| Nbmc-main | |
|
1900 Woodland Dr Coos Bay OR 97420-0000 | |
| (541) 267-5151 | |
| (541) 266-4501 |
| Full Name | Nbmc-main |
|---|---|
| Speciality | Clinic/Center |
| Location | 1900 Woodland Dr, Coos Bay, Oregon |
| Authorized Official Name and Position | Steven A Tersigni (INTERIM CEO) |
| Authorized Official Contact | 5412675151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nbmc-main 1900 Woodland Dr Coos Bay OR 97420-0000 Ph: (541) 267-5151 | Nbmc-main 1900 Woodland Dr Coos Bay OR 97420-0000 Ph: (541) 267-5151 |
| NPI Number | 1407812365 |
|---|---|
| Provider Enumeration Date | 04/20/2006 |
| Last Update Date | 12/04/2023 |
| Medicare PECOS PAC ID | 5597677716 |
|---|---|
| Medicare Enrollment ID | O20031105000138 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407812365 | NPI | - | NPPES |
| 383876 | Other | OR | MEDICARE OSCAR LISTED - 383876-BANDON |
| 1386650778 | Other | OR | NBMC DAY SURGERY NPI # |
| 383853 | Other | OR | MEDICARE OSCAR LISTED-383853-GOLD BEACH |
| 1760404396 | Other | OR | NBMC LAB NPI NUMBER |
| 161133 | Other | OR | MEDICAID-OMAP GROUP # |
| R0000WFBTV | Other | OR | GROUP MEDICARE PIN NUMBER |
| 1063428308 | Other | OR | NBMC XRAY-EKG NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 0000760 (Oregon) | Primary |
| Provider Name | William J Moriarty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417932112 PECOS PAC ID: 1456245828 Enrollment ID: I20040209000686 |
| Provider Name | Brigitte D Fink |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699716480 PECOS PAC ID: 7911893664 Enrollment ID: I20040227000544 |
| Provider Name | Dennis J Gory |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1548268790 PECOS PAC ID: 2961496591 Enrollment ID: I20040414001171 |
| Provider Name | Rajesh Ravuri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952386112 PECOS PAC ID: 9830188515 Enrollment ID: I20040507001260 |
| Provider Name | Reginald G Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225014632 PECOS PAC ID: 2860482866 Enrollment ID: I20040513000075 |
| Provider Name | Basil Pittenger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225013485 PECOS PAC ID: 8729060843 Enrollment ID: I20040603000027 |
| Provider Name | Henry H Holmes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346277027 PECOS PAC ID: 3971581869 Enrollment ID: I20040708000420 |
| Provider Name | Julie A Abbott |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1609881028 PECOS PAC ID: 9537149273 Enrollment ID: I20040722000880 |
| Provider Name | Stephan J Groth |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699780015 PECOS PAC ID: 7214917962 Enrollment ID: I20040722001001 |
| Provider Name | Jack E Berndt |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1467408682 PECOS PAC ID: 0345214193 Enrollment ID: I20040825001638 |
| Provider Name | Robert W Gerber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518941350 PECOS PAC ID: 1759356413 Enrollment ID: I20040908000593 |
| Provider Name | Susan Lynn Chaney |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1649402066 PECOS PAC ID: 5799744223 Enrollment ID: I20041008000788 |
| Provider Name | Alexander S Whidden |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1144302639 PECOS PAC ID: 5496715575 Enrollment ID: I20041013000630 |
| Provider Name | Julie L Batchelor |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1407832660 PECOS PAC ID: 4385605351 Enrollment ID: I20041022000553 |
| Provider Name | Jenni C Deleon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215911045 PECOS PAC ID: 8921069618 Enrollment ID: I20041026000326 |
| Provider Name | Gail K Mcclave |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902964125 PECOS PAC ID: 8123077393 Enrollment ID: I20050113001097 |
| Provider Name | Kathryn Moon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508897778 PECOS PAC ID: 6002894045 Enrollment ID: I20050117000216 |
| Provider Name | Dale Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265464325 PECOS PAC ID: 1052200219 Enrollment ID: I20050117000228 |
| Provider Name | Dallas Carter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972587764 PECOS PAC ID: 8022068857 Enrollment ID: I20050201000195 |
| Provider Name | Andrea O Blattler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912013707 PECOS PAC ID: 7315972494 Enrollment ID: I20050927001481 |
| Provider Name | Aleksandar Curcin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1851344691 PECOS PAC ID: 0941109615 Enrollment ID: I20050930000026 |
| Provider Name | Amit Bhandari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669456448 PECOS PAC ID: 9032134689 Enrollment ID: I20051012000756 |
| Provider Name | William D King |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740264399 PECOS PAC ID: 3476579913 Enrollment ID: I20051024000407 |
| Provider Name | Geraldine A Somera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174509210 PECOS PAC ID: 1052338019 Enrollment ID: I20051028000439 |
| Provider Name | Anton E Lotman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730173691 PECOS PAC ID: 9032138193 Enrollment ID: I20051117000500 |
| Provider Name | Troy A Cribbins |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831174812 PECOS PAC ID: 1557381274 Enrollment ID: I20051128000033 |
| Provider Name | Audrey M Duke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417923632 PECOS PAC ID: 7618984063 Enrollment ID: I20060310000069 |
| Provider Name | Susan R Berry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861416240 PECOS PAC ID: 0547277360 Enrollment ID: I20060320000089 |
| Provider Name | Vicki Faucher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295724375 PECOS PAC ID: 2163434978 Enrollment ID: I20060619000076 |
| Provider Name | Kimberly L James |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467403378 PECOS PAC ID: 4688686389 Enrollment ID: I20060621000155 |
| Provider Name | Roger C Willis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477501815 PECOS PAC ID: 1759311483 Enrollment ID: I20060712000344 |
| Provider Name | Danielle L Jensen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1578664710 PECOS PAC ID: 4183621097 Enrollment ID: I20061106000491 |
| Provider Name | Leann J Willis Welch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679523971 PECOS PAC ID: 8527067545 Enrollment ID: I20061220000132 |
| Provider Name | Leo Kusuda |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1578533303 PECOS PAC ID: 5597863456 Enrollment ID: I20070531000354 |
| Provider Name | William W Webster |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1528166287 PECOS PAC ID: 4486650397 Enrollment ID: I20070616000028 |
| Provider Name | Kelly W Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508083189 PECOS PAC ID: 6709985781 Enrollment ID: I20070618000089 |
| Provider Name | William B Croson |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1376610915 PECOS PAC ID: 3375557952 Enrollment ID: I20070905000082 |
| Provider Name | Lance K Y Cheung |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1457543761 PECOS PAC ID: 6103919857 Enrollment ID: I20070911000525 |
| Provider Name | Megan M Holland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184632366 PECOS PAC ID: 5193740462 Enrollment ID: I20070914000042 |
| Provider Name | Brenna E Wolford |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1144429994 PECOS PAC ID: 2567409527 Enrollment ID: I20070926001093 |
| Provider Name | Pauletta J Tokich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578663332 PECOS PAC ID: 7911906482 Enrollment ID: I20080311000375 |
| Provider Name | Michael M Ivanitsky |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1003837410 PECOS PAC ID: 6901985498 Enrollment ID: I20080508000761 |
| Provider Name | Rio M Lion |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346441680 PECOS PAC ID: 0648344473 Enrollment ID: I20080728000731 |
| Provider Name | Laura K Kent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912944208 PECOS PAC ID: 1658375423 Enrollment ID: I20081008000498 |
| Provider Name | John M Holland |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1104834662 PECOS PAC ID: 5092873885 Enrollment ID: I20081023000144 |
| Provider Name | Lawrence R Cheal |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1053403592 PECOS PAC ID: 5395801492 Enrollment ID: I20090225000323 |
| Provider Name | Mark A Pasternak |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760552483 PECOS PAC ID: 4688723471 Enrollment ID: I20090527000622 |
| Provider Name | Kamara M Dodd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114159068 PECOS PAC ID: 7012063589 Enrollment ID: I20090924000459 |
| Provider Name | Joseph El Youssef |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154445641 PECOS PAC ID: 7012009988 Enrollment ID: I20091007000174 |
| Provider Name | Prabhakar A Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770716144 PECOS PAC ID: 8123165933 Enrollment ID: I20091028000169 |
| Provider Name | Kariktan G Cruz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275720054 PECOS PAC ID: 3173660982 Enrollment ID: I20091028000221 |
| Provider Name | Douglas G Crane |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689650673 PECOS PAC ID: 4284775461 Enrollment ID: I20100111000105 |
| Provider Name | Richard S Jany |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1316922602 PECOS PAC ID: 7012077183 Enrollment ID: I20100111000165 |
| Provider Name | Bret A Cook |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1184608994 PECOS PAC ID: 4385785567 Enrollment ID: I20100111000177 |
| Provider Name | Heather R Maclean |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1528042116 PECOS PAC ID: 6901947191 Enrollment ID: I20100111000240 |
| Provider Name | Thomas A Mcandrew |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164407375 PECOS PAC ID: 4789769712 Enrollment ID: I20100112000705 |
| Provider Name | Carla D Mckelvey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669457883 PECOS PAC ID: 1355431446 Enrollment ID: I20100112000718 |
| Provider Name | Christopher M Muller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619952876 PECOS PAC ID: 1658412689 Enrollment ID: I20100112000768 |
| Provider Name | Jonathon L Park |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588649289 PECOS PAC ID: 7911048954 Enrollment ID: I20100112000789 |
| Provider Name | Kenton D Sharman |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1063498475 PECOS PAC ID: 5991895088 Enrollment ID: I20100112000807 |
| Provider Name | Steven G Shimotakahara |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1326024738 PECOS PAC ID: 4183609175 Enrollment ID: I20100112000815 |
| Provider Name | Steven A Tersigni |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649256892 PECOS PAC ID: 5193700185 Enrollment ID: I20100112000829 |
| Provider Name | Unknown Cherry |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1689659377 PECOS PAC ID: 0446392047 Enrollment ID: I20100120000445 |
| Provider Name | Nancy Keller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063496602 PECOS PAC ID: 5597807933 Enrollment ID: I20100122000216 |
| Provider Name | Mary K Ruth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326085846 PECOS PAC ID: 6507901097 Enrollment ID: I20100309000239 |
| Provider Name | Philip Carey Lagesse |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326022997 PECOS PAC ID: 7517006414 Enrollment ID: I20100415000081 |
| Provider Name | Michelle Petrofes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902837099 PECOS PAC ID: 1254220429 Enrollment ID: I20100504000315 |
| Provider Name | Charles G Hurbis |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1760542724 PECOS PAC ID: 8921137415 Enrollment ID: I20100520001065 |
| Provider Name | Wendy G Haack |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518164250 PECOS PAC ID: 7618863440 Enrollment ID: I20100817001277 |
| Provider Name | Shaun M Hobson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1356388458 PECOS PAC ID: 5890720619 Enrollment ID: I20100818000301 |
| Provider Name | Ryan D Pederson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1063605384 PECOS PAC ID: 5991839409 Enrollment ID: I20100819000887 |
| Provider Name | Wade A Savik |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1871512368 PECOS PAC ID: 5597856658 Enrollment ID: I20110201000923 |
| Provider Name | Sandra Renae Randolph |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1023268968 PECOS PAC ID: 3173703386 Enrollment ID: I20110204000682 |
| Provider Name | Kevin Henry Molteni |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124123351 PECOS PAC ID: 0840374377 Enrollment ID: I20110214000540 |
| Provider Name | Audrey C Shank |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912201062 PECOS PAC ID: 7618158692 Enrollment ID: I20110223001146 |
| Provider Name | Angela York |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063457612 PECOS PAC ID: 5890773774 Enrollment ID: I20110726000785 |
| Provider Name | Bhargavbhai K Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134382328 PECOS PAC ID: 3173792025 Enrollment ID: I20110809000847 |
| Provider Name | Sushan Joshi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982851143 PECOS PAC ID: 9931378502 Enrollment ID: I20110816000713 |
| Provider Name | Debra Sue Guzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255627253 PECOS PAC ID: 9436329950 Enrollment ID: I20110818000875 |
| Provider Name | Charles W James |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942274956 PECOS PAC ID: 8325120348 Enrollment ID: I20120305000388 |
| Provider Name | Judith M Randall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891978763 PECOS PAC ID: 1052493749 Enrollment ID: I20120314000682 |
| Provider Name | David A Clark |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578760278 PECOS PAC ID: 6406033141 Enrollment ID: I20120724000001 |
| Provider Name | Bhavani Peddagovindu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013167303 PECOS PAC ID: 0446406334 Enrollment ID: I20120808000727 |
| Provider Name | Mildred H Rowley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003874199 PECOS PAC ID: 1355328121 Enrollment ID: I20120910000259 |
| Provider Name | David Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912135690 PECOS PAC ID: 7214186626 Enrollment ID: I20120928000461 |
| Provider Name | Garry T Vallier |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376551424 PECOS PAC ID: 5294731832 Enrollment ID: I20121019000068 |
| Provider Name | Satyendra N Giri |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1982662938 PECOS PAC ID: 2961472600 Enrollment ID: I20130509000576 |
| Provider Name | Brock W Millet |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265758973 PECOS PAC ID: 5193984151 Enrollment ID: I20130730000586 |
| Provider Name | Keith Gingerich |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1114972742 PECOS PAC ID: 8224004726 Enrollment ID: I20130827000658 |
| Provider Name | Jennifer Veit Hall Jackson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174784367 PECOS PAC ID: 1052567674 Enrollment ID: I20130904000797 |
| Provider Name | Lina Dorfmeister |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699875278 PECOS PAC ID: 0042318081 Enrollment ID: I20130923000801 |
| Provider Name | Bhaskar Ongole |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720216963 PECOS PAC ID: 2668623646 Enrollment ID: I20140114001834 |
| Provider Name | Teresa Lanier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104865658 PECOS PAC ID: 2163501669 Enrollment ID: I20140120000522 |
| Provider Name | Timur Mitin |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1679745822 PECOS PAC ID: 8921265117 Enrollment ID: I20140226000853 |
| Provider Name | James J Sinnott |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053397463 PECOS PAC ID: 7810805413 Enrollment ID: I20140331000962 |
| Provider Name | Nhan V. Pham |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457775611 PECOS PAC ID: 2668698010 Enrollment ID: I20140722000308 |
| Provider Name | Satish Bankuru |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689968943 PECOS PAC ID: 6305063504 Enrollment ID: I20140812001811 |
| Provider Name | Samir Bir Ale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447538533 PECOS PAC ID: 0042439085 Enrollment ID: I20140924000599 |
| Provider Name | Randall Wayne Jennings |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467449827 PECOS PAC ID: 5395715783 Enrollment ID: I20141016002380 |
| Provider Name | Ana Marie V Ferguson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720407786 PECOS PAC ID: 1153542360 Enrollment ID: I20141031000000 |
| Provider Name | Ernest Kelvin Manders |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1326012493 PECOS PAC ID: 4385831544 Enrollment ID: I20141230001579 |
| Provider Name | Eric R Muller |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1841467347 PECOS PAC ID: 4587839592 Enrollment ID: I20150330001584 |
| Provider Name | Shaneen Diane Stacer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427485440 PECOS PAC ID: 8628398567 Enrollment ID: I20150518001034 |
| Provider Name | Raphael El Youssef |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1710197116 PECOS PAC ID: 8022339969 Enrollment ID: I20150604000809 |
| Provider Name | Martin R Roco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255683140 PECOS PAC ID: 8123254596 Enrollment ID: I20150608003084 |
| Provider Name | Mihal Anne Kaufman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548518913 PECOS PAC ID: 0840501102 Enrollment ID: I20150612002186 |
| Provider Name | Keerti Jaini |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386908598 PECOS PAC ID: 6002120326 Enrollment ID: I20150730013448 |
| Provider Name | Ashley Karynn Merz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508249855 PECOS PAC ID: 7214241546 Enrollment ID: I20150730013695 |
| Provider Name | Stephanie Robin Casey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023399367 PECOS PAC ID: 2961657549 Enrollment ID: I20150817000072 |
| Provider Name | Wesley J Johnson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1598758880 PECOS PAC ID: 7113922501 Enrollment ID: I20150825005842 |
| Provider Name | Jason R Sargent |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972869832 PECOS PAC ID: 0648400184 Enrollment ID: I20150831002359 |
| Provider Name | Paavani Atluri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538424346 PECOS PAC ID: 2062720154 Enrollment ID: I20151009002093 |
| Provider Name | Carol S. Frank |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023049541 PECOS PAC ID: 6507908647 Enrollment ID: I20151105002358 |
| Provider Name | Felisha Alexandria Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588061048 PECOS PAC ID: 1658680780 Enrollment ID: I20151228001975 |
| Provider Name | Maynika Rastogi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023253358 PECOS PAC ID: 6002119237 Enrollment ID: I20160122000347 |
| Provider Name | Jerry Jaboin |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1578610382 PECOS PAC ID: 0446376883 Enrollment ID: I20160208001353 |
| Provider Name | Pei J Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366825341 PECOS PAC ID: 8123328317 Enrollment ID: I20160301002328 |
| Provider Name | Alexey Markelov |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1851550867 PECOS PAC ID: 3072802438 Enrollment ID: I20160525001626 |
| Provider Name | Randell P Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144640293 PECOS PAC ID: 5395968127 Enrollment ID: I20160720001412 |
| Provider Name | Nima Nabavizadeh |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1538453741 PECOS PAC ID: 4587819123 Enrollment ID: I20160802002662 |
| Provider Name | Mark Lafayette Van Over |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306015417 PECOS PAC ID: 4587732938 Enrollment ID: I20160909001047 |
| Provider Name | Angela H Marcucilli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942655931 PECOS PAC ID: 9830486851 Enrollment ID: I20160919002707 |
| Provider Name | Patrick Timothy Bringardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154877025 PECOS PAC ID: 1254628175 Enrollment ID: I20160921000461 |
| Provider Name | Matthew S Morris |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124389903 PECOS PAC ID: 2466617105 Enrollment ID: I20161122001803 |
| Provider Name | Alexander S Csajko |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144614728 PECOS PAC ID: 1759661085 Enrollment ID: I20161202001609 |
| Provider Name | James F Tracy |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1639303852 PECOS PAC ID: 4981848215 Enrollment ID: I20161207001675 |
| Provider Name | John Joseph Frank |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1003019563 PECOS PAC ID: 4688707060 Enrollment ID: I20170125003076 |
| Provider Name | Wojciech Nowak |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1205019650 PECOS PAC ID: 7113107202 Enrollment ID: I20170126002845 |
| Provider Name | Hammad Qadir |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1750460192 PECOS PAC ID: 2365413952 Enrollment ID: I20170228002708 |
| Provider Name | Gabriela Lombardi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568918563 PECOS PAC ID: 9638456882 Enrollment ID: I20170426001012 |
| Provider Name | Yetunde E Adio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770856155 PECOS PAC ID: 6204061617 Enrollment ID: I20170517002370 |
| Provider Name | Jennifer Ruth Christenson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1801156161 PECOS PAC ID: 3274800842 Enrollment ID: I20170602000253 |
| Provider Name | David P Frey |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639445067 PECOS PAC ID: 1254651656 Enrollment ID: I20170802003343 |
| Provider Name | Emily E Scotland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417388521 PECOS PAC ID: 4789812637 Enrollment ID: I20170823002834 |
| Provider Name | Ravindra Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316344807 PECOS PAC ID: 4880966910 Enrollment ID: I20170823003753 |
| Provider Name | Jennifer Laurel Webster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184638124 PECOS PAC ID: 1658429584 Enrollment ID: I20170920003691 |
| Provider Name | Shannon M Carlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700285582 PECOS PAC ID: 5193945103 Enrollment ID: I20171102000772 |
| Provider Name | Brendan Tennefoss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528571130 PECOS PAC ID: 4880951391 Enrollment ID: I20171207002046 |
| Provider Name | Angelique Harris Murphy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518105105 PECOS PAC ID: 1355519810 Enrollment ID: I20171226000864 |
| Provider Name | Jesse Allen Dorfmeister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407362197 PECOS PAC ID: 9133487911 Enrollment ID: I20171228000177 |
| Provider Name | Karim Hussein |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780654467 PECOS PAC ID: 9830162585 Enrollment ID: I20180216002017 |
| Provider Name | Shu-wen Cheng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043719990 PECOS PAC ID: 4284996810 Enrollment ID: I20180320001397 |
| Provider Name | Davina Lynn Bledsoe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295245108 PECOS PAC ID: 8224390455 Enrollment ID: I20180327002465 |
| Provider Name | Amy Hinshaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720582315 PECOS PAC ID: 2860755568 Enrollment ID: I20180411000763 |
| Provider Name | Brian Fuller |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1396834412 PECOS PAC ID: 0749289643 Enrollment ID: I20180420001293 |
| Provider Name | Terry Lee Parthemore |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902008360 PECOS PAC ID: 0244593135 Enrollment ID: I20180802003780 |
| Provider Name | Yulia Viktorovna Whidden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801382155 PECOS PAC ID: 3678821402 Enrollment ID: I20180809005435 |
| Provider Name | Julian Andres Ospina |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861945487 PECOS PAC ID: 5890077267 Enrollment ID: I20180917000541 |
| Provider Name | Alyssa Mary Elizabeth Sader |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891170502 PECOS PAC ID: 1951652171 Enrollment ID: I20180926002343 |
| Provider Name | Catherine M O'brien |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1871830125 PECOS PAC ID: 7113148438 Enrollment ID: I20190102001794 |
| Provider Name | Jay A Bryngelson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255502001 PECOS PAC ID: 7315016177 Enrollment ID: I20190109001055 |
| Provider Name | Toyin A Akanni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689141236 PECOS PAC ID: 2365789732 Enrollment ID: I20190123001344 |
| Provider Name | Alaina Therese Hendrix |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750857090 PECOS PAC ID: 3870830045 Enrollment ID: I20190125000772 |
| Provider Name | Veronica L Simmonds |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801004445 PECOS PAC ID: 8022202753 Enrollment ID: I20190301001247 |
| Provider Name | Hannah E Lund |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336642321 PECOS PAC ID: 1355681289 Enrollment ID: I20190312003475 |
| Provider Name | Anna Delaine Dodd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023582673 PECOS PAC ID: 6608117510 Enrollment ID: I20190402002364 |
| Provider Name | Nancy Fajardo Altamirano |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932159159 PECOS PAC ID: 0143532499 Enrollment ID: I20190412001657 |
| Provider Name | Sharon Ai Hung Peng |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1902156557 PECOS PAC ID: 1153662309 Enrollment ID: I20190416002181 |
| Provider Name | Jodi Deanne Strand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942543749 PECOS PAC ID: 5496993396 Enrollment ID: I20190508002489 |
| Provider Name | James Andrew Murray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861050189 PECOS PAC ID: 3678807815 Enrollment ID: I20190621002785 |
| Provider Name | Suchada Chaiwechakarn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558647495 PECOS PAC ID: 3678748647 Enrollment ID: I20190627002613 |
| Provider Name | Linda H Stamm |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386637452 PECOS PAC ID: 4789636937 Enrollment ID: I20190711001968 |
| Provider Name | Nikkona Verna Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568014942 PECOS PAC ID: 7719146703 Enrollment ID: I20190814001185 |
| Provider Name | Joni L Whipple |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588199863 PECOS PAC ID: 0345527701 Enrollment ID: I20190814001521 |
| Provider Name | Heather Brianna Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205383890 PECOS PAC ID: 7517248958 Enrollment ID: I20190816001826 |
| Provider Name | Saralyn J Veech |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699191510 PECOS PAC ID: 6709009632 Enrollment ID: I20190828003840 |
| Provider Name | Rolando L Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356370696 PECOS PAC ID: 2567618168 Enrollment ID: I20191018001796 |
| Provider Name | Amanda Nadine Krantz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164082988 PECOS PAC ID: 7113259524 Enrollment ID: I20191104001393 |
| Provider Name | Yvonne L Fenrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376588111 PECOS PAC ID: 1759369465 Enrollment ID: I20191205001818 |
| Provider Name | Tammy Lynn Ashburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275828592 PECOS PAC ID: 7214109925 Enrollment ID: I20200116001554 |
| Provider Name | Mitaliben Rajendrakumar Gor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114564630 PECOS PAC ID: 1254766330 Enrollment ID: I20200117001671 |
| Provider Name | Daniel Ewing Clark |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1295267029 PECOS PAC ID: 7214214618 Enrollment ID: I20200131002314 |
| Provider Name | Jacklyn S Hardin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235764143 PECOS PAC ID: 2365872454 Enrollment ID: I20200413001980 |
| Provider Name | Stephanie M Dulian |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255502423 PECOS PAC ID: 0749340362 Enrollment ID: I20200521001706 |
| Provider Name | Kellilynn Bosak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205363421 PECOS PAC ID: 8729357892 Enrollment ID: I20200527000384 |
| Provider Name | Derek Knight Rogalsky |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184010191 PECOS PAC ID: 1658688213 Enrollment ID: I20200608002448 |
| Provider Name | Sharon Elaine Monsivais |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1023455490 PECOS PAC ID: 3476833930 Enrollment ID: I20200611000817 |
| Provider Name | Lori D Shott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083246730 PECOS PAC ID: 4082036470 Enrollment ID: I20200611001684 |
| Provider Name | Kim Lewis Slight |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093754400 PECOS PAC ID: 2365336641 Enrollment ID: I20200622000569 |
| Provider Name | Anushi Bulumulle |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1770996589 PECOS PAC ID: 1355633439 Enrollment ID: I20200625001701 |
| Provider Name | James Alan Maddox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932216751 PECOS PAC ID: 3577455112 Enrollment ID: I20200727001178 |
| Provider Name | Alex Spencer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982088464 PECOS PAC ID: 5799100079 Enrollment ID: I20200804000192 |
| Provider Name | Ram Hanno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780003525 PECOS PAC ID: 5698065928 Enrollment ID: I20201005001792 |
| Provider Name | Ya-chi C Chang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568002749 PECOS PAC ID: 9234559949 Enrollment ID: I20201019002890 |
| Provider Name | Sophia Elizabeth Massey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346803640 PECOS PAC ID: 0446660765 Enrollment ID: I20201027002859 |
| Provider Name | Sandy Lynn Teeter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477189009 PECOS PAC ID: 1557771557 Enrollment ID: I20201103000873 |
| Provider Name | Meredith Johanna Batty |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1659840288 PECOS PAC ID: 2769896406 Enrollment ID: I20210120003085 |
| Provider Name | Mary Lou Freitag |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962090621 PECOS PAC ID: 5991119141 Enrollment ID: I20210128002356 |
| Provider Name | Melissa R Pallin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477820801 PECOS PAC ID: 7517372196 Enrollment ID: I20210211001991 |
| Provider Name | Luana West Machado Hearn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881117372 PECOS PAC ID: 0143636431 Enrollment ID: I20210311001189 |
| Provider Name | Dana Harbuck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275033540 PECOS PAC ID: 6608112313 Enrollment ID: I20210419000045 |
| Provider Name | Araz Baboujian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881115368 PECOS PAC ID: 3072850338 Enrollment ID: I20210603001573 |
| Provider Name | Kimberly Ann Kyllo-martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649849142 PECOS PAC ID: 5991106841 Enrollment ID: I20210629002256 |
| Provider Name | Keithlee Gael Orpilla Dolinta |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427547165 PECOS PAC ID: 5496001034 Enrollment ID: I20210714001624 |
| Provider Name | Jamie Nadine Mayo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548939218 PECOS PAC ID: 9931506367 Enrollment ID: I20210927003177 |
| Provider Name | Jason Daniel Empson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770255283 PECOS PAC ID: 3779981154 Enrollment ID: I20211015000867 |
| Provider Name | Ramses Carlos Masis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063705663 PECOS PAC ID: 6002069515 Enrollment ID: I20220207001334 |
| Provider Name | Cassandra Kay Hastings |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255822144 PECOS PAC ID: 0941551337 Enrollment ID: I20220720001621 |
| Provider Name | Swetha Vutukuri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205499662 PECOS PAC ID: 6002298825 Enrollment ID: I20220726003001 |
| Provider Name | Antonia Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619377322 PECOS PAC ID: 9931426558 Enrollment ID: I20230215000855 |
| Provider Name | Kathryn S Mead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497186530 PECOS PAC ID: 8820462104 Enrollment ID: I20230328002844 |
| Provider Name | Matthew D Laird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619683224 PECOS PAC ID: 1658745880 Enrollment ID: I20230329002167 |
| Provider Name | Hsiang-neng Hung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447948682 PECOS PAC ID: 1456718410 Enrollment ID: I20230606002731 |
| Provider Name | John S Oglesby |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245385962 PECOS PAC ID: 2365493558 Enrollment ID: I20230616001456 |
| Provider Name | Brittany Rose Decker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871279463 PECOS PAC ID: 7719346816 Enrollment ID: I20230707001954 |
| Provider Name | Misael Manalo Marquez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922088426 PECOS PAC ID: 2668462755 Enrollment ID: I20231113001160 |
| Provider Name | Kathryn Johnson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1154827228 PECOS PAC ID: 1557612819 Enrollment ID: I20240122003008 |
Coos Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 320 Central Ave, Suite 418, Coos Bay, OR 97420 Phone: 541-294-0257 | |
Ko-kwell Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 630 Miluk Dr, Coos Bay, OR 97420 Phone: 541-888-9494 Fax: 541-888-4435 | |
Proactive Nutrition & Wellness Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1455 Laurel Ave, Coos Bay, OR 97420 Phone: 727-409-0016 | |
Waterfall Clinic, Incorporated Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 826 S 11th St, Coos Bay, OR 97420 Phone: 541-756-6232 Fax: 541-756-6234 | |
Dr. King Scope Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2699 N 17th St, Coos Bay, OR 97420 Phone: 541-269-7358 | |
Waterfall Clinic Incorporated Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 465 Elrod Ave, Coos Bay, OR 97420 Phone: 541-756-6232 Fax: 541-756-6234 |