| Licking Memorial Health Professionals | |
|
1320 W Main St Newark OH 43055-1822 | |
| (220) 564-4027 | |
| (220) 564-4012 |
| Full Name | Licking Memorial Health Professionals |
|---|---|
| Speciality | Family Medicine |
| Location | 1320 W Main St, Newark, Ohio |
| Authorized Official Name and Position | Cynthia L. Webster (VP FINANCIAL SERVICE) |
| Authorized Official Contact | 2205644027 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Licking Memorial Health Professionals 1320 W Main St Newark OH 43055-1822 Ph: (220) 564-4027 | Licking Memorial Health Professionals 1320 W Main St Newark OH 43055-1822 Ph: (220) 564-4027 |
| NPI Number | 1326072265 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 01/12/2026 |
| Certification Date | 01/12/2026 |
| Medicare PECOS PAC ID | 6204740731 |
|---|---|
| Medicare Enrollment ID | O20031203000131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326072265 | NPI | - | NPPES |
| 2144629 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 208M00000X | Hospitalist | () | Secondary |
| Provider Name | Anil S Gokhale |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1740353879 PECOS PAC ID: 0244136554 Enrollment ID: I20031209000205 |
| Provider Name | Hassan Rajjoub |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1811060999 PECOS PAC ID: 6800798455 Enrollment ID: I20040127001212 |
| Provider Name | Jennifer J Aikey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1548359268 PECOS PAC ID: 7517860414 Enrollment ID: I20040128001176 |
| Provider Name | Evan B Cohn |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1164463451 PECOS PAC ID: 7113810482 Enrollment ID: I20040203000118 |
| Provider Name | Nathan H Kander |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1073518940 PECOS PAC ID: 6204738057 Enrollment ID: I20040303000551 |
| Provider Name | Laura J Schaeffer |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1326047028 PECOS PAC ID: 5294625679 Enrollment ID: I20040318000944 |
| Provider Name | Mohamud Si Mohamed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700869377 PECOS PAC ID: 4981697935 Enrollment ID: I20040406000208 |
| Provider Name | Bassam Kret |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104824960 PECOS PAC ID: 1254327984 Enrollment ID: I20040420001594 |
| Provider Name | Joe Hackworth |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1619974987 PECOS PAC ID: 8426945833 Enrollment ID: I20040504000201 |
| Provider Name | Laurian Mark Dean |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1043299274 PECOS PAC ID: 5890785349 Enrollment ID: I20040517000018 |
| Provider Name | Jane Mannag Zamora Rodgers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710991260 PECOS PAC ID: 9335122357 Enrollment ID: I20040610001188 |
| Provider Name | James Wright Desapri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851334072 PECOS PAC ID: 9537143862 Enrollment ID: I20040615001036 |
| Provider Name | Scott a Tritt |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1326057126 PECOS PAC ID: 6901898360 Enrollment ID: I20040624000333 |
| Provider Name | David Edward Subler |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1881693349 PECOS PAC ID: 8123003118 Enrollment ID: I20040628000544 |
| Provider Name | Andrew C Seipel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578530127 PECOS PAC ID: 1951387117 Enrollment ID: I20040628001003 |
| Provider Name | Brian William Korn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912988155 PECOS PAC ID: 4183601347 Enrollment ID: I20040706000729 |
| Provider Name | Olugbenga F Tolani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255439675 PECOS PAC ID: 8426020041 Enrollment ID: I20040812000613 |
| Provider Name | Ejaz Ahmad |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1831158070 PECOS PAC ID: 1951374933 Enrollment ID: I20040817001366 |
| Provider Name | Romi Bhasin |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1588653711 PECOS PAC ID: 6305819699 Enrollment ID: I20040818000446 |
| Provider Name | Mark Defrancisco |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1588605729 PECOS PAC ID: 6709852551 Enrollment ID: I20040903000008 |
| Provider Name | Brad Goldman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700877933 PECOS PAC ID: 2668448101 Enrollment ID: I20040907000989 |
| Provider Name | Laura Kenny Fortner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710973508 PECOS PAC ID: 8527037407 Enrollment ID: I20040928000414 |
| Provider Name | Garth Allen Bennington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184606303 PECOS PAC ID: 8729047022 Enrollment ID: I20041004000273 |
| Provider Name | May U Mbah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669428504 PECOS PAC ID: 9638132343 Enrollment ID: I20041104000286 |
| Provider Name | Kevin J Finley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205835394 PECOS PAC ID: 1850355009 Enrollment ID: I20041117000287 |
| Provider Name | Tina M Harmon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356312102 PECOS PAC ID: 8820053697 Enrollment ID: I20041122000659 |
| Provider Name | Robert S Cooke |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1053391375 PECOS PAC ID: 4284690926 Enrollment ID: I20041206000086 |
| Provider Name | Gary D Sutliff |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699755603 PECOS PAC ID: 9739138546 Enrollment ID: I20050119000761 |
| Provider Name | Phillip Savage |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609875202 PECOS PAC ID: 7517912363 Enrollment ID: I20050315000590 |
| Provider Name | Talya R Greathouse |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063411155 PECOS PAC ID: 4688611577 Enrollment ID: I20050412001152 |
| Provider Name | Megan E Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255330072 PECOS PAC ID: 4082653878 Enrollment ID: I20050502000244 |
| Provider Name | John J Keller |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1700849114 PECOS PAC ID: 1951344159 Enrollment ID: I20050608000845 |
| Provider Name | James S Bembry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962468165 PECOS PAC ID: 8325082167 Enrollment ID: I20050614000011 |
| Provider Name | Martin T Ryan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639106537 PECOS PAC ID: 5597700484 Enrollment ID: I20050622000001 |
| Provider Name | Ian Martin Thompson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1619928371 PECOS PAC ID: 3577543602 Enrollment ID: I20050712000177 |
| Provider Name | Ralph J Napolitano |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1831240795 PECOS PAC ID: 8022057959 Enrollment ID: I20050804000944 |
| Provider Name | Melissa Ann Lenko |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730105065 PECOS PAC ID: 6800826181 Enrollment ID: I20050816001004 |
| Provider Name | William a Highberger |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1629022207 PECOS PAC ID: 4082645551 Enrollment ID: I20050824000572 |
| Provider Name | Gloria M Galloway |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265433635 PECOS PAC ID: 4688691546 Enrollment ID: I20051031000003 |
| Provider Name | Vinay K Chitkara |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1659336337 PECOS PAC ID: 2860448545 Enrollment ID: I20051103000096 |
| Provider Name | Bradley R Allen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700893013 PECOS PAC ID: 8729000229 Enrollment ID: I20051227000704 |
| Provider Name | David Edward Weng |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1831154731 PECOS PAC ID: 2769494764 Enrollment ID: I20060612000034 |
| Provider Name | Brent M Savage |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366437949 PECOS PAC ID: 3173599073 Enrollment ID: I20060623000254 |
| Provider Name | Amr Fergany |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1811923394 PECOS PAC ID: 5991718702 Enrollment ID: I20060721000156 |
| Provider Name | Richard a Roy |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1366449464 PECOS PAC ID: 0446263933 Enrollment ID: I20060803000280 |
| Provider Name | Asegid H Kebede |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1598716201 PECOS PAC ID: 7810991833 Enrollment ID: I20060906000360 |
| Provider Name | Ryan Longstreth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447290580 PECOS PAC ID: 4183628035 Enrollment ID: I20060907000000 |
| Provider Name | Kenneth Parker |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1841256765 PECOS PAC ID: 3971405184 Enrollment ID: I20060919000008 |
| Provider Name | Janae M Davis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891808861 PECOS PAC ID: 4880691302 Enrollment ID: I20061026000034 |
| Provider Name | Robert Mueller |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1316916752 PECOS PAC ID: 4082612551 Enrollment ID: I20061116000196 |
| Provider Name | Mark E Plaugher |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1306921770 PECOS PAC ID: 5092701045 Enrollment ID: I20061213000189 |
| Provider Name | Michael D Barth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326046541 PECOS PAC ID: 3375543630 Enrollment ID: I20070110000392 |
| Provider Name | Joel W Anders |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780622563 PECOS PAC ID: 9931201431 Enrollment ID: I20070302000026 |
| Provider Name | Nawar Saieg |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1750400867 PECOS PAC ID: 5395843817 Enrollment ID: I20070607000188 |
| Provider Name | Victor Frank Ferrini |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629018700 PECOS PAC ID: 1456451756 Enrollment ID: I20070716000766 |
| Provider Name | Veera Veerla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053524868 PECOS PAC ID: 1355433707 Enrollment ID: I20070815000629 |
| Provider Name | Aruna C Gowda |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1407070576 PECOS PAC ID: 3274520291 Enrollment ID: I20070830000460 |
| Provider Name | Brian L Bachelder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356439228 PECOS PAC ID: 2163418617 Enrollment ID: I20071008000308 |
| Provider Name | Christopher P Reedy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639162803 PECOS PAC ID: 3870681067 Enrollment ID: I20071126000145 |
| Provider Name | David W Koontz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730193137 PECOS PAC ID: 0749214492 Enrollment ID: I20080307000307 |
| Provider Name | Maria M Defante |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1811106289 PECOS PAC ID: 0244315349 Enrollment ID: I20080313000491 |
| Provider Name | Eric J Hoff |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063681393 PECOS PAC ID: 3779668694 Enrollment ID: I20080317000239 |
| Provider Name | Katrina M Timson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144228131 PECOS PAC ID: 5799861894 Enrollment ID: I20080331000181 |
| Provider Name | Niranjan Seshadri |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306840210 PECOS PAC ID: 3072594852 Enrollment ID: I20080409000041 |
| Provider Name | Bradley R Lewis |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1710108865 PECOS PAC ID: 2567549694 Enrollment ID: I20080414000266 |
| Provider Name | Joan M Crumrine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023042660 PECOS PAC ID: 3173601614 Enrollment ID: I20080423000508 |
| Provider Name | Colleen M Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255330965 PECOS PAC ID: 6406934629 Enrollment ID: I20080429000002 |
| Provider Name | Kristine Plotts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184895567 PECOS PAC ID: 3072692672 Enrollment ID: I20080508000003 |
| Provider Name | Erica L Brown |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1881863736 PECOS PAC ID: 1658443551 Enrollment ID: I20080710000050 |
| Provider Name | Roy R Brown |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1417990565 PECOS PAC ID: 3779658646 Enrollment ID: I20080813000026 |
| Provider Name | Kurt Palazzo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649298258 PECOS PAC ID: 4284700915 Enrollment ID: I20080904000164 |
| Provider Name | Latha Urs |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1215197421 PECOS PAC ID: 3476620634 Enrollment ID: I20080930000430 |
| Provider Name | Abhay J Anand |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1083634927 PECOS PAC ID: 5395730220 Enrollment ID: I20081018000270 |
| Provider Name | Petter Andre Vaagenes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982810289 PECOS PAC ID: 8820158272 Enrollment ID: I20081115000110 |
| Provider Name | Saad a Hagras |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740460161 PECOS PAC ID: 4880744143 Enrollment ID: I20090608000147 |
| Provider Name | Jason T Jankowski |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1053512822 PECOS PAC ID: 4486713427 Enrollment ID: I20090630000026 |
| Provider Name | Emilia N Anigbo |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1083816953 PECOS PAC ID: 1052466455 Enrollment ID: I20090909000274 |
| Provider Name | Bethany a Wyles |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1245238120 PECOS PAC ID: 1557416716 Enrollment ID: I20090911000450 |
| Provider Name | Nosayaba Agidigbi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1356572879 PECOS PAC ID: 3779629696 Enrollment ID: I20091007000368 |
| Provider Name | Terrill Burnworth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578561676 PECOS PAC ID: 9032256425 Enrollment ID: I20091016000003 |
| Provider Name | Laura Higgins |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861618357 PECOS PAC ID: 4183725385 Enrollment ID: I20091030000016 |
| Provider Name | Jeff Allen Bare |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629076898 PECOS PAC ID: 2264570894 Enrollment ID: I20091118000672 |
| Provider Name | Khanh Vinh Dang |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922007111 PECOS PAC ID: 4688695471 Enrollment ID: I20091123000198 |
| Provider Name | Scott D Jolly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790783694 PECOS PAC ID: 4688713076 Enrollment ID: I20091124000367 |
| Provider Name | Matthew C Bromley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003023771 PECOS PAC ID: 2365581337 Enrollment ID: I20091203000766 |
| Provider Name | Marita L Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528157468 PECOS PAC ID: 4981679776 Enrollment ID: I20091231000031 |
| Provider Name | Todd F Lemmon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730187501 PECOS PAC ID: 1658412432 Enrollment ID: I20091231000320 |
| Provider Name | William H Phillips |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1356343586 PECOS PAC ID: 4385789155 Enrollment ID: I20100304000224 |
| Provider Name | Charles L Geiger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235115270 PECOS PAC ID: 5597892802 Enrollment ID: I20100419000404 |
| Provider Name | Ibiene a Osuobeni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215197165 PECOS PAC ID: 2365573086 Enrollment ID: I20100624000496 |
| Provider Name | Rachel Demita |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1750562666 PECOS PAC ID: 4880726454 Enrollment ID: I20100716000500 |
| Provider Name | Yanjuan Zhu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316143498 PECOS PAC ID: 4385778695 Enrollment ID: I20100820001114 |
| Provider Name | John Abboud |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1417957416 PECOS PAC ID: 2365481983 Enrollment ID: I20100908000069 |
| Provider Name | Howard L Reeves |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1639245350 PECOS PAC ID: 1254359631 Enrollment ID: I20101215000787 |
| Provider Name | Christopher S Meyer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639130701 PECOS PAC ID: 4688863293 Enrollment ID: I20110113000413 |
| Provider Name | Karen Lynn Smith-silone |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356320667 PECOS PAC ID: 9436338605 Enrollment ID: I20110120000869 |
| Provider Name | Tamara a Mills |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1699099986 PECOS PAC ID: 4284816455 Enrollment ID: I20110309000210 |
| Provider Name | Sana Siddiqui |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417100694 PECOS PAC ID: 9436331444 Enrollment ID: I20110314000072 |
| Provider Name | Abdul Elhabyan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104847144 PECOS PAC ID: 6901805043 Enrollment ID: I20110321000658 |
| Provider Name | Bryan M Cairns |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841419165 PECOS PAC ID: 9133305618 Enrollment ID: I20110518000086 |
| Provider Name | Linda Yu |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164624052 PECOS PAC ID: 4587834098 Enrollment ID: I20110818000793 |
| Provider Name | Sejal R Patel |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1902052129 PECOS PAC ID: 5890965628 Enrollment ID: I20110902000177 |
| Provider Name | Jamie a Rhodes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619120276 PECOS PAC ID: 4880865898 Enrollment ID: I20110923000314 |
| Provider Name | Amanda S John |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164409124 PECOS PAC ID: 4789856972 Enrollment ID: I20111012000468 |
| Provider Name | Tabatha L Menapace |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922382233 PECOS PAC ID: 5890967699 Enrollment ID: I20111019000786 |
| Provider Name | Lea Ann Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134496227 PECOS PAC ID: 9739355884 Enrollment ID: I20111220000780 |
| Provider Name | Michael Mcfarlane |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093755126 PECOS PAC ID: 3870750623 Enrollment ID: I20120206000574 |
| Provider Name | Shelley a Gittens |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801895990 PECOS PAC ID: 7012175029 Enrollment ID: I20120222000573 |
| Provider Name | Catherine Chiodo |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1063580199 PECOS PAC ID: 7012175714 Enrollment ID: I20120227000810 |
| Provider Name | James Kasten |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1649264128 PECOS PAC ID: 1850384660 Enrollment ID: I20120229000133 |
| Provider Name | Nadia K Gill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770628893 PECOS PAC ID: 3779748835 Enrollment ID: I20120622000629 |
| Provider Name | Muhannad Heif |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1710088471 PECOS PAC ID: 5991875452 Enrollment ID: I20120710000581 |
| Provider Name | Dawit M Wubishet |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1083971311 PECOS PAC ID: 5395992523 Enrollment ID: I20120823000331 |
| Provider Name | Valerie Denise Collins |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1467627406 PECOS PAC ID: 9335317544 Enrollment ID: I20120829000331 |
| Provider Name | Rachel M Terlecky |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245550904 PECOS PAC ID: 6406004696 Enrollment ID: I20120912000904 |
| Provider Name | Mary E Moyer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013268671 PECOS PAC ID: 0840440186 Enrollment ID: I20121023000725 |
| Provider Name | Bashar a Alawad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396024121 PECOS PAC ID: 4688825334 Enrollment ID: I20121106000648 |
| Provider Name | Kathy Williams |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013269141 PECOS PAC ID: 7810148038 Enrollment ID: I20121117000098 |
| Provider Name | Irina S Petty |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619211463 PECOS PAC ID: 4284872094 Enrollment ID: I20130605000644 |
| Provider Name | Christopher John Shiepis |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1992964266 PECOS PAC ID: 2163596453 Enrollment ID: I20130717000853 |
| Provider Name | Rosemari Susan Kauser |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740620459 PECOS PAC ID: 1153563671 Enrollment ID: I20130813000766 |
| Provider Name | Sylvia a Zucco |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467893735 PECOS PAC ID: 7315180924 Enrollment ID: I20130829000790 |
| Provider Name | Tabitha G Mcconnell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881032530 PECOS PAC ID: 8820232739 Enrollment ID: I20130916000373 |
| Provider Name | Darren Burgin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629239322 PECOS PAC ID: 3375777535 Enrollment ID: I20131002000306 |
| Provider Name | Dustin E Alspach |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598067209 PECOS PAC ID: 3173704848 Enrollment ID: I20140224001500 |
| Provider Name | Adam J Clemens |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1477798049 PECOS PAC ID: 3476797259 Enrollment ID: I20140528002169 |
| Provider Name | Jennifer L Brockmeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073952446 PECOS PAC ID: 7517182454 Enrollment ID: I20140708002283 |
| Provider Name | Courtney N Rengel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427460039 PECOS PAC ID: 3971728783 Enrollment ID: I20140711001258 |
| Provider Name | Joshua B Nething |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1548410772 PECOS PAC ID: 9032358361 Enrollment ID: I20140723001486 |
| Provider Name | Henry Wheeler Turner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730503624 PECOS PAC ID: 7416173463 Enrollment ID: I20140728001265 |
| Provider Name | Jesse Michael Ewald |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104196591 PECOS PAC ID: 2062638877 Enrollment ID: I20140730001757 |
| Provider Name | D'anna N Mullins |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1790946861 PECOS PAC ID: 5395984264 Enrollment ID: I20140805003036 |
| Provider Name | Grant Leo Yoder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477714640 PECOS PAC ID: 6709066905 Enrollment ID: I20140811001116 |
| Provider Name | Mohammed K Mazumder |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1891935250 PECOS PAC ID: 3779764337 Enrollment ID: I20140908002087 |
| Provider Name | Jennifer a White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710392923 PECOS PAC ID: 8426279217 Enrollment ID: I20141020002228 |
| Provider Name | Erin M Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619386794 PECOS PAC ID: 2769603117 Enrollment ID: I20141028001681 |
| Provider Name | Elizabeth a Yoder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346324167 PECOS PAC ID: 2062634561 Enrollment ID: I20141118001916 |
| Provider Name | Ryan C Hedgepeth |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1326225301 PECOS PAC ID: 2466535984 Enrollment ID: I20150122001941 |
| Provider Name | Katie M. Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982009288 PECOS PAC ID: 7012234891 Enrollment ID: I20150317000954 |
| Provider Name | Prem P Mathai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518192780 PECOS PAC ID: 7315268158 Enrollment ID: I20150605000795 |
| Provider Name | Kevin M Ouweleen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1598781460 PECOS PAC ID: 3678487311 Enrollment ID: I20150728004587 |
| Provider Name | Henry Y Lu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1558658914 PECOS PAC ID: 3274847108 Enrollment ID: I20150805007310 |
| Provider Name | Summiyah Nasir |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962692103 PECOS PAC ID: 7911194030 Enrollment ID: I20150901000510 |
| Provider Name | Rachelle R Stevens |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689802399 PECOS PAC ID: 0143373019 Enrollment ID: I20150909000446 |
| Provider Name | Christopher M Forbush |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396905584 PECOS PAC ID: 3870801871 Enrollment ID: I20150924000943 |
| Provider Name | Anthony David D'amico |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811368822 PECOS PAC ID: 4789994468 Enrollment ID: I20151109002040 |
| Provider Name | Allan R Thomas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437445715 PECOS PAC ID: 7315245412 Enrollment ID: I20160405002307 |
| Provider Name | Keri Lynn Hershberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114210374 PECOS PAC ID: 4880810928 Enrollment ID: I20160610001489 |
| Provider Name | Rami M Hanna |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1821028242 PECOS PAC ID: 1557350675 Enrollment ID: I20160727000341 |
| Provider Name | Daniel Fitzmaurice |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568823987 PECOS PAC ID: 7810281664 Enrollment ID: I20160802002566 |
| Provider Name | Thomas J Hagele |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1659638443 PECOS PAC ID: 0042506750 Enrollment ID: I20160907000544 |
| Provider Name | Teressa M Blanchard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659721579 PECOS PAC ID: 1254627367 Enrollment ID: I20160915000652 |
| Provider Name | Fikadu Tekleyes |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679787386 PECOS PAC ID: 6507948361 Enrollment ID: I20160915001154 |
| Provider Name | Maruf a Ali |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104258979 PECOS PAC ID: 4284864497 Enrollment ID: I20160927000153 |
| Provider Name | Clinton Norris |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679921894 PECOS PAC ID: 4385931500 Enrollment ID: I20160930002201 |
| Provider Name | Harrison Taylor King |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528411121 PECOS PAC ID: 8325326580 Enrollment ID: I20161024001379 |
| Provider Name | Andrew J Terlecky |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467729442 PECOS PAC ID: 4688813272 Enrollment ID: I20161102002520 |
| Provider Name | Jennifer Michelle Edwards |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124573928 PECOS PAC ID: 3577845940 Enrollment ID: I20170119000796 |
| Provider Name | Wondwossen Y Dererie |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1760793897 PECOS PAC ID: 4981831328 Enrollment ID: I20170206002690 |
| Provider Name | Bradley R Lawson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1033405139 PECOS PAC ID: 6608192349 Enrollment ID: I20170322000542 |
| Provider Name | Meghan J Meerschaert |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194266205 PECOS PAC ID: 3870879505 Enrollment ID: I20170412002177 |
| Provider Name | Gabrielle Farkas |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487997896 PECOS PAC ID: 8224335641 Enrollment ID: I20170524001631 |
| Provider Name | Jemila Raji |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740530310 PECOS PAC ID: 2769750959 Enrollment ID: I20170612001729 |
| Provider Name | Leah Thornton |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1518302066 PECOS PAC ID: 8224270798 Enrollment ID: I20170712002961 |
| Provider Name | Tyler James Weese |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790197689 PECOS PAC ID: 7719257062 Enrollment ID: I20170720000146 |
| Provider Name | Ana Elisa Pantel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366784712 PECOS PAC ID: 1052683638 Enrollment ID: I20170816002566 |
| Provider Name | Rory Nesbitt |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164488367 PECOS PAC ID: 2961394507 Enrollment ID: I20170823003696 |
| Provider Name | Alexandra M Haffner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588193171 PECOS PAC ID: 7911273198 Enrollment ID: I20171017001524 |
| Provider Name | Leslie Solomon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790203842 PECOS PAC ID: 0648546705 Enrollment ID: I20171018001112 |
| Provider Name | Mikhail S Koren |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467421412 PECOS PAC ID: 0648291682 Enrollment ID: I20180315002020 |
| Provider Name | Erika Dickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356854491 PECOS PAC ID: 4183986813 Enrollment ID: I20180316001986 |
| Provider Name | Amanda N Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437667607 PECOS PAC ID: 2567724750 Enrollment ID: I20180328001845 |
| Provider Name | Justin R Lee |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1578067724 PECOS PAC ID: 4082977566 Enrollment ID: I20180416000819 |
| Provider Name | Johanna L Cook |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770844466 PECOS PAC ID: 6103182217 Enrollment ID: I20180625002661 |
| Provider Name | Angela Marie Raake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205329513 PECOS PAC ID: 6103175260 Enrollment ID: I20180822002267 |
| Provider Name | Sadie a Deckard |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831698729 PECOS PAC ID: 9830449198 Enrollment ID: I20180906002739 |
| Provider Name | Christopher T Brower |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427323682 PECOS PAC ID: 1951562073 Enrollment ID: I20180919003749 |
| Provider Name | Jeremy Ryan Hughes |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1437630134 PECOS PAC ID: 2668725516 Enrollment ID: I20181023003479 |
| Provider Name | Eli Ross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275979296 PECOS PAC ID: 8921223272 Enrollment ID: I20190205001779 |
| Provider Name | Tabitha a Gartner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851860589 PECOS PAC ID: 1850639295 Enrollment ID: I20190211002215 |
| Provider Name | Donald Andrew Bowsher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730460528 PECOS PAC ID: 2163681131 Enrollment ID: I20190516002458 |
| Provider Name | Leonid Levertov |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1720552714 PECOS PAC ID: 4082957311 Enrollment ID: I20190529003021 |
| Provider Name | Laura Emily Roache |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003297383 PECOS PAC ID: 1052628930 Enrollment ID: I20190613003327 |
| Provider Name | Andrew Michael Reaven |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1366862906 PECOS PAC ID: 7113276965 Enrollment ID: I20190828004176 |
| Provider Name | Rahel Mitiku |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376195248 PECOS PAC ID: 1557699444 Enrollment ID: I20190830001538 |
| Provider Name | Navin Muni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710331715 PECOS PAC ID: 1254624232 Enrollment ID: I20190903000882 |
| Provider Name | Cynthia a Kearse |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164853735 PECOS PAC ID: 8224367826 Enrollment ID: I20190906002439 |
| Provider Name | Wendell Ronald Parrish |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609419670 PECOS PAC ID: 9830526342 Enrollment ID: I20200224000133 |
| Provider Name | John Marvin Mitchell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427044114 PECOS PAC ID: 2961479746 Enrollment ID: I20200317001773 |
| Provider Name | Brandon Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689207292 PECOS PAC ID: 8123457868 Enrollment ID: I20200401002047 |
| Provider Name | Frank K Boateng |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609025527 PECOS PAC ID: 7719169713 Enrollment ID: I20200408002101 |
| Provider Name | Carrie L Brehm |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316572290 PECOS PAC ID: 1850721721 Enrollment ID: I20200416000353 |
| Provider Name | Richard S Scarborough |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1003159088 PECOS PAC ID: 4082995485 Enrollment ID: I20200427002651 |
| Provider Name | Lydia E Cortes-betancourt |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1912308024 PECOS PAC ID: 7416212162 Enrollment ID: I20200610003171 |
| Provider Name | Courtney Marie Adams |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912521451 PECOS PAC ID: 1456773878 Enrollment ID: I20200611003055 |
| Provider Name | Paul Nicholson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962934109 PECOS PAC ID: 6800166117 Enrollment ID: I20200618001447 |
| Provider Name | Dwight Justin Goddard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407835572 PECOS PAC ID: 9931150356 Enrollment ID: I20200723003524 |
| Provider Name | Kari Vance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720646037 PECOS PAC ID: 8820413123 Enrollment ID: I20200804000988 |
| Provider Name | Sami Getahun |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285161653 PECOS PAC ID: 0446520753 Enrollment ID: I20200813001383 |
| Provider Name | Elizabeth W Mcintosh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518490317 PECOS PAC ID: 7810268133 Enrollment ID: I20200821002845 |
| Provider Name | Yuxuan Qiu |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417451840 PECOS PAC ID: 7911253257 Enrollment ID: I20201005002811 |
| Provider Name | Jacqueline L Cleland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285961805 PECOS PAC ID: 4789723057 Enrollment ID: I20201120002045 |
| Provider Name | Robert S Speelman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104431352 PECOS PAC ID: 0840603817 Enrollment ID: I20210112001194 |
| Provider Name | Richard J Straker |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1639156300 PECOS PAC ID: 9032180146 Enrollment ID: I20210326001669 |
| Provider Name | Nicole C Miller |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1720303662 PECOS PAC ID: 8820220650 Enrollment ID: I20210415002827 |
| Provider Name | Tyler P Harclerode |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295262145 PECOS PAC ID: 8527493881 Enrollment ID: I20210603003285 |
| Provider Name | Suba Pathmanathan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205191871 PECOS PAC ID: 7315252822 Enrollment ID: I20210622002738 |
| Provider Name | Gurunanthan Palani |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1477865285 PECOS PAC ID: 9032350624 Enrollment ID: I20210624003201 |
| Provider Name | Courtney Nicole James |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1114474921 PECOS PAC ID: 0648551374 Enrollment ID: I20210629003271 |
| Provider Name | Derek Alan Lapp |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1679936819 PECOS PAC ID: 7719277292 Enrollment ID: I20210719002922 |
| Provider Name | Dzifaa Kofi Lotsu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1770739211 PECOS PAC ID: 1355582354 Enrollment ID: I20210723002706 |
| Provider Name | Tiffany Nicole Corbean |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871052621 PECOS PAC ID: 0446584452 Enrollment ID: I20210928001440 |
| Provider Name | Vashti Otuya |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336494814 PECOS PAC ID: 0143519496 Enrollment ID: I20220124000682 |
| Provider Name | Lucas J Halliday |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154072866 PECOS PAC ID: 4981097474 Enrollment ID: I20220204001138 |
| Provider Name | Jody Lee Wall |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245648971 PECOS PAC ID: 9234523820 Enrollment ID: I20220228001529 |
| Provider Name | Kalpana Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265608004 PECOS PAC ID: 4981778073 Enrollment ID: I20220406002781 |
| Provider Name | Noman Ahmed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144464769 PECOS PAC ID: 6901053859 Enrollment ID: I20220627002791 |
| Provider Name | Mohammad K. Islam |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1003268095 PECOS PAC ID: 2860785144 Enrollment ID: I20220629002248 |
| Provider Name | Jennifer Mary Hughes |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1083357990 PECOS PAC ID: 8325428345 Enrollment ID: I20220708001237 |
| Provider Name | Samuel Akinyeye |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023462876 PECOS PAC ID: 1153658547 Enrollment ID: I20220713002151 |
| Provider Name | Oluwatoyin V. Aduloju-odunaiya |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1720479959 PECOS PAC ID: 3173842085 Enrollment ID: I20220727000484 |
| Provider Name | Sarah E. Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417681974 PECOS PAC ID: 6800278904 Enrollment ID: I20220805002984 |
| Provider Name | Robert Lee Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770216913 PECOS PAC ID: 7214310556 Enrollment ID: I20220818001722 |
| Provider Name | Shaina L Schochat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649690579 PECOS PAC ID: 8729203195 Enrollment ID: I20220913003478 |
| Provider Name | Abigail T. Hrusovsky |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700521952 PECOS PAC ID: 8628454709 Enrollment ID: I20220927000754 |
| Provider Name | Sarah Elizabeth Karling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043932304 PECOS PAC ID: 6800263377 Enrollment ID: I20221114001292 |
| Provider Name | Eesha Maiodna |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689075632 PECOS PAC ID: 1557653292 Enrollment ID: I20221202001463 |
| Provider Name | Robert Parker Guinsler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720541253 PECOS PAC ID: 0749515054 Enrollment ID: I20221208001567 |
| Provider Name | Diana Pereira |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1730837816 PECOS PAC ID: 2264801018 Enrollment ID: I20221216002465 |
| Provider Name | Thomas M. Grogan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1821250895 PECOS PAC ID: 4789862905 Enrollment ID: I20221221002580 |
| Provider Name | Richard A. Baltisberger |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467450668 PECOS PAC ID: 2264804764 Enrollment ID: I20230209002034 |
| Provider Name | Pamela Lynn Fincato |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871290684 PECOS PAC ID: 9739544073 Enrollment ID: I20230420001725 |
| Provider Name | Linda N Nabha |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1558520601 PECOS PAC ID: 9537303995 Enrollment ID: I20230510000988 |
| Provider Name | Benjamin a Pasley |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326676917 PECOS PAC ID: 5597167783 Enrollment ID: I20230720000234 |
| Provider Name | Kush Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073140620 PECOS PAC ID: 2163844952 Enrollment ID: I20230728001930 |
| Provider Name | Taylor John Kovalycsik |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134749674 PECOS PAC ID: 7719364322 Enrollment ID: I20230802003021 |
| Provider Name | Catherine R Wohlford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104146711 PECOS PAC ID: 3375906043 Enrollment ID: I20230828003816 |
| Provider Name | Zeyn T. Mirza |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1578095717 PECOS PAC ID: 4880057272 Enrollment ID: I20230901001108 |
| Provider Name | Prit Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205576469 PECOS PAC ID: 3678950003 Enrollment ID: I20231017002270 |
| Provider Name | Mechelle Ann Mckee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376321216 PECOS PAC ID: 6901254580 Enrollment ID: I20231120002358 |
| Provider Name | Zackary Birchard |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376064642 PECOS PAC ID: 2062771678 Enrollment ID: I20231214001317 |
| Provider Name | Jessica L. Englehart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821436650 PECOS PAC ID: 8628421567 Enrollment ID: I20240127000275 |
| Provider Name | Kai Yuan Teng |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932785763 PECOS PAC ID: 5698174068 Enrollment ID: I20240221004204 |
| Provider Name | Tanisha Dilo |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1902669328 PECOS PAC ID: 7618315847 Enrollment ID: I20240405002257 |
| Provider Name | Nazia Khan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1811334949 PECOS PAC ID: 3274751235 Enrollment ID: I20240429002345 |
| Provider Name | Stephen M Maurer |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1942794300 PECOS PAC ID: 8224384227 Enrollment ID: I20240429002407 |
| Provider Name | Diana Zhong |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1376924365 PECOS PAC ID: 2163721861 Enrollment ID: I20240430003676 |
| Provider Name | Aaron M Mcneilan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1851149876 PECOS PAC ID: 8628512563 Enrollment ID: I20240702001760 |
| Provider Name | Charles Lynwood Murray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518225341 PECOS PAC ID: 2365987468 Enrollment ID: I20240712003172 |
| Provider Name | Courtney A. Morris |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679335509 PECOS PAC ID: 2264977065 Enrollment ID: I20240717001140 |
| Provider Name | Bryan Paul Large |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1336769397 PECOS PAC ID: 1355763954 Enrollment ID: I20240823001931 |
| Provider Name | Antonie Auguste |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1508063165 PECOS PAC ID: 0042469843 Enrollment ID: I20240828000799 |
| Provider Name | Colin Tkatch |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1912467531 PECOS PAC ID: 4385971787 Enrollment ID: I20240828001083 |
| Provider Name | Alyssa Danielle Drosdak |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033613500 PECOS PAC ID: 3072845569 Enrollment ID: I20240910000445 |
| Provider Name | Jess A. Miller |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033178231 PECOS PAC ID: 4981637634 Enrollment ID: I20240912003919 |
| Provider Name | Booth Wainscoat |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1699707141 PECOS PAC ID: 7012912165 Enrollment ID: I20240930001856 |
| Provider Name | Ezana Negussu Bekele |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1407344922 PECOS PAC ID: 1557894375 Enrollment ID: I20241031001273 |
| Provider Name | Esteban Grovas Cordovi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1134623200 PECOS PAC ID: 7719411172 Enrollment ID: I20241108000472 |
| Provider Name | Earl Braunlich |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205811130 PECOS PAC ID: 5698841096 Enrollment ID: I20241217000483 |
| Provider Name | David M. Muncy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952763484 PECOS PAC ID: 6204107758 Enrollment ID: I20250102002597 |
| Provider Name | Timothy J. Tremblay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598521767 PECOS PAC ID: 7315475902 Enrollment ID: I20250109003682 |
| Provider Name | Scott M Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316753866 PECOS PAC ID: 3072043215 Enrollment ID: I20250204000779 |
| Provider Name | Kaitlin E. Londot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851120984 PECOS PAC ID: 2365972098 Enrollment ID: I20250211002829 |
| Provider Name | Darci J. Hartshorn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528651023 PECOS PAC ID: 1456871581 Enrollment ID: I20250220000047 |
| Provider Name | Chelsey J. Benner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962293357 PECOS PAC ID: 2365961869 Enrollment ID: I20250528002328 |
| Provider Name | Rebecca Anne Wheeler |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912798497 PECOS PAC ID: 2769901057 Enrollment ID: I20250529002784 |
| Provider Name | Kayla Rae Thomsen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356132757 PECOS PAC ID: 7113436411 Enrollment ID: I20250529003221 |
| Provider Name | Nadia Hameed |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1457931016 PECOS PAC ID: 5395275119 Enrollment ID: I20250613001451 |
| Provider Name | Janae L Otto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407749179 PECOS PAC ID: 7810400793 Enrollment ID: I20250702003976 |
| Provider Name | Mohammed Al-issa |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700536976 PECOS PAC ID: 1658759527 Enrollment ID: I20250717001885 |
| Provider Name | Timothy Adam Eckert |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467102608 PECOS PAC ID: 1254718851 Enrollment ID: I20250717002759 |
| Provider Name | Alisha Gupta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508504721 PECOS PAC ID: 9436538717 Enrollment ID: I20250820002322 |
| Provider Name | Caleb A. Kennon |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1144789918 PECOS PAC ID: 0345780060 Enrollment ID: I20251007002942 |
| Provider Name | Caleb a Haeussler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306605597 PECOS PAC ID: 1759820178 Enrollment ID: I20251028001928 |
| Provider Name | Justin M. Gill |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952191322 PECOS PAC ID: 0547759888 Enrollment ID: I20251028002438 |
| Provider Name | Lorena Lopez |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1164042289 PECOS PAC ID: 8921423997 Enrollment ID: I20251112000298 |
| Provider Name | Yvonne Treece |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255520599 PECOS PAC ID: 4183706690 Enrollment ID: I20251222002680 |
| Provider Name | Yumei Chen |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1932303898 PECOS PAC ID: 9931377553 Enrollment ID: I20251230001360 |
| Provider Name | Ross M Michels |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1679740211 PECOS PAC ID: 7012134497 Enrollment ID: I20260115003577 |
| Provider Name | Page Kimber |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457702359 PECOS PAC ID: 9032532122 Enrollment ID: I20260205000070 |
| Provider Name | Dina R Assali |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447992094 PECOS PAC ID: 7517344054 Enrollment ID: I20260218000494 |
| Provider Name | Ellen M. Hancox |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609287580 PECOS PAC ID: 8628328374 Enrollment ID: I20260330002302 |
Licking Memorial Family Practice Licking Valley Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2181 W High St, Newark, OH 43055 Phone: 740-348-1720 Fax: 740-348-1726 |
Licking Memorial Family Practice East Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 399 E Main St, Newark, OH 43055 Phone: 740-348-1849 Fax: 740-348-1847 |
Licking Memorial Endocrinology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1272 W Main St, Bldg 2 Ste 3, Newark, OH 43055 Phone: 740-348-7950 Fax: 740-348-7951 |
Licking Memorial Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 Mcmillen Dr, Newark, OH 43055 Phone: 740-348-4827 Fax: 740-348-1894 |
Primetown Ohio LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 905 N 21st St Ste A, Newark, OH 43055 Phone: 740-281-3663 Fax: 740-281-3818 |
Lower Lights Christian Health Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 69 S Terrace Ave, Newark, OH 43055 Phone: 614-274-1455 Fax: 614-274-1433 |