| Elite Patient Care Of South Carolina Pc | |
|
2375 Baker Hospital Blvd North Charleston SC 29405-8233 | |
| (337) 408-0797 | |
| Not Available |
| Full Name | Elite Patient Care Of South Carolina Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2375 Baker Hospital Blvd, North Charleston, South Carolina |
| Authorized Official Name and Position | Antonio Gamboa (OWNER) |
| Authorized Official Contact | 3374080797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Patient Care Of South Carolina Pc 1509 Dulles Dr Lafayette LA 70506-3718 Ph: (337) 408-0797 | Elite Patient Care Of South Carolina Pc 2375 Baker Hospital Blvd North Charleston SC 29405-8233 Ph: (337) 408-0797 |
| NPI Number | 1316477896 |
|---|---|
| Provider Enumeration Date | 06/15/2017 |
| Last Update Date | 05/12/2023 |
| Medicare PECOS PAC ID | 1951672617 |
|---|---|
| Medicare Enrollment ID | O20170731000866 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316477896 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Todd H Engles |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316912017 PECOS PAC ID: 5597679779 Enrollment ID: I20031113000298 |
| Provider Name | Leo Joseph Jesion |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114979259 PECOS PAC ID: 3870572845 Enrollment ID: I20040715000432 |
| Provider Name | Randi Popp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093793424 PECOS PAC ID: 9537107560 Enrollment ID: I20050421000029 |
| Provider Name | Katherine M Saunders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972596302 PECOS PAC ID: 7315986742 Enrollment ID: I20050426000841 |
| Provider Name | Dana Wiley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427006808 PECOS PAC ID: 5799726923 Enrollment ID: I20050519000056 |
| Provider Name | Beth S Price |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912931007 PECOS PAC ID: 8820030927 Enrollment ID: I20050531000370 |
| Provider Name | Oliver Pierre Harden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164479747 PECOS PAC ID: 7517991789 Enrollment ID: I20050927000368 |
| Provider Name | Dana Giarrizzi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497784680 PECOS PAC ID: 5395770044 Enrollment ID: I20051019000345 |
| Provider Name | Robert Clive Greaves |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629003546 PECOS PAC ID: 8325066699 Enrollment ID: I20051104000334 |
| Provider Name | Donnielle Lynn Green |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073620530 PECOS PAC ID: 6800810375 Enrollment ID: I20060124000086 |
| Provider Name | Deborah Taylor |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1114946001 PECOS PAC ID: 7618986803 Enrollment ID: I20060417000592 |
| Provider Name | Dominique Pinilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124103965 PECOS PAC ID: 4880604446 Enrollment ID: I20060426000559 |
| Provider Name | Loretta J Shaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033163456 PECOS PAC ID: 9234142134 Enrollment ID: I20060719000049 |
| Provider Name | Veronica Ortiz Doyle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811061062 PECOS PAC ID: 5991705386 Enrollment ID: I20070109000336 |
| Provider Name | Dawn H Clancy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376651224 PECOS PAC ID: 2860599115 Enrollment ID: I20070521000451 |
| Provider Name | Yvonne J Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639107162 PECOS PAC ID: 9739287764 Enrollment ID: I20070614000195 |
| Provider Name | Kim J Gilmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184810665 PECOS PAC ID: 8022187368 Enrollment ID: I20080513000453 |
| Provider Name | Kevin Cullen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679769723 PECOS PAC ID: 3678645033 Enrollment ID: I20080701000214 |
| Provider Name | Cynthia Denise Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184884702 PECOS PAC ID: 3577636158 Enrollment ID: I20080715000352 |
| Provider Name | Monica N Milas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427182005 PECOS PAC ID: 9931264587 Enrollment ID: I20090213000220 |
| Provider Name | Jason Barber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598893257 PECOS PAC ID: 4587721469 Enrollment ID: I20090319000589 |
| Provider Name | Margaret S Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750535530 PECOS PAC ID: 3375691553 Enrollment ID: I20090427000528 |
| Provider Name | Amy B Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649404757 PECOS PAC ID: 6709936719 Enrollment ID: I20090615000041 |
| Provider Name | Vlastimil Smetka |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1497974273 PECOS PAC ID: 1658424825 Enrollment ID: I20090805000552 |
| Provider Name | Hayley S Carter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417197922 PECOS PAC ID: 8426043357 Enrollment ID: I20090928000621 |
| Provider Name | Holly M Gwaltney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871526335 PECOS PAC ID: 4385780014 Enrollment ID: I20091009000043 |
| Provider Name | Chrissie M Middleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104153006 PECOS PAC ID: 0941344774 Enrollment ID: I20100217000726 |
| Provider Name | Kimberly Cecchini Purgavie |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1093774028 PECOS PAC ID: 9335100197 Enrollment ID: I20100722000215 |
| Provider Name | Greg Hawkesworth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790978120 PECOS PAC ID: 0345434221 Enrollment ID: I20101104000899 |
| Provider Name | Vinay Jagadeesha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518175777 PECOS PAC ID: 7517152945 Enrollment ID: I20101111000553 |
| Provider Name | Shantae J Jenkins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194923094 PECOS PAC ID: 0345435640 Enrollment ID: I20101112000109 |
| Provider Name | Lindsey D States |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457668386 PECOS PAC ID: 7719161207 Enrollment ID: I20110407000229 |
| Provider Name | Amy Jeanette Dievendorf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871802686 PECOS PAC ID: 7315123031 Enrollment ID: I20110513000560 |
| Provider Name | Ashley Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467741108 PECOS PAC ID: 5597941088 Enrollment ID: I20110518000248 |
| Provider Name | Lisa Marie Forgione |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881645562 PECOS PAC ID: 5698774107 Enrollment ID: I20110606000017 |
| Provider Name | Antionette Akia Bennett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871769968 PECOS PAC ID: 9739358532 Enrollment ID: I20110812000136 |
| Provider Name | Appala Raju Nagubilli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720241862 PECOS PAC ID: 1557549607 Enrollment ID: I20120430000004 |
| Provider Name | Nyabilondi Huguette Ebama |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1467618900 PECOS PAC ID: 1850562976 Enrollment ID: I20120723000033 |
| Provider Name | Jonathan Snipes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821250077 PECOS PAC ID: 8123298254 Enrollment ID: I20120810000464 |
| Provider Name | Kenneth Allan Santiago |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801878186 PECOS PAC ID: 3072565431 Enrollment ID: I20120913000525 |
| Provider Name | Scottie M Shelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689948911 PECOS PAC ID: 9739342494 Enrollment ID: I20120917000010 |
| Provider Name | Kelli Coleman Knotts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972886026 PECOS PAC ID: 1850540352 Enrollment ID: I20120926000802 |
| Provider Name | Christine Maggi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245530690 PECOS PAC ID: 8022267913 Enrollment ID: I20121010000019 |
| Provider Name | June B Jones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730256389 PECOS PAC ID: 1254323900 Enrollment ID: I20121107000500 |
| Provider Name | John Derrick George |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164733374 PECOS PAC ID: 1254580509 Enrollment ID: I20130703000380 |
| Provider Name | Justine D Decastro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194936831 PECOS PAC ID: 9537308242 Enrollment ID: I20130726000539 |
| Provider Name | Andrew Thomas Simpson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518282367 PECOS PAC ID: 9032374665 Enrollment ID: I20130819000739 |
| Provider Name | Victoria M Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043477912 PECOS PAC ID: 3577797299 Enrollment ID: I20131014000571 |
| Provider Name | Morgan M Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184053779 PECOS PAC ID: 6103053152 Enrollment ID: I20131218001402 |
| Provider Name | Dana L Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578890224 PECOS PAC ID: 5890923551 Enrollment ID: I20140102001412 |
| Provider Name | Russell S Blackwelder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407118508 PECOS PAC ID: 2062650815 Enrollment ID: I20140128001870 |
| Provider Name | Elizabeth Michelle Pollack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851712236 PECOS PAC ID: 9436388428 Enrollment ID: I20140218000380 |
| Provider Name | Felicia Minniette Heyward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619307956 PECOS PAC ID: 0547490237 Enrollment ID: I20140225000488 |
| Provider Name | Cynthia L Macdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295988996 PECOS PAC ID: 7517096068 Enrollment ID: I20140814001308 |
| Provider Name | Samuel J Tomlinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407147721 PECOS PAC ID: 9931328804 Enrollment ID: I20140909000887 |
| Provider Name | Marlon A Clarke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629366166 PECOS PAC ID: 4385866557 Enrollment ID: I20141104001806 |
| Provider Name | Maria Hymon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790927630 PECOS PAC ID: 7416007208 Enrollment ID: I20141107001856 |
| Provider Name | Andrea Denise Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376955906 PECOS PAC ID: 4880916527 Enrollment ID: I20141208000469 |
| Provider Name | Ashley Elisabeth Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487058434 PECOS PAC ID: 3971827049 Enrollment ID: I20150120001297 |
| Provider Name | Stania Ayanna Dejesus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205097516 PECOS PAC ID: 3779749916 Enrollment ID: I20150128002111 |
| Provider Name | Vinod K Doultani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487802377 PECOS PAC ID: 2668549924 Enrollment ID: I20150223001511 |
| Provider Name | George Clark Pursley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093758724 PECOS PAC ID: 6204873045 Enrollment ID: I20150317001199 |
| Provider Name | Sonya Belin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013327949 PECOS PAC ID: 1557587011 Enrollment ID: I20150429001397 |
| Provider Name | Whitney P Pitts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366835787 PECOS PAC ID: 0749591642 Enrollment ID: I20150618002141 |
| Provider Name | Jodi Dee Grainger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528458585 PECOS PAC ID: 0446562060 Enrollment ID: I20150709002060 |
| Provider Name | Natasha P Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154716181 PECOS PAC ID: 3375855810 Enrollment ID: I20150711000011 |
| Provider Name | Shannon U Burrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912399742 PECOS PAC ID: 3779896188 Enrollment ID: I20150714002134 |
| Provider Name | Bradford Cheek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952799918 PECOS PAC ID: 8325367311 Enrollment ID: I20150721001259 |
| Provider Name | Christina Renee Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679951776 PECOS PAC ID: 5890008759 Enrollment ID: I20150721001765 |
| Provider Name | Heather Martin Page |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083059281 PECOS PAC ID: 8527377902 Enrollment ID: I20151026002408 |
| Provider Name | Jennifer L Bradshaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760854145 PECOS PAC ID: 6709187495 Enrollment ID: I20151222002795 |
| Provider Name | Amanda Chamelle Ivey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770970873 PECOS PAC ID: 9234434143 Enrollment ID: I20160301001299 |
| Provider Name | Lisa D Churchill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295196947 PECOS PAC ID: 4587963103 Enrollment ID: I20160504000424 |
| Provider Name | Marie Myriam Fenelon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518328418 PECOS PAC ID: 7113217423 Enrollment ID: I20160527000717 |
| Provider Name | Lisa Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750774642 PECOS PAC ID: 9133419278 Enrollment ID: I20160602001002 |
| Provider Name | Cynthia C Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366806069 PECOS PAC ID: 2264722941 Enrollment ID: I20160608002076 |
| Provider Name | Keyonna Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891159794 PECOS PAC ID: 1951693068 Enrollment ID: I20160711001861 |
| Provider Name | La Toya Long-gregory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891151726 PECOS PAC ID: 2567765480 Enrollment ID: I20160801002717 |
| Provider Name | Teresa Ann Yarborough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881088789 PECOS PAC ID: 5698069342 Enrollment ID: I20160803002272 |
| Provider Name | Timothy Bruce Bradford |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861837528 PECOS PAC ID: 1153562988 Enrollment ID: I20160815000225 |
| Provider Name | Christopher B Zakhary |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104168863 PECOS PAC ID: 7113213356 Enrollment ID: I20160914001183 |
| Provider Name | Dorian R Mann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821440215 PECOS PAC ID: 3870881766 Enrollment ID: I20161010000247 |
| Provider Name | Kimberly Jeanne Winters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558819052 PECOS PAC ID: 3779861463 Enrollment ID: I20161101000422 |
| Provider Name | Binyue Chang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427497817 PECOS PAC ID: 0042433674 Enrollment ID: I20161107000541 |
| Provider Name | Katherine E Craig-earl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700332152 PECOS PAC ID: 3072892363 Enrollment ID: I20161109000155 |
| Provider Name | Jessica H Brubeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467904912 PECOS PAC ID: 0244511087 Enrollment ID: I20170110000904 |
| Provider Name | Anna Mataruka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497204119 PECOS PAC ID: 1658653357 Enrollment ID: I20170112001618 |
| Provider Name | Marcia Hindman Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033651500 PECOS PAC ID: 7719269703 Enrollment ID: I20170127000739 |
| Provider Name | Jeannie Schumpert Dias |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750511176 PECOS PAC ID: 3870734189 Enrollment ID: I20170223000421 |
| Provider Name | Melodie G Hanks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043752579 PECOS PAC ID: 9638453376 Enrollment ID: I20170224001844 |
| Provider Name | Jennifer Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265979827 PECOS PAC ID: 5092091777 Enrollment ID: I20170412000241 |
| Provider Name | Mary Beth Hood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275080723 PECOS PAC ID: 6103193339 Enrollment ID: I20170518001838 |
| Provider Name | Albert Shederick Ford |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558369462 PECOS PAC ID: 4486746401 Enrollment ID: I20170612000124 |
| Provider Name | James Hanna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962818583 PECOS PAC ID: 0547586430 Enrollment ID: I20170627000082 |
| Provider Name | Kara Lapin Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235662438 PECOS PAC ID: 6608145800 Enrollment ID: I20170703000043 |
| Provider Name | Heather Michelle Lawter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861926685 PECOS PAC ID: 3072883610 Enrollment ID: I20170714001064 |
| Provider Name | Drashti Jani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619330701 PECOS PAC ID: 8921391632 Enrollment ID: I20170725000714 |
| Provider Name | Karen L Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730612342 PECOS PAC ID: 2961773502 Enrollment ID: I20170801001174 |
| Provider Name | Antonio Gamboa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154356780 PECOS PAC ID: 2264468222 Enrollment ID: I20170801002456 |
| Provider Name | Immanuel Susai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558688523 PECOS PAC ID: 9830324300 Enrollment ID: I20170801002597 |
| Provider Name | Danielle A Altman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578000840 PECOS PAC ID: 3870865611 Enrollment ID: I20170815000452 |
| Provider Name | Stephanie C Blume |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447788039 PECOS PAC ID: 3476826231 Enrollment ID: I20170830002613 |
| Provider Name | Leah Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356715668 PECOS PAC ID: 7113291964 Enrollment ID: I20170919000010 |
| Provider Name | Mary C Lasater |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760904114 PECOS PAC ID: 4789958927 Enrollment ID: I20170926004119 |
| Provider Name | Melody E Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114441458 PECOS PAC ID: 9436424967 Enrollment ID: I20171009001646 |
| Provider Name | John Frederick Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487178844 PECOS PAC ID: 0648545020 Enrollment ID: I20171011001501 |
| Provider Name | Kimberly D Hunsucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134656606 PECOS PAC ID: 6305974320 Enrollment ID: I20171023000090 |
| Provider Name | Victor J Aguin Melendez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538563903 PECOS PAC ID: 6305160193 Enrollment ID: I20171025001236 |
| Provider Name | Latisha Shontae Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114452083 PECOS PAC ID: 0345516811 Enrollment ID: I20171027001852 |
| Provider Name | Andrea K Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679091128 PECOS PAC ID: 3779849922 Enrollment ID: I20171104000001 |
| Provider Name | Alison Leah Gifford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588174171 PECOS PAC ID: 3577820356 Enrollment ID: I20171204000810 |
| Provider Name | Benjamin C Weathersby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245740414 PECOS PAC ID: 5597024216 Enrollment ID: I20180125001061 |
| Provider Name | Brittany Earnhardt Saleeby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275057770 PECOS PAC ID: 4587924543 Enrollment ID: I20180213000030 |
| Provider Name | Sean Patrick Haley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154700771 PECOS PAC ID: 7911267760 Enrollment ID: I20180216000132 |
| Provider Name | Marian Stokes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043562150 PECOS PAC ID: 9436394079 Enrollment ID: I20180312000441 |
| Provider Name | Mary Arntz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689174401 PECOS PAC ID: 9436412160 Enrollment ID: I20180411001971 |
| Provider Name | Paula Requeijo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427084763 PECOS PAC ID: 8325003742 Enrollment ID: I20180412000751 |
| Provider Name | Lisa M Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235637182 PECOS PAC ID: 6709140619 Enrollment ID: I20180501000702 |
| Provider Name | Vanessa Latimer Copeland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548761000 PECOS PAC ID: 2466716188 Enrollment ID: I20180504001977 |
| Provider Name | Bronwyn Dougherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376059543 PECOS PAC ID: 4981968443 Enrollment ID: I20180509000518 |
| Provider Name | Karen Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205330065 PECOS PAC ID: 2466717236 Enrollment ID: I20180525001385 |
| Provider Name | Jamie Grimaud Andrews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932601903 PECOS PAC ID: 0042575847 Enrollment ID: I20180529000822 |
| Provider Name | Valeea James Sutton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013412972 PECOS PAC ID: 0042575573 Enrollment ID: I20180604000190 |
| Provider Name | Timekia Renee Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326542887 PECOS PAC ID: 9436414885 Enrollment ID: I20180605003569 |
| Provider Name | Avril J Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881101442 PECOS PAC ID: 7719232917 Enrollment ID: I20180612000299 |
| Provider Name | Angela Nicole Gary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760980908 PECOS PAC ID: 2668727405 Enrollment ID: I20180619000594 |
| Provider Name | Tamara Elizabeth Chittenden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568495547 PECOS PAC ID: 3971524695 Enrollment ID: I20180629002106 |
| Provider Name | Satara Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104237379 PECOS PAC ID: 1254602071 Enrollment ID: I20180727000015 |
| Provider Name | Robin M Mclean-rimkus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316458953 PECOS PAC ID: 9830448497 Enrollment ID: I20180815003321 |
| Provider Name | Ashley Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750875217 PECOS PAC ID: 2365791753 Enrollment ID: I20180817001672 |
| Provider Name | Faisal Majeed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225411838 PECOS PAC ID: 7113218124 Enrollment ID: I20180926004195 |
| Provider Name | Jessica L Weiland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619453289 PECOS PAC ID: 9830441104 Enrollment ID: I20181015002352 |
| Provider Name | Crystal L Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215440862 PECOS PAC ID: 6800149568 Enrollment ID: I20181025001877 |
| Provider Name | Gregory Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699253294 PECOS PAC ID: 4789937103 Enrollment ID: I20181031002089 |
| Provider Name | Lauren Christine Gamble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316423593 PECOS PAC ID: 8022362904 Enrollment ID: I20181112002439 |
| Provider Name | Shela Beth Hipolito |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386129336 PECOS PAC ID: 1355695248 Enrollment ID: I20181112002673 |
| Provider Name | Chineita Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417447236 PECOS PAC ID: 4587908777 Enrollment ID: I20181128002545 |
| Provider Name | Krystle Mcgee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528542917 PECOS PAC ID: 6103160304 Enrollment ID: I20181128003132 |
| Provider Name | Michelle Breedlove |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316432099 PECOS PAC ID: 9133477755 Enrollment ID: I20181203003064 |
| Provider Name | Stephanie Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770993412 PECOS PAC ID: 3476873480 Enrollment ID: I20181212001264 |
| Provider Name | Kristin Mckenzie Hartman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164907853 PECOS PAC ID: 9133464555 Enrollment ID: I20181212003714 |
| Provider Name | Lynnette K Beyerle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194206540 PECOS PAC ID: 7012252331 Enrollment ID: I20181214000580 |
| Provider Name | Eun Jee C Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184191322 PECOS PAC ID: 8224373121 Enrollment ID: I20181220003416 |
| Provider Name | Marsha L Johnson Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104112606 PECOS PAC ID: 5294965570 Enrollment ID: I20190108003121 |
| Provider Name | Sherrika Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144681594 PECOS PAC ID: 1254639875 Enrollment ID: I20190115003447 |
| Provider Name | Claretta C Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861969859 PECOS PAC ID: 1951647734 Enrollment ID: I20190116000104 |
| Provider Name | Aimee Heather Aline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700382660 PECOS PAC ID: 4880931377 Enrollment ID: I20190122001868 |
| Provider Name | James F. Lawrence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265430458 PECOS PAC ID: 2961540703 Enrollment ID: I20190129000461 |
| Provider Name | Jennifer M Newton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720402753 PECOS PAC ID: 6709186810 Enrollment ID: I20190201000979 |
| Provider Name | Jessica Jems Oing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609347129 PECOS PAC ID: 5698013308 Enrollment ID: I20190205000792 |
| Provider Name | Ashley V Watts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992287312 PECOS PAC ID: 6204174618 Enrollment ID: I20190211000844 |
| Provider Name | Lara J Alicea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538624705 PECOS PAC ID: 5496095093 Enrollment ID: I20190319000066 |
| Provider Name | Taylor Bryant Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881155380 PECOS PAC ID: 6305188970 Enrollment ID: I20190501000215 |
| Provider Name | Jamye Buckner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912488941 PECOS PAC ID: 0840532024 Enrollment ID: I20190509000511 |
| Provider Name | Samica Snipes-smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023576139 PECOS PAC ID: 8022351295 Enrollment ID: I20190510001674 |
| Provider Name | Solomon Tafari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235128828 PECOS PAC ID: 4587670591 Enrollment ID: I20190606002156 |
| Provider Name | Deanna Christine Harley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255997151 PECOS PAC ID: 5193059145 Enrollment ID: I20190625001036 |
| Provider Name | Mark Nicholas Ziats |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1356790091 PECOS PAC ID: 5597050005 Enrollment ID: I20190722002713 |
| Provider Name | Louise W Swindler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851950596 PECOS PAC ID: 5597091678 Enrollment ID: I20190726002014 |
| Provider Name | Kristin Kay Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396034278 PECOS PAC ID: 4789861121 Enrollment ID: I20190806000701 |
| Provider Name | Alyson Nicole Honko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316392186 PECOS PAC ID: 1658665237 Enrollment ID: I20190812001191 |
| Provider Name | Nicholas Stephen Honko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508210097 PECOS PAC ID: 6204120868 Enrollment ID: I20190812001308 |
| Provider Name | Michael Paul Beavers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588225106 PECOS PAC ID: 5597093765 Enrollment ID: I20190826003254 |
| Provider Name | Brandon Anthony Haubner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336526235 PECOS PAC ID: 0840595245 Enrollment ID: I20190920001151 |
| Provider Name | Rachel M Blackwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376954198 PECOS PAC ID: 9931320892 Enrollment ID: I20190925003301 |
| Provider Name | Shavon Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134777543 PECOS PAC ID: 8820320526 Enrollment ID: I20191030001101 |
| Provider Name | Jana Michelle Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982695920 PECOS PAC ID: 9537181482 Enrollment ID: I20191104003001 |
| Provider Name | Dana Liles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356990451 PECOS PAC ID: 9638401946 Enrollment ID: I20191105002082 |
| Provider Name | Brittany Nicole Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427605658 PECOS PAC ID: 1759713514 Enrollment ID: I20191115001649 |
| Provider Name | Collene Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063063642 PECOS PAC ID: 3274965694 Enrollment ID: I20191122001148 |
| Provider Name | Tiffany B Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265518732 PECOS PAC ID: 4587097613 Enrollment ID: I20191204000907 |
| Provider Name | Shenif Ladak |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1376948604 PECOS PAC ID: 5890018501 Enrollment ID: I20191213002389 |
| Provider Name | Nakisha Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699323972 PECOS PAC ID: 5092149237 Enrollment ID: I20191223000785 |
| Provider Name | Autumn Hillegas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285107110 PECOS PAC ID: 7416381454 Enrollment ID: I20191227000040 |
| Provider Name | Crystal Kingcade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811496631 PECOS PAC ID: 3375977226 Enrollment ID: I20191230002608 |
| Provider Name | Connie B Moody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356985196 PECOS PAC ID: 6204260193 Enrollment ID: I20191231001725 |
| Provider Name | Stacey Banis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396389938 PECOS PAC ID: 2466886064 Enrollment ID: I20200107000185 |
| Provider Name | Rebecca Rothemich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063058154 PECOS PAC ID: 1153756416 Enrollment ID: I20200114001607 |
| Provider Name | Crystal Gilmore-hope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245797943 PECOS PAC ID: 6406281658 Enrollment ID: I20200115002285 |
| Provider Name | Catherine Sasser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588208813 PECOS PAC ID: 0749615441 Enrollment ID: I20200126000019 |
| Provider Name | Jaimie Elizabeth Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861039687 PECOS PAC ID: 6901232867 Enrollment ID: I20200212002468 |
| Provider Name | Tara Jean Caldwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245876598 PECOS PAC ID: 5991132243 Enrollment ID: I20200226000112 |
| Provider Name | Jessica M Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770113920 PECOS PAC ID: 2668800376 Enrollment ID: I20200311002006 |
| Provider Name | Jason L Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356973820 PECOS PAC ID: 3476982026 Enrollment ID: I20200401003167 |
| Provider Name | Ashleigh Potter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730716689 PECOS PAC ID: 2769811298 Enrollment ID: I20200406000268 |
| Provider Name | Allison Buryk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174151922 PECOS PAC ID: 1456781327 Enrollment ID: I20200416000534 |
| Provider Name | Jonathan Richard Daly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518352707 PECOS PAC ID: 5496042749 Enrollment ID: I20200715000667 |
| Provider Name | Dominique Moreno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346861341 PECOS PAC ID: 5991121493 Enrollment ID: I20200814000374 |
| Provider Name | Jessica L Cvinar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255794780 PECOS PAC ID: 6103113758 Enrollment ID: I20200818000531 |
| Provider Name | Margaret F Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063047454 PECOS PAC ID: 9133545247 Enrollment ID: I20200820000420 |
| Provider Name | Yolanda Bryant |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023233129 PECOS PAC ID: 6305070517 Enrollment ID: I20210112000440 |
| Provider Name | Megan Suzanne Abbott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063889749 PECOS PAC ID: 0446550974 Enrollment ID: I20210120002977 |
| Provider Name | Kosha Vyas Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932753738 PECOS PAC ID: 9931513587 Enrollment ID: I20210122001385 |
| Provider Name | Eileen M Manning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699316331 PECOS PAC ID: 4183056997 Enrollment ID: I20210123000156 |
| Provider Name | Sylvia Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154705911 PECOS PAC ID: 0941519136 Enrollment ID: I20210126000660 |
| Provider Name | Chappel Tenille Timmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174084537 PECOS PAC ID: 6305252289 Enrollment ID: I20210302001060 |
| Provider Name | Kelsey Elise Hallinan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790361954 PECOS PAC ID: 9133536402 Enrollment ID: I20210402000857 |
| Provider Name | Kaila Robbins Grove |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336775154 PECOS PAC ID: 7911314067 Enrollment ID: I20210407002666 |
| Provider Name | Amanda Marie Bishop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427535012 PECOS PAC ID: 0244571974 Enrollment ID: I20210506002522 |
| Provider Name | Andrew E Mcgettigan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700107034 PECOS PAC ID: 3072887660 Enrollment ID: I20210708001468 |
| Provider Name | Courtney Sturgill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275115354 PECOS PAC ID: 1052715208 Enrollment ID: I20210810001720 |
| Provider Name | Sara Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295324895 PECOS PAC ID: 0143625111 Enrollment ID: I20210830001341 |
| Provider Name | Charnele Vontese Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932778107 PECOS PAC ID: 9537566120 Enrollment ID: I20210924000034 |
| Provider Name | Cheryl Whittaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306418207 PECOS PAC ID: 8729485974 Enrollment ID: I20210930001639 |
| Provider Name | Lorenzo Lamont Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265043152 PECOS PAC ID: 4284031469 Enrollment ID: I20210930003025 |
| Provider Name | Whitney Moody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730858226 PECOS PAC ID: 0143627620 Enrollment ID: I20211108001488 |
| Provider Name | Omega Denise Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225606890 PECOS PAC ID: 1254720592 Enrollment ID: I20211111002047 |
| Provider Name | Davina Norman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609475821 PECOS PAC ID: 6709293251 Enrollment ID: I20211213000089 |
| Provider Name | Patricia Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679025829 PECOS PAC ID: 4880975598 Enrollment ID: I20211228000856 |
| Provider Name | Krystal Cooley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245627272 PECOS PAC ID: 7618369786 Enrollment ID: I20220121002193 |
| Provider Name | Julia A Keefe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962154427 PECOS PAC ID: 7618360058 Enrollment ID: I20220208002010 |
| Provider Name | Meredith Altenburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659043412 PECOS PAC ID: 7810382843 Enrollment ID: I20220309002638 |
| Provider Name | Jody Kay Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043459134 PECOS PAC ID: 8729474200 Enrollment ID: I20220409000285 |
| Provider Name | Christopher Hutter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437806973 PECOS PAC ID: 3476949983 Enrollment ID: I20220411000966 |
| Provider Name | Kristin Claude |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396225769 PECOS PAC ID: 8426302548 Enrollment ID: I20220627000735 |
| Provider Name | Ophillia Dominique |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871226738 PECOS PAC ID: 9537545827 Enrollment ID: I20221011001316 |
| Provider Name | Sophia Margareta Praskala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154772150 PECOS PAC ID: 3779871413 Enrollment ID: I20221102002020 |
| Provider Name | Elizabeth Jessen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679280697 PECOS PAC ID: 2769851088 Enrollment ID: I20221208001832 |
| Provider Name | Aubrey Rickard Holladay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629793872 PECOS PAC ID: 3870962731 Enrollment ID: I20221215001716 |
| Provider Name | Brigitte Britt Huttemeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437795747 PECOS PAC ID: 0749650786 Enrollment ID: I20230109000151 |
| Provider Name | Andrea Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629472550 PECOS PAC ID: 2567785900 Enrollment ID: I20230111000794 |
| Provider Name | Catherine Sasser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588208813 PECOS PAC ID: 0749615441 Enrollment ID: I20230117002073 |
| Provider Name | Theresa Isadore Frazier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134841794 PECOS PAC ID: 6204207814 Enrollment ID: I20230118001989 |
| Provider Name | Brooke Wells Fernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265054464 PECOS PAC ID: 7012388341 Enrollment ID: I20230125001531 |
| Provider Name | Haley Kenimer Ham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164171070 PECOS PAC ID: 4981075959 Enrollment ID: I20230131000138 |
| Provider Name | Kimberly Bennett Qualls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700558202 PECOS PAC ID: 1951773738 Enrollment ID: I20230203000419 |
| Provider Name | Sarah A Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821701541 PECOS PAC ID: 1951773399 Enrollment ID: I20230210000900 |
| Provider Name | James Woody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144705955 PECOS PAC ID: 5799029062 Enrollment ID: I20230223002311 |
| Provider Name | Eloose Saint Jean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184330805 PECOS PAC ID: 5597138347 Enrollment ID: I20230227001969 |
| Provider Name | Jennifer Parker Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013245745 PECOS PAC ID: 0648497479 Enrollment ID: I20230320003062 |
| Provider Name | Catrina Grefe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083194500 PECOS PAC ID: 2567714181 Enrollment ID: I20230405000354 |
| Provider Name | Byron Kendall Herpich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164629515 PECOS PAC ID: 6002931839 Enrollment ID: I20230410002156 |
| Provider Name | Denise Marie Wolfe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568177004 PECOS PAC ID: 6507231917 Enrollment ID: I20230417000425 |
| Provider Name | Dawnna Monique Scipio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992434419 PECOS PAC ID: 5294193314 Enrollment ID: I20230622001435 |
| Provider Name | Hosea Kibet Koech |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760173991 PECOS PAC ID: 6608236203 Enrollment ID: I20230713004125 |
| Provider Name | Paul Ziomek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548357908 PECOS PAC ID: 7719955343 Enrollment ID: I20230804000039 |
| Provider Name | Steven Paul Sponaugle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679161129 PECOS PAC ID: 4183039670 Enrollment ID: I20230823003248 |
| Provider Name | Jennifer Kerry Kerry Amber Wareham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841894227 PECOS PAC ID: 3375906381 Enrollment ID: I20230823003835 |
| Provider Name | Delila Bailey Modzik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760625834 PECOS PAC ID: 8628129335 Enrollment ID: I20230825003570 |
| Provider Name | Meghan Nichole Dunlap |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912692682 PECOS PAC ID: 9537514971 Enrollment ID: I20231004004211 |
| Provider Name | Tina Shenouda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326386996 PECOS PAC ID: 9537397872 Enrollment ID: I20231020003091 |
| Provider Name | Rebecca Renee Ferneding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194418582 PECOS PAC ID: 8224485529 Enrollment ID: I20231108001198 |
| Provider Name | Jacqueline Ola Showalter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780457036 PECOS PAC ID: 3779930490 Enrollment ID: I20231116002867 |
| Provider Name | Allison Cimler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871812842 PECOS PAC ID: 7113107061 Enrollment ID: I20231205003000 |
| Provider Name | Gabrielle Cherie Jeffrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457129561 PECOS PAC ID: 5193177228 Enrollment ID: I20240114000196 |
| Provider Name | Alissa Gail Babcock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619742160 PECOS PAC ID: 1052754561 Enrollment ID: I20240212001406 |
Northwoods Family Practice, Llc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9313 Medical Plaza Dr, Suite 302, North Charleston, SC 29406 Phone: 843-553-0484 Fax: 843-569-1556 | |
Coosaw Eye Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8484 Dorchester Rd, B-3, North Charleston, SC 29420 Phone: 843-767-2328 | |
Family Wellness Center Of Charleston Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9217 University Blvd, Suite C1b, North Charleston, SC 29406 Phone: 843-729-8269 | |
Morningside Middle School Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1999 Singley St, North Charleston, SC 29405 Phone: 843-745-2000 | |
Roper St. Francis Physician Partners Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9165 University Blvd, North Charleston, SC 29406 Phone: 843-212-8038 | |
Low Country Internal Medicine Of Sc, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2845 Tricom St, North Charleston, SC 29406 Phone: 843-797-1770 | |
Avant Mso, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2500 Elms Center Rd, North Charleston, SC 29406 Phone: 843-572-7727 |