228093 PECOS PAC ID: 4385675669 Enrollment ID: I20211122001654 |
| Provider Name | Emma L Mallory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013672104 PECOS PAC ID: 9133519572 Enrollment ID: I20211129002282 |
| Provider Name | Julia Cosma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194711515 PECOS PAC ID: 0749207991 Enrollment ID: I20211202000944 |
| Provider Name | Kellee Lorraine Randle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932449055 PECOS PAC ID: 1850533274 Enrollment ID: I20211202002803 |
| Provider Name | Andrea Feger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518530385 PECOS PAC ID: 9133519226 Enrollment ID: I20211203001578 |
| Provider Name | Brogan Tipton |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225552664 PECOS PAC ID: 0244563450 Enrollment ID: I20211206001012 |
| Provider Name | Nakeya Lynn Steele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477218717 PECOS PAC ID: 2062802010 Enrollment ID: I20211206001274 |
| Provider Name | Lance Joseph Leverenz |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457010647 PECOS PAC ID: 3476944059 Enrollment ID: I20211216000681 |
| Provider Name | Tawny M Loyd |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1275205643 PECOS PAC ID: 3971994120 Enrollment ID: I20211222001152 |
| Provider Name | Cameron Olsen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285252973 PECOS PAC ID: 5193116325 Enrollment ID: I20211227000198 |
| Provider Name | Morgan L Lewis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003572850 PECOS PAC ID: 5294128872 Enrollment ID: I20220202002512 |
| Provider Name | Tammy L Doerhoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518628163 PECOS PAC ID: 9830582444 Enrollment ID: I20220203000224 |
| Provider Name | Carley Kloess |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528723285 PECOS PAC ID: 1557757010 Enrollment ID: I20220408001715 |
| Provider Name | Joseph William Galaske |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1568112308 PECOS PAC ID: 9739576430 Enrollment ID: I20220427002880 |
| Provider Name | James Bryce Boudreau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689312787 PECOS PAC ID: 9739561812 Enrollment ID: I20220805002064 |
| Provider Name | Mary R.a Mikhael |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285286674 PECOS PAC ID: 7315277514 Enrollment ID: I20220809000271 |
| Provider Name | Ronald Jones |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063919538 PECOS PAC ID: 3779838495 Enrollment ID: I20220818000712 |
| Provider Name | Joseph W Mcgreevy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447716683 PECOS PAC ID: 2365770567 Enrollment ID: I20220823001215 |
| Provider Name | Sarah Elizabeth Severance |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1609256981 PECOS PAC ID: 0244551927 Enrollment ID: I20220908001717 |
| Provider Name | Daniel Elizondo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366002362 PECOS PAC ID: 1456687672 Enrollment ID: I20220913000682 |
| Provider Name | Meagan Michelle Fansler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720715485 PECOS PAC ID: 0345625125 Enrollment ID: I20220914002426 |
| Provider Name | Brian Edward Gonzales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295453397 PECOS PAC ID: 8325423106 Enrollment ID: I20220914002526 |
| Provider Name | Benjamin Gerber |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467748673 PECOS PAC ID: 6800038555 Enrollment ID: I20220919003031 |
| Provider Name | Peter James Nilsson |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1104347046 PECOS PAC ID: 4284904665 Enrollment ID: I20220923002664 |
| Provider Name | Megan Bethany Koenig |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1447830492 PECOS PAC ID: 6800262916 Enrollment ID: I20221014000647 |
| Provider Name | Cheryl a Stallo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881322600 PECOS PAC ID: 0941676522 Enrollment ID: I20221024000305 |
| Provider Name | Julie M Bresnahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881311009 PECOS PAC ID: 3678942604 Enrollment ID: I20221213002166 |
| Provider Name | Briana Kathleen Kile |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447961511 PECOS PAC ID: 8123497088 Enrollment ID: I20221215001792 |
| Provider Name | Antoinette M Metzner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295447886 PECOS PAC ID: 5294105029 Enrollment ID: I20230111003037 |
| Provider Name | Nikki a Clatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568101822 PECOS PAC ID: 8729450093 Enrollment ID: I20230214002967 |
| Provider Name | Christopher Michael Benne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487353942 PECOS PAC ID: 0648644518 Enrollment ID: I20230315001973 |
| Provider Name | Chukwudi Eke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801066733 PECOS PAC ID: 7012078553 Enrollment ID: I20230322002070 |
| Provider Name | Sadiat Adebiyi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811627672 PECOS PAC ID: 8426423591 Enrollment ID: I20230621002986 |
| Provider Name | Brandi J Haerer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467144931 PECOS PAC ID: 7012376684 Enrollment ID: I20230630000155 |
| Provider Name | Kevin Hicks |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669490413 PECOS PAC ID: 7719046168 Enrollment ID: I20230714002545 |
| Provider Name | Conor T Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952927667 PECOS PAC ID: 7416375431 Enrollment ID: I20230801000899 |
| Provider Name | John D Richard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1568448116 PECOS PAC ID: 9830550045 Enrollment ID: I20230804000443 |
| Provider Name | Theppharit Panichsillapakit |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1972033397 PECOS PAC ID: 4587094966 Enrollment ID: I20230908001541 |
| Provider Name | Noel Lucas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184676090 PECOS PAC ID: 1759317316 Enrollment ID: I20230912002740 |
| Provider Name | Natalie Ann Bethel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447843263 PECOS PAC ID: 5698129732 Enrollment ID: I20230923000561 |
| Provider Name | Gustavo Arturo Avila Amat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437655131 PECOS PAC ID: 8628305182 Enrollment ID: I20231005002802 |
| Provider Name | Mohammad M Hassan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326049420 PECOS PAC ID: 9739121781 Enrollment ID: I20231010000437 |
| Provider Name | Kerissa Taylor Harris |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841068038 PECOS PAC ID: 9739539958 Enrollment ID: I20231229000629 |
| Provider Name | Kim Train |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285743856 PECOS PAC ID: 0749324697 Enrollment ID: I20240108002867 |
| Provider Name | Balint Istvan Otvos |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1720338452 PECOS PAC ID: 6305148644 Enrollment ID: I20240108005217 |
| Provider Name | Brooke Zukowski |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720856487 PECOS PAC ID: 3476905571 Enrollment ID: I20240113000203 |
| Provider Name | Noah Brayden Cunningham |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1053194217 PECOS PAC ID: 1658724281 Enrollment ID: I20240130002286 |
| Provider Name | Raymond Churk-yin Lee |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1134422934 PECOS PAC ID: 4981851292 Enrollment ID: I20240401000206 |
| Provider Name | Bryton E Perman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952963241 PECOS PAC ID: 7416287487 Enrollment ID: I20240405001410 |
| Provider Name | Brandon Michael Wiler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932643160 PECOS PAC ID: 6507205226 Enrollment ID: I20240415001877 |
| Provider Name | Jeremy J Song |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1467879379 PECOS PAC ID: 4587901947 Enrollment ID: I20240419001667 |
| Provider Name | Jordan Nicole Newman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508322611 PECOS PAC ID: 6305286139 Enrollment ID: I20240426002590 |
| Provider Name | Paige Berniece Lang |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932955358 PECOS PAC ID: 9739520537 Enrollment ID: I20240510001456 |
| Provider Name | Okechukwu Anochie |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346772894 PECOS PAC ID: 0345659587 Enrollment ID: I20240522003811 |
| Provider Name | Kim Pham |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699303305 PECOS PAC ID: 5698199537 Enrollment ID: I20240601000125 |
| Provider Name | Cameron S Gilbert |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780034892 PECOS PAC ID: 1355633249 Enrollment ID: I20240620001934 |
| Provider Name | Kanchan Bhattarai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336983006 PECOS PAC ID: 8123562840 Enrollment ID: I20240704000208 |
| Provider Name | El Hacen Vall |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1689243750 PECOS PAC ID: 8325587363 Enrollment ID: I20240822001566 |
| Provider Name | Abdul Mounaem Majzoub |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336708759 PECOS PAC ID: 6901133503 Enrollment ID: I20240831000391 |
| Provider Name | Lin Zhuang |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669054052 PECOS PAC ID: 2062815442 Enrollment ID: I20240909002940 |
| Provider Name | Joseph Ferry |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831777960 PECOS PAC ID: 9537560123 Enrollment ID: I20240912001336 |
| Provider Name | Hadassah Michelle Consuegra Anderson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1699190983 PECOS PAC ID: 6103150073 Enrollment ID: I20240913000850 |
| Provider Name | Mackenzie Taychert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366010043 PECOS PAC ID: 7911308309 Enrollment ID: I20240917001323 |
| Provider Name | Kyle C Markway |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1154634855 PECOS PAC ID: 9830381698 Enrollment ID: I20240920000657 |
| Provider Name | Michael Naylor |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1992720601 PECOS PAC ID: 5890740039 Enrollment ID: I20240921000361 |
| Provider Name | Blaine Winterton |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1154983237 PECOS PAC ID: 4587992318 Enrollment ID: I20240923000116 |
| Provider Name | Prathik Kolluru |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245612175 PECOS PAC ID: 2163771395 Enrollment ID: I20240927002512 |
| Provider Name | Claire Kuhlman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619795127 PECOS PAC ID: 4082146303 Enrollment ID: I20241011001026 |
| Provider Name | Sairah P Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447868583 PECOS PAC ID: 3476085911 Enrollment ID: I20241022002038 |
| Provider Name | Naga Perisetti |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922238922 PECOS PAC ID: 8729254883 Enrollment ID: I20241024003121 |
| Provider Name | Brenna Stotlemeyer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619738853 PECOS PAC ID: 4880129154 Enrollment ID: I20241122002425 |
| Provider Name | Claudia Martin |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1134272743 PECOS PAC ID: 7214023621 Enrollment ID: I20241210003681 |
| Provider Name | Heidi Mahnken |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942658745 PECOS PAC ID: 3779879234 Enrollment ID: I20241216003323 |
| Provider Name | Hunter Nicole Damron |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1467283556 PECOS PAC ID: 9830628387 Enrollment ID: I20250128004455 |
| Provider Name | Jennifer O'neill |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730171760 PECOS PAC ID: 0648232348 Enrollment ID: I20250213001086 |
| Provider Name | Karlee Ann Shettlesworth |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1891594297 PECOS PAC ID: 2769906858 Enrollment ID: I20250410001155 |
| Provider Name | Vikram Palkar |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1376947135 PECOS PAC ID: 8022381722 Enrollment ID: I20250411002297 |
| Provider Name | Lana Ann Zerrer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295799096 PECOS PAC ID: 5890936272 Enrollment ID: I20250423000153 |
| Provider Name | Rayni Nicole Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942019724 PECOS PAC ID: 7618495623 Enrollment ID: I20250514000567 |
| Provider Name | Rebecca Kay Griggs |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336717636 PECOS PAC ID: 6103330204 Enrollment ID: I20250710000420 |
| Provider Name | John Cho |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114245990 PECOS PAC ID: 8527355718 Enrollment ID: I20251114003597 |
| Provider Name | Monik M Lala |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194847038 PECOS PAC ID: 9830264290 Enrollment ID: I20251120003965 |
| Provider Name | Shyla Penaroza |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821293747 PECOS PAC ID: 0648449710 Enrollment ID: I20251121001074 |
| Provider Name | Alwalid Ashmeik |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225667835 PECOS PAC ID: 6901315845 Enrollment ID: I20251121001942 |
| Provider Name | Michael Munz |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1093712572 PECOS PAC ID: 1850283581 Enrollment ID: I20251121001988 |
| Provider Name | Jack Klem |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1871710004 PECOS PAC ID: 4587741236 Enrollment ID: I20251121004299 |
| Provider Name | Ben Paxton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548469372 PECOS PAC ID: 4981846219 Enrollment ID: I20251122000427 |
| Provider Name | Tarang Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144372020 PECOS PAC ID: 4587703491 Enrollment ID: I20251122000634 |
| Provider Name | Linda K Armstrong |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285841916 PECOS PAC ID: 4486816105 Enrollment ID: I20251126000493 |
| Provider Name | Matthew Zweerink |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1215414867 PECOS PAC ID: 4385988591 Enrollment ID: I20251129000245 |
| Provider Name | Rajiv Srinivasa |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1962768457 PECOS PAC ID: 3476808619 Enrollment ID: I20251202002277 |
| Provider Name | Eric Davis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831312099 PECOS PAC ID: 3375629587 Enrollment ID: I20251203000828 |
| Provider Name | Ian Fischer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306937198 PECOS PAC ID: 5799783023 Enrollment ID: I20251204004506 |
| Provider Name | Melissa Levack |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1629273214 PECOS PAC ID: 8224281456 Enrollment ID: I20251208001370 |
| Provider Name | Yehia Elguindy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326303736 PECOS PAC ID: 9436404753 Enrollment ID: I20251215002658 |
| Provider Name | Louis Gerges |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528700762 PECOS PAC ID: 5092193904 Enrollment ID: I20251216004113 |
| Provider Name | David Kephart |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376906958 PECOS PAC ID: 0345532727 Enrollment ID: I20251216004372 |
| Provider Name | Kush Shah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710304746 PECOS PAC ID: 1355760992 Enrollment ID: I20251223002971 |
| Provider Name | Aparna Baheti |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902149339 PECOS PAC ID: 8729322938 Enrollment ID: I20251224000750 |
| Provider Name | Matthew Pipho |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285054064 PECOS PAC ID: 8022311919 Enrollment ID: I20260105000147 |
| Provider Name | Jamie L Froeschner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619265808 PECOS PAC ID: 9032342431 Enrollment ID: I20260106000391 |
| Provider Name | Richard Downey |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1467409417 PECOS PAC ID: 3476637836 Enrollment ID: I20260112001172 |
| Provider Name | Jarrod Dale |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457586562 PECOS PAC ID: 8426271198 Enrollment ID: I20260114003856 |
| Provider Name | Mari Biers |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1417830449 PECOS PAC ID: 6103304647 Enrollment ID: I20260127003936 |
| Provider Name | Stephanie Marie Richards |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1427916303 PECOS PAC ID: 9133609134 Enrollment ID: I20260218001310 |
| Provider Name | Lydia Sexton |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891659207 PECOS PAC ID: 9234610650 Enrollment ID: I20260224003357 |
| Provider Name | Taylor Maloney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144753658 PECOS PAC ID: 6103194378 Enrollment ID: I20260302003092 |
| Provider Name | Loren Longenecker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194016659 PECOS PAC ID: 6305078155 Enrollment ID: I20260302003338 |
| Provider Name | Joseph Cherri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144713082 PECOS PAC ID: 5193078350 Enrollment ID: I20260304003949 |
| Provider Name | Jessa Marie Tunacao |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912438474 PECOS PAC ID: 7810267648 Enrollment ID: I20260306000556 |
| Provider Name | Rakhee Goel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659506921 PECOS PAC ID: 7315259876 Enrollment ID: I20260310001016 |
| Provider Name | Courtney Lynn Kessler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033079231 PECOS PAC ID: 1951884873 Enrollment ID: I20260310001451 |
| Provider Name | Thomas Barbata |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1356958862 PECOS PAC ID: 3072922350 Enrollment ID: I20260316002774 |
| Provider Name | Jennifer Hedgecorth |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891647251 PECOS PAC ID: 4880177088 Enrollment ID: I20260316003694 |
| Provider Name | Ali Sepahdari |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508081969 PECOS PAC ID: 0345390142 Enrollment ID: I20260319001788 |
| Provider Name | Joe Parkey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699732925 PECOS PAC ID: 2567446735 Enrollment ID: I20260323001604 |
| Provider Name | Ali Amanda See |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699572552 PECOS PAC ID: 0749764967 Enrollment ID: I20260325001397 |
| Provider Name | David E Hole |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1124280482 PECOS PAC ID: 1557436920 Enrollment ID: I20260327004004 |
| Provider Name | Kathryn Darkow |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1477412724 PECOS PAC ID: 9537644414 Enrollment ID: I20260328000343 |
| Provider Name | Francisco Contreras |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184034118 PECOS PAC ID: 2860817533 Enrollment ID: I20260331002304 |
| Provider Name | Caitlyn Tennile Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104779370 PECOS PAC ID: 2163997198 Enrollment ID: I20260408000386 |
| Provider Name | Ranjit Chima |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538587266 PECOS PAC ID: 1355560525 Enrollment ID: I20260410002065 |
| Provider Name | Ibrahim Darwish |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295293587 PECOS PAC ID: 8820424112 Enrollment ID: I20260414000167 |
| Provider Name | Hakeem Hindi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093174617 PECOS PAC ID: 2860880408 Enrollment ID: I20260416002938 |
| Provider Name | Muddassar Mahboob |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790417855 PECOS PAC ID: 9638553753 Enrollment ID: I20260421003477 |
| Provider Name | Cyrus Anderson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871707265 PECOS PAC ID: 8527133222 Enrollment ID: I20260422000513 |
| Provider Name | Meghan Wood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487234969 PECOS PAC ID: 3971905647 Enrollment ID: I20260422000875 |
| Provider Name | Cyrillo Araujo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295983179 PECOS PAC ID: 8729126230 Enrollment ID: I20260507002423 |
| Provider Name | Cathryn Shaw |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467629113 PECOS PAC ID: 0547438293 Enrollment ID: I20260521000448 |
| Provider Name | David Welch |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1447147699 PECOS PAC ID: 2163992892 Enrollment ID: I20260522002866 |
| Provider Name | Marie Hole |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083873814 PECOS PAC ID: 5991921900 Enrollment ID: I20260616002069 |
| Provider Name | Brooke Christine Hendrickson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1356208979 PECOS PAC ID: 0446723043 Enrollment ID: I20260625000914 |
Columbia Family Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 303 N Keene St, Suite 301, Columbia, MO 65201 Phone: 573-449-0808 Fax: 573-442-1331 |
University Physicians Specialty Care Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3100 W Broadway, Columbia, MO 65203 Phone: 573-884-7701 |
Nephrology and Hypertension Associates Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1205 W Broadway, Columbia, MO 65203 Phone: 573-499-0642 Fax: 573-449-1787 |
Family Dental Center Columbia East Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2475 Broadway Bluffs Dr, Suite 200, Columbia, MO 65201 Phone: 573-777-9282 Fax: 573-777-9569 |
Curated Medicine, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3610 Buttonwood Dr Ste 200, Columbia, MO 65201 Phone: 573-810-8800 |
To Your Health Medical Clinic, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2614 Forum Boulevard, Suite 100, Columbia, MO 65203 Phone: 573-445-3430 Fax: 573-445-3460 |