| Jayhawk Primary Care Inc | |
|
7405 Renner Rd Ku Medwest Shawnee KS 66217-9414 | |
| (913) 588-8400 | |
| (913) 588-8413 |
| Full Name | Jayhawk Primary Care Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 7405 Renner Rd, Shawnee, Kansas |
| Authorized Official Name and Position | Steven Brown (BILLING DIRECTOR) |
| Authorized Official Contact | 9139455603 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jayhawk Primary Care Inc 2330 Shawnee Mission Pkwy Medical Administrative Services Of Ku Med. Ste. 312 Westwood KS 66205-2005 Ph: (913) 588-9000 | Jayhawk Primary Care Inc 7405 Renner Rd Ku Medwest Shawnee KS 66217-9414 Ph: (913) 588-8400 |
| NPI Number | 1528025053 |
|---|---|
| Provider Enumeration Date | 04/27/2006 |
| Last Update Date | 04/09/2012 |
| Medicare PECOS PAC ID | 8123928900 |
|---|---|
| Medicare Enrollment ID | O20050721001078 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528025053 | NPI | - | NPPES |
| 25562019 | Other | BCBS GROUP NUMBER | |
| 100217070C | Medicaid | KS |
| Provider Name | Sherri L Vaughn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356344709 PECOS PAC ID: 3779497656 Enrollment ID: I20031125000358 |
| Provider Name | David M Riley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306899497 PECOS PAC ID: 6800783663 Enrollment ID: I20040304000545 |
| Provider Name | Martin J Schermoly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861445009 PECOS PAC ID: 8426096165 Enrollment ID: I20050422000464 |
| Provider Name | James M Sebghati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770536914 PECOS PAC ID: 9931148939 Enrollment ID: I20050429000347 |
| Provider Name | Eric L Dyck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497708580 PECOS PAC ID: 0042253791 Enrollment ID: I20050603000831 |
| Provider Name | Danielle R Stebbins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891732137 PECOS PAC ID: 0749260214 Enrollment ID: I20051028000700 |
| Provider Name | Belinda A Vail |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902903479 PECOS PAC ID: 8224071337 Enrollment ID: I20051031000231 |
| Provider Name | Donald B Milligan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902902240 PECOS PAC ID: 0244266179 Enrollment ID: I20051031000618 |
| Provider Name | Roger A Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578652574 PECOS PAC ID: 4880588110 Enrollment ID: I20051112000007 |
| Provider Name | Pennie L Mesmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013939982 PECOS PAC ID: 4587555271 Enrollment ID: I20051215000360 |
| Provider Name | Joseph B Noland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285681775 PECOS PAC ID: 8325041882 Enrollment ID: I20060823000218 |
| Provider Name | Kristine G Arano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629083324 PECOS PAC ID: 2769488535 Enrollment ID: I20061018000583 |
| Provider Name | Maiko G Ebersole Robinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386611457 PECOS PAC ID: 9830142850 Enrollment ID: I20070710000674 |
| Provider Name | Janice K Langholz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790704583 PECOS PAC ID: 2365533841 Enrollment ID: I20070813000660 |
| Provider Name | Rita M Hyde |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790701084 PECOS PAC ID: 5799876280 Enrollment ID: I20070813000695 |
| Provider Name | Deborah M Hall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063431823 PECOS PAC ID: 0941391437 Enrollment ID: I20070813000731 |
| Provider Name | Tara J Grimaldi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043414105 PECOS PAC ID: 2163515511 Enrollment ID: I20070830000790 |
| Provider Name | Jessica A Stone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003037615 PECOS PAC ID: 7012001852 Enrollment ID: I20070924000491 |
| Provider Name | Jane T Broxterman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679686380 PECOS PAC ID: 3274622766 Enrollment ID: I20071207000127 |
| Provider Name | Susanne M Conrad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144286733 PECOS PAC ID: 3971527565 Enrollment ID: I20080502000565 |
| Provider Name | Kerri L Fellows |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598881468 PECOS PAC ID: 0143392886 Enrollment ID: I20080711000532 |
| Provider Name | Ronald G Graham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326091430 PECOS PAC ID: 3870655855 Enrollment ID: I20081230000090 |
| Provider Name | Jane V Makona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407874209 PECOS PAC ID: 2961564802 Enrollment ID: I20081231000049 |
| Provider Name | Bruce H Salvaggio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558341347 PECOS PAC ID: 8820155625 Enrollment ID: I20090428000479 |
| Provider Name | Faye E Vandendaele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851483101 PECOS PAC ID: 9133288160 Enrollment ID: I20090615000070 |
| Provider Name | Denny M Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558403576 PECOS PAC ID: 1557414406 Enrollment ID: I20090724000702 |
| Provider Name | Kevin J Punswick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275774853 PECOS PAC ID: 6507919826 Enrollment ID: I20090804000830 |
| Provider Name | Heather M Baker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215101878 PECOS PAC ID: 7214081785 Enrollment ID: I20090818000503 |
| Provider Name | Alisa B Cahill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609829233 PECOS PAC ID: 8022073667 Enrollment ID: I20100109000400 |
| Provider Name | James R Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073566600 PECOS PAC ID: 0648312215 Enrollment ID: I20100120000187 |
| Provider Name | Virginia A Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255398152 PECOS PAC ID: 0547303166 Enrollment ID: I20100204000657 |
| Provider Name | Rita M Oplotnik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922051580 PECOS PAC ID: 9638212863 Enrollment ID: I20100210000088 |
| Provider Name | Timothy C Frey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447298385 PECOS PAC ID: 5698819209 Enrollment ID: I20100220000176 |
| Provider Name | John M Feehan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063464071 PECOS PAC ID: 0143364778 Enrollment ID: I20100220000408 |
| Provider Name | Huda H Alani |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013945690 PECOS PAC ID: 8325183353 Enrollment ID: I20100302000835 |
| Provider Name | Rozina A Mohiuddin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538100318 PECOS PAC ID: 5395880348 Enrollment ID: I20100302000952 |
| Provider Name | David B Karty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144272949 PECOS PAC ID: 9032244264 Enrollment ID: I20100312000841 |
| Provider Name | Patrick R Herrick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164475851 PECOS PAC ID: 9739214115 Enrollment ID: I20100324000602 |
| Provider Name | Todd W Morrison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194751172 PECOS PAC ID: 4385671494 Enrollment ID: I20100423000837 |
| Provider Name | Anne L Jones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740223601 PECOS PAC ID: 6608861018 Enrollment ID: I20100429000082 |
| Provider Name | Pamela M Weinhold |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467495366 PECOS PAC ID: 7618004383 Enrollment ID: I20100429000100 |
| Provider Name | Keith T Ratzlaff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770536880 PECOS PAC ID: 8921136078 Enrollment ID: I20100511000205 |
| Provider Name | John L Sherard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861445561 PECOS PAC ID: 4486782554 Enrollment ID: I20100511000454 |
| Provider Name | Scott A Nitzel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861443749 PECOS PAC ID: 3274662671 Enrollment ID: I20100524000380 |
| Provider Name | Amber E Niewald |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881892487 PECOS PAC ID: 1254464811 Enrollment ID: I20100803000392 |
| Provider Name | Martin R Dolphino |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1659474997 PECOS PAC ID: 0749313229 Enrollment ID: I20100804000628 |
| Provider Name | Michael Morgan Bergman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952548307 PECOS PAC ID: 9931224086 Enrollment ID: I20100914000435 |
| Provider Name | Uyen N Vu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710167887 PECOS PAC ID: 8729276704 Enrollment ID: I20101216000933 |
| Provider Name | Joseph W Lemaster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275590713 PECOS PAC ID: 4082711148 Enrollment ID: I20110713000230 |
| Provider Name | Girma T Assefa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134321292 PECOS PAC ID: 2264526367 Enrollment ID: I20111006000332 |
| Provider Name | Jennifer L Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841284239 PECOS PAC ID: 1850473919 Enrollment ID: I20120223000099 |
| Provider Name | Margaret L Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578857900 PECOS PAC ID: 3678540713 Enrollment ID: I20120508000161 |
| Provider Name | Amanda J Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790042661 PECOS PAC ID: 2466616644 Enrollment ID: I20120620000198 |
| Provider Name | Jessica N Gillespie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902070261 PECOS PAC ID: 0941466080 Enrollment ID: I20120718000369 |
| Provider Name | Melissa L Yeats |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609197060 PECOS PAC ID: 5294981361 Enrollment ID: I20120806000039 |
| Provider Name | Carrie W Lehr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356390322 PECOS PAC ID: 7113949074 Enrollment ID: I20120820000993 |
| Provider Name | Kallie M Foss |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447488812 PECOS PAC ID: 4183875909 Enrollment ID: I20121102000535 |
| Provider Name | Melissa L Lane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841429958 PECOS PAC ID: 3375709884 Enrollment ID: I20121214000286 |
| Provider Name | Marcia L Norwich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699081653 PECOS PAC ID: 9830344886 Enrollment ID: I20130225000263 |
| Provider Name | Colleen E Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790096774 PECOS PAC ID: 4284875279 Enrollment ID: I20130802000794 |
| Provider Name | Kelsie Anne Kelly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952612251 PECOS PAC ID: 7416195144 Enrollment ID: I20130805000219 |
| Provider Name | Benjamin M. Petelin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386955334 PECOS PAC ID: 6406099589 Enrollment ID: I20130821000994 |
| Provider Name | Erica J Red Corn |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457672990 PECOS PAC ID: 6507090354 Enrollment ID: I20131009001589 |
| Provider Name | Michelle R Vieira |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275806457 PECOS PAC ID: 7810121449 Enrollment ID: I20131014001007 |
| Provider Name | Linda L Bunten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760816185 PECOS PAC ID: 2163656778 Enrollment ID: I20131015001523 |
| Provider Name | Monica D Pfeiffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770918526 PECOS PAC ID: 2769618024 Enrollment ID: I20131115001263 |
| Provider Name | Adam B Dobbins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407286438 PECOS PAC ID: 7618106857 Enrollment ID: I20140402002294 |
| Provider Name | Jennifer R Dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942624903 PECOS PAC ID: 0345465779 Enrollment ID: I20140627000603 |
| Provider Name | Emily L Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578985131 PECOS PAC ID: 8729204615 Enrollment ID: I20140730000833 |
| Provider Name | Paul D Martis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508154659 PECOS PAC ID: 8729239629 Enrollment ID: I20140821000897 |
| Provider Name | Catherine Gailloux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225474596 PECOS PAC ID: 3476775974 Enrollment ID: I20141118002073 |
| Provider Name | Mistee M Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699061218 PECOS PAC ID: 6406075241 Enrollment ID: I20141120001599 |
| Provider Name | Anjalee G Carlson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053609107 PECOS PAC ID: 4082861489 Enrollment ID: I20141217002749 |
| Provider Name | Melanie Lee Palma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649660036 PECOS PAC ID: 1254656101 Enrollment ID: I20150217001222 |
| Provider Name | Erin A Corriveau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962631044 PECOS PAC ID: 2062659683 Enrollment ID: I20150226000323 |
| Provider Name | Elisa M Van Daalen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861888380 PECOS PAC ID: 8921329194 Enrollment ID: I20150601001268 |
| Provider Name | Michael G Stone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396078226 PECOS PAC ID: 1759553993 Enrollment ID: I20150623000971 |
| Provider Name | Neha Sood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447571567 PECOS PAC ID: 3274770185 Enrollment ID: I20150625000544 |
| Provider Name | Sarah M Stolte |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982967717 PECOS PAC ID: 7517270564 Enrollment ID: I20150720001758 |
| Provider Name | Kelly M Andra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275754202 PECOS PAC ID: 8820180995 Enrollment ID: I20150724010589 |
| Provider Name | Megan R Caldwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134518350 PECOS PAC ID: 2860706272 Enrollment ID: I20150729009285 |
| Provider Name | Paul P Pena |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497017149 PECOS PAC ID: 9335453257 Enrollment ID: I20150805007039 |
| Provider Name | Daniel J Love |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043691363 PECOS PAC ID: 2264747229 Enrollment ID: I20150819009110 |
| Provider Name | Amanda F Cavlovich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124373238 PECOS PAC ID: 1355658469 Enrollment ID: I20150922000048 |
| Provider Name | Jana K Graber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982076592 PECOS PAC ID: 3173823408 Enrollment ID: I20151118001560 |
| Provider Name | Stephanie B Crabtree |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255533683 PECOS PAC ID: 4688850076 Enrollment ID: I20151119001471 |
| Provider Name | Vanessa E Winters |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942649280 PECOS PAC ID: 4082906698 Enrollment ID: I20160629002889 |
| Provider Name | Allyson D. Lenz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003161548 PECOS PAC ID: 3072751569 Enrollment ID: I20160812000549 |
| Provider Name | Darius Amani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457614026 PECOS PAC ID: 0446544548 Enrollment ID: I20160812000853 |
| Provider Name | Paul B Rotert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992071393 PECOS PAC ID: 5698080349 Enrollment ID: I20160818001558 |
| Provider Name | Jennifer Kendall |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1902244015 PECOS PAC ID: 0244535128 Enrollment ID: I20160818001598 |
| Provider Name | Ashley I Lutjemeier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154779197 PECOS PAC ID: 0749575397 Enrollment ID: I20160823000190 |
| Provider Name | Kevin O Guevarra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356744981 PECOS PAC ID: 7618258260 Enrollment ID: I20161220000824 |
| Provider Name | Kyle A Martin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1780093948 PECOS PAC ID: 0648490920 Enrollment ID: I20170207000836 |
| Provider Name | Erin L Buckley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477733434 PECOS PAC ID: 1456431022 Enrollment ID: I20170217001943 |
| Provider Name | Emily M Ryan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427348796 PECOS PAC ID: 0941517288 Enrollment ID: I20170322000095 |
| Provider Name | Jennifer L Woodward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447562798 PECOS PAC ID: 3870897747 Enrollment ID: I20170418001580 |
| Provider Name | Sarita K Singh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528323474 PECOS PAC ID: 3779891015 Enrollment ID: I20170418001615 |
| Provider Name | Sharissa B Mabry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467605188 PECOS PAC ID: 1658542998 Enrollment ID: I20170607003174 |
| Provider Name | Denton K Shanks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811334550 PECOS PAC ID: 0446553853 Enrollment ID: I20170629000496 |
| Provider Name | Nicole T Yedlinsky |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1366431645 PECOS PAC ID: 1759676604 Enrollment ID: I20170810001719 |
| Provider Name | Elizabeth Wells Musil |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558773119 PECOS PAC ID: 3870717218 Enrollment ID: I20170822000104 |
| Provider Name | Rochelle M Herre |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477829380 PECOS PAC ID: 8527379536 Enrollment ID: I20171011000065 |
| Provider Name | Stephanie L Petralie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699291583 PECOS PAC ID: 6305103540 Enrollment ID: I20171127002194 |
| Provider Name | Margaret Q Mesmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306350392 PECOS PAC ID: 1951668615 Enrollment ID: I20171205002030 |
| Provider Name | Emily J Barnett-doyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730687013 PECOS PAC ID: 4789945403 Enrollment ID: I20180221000054 |
| Provider Name | Gregory A Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780186908 PECOS PAC ID: 7810259157 Enrollment ID: I20180326000654 |
| Provider Name | Dayna G Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639667041 PECOS PAC ID: 7315202918 Enrollment ID: I20180601000536 |
| Provider Name | Benjamin W Quick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104211192 PECOS PAC ID: 2264737444 Enrollment ID: I20180606000668 |
| Provider Name | Jean-philippe E Darche |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164836920 PECOS PAC ID: 4082910088 Enrollment ID: I20180711000233 |
| Provider Name | Kathryn K Murray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326249269 PECOS PAC ID: 3971679937 Enrollment ID: I20180806002499 |
| Provider Name | Jennifer L Sturgeon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609352624 PECOS PAC ID: 8426306317 Enrollment ID: I20180809001039 |
| Provider Name | Victoria Weaver |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497137566 PECOS PAC ID: 1254636301 Enrollment ID: I20181001002578 |
| Provider Name | Jaclyn Whitlock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699252015 PECOS PAC ID: 4789936378 Enrollment ID: I20181009003418 |
| Provider Name | Edward B Christiansen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538541107 PECOS PAC ID: 2860789609 Enrollment ID: I20181101002804 |
| Provider Name | Kelsey Nicole Wampler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841773496 PECOS PAC ID: 6608120746 Enrollment ID: I20181108001903 |
| Provider Name | Adam J Zerr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184041964 PECOS PAC ID: 3971729609 Enrollment ID: I20181222000474 |
| Provider Name | Jessica L Mowry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063655348 PECOS PAC ID: 6800060427 Enrollment ID: I20190715002912 |
| Provider Name | Christopher S Jozwick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720640782 PECOS PAC ID: 8921334160 Enrollment ID: I20190725003756 |
| Provider Name | Brittany Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841857810 PECOS PAC ID: 2466789003 Enrollment ID: I20190806000863 |
| Provider Name | Alyssa Albakour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902372055 PECOS PAC ID: 0648516302 Enrollment ID: I20191023002120 |
| Provider Name | Katlynn D Walter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184266439 PECOS PAC ID: 0749615821 Enrollment ID: I20200117001467 |
| Provider Name | Briana B Finch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740811660 PECOS PAC ID: 5294162160 Enrollment ID: I20200305002385 |
| Provider Name | Debra K Altenhofen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336677467 PECOS PAC ID: 4183996994 Enrollment ID: I20200923002748 |
| Provider Name | Li Y Lan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316470388 PECOS PAC ID: 6507285707 Enrollment ID: I20201007000356 |
| Provider Name | Nour Boulad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164953329 PECOS PAC ID: 7517383854 Enrollment ID: I20201013003274 |
| Provider Name | Jolene Marie Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063932051 PECOS PAC ID: 6204105695 Enrollment ID: I20201027003030 |
| Provider Name | Frances Eleanor Lafferty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962930891 PECOS PAC ID: 3779857263 Enrollment ID: I20201027003100 |
| Provider Name | Cory B Gutovitz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750810099 PECOS PAC ID: 9436421971 Enrollment ID: I20201110002972 |
| Provider Name | Nina Nadu K Lawson-moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619431608 PECOS PAC ID: 1557772878 Enrollment ID: I20201117003096 |
| Provider Name | Sarah M Stoughton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417566100 PECOS PAC ID: 9133531833 Enrollment ID: I20201222003028 |
| Provider Name | Darren E Killen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114920295 PECOS PAC ID: 8325233489 Enrollment ID: I20210406001831 |
| Provider Name | Megan M Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780945493 PECOS PAC ID: 7416105838 Enrollment ID: I20210528001556 |
| Provider Name | Elizabeth G Wheeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568082048 PECOS PAC ID: 9234531252 Enrollment ID: I20210714000882 |
| Provider Name | Kalee A Kirmer-voss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962907980 PECOS PAC ID: 4880942150 Enrollment ID: I20210824000759 |
| Provider Name | Oscar Lu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649775735 PECOS PAC ID: 8022362060 Enrollment ID: I20210831000456 |
| Provider Name | Sara Shelden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316611379 PECOS PAC ID: 1254737729 Enrollment ID: I20210908002990 |
| Provider Name | Faddy I Khamis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891288338 PECOS PAC ID: 8729336003 Enrollment ID: I20210915000524 |
| Provider Name | Susana Rodriguez-esler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831856954 PECOS PAC ID: 2567853591 Enrollment ID: I20211229001109 |
| Provider Name | Cassi R Grimes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962153718 PECOS PAC ID: 2668865379 Enrollment ID: I20220201002426 |
| Provider Name | Emily Kristen Johansen Stoll |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669977781 PECOS PAC ID: 3779837265 Enrollment ID: I20220210000782 |
| Provider Name | Angela K Dailing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619361177 PECOS PAC ID: 7416278742 Enrollment ID: I20220216002374 |
| Provider Name | Paige N Diel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740867803 PECOS PAC ID: 2365836103 Enrollment ID: I20220222000599 |
| Provider Name | Heather Renee Colaizzi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841840659 PECOS PAC ID: 1951633403 Enrollment ID: I20220315001146 |
| Provider Name | Jacqueline N Steinhoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417501156 PECOS PAC ID: 1456748896 Enrollment ID: I20220503001942 |
| Provider Name | Patrick J Boos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982346607 PECOS PAC ID: 4385021740 Enrollment ID: I20220524002842 |
| Provider Name | Jordan K Brennan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013549286 PECOS PAC ID: 7416334875 Enrollment ID: I20220524003107 |
| Provider Name | Maria E Klug |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568071231 PECOS PAC ID: 5698154110 Enrollment ID: I20220614000419 |
| Provider Name | Besma M Hasan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588059976 PECOS PAC ID: 7719298850 Enrollment ID: I20220722000963 |
| Provider Name | Mariah J Andrews |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518524024 PECOS PAC ID: 6305172065 Enrollment ID: I20220802001567 |
| Provider Name | Ethan S Jaeger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104319748 PECOS PAC ID: 6002161742 Enrollment ID: I20220815001831 |
| Provider Name | Robert P Andrews |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164080560 PECOS PAC ID: 3577897073 Enrollment ID: I20220815002310 |
| Provider Name | Janna N Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891363636 PECOS PAC ID: 7315348430 Enrollment ID: I20220901002253 |
| Provider Name | Robert J Breeden |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619430345 PECOS PAC ID: 7315272887 Enrollment ID: I20220921000514 |
| Provider Name | Clare D Brady |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437619152 PECOS PAC ID: 9234515750 Enrollment ID: I20221005003562 |
| Provider Name | Jessica M Oyervides |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215676143 PECOS PAC ID: 5092181974 Enrollment ID: I20221018000894 |
| Provider Name | John C Holloway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114654787 PECOS PAC ID: 2769858299 Enrollment ID: I20221025000231 |
| Provider Name | Cara E Metzinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699483347 PECOS PAC ID: 7315317971 Enrollment ID: I20221223001250 |
| Provider Name | Jennifer R Herriage |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518674274 PECOS PAC ID: 0042680530 Enrollment ID: I20221227001358 |
| Provider Name | Matthew B Sutton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598787186 PECOS PAC ID: 8325180318 Enrollment ID: I20230307002829 |
| Provider Name | Cory T Carpenter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679833800 PECOS PAC ID: 1759697790 Enrollment ID: I20230404002263 |
| Provider Name | Lindsay Nadine Wahlstrom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598148108 PECOS PAC ID: 1052697539 Enrollment ID: I20230404002450 |
| Provider Name | John J May |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083633895 PECOS PAC ID: 2567598113 Enrollment ID: I20230406000130 |
| Provider Name | Javon Heinrichs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881399053 PECOS PAC ID: 8628433851 Enrollment ID: I20230424000355 |
| Provider Name | Paige E Bowman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710339239 PECOS PAC ID: 5092175836 Enrollment ID: I20230712002168 |
| Provider Name | Alexandra J Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689203200 PECOS PAC ID: 4385034396 Enrollment ID: I20230721000670 |
| Provider Name | Carla B Aamodt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306948609 PECOS PAC ID: 9133200447 Enrollment ID: I20230823004092 |
| Provider Name | Thomas J Katzfey |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1245896869 PECOS PAC ID: 3779818372 Enrollment ID: I20240118000496 |
| Provider Name | Courtney Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528757713 PECOS PAC ID: 4082066600 Enrollment ID: I20240119001151 |
| Provider Name | Kristen Geis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316728306 PECOS PAC ID: 2365895356 Enrollment ID: I20240125003202 |
| Provider Name | Lou T Herr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174307490 PECOS PAC ID: 1052750932 Enrollment ID: I20240412000271 |
| Provider Name | Taylor M Adams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861079030 PECOS PAC ID: 9133522618 Enrollment ID: I20240806003361 |
| Provider Name | Joshua E Chan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346828670 PECOS PAC ID: 6204367493 Enrollment ID: I20240928000138 |
| Provider Name | Spencer L Shearer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295302065 PECOS PAC ID: 7618371881 Enrollment ID: I20241014001382 |
| Provider Name | Lenzi R Kaub |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265024426 PECOS PAC ID: 1456884667 Enrollment ID: I20241026000191 |
| Provider Name | Magnus C Nwora |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033747126 PECOS PAC ID: 4082031299 Enrollment ID: I20241213002430 |
| Provider Name | Molly G Sadick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659189314 PECOS PAC ID: 1153843701 Enrollment ID: I20250324002123 |
| Provider Name | Katharine J Murphree |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952797730 PECOS PAC ID: 6103132048 Enrollment ID: I20250606002167 |
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