| Genesis Convenient Care Bettendorf | |
|
4017 Devils Glen Rd Bettendorf IA 52722-7221 | |
| (563) 421-3700 | |
| (563) 421-3710 |
| Full Name | Genesis Convenient Care Bettendorf |
|---|---|
| Speciality | Clinic/Center |
| Location | 4017 Devils Glen Rd, Bettendorf, Iowa |
| Authorized Official Name and Position | Mark G Rogers (INTERIM CFO) |
| Authorized Official Contact | 5634216513 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Convenient Care Bettendorf Po Box 765 East Moline IL 61244-0765 Ph: (563) 355-9200 | Genesis Convenient Care Bettendorf 4017 Devils Glen Rd Bettendorf IA 52722-7221 Ph: (563) 421-3700 |
| NPI Number | 1497772008 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 7214841436 |
|---|---|
| Medicare Enrollment ID | O20031113000044 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497772008 | NPI | - | NPPES |
| 08753 | Other | IA | BLUE CROSS/BLUE SHIELD IA |
| 660022 | Other | HEALTH ALLIANCE | |
| 2243972 | Medicaid | IA | |
| 387175 | Other | HEALTHLINK | |
| IA0100 | Other | JDHC | |
| 616351 | Other | HARVARD PILGRIM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Iowa) | Primary |
| Provider Name | Jennifer L Bell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225079817 PECOS PAC ID: 9638078041 Enrollment ID: I20040105000839 |
| Provider Name | Mouhamed W Al Sheikha |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1063418374 PECOS PAC ID: 1850292244 Enrollment ID: I20040119000244 |
| Provider Name | Karl Treiber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932105855 PECOS PAC ID: 4385537901 Enrollment ID: I20040205001305 |
| Provider Name | Carolyn K Miller |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1235130766 PECOS PAC ID: 8729972187 Enrollment ID: I20040209000622 |
| Provider Name | Karen M Fitzsimmons |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1821099490 PECOS PAC ID: 4789578154 Enrollment ID: I20040209000648 |
| Provider Name | David J Aanestad |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548230832 PECOS PAC ID: 0042104580 Enrollment ID: I20040213000429 |
| Provider Name | Cynthia Morrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508068362 PECOS PAC ID: 6204724537 Enrollment ID: I20040309000223 |
| Provider Name | Rafat F Padaria |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1497734388 PECOS PAC ID: 7911809488 Enrollment ID: I20040414000640 |
| Provider Name | Blair W Foreman |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1750360616 PECOS PAC ID: 9032106307 Enrollment ID: I20040428001001 |
| Provider Name | Robert D Mixsell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598717449 PECOS PAC ID: 5092703439 Enrollment ID: I20040504000831 |
| Provider Name | Nidal H Harb |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1871572677 PECOS PAC ID: 4082603725 Enrollment ID: I20040508000287 |
| Provider Name | Mark Kovach |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1336128222 PECOS PAC ID: 1850293366 Enrollment ID: I20040513001050 |
| Provider Name | Matthew C Christophersen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629048939 PECOS PAC ID: 7719960244 Enrollment ID: I20040608000102 |
| Provider Name | Rick L Garrels |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679535264 PECOS PAC ID: 2264329473 Enrollment ID: I20040609000391 |
| Provider Name | Cindy J Ramsay |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1437138120 PECOS PAC ID: 2668457508 Enrollment ID: I20040623000995 |
| Provider Name | Christopher M Crome |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205831211 PECOS PAC ID: 4082699954 Enrollment ID: I20040623001170 |
| Provider Name | Catherine a Hagedorn |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770552051 PECOS PAC ID: 4183601123 Enrollment ID: I20040707000652 |
| Provider Name | Christopher Michael Posey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982666301 PECOS PAC ID: 1658346317 Enrollment ID: I20040827000174 |
| Provider Name | Nader B Ailabouni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497728661 PECOS PAC ID: 8022075340 Enrollment ID: I20041217000350 |
| Provider Name | Ann G Mcdonald |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104814839 PECOS PAC ID: 2961460720 Enrollment ID: I20050104000761 |
| Provider Name | Ghada Hamdan Allen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912991340 PECOS PAC ID: 0446217079 Enrollment ID: I20050422000469 |
| Provider Name | Mark P Iltis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659369353 PECOS PAC ID: 8820013808 Enrollment ID: I20051008000244 |
| Provider Name | Deborah S Haas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023006798 PECOS PAC ID: 8729004924 Enrollment ID: I20051018000045 |
| Provider Name | Robert J Knudson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528056207 PECOS PAC ID: 3173549375 Enrollment ID: I20051018000051 |
| Provider Name | Mary L Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760470454 PECOS PAC ID: 4284691817 Enrollment ID: I20051018000088 |
| Provider Name | Stephen M Sorensen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881647071 PECOS PAC ID: 1759273204 Enrollment ID: I20051107000248 |
| Provider Name | Edmund P Coyne |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1114906138 PECOS PAC ID: 4587566047 Enrollment ID: I20051108000472 |
| Provider Name | Kimberly a Hayden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740255736 PECOS PAC ID: 2264323252 Enrollment ID: I20051205000858 |
| Provider Name | Gena L.R. Benoit |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730184003 PECOS PAC ID: 8527080951 Enrollment ID: I20051228000356 |
| Provider Name | Nicolas W Shammas |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1922087857 PECOS PAC ID: 9931001492 Enrollment ID: I20060104000363 |
| Provider Name | Christel L Seemann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205801115 PECOS PAC ID: 7113941147 Enrollment ID: I20060118000088 |
| Provider Name | Randy R Robinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497736326 PECOS PAC ID: 2163414152 Enrollment ID: I20060125000213 |
| Provider Name | Alexander Locascio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568468007 PECOS PAC ID: 3274547369 Enrollment ID: I20060127000302 |
| Provider Name | Rose a Warhank |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275502288 PECOS PAC ID: 0840208773 Enrollment ID: I20060404000067 |
| Provider Name | Kelly J Airey |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1538186382 PECOS PAC ID: 2668419151 Enrollment ID: I20060404000326 |
| Provider Name | Kenneth J Hartman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366407322 PECOS PAC ID: 5799798914 Enrollment ID: I20060711000003 |
| Provider Name | James a Darrow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023013042 PECOS PAC ID: 8729082664 Enrollment ID: I20060906000606 |
| Provider Name | Jennifer a George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336144195 PECOS PAC ID: 3072518695 Enrollment ID: I20061003000334 |
| Provider Name | Packy a Huettman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831194307 PECOS PAC ID: 3971508524 Enrollment ID: I20061003000597 |
| Provider Name | Thomas E Lyons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952307407 PECOS PAC ID: 1456356021 Enrollment ID: I20061004000013 |
| Provider Name | Patricia J Mccaw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801892351 PECOS PAC ID: 3173528742 Enrollment ID: I20061004000016 |
| Provider Name | Christa S Mclaughlin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780680272 PECOS PAC ID: 9436154002 Enrollment ID: I20061004000029 |
| Provider Name | Matthew L Neil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578569091 PECOS PAC ID: 8325043904 Enrollment ID: I20061004000061 |
| Provider Name | John J Patton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982600912 PECOS PAC ID: 0345245924 Enrollment ID: I20061004000119 |
| Provider Name | Richard L Syfert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881690709 PECOS PAC ID: 6204832843 Enrollment ID: I20061004000612 |
| Provider Name | Steven J Aguilar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427053842 PECOS PAC ID: 7911903448 Enrollment ID: I20061005000663 |
| Provider Name | Robert E Harson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356390207 PECOS PAC ID: 6901809110 Enrollment ID: I20061102000154 |
| Provider Name | Anna M Hansen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689670747 PECOS PAC ID: 6800894718 Enrollment ID: I20061130000416 |
| Provider Name | Joseph E Bergstrom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831154822 PECOS PAC ID: 8628060670 Enrollment ID: I20061205000018 |
| Provider Name | Laura B Thayer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134233927 PECOS PAC ID: 5092716589 Enrollment ID: I20070125000612 |
| Provider Name | Vickie Diamandakis Pyevich |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1003882374 PECOS PAC ID: 6002717436 Enrollment ID: I20070130000715 |
| Provider Name | Jon a Robken |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1750360764 PECOS PAC ID: 3476455940 Enrollment ID: I20070131000779 |
| Provider Name | Kathleen J Keyes |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1316926264 PECOS PAC ID: 9830198670 Enrollment ID: I20070209000095 |
| Provider Name | William J Witcik |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1619956547 PECOS PAC ID: 5294637765 Enrollment ID: I20070209000225 |
| Provider Name | Steven M Strom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316965387 PECOS PAC ID: 4789686338 Enrollment ID: I20070209000538 |
| Provider Name | Peter John Sharis |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1275512154 PECOS PAC ID: 6305859554 Enrollment ID: I20070226000801 |
| Provider Name | Bryant a Mutchler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023053972 PECOS PAC ID: 0749385227 Enrollment ID: I20070411000200 |
| Provider Name | Michael J Gimbel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1871687087 PECOS PAC ID: 0547360927 Enrollment ID: I20070726000361 |
| Provider Name | Marc E Hoskins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457389116 PECOS PAC ID: 8022050780 Enrollment ID: I20070922000264 |
| Provider Name | Gina L Frenell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639362734 PECOS PAC ID: 1658465430 Enrollment ID: I20070925000029 |
| Provider Name | Niral H Tilala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780884551 PECOS PAC ID: 6709966682 Enrollment ID: I20080104000180 |
| Provider Name | Michael C Persson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356485775 PECOS PAC ID: 6406930304 Enrollment ID: I20080303000282 |
| Provider Name | Sharon L Marguglio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033360284 PECOS PAC ID: 9436218153 Enrollment ID: I20081110000212 |
| Provider Name | Gaurav Ahuja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518144195 PECOS PAC ID: 8921169467 Enrollment ID: I20081203000146 |
| Provider Name | Jack J Swanson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467445007 PECOS PAC ID: 7113075920 Enrollment ID: I20090506000005 |
| Provider Name | Daniel E Wesemann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366435125 PECOS PAC ID: 5193707172 Enrollment ID: I20090512000425 |
| Provider Name | Frank R Claudy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255343364 PECOS PAC ID: 7719944347 Enrollment ID: I20090515000111 |
| Provider Name | Taryn J Hancock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992846448 PECOS PAC ID: 7810046869 Enrollment ID: I20090521000168 |
| Provider Name | Peter J Laureijs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831141043 PECOS PAC ID: 3476442278 Enrollment ID: I20090609000025 |
| Provider Name | Richard T Nelson |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1255541843 PECOS PAC ID: 1355492398 Enrollment ID: I20090702000087 |
| Provider Name | Vinay V Satti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629099726 PECOS PAC ID: 6204831860 Enrollment ID: I20091102000263 |
| Provider Name | Sayed a Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255327425 PECOS PAC ID: 6204800725 Enrollment ID: I20091125000011 |
| Provider Name | Colleen a Hensel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841295300 PECOS PAC ID: 9931104544 Enrollment ID: I20091210000543 |
| Provider Name | Steven C Fowler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619927126 PECOS PAC ID: 9830088640 Enrollment ID: I20091228000055 |
| Provider Name | Neeru Aggarwal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467410084 PECOS PAC ID: 5294624078 Enrollment ID: I20100104000063 |
| Provider Name | Joseph M. Compton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376512814 PECOS PAC ID: 2062320971 Enrollment ID: I20100202000771 |
| Provider Name | Tammy J Wells |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093794968 PECOS PAC ID: 5698820843 Enrollment ID: I20100216000068 |
| Provider Name | Jason G Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588662050 PECOS PAC ID: 1355333527 Enrollment ID: I20100520000106 |
| Provider Name | Joanne M Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093777518 PECOS PAC ID: 1254461593 Enrollment ID: I20100611000510 |
| Provider Name | Julie a Cabel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235350976 PECOS PAC ID: 2769583376 Enrollment ID: I20100617000008 |
| Provider Name | Catherine D Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821317678 PECOS PAC ID: 1153452362 Enrollment ID: I20100702000499 |
| Provider Name | Gautam Kukreja |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205151198 PECOS PAC ID: 8022141159 Enrollment ID: I20100727000124 |
| Provider Name | Kenneth Naylor |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780658229 PECOS PAC ID: 3678514817 Enrollment ID: I20100820001030 |
| Provider Name | Randel O Cardott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295704674 PECOS PAC ID: 6709887797 Enrollment ID: I20100827000708 |
| Provider Name | Carla R Cloos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649439175 PECOS PAC ID: 6305960782 Enrollment ID: I20100908000405 |
| Provider Name | Jill C Goodman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841400272 PECOS PAC ID: 0143345660 Enrollment ID: I20100921000203 |
| Provider Name | Amy Bingaman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750359147 PECOS PAC ID: 2365568656 Enrollment ID: I20100923000992 |
| Provider Name | Bradley W Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134116684 PECOS PAC ID: 4385831346 Enrollment ID: I20101203000411 |
| Provider Name | Robert D Padgett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306832910 PECOS PAC ID: 6002914074 Enrollment ID: I20110516000738 |
| Provider Name | Deepna Kukreja |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194017913 PECOS PAC ID: 6406025683 Enrollment ID: I20110803000894 |
| Provider Name | Beau B Shay |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1831351584 PECOS PAC ID: 7719166255 Enrollment ID: I20110804000545 |
| Provider Name | Linda a Jager |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184917981 PECOS PAC ID: 4082883582 Enrollment ID: I20110817000312 |
| Provider Name | Jason C Hagemann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285954594 PECOS PAC ID: 9234308735 Enrollment ID: I20110817000344 |
| Provider Name | Jennifer C Steines Wagemester |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467613091 PECOS PAC ID: 6103081864 Enrollment ID: I20120702000120 |
| Provider Name | Stacie L Salowitz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639462443 PECOS PAC ID: 4082863758 Enrollment ID: I20121012000788 |
| Provider Name | Catherine L Schierbrock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235423377 PECOS PAC ID: 6800046863 Enrollment ID: I20121029000213 |
| Provider Name | Sheena L Harker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447544580 PECOS PAC ID: 9234380783 Enrollment ID: I20121110000215 |
| Provider Name | Deanne M Hobert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558300780 PECOS PAC ID: 5698773570 Enrollment ID: I20121112000147 |
| Provider Name | Amanda S Dalaska |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962750422 PECOS PAC ID: 7012168206 Enrollment ID: I20121116000249 |
| Provider Name | Regan a Cone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538509443 PECOS PAC ID: 7911141015 Enrollment ID: I20130911000180 |
| Provider Name | Sarah B Schlickman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992138747 PECOS PAC ID: 6507092988 Enrollment ID: I20131112001997 |
| Provider Name | Mai Shehata |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548588429 PECOS PAC ID: 9234366378 Enrollment ID: I20131216001233 |
| Provider Name | Alyssa Lakin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1629415922 PECOS PAC ID: 0941438824 Enrollment ID: I20140123000448 |
| Provider Name | Jennifer Lynn Prather |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1548436215 PECOS PAC ID: 7719127422 Enrollment ID: I20140212000601 |
| Provider Name | Jennifer M Kammer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982971115 PECOS PAC ID: 2062671035 Enrollment ID: I20140321000342 |
| Provider Name | Laura Elizabeth Sierra |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1255680484 PECOS PAC ID: 1850514969 Enrollment ID: I20140519000682 |
| Provider Name | Zachary J Lewis |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1396987574 PECOS PAC ID: 1759504509 Enrollment ID: I20140522002294 |
| Provider Name | Iurie Caraman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821237660 PECOS PAC ID: 6103983994 Enrollment ID: I20140708000483 |
| Provider Name | Lindsey Lee Jenkins |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023339728 PECOS PAC ID: 4587803796 Enrollment ID: I20140724002475 |
| Provider Name | Julie M Stecher |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215220207 PECOS PAC ID: 6709026248 Enrollment ID: I20140820002368 |
| Provider Name | Julia C Hensch |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770879017 PECOS PAC ID: 1557580412 Enrollment ID: I20140909000583 |
| Provider Name | Matthew F Fleming |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1508121518 PECOS PAC ID: 6507017449 Enrollment ID: I20140917001599 |
| Provider Name | Shannon L Leveridge |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962728972 PECOS PAC ID: 2365764560 Enrollment ID: I20141125000321 |
| Provider Name | Calene L Woodhouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790199701 PECOS PAC ID: 1254653736 Enrollment ID: I20141212000263 |
| Provider Name | Kara L Meyer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1992197339 PECOS PAC ID: 3274850391 Enrollment ID: I20150327002519 |
| Provider Name | Usama M Younis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740412766 PECOS PAC ID: 5294040739 Enrollment ID: I20150813009668 |
| Provider Name | Jessica M Mckearney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891171369 PECOS PAC ID: 0648586107 Enrollment ID: I20150828000301 |
| Provider Name | Kelsey M Kropf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699141515 PECOS PAC ID: 4284942228 Enrollment ID: I20150924002332 |
| Provider Name | Sanjay S Pancholi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780894816 PECOS PAC ID: 4284725110 Enrollment ID: I20151002000388 |
| Provider Name | Lindsey J Lange |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851760151 PECOS PAC ID: 0749598944 Enrollment ID: I20151008001520 |
| Provider Name | Rebecca Wagschal |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1164878542 PECOS PAC ID: 2062702715 Enrollment ID: I20160608001177 |
| Provider Name | Phanicharan Aditya Sistla |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1720427453 PECOS PAC ID: 9931408234 Enrollment ID: I20160715001136 |
| Provider Name | Clare B Harney |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144545591 PECOS PAC ID: 1658592696 Enrollment ID: I20160718000260 |
| Provider Name | Babuji Gandra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215184726 PECOS PAC ID: 6800042219 Enrollment ID: I20160728000024 |
| Provider Name | Srikanth Reddy Kasula |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1497080709 PECOS PAC ID: 9537453725 Enrollment ID: I20160811000043 |
| Provider Name | Brittney N Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215383070 PECOS PAC ID: 8527352582 Enrollment ID: I20160815000522 |
| Provider Name | Molly a Stehn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508218629 PECOS PAC ID: 2668760810 Enrollment ID: I20161004001775 |
| Provider Name | Brady J Thomas |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306158456 PECOS PAC ID: 7113165325 Enrollment ID: I20161017002044 |
| Provider Name | Jessica L Wasson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316491442 PECOS PAC ID: 6901184878 Enrollment ID: I20161027000658 |
| Provider Name | Janel Miner |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1770838773 PECOS PAC ID: 0143474429 Enrollment ID: I20170227000861 |
| Provider Name | Serena Arancibia |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205373610 PECOS PAC ID: 3476838483 Enrollment ID: I20170314000265 |
| Provider Name | Heather J Ohnemus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851673933 PECOS PAC ID: 9830350164 Enrollment ID: I20170317001664 |
| Provider Name | Ellen Holm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942606413 PECOS PAC ID: 4789906827 Enrollment ID: I20170818000310 |
| Provider Name | Tenille M Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457871907 PECOS PAC ID: 8527330877 Enrollment ID: I20170821002477 |
| Provider Name | Christina L Thornburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730602947 PECOS PAC ID: 7113291048 Enrollment ID: I20170915002262 |
| Provider Name | Barbara Rose Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902161508 PECOS PAC ID: 4486968005 Enrollment ID: I20170919001283 |
| Provider Name | Rachel Riedesel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396269221 PECOS PAC ID: 8820362023 Enrollment ID: I20170927002356 |
| Provider Name | Amber Galey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699185801 PECOS PAC ID: 6901023415 Enrollment ID: I20171009000490 |
| Provider Name | Sara E Terronez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841712486 PECOS PAC ID: 0244505865 Enrollment ID: I20171009000729 |
| Provider Name | Margaret a Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437674629 PECOS PAC ID: 7012283799 Enrollment ID: I20171024003396 |
| Provider Name | Danielle Wesner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700395381 PECOS PAC ID: 5496012437 Enrollment ID: I20171130000591 |
| Provider Name | Jacqueline a Madunic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659889913 PECOS PAC ID: 2062771876 Enrollment ID: I20180123002558 |
| Provider Name | Sandra K Droessler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417487455 PECOS PAC ID: 3971872789 Enrollment ID: I20180213002225 |
| Provider Name | Rajeev S. Dixit |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003903899 PECOS PAC ID: 3375803844 Enrollment ID: I20180305002645 |
| Provider Name | Ty B Wakefield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386005338 PECOS PAC ID: 9931461209 Enrollment ID: I20180326002122 |
| Provider Name | Michael P Cloos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750761383 PECOS PAC ID: 8820301773 Enrollment ID: I20180630000151 |
| Provider Name | Jong J Lee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336599869 PECOS PAC ID: 6305139429 Enrollment ID: I20180723003159 |
| Provider Name | Elise N a Bream |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831459759 PECOS PAC ID: 2769621630 Enrollment ID: I20180813001405 |
| Provider Name | Wendy M Lind |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285129668 PECOS PAC ID: 8224388129 Enrollment ID: I20180913000744 |
| Provider Name | Kathleen B Vickroy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831677921 PECOS PAC ID: 7012268519 Enrollment ID: I20180921002724 |
| Provider Name | Meghan L Grothus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750876751 PECOS PAC ID: 1759632276 Enrollment ID: I20180924000062 |
| Provider Name | Ellen M Hosch |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1669921607 PECOS PAC ID: 1658622170 Enrollment ID: I20180924000107 |
| Provider Name | Lauren Bethany Warner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699257923 PECOS PAC ID: 6305190067 Enrollment ID: I20181115000831 |
| Provider Name | Rachel K Ash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811305329 PECOS PAC ID: 9436379104 Enrollment ID: I20190102001967 |
| Provider Name | Ann Maria Passini |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578944476 PECOS PAC ID: 0244544385 Enrollment ID: I20190221002513 |
| Provider Name | Christian Mann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932685013 PECOS PAC ID: 2365782059 Enrollment ID: I20190315000610 |
| Provider Name | Jennifer R Cassatt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255890869 PECOS PAC ID: 5597006643 Enrollment ID: I20190418000538 |
| Provider Name | Anthony M Chesser |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1740676055 PECOS PAC ID: 7911294277 Enrollment ID: I20190620001873 |
| Provider Name | Shannon Jans |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053845677 PECOS PAC ID: 2860761822 Enrollment ID: I20190711000515 |
| Provider Name | Daniel L Larson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093077398 PECOS PAC ID: 3870829344 Enrollment ID: I20190723000829 |
| Provider Name | Anthony Richard White |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1205488046 PECOS PAC ID: 9133455215 Enrollment ID: I20190726001986 |
| Provider Name | Rose a Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518059971 PECOS PAC ID: 3173693678 Enrollment ID: I20190828001848 |
| Provider Name | Bethany K Oberfoell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619538634 PECOS PAC ID: 5698003614 Enrollment ID: I20190828002260 |
| Provider Name | Nicole Y Brokloff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285085704 PECOS PAC ID: 3476847211 Enrollment ID: I20190911002790 |
| Provider Name | Abbi a Madden |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487035432 PECOS PAC ID: 0648573550 Enrollment ID: I20190919000095 |
| Provider Name | April R Lanning |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437509957 PECOS PAC ID: 7214220300 Enrollment ID: I20190924003555 |
| Provider Name | Cheryl Lynn Ehrler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124680962 PECOS PAC ID: 3476884867 Enrollment ID: I20191018002753 |
| Provider Name | Whitney R Hess |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255983813 PECOS PAC ID: 8123350345 Enrollment ID: I20191021002685 |
| Provider Name | Ahmad M Nafe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841640190 PECOS PAC ID: 9638401078 Enrollment ID: I20191104002513 |
| Provider Name | Brooke M Jewell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881255800 PECOS PAC ID: 4587096268 Enrollment ID: I20191121000638 |
| Provider Name | Hannah M Feldman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457823437 PECOS PAC ID: 4183967789 Enrollment ID: I20200207001085 |
| Provider Name | Alexandria N Lyon |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144850801 PECOS PAC ID: 2860821048 Enrollment ID: I20200409001620 |
| Provider Name | Karly R Dankert |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528695426 PECOS PAC ID: 2163853284 Enrollment ID: I20200505002236 |
| Provider Name | Christa Jackson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1760791230 PECOS PAC ID: 7517146061 Enrollment ID: I20200506002276 |
| Provider Name | Mitchell T Binkley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790215994 PECOS PAC ID: 7618247123 Enrollment ID: I20200617000611 |
| Provider Name | Julianne Scheskie |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346357464 PECOS PAC ID: 1557462397 Enrollment ID: I20200902001062 |
| Provider Name | Lauren E Rumburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912516881 PECOS PAC ID: 5799104337 Enrollment ID: I20200930002157 |
| Provider Name | Kristen R Olin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033684832 PECOS PAC ID: 9739421553 Enrollment ID: I20201228002486 |
| Provider Name | Mahtab U Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891755021 PECOS PAC ID: 1850347923 Enrollment ID: I20210128001784 |
| Provider Name | Kali Sweers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982003216 PECOS PAC ID: 7315225091 Enrollment ID: I20210409000496 |
| Provider Name | Bridget Clemens |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952992240 PECOS PAC ID: 7416366976 Enrollment ID: I20210513000415 |
| Provider Name | Anne M Boyler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437709763 PECOS PAC ID: 1355740697 Enrollment ID: I20210519000433 |
| Provider Name | Mohammad a Kotob |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538726617 PECOS PAC ID: 4284969395 Enrollment ID: I20210603000841 |
| Provider Name | Heather M Bruss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639755747 PECOS PAC ID: 5991113425 Enrollment ID: I20210624000723 |
| Provider Name | Kathleen E Rogalski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245807460 PECOS PAC ID: 7810399516 Enrollment ID: I20210716000874 |
| Provider Name | Ryan D Beardsley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356870034 PECOS PAC ID: 8123392792 Enrollment ID: I20210813000915 |
| Provider Name | Jessica Yeoward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972172021 PECOS PAC ID: 5799180626 Enrollment ID: I20210816002699 |
| Provider Name | Morgan Nichols |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952890196 PECOS PAC ID: 7517395049 Enrollment ID: I20210820000970 |
| Provider Name | Jesicah E Ambrisco |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023502622 PECOS PAC ID: 5698022176 Enrollment ID: I20210824000938 |
| Provider Name | Kelly M Krei |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477082436 PECOS PAC ID: 7012287626 Enrollment ID: I20210903001296 |
| Provider Name | Bryan William Brooks |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184006348 PECOS PAC ID: 6406164284 Enrollment ID: I20210908000822 |
| Provider Name | Caryn S Reuland |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033240783 PECOS PAC ID: 6204234669 Enrollment ID: I20211015000121 |
| Provider Name | Danielle E Pratt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740958735 PECOS PAC ID: 3779971296 Enrollment ID: I20211102001172 |
| Provider Name | Jennifer M Frandsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780257535 PECOS PAC ID: 1951799402 Enrollment ID: I20211102002520 |
| Provider Name | Benjamin Dille |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821353533 PECOS PAC ID: 4486954864 Enrollment ID: I20211116001962 |
| Provider Name | Alison E Fraehlich |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1205495736 PECOS PAC ID: 4789912643 Enrollment ID: I20211221000837 |
| Provider Name | Ashley M Fischer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720363526 PECOS PAC ID: 0749570356 Enrollment ID: I20220105002610 |
| Provider Name | Rebecca a Fish |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447690631 PECOS PAC ID: 9032343124 Enrollment ID: I20220105002984 |
| Provider Name | Gretchen L Kopec |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063856342 PECOS PAC ID: 2961704390 Enrollment ID: I20220222001081 |
| Provider Name | Mary a Defrance |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184244584 PECOS PAC ID: 2769806793 Enrollment ID: I20220307001063 |
| Provider Name | Audrey M Bunce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902567639 PECOS PAC ID: 7810382645 Enrollment ID: I20220315000437 |
| Provider Name | Emily a Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578187514 PECOS PAC ID: 0840614822 Enrollment ID: I20220316003204 |
| Provider Name | Jacqueline Jo Klossing |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790262822 PECOS PAC ID: 5193110781 Enrollment ID: I20220317001227 |
| Provider Name | Marissa Huettman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386396398 PECOS PAC ID: 8921493495 Enrollment ID: I20220318001825 |
| Provider Name | Maria E Dimusto-poortenga |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013940980 PECOS PAC ID: 4486987229 Enrollment ID: I20220321000223 |
| Provider Name | Rebecca a Solomon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770133159 PECOS PAC ID: 0547683740 Enrollment ID: I20220405000664 |
| Provider Name | Amanda Kenney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407501513 PECOS PAC ID: 1658768619 Enrollment ID: I20220422000551 |
| Provider Name | Matthew Compton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407175987 PECOS PAC ID: 0648523720 Enrollment ID: I20220613002624 |
| Provider Name | Abdur Rahman Ahmad |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1053727776 PECOS PAC ID: 2961751714 Enrollment ID: I20220622000433 |
| Provider Name | Amit Bahia |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1326010190 PECOS PAC ID: 0941234363 Enrollment ID: I20220706000367 |
| Provider Name | Arwyn G Cunningham |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1538514138 PECOS PAC ID: 1456645811 Enrollment ID: I20220713003404 |
| Provider Name | Ayoob Ali |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700832391 PECOS PAC ID: 8921164583 Enrollment ID: I20220822000578 |
| Provider Name | Thomas Harris |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720585219 PECOS PAC ID: 9638426745 Enrollment ID: I20220822002629 |
| Provider Name | Kimberly Hurley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851024004 PECOS PAC ID: 8022492412 Enrollment ID: I20220902001727 |
| Provider Name | Scottie Paitl |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114308020 PECOS PAC ID: 3870808033 Enrollment ID: I20220929000383 |
| Provider Name | Waqas Siddiqui |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386061729 PECOS PAC ID: 3678977717 Enrollment ID: I20221004000599 |
| Provider Name | Courtney Stonskas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972230860 PECOS PAC ID: 0749656486 Enrollment ID: I20221020000866 |
| Provider Name | Mehtap Yurt |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184937328 PECOS PAC ID: 6305089525 Enrollment ID: I20221129000629 |
| Provider Name | Keri L Shady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659759371 PECOS PAC ID: 0547638223 Enrollment ID: I20221130002824 |
| Provider Name | Nicholas Grande |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316085756 PECOS PAC ID: 6800971532 Enrollment ID: I20221206000356 |
| Provider Name | Shannon M West |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609322536 PECOS PAC ID: 9335489731 Enrollment ID: I20230103002370 |
| Provider Name | Kodee a Plambeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881306025 PECOS PAC ID: 0042682577 Enrollment ID: I20230210000071 |
| Provider Name | Marta M Van Straten |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1891006276 PECOS PAC ID: 7113217712 Enrollment ID: I20230210000327 |
| Provider Name | Mark J Shen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346539467 PECOS PAC ID: 0244457935 Enrollment ID: I20230221000735 |
| Provider Name | Madison C Adank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376258905 PECOS PAC ID: 7618340613 Enrollment ID: I20230222000358 |
| Provider Name | Alec M Austin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174220321 PECOS PAC ID: 8325411622 Enrollment ID: I20230308000343 |
| Provider Name | Andrew Rowland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477251007 PECOS PAC ID: 8123493954 Enrollment ID: I20230410002092 |
| Provider Name | Jason R Pryor |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316239064 PECOS PAC ID: 2365715646 Enrollment ID: I20230421000444 |
| Provider Name | Katherine a Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366142051 PECOS PAC ID: 5395101760 Enrollment ID: I20230510002288 |
| Provider Name | Karla Gruman Rippchen |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1447630603 PECOS PAC ID: 3173419272 Enrollment ID: I20230518000974 |
| Provider Name | Jennifer Hook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033662044 PECOS PAC ID: 8729367008 Enrollment ID: I20230612001566 |
| Provider Name | Maggie Jane Limoges-davies |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104119965 PECOS PAC ID: 1850683517 Enrollment ID: I20230614000282 |
| Provider Name | Omar Aceviz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215655568 PECOS PAC ID: 3779943790 Enrollment ID: I20230721000875 |
| Provider Name | Andrew Ganshirt |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1780213223 PECOS PAC ID: 4688030380 Enrollment ID: I20230801004134 |
| Provider Name | Laura Schinke |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1780290387 PECOS PAC ID: 0749641157 Enrollment ID: I20230802000425 |
| Provider Name | Margaret Lohf |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1881218501 PECOS PAC ID: 1557761434 Enrollment ID: I20230803001113 |
| Provider Name | Michella Azar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922480201 PECOS PAC ID: 9234441346 Enrollment ID: I20230821003377 |
| Provider Name | Kyle E Carver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457974347 PECOS PAC ID: 6800210931 Enrollment ID: I20230830000395 |
| Provider Name | Michael Yang |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1417338229 PECOS PAC ID: 4082905369 Enrollment ID: I20230911001091 |
| Provider Name | Sarah Rabice |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033615000 PECOS PAC ID: 3779830252 Enrollment ID: I20231003000574 |
| Provider Name | Allison Edmunds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518647932 PECOS PAC ID: 4284080664 Enrollment ID: I20231020001112 |
| Provider Name | Nancy Cortes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154001527 PECOS PAC ID: 1153778709 Enrollment ID: I20231103002293 |
| Provider Name | Keston M John |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417519794 PECOS PAC ID: 4981051331 Enrollment ID: I20231107003453 |
| Provider Name | Steve G Kopp |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205824935 PECOS PAC ID: 2961854823 Enrollment ID: I20240117001050 |
| Provider Name | Nicholas G Viyuoh |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952410219 PECOS PAC ID: 2466348263 Enrollment ID: I20240122004242 |
| Provider Name | Gary Joseph Kummet |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467626051 PECOS PAC ID: 5890935209 Enrollment ID: I20240131001464 |
| Provider Name | Michelle Christine Kelley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467593962 PECOS PAC ID: 2163759648 Enrollment ID: I20240210000205 |
| Provider Name | Michael a Porte |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336141530 PECOS PAC ID: 4981678299 Enrollment ID: I20240214002604 |
| Provider Name | Rayna Narvaez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740042373 PECOS PAC ID: 4789021601 Enrollment ID: I20240327000420 |
| Provider Name | Troy Dolmetsch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194464107 PECOS PAC ID: 8628453651 Enrollment ID: I20240503000930 |
| Provider Name | Jeanea Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972227304 PECOS PAC ID: 9638545676 Enrollment ID: I20240503003535 |
| Provider Name | Haley Wiggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851154744 PECOS PAC ID: 3870934748 Enrollment ID: I20240509000260 |
| Provider Name | Michael Warhank |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831767516 PECOS PAC ID: 8729482401 Enrollment ID: I20240725001528 |
| Provider Name | Deirdre Knobeloch |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982947149 PECOS PAC ID: 6608175674 Enrollment ID: I20240826002995 |
| Provider Name | Devika Kir |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1023466414 PECOS PAC ID: 2163716911 Enrollment ID: I20240830001977 |
| Provider Name | Heather Caulkins |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1720641087 PECOS PAC ID: 8820320393 Enrollment ID: I20240831000339 |
| Provider Name | Rylee Hunter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689415812 PECOS PAC ID: 5193265221 Enrollment ID: I20240904002188 |
| Provider Name | Aubree Dane |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972239648 PECOS PAC ID: 2062859903 Enrollment ID: I20240904003228 |
| Provider Name | Mckenna Kathryn Sexton |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1144959073 PECOS PAC ID: 6002282852 Enrollment ID: I20240904004551 |
| Provider Name | Adnan Yousaf |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306324975 PECOS PAC ID: 7214477454 Enrollment ID: I20240913002744 |
| Provider Name | Rachel Buttimer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902474372 PECOS PAC ID: 7113321894 Enrollment ID: I20240913002778 |
| Provider Name | Nilarun Chowdhuri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104278878 PECOS PAC ID: 7214223148 Enrollment ID: I20240920000387 |
| Provider Name | Pamela M Prince |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053176974 PECOS PAC ID: 4385185701 Enrollment ID: I20240925000809 |
| Provider Name | Kyllie Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639916273 PECOS PAC ID: 4486185741 Enrollment ID: I20240927001506 |
| Provider Name | Susan Marie Pereira |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134799737 PECOS PAC ID: 2466983556 Enrollment ID: I20240930003374 |
| Provider Name | Danielle Fico |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487492609 PECOS PAC ID: 2668903717 Enrollment ID: I20241001001485 |
| Provider Name | Gursukhman Deep Singh Sidhu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1871930719 PECOS PAC ID: 2567602162 Enrollment ID: I20241211002792 |
| Provider Name | Cassandra Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487482162 PECOS PAC ID: 1153856133 Enrollment ID: I20241217004275 |
| Provider Name | Madeleine Ranshaw |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1114392719 PECOS PAC ID: 5799212866 Enrollment ID: I20241231003020 |
| Provider Name | Rebekah Morden |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1790423937 PECOS PAC ID: 1254772486 Enrollment ID: I20250211002321 |
| Provider Name | Deborah Taylor |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073737680 PECOS PAC ID: 6608954524 Enrollment ID: I20250312000297 |
| Provider Name | Madisen Ahlstrom |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255021770 PECOS PAC ID: 4082138466 Enrollment ID: I20250407002833 |
| Provider Name | Julia Hageman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346058013 PECOS PAC ID: 6507381126 Enrollment ID: I20250416001860 |
| Provider Name | Michele Moritz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710492582 PECOS PAC ID: 1557621323 Enrollment ID: I20250417000583 |
| Provider Name | Michael Ray Quinton |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1205321619 PECOS PAC ID: 2062939085 Enrollment ID: I20250502002713 |
| Provider Name | Jake Walburg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245898394 PECOS PAC ID: 1355670100 Enrollment ID: I20250521001543 |
| Provider Name | Amy Lynn Bright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801609961 PECOS PAC ID: 2567973365 Enrollment ID: I20250618001882 |
| Provider Name | Kyle Christopher Varon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912573411 PECOS PAC ID: 3779985320 Enrollment ID: I20250712000135 |
| Provider Name | Brooke Elizabeth Turek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649071523 PECOS PAC ID: 6608374947 Enrollment ID: I20250807000786 |
| Provider Name | Wendell Beaty Shepherd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215721428 PECOS PAC ID: 3577061696 Enrollment ID: I20250808000738 |
| Provider Name | Ceara Patricia Van Buskirk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972306942 PECOS PAC ID: 1254839236 Enrollment ID: I20250808002629 |
| Provider Name | Andrea Fjelstul-bonert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801699533 PECOS PAC ID: 5294233227 Enrollment ID: I20250808004104 |
| Provider Name | Parth V Desai |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1831541093 PECOS PAC ID: 6305139718 Enrollment ID: I20250814000371 |
| Provider Name | Madison Kay Purvis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396530531 PECOS PAC ID: 7315446291 Enrollment ID: I20250818002769 |
| Provider Name | Nicholas Jordan Howard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225830755 PECOS PAC ID: 9234638149 Enrollment ID: I20250818003222 |
| Provider Name | Linda M Anders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508456039 PECOS PAC ID: 4880195742 Enrollment ID: I20250902000471 |
| Provider Name | Grace Hampton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043920721 PECOS PAC ID: 8729451901 Enrollment ID: I20251006000692 |
| Provider Name | John Llewelyn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942209424 PECOS PAC ID: 7719076165 Enrollment ID: I20251007002045 |
| Provider Name | Sarah Bakir |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891363016 PECOS PAC ID: 5395147698 Enrollment ID: I20251015001424 |
| Provider Name | Nicholas Nicchitta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053050484 PECOS PAC ID: 8729464508 Enrollment ID: I20251022004173 |
| Provider Name | Claire Elizabeth Fourdyce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437949237 PECOS PAC ID: 8022506724 Enrollment ID: I20251023004243 |
| Provider Name | Jennifer Maschmann |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023021433 PECOS PAC ID: 6800948605 Enrollment ID: I20251030004686 |
| Provider Name | Anish Reddy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427636950 PECOS PAC ID: 9638570997 Enrollment ID: I20251113000726 |
| Provider Name | Amanda Digeorge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508365750 PECOS PAC ID: 3779845334 Enrollment ID: I20251202001996 |
| Provider Name | Caroline Sidlinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033000344 PECOS PAC ID: 8921585324 Enrollment ID: I20260115003705 |
| Provider Name | Manisha Fenzl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497285373 PECOS PAC ID: 2365712809 Enrollment ID: I20260116000534 |
| Provider Name | Nichole Susanne Minch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083580088 PECOS PAC ID: 6103305347 Enrollment ID: I20260209002427 |
| Provider Name | Suchada Chaiwechakarn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558647495 PECOS PAC ID: 3678748647 Enrollment ID: I20260306000534 |
| Provider Name | Ross Burandt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093416935 PECOS PAC ID: 8426594292 Enrollment ID: I20260320000524 |
| Provider Name | Tasia Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922866292 PECOS PAC ID: 8527590074 Enrollment ID: I20260326000227 |
| Provider Name | Jacob E Staudt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801586250 PECOS PAC ID: 4284082058 Enrollment ID: I20260417001787 |
| Provider Name | Nelly Heiman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033326103 PECOS PAC ID: 0648365072 Enrollment ID: I20260430001738 |
| Provider Name | Carissa May |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194107755 PECOS PAC ID: 9335441591 Enrollment ID: I20260506003041 |
| Provider Name | Davinder Mann |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740410125 PECOS PAC ID: 7012158751 Enrollment ID: I20260606000116 |
| Provider Name | Norah Toraason |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619082948 PECOS PAC ID: 6103977541 Enrollment ID: I20260609001118 |
| Provider Name | Addie Marie Lintz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396690368 PECOS PAC ID: 6901379312 Enrollment ID: I20260626002594 |
Genesis Health Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 865 Lincoln Rd, Suite 400, Bettendorf, IA 52722 Phone: 563-355-7548 Fax: 563-355-7540 |
Champion Chiropractic, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 325 16th St, Bettendorf, IA 52722 Phone: 563-823-0386 Fax: 563-823-0651 |
Family Care Partners of the Quad Cities, P.C. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3740 Utica Ridge Rd, Suite B, Bettendorf, IA 52722 Phone: 563-344-7400 Fax: 563-359-9395 |
Byrum Family Dentistry Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3878 Middle Rd, Suite A, Bettendorf, IA 52722 Phone: 563-332-7734 Fax: 563-332-1649 |
Family Care Partners of the Quad Cities, P.C. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3740 Utica Ridge Rd, Suite B, Bettendorf, IA 52722 Phone: 563-344-7400 Fax: 563-359-9395 |
Genesis Health Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 865 Lincoln Rd, Suite L10, Bettendorf, IA 52722 Phone: 563-355-9191 Fax: 563-355-3419 |