| Jackson Hospital And Clinic, Inc. | |
|
1725 Pine St Montgomery AL 36106-1117 | |
| (334) 293-8147 | |
| Not Available |
| Full Name | Jackson Hospital And Clinic, Inc. |
|---|---|
| Speciality | Emergency Medicine |
| Location | 1725 Pine St, Montgomery, Alabama |
| Authorized Official Name and Position | Melody Cowdrey (DIRECTOR-REVENUE CYCLE INTEGRATION) |
| Authorized Official Contact | 3342938147 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Hospital And Clinic, Inc. 1725 Pine St Montgomery AL 36106-1109 Ph: (334) 293-8147 | Jackson Hospital And Clinic, Inc. 1725 Pine St Montgomery AL 36106-1117 Ph: (334) 293-8147 |
| NPI Number | 1073264107 |
|---|---|
| Provider Enumeration Date | 01/11/2022 |
| Last Update Date | 02/24/2023 |
| Medicare PECOS PAC ID | 0547254153 |
|---|---|
| Medicare Enrollment ID | O20040414000971 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073264107 | NPI | - | NPPES |
| Provider Name | Randal M Sedlak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780733220 PECOS PAC ID: 2365348794 Enrollment ID: I20031208000925 |
| Provider Name | Bobby G Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336117183 PECOS PAC ID: 2567360357 Enrollment ID: I20031231000030 |
| Provider Name | William D Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669481537 PECOS PAC ID: 3072413905 Enrollment ID: I20040109000285 |
| Provider Name | Steven D Avezzano |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730123217 PECOS PAC ID: 7618870379 Enrollment ID: I20040129000890 |
| Provider Name | Stewart H Tankersley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952375917 PECOS PAC ID: 2769371103 Enrollment ID: I20040312001022 |
| Provider Name | Gerald G Lim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407819014 PECOS PAC ID: 6103717723 Enrollment ID: I20040323001115 |
| Provider Name | Rakeshkuma R Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285625442 PECOS PAC ID: 9436141686 Enrollment ID: I20040330001637 |
| Provider Name | Beatrice B Norris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053362855 PECOS PAC ID: 0840284469 Enrollment ID: I20040414001094 |
| Provider Name | Oluyinka S Adediji |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245226612 PECOS PAC ID: 8224024658 Enrollment ID: I20040421001834 |
| Provider Name | Eric S Cunningham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033209473 PECOS PAC ID: 4981686268 Enrollment ID: I20040601001447 |
| Provider Name | Elizabeth A Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255384400 PECOS PAC ID: 6608840095 Enrollment ID: I20040823000272 |
| Provider Name | Beverly A Stoudemire- Howlett |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891766630 PECOS PAC ID: 0446222921 Enrollment ID: I20040825001362 |
| Provider Name | John A Jernigan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881635480 PECOS PAC ID: 8921070400 Enrollment ID: I20040825001421 |
| Provider Name | Carol M Holder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184803066 PECOS PAC ID: 1658331970 Enrollment ID: I20041012000841 |
| Provider Name | Mukeshkumar B Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861459703 PECOS PAC ID: 8426013301 Enrollment ID: I20041120000128 |
| Provider Name | Steven L Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508814922 PECOS PAC ID: 4183602758 Enrollment ID: I20041206000210 |
| Provider Name | Mohammad L Ahmed |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1457358053 PECOS PAC ID: 9830151760 Enrollment ID: I20050215000580 |
| Provider Name | Kristopher N Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750342556 PECOS PAC ID: 3375599418 Enrollment ID: I20050322001057 |
| Provider Name | Steven G Omara |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215972922 PECOS PAC ID: 6305750118 Enrollment ID: I20050627000704 |
| Provider Name | Richard L Sample |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497713200 PECOS PAC ID: 5193754943 Enrollment ID: I20050811000585 |
| Provider Name | Rodney D Soto |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588616890 PECOS PAC ID: 6608819545 Enrollment ID: I20050830000944 |
| Provider Name | Karen A Flanagan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457324600 PECOS PAC ID: 0244256451 Enrollment ID: I20051018000166 |
| Provider Name | Praful Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386607984 PECOS PAC ID: 9234158122 Enrollment ID: I20051121000667 |
| Provider Name | Xiongying Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306807599 PECOS PAC ID: 4486673373 Enrollment ID: I20051121000695 |
| Provider Name | Ronaldo V Dejesus |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962552448 PECOS PAC ID: 6608857537 Enrollment ID: I20060119000557 |
| Provider Name | Sandra D Whaley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285679746 PECOS PAC ID: 8426067216 Enrollment ID: I20060405000589 |
| Provider Name | Tamjeed Arshad |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568492544 PECOS PAC ID: 0840294385 Enrollment ID: I20060914000159 |
| Provider Name | Jose L Escobar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1053341024 PECOS PAC ID: 4183628621 Enrollment ID: I20060914000188 |
| Provider Name | Paul B Moore |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1285668699 PECOS PAC ID: 5698779130 Enrollment ID: I20060914000231 |
| Provider Name | Lisa J Williams |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1073543617 PECOS PAC ID: 5395740765 Enrollment ID: I20060919000404 |
| Provider Name | Kimberly A Hindi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043221161 PECOS PAC ID: 8527063163 Enrollment ID: I20061003000502 |
| Provider Name | Brian C Gary |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720181886 PECOS PAC ID: 6305843962 Enrollment ID: I20061025000210 |
| Provider Name | Muhammad Z Akbar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801994983 PECOS PAC ID: 6800999046 Enrollment ID: I20070308000630 |
| Provider Name | Stephen A Ensminger |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1619941705 PECOS PAC ID: 2163407578 Enrollment ID: I20070806000395 |
| Provider Name | Leena Bhasin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578770152 PECOS PAC ID: 2163504259 Enrollment ID: I20080129000121 |
| Provider Name | Alfred J Newman |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1609864867 PECOS PAC ID: 1850475856 Enrollment ID: I20080229000229 |
| Provider Name | Scott A Bell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770675704 PECOS PAC ID: 3870677685 Enrollment ID: I20080303000402 |
| Provider Name | Rao Meka |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275608853 PECOS PAC ID: 1658472485 Enrollment ID: I20080416000279 |
| Provider Name | Urmil S Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336119015 PECOS PAC ID: 1759469448 Enrollment ID: I20080422000090 |
| Provider Name | William D Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548336951 PECOS PAC ID: 3678651080 Enrollment ID: I20080428000411 |
| Provider Name | Nellda C Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407853880 PECOS PAC ID: 4284703570 Enrollment ID: I20080513000036 |
| Provider Name | Adelle Hutchins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336337849 PECOS PAC ID: 5890864128 Enrollment ID: I20080513000373 |
| Provider Name | Michael W Peaden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437122884 PECOS PAC ID: 9032288212 Enrollment ID: I20080514000037 |
| Provider Name | Mihir M Pradhan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043401821 PECOS PAC ID: 9739259797 Enrollment ID: I20080603000066 |
| Provider Name | Robert Boatwright Harris |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215011846 PECOS PAC ID: 0840226510 Enrollment ID: I20080609000485 |
| Provider Name | William Todd Sherrer |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1831189158 PECOS PAC ID: 4385716794 Enrollment ID: I20080630000484 |
| Provider Name | William G Cumbie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053303602 PECOS PAC ID: 8426120346 Enrollment ID: I20080709000219 |
| Provider Name | Timothy W Morrow |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1558331868 PECOS PAC ID: 6204901259 Enrollment ID: I20080826000535 |
| Provider Name | Audrey Hodge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437324613 PECOS PAC ID: 4587730684 Enrollment ID: I20080912000424 |
| Provider Name | Gloria S Massey |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1962667873 PECOS PAC ID: 7911074752 Enrollment ID: I20080922000160 |
| Provider Name | Thomas Leon Horton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972531127 PECOS PAC ID: 8921019225 Enrollment ID: I20081007000777 |
| Provider Name | Angela H Seals |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962653782 PECOS PAC ID: 1557427077 Enrollment ID: I20090309000550 |
| Provider Name | Michael Todd Miller |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1891985263 PECOS PAC ID: 6608927280 Enrollment ID: I20090622000087 |
| Provider Name | William P Saliski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720048523 PECOS PAC ID: 8820141708 Enrollment ID: I20090727000175 |
| Provider Name | Manuel Caceres Serrano |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1407081300 PECOS PAC ID: 3274687975 Enrollment ID: I20090814000257 |
| Provider Name | Parham Mora |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417915679 PECOS PAC ID: 7214074061 Enrollment ID: I20091027000581 |
| Provider Name | Rajeev Nagarad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417164831 PECOS PAC ID: 7012054885 Enrollment ID: I20091027000699 |
| Provider Name | Gaeton D Lorino |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1871553677 PECOS PAC ID: 9739227489 Enrollment ID: I20100125000015 |
| Provider Name | David Thrasher |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1831150259 PECOS PAC ID: 2466590112 Enrollment ID: I20100125000027 |
| Provider Name | Maher Farah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558442194 PECOS PAC ID: 3072658863 Enrollment ID: I20100304000384 |
| Provider Name | William J Leuschke |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730295411 PECOS PAC ID: 3173654217 Enrollment ID: I20100706000412 |
| Provider Name | Joel Mccloud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801836457 PECOS PAC ID: 5698807261 Enrollment ID: I20100716000510 |
| Provider Name | Norman Taylor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811937469 PECOS PAC ID: 0143352724 Enrollment ID: I20100716000610 |
| Provider Name | Jessica Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144468851 PECOS PAC ID: 1355533779 Enrollment ID: I20101004001196 |
| Provider Name | Doris D. Donald |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912953522 PECOS PAC ID: 0749178317 Enrollment ID: I20101005000632 |
| Provider Name | Tommy W Garnett |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1992865794 PECOS PAC ID: 0042282956 Enrollment ID: I20101020000261 |
| Provider Name | George M Handey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306901624 PECOS PAC ID: 7517150774 Enrollment ID: I20101020000297 |
| Provider Name | William Veale |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1093992646 PECOS PAC ID: 6002000361 Enrollment ID: I20101101000067 |
| Provider Name | Pavan K Madadi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306178496 PECOS PAC ID: 6103010483 Enrollment ID: I20101101000146 |
| Provider Name | Ishwarlal Bhuta |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1598823122 PECOS PAC ID: 9931395019 Enrollment ID: I20101201000781 |
| Provider Name | Glenn A Yates |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124019781 PECOS PAC ID: 4082800172 Enrollment ID: I20101202000850 |
| Provider Name | Raghu Mukkamala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720079395 PECOS PAC ID: 7719173806 Enrollment ID: I20101202000933 |
| Provider Name | James T Mclaughlin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568453124 PECOS PAC ID: 1153480983 Enrollment ID: I20101203000082 |
| Provider Name | Wesley H Barry |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477662617 PECOS PAC ID: 8628044898 Enrollment ID: I20101207000419 |
| Provider Name | Sandeep S Virk |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578766564 PECOS PAC ID: 4284822214 Enrollment ID: I20101217000268 |
| Provider Name | Gregory P Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043357221 PECOS PAC ID: 2264618362 Enrollment ID: I20110524000847 |
| Provider Name | Dongjin Yoon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851501266 PECOS PAC ID: 5799964136 Enrollment ID: I20110601000893 |
| Provider Name | Jurwardolyn Shuford-guice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114244456 PECOS PAC ID: 3173791852 Enrollment ID: I20110725000233 |
| Provider Name | Thomas Cawthon |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1336256601 PECOS PAC ID: 3476722521 Enrollment ID: I20110808000423 |
| Provider Name | Stephen Chandler |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1386752723 PECOS PAC ID: 2264570910 Enrollment ID: I20110809000190 |
| Provider Name | Gregory Borg |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1487761391 PECOS PAC ID: 3274634142 Enrollment ID: I20110811000547 |
| Provider Name | Olan Evans |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1417064478 PECOS PAC ID: 4183725054 Enrollment ID: I20110811000563 |
| Provider Name | Brian E Richardson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1861565624 PECOS PAC ID: 4688844665 Enrollment ID: I20110830000686 |
| Provider Name | Vladimir Zahradnik |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1528218393 PECOS PAC ID: 5496925471 Enrollment ID: I20110830000705 |
| Provider Name | Basil Omar Burney |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1043414485 PECOS PAC ID: 8921278953 Enrollment ID: I20110831000452 |
| Provider Name | Xinyu Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467613729 PECOS PAC ID: 5799955472 Enrollment ID: I20110907001488 |
| Provider Name | Richard E Crum |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1164456570 PECOS PAC ID: 1951317270 Enrollment ID: I20110920000199 |
| Provider Name | Darryl A Hamilton |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1972537397 PECOS PAC ID: 8224032768 Enrollment ID: I20110921000657 |
| Provider Name | Teresa M Watkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174775209 PECOS PAC ID: 1052583556 Enrollment ID: I20111005000438 |
| Provider Name | Jade Hoy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528268703 PECOS PAC ID: 9335272087 Enrollment ID: I20111010000256 |
| Provider Name | Howard Lee Brazil |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699765271 PECOS PAC ID: 1254504632 Enrollment ID: I20111031000387 |
| Provider Name | Stephen Kwan |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1518052356 PECOS PAC ID: 4385614346 Enrollment ID: I20111121000820 |
| Provider Name | Christopher R Duggar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982618633 PECOS PAC ID: 4284800822 Enrollment ID: I20120103000039 |
| Provider Name | Peter S Shashy |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1477515971 PECOS PAC ID: 1557341856 Enrollment ID: I20120117000822 |
| Provider Name | Katherine B Windham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942296512 PECOS PAC ID: 2163688813 Enrollment ID: I20120724000618 |
| Provider Name | Shelley S Byrd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841576915 PECOS PAC ID: 5193971505 Enrollment ID: I20120821000232 |
| Provider Name | Ezmina K Lalani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831407964 PECOS PAC ID: 5496907750 Enrollment ID: I20121212000572 |
| Provider Name | Kristopher N Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881036473 PECOS PAC ID: 4789827155 Enrollment ID: I20130904000467 |
| Provider Name | Breena R Till |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376976183 PECOS PAC ID: 5597909804 Enrollment ID: I20130926000052 |
| Provider Name | Hayley E Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992137178 PECOS PAC ID: 9032353354 Enrollment ID: I20130926000173 |
| Provider Name | Christopher J Waguespack |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275775165 PECOS PAC ID: 2365683166 Enrollment ID: I20131120002075 |
| Provider Name | Brian Sellers |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1801916788 PECOS PAC ID: 3274688312 Enrollment ID: I20140305001593 |
| Provider Name | William Blake Hubert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659704658 PECOS PAC ID: 7810129947 Enrollment ID: I20140403001946 |
| Provider Name | Latoya S Clark |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346566700 PECOS PAC ID: 7012137391 Enrollment ID: I20141008002549 |
| Provider Name | Joshua C Waits |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1730323056 PECOS PAC ID: 5092951707 Enrollment ID: I20141010001208 |
| Provider Name | Shamsuddin B Lalani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578853594 PECOS PAC ID: 7214252683 Enrollment ID: I20150205000879 |
| Provider Name | Glenn J Saucer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790770238 PECOS PAC ID: 2567775612 Enrollment ID: I20150717001423 |
| Provider Name | William Saliski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528475084 PECOS PAC ID: 2466760871 Enrollment ID: I20151005003202 |
| Provider Name | Jonathan Lamar Benson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821467267 PECOS PAC ID: 6002125853 Enrollment ID: I20151019002336 |
| Provider Name | Jodie M Shedd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346619368 PECOS PAC ID: 9436459930 Enrollment ID: I20151207001225 |
| Provider Name | Sunni L Beeck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164862942 PECOS PAC ID: 0648257899 Enrollment ID: I20151224000049 |
| Provider Name | Ngozi Okeke Essandoh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053547745 PECOS PAC ID: 6709033491 Enrollment ID: I20160104000732 |
| Provider Name | Ravichandra R Boyella |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1104021567 PECOS PAC ID: 7719158807 Enrollment ID: I20160301001151 |
| Provider Name | Richard Salazar Montero |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245436955 PECOS PAC ID: 4880835263 Enrollment ID: I20160428002347 |
| Provider Name | Vijaya Dhanireddy Boyella |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1932263993 PECOS PAC ID: 4284737362 Enrollment ID: I20160510001539 |
| Provider Name | Susan W Aguiar |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1336143999 PECOS PAC ID: 8729140546 Enrollment ID: I20160517002768 |
| Provider Name | Wanjiru Muigai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093036311 PECOS PAC ID: 1153611868 Enrollment ID: I20160609000197 |
| Provider Name | Marlene L Wilson-lavalley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275919698 PECOS PAC ID: 9436454741 Enrollment ID: I20160812001570 |
| Provider Name | Yingying Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710116199 PECOS PAC ID: 2466603303 Enrollment ID: I20160822001714 |
| Provider Name | Britney M Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043671951 PECOS PAC ID: 9830484294 Enrollment ID: I20160824000999 |
| Provider Name | Margaret Lamkin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215128376 PECOS PAC ID: 7113212309 Enrollment ID: I20160826001911 |
| Provider Name | Julie Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194178772 PECOS PAC ID: 3779879721 Enrollment ID: I20160831000929 |
| Provider Name | Taimoor Hashim |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1487867172 PECOS PAC ID: 1951450576 Enrollment ID: I20160913001355 |
| Provider Name | Himanshu Aggarwal |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1316106164 PECOS PAC ID: 7911295985 Enrollment ID: I20161006000566 |
| Provider Name | Tiara T Hypolite |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1831486489 PECOS PAC ID: 2668792409 Enrollment ID: I20161006000935 |
| Provider Name | Rikka Asuncion Banayat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033559448 PECOS PAC ID: 9931497831 Enrollment ID: I20161010000338 |
| Provider Name | Nicolette C Peters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669925251 PECOS PAC ID: 0345538864 Enrollment ID: I20161014001609 |
| Provider Name | Katrina Jones Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316491046 PECOS PAC ID: 8527346915 Enrollment ID: I20161107001096 |
| Provider Name | Christopher O Ike |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1043346893 PECOS PAC ID: 1759488604 Enrollment ID: I20170119000199 |
| Provider Name | Adaeze C Ike |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407292840 PECOS PAC ID: 4183927833 Enrollment ID: I20170127002356 |
| Provider Name | Sahil Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467887299 PECOS PAC ID: 3870879679 Enrollment ID: I20170410002286 |
| Provider Name | Amanda P Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255864732 PECOS PAC ID: 0244503795 Enrollment ID: I20170905000776 |
| Provider Name | Carla De La Garza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871931832 PECOS PAC ID: 7113078700 Enrollment ID: I20170915001727 |
| Provider Name | Angela Floyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841733045 PECOS PAC ID: 1951676071 Enrollment ID: I20170928004144 |
| Provider Name | Amber Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275069759 PECOS PAC ID: 6204101322 Enrollment ID: I20170928004233 |
| Provider Name | Travis Woodley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396274072 PECOS PAC ID: 7810262045 Enrollment ID: I20171013001138 |
| Provider Name | Se Young Suh |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1215355425 PECOS PAC ID: 4082992276 Enrollment ID: I20171019001967 |
| Provider Name | Jennifer Coker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760928808 PECOS PAC ID: 3173899010 Enrollment ID: I20171020002933 |
| Provider Name | Tressa Bolton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306376694 PECOS PAC ID: 7315213907 Enrollment ID: I20171026001172 |
| Provider Name | Shyam Padmanabhan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013224609 PECOS PAC ID: 1658651229 Enrollment ID: I20171121001058 |
| Provider Name | Ashley Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174058432 PECOS PAC ID: 1557629656 Enrollment ID: I20171219001546 |
| Provider Name | Kaysie M Bronson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619495173 PECOS PAC ID: 4880953116 Enrollment ID: I20180112002145 |
| Provider Name | Ashley Norwood Strickland |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841718954 PECOS PAC ID: 2062771827 Enrollment ID: I20180124001612 |
| Provider Name | Elizabeth Woodfin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497273395 PECOS PAC ID: 3779843255 Enrollment ID: I20180131002486 |
| Provider Name | Amy D Cassady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407383268 PECOS PAC ID: 7911272356 Enrollment ID: I20180201001685 |
| Provider Name | Brandi Huett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043723232 PECOS PAC ID: 2163787011 Enrollment ID: I20180524002894 |
| Provider Name | Megan R Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407360845 PECOS PAC ID: 8325393085 Enrollment ID: I20180620002247 |
| Provider Name | Michael Crouse |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1295973618 PECOS PAC ID: 3375898844 Enrollment ID: I20180625002163 |
| Provider Name | Sarah Connors Beucher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265834618 PECOS PAC ID: 6800141383 Enrollment ID: I20180625002633 |
| Provider Name | Brooke A Benton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871905505 PECOS PAC ID: 5193944767 Enrollment ID: I20180712003028 |
| Provider Name | Rebecca Lee Buckalew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649635079 PECOS PAC ID: 0446507800 Enrollment ID: I20180717003254 |
| Provider Name | Paul Vincent Co |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1992069348 PECOS PAC ID: 7517268048 Enrollment ID: I20180830001195 |
| Provider Name | Andrea K Steinbrink |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710470554 PECOS PAC ID: 5193075489 Enrollment ID: I20180907000138 |
| Provider Name | Jacquelin Ratunil Chua |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1033467196 PECOS PAC ID: 9133419674 Enrollment ID: I20180920002923 |
| Provider Name | Bowei Tan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477936086 PECOS PAC ID: 2769734391 Enrollment ID: I20181010001062 |
| Provider Name | Kaitlyn Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013408723 PECOS PAC ID: 4183976467 Enrollment ID: I20181015003113 |
| Provider Name | Hiren G Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316202823 PECOS PAC ID: 4385996545 Enrollment ID: I20181016003293 |
| Provider Name | Nina Yvette Massey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750869814 PECOS PAC ID: 9133472020 Enrollment ID: I20181023000945 |
| Provider Name | Andrew Hunter Ford |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1164411963 PECOS PAC ID: 4981785540 Enrollment ID: I20181113002274 |
| Provider Name | Sharon Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821563768 PECOS PAC ID: 1456605286 Enrollment ID: I20181114002958 |
| Provider Name | Crystal S Reese |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780003822 PECOS PAC ID: 2769784057 Enrollment ID: I20190528000273 |
| Provider Name | Amy Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518528785 PECOS PAC ID: 7416286109 Enrollment ID: I20190905001138 |
| Provider Name | Tijil Agarwal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104231257 PECOS PAC ID: 1052604964 Enrollment ID: I20191002001305 |
| Provider Name | Jasmine N Abebe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699336644 PECOS PAC ID: 9739410143 Enrollment ID: I20191016003195 |
| Provider Name | Virginia R Mcdaniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609435155 PECOS PAC ID: 3779815733 Enrollment ID: I20191024002765 |
| Provider Name | Bethany F Phelps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982264867 PECOS PAC ID: 1759714827 Enrollment ID: I20191203001900 |
| Provider Name | Kimberly Corona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720503287 PECOS PAC ID: 5395170633 Enrollment ID: I20200115001462 |
| Provider Name | Janet M Baumann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053750315 PECOS PAC ID: 5597064311 Enrollment ID: I20200116002852 |
| Provider Name | Edwin Seelye |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902253651 PECOS PAC ID: 6406149657 Enrollment ID: I20200117000782 |
| Provider Name | Rekha Jiswant |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1457702490 PECOS PAC ID: 2567897465 Enrollment ID: I20200123001370 |
| Provider Name | Miho Suga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194175513 PECOS PAC ID: 1153757836 Enrollment ID: I20200129001655 |
| Provider Name | Gary D Harmon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245209303 PECOS PAC ID: 5698937506 Enrollment ID: I20200408001468 |
| Provider Name | Azad A Kabir |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285845933 PECOS PAC ID: 9931233681 Enrollment ID: I20200519002070 |
| Provider Name | Katlin Nolan Hancock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497200638 PECOS PAC ID: 8325316151 Enrollment ID: I20200526001371 |
| Provider Name | Valerie P Bauer |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1609812353 PECOS PAC ID: 5193721652 Enrollment ID: I20200526003195 |
| Provider Name | Justin Alexander Parden |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1578790895 PECOS PAC ID: 9830333244 Enrollment ID: I20200609001935 |
| Provider Name | Pamela Beams |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1750764221 PECOS PAC ID: 4981917846 Enrollment ID: I20200803001238 |
| Provider Name | Elizabeth Alison Knight Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982213898 PECOS PAC ID: 7315363306 Enrollment ID: I20200820003890 |
| Provider Name | Harry Shao |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669902375 PECOS PAC ID: 0547687824 Enrollment ID: I20200901002066 |
| Provider Name | Blake Stephen Raggio |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1497174189 PECOS PAC ID: 2668750829 Enrollment ID: I20201105002949 |
| Provider Name | Max Capouano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811416050 PECOS PAC ID: 9335552769 Enrollment ID: I20210104001676 |
| Provider Name | John Bauer |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1437269941 PECOS PAC ID: 4587661871 Enrollment ID: I20210217000734 |
| Provider Name | Cassandra Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952956567 PECOS PAC ID: 3375950397 Enrollment ID: I20210318000843 |
| Provider Name | Giorgia Grace Lamberth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740741438 PECOS PAC ID: 2668889015 Enrollment ID: I20210331000901 |
| Provider Name | Leslie Rutkowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821519547 PECOS PAC ID: 0941604284 Enrollment ID: I20210809000802 |
| Provider Name | Rebecca Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023601309 PECOS PAC ID: 2567866643 Enrollment ID: I20210811003010 |
| Provider Name | Levani Odikadze |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265963441 PECOS PAC ID: 2961772710 Enrollment ID: I20211006001769 |
| Provider Name | Lauren Ashlee Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578195871 PECOS PAC ID: 1254722481 Enrollment ID: I20211227000266 |
| Provider Name | Jerrie D Baldwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962954768 PECOS PAC ID: 9638562606 Enrollment ID: I20220215002693 |
| Provider Name | Nikeya Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013661180 PECOS PAC ID: 9739575929 Enrollment ID: I20220418000319 |
| Provider Name | Maegan Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598339038 PECOS PAC ID: 1557741543 Enrollment ID: I20220708000353 |
| Provider Name | Yao Peng |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831669530 PECOS PAC ID: 7810378460 Enrollment ID: I20220714000565 |
| Provider Name | Bradley Hamm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255891289 PECOS PAC ID: 8628459286 Enrollment ID: I20220714000947 |
| Provider Name | Raymond D Wheat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992438071 PECOS PAC ID: 9537540331 Enrollment ID: I20220725001384 |
| Provider Name | Irwin White-gittens |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1144635418 PECOS PAC ID: 1759763550 Enrollment ID: I20220726002361 |
| Provider Name | Jaime Carroll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316922073 PECOS PAC ID: 8628011939 Enrollment ID: I20220812003177 |
| Provider Name | Aimee Duthil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891350559 PECOS PAC ID: 6406230218 Enrollment ID: I20220829000830 |
| Provider Name | Warda Niaz |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1184090656 PECOS PAC ID: 0749587160 Enrollment ID: I20220920002918 |
| Provider Name | Andrea Lowery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881223840 PECOS PAC ID: 1052796331 Enrollment ID: I20220922002615 |
| Provider Name | Rachel Vought |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629749684 PECOS PAC ID: 9931585098 Enrollment ID: I20220928000282 |
| Provider Name | Amy Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528690542 PECOS PAC ID: 6901272574 Enrollment ID: I20221024000064 |
| Provider Name | Hima Ammana |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1902250343 PECOS PAC ID: 8628315611 Enrollment ID: I20221026002339 |
| Provider Name | Kylie Alexander Huggins |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1902514334 PECOS PAC ID: 1456729102 Enrollment ID: I20221130001465 |
| Provider Name | John Bachmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750004065 PECOS PAC ID: 8022487412 Enrollment ID: I20221206003465 |
| Provider Name | Dusty Lambert-wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073151007 PECOS PAC ID: 8426428947 Enrollment ID: I20221228000572 |
| Provider Name | Elaina Adderley |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1699220988 PECOS PAC ID: 3476841321 Enrollment ID: I20230103000181 |
| Provider Name | Mary L Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871185371 PECOS PAC ID: 5698146736 Enrollment ID: I20230127000390 |
| Provider Name | Jad Chamieh |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285084087 PECOS PAC ID: 8729337373 Enrollment ID: I20230215002483 |
| Provider Name | Paul E Sheffield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093783672 PECOS PAC ID: 4385661768 Enrollment ID: I20230227000985 |
| Provider Name | Rhonda L. Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386359057 PECOS PAC ID: 0547635807 Enrollment ID: I20230419000736 |
| Provider Name | Schaquwa R Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093417883 PECOS PAC ID: 8820453889 Enrollment ID: I20230426000612 |
| Provider Name | Jennifer M Farrior |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467166975 PECOS PAC ID: 2860857513 Enrollment ID: I20230502001237 |
| Provider Name | Michael S Galitz |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1275503690 PECOS PAC ID: 5193963619 Enrollment ID: I20230607000570 |
| Provider Name | Syed Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477087427 PECOS PAC ID: 3678844784 Enrollment ID: I20230621001018 |
| Provider Name | Destiny Mathis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609452630 PECOS PAC ID: 9335507334 Enrollment ID: I20230623001345 |
| Provider Name | Meagan Renea Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093235418 PECOS PAC ID: 4082989678 Enrollment ID: I20230721000162 |
| Provider Name | Pooja Poudel |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1588186142 PECOS PAC ID: 4183961709 Enrollment ID: I20230802002780 |
| Provider Name | Michelle L Bez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609820851 PECOS PAC ID: 8123201910 Enrollment ID: I20230907000723 |
| Provider Name | Shreesh Shrestha |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1366893562 PECOS PAC ID: 0042637316 Enrollment ID: I20230920001273 |
| Provider Name | Muhammad Haris |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1073043279 PECOS PAC ID: 3375812878 Enrollment ID: I20230922000296 |
| Provider Name | Hajrunisa Cubro |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1649730136 PECOS PAC ID: 9032564869 Enrollment ID: I20231013000372 |
| Provider Name | Victor Francisco Coloso |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225090038 PECOS PAC ID: 3274636261 Enrollment ID: I20231013002332 |
| Provider Name | Aryn Boswell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801675608 PECOS PAC ID: 4880040450 Enrollment ID: I20231102002178 |
| Provider Name | Nawaf Al Hashemi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811414626 PECOS PAC ID: 9032454608 Enrollment ID: I20231207000299 |
| Provider Name | Pranav Garlapati |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003269937 PECOS PAC ID: 2264883248 Enrollment ID: I20240104001769 |
| Provider Name | Courtney A Qualls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275218307 PECOS PAC ID: 1052763059 Enrollment ID: I20240116000417 |
| Provider Name | Hasrat Sidhu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1083277685 PECOS PAC ID: 2769717305 Enrollment ID: I20240306001247 |
| Provider Name | Lela S Rivers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174202063 PECOS PAC ID: 7517303654 Enrollment ID: I20240311003367 |
| Provider Name | Christi A Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174209779 PECOS PAC ID: 6709224538 Enrollment ID: I20240329000883 |
| Provider Name | Ernestine Takang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619554755 PECOS PAC ID: 7810339801 Enrollment ID: I20240522001322 |
| Provider Name | Tiffany R Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013649755 PECOS PAC ID: 8628514163 Enrollment ID: I20240722000591 |
| Provider Name | Silvia P Schibeci Oraa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801381512 PECOS PAC ID: 8022557909 Enrollment ID: I20240822003528 |
| Provider Name | Nathaniel C Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447088620 PECOS PAC ID: 2264964048 Enrollment ID: I20241017003025 |
Your Doctor's Office, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8630 Vaughn Rd, Montgomery, AL 36117 Phone: 334-676-4076 Fax: 334-676-4064 | |
Hca For Baptist Health, An Affiliate Of Uab Health System Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 470 Taylor Rd Ste 310, Montgomery, AL 36117 Phone: 334-244-4322 Fax: 334-244-4321 | |
Jackson Hospital And Clinic Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1801 Pine Street, Suite 103, Montgomery, AL 36106 Phone: 334-293-8888 Fax: 334-293-8154 | |
Little Village Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2640 Bell Rd, Montgomery, AL 36117 Phone: 334-621-0583 | |
Health Care Authority For Baptist Health, An Affiliate Of Uabhs Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Brown Springs Rd, Montgomery, AL 36117 Phone: 334-273-4159 Fax: 334-273-4556 | |
Aikam Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2895 Zelda Rd, Montgomery, AL 36106 Phone: 334-245-5969 | |
Jackson Hospital And Clinic, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1801 Pine St, Suite 203, Montgomery, AL 36106 Phone: 334-240-2334 |