| Capital Region Physicians | |
|
1125 Madison St Jefferson City MO 65101-5227 | |
| (573) 632-5583 | |
| (573) 632-5896 |
| Full Name | Capital Region Physicians |
|---|---|
| Speciality | Family Medicine |
| Location | 1125 Madison St, Jefferson City, Missouri |
| Authorized Official Name and Position | Tom Luebbering (VICE PRESIDENT OF FINANCE) |
| Authorized Official Contact | 5736325100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Capital Region Physicians 1125 Madison St Jefferson City MO 65101-5227 Ph: (573) 632-5583 | Capital Region Physicians 1125 Madison St Jefferson City MO 65101-5227 Ph: (573) 632-5583 |
| NPI Number | 1477980837 |
|---|---|
| Provider Enumeration Date | 10/01/2013 |
| Last Update Date | 07/29/2020 |
| Medicare PECOS PAC ID | 4688573686 |
|---|---|
| Medicare Enrollment ID | O20070323000507 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477980837 | NPI | - | NPPES |
| Provider Name | Serese Y Smith-haxton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518048735 PECOS PAC ID: 8022919273 Enrollment ID: I20040120000302 |
| Provider Name | Daniel L Gibson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699748772 PECOS PAC ID: 1850287103 Enrollment ID: I20040224001214 |
| Provider Name | Monica L Biddle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396859153 PECOS PAC ID: 6204828403 Enrollment ID: I20040330001324 |
| Provider Name | Keith E Segall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639245368 PECOS PAC ID: 9739084757 Enrollment ID: I20040331000436 |
| Provider Name | Raonak Ekram |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1255300133 PECOS PAC ID: 8527050475 Enrollment ID: I20040331001052 |
| Provider Name | Morgan R Hahn |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1316981723 PECOS PAC ID: 8123011178 Enrollment ID: I20040406000246 |
| Provider Name | John R Russell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063486660 PECOS PAC ID: 8022002278 Enrollment ID: I20040415001032 |
| Provider Name | Dennis C Luetkemeyer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649378597 PECOS PAC ID: 7416944772 Enrollment ID: I20040428000903 |
| Provider Name | Joseph P Stitzer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1578622353 PECOS PAC ID: 9537140892 Enrollment ID: I20040525000411 |
| Provider Name | Theresa Marie Hogg |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1952460818 PECOS PAC ID: 9335121177 Enrollment ID: I20040604000148 |
| Provider Name | Tawnyia Jerome |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710955760 PECOS PAC ID: 6204814049 Enrollment ID: I20040709000083 |
| Provider Name | James F Tritz |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1447230131 PECOS PAC ID: 4789664947 Enrollment ID: I20040720001354 |
| Provider Name | Mary Ann Jankowski |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336190925 PECOS PAC ID: 5193795136 Enrollment ID: I20040728000543 |
| Provider Name | Elizabeth Kay Early |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1962408492 PECOS PAC ID: 6406826916 Enrollment ID: I20040730000230 |
| Provider Name | Jonathon Strong |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1578536363 PECOS PAC ID: 6406828482 Enrollment ID: I20040810001013 |
| Provider Name | Brian Edwards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639147283 PECOS PAC ID: 3971578568 Enrollment ID: I20040827000437 |
| Provider Name | Gregory P Markway |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255373148 PECOS PAC ID: 3173599602 Enrollment ID: I20040907000941 |
| Provider Name | Brian W Herrbold |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689650509 PECOS PAC ID: 6507832896 Enrollment ID: I20040911000165 |
| Provider Name | Kent P Taylor |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1649234089 PECOS PAC ID: 4981663010 Enrollment ID: I20041005000977 |
| Provider Name | Kevin J Lockett |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265483028 PECOS PAC ID: 6103886338 Enrollment ID: I20041013000096 |
| Provider Name | Daniel G Hoernschemeyer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1558312165 PECOS PAC ID: 1355305798 Enrollment ID: I20041116000707 |
| Provider Name | Mark F Gortmaker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1649244161 PECOS PAC ID: 0749239036 Enrollment ID: I20050113000393 |
| Provider Name | Thomas E Reinsel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1508837634 PECOS PAC ID: 1052360658 Enrollment ID: I20050124000001 |
| Provider Name | Rick L Wade |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1780634527 PECOS PAC ID: 1557312048 Enrollment ID: I20050202000145 |
| Provider Name | Richard J Iken |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962613430 PECOS PAC ID: 9032165865 Enrollment ID: I20050324000848 |
| Provider Name | Edwin D Breshears |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154417178 PECOS PAC ID: 4284674003 Enrollment ID: I20050511000000 |
| Provider Name | Karl James Haake |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1003801747 PECOS PAC ID: 3274506050 Enrollment ID: I20050606000578 |
| Provider Name | Sarah Kelly Dunn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831291517 PECOS PAC ID: 7719916493 Enrollment ID: I20050812000228 |
| Provider Name | Anna Michaele Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275531741 PECOS PAC ID: 0244260248 Enrollment ID: I20050819000016 |
| Provider Name | Chia Wai Chang |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1013975986 PECOS PAC ID: 0143297580 Enrollment ID: I20050920000075 |
| Provider Name | Scott A Anderson |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1154302677 PECOS PAC ID: 1153229968 Enrollment ID: I20051123000205 |
| Provider Name | Laura J Sievert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144217233 PECOS PAC ID: 2062434061 Enrollment ID: I20051219000621 |
| Provider Name | Annaliese Kay Tapee |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1629020250 PECOS PAC ID: 7416973326 Enrollment ID: I20060217000671 |
| Provider Name | Daniel K Tucker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760543078 PECOS PAC ID: 4587672621 Enrollment ID: I20060406000062 |
| Provider Name | Victor M Phillips |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1831131762 PECOS PAC ID: 3779593322 Enrollment ID: I20060427000275 |
| Provider Name | Thomas Leupold |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245285881 PECOS PAC ID: 1850302936 Enrollment ID: I20060606000255 |
| Provider Name | Kelly J Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922041854 PECOS PAC ID: 2062415037 Enrollment ID: I20060811000071 |
| Provider Name | Mark R Katsaros |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306894019 PECOS PAC ID: 9931105871 Enrollment ID: I20061017000039 |
| Provider Name | Lorrie L Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033170006 PECOS PAC ID: 9234142167 Enrollment ID: I20061019000432 |
| Provider Name | Thomas E Hetherington |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1063450104 PECOS PAC ID: 1658370705 Enrollment ID: I20061219000074 |
| Provider Name | Madhukar Misra |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1851342158 PECOS PAC ID: 0446250203 Enrollment ID: I20070102000267 |
| Provider Name | Jennifer M Hulett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255349486 PECOS PAC ID: 4587664636 Enrollment ID: I20070113000077 |
| Provider Name | Elizabeth A Blanchard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912900085 PECOS PAC ID: 1951303924 Enrollment ID: I20070203000030 |
| Provider Name | Eric Caywood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194722371 PECOS PAC ID: 1355341686 Enrollment ID: I20070323000520 |
| Provider Name | Dustin Warbritton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093712275 PECOS PAC ID: 0244230571 Enrollment ID: I20070323000527 |
| Provider Name | Nathan P Meyer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992830467 PECOS PAC ID: 5092810234 Enrollment ID: I20070418000099 |
| Provider Name | Gregory S Campbell |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1598754566 PECOS PAC ID: 4880644772 Enrollment ID: I20070502000441 |
| Provider Name | Chandler F Bowser |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902856966 PECOS PAC ID: 0547367310 Enrollment ID: I20070514000414 |
| Provider Name | Robert Paul Zitsch |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1295793164 PECOS PAC ID: 5799882411 Enrollment ID: I20070515000098 |
| Provider Name | Gregory Renner |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1770536195 PECOS PAC ID: 2264539683 Enrollment ID: I20070521000114 |
| Provider Name | William C Kinney |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1548323777 PECOS PAC ID: 9133227804 Enrollment ID: I20070604000241 |
| Provider Name | Karen M Thies |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982791711 PECOS PAC ID: 7315047453 Enrollment ID: I20070703000224 |
| Provider Name | Mitchell Godbee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558455196 PECOS PAC ID: 7416058615 Enrollment ID: I20070718000216 |
| Provider Name | Carol Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588855811 PECOS PAC ID: 4183718729 Enrollment ID: I20070913000467 |
| Provider Name | Amber Backes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881886117 PECOS PAC ID: 2567556814 Enrollment ID: I20070918000590 |
| Provider Name | Michelle Barg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528010071 PECOS PAC ID: 2365454204 Enrollment ID: I20070921000234 |
| Provider Name | Deborah Krause |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962568550 PECOS PAC ID: 8527069251 Enrollment ID: I20071106000747 |
| Provider Name | Neal Lapointe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285714691 PECOS PAC ID: 7517860067 Enrollment ID: I20080310000188 |
| Provider Name | Eliav Gov-ari |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1508868951 PECOS PAC ID: 1850372566 Enrollment ID: I20080430000818 |
| Provider Name | Jeffrey S Sanders |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1407843139 PECOS PAC ID: 4385688340 Enrollment ID: I20080703000020 |
| Provider Name | William L Schlegel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1487640223 PECOS PAC ID: 3274623624 Enrollment ID: I20080703000029 |
| Provider Name | Karen H Rice |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1235125071 PECOS PAC ID: 2466542816 Enrollment ID: I20080805000446 |
| Provider Name | Gracia L Nabhane |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1184610917 PECOS PAC ID: 0648360099 Enrollment ID: I20080805000513 |
| Provider Name | Peter Allen Boyer |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1760478531 PECOS PAC ID: 9436052982 Enrollment ID: I20080805000598 |
| Provider Name | Lisa G Kolb |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1336135276 PECOS PAC ID: 2567552912 Enrollment ID: I20080805000627 |
| Provider Name | Randall Dean Haight |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306832266 PECOS PAC ID: 6002906450 Enrollment ID: I20080805000640 |
| Provider Name | Julia Christine Sohal |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1780772566 PECOS PAC ID: 3779582846 Enrollment ID: I20080808000434 |
| Provider Name | Kurt Daniel Tarwater |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1134230097 PECOS PAC ID: 7315012598 Enrollment ID: I20080822000310 |
| Provider Name | Jeffrey C Mees |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427037746 PECOS PAC ID: 1759316607 Enrollment ID: I20080828000144 |
| Provider Name | Joseph Wang |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437118718 PECOS PAC ID: 9830265545 Enrollment ID: I20080903000639 |
| Provider Name | Diane L Light |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831185651 PECOS PAC ID: 7911097365 Enrollment ID: I20080911000291 |
| Provider Name | Sheila Carnett |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811902638 PECOS PAC ID: 9436153699 Enrollment ID: I20081030000295 |
| Provider Name | Arthur A Bante |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1538155460 PECOS PAC ID: 9032113840 Enrollment ID: I20090109000244 |
| Provider Name | Patrick J Morello |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1194760041 PECOS PAC ID: 9739251919 Enrollment ID: I20090109000577 |
| Provider Name | Carl R Doerhoff |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003800244 PECOS PAC ID: 6305840935 Enrollment ID: I20090320000214 |
| Provider Name | Beverly Wilhelm-oney |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1912980186 PECOS PAC ID: 3173680717 Enrollment ID: I20090325000592 |
| Provider Name | Stacy A Kretzer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518151117 PECOS PAC ID: 3173673803 Enrollment ID: I20090618000024 |
| Provider Name | Michelle Nolph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407081532 PECOS PAC ID: 4486705886 Enrollment ID: I20090624000721 |
| Provider Name | Greggory Mark Kuhlmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972742807 PECOS PAC ID: 6002968955 Enrollment ID: I20090723000479 |
| Provider Name | Ajay Aggarwal |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1417062217 PECOS PAC ID: 5698828580 Enrollment ID: I20090724000127 |
| Provider Name | Arun Kumar |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1912164963 PECOS PAC ID: 1658424544 Enrollment ID: I20090724000169 |
| Provider Name | Matthew A Hrastich |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669453866 PECOS PAC ID: 9133272446 Enrollment ID: I20090804000752 |
| Provider Name | Jerri D Robertson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407070816 PECOS PAC ID: 5799838702 Enrollment ID: I20090807000404 |
| Provider Name | Nick S Koval |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1669603866 PECOS PAC ID: 4284789272 Enrollment ID: I20090826000840 |
| Provider Name | James Robert Zynda |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1336310044 PECOS PAC ID: 8628124914 Enrollment ID: I20090929000480 |
| Provider Name | David Louis Flood |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1255472718 PECOS PAC ID: 2567364243 Enrollment ID: I20090929000540 |
| Provider Name | William K Lafoe |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1700822855 PECOS PAC ID: 2466432224 Enrollment ID: I20091015000359 |
| Provider Name | Lorenzo D Mcknelly |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1861508095 PECOS PAC ID: 9133269400 Enrollment ID: I20091217000106 |
| Provider Name | Shelly Lynn Gudehus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629043849 PECOS PAC ID: 6103843396 Enrollment ID: I20100120000703 |
| Provider Name | Rodney K Adkison |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164538229 PECOS PAC ID: 3173667805 Enrollment ID: I20100226000648 |
| Provider Name | Joseph Morris |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851407910 PECOS PAC ID: 2365586096 Enrollment ID: I20100312000162 |
| Provider Name | Janice M Gessel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881666238 PECOS PAC ID: 2860535986 Enrollment ID: I20100316000503 |
| Provider Name | Anna B Hummel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447580030 PECOS PAC ID: 7719012640 Enrollment ID: I20100317000955 |
| Provider Name | Michael Griswold |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972575694 PECOS PAC ID: 4082702154 Enrollment ID: I20100526000115 |
| Provider Name | Frederick M Schekorra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730167164 PECOS PAC ID: 9537298872 Enrollment ID: I20100526000129 |
| Provider Name | Joseph C Rakestraw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922002864 PECOS PAC ID: 4880694116 Enrollment ID: I20100603000921 |
| Provider Name | Jan R Finney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295707693 PECOS PAC ID: 3779614284 Enrollment ID: I20100628000509 |
| Provider Name | Teri A Deffenbaugh |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427006071 PECOS PAC ID: 1355472515 Enrollment ID: I20100701000698 |
| Provider Name | Ann E Blackman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588640510 PECOS PAC ID: 3779560305 Enrollment ID: I20100709000117 |
| Provider Name | Sabine Dessiuex Boudreau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245462423 PECOS PAC ID: 6002949542 Enrollment ID: I20100805000611 |
| Provider Name | Jeannette Lucille Welty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962581603 PECOS PAC ID: 6507875630 Enrollment ID: I20100806000653 |
| Provider Name | Sara M Echelmeyer |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346220746 PECOS PAC ID: 2961432273 Enrollment ID: I20100810000324 |
| Provider Name | Preethi Yerram |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1811008501 PECOS PAC ID: 4789718453 Enrollment ID: I20100817000603 |
| Provider Name | Timothy Craig Galbraith |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1861597304 PECOS PAC ID: 4789660242 Enrollment ID: I20100818001226 |
| Provider Name | Ravi Nistala |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1558464776 PECOS PAC ID: 5890819452 Enrollment ID: I20100902001057 |
| Provider Name | Darren M Elliott |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1104898097 PECOS PAC ID: 6002942463 Enrollment ID: I20101005000489 |
| Provider Name | David G Lancaster |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1114136686 PECOS PAC ID: 8729270913 Enrollment ID: I20101006000545 |
| Provider Name | Patrick Sporleder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922099506 PECOS PAC ID: 6406992445 Enrollment ID: I20101011000658 |
| Provider Name | Guido Lastra Gonzalez |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1558454017 PECOS PAC ID: 1557554896 Enrollment ID: I20101019001637 |
| Provider Name | John L Williams |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689984783 PECOS PAC ID: 8921292442 Enrollment ID: I20101028001178 |
| Provider Name | Christy N Huff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063728970 PECOS PAC ID: 7214122035 Enrollment ID: I20101105001134 |
| Provider Name | William Andrew Parker |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790946333 PECOS PAC ID: 8123214251 Enrollment ID: I20101201000206 |
| Provider Name | Mark A Lee |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1932180940 PECOS PAC ID: 7719967785 Enrollment ID: I20101220000404 |
| Provider Name | Brandi N Kincaid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144527490 PECOS PAC ID: 3870775638 Enrollment ID: I20110315000939 |
| Provider Name | Michael R Fann |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1235433319 PECOS PAC ID: 4688859515 Enrollment ID: I20110419000774 |
| Provider Name | Donna K Mccluskey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902885452 PECOS PAC ID: 4385534940 Enrollment ID: I20110427000506 |
| Provider Name | Todd Mccluskey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003882200 PECOS PAC ID: 4789574435 Enrollment ID: I20110512000482 |
| Provider Name | Adam C Patterson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912013582 PECOS PAC ID: 2365620945 Enrollment ID: I20110630000102 |
| Provider Name | Sarah E Hyman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871897405 PECOS PAC ID: 0345428603 Enrollment ID: I20110711000302 |
| Provider Name | Jason A Dundulis |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1548421183 PECOS PAC ID: 1456529759 Enrollment ID: I20110712000201 |
| Provider Name | Crystal L Cook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285897827 PECOS PAC ID: 5092984138 Enrollment ID: I20110808000318 |
| Provider Name | Michael Whitcomb |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972894269 PECOS PAC ID: 2961671748 Enrollment ID: I20110811000828 |
| Provider Name | Benjamin J Summerhays |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1598087413 PECOS PAC ID: 3375714512 Enrollment ID: I20110920000912 |
| Provider Name | Allison F Bax |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811287642 PECOS PAC ID: 5698947133 Enrollment ID: I20111005000845 |
| Provider Name | Heather Mcbee Johns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639287915 PECOS PAC ID: 4880867548 Enrollment ID: I20111026000075 |
| Provider Name | Lara Briseno Kenney |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1083688584 PECOS PAC ID: 5395928550 Enrollment ID: I20111228000037 |
| Provider Name | Kelly Jo Mccollegan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1235377839 PECOS PAC ID: 4183780745 Enrollment ID: I20120117000679 |
| Provider Name | Rachel Lynne Lenon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205114089 PECOS PAC ID: 8628235405 Enrollment ID: I20120206000885 |
| Provider Name | Alison Rose Burco |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1942587050 PECOS PAC ID: 3971762279 Enrollment ID: I20120306000544 |
| Provider Name | Elbert S Tillerson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003872714 PECOS PAC ID: 8527089911 Enrollment ID: I20120326000015 |
| Provider Name | Krista Deann Jacques |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326024548 PECOS PAC ID: 9638339302 Enrollment ID: I20120404000808 |
| Provider Name | Kimberly R Lorentz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255605895 PECOS PAC ID: 3072775923 Enrollment ID: I20120510000334 |
| Provider Name | Melissa A Pickett |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1548565666 PECOS PAC ID: 2961666193 Enrollment ID: I20120619000399 |
| Provider Name | Nicolette Wise |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1104084888 PECOS PAC ID: 5092970954 Enrollment ID: I20120628000072 |
| Provider Name | Susan Voss |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023073145 PECOS PAC ID: 7416104567 Enrollment ID: I20120824000777 |
| Provider Name | Michael Dewayne Roach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740592435 PECOS PAC ID: 7719153279 Enrollment ID: I20121002000775 |
| Provider Name | Pauline Burrell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326267659 PECOS PAC ID: 3173773447 Enrollment ID: I20121022000689 |
| Provider Name | Kraig Jason Lage |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972793842 PECOS PAC ID: 2365693116 Enrollment ID: I20121105000133 |
| Provider Name | Jason Hagely |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982833885 PECOS PAC ID: 3779734314 Enrollment ID: I20121108000197 |
| Provider Name | Douglas A Boudreau |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598720617 PECOS PAC ID: 1759532393 Enrollment ID: I20121108000219 |
| Provider Name | John Kerr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972850964 PECOS PAC ID: 7416108386 Enrollment ID: I20121127000502 |
| Provider Name | Sumit Kumar Gupta |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1225382302 PECOS PAC ID: 8729233812 Enrollment ID: I20130220000421 |
| Provider Name | Jay T Bridgeman |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1720200918 PECOS PAC ID: 1254407174 Enrollment ID: I20130312000099 |
| Provider Name | Melisa Anne Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740520915 PECOS PAC ID: 8022254325 Enrollment ID: I20130411000027 |
| Provider Name | Cynthia A Rose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639432057 PECOS PAC ID: 2466698774 Enrollment ID: I20130411000052 |
| Provider Name | Walter C Coats |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1316122245 PECOS PAC ID: 0941440911 Enrollment ID: I20130716000286 |
| Provider Name | Kunal Malhotra |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1720236904 PECOS PAC ID: 2860635786 Enrollment ID: I20130826000239 |
| Provider Name | Ruthanna R Hunter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821228404 PECOS PAC ID: 6204079643 Enrollment ID: I20130904000102 |
| Provider Name | Amanda Michelle Tucker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1093058224 PECOS PAC ID: 2264676196 Enrollment ID: I20130916000665 |
| Provider Name | Kevin L Ingalls |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770748543 PECOS PAC ID: 9436393972 Enrollment ID: I20130923000647 |
| Provider Name | Charles P Coyne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295048031 PECOS PAC ID: 5991948689 Enrollment ID: I20131001000503 |
| Provider Name | Kerri Lynn Rohr-stephens |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1578907077 PECOS PAC ID: 6800020421 Enrollment ID: I20131014000749 |
| Provider Name | Albert K Chan |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1669598629 PECOS PAC ID: 0143476036 Enrollment ID: I20131030000265 |
| Provider Name | Amy R Harrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811338767 PECOS PAC ID: 7719115641 Enrollment ID: I20140122000872 |
| Provider Name | Gaynelle V Rolling |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699782730 PECOS PAC ID: 0648168971 Enrollment ID: I20140224001177 |
| Provider Name | Harathi Bandaru |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629229935 PECOS PAC ID: 7315113008 Enrollment ID: I20140409002082 |
| Provider Name | John A Declue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235104886 PECOS PAC ID: 5193703577 Enrollment ID: I20140604000065 |
| Provider Name | Jaime Basnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659792695 PECOS PAC ID: 8820212087 Enrollment ID: I20140610001876 |
| Provider Name | Jason Michael Cox |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710117577 PECOS PAC ID: 9032334990 Enrollment ID: I20140709000529 |
| Provider Name | Jihad Ibrahim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043464431 PECOS PAC ID: 2961628284 Enrollment ID: I20140723000700 |
| Provider Name | Kevin Andrew Lease |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083909055 PECOS PAC ID: 2163650953 Enrollment ID: I20140805002189 |
| Provider Name | Manav Nayyar |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1164678116 PECOS PAC ID: 7416134770 Enrollment ID: I20140813001135 |
| Provider Name | Leah D Bolten |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1346667706 PECOS PAC ID: 6800013822 Enrollment ID: I20140814000546 |
| Provider Name | Clayton W Nuelle |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1811125859 PECOS PAC ID: 3072757459 Enrollment ID: I20140815000327 |
| Provider Name | Amanda K Shipp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508152992 PECOS PAC ID: 3577707116 Enrollment ID: I20140819000107 |
| Provider Name | Poorna Rajasekhar Karuparthi |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1225235286 PECOS PAC ID: 2860611100 Enrollment ID: I20140918000194 |
| Provider Name | Delali K Buatsi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275778649 PECOS PAC ID: 4082872346 Enrollment ID: I20141008000790 |
| Provider Name | Wesley Clifford Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053714154 PECOS PAC ID: 9931320306 Enrollment ID: I20141028002156 |
| Provider Name | Arnaldo L Rivera Perez |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1962482232 PECOS PAC ID: 9638396880 Enrollment ID: I20141205001835 |
| Provider Name | Paul J Imperato |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1295787760 PECOS PAC ID: 5991748972 Enrollment ID: I20141209002486 |
| Provider Name | Tiona J Langton |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295993962 PECOS PAC ID: 7416112040 Enrollment ID: I20141216000110 |
| Provider Name | Vashti A Ivey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497159933 PECOS PAC ID: 5890019004 Enrollment ID: I20150116001906 |
| Provider Name | Julia A Fiecke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285038299 PECOS PAC ID: 9133444300 Enrollment ID: I20150210001267 |
| Provider Name | Don Lcsw Carter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982725743 PECOS PAC ID: 3678890662 Enrollment ID: I20150401001230 |
| Provider Name | Imran Ashraf |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1659683498 PECOS PAC ID: 0648414169 Enrollment ID: I20150403000201 |
| Provider Name | Clinton L Harris |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1417940321 PECOS PAC ID: 4486695129 Enrollment ID: I20150508001859 |
| Provider Name | Mark A Beresh |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760409403 PECOS PAC ID: 1456245067 Enrollment ID: I20150605000205 |
| Provider Name | Rachel Jackman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1174946610 PECOS PAC ID: 7012229958 Enrollment ID: I20150706002381 |
| Provider Name | Deanna Mantle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194117671 PECOS PAC ID: 8729391214 Enrollment ID: I20150713001563 |
| Provider Name | Sharmila Suri Mohanram |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053690669 PECOS PAC ID: 4688818487 Enrollment ID: I20150716002204 |
| Provider Name | Ani Nathalang-pinon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174838759 PECOS PAC ID: 7214241231 Enrollment ID: I20150805006771 |
| Provider Name | Sandra Brenner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629456355 PECOS PAC ID: 3476867326 Enrollment ID: I20150805007992 |
| Provider Name | David M Brogan |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1710115712 PECOS PAC ID: 0143354472 Enrollment ID: I20150811004600 |
| Provider Name | Morgan Schiermeier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841552700 PECOS PAC ID: 9931343548 Enrollment ID: I20150811004704 |
| Provider Name | Keri Salvatore |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1467835728 PECOS PAC ID: 6002121357 Enrollment ID: I20150814013614 |
| Provider Name | Jamie Brianne Luetkemeyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386906899 PECOS PAC ID: 6901040500 Enrollment ID: I20150818004744 |
| Provider Name | Craig Luetkemeyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013279967 PECOS PAC ID: 5597909101 Enrollment ID: I20150818005630 |
| Provider Name | Jason Andrew Showmaker |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1609187871 PECOS PAC ID: 4688809791 Enrollment ID: I20150831002551 |
| Provider Name | Purvi G Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245594266 PECOS PAC ID: 4486883600 Enrollment ID: I20150914000098 |
| Provider Name | Ashley Lepage |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790177236 PECOS PAC ID: 2668789140 Enrollment ID: I20150916000571 |
| Provider Name | Katy Farber Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922360882 PECOS PAC ID: 2769626308 Enrollment ID: I20150917002176 |
| Provider Name | Mauricio Kfuri |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1184091118 PECOS PAC ID: 3577870765 Enrollment ID: I20150921002460 |
| Provider Name | Ashley Sandbothe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689083511 PECOS PAC ID: 2961711411 Enrollment ID: I20151022002569 |
| Provider Name | Shelby Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508232166 PECOS PAC ID: 6204145402 Enrollment ID: I20151028001773 |
| Provider Name | William Carpenter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164787594 PECOS PAC ID: 9032345400 Enrollment ID: I20151211000481 |
| Provider Name | Nicole Borrenpohl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235473380 PECOS PAC ID: 0446404743 Enrollment ID: I20160106002832 |
| Provider Name | Christine B Franzese |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1932171352 PECOS PAC ID: 6002880168 Enrollment ID: I20160114000907 |
| Provider Name | Elizabeth Ann Yarbrough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023491099 PECOS PAC ID: 1850697277 Enrollment ID: I20160311000254 |
| Provider Name | John Starke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114355633 PECOS PAC ID: 6002114436 Enrollment ID: I20160418001938 |
| Provider Name | Katherine A Cavender |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184081168 PECOS PAC ID: 6901105782 Enrollment ID: I20160428001744 |
| Provider Name | Maryam D Sammet |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1598076085 PECOS PAC ID: 0143449926 Enrollment ID: I20160506000047 |
| Provider Name | Tina Dreger |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1760794275 PECOS PAC ID: 4486957883 Enrollment ID: I20160727001967 |
| Provider Name | Tabitha Lynn Ireland Galloway |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1740591916 PECOS PAC ID: 9234365602 Enrollment ID: I20160801000679 |
| Provider Name | Patricia Marie Petzold |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013941152 PECOS PAC ID: 3779544226 Enrollment ID: I20160801002770 |
| Provider Name | Kyle Michael Schweser |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1912293952 PECOS PAC ID: 1456653260 Enrollment ID: I20160802000658 |
| Provider Name | Alaina Marie Lenzen |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1629426606 PECOS PAC ID: 4688968365 Enrollment ID: I20160803000419 |
| Provider Name | Lauren P Cook |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1275829764 PECOS PAC ID: 6608010004 Enrollment ID: I20160808001061 |
| Provider Name | Rebecca Seitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922446343 PECOS PAC ID: 0749575470 Enrollment ID: I20160822000593 |
| Provider Name | David J Lemons |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1932338753 PECOS PAC ID: 7113212275 Enrollment ID: I20160829001018 |
| Provider Name | Michael D Lehmkuhl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700332319 PECOS PAC ID: 2365739299 Enrollment ID: I20160921000775 |
| Provider Name | Kassie Thoenen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619427945 PECOS PAC ID: 8325327752 Enrollment ID: I20161108000615 |
| Provider Name | Monica Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093266470 PECOS PAC ID: 1759660988 Enrollment ID: I20161110002505 |
| Provider Name | Natasha N Patel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841557121 PECOS PAC ID: 5496035354 Enrollment ID: I20161212000263 |
| Provider Name | Elaine K Hobein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396296265 PECOS PAC ID: 9537444575 Enrollment ID: I20170314001259 |
| Provider Name | Erin B Gerloff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740720358 PECOS PAC ID: 8628353281 Enrollment ID: I20170321002679 |
| Provider Name | Morgan Ashley Shahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073990388 PECOS PAC ID: 1153628557 Enrollment ID: I20170515001031 |
| Provider Name | Devin Langendoerfer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245769017 PECOS PAC ID: 6002185568 Enrollment ID: I20170627002260 |
| Provider Name | Jennifer L Adelman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780105007 PECOS PAC ID: 3678844107 Enrollment ID: I20170802001168 |
| Provider Name | John Robert Burger |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1194089912 PECOS PAC ID: 4789955212 Enrollment ID: I20170802001488 |
| Provider Name | Paul A Henkel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1235484312 PECOS PAC ID: 0345511523 Enrollment ID: I20170807001101 |
| Provider Name | Brian Wayne Toedebusch |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1588929566 PECOS PAC ID: 9638309719 Enrollment ID: I20170814001022 |
| Provider Name | Keerat Singh |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1083971691 PECOS PAC ID: 1951604495 Enrollment ID: I20170831000557 |
| Provider Name | Jalyn N North |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578921052 PECOS PAC ID: 8820395460 Enrollment ID: I20171002002686 |
| Provider Name | Grace Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851816334 PECOS PAC ID: 4385910827 Enrollment ID: I20171027000622 |
| Provider Name | Babatunde O Oyediran |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639432107 PECOS PAC ID: 3072800994 Enrollment ID: I20180116000134 |
| Provider Name | Sebastien Lalonde |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1861990731 PECOS PAC ID: 7517228232 Enrollment ID: I20180220003240 |
| Provider Name | Nashoria K Aclis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730548868 PECOS PAC ID: 7416242698 Enrollment ID: I20180328000249 |
| Provider Name | Don K Moore |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1255302261 PECOS PAC ID: 3072640705 Enrollment ID: I20180607001671 |
| Provider Name | Alisha M Hinds |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1578825485 PECOS PAC ID: 9133353246 Enrollment ID: I20180608001590 |
| Provider Name | Cassandra J Stegeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194228155 PECOS PAC ID: 3577810001 Enrollment ID: I20180716000906 |
| Provider Name | Dayna Lynette Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306349261 PECOS PAC ID: 6204184799 Enrollment ID: I20180731001302 |
| Provider Name | Christopher J Schaefer |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1720349558 PECOS PAC ID: 8628212008 Enrollment ID: I20180802000304 |
| Provider Name | Mark Karim Lane |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1912941089 PECOS PAC ID: 8820029911 Enrollment ID: I20180817003041 |
| Provider Name | Roland Fokwen Njoh |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1932429719 PECOS PAC ID: 5799926697 Enrollment ID: I20180821003752 |
| Provider Name | Haley E Brantley |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1225516628 PECOS PAC ID: 8921358326 Enrollment ID: I20180905003571 |
| Provider Name | Justin Charles Woods |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1649614082 PECOS PAC ID: 2163662859 Enrollment ID: I20180910002427 |
| Provider Name | Ryan Scott Woodman |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1184988644 PECOS PAC ID: 1658508122 Enrollment ID: I20180928001628 |
| Provider Name | Jill Wildhaber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821472614 PECOS PAC ID: 9739431552 Enrollment ID: I20181005001618 |
| Provider Name | Steven Lyons |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083979074 PECOS PAC ID: 4688926348 Enrollment ID: I20181008000526 |
| Provider Name | Mark Raymond Gilbert |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1851534960 PECOS PAC ID: 1951671338 Enrollment ID: I20181105000260 |
| Provider Name | Megan Elaine Hilderbrand |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013468446 PECOS PAC ID: 7113296310 Enrollment ID: I20181205003140 |
| Provider Name | Jessica Leigh Frederick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093280042 PECOS PAC ID: 2365786928 Enrollment ID: I20181207002198 |
| Provider Name | Susan Lipasek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679050678 PECOS PAC ID: 2567707383 Enrollment ID: I20181226002100 |
| Provider Name | Taishi Hirai |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1932495165 PECOS PAC ID: 0042580250 Enrollment ID: I20190109001755 |
| Provider Name | Adrienne Crow |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538320668 PECOS PAC ID: 5799935599 Enrollment ID: I20190304000153 |
| Provider Name | Christina Marie Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780629758 PECOS PAC ID: 8921026816 Enrollment ID: I20190508000352 |
| Provider Name | Abiola Aina Shitta-bey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073640199 PECOS PAC ID: 7810156304 Enrollment ID: I20190723000641 |
| Provider Name | Joshua Delozier |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598320558 PECOS PAC ID: 8426384876 Enrollment ID: I20190724000096 |
| Provider Name | William Brady Shaw |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1417344011 PECOS PAC ID: 1456664739 Enrollment ID: I20190725001767 |
| Provider Name | Carissa Wentland |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1558682815 PECOS PAC ID: 9739409905 Enrollment ID: I20190910001825 |
| Provider Name | Patrick Toerner Tassone |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1326481672 PECOS PAC ID: 1951533017 Enrollment ID: I20190910002263 |
| Provider Name | Amber Dawn Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326526542 PECOS PAC ID: 2062742349 Enrollment ID: I20190930002323 |
| Provider Name | Jamie Lynn Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205489630 PECOS PAC ID: 0840521118 Enrollment ID: I20191017001690 |
| Provider Name | Michael Sands |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558551358 PECOS PAC ID: 1658603352 Enrollment ID: I20191030001058 |
| Provider Name | John K Olson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447254081 PECOS PAC ID: 7113970922 Enrollment ID: I20191111002987 |
| Provider Name | Matthew P Tucker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285106450 PECOS PAC ID: 6103153606 Enrollment ID: I20200107002424 |
| Provider Name | Heather R Graves |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1275984197 PECOS PAC ID: 2567750847 Enrollment ID: I20200312000525 |
| Provider Name | Ellen Louise Marolf |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1538651021 PECOS PAC ID: 6901147305 Enrollment ID: I20200401001140 |
| Provider Name | Allison J Wildin |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1437569381 PECOS PAC ID: 4789800012 Enrollment ID: I20200418000282 |
| Provider Name | Amy Wyatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508499278 PECOS PAC ID: 3779914494 Enrollment ID: I20200513002610 |
| Provider Name | Jonathan A Levin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255878237 PECOS PAC ID: 8123301009 Enrollment ID: I20200527000711 |
| Provider Name | Jessica Cynthia Luebbering |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760839823 PECOS PAC ID: 7416238720 Enrollment ID: I20200812002340 |
| Provider Name | David Badami |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245768696 PECOS PAC ID: 2264700566 Enrollment ID: I20200819003284 |
| Provider Name | Jared James |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386176840 PECOS PAC ID: 4688946023 Enrollment ID: I20200909002749 |
| Provider Name | Thomas Mcafee |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1366479966 PECOS PAC ID: 4183529068 Enrollment ID: I20201015000081 |
| Provider Name | Courtney Kunze |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740807031 PECOS PAC ID: 1153734892 Enrollment ID: I20210119001860 |
| Provider Name | Gregory Ryan Daniels |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1700216611 PECOS PAC ID: 7214167352 Enrollment ID: I20210211002438 |
| Provider Name | Norma Hagans |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750741237 PECOS PAC ID: 3577860956 Enrollment ID: I20210331000374 |
| Provider Name | Echo R Reardon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124041884 PECOS PAC ID: 6002718822 Enrollment ID: I20210331000523 |
| Provider Name | Michael Stephen Griffith |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1437141439 PECOS PAC ID: 0547251654 Enrollment ID: I20210407002210 |
| Provider Name | Diana C Hyden |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1093813529 PECOS PAC ID: 7416858147 Enrollment ID: I20210412002628 |
| Provider Name | Kirk Denti |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427548031 PECOS PAC ID: 4183059454 Enrollment ID: I20210419002564 |
| Provider Name | Caroline N Mbom |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770007080 PECOS PAC ID: 8820359581 Enrollment ID: I20210505000496 |
| Provider Name | John Steven Waschak |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922102045 PECOS PAC ID: 3072596782 Enrollment ID: I20210514001714 |
| Provider Name | Stephanie Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851985832 PECOS PAC ID: 3779983549 Enrollment ID: I20210616000406 |
| Provider Name | Ryan Michael Schell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629428578 PECOS PAC ID: 0749551190 Enrollment ID: I20210712000088 |
| Provider Name | Chirag Pankajkumar Bavishi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518224476 PECOS PAC ID: 8729321617 Enrollment ID: I20210712002039 |
| Provider Name | Molly Peoples |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336727783 PECOS PAC ID: 0446654172 Enrollment ID: I20210803002000 |
| Provider Name | Daniel William Anderson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1063932978 PECOS PAC ID: 1951658384 Enrollment ID: I20210805003147 |
| Provider Name | Tiara Renee Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982138293 PECOS PAC ID: 1850795204 Enrollment ID: I20210806000277 |
| Provider Name | Daniel A London |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1053706192 PECOS PAC ID: 9133465446 Enrollment ID: I20210806000626 |
| Provider Name | Julia Ann Vetter Nuelle |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1144516634 PECOS PAC ID: 9830333129 Enrollment ID: I20210809002356 |
| Provider Name | Kenrick Lam |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1366891657 PECOS PAC ID: 4587067368 Enrollment ID: I20210809002554 |
| Provider Name | Troy Joseph Loethen |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1457731234 PECOS PAC ID: 2668784000 Enrollment ID: I20210830000248 |
| Provider Name | Baylee A Gerstner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629741574 PECOS PAC ID: 0143625194 Enrollment ID: I20210830000959 |
| Provider Name | Nicole M Decher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801340609 PECOS PAC ID: 8224435979 Enrollment ID: I20210922001399 |
| Provider Name | Alexandria Geist |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417453655 PECOS PAC ID: 0345595922 Enrollment ID: I20211005001351 |
| Provider Name | Bryce Bond |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649624016 PECOS PAC ID: 4385938638 Enrollment ID: I20211011000848 |
| Provider Name | James Patrick Newman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336633858 PECOS PAC ID: 7315345816 Enrollment ID: I20211014000645 |
| Provider Name | Jana Lynn Holsman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679239719 PECOS PAC ID: 1658761630 Enrollment ID: I20211206002349 |
| Provider Name | Vineela Kasireddy |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1003256645 PECOS PAC ID: 8820239809 Enrollment ID: I20220217000118 |
| Provider Name | Cynthia A De Meester |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558476168 PECOS PAC ID: 4486656501 Enrollment ID: I20220409000247 |
| Provider Name | Abdul Fettah Buyuk |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1407371545 PECOS PAC ID: 8325370299 Enrollment ID: I20220524000315 |
| Provider Name | Jeffrey Liaw |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1912438086 PECOS PAC ID: 6305102799 Enrollment ID: I20220719001772 |
| Provider Name | Zachary Luebbering |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346697455 PECOS PAC ID: 5597035022 Enrollment ID: I20220730000068 |
| Provider Name | Sally Claire Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982349700 PECOS PAC ID: 7618359126 Enrollment ID: I20220801000391 |
| Provider Name | Carissa Danielle Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306592696 PECOS PAC ID: 0749662880 Enrollment ID: I20220805000650 |
| Provider Name | Sarah R Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720507981 PECOS PAC ID: 3870859440 Enrollment ID: I20220809001315 |
| Provider Name | Olakunle Oni |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033774716 PECOS PAC ID: 6507249984 Enrollment ID: I20220817003091 |
| Provider Name | Sostanie Enoru |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1740671254 PECOS PAC ID: 9537404561 Enrollment ID: I20220823003529 |
| Provider Name | Miranda Luebbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982336640 PECOS PAC ID: 3173907946 Enrollment ID: I20220826002864 |
| Provider Name | Timothy Raymond Niedzielak |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972028421 PECOS PAC ID: 6103200951 Enrollment ID: I20220829002478 |
| Provider Name | Kathryn Joan Ideker |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1588300404 PECOS PAC ID: 6103200597 Enrollment ID: I20220902001808 |
| Provider Name | Amanda Elizabeth Mccarthy |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1215674924 PECOS PAC ID: 4587048806 Enrollment ID: I20220904000071 |
| Provider Name | Emma Sayre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245790807 PECOS PAC ID: 8820415318 Enrollment ID: I20220909001431 |
| Provider Name | John Savooji |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1447684808 PECOS PAC ID: 8729400130 Enrollment ID: I20220915000324 |
| Provider Name | Jaime Renee Renfro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356073712 PECOS PAC ID: 6305222720 Enrollment ID: I20221007000866 |
| Provider Name | Justin Kolby Fritz |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1770010969 PECOS PAC ID: 3577832617 Enrollment ID: I20221019001729 |
| Provider Name | Brian J Kenkel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518122381 PECOS PAC ID: 9234373358 Enrollment ID: I20221212000577 |
| Provider Name | Sunny Buchler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356803977 PECOS PAC ID: 5496086597 Enrollment ID: I20221213002175 |
| Provider Name | Ana Cecilia Belzarena Genovese |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1982159810 PECOS PAC ID: 5597019257 Enrollment ID: I20230214002077 |
| Provider Name | Nikki A Clatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568101822 PECOS PAC ID: 8729450093 Enrollment ID: I20230214002967 |
| Provider Name | Taran E Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033821640 PECOS PAC ID: 0244603140 Enrollment ID: I20230223001404 |
| Provider Name | Angela M Stonner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821763855 PECOS PAC ID: 5890168751 Enrollment ID: I20230224001145 |
| Provider Name | Alice G Cintron |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518070861 PECOS PAC ID: 8729029566 Enrollment ID: I20230721001134 |
| Provider Name | Garrett T Hull |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528685906 PECOS PAC ID: 1355765512 Enrollment ID: I20230724001986 |
| Provider Name | Staci D Reinert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871152827 PECOS PAC ID: 8426419375 Enrollment ID: I20230725003719 |
| Provider Name | Jacob R Hayden |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1871022954 PECOS PAC ID: 2365712882 Enrollment ID: I20230726003141 |
| Provider Name | Rohan Asit Patel |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1740779032 PECOS PAC ID: 9234475807 Enrollment ID: I20230824003284 |
| Provider Name | Henry Wei-en Tsang |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1578017174 PECOS PAC ID: 1658735642 Enrollment ID: I20230908002684 |
| Provider Name | Elliot Sun Toy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871080747 PECOS PAC ID: 0547624405 Enrollment ID: I20230911002220 |
| Provider Name | Jeffrey Daniel Klott |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1306376801 PECOS PAC ID: 1355610387 Enrollment ID: I20230922003596 |
| Provider Name | Emily Angelynne Graves |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1922793140 PECOS PAC ID: 9335593037 Enrollment ID: I20230929000243 |
| Provider Name | Benjamin Christian Castro |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881117018 PECOS PAC ID: 1951755578 Enrollment ID: I20230929001308 |
| Provider Name | Gary J Jarvis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134717283 PECOS PAC ID: 8325454002 Enrollment ID: I20231127002320 |
Spine Midwest, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Saint Marys Medical Plz, Suite 301, Jefferson City, MO 65101 Phone: 573-634-4212 | |
Capital Region Corporate Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 Southwest Blvd, Ste C, Jefferson City, MO 65109 Phone: 573-632-5786 Fax: 573-632-5833 | |
Family Medicine Of Jefferson City, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1616 Southridge Dr, Suite #203, Jefferson City, MO 65109 Phone: 573-659-7300 Fax: 573-636-0555 | |
Ssm Health Wound Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2505 Mission Dr, Suite 210, Jefferson City, MO 65109 Phone: 573-681-3000 Fax: 573-659-2503 | |
Innovative Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3218 W Edgewood Dr, Ste 500, Jefferson City, MO 65109 Phone: 949-696-6157 | |
Capital Region Physicians - Family Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 E High St, Jefferson City, MO 65101 Phone: 573-635-0916 Fax: 573-635-8812 | |
Capital Region Physicians - Southwest Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 Southwest Blvd, Ste D, Jefferson City, MO 65109 Phone: 573-632-5780 Fax: 573-632-5833 |