| Montgomery Primary Medicine Associates | |
|
2055 E South Blvd Suite 308 Montgomery AL 36116-2003 | |
| (334) 286-2390 | |
| (334) 286-2397 |
| Full Name | Montgomery Primary Medicine Associates |
|---|---|
| Speciality | Family Medicine |
| Location | 2055 E South Blvd, Montgomery, Alabama |
| Authorized Official Name and Position | Christine Bruton (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 3342734447 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Montgomery Primary Medicine Associates 2055 E South Blvd Suite 308 Montgomery AL 36116-2003 Ph: (334) 286-2390 | Montgomery Primary Medicine Associates 2055 E South Blvd Suite 308 Montgomery AL 36116-2003 Ph: (334) 286-2390 |
| NPI Number | 1982653390 |
|---|---|
| Provider Enumeration Date | 05/10/2006 |
| Last Update Date | 11/28/2023 |
| Medicare PECOS PAC ID | 8426076670 |
|---|---|
| Medicare Enrollment ID | O20060220000538 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982653390 | NPI | - | NPPES |
| 529929300 | Medicaid | AL | |
| 1982653390 | Other | AL | GROUP MEDICARE NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jewell H Halanych |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427018621 PECOS PAC ID: 3375457260 Enrollment ID: I20031114000520 |
| Provider Name | Maarten Wybenga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902987555 PECOS PAC ID: 1153225230 Enrollment ID: I20031120000744 |
| Provider Name | Adedoyin B0dinrin Dosunmu-ogunbi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306817184 PECOS PAC ID: 0941114086 Enrollment ID: I20031230000763 |
| Provider Name | Lori C White |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1184767220 PECOS PAC ID: 2961303862 Enrollment ID: I20040114000667 |
| Provider Name | Howard C Snider |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356323125 PECOS PAC ID: 8123920253 Enrollment ID: I20040127000298 |
| Provider Name | Charles Melbern Wilcox |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1740297027 PECOS PAC ID: 1052205481 Enrollment ID: I20040209000499 |
| Provider Name | Julian E Mcintyre |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366464216 PECOS PAC ID: 0840109831 Enrollment ID: I20040211001125 |
| Provider Name | Mickey L Gay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811949514 PECOS PAC ID: 9234123860 Enrollment ID: I20040414001153 |
| Provider Name | Karis Dampier Knight |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245374743 PECOS PAC ID: 5294722567 Enrollment ID: I20040428000946 |
| Provider Name | Stephan G Moran |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417922683 PECOS PAC ID: 1153312624 Enrollment ID: I20040522000071 |
| Provider Name | Keith A Thompson |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1841246022 PECOS PAC ID: 6103807565 Enrollment ID: I20040601000454 |
| Provider Name | Victor E Pena |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003994948 PECOS PAC ID: 6204811375 Enrollment ID: I20040622001393 |
| Provider Name | Margaret J Vereb |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1265494215 PECOS PAC ID: 0244210565 Enrollment ID: I20040726000518 |
| Provider Name | William Haymond Cook |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1598799850 PECOS PAC ID: 2567432529 Enrollment ID: I20040727001596 |
| Provider Name | Cheryl A Zimmerman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922186873 PECOS PAC ID: 8820062276 Enrollment ID: I20040823000700 |
| Provider Name | Maryluz Fuentes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528116365 PECOS PAC ID: 0840267852 Enrollment ID: I20040910000333 |
| Provider Name | Carmelita G Prieto-dejesus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295800654 PECOS PAC ID: 0143285023 Enrollment ID: I20041120000140 |
| Provider Name | Meloni N Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477502748 PECOS PAC ID: 4183680804 Enrollment ID: I20041204000220 |
| Provider Name | Fred S Stucky |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1992751754 PECOS PAC ID: 1658339916 Enrollment ID: I20050103000819 |
| Provider Name | Sandria R Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841215084 PECOS PAC ID: 3476501727 Enrollment ID: I20050104000562 |
| Provider Name | Melissa M English |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881693588 PECOS PAC ID: 9436101227 Enrollment ID: I20050221000487 |
| Provider Name | Donna W Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851346365 PECOS PAC ID: 3476593559 Enrollment ID: I20050509000239 |
| Provider Name | Stephen L Davidson |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1902852171 PECOS PAC ID: 8820038904 Enrollment ID: I20050509000254 |
| Provider Name | Harry M Barnes |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1356395214 PECOS PAC ID: 4789624578 Enrollment ID: I20050511000539 |
| Provider Name | Kristi F Springer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306891817 PECOS PAC ID: 2163462953 Enrollment ID: I20050511000600 |
| Provider Name | Reynaldo L Rodriguez |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023055340 PECOS PAC ID: 3375583099 Enrollment ID: I20050511000842 |
| Provider Name | Gustavo R Heudebert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225064298 PECOS PAC ID: 9739121336 Enrollment ID: I20050524000882 |
| Provider Name | John Mark Vermillion |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659454254 PECOS PAC ID: 4789650102 Enrollment ID: I20050713001071 |
| Provider Name | Charles M Ellis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134165343 PECOS PAC ID: 8820064298 Enrollment ID: I20050901000922 |
| Provider Name | Charles D Wooldridge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114959459 PECOS PAC ID: 7012941917 Enrollment ID: I20050920001253 |
| Provider Name | Terry A Treadwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376637025 PECOS PAC ID: 4284668518 Enrollment ID: I20050926000371 |
| Provider Name | Peter D Miller |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1215911490 PECOS PAC ID: 4587682372 Enrollment ID: I20051110000209 |
| Provider Name | Scott A Mcdaniel |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1780623850 PECOS PAC ID: 9234159146 Enrollment ID: I20051206000712 |
| Provider Name | Daniel M Daly |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720161391 PECOS PAC ID: 5395771067 Enrollment ID: I20051214000493 |
| Provider Name | Roosevelt Mccorvey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093825127 PECOS PAC ID: 6103811567 Enrollment ID: I20060110000345 |
| Provider Name | Amy M Wybenga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093896540 PECOS PAC ID: 9537176896 Enrollment ID: I20060310000165 |
| Provider Name | Pamela P Tuck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720048275 PECOS PAC ID: 1759398431 Enrollment ID: I20060322000332 |
| Provider Name | Jeffry G Pirofsky |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1659318004 PECOS PAC ID: 4385654938 Enrollment ID: I20060427000300 |
| Provider Name | Steven M Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588617666 PECOS PAC ID: 3971514787 Enrollment ID: I20060508000966 |
| Provider Name | Parvez K Sultan |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1356381685 PECOS PAC ID: 4789696030 Enrollment ID: I20060705000031 |
| Provider Name | Samuel J Saliba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336116573 PECOS PAC ID: 5799798419 Enrollment ID: I20060725000412 |
| Provider Name | Pamela L Strickland |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508859471 PECOS PAC ID: 6305843368 Enrollment ID: I20061110000397 |
| Provider Name | Rowena C Nazareno |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326133638 PECOS PAC ID: 3173520699 Enrollment ID: I20061128000370 |
| Provider Name | David Brenner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124072475 PECOS PAC ID: 3476552399 Enrollment ID: I20061204000160 |
| Provider Name | Gary Gross |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1760434252 PECOS PAC ID: 2860594330 Enrollment ID: I20070301000442 |
| Provider Name | Ehtsham U Haq |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497847149 PECOS PAC ID: 5597862284 Enrollment ID: I20070514000516 |
| Provider Name | Della K Fuller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669506713 PECOS PAC ID: 5496852899 Enrollment ID: I20070518000556 |
| Provider Name | Rachel M Chance |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124176722 PECOS PAC ID: 4880794874 Enrollment ID: I20070703000722 |
| Provider Name | Harold W Cox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114991072 PECOS PAC ID: 5496847923 Enrollment ID: I20070828000819 |
| Provider Name | Christy O Hensley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093759813 PECOS PAC ID: 4981662947 Enrollment ID: I20080215000085 |
| Provider Name | Duncan Mcrae |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952484560 PECOS PAC ID: 5496752453 Enrollment ID: I20080215000165 |
| Provider Name | Roland A Hester |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1184684334 PECOS PAC ID: 4082625280 Enrollment ID: I20080423000210 |
| Provider Name | Stephen W Samelson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1265492441 PECOS PAC ID: 1355352550 Enrollment ID: I20080423000255 |
| Provider Name | N Tucker Mattox |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1750341913 PECOS PAC ID: 9537170733 Enrollment ID: I20080423000281 |
| Provider Name | Joseph F Curtis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790744589 PECOS PAC ID: 5991716193 Enrollment ID: I20080423000296 |
| Provider Name | Michael E Freeman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1740240993 PECOS PAC ID: 3173534377 Enrollment ID: I20080423000306 |
| Provider Name | Adelle Hutchins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336337849 PECOS PAC ID: 5890864128 Enrollment ID: I20080513000373 |
| Provider Name | James Edward Davies |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1629056544 PECOS PAC ID: 0749226181 Enrollment ID: I20080707000522 |
| Provider Name | Andrew Knott |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1861415986 PECOS PAC ID: 8729083712 Enrollment ID: I20080716000438 |
| Provider Name | Johnnie L Alston |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1518128669 PECOS PAC ID: 1557435104 Enrollment ID: I20080731000251 |
| Provider Name | Tracey S Wilson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1902856735 PECOS PAC ID: 4082688494 Enrollment ID: I20080805000394 |
| Provider Name | Gloria S Massey |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1962667873 PECOS PAC ID: 7911074752 Enrollment ID: I20080922000160 |
| Provider Name | Caroline B Klingler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700033396 PECOS PAC ID: 6204903057 Enrollment ID: I20080922000226 |
| Provider Name | Nziavake Masimasi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366457160 PECOS PAC ID: 6406856129 Enrollment ID: I20080930000637 |
| Provider Name | Bobby Stephen Sanders |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174790299 PECOS PAC ID: 5991869810 Enrollment ID: I20090121000469 |
| Provider Name | Clifton T Lewis |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1639173271 PECOS PAC ID: 8628964558 Enrollment ID: I20090223000527 |
| Provider Name | Robert A Avery |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407860380 PECOS PAC ID: 6709811250 Enrollment ID: I20090602000511 |
| Provider Name | John E Reardon |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1679786354 PECOS PAC ID: 1557413218 Enrollment ID: I20090710000470 |
| Provider Name | Naresh Bellam |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1538373907 PECOS PAC ID: 5294880035 Enrollment ID: I20090901000103 |
| Provider Name | Jason T Randall |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1700974904 PECOS PAC ID: 0648325357 Enrollment ID: I20090902000133 |
| Provider Name | William H Burkhalter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649353756 PECOS PAC ID: 3870585557 Enrollment ID: I20091001000349 |
| Provider Name | Jyoti S Samant |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1407053150 PECOS PAC ID: 3476699539 Enrollment ID: I20091005000319 |
| Provider Name | Leslie Harris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891755971 PECOS PAC ID: 2365584943 Enrollment ID: I20100120000208 |
| Provider Name | Felicia M Monroe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275510984 PECOS PAC ID: 6002950078 Enrollment ID: I20100216000035 |
| Provider Name | Leah O Sanchez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518077965 PECOS PAC ID: 6608901376 Enrollment ID: I20100319000364 |
| Provider Name | Akinola O Ayodeji |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1295788792 PECOS PAC ID: 4981733524 Enrollment ID: I20100520000352 |
| Provider Name | Hamp H Greene |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821104514 PECOS PAC ID: 9234269614 Enrollment ID: I20100610000979 |
| Provider Name | William J Leuschke |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730295411 PECOS PAC ID: 3173654217 Enrollment ID: I20100706000412 |
| Provider Name | Bryan D Strickland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528042017 PECOS PAC ID: 9234171893 Enrollment ID: I20100915000097 |
| Provider Name | Barbara Sharon Murray |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245258987 PECOS PAC ID: 1557333838 Enrollment ID: I20100915000657 |
| Provider Name | Lee Douglass Roberson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1790750065 PECOS PAC ID: 5991806259 Enrollment ID: I20100917000975 |
| Provider Name | Thomas Kincer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114994357 PECOS PAC ID: 5890810493 Enrollment ID: I20100920001004 |
| Provider Name | Jeffrey A Walker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386808970 PECOS PAC ID: 7810042157 Enrollment ID: I20100920001031 |
| Provider Name | Richard L Mullins |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174597843 PECOS PAC ID: 4688799281 Enrollment ID: I20100920001035 |
| Provider Name | F. Kendrick |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1760598999 PECOS PAC ID: 2769677863 Enrollment ID: I20101115001184 |
| Provider Name | James A Harrow |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1104992411 PECOS PAC ID: 6305032046 Enrollment ID: I20101120000212 |
| Provider Name | Phillip K Henderson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1144450792 PECOS PAC ID: 1153517560 Enrollment ID: I20101124000962 |
| Provider Name | Louisa M Tolentino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770583296 PECOS PAC ID: 2365535879 Enrollment ID: I20101216000364 |
| Provider Name | Jeana Ann Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811206386 PECOS PAC ID: 8123216645 Enrollment ID: I20101228000956 |
| Provider Name | Robert Bradley |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1801998844 PECOS PAC ID: 6406884188 Enrollment ID: I20110118000004 |
| Provider Name | Robert K Nichols |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013069939 PECOS PAC ID: 8426238924 Enrollment ID: I20110215000490 |
| Provider Name | Lewis N Cunningham |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1497826796 PECOS PAC ID: 9133226012 Enrollment ID: I20110408000254 |
| Provider Name | Amy C Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427366657 PECOS PAC ID: 4789868027 Enrollment ID: I20110411000318 |
| Provider Name | Vanosia Shablee Faison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023199817 PECOS PAC ID: 2365442126 Enrollment ID: I20110525000388 |
| Provider Name | Paul M Gilreath |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124229117 PECOS PAC ID: 1355529249 Enrollment ID: I20110623000488 |
| Provider Name | Ginger W Mcdougal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699077834 PECOS PAC ID: 4082882543 Enrollment ID: I20110727000748 |
| Provider Name | Amanda D Wilcox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669763868 PECOS PAC ID: 6709055130 Enrollment ID: I20110801000835 |
| Provider Name | Stephen Suggs |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689675936 PECOS PAC ID: 1759343643 Enrollment ID: I20110805000533 |
| Provider Name | Dharampal P Bhuta |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1386720860 PECOS PAC ID: 2860662616 Enrollment ID: I20110902000496 |
| Provider Name | Teresa M Watkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174775209 PECOS PAC ID: 1052583556 Enrollment ID: I20111005000438 |
| Provider Name | Vernishia Jenine Hill Graham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679864870 PECOS PAC ID: 3173795077 Enrollment ID: I20111019000769 |
| Provider Name | Susmitha Nimmagadda |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1689847436 PECOS PAC ID: 4789858408 Enrollment ID: I20111115000580 |
| Provider Name | Frank M Skidmore |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760585061 PECOS PAC ID: 5890769194 Enrollment ID: I20111222000598 |
| Provider Name | Vikas Gupta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255613527 PECOS PAC ID: 5991971756 Enrollment ID: I20111228000127 |
| Provider Name | Angela L Stallworth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679507453 PECOS PAC ID: 8921288564 Enrollment ID: I20120105000117 |
| Provider Name | William Lievens |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013110006 PECOS PAC ID: 2264697184 Enrollment ID: I20120627000385 |
| Provider Name | Mark D Moglowsky |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1679527485 PECOS PAC ID: 5395752067 Enrollment ID: I20120731000678 |
| Provider Name | Paige H Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285923151 PECOS PAC ID: 6901052182 Enrollment ID: I20120802000669 |
| Provider Name | Max Burkett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982966867 PECOS PAC ID: 3870740137 Enrollment ID: I20120822000248 |
| Provider Name | Paul C. Harrison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780811158 PECOS PAC ID: 4183871072 Enrollment ID: I20120828000857 |
| Provider Name | John Ryan Aldridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902150089 PECOS PAC ID: 7315198199 Enrollment ID: I20121105000452 |
| Provider Name | Richard H Chin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558501460 PECOS PAC ID: 8729239991 Enrollment ID: I20121116000007 |
| Provider Name | Henry G Johnson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184719379 PECOS PAC ID: 1658376405 Enrollment ID: I20130521000521 |
| Provider Name | Jessica W Adair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467793224 PECOS PAC ID: 8628216728 Enrollment ID: I20130531000333 |
| Provider Name | Kristin Jann Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467795765 PECOS PAC ID: 3678712973 Enrollment ID: I20130618000213 |
| Provider Name | William R Meador |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861629230 PECOS PAC ID: 7315183092 Enrollment ID: I20130626000066 |
| Provider Name | Jeffrey W Nix |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1215159843 PECOS PAC ID: 1456517887 Enrollment ID: I20130710000854 |
| Provider Name | Nina J Hibbard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568800712 PECOS PAC ID: 2567602535 Enrollment ID: I20130716000321 |
| Provider Name | George Austin Boothe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134568967 PECOS PAC ID: 9133360043 Enrollment ID: I20130718000380 |
| Provider Name | Carlos Alberto Reyes-sacin |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1902079577 PECOS PAC ID: 8123269313 Enrollment ID: I20130731000296 |
| Provider Name | Jack Cooper |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255511572 PECOS PAC ID: 8729242292 Enrollment ID: I20130801000230 |
| Provider Name | John M Kast |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1376579383 PECOS PAC ID: 1052399623 Enrollment ID: I20130826000612 |
| Provider Name | Kristen Thomas Osborne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972948032 PECOS PAC ID: 9638312499 Enrollment ID: I20130826000855 |
| Provider Name | Nandini Yshwanti Ramroop |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073954244 PECOS PAC ID: 1759524119 Enrollment ID: I20130904000243 |
| Provider Name | Catherine W Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639429426 PECOS PAC ID: 7416191226 Enrollment ID: I20130918000158 |
| Provider Name | Holly Jones Cluck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275875585 PECOS PAC ID: 0941439145 Enrollment ID: I20140211000896 |
| Provider Name | Lindsey Barton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215285879 PECOS PAC ID: 9436389012 Enrollment ID: I20140226001906 |
| Provider Name | Debra A Phipps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780970038 PECOS PAC ID: 0244460632 Enrollment ID: I20140304001931 |
| Provider Name | Karlene R Boozer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417902917 PECOS PAC ID: 3577726744 Enrollment ID: I20140421000087 |
| Provider Name | Christine Dawn Darwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235552894 PECOS PAC ID: 1052544277 Enrollment ID: I20140423001974 |
| Provider Name | Terry Shaneyfelt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073530754 PECOS PAC ID: 5496993131 Enrollment ID: I20140508001954 |
| Provider Name | Ashton P Jerkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720495344 PECOS PAC ID: 4486873726 Enrollment ID: I20140918000282 |
| Provider Name | Jennifer Conner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417367582 PECOS PAC ID: 6709005812 Enrollment ID: I20140922001412 |
| Provider Name | Meaghan W Baxley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033557319 PECOS PAC ID: 0446470173 Enrollment ID: I20141001001578 |
| Provider Name | Jennifer Abt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619218369 PECOS PAC ID: 6103046842 Enrollment ID: I20141001001912 |
| Provider Name | William Streetman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477730026 PECOS PAC ID: 7719019728 Enrollment ID: I20141002001456 |
| Provider Name | Preet Kiran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700291879 PECOS PAC ID: 6406076017 Enrollment ID: I20141002001520 |
| Provider Name | Joshua C Waits |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1730323056 PECOS PAC ID: 5092951707 Enrollment ID: I20141010001208 |
| Provider Name | Soroush Rais-bahrami |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1851660849 PECOS PAC ID: 4688894728 Enrollment ID: I20141013001367 |
| Provider Name | Gurvinder Singh Mangat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851606123 PECOS PAC ID: 3476877499 Enrollment ID: I20150122002386 |
| Provider Name | Holly P Cobb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316342975 PECOS PAC ID: 3870819535 Enrollment ID: I20150224001753 |
| Provider Name | Mohamed Kazamel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013144484 PECOS PAC ID: 8022254721 Enrollment ID: I20150526000057 |
| Provider Name | John Patrick Selph |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1336383934 PECOS PAC ID: 9537382726 Enrollment ID: I20150617003067 |
| Provider Name | Katherine Allen Gamper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124417159 PECOS PAC ID: 5890006787 Enrollment ID: I20150618001928 |
| Provider Name | Chaquita Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609293463 PECOS PAC ID: 2062725443 Enrollment ID: I20150714001014 |
| Provider Name | Abigail L Brock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912339516 PECOS PAC ID: 9830402106 Enrollment ID: I20150715001038 |
| Provider Name | Audrey B Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336548924 PECOS PAC ID: 2860706439 Enrollment ID: I20150728003650 |
| Provider Name | Sharon R Silverman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528446499 PECOS PAC ID: 0840504353 Enrollment ID: I20150728005622 |
| Provider Name | Bhanu P Maturi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790042802 PECOS PAC ID: 4688988827 Enrollment ID: I20150803000237 |
| Provider Name | Ashish A Vyas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528215811 PECOS PAC ID: 3870736093 Enrollment ID: I20150810002181 |
| Provider Name | Kent Edward Taylor |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1013141431 PECOS PAC ID: 7618192527 Enrollment ID: I20150818003423 |
| Provider Name | Robert Edgar Howell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205070901 PECOS PAC ID: 8820234446 Enrollment ID: I20150828001367 |
| Provider Name | Howard W Jennings |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1649404344 PECOS PAC ID: 8921253253 Enrollment ID: I20151029002838 |
| Provider Name | Danielle N Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1922484252 PECOS PAC ID: 1355651753 Enrollment ID: I20151116001758 |
| Provider Name | Sundip Somabhai Patel |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1487857025 PECOS PAC ID: 0648443408 Enrollment ID: I20151119002345 |
| Provider Name | Zahra Daftarian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811232887 PECOS PAC ID: 2567602337 Enrollment ID: I20160114002748 |
| Provider Name | Holland D Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699146829 PECOS PAC ID: 1557665155 Enrollment ID: I20160202000643 |
| Provider Name | Holly Ann Vezertzis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033532874 PECOS PAC ID: 1557592656 Enrollment ID: I20160411001167 |
| Provider Name | Kyle D Wood |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1942595350 PECOS PAC ID: 4284934407 Enrollment ID: I20160606001023 |
| Provider Name | Brad Denney |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1962663229 PECOS PAC ID: 6709023195 Enrollment ID: I20160627000137 |
| Provider Name | Pranav B Patel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1114176419 PECOS PAC ID: 6305139346 Enrollment ID: I20160727003100 |
| Provider Name | Jacob Adam Anderson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184916702 PECOS PAC ID: 9931331683 Enrollment ID: I20160728001632 |
| Provider Name | Omair Atiq |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336455260 PECOS PAC ID: 0941448716 Enrollment ID: I20160824002227 |
| Provider Name | Matthew B Mullen |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1336439595 PECOS PAC ID: 1153568886 Enrollment ID: I20160907003031 |
| Provider Name | Manisha Garg |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1215215389 PECOS PAC ID: 7113213588 Enrollment ID: I20160912000218 |
| Provider Name | Joseph Pazona |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1447422951 PECOS PAC ID: 7012087471 Enrollment ID: I20160913001779 |
| Provider Name | Kashiff M Muneer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225432453 PECOS PAC ID: 5395031686 Enrollment ID: I20160913001785 |
| Provider Name | Jeremy Pfeil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174971543 PECOS PAC ID: 5799071080 Enrollment ID: I20160913001969 |
| Provider Name | Ashlee Carlo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831573237 PECOS PAC ID: 5890081038 Enrollment ID: I20160914001027 |
| Provider Name | Geoffrey M Habermacher |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1083882096 PECOS PAC ID: 0042380941 Enrollment ID: I20160921002041 |
| Provider Name | Rajasree Nambron |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1114219409 PECOS PAC ID: 4082843826 Enrollment ID: I20160930001402 |
| Provider Name | Himanshu Aggarwal |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1316106164 PECOS PAC ID: 7911295985 Enrollment ID: I20161006000566 |
| Provider Name | Brandon Hemphill |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376705160 PECOS PAC ID: 7618156076 Enrollment ID: I20161010001188 |
| Provider Name | Wendy Liana Castillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518326230 PECOS PAC ID: 7315245255 Enrollment ID: I20161018000427 |
| Provider Name | Ashley Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194275321 PECOS PAC ID: 7315225703 Enrollment ID: I20161107001215 |
| Provider Name | Jessica Rollins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053867945 PECOS PAC ID: 3779862735 Enrollment ID: I20161115000267 |
| Provider Name | Ravi N Pahwani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134429756 PECOS PAC ID: 6002058195 Enrollment ID: I20161116000849 |
| Provider Name | William W Mcalexander |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1073558524 PECOS PAC ID: 1355313669 Enrollment ID: I20170207002380 |
| Provider Name | Carlos Manuel Gadea |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1417141763 PECOS PAC ID: 9739344300 Enrollment ID: I20170208000201 |
| Provider Name | Carolyn A Allman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114362696 PECOS PAC ID: 2769707553 Enrollment ID: I20170217000916 |
| Provider Name | William Samuel Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982143228 PECOS PAC ID: 5395022545 Enrollment ID: I20170426000921 |
| Provider Name | Laura L Crum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033640255 PECOS PAC ID: 1153699673 Enrollment ID: I20170623002009 |
| Provider Name | John S Anastasi |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1285691113 PECOS PAC ID: 2163466376 Enrollment ID: I20170720002989 |
| Provider Name | Ashley Mann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962931410 PECOS PAC ID: 7810267846 Enrollment ID: I20170724002307 |
| Provider Name | Kyle W Eudailey |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1063709624 PECOS PAC ID: 0345511184 Enrollment ID: I20170811002750 |
| Provider Name | Benton M Cason |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871912139 PECOS PAC ID: 8325367204 Enrollment ID: I20170823001582 |
| Provider Name | Manuel Guillermo Escobar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023547833 PECOS PAC ID: 6608149414 Enrollment ID: I20170830000689 |
| Provider Name | Meaghan P Caton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134660285 PECOS PAC ID: 2668745845 Enrollment ID: I20170911000891 |
| Provider Name | Harry Kourlis |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1902865678 PECOS PAC ID: 9133315294 Enrollment ID: I20171004000083 |
| Provider Name | Krishna Vardhan Reddy Venkata Dasari Lakshmi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043629157 PECOS PAC ID: 1557636396 Enrollment ID: I20171004003447 |
| Provider Name | Melissa Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578081097 PECOS PAC ID: 7911273974 Enrollment ID: I20171019001935 |
| Provider Name | Matthew S Burge |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902169808 PECOS PAC ID: 8224310529 Enrollment ID: I20171023001151 |
| Provider Name | Anna Affan |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1407296866 PECOS PAC ID: 7810263548 Enrollment ID: I20171025002251 |
| Provider Name | John Mckinney |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1457330813 PECOS PAC ID: 6305940537 Enrollment ID: I20171031002986 |
| Provider Name | Melissa E Krisht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316467616 PECOS PAC ID: 5799042776 Enrollment ID: I20171129001817 |
| Provider Name | Vaishall Thudi |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1699039172 PECOS PAC ID: 4880951797 Enrollment ID: I20171201000883 |
| Provider Name | Joseph H Sewell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497191159 PECOS PAC ID: 2062644040 Enrollment ID: I20171206003192 |
| Provider Name | Larry Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386168524 PECOS PAC ID: 8729346291 Enrollment ID: I20171212000473 |
| Provider Name | Ximena D Ruiz |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1861650988 PECOS PAC ID: 7214176312 Enrollment ID: I20171213000511 |
| Provider Name | Brian Hassani |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174919310 PECOS PAC ID: 8628399367 Enrollment ID: I20171215001008 |
| Provider Name | Ashley Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174058432 PECOS PAC ID: 1557629656 Enrollment ID: I20171219001546 |
| Provider Name | Gary Ray Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902315146 PECOS PAC ID: 1355609462 Enrollment ID: I20171219002253 |
| Provider Name | Donette Survance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487047775 PECOS PAC ID: 0648599464 Enrollment ID: I20180108001923 |
| Provider Name | Kertrisa R Mcwhite |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1023053485 PECOS PAC ID: 9739190471 Enrollment ID: I20180125003158 |
| Provider Name | Amy D Cassady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407383268 PECOS PAC ID: 7911272356 Enrollment ID: I20180201001685 |
| Provider Name | Carlie L Peacock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407382864 PECOS PAC ID: 7810258944 Enrollment ID: I20180306000016 |
| Provider Name | Megan R Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407360845 PECOS PAC ID: 8325393085 Enrollment ID: I20180620002247 |
| Provider Name | Griffin Frazer Gibson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104203439 PECOS PAC ID: 3375856693 Enrollment ID: I20180625002078 |
| Provider Name | Christalyn J Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811425135 PECOS PAC ID: 6305119397 Enrollment ID: I20180703002263 |
| Provider Name | Ninh Ba Doan |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1477852739 PECOS PAC ID: 9335468727 Enrollment ID: I20180716002510 |
| Provider Name | Rebecca Lee Buckalew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649635079 PECOS PAC ID: 0446507800 Enrollment ID: I20180717003254 |
| Provider Name | Summer Bass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497029003 PECOS PAC ID: 1052668035 Enrollment ID: I20180723000615 |
| Provider Name | Muhammad Ali Khan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1588913867 PECOS PAC ID: 2668721549 Enrollment ID: I20180827001435 |
| Provider Name | Khayriyyah Salaam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124214655 PECOS PAC ID: 7517217078 Enrollment ID: I20180904000741 |
| Provider Name | Raymond A Mock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740308121 PECOS PAC ID: 8224102090 Enrollment ID: I20180904001093 |
| Provider Name | Cory Allen Luckie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457708166 PECOS PAC ID: 5890071914 Enrollment ID: I20180927003316 |
| Provider Name | Jordan T Fain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912487901 PECOS PAC ID: 9638421803 Enrollment ID: I20181017000000 |
| Provider Name | Nina Massey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750869814 PECOS PAC ID: 9133472020 Enrollment ID: I20181023000945 |
| Provider Name | Trupti Nadkar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073979456 PECOS PAC ID: 3971856261 Enrollment ID: I20181102002552 |
| Provider Name | Sharon Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821563768 PECOS PAC ID: 1456605286 Enrollment ID: I20181114002958 |
| Provider Name | Natalie Munroe |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1285118265 PECOS PAC ID: 1456605039 Enrollment ID: I20181117000412 |
| Provider Name | Kristian M Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760954523 PECOS PAC ID: 6800929100 Enrollment ID: I20190403000230 |
| Provider Name | Kathleen Santiago |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124471354 PECOS PAC ID: 5193067346 Enrollment ID: I20190508002278 |
| Provider Name | Josiah M Yance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730647918 PECOS PAC ID: 9133452022 Enrollment ID: I20190607001874 |
| Provider Name | Panayotis Vardas |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1801181649 PECOS PAC ID: 5698917615 Enrollment ID: I20190613002645 |
| Provider Name | Charles C Peyton |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1205195195 PECOS PAC ID: 3173857091 Enrollment ID: I20190627000230 |
| Provider Name | Onickie S Lynch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306321211 PECOS PAC ID: 6608103775 Enrollment ID: I20190812003989 |
| Provider Name | Perry O Hooper |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1609117266 PECOS PAC ID: 3971807116 Enrollment ID: I20190909004257 |
| Provider Name | Ashley Rhye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669039194 PECOS PAC ID: 1850620287 Enrollment ID: I20190911000721 |
| Provider Name | Amanda Backinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356824841 PECOS PAC ID: 3476807223 Enrollment ID: I20190911003402 |
| Provider Name | Katie Michelle Strickland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093374985 PECOS PAC ID: 6002145083 Enrollment ID: I20190917002647 |
| Provider Name | Jessica B Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518528298 PECOS PAC ID: 6709116221 Enrollment ID: I20190926001774 |
| Provider Name | Tijil Agarwal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104231257 PECOS PAC ID: 1052604964 Enrollment ID: I20191002001305 |
| Provider Name | Hannah Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932753357 PECOS PAC ID: 2567793748 Enrollment ID: I20191021000712 |
| Provider Name | Sarah C Passmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366002081 PECOS PAC ID: 2769714864 Enrollment ID: I20191022002965 |
| Provider Name | Tony E Pinson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1497764104 PECOS PAC ID: 2860491487 Enrollment ID: I20191022003411 |
| Provider Name | Heather Bland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447800081 PECOS PAC ID: 5092047340 Enrollment ID: I20191106000554 |
| Provider Name | Ashton L Fondren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205480621 PECOS PAC ID: 2365874377 Enrollment ID: I20191113001281 |
| Provider Name | Fahad Malik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184078404 PECOS PAC ID: 5294072294 Enrollment ID: I20191210002365 |
| Provider Name | Jon Marie Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487201794 PECOS PAC ID: 9032542691 Enrollment ID: I20191212000886 |
| Provider Name | Sanath Bhargav Kasi Reddy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1376951145 PECOS PAC ID: 3476860974 Enrollment ID: I20191216003129 |
| Provider Name | Pooja Ummalaneni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770025520 PECOS PAC ID: 5395170591 Enrollment ID: I20200116000946 |
| Provider Name | Rehan Ajmal Sarmad |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1417398033 PECOS PAC ID: 5395023840 Enrollment ID: I20200311001923 |
| Provider Name | Abayomi R Sanusi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1417055179 PECOS PAC ID: 6608920509 Enrollment ID: I20200326001003 |
| Provider Name | Malia Silva Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023662111 PECOS PAC ID: 0749619989 Enrollment ID: I20200408004833 |
| Provider Name | Thomas R Sellers |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1558780411 PECOS PAC ID: 4183967565 Enrollment ID: I20200717001383 |
| Provider Name | Carine Laure Djuidje |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063034320 PECOS PAC ID: 8325463805 Enrollment ID: I20200730002470 |
| Provider Name | Cynthia Frederick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235475039 PECOS PAC ID: 8820413347 Enrollment ID: I20200730003865 |
| Provider Name | Tanner Grant |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1902388002 PECOS PAC ID: 7719302157 Enrollment ID: I20200803001560 |
| Provider Name | Kellie Bagi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093368631 PECOS PAC ID: 5597180851 Enrollment ID: I20200803002890 |
| Provider Name | Vamshi Balasetti |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467894675 PECOS PAC ID: 9830321991 Enrollment ID: I20200818001124 |
| Provider Name | Claudine Nicolle Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548809916 PECOS PAC ID: 7416373493 Enrollment ID: I20200820003281 |
| Provider Name | Curry Biggio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881204709 PECOS PAC ID: 7012334071 Enrollment ID: I20200904001756 |
| Provider Name | Sharleen Glass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235680398 PECOS PAC ID: 7315109816 Enrollment ID: I20200915002681 |
| Provider Name | Kara E Kilpatrick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235591231 PECOS PAC ID: 7911279245 Enrollment ID: I20200917002401 |
| Provider Name | Travis Dum |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1578829958 PECOS PAC ID: 7214233766 Enrollment ID: I20200929003700 |
| Provider Name | Jonathan Nwiloh |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1194782011 PECOS PAC ID: 1254244932 Enrollment ID: I20201106001425 |
| Provider Name | Lyudmila Y Nikolaychook |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578794533 PECOS PAC ID: 7517144744 Enrollment ID: I20201110000659 |
| Provider Name | Melanie Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376142364 PECOS PAC ID: 4082026521 Enrollment ID: I20201207003074 |
| Provider Name | Gwendolyn Denise Childress |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467862318 PECOS PAC ID: 2668693300 Enrollment ID: I20210305001429 |
| Provider Name | Jessica S Minor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306464599 PECOS PAC ID: 2163839952 Enrollment ID: I20210323000825 |
| Provider Name | Stacy Glass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487277513 PECOS PAC ID: 2769882497 Enrollment ID: I20210616002893 |
| Provider Name | Austin D Worley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922531193 PECOS PAC ID: 5294006433 Enrollment ID: I20210622000433 |
| Provider Name | Sasha Still |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1700206729 PECOS PAC ID: 1759606031 Enrollment ID: I20210629000329 |
| Provider Name | Cameron Chick Hudson |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1356964563 PECOS PAC ID: 7416372040 Enrollment ID: I20210722003718 |
| Provider Name | Tasha R Garrett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588144075 PECOS PAC ID: 0648673541 Enrollment ID: I20210729003573 |
| Provider Name | Karl Sillay |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1184734030 PECOS PAC ID: 0941309447 Enrollment ID: I20210813002242 |
| Provider Name | Ahsan Farooq |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1558712596 PECOS PAC ID: 5991100406 Enrollment ID: I20210823000149 |
| Provider Name | Angela Bowman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598028524 PECOS PAC ID: 6800015744 Enrollment ID: I20210902000814 |
| Provider Name | Katelin Turner Holmes |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396127155 PECOS PAC ID: 0244651545 Enrollment ID: I20211001002976 |
| Provider Name | Tilachan Parajuli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932695665 PECOS PAC ID: 7012315559 Enrollment ID: I20211013002133 |
| Provider Name | Trung Tran |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1609211572 PECOS PAC ID: 1850789017 Enrollment ID: I20211021001010 |
| Provider Name | Mahmood A Zaied |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932121894 PECOS PAC ID: 2163454109 Enrollment ID: I20211208000434 |
| Provider Name | David Schull |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1750300356 PECOS PAC ID: 9335210764 Enrollment ID: I20220201001380 |
| Provider Name | Ankur D Upadhyay |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265964118 PECOS PAC ID: 7315283447 Enrollment ID: I20220302000284 |
| Provider Name | Kathryn Logan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003437880 PECOS PAC ID: 2860886090 Enrollment ID: I20220303001242 |
| Provider Name | Ashley Chislom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578234951 PECOS PAC ID: 5395139554 Enrollment ID: I20220303002141 |
| Provider Name | Louis R Lambiase |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1245207513 PECOS PAC ID: 4981680238 Enrollment ID: I20220304000311 |
| Provider Name | Thomas Hunter Lindsey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841853108 PECOS PAC ID: 1355774233 Enrollment ID: I20220314001414 |
| Provider Name | Lauren Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699342550 PECOS PAC ID: 9133515539 Enrollment ID: I20220412002263 |
| Provider Name | Trina Gaston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629663323 PECOS PAC ID: 4688061120 Enrollment ID: I20220502000171 |
| Provider Name | Tara Mollus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437613049 PECOS PAC ID: 7517345846 Enrollment ID: I20220527001200 |
| Provider Name | Mohamad Imam |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1447696406 PECOS PAC ID: 5395025761 Enrollment ID: I20220531001696 |
| Provider Name | Gabrielle A Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134681950 PECOS PAC ID: 8224417514 Enrollment ID: I20220616000775 |
| Provider Name | Emily Sater |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134891252 PECOS PAC ID: 5395125132 Enrollment ID: I20220711001232 |
| Provider Name | Cang T Nguyen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1154860518 PECOS PAC ID: 3971878711 Enrollment ID: I20220714001508 |
| Provider Name | Nitish Kumar |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1811370240 PECOS PAC ID: 1759683162 Enrollment ID: I20220804003564 |
| Provider Name | Deana Morrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487244018 PECOS PAC ID: 8527386440 Enrollment ID: I20220811003165 |
| Provider Name | Jackson Averett Reynolds |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1689036048 PECOS PAC ID: 0143528364 Enrollment ID: I20220815000027 |
| Provider Name | Yousif Abderrahman Hossiew Elmofti |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1932551371 PECOS PAC ID: 6002100534 Enrollment ID: I20220815002404 |
| Provider Name | Wesley Field |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750813127 PECOS PAC ID: 0749521359 Enrollment ID: I20220818002810 |
| Provider Name | Patty B Benson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639897317 PECOS PAC ID: 4284018847 Enrollment ID: I20220831000214 |
| Provider Name | Mariam S Muneer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629623624 PECOS PAC ID: 1355725755 Enrollment ID: I20220902002350 |
| Provider Name | Sanjay T Kishore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942864202 PECOS PAC ID: 9133504269 Enrollment ID: I20220909002604 |
| Provider Name | Rachel T Notareschi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174191027 PECOS PAC ID: 3072998954 Enrollment ID: I20220913001490 |
| Provider Name | Margaret C Hayden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164985479 PECOS PAC ID: 6002291911 Enrollment ID: I20220913002968 |
| Provider Name | Katherine Williams Sheridan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750011573 PECOS PAC ID: 0244616035 Enrollment ID: I20221001000046 |
| Provider Name | Casey Mcgathey Culpepper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487382859 PECOS PAC ID: 5092191387 Enrollment ID: I20221011001293 |
| Provider Name | Carol Ann Mcintyre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477132199 PECOS PAC ID: 8527434810 Enrollment ID: I20221011001380 |
| Provider Name | Margaret Macgregor |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1679665541 PECOS PAC ID: 0244250751 Enrollment ID: I20221012001360 |
| Provider Name | Isis Holloway |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356907323 PECOS PAC ID: 7012243058 Enrollment ID: I20221020000009 |
| Provider Name | Glen Lee Watkins |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1124023874 PECOS PAC ID: 7911949110 Enrollment ID: I20221108000320 |
| Provider Name | Muhammad J Khalil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205492501 PECOS PAC ID: 1355718958 Enrollment ID: I20221111000918 |
| Provider Name | Kylie A Huggins |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1902514334 PECOS PAC ID: 1456729102 Enrollment ID: I20221130001465 |
| Provider Name | Yao Peng |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831669530 PECOS PAC ID: 7810378460 Enrollment ID: I20221215002364 |
| Provider Name | Sean M Clare |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417518333 PECOS PAC ID: 2961732789 Enrollment ID: I20230110002375 |
| Provider Name | Franklin D Scott |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134197916 PECOS PAC ID: 5496128175 Enrollment ID: I20230228000668 |
| Provider Name | Viktor Perovic |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699123299 PECOS PAC ID: 3173878949 Enrollment ID: I20230502002172 |
| Provider Name | Jacqueline Ansell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750357042 PECOS PAC ID: 9638171853 Enrollment ID: I20230515001777 |
| Provider Name | David Gutman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376507079 PECOS PAC ID: 8921012113 Enrollment ID: I20230518002510 |
| Provider Name | Asia D Mcintosh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104471192 PECOS PAC ID: 9133581051 Enrollment ID: I20230809002667 |
| Provider Name | Justin Walton Lewis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871081398 PECOS PAC ID: 1557724010 Enrollment ID: I20230830003710 |
| Provider Name | Jasmine Loretta Johnson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730641283 PECOS PAC ID: 9739414087 Enrollment ID: I20230913000417 |
| Provider Name | Ned John Panara |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1922082130 PECOS PAC ID: 1850345208 Enrollment ID: I20230921000347 |
| Provider Name | Nikhil Suresh Shah |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1104810027 PECOS PAC ID: 4688574304 Enrollment ID: I20230922001537 |
| Provider Name | Morgan Renee Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003550336 PECOS PAC ID: 7012362478 Enrollment ID: I20231005000699 |
| Provider Name | Andrea Harris Brush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790469955 PECOS PAC ID: 2062867427 Enrollment ID: I20231005000971 |
| Provider Name | Laura L Callaway |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1376970103 PECOS PAC ID: 2567781289 Enrollment ID: I20231013002928 |
| Provider Name | Jatinder Goyal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760772925 PECOS PAC ID: 1850538695 Enrollment ID: I20231017002713 |
| Provider Name | Curless A Patterson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548324635 PECOS PAC ID: 3971673203 Enrollment ID: I20231023002328 |
| Provider Name | Helen Yu How |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912932203 PECOS PAC ID: 5799770988 Enrollment ID: I20231103002689 |
| Provider Name | Jessica Rose Poulin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972896694 PECOS PAC ID: 9830402999 Enrollment ID: I20231114000458 |
| Provider Name | Ana Carolina Coronado Reyna |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790206605 PECOS PAC ID: 6406204114 Enrollment ID: I20231117003115 |
| Provider Name | Binay Kumar Kshetree |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932723228 PECOS PAC ID: 0749638427 Enrollment ID: I20231120001736 |
| Provider Name | Omar Saud Waqhar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881081685 PECOS PAC ID: 0547562480 Enrollment ID: I20231220000243 |
| Provider Name | Jimmy Metellus |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184187742 PECOS PAC ID: 1557722998 Enrollment ID: I20231227000339 |
| Provider Name | Folu O Olufehinti |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225619455 PECOS PAC ID: 4284086851 Enrollment ID: I20240118003959 |
| Provider Name | Daphne Crenshaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346755675 PECOS PAC ID: 0345508156 Enrollment ID: I20240123001084 |
| Provider Name | Karen Renee Goodwin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447619812 PECOS PAC ID: 8527401157 Enrollment ID: I20240209002999 |
Your Doctor's Office, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8630 Vaughn Rd, Montgomery, AL 36117 Phone: 334-676-4076 Fax: 334-676-4064 | |
Baptist Health Physician Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 470 Taylor Rd Ste 310, Montgomery, AL 36117 Phone: 334-244-4322 Fax: 334-244-4321 | |
Jackson Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1801 Pine Street, Suite 103, Montgomery, AL 36106 Phone: 334-293-8888 Fax: 334-293-8154 | |
Baptist Health Physician Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Brown Springs Rd, Montgomery, AL 36117 Phone: 334-273-4159 Fax: 334-273-4556 | |
Aikam Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2895 Zelda Rd, Montgomery, AL 36106 Phone: 334-245-5969 | |
Stewart H. Tankersley, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1801 Pine St, Suite 203, Montgomery, AL 36106 Phone: 334-240-2334 | |
Vaughn Urgent Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9540 Wynlakes Pl, Montgomery, AL 36117 Phone: 334-395-9933 Fax: 334-395-9907 |