| Northeast Arkansas Clinic Charitable Foundation, Inc. | |
|
4802 E Johnson Ave Jonesboro AR 72401-8413 | |
| (870) 936-8000 | |
| (870) 936-0100 |
| Full Name | Northeast Arkansas Clinic Charitable Foundation, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 4802 E Johnson Ave, Jonesboro, Arkansas |
| Authorized Official Name and Position | Gregory M Duckett (SR VP/CLO) |
| Authorized Official Contact | 9012275233 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Arkansas Clinic Charitable Foundation, Inc. 350 N Humphreys Blvd Memphis TN 38120-2177 Ph: () - | Northeast Arkansas Clinic Charitable Foundation, Inc. 4802 E Johnson Ave Jonesboro AR 72401-8413 Ph: (870) 936-8000 |
| NPI Number | 1861721839 |
|---|---|
| Provider Enumeration Date | 12/21/2009 |
| Last Update Date | 09/30/2020 |
| Medicare PECOS PAC ID | 2961547526 |
|---|---|
| Medicare Enrollment ID | O20100315000190 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861721839 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Glen C Knowles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679579536 PECOS PAC ID: 6103726856 Enrollment ID: I20040109001029 |
| Provider Name | Daniel Stevenson |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1558366443 PECOS PAC ID: 2961304803 Enrollment ID: I20040122000343 |
| Provider Name | Diana Michelle Montgomery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457356347 PECOS PAC ID: 6204722580 Enrollment ID: I20040224000781 |
| Provider Name | Eumar T Tagupa |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1497717128 PECOS PAC ID: 4789576703 Enrollment ID: I20040325001288 |
| Provider Name | Anthony Taylor White |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548239585 PECOS PAC ID: 5991697948 Enrollment ID: I20040325001520 |
| Provider Name | Meredith Moore Walker |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1720040470 PECOS PAC ID: 0446142319 Enrollment ID: I20040325001587 |
| Provider Name | William S Hubbard |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1336118314 PECOS PAC ID: 4284526153 Enrollment ID: I20040325001640 |
| Provider Name | Robert Dale Taylor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316915424 PECOS PAC ID: 0143212381 Enrollment ID: I20040330001583 |
| Provider Name | Michael Linell Isaacson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1972572097 PECOS PAC ID: 5597757765 Enrollment ID: I20040330001720 |
| Provider Name | Dharmendra V Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1942262571 PECOS PAC ID: 0840282919 Enrollment ID: I20040330001790 |
| Provider Name | Kenneth Chan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1720042138 PECOS PAC ID: 8426040148 Enrollment ID: I20040401001237 |
| Provider Name | Daron Edward Merryman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356347207 PECOS PAC ID: 0648267898 Enrollment ID: I20040428001528 |
| Provider Name | James T Hannah |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245290535 PECOS PAC ID: 3779564778 Enrollment ID: I20040526000599 |
| Provider Name | Randy J Horras |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376658781 PECOS PAC ID: 8022091511 Enrollment ID: I20040607001452 |
| Provider Name | Fred Joseph George |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1770540544 PECOS PAC ID: 8921086455 Enrollment ID: I20040712000482 |
| Provider Name | James David Cullins |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1346206406 PECOS PAC ID: 3274511605 Enrollment ID: I20040712000582 |
| Provider Name | Nathan W Turney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346207115 PECOS PAC ID: 1759361421 Enrollment ID: I20040722001149 |
| Provider Name | Danna Scott Deaton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578667010 PECOS PAC ID: 0840267415 Enrollment ID: I20040913001412 |
| Provider Name | Kristy Lynn Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134143472 PECOS PAC ID: 0345208815 Enrollment ID: I20041230000119 |
| Provider Name | Ray H Hall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598733602 PECOS PAC ID: 5496713794 Enrollment ID: I20050103000359 |
| Provider Name | Stephen O Woodruff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467420570 PECOS PAC ID: 1557329869 Enrollment ID: I20050103000464 |
| Provider Name | Michael G Mackey |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1437127800 PECOS PAC ID: 8921066283 Enrollment ID: I20050103000817 |
| Provider Name | Angela Rachelle Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790709038 PECOS PAC ID: 9335107697 Enrollment ID: I20050103000863 |
| Provider Name | David L Harshfield |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265437503 PECOS PAC ID: 3173576105 Enrollment ID: I20050310000396 |
| Provider Name | Tommy G Taylor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831158302 PECOS PAC ID: 1254388481 Enrollment ID: I20050331000300 |
| Provider Name | Jeffrey Wayne Ramsey |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1326005737 PECOS PAC ID: 4880641745 Enrollment ID: I20050401000873 |
| Provider Name | Kara L Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588671747 PECOS PAC ID: 7113966979 Enrollment ID: I20050430000069 |
| Provider Name | Russell Dwight Degges |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902860620 PECOS PAC ID: 6901846039 Enrollment ID: I20050509000725 |
| Provider Name | Albert J Mcgrath |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578524047 PECOS PAC ID: 5799726303 Enrollment ID: I20050513000251 |
| Provider Name | Tara L Waggoner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568515930 PECOS PAC ID: 4587605977 Enrollment ID: I20050516000886 |
| Provider Name | Ronald D Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275572380 PECOS PAC ID: 7012817968 Enrollment ID: I20050623001060 |
| Provider Name | Melissa M Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992762504 PECOS PAC ID: 4284670423 Enrollment ID: I20050628001217 |
| Provider Name | Kevin Douglas Claybrook |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1578538229 PECOS PAC ID: 8426094186 Enrollment ID: I20050701000968 |
| Provider Name | Stacia Lynne Gallion |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063479814 PECOS PAC ID: 6901842210 Enrollment ID: I20050707000840 |
| Provider Name | Carroll Dean Scroggin |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1821058991 PECOS PAC ID: 8628014933 Enrollment ID: I20050707000971 |
| Provider Name | David Allen Nixon |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1700846045 PECOS PAC ID: 9133165459 Enrollment ID: I20050707000985 |
| Provider Name | Stacy Leann Wilbanks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336203348 PECOS PAC ID: 2466488663 Enrollment ID: I20050711000287 |
| Provider Name | Leslie D Mccasland |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1003873019 PECOS PAC ID: 0446241749 Enrollment ID: I20050728000592 |
| Provider Name | Robert B White |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932166501 PECOS PAC ID: 3870548464 Enrollment ID: I20050728001182 |
| Provider Name | James W Fletcher |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407880644 PECOS PAC ID: 4284663493 Enrollment ID: I20050808001263 |
| Provider Name | Jeffrey B Marotte |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1942276316 PECOS PAC ID: 5294766135 Enrollment ID: I20050830000709 |
| Provider Name | Timothy A Shown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811953177 PECOS PAC ID: 2668406356 Enrollment ID: I20050922000086 |
| Provider Name | Linda A Farris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336160324 PECOS PAC ID: 6204852114 Enrollment ID: I20051020000310 |
| Provider Name | Rebecca J Barrett-tuck |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1104911759 PECOS PAC ID: 2062324031 Enrollment ID: I20051128000806 |
| Provider Name | Gregory F Ricca |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1386615177 PECOS PAC ID: 0244142206 Enrollment ID: I20051128000835 |
| Provider Name | Samuel Ray Hiser |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1760459648 PECOS PAC ID: 1759301781 Enrollment ID: I20051205000864 |
| Provider Name | Jason Brandt |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1952368565 PECOS PAC ID: 6608788674 Enrollment ID: I20060109001070 |
| Provider Name | Jeffery L Barber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942267513 PECOS PAC ID: 8729090766 Enrollment ID: I20060612000301 |
| Provider Name | Joseph Sams |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912978255 PECOS PAC ID: 8921074386 Enrollment ID: I20061109000496 |
| Provider Name | William Warren Henry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710962485 PECOS PAC ID: 0345152344 Enrollment ID: I20070130000238 |
| Provider Name | Yuanyuan Long |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588751523 PECOS PAC ID: 2062414691 Enrollment ID: I20070209000373 |
| Provider Name | Homer E Brooks |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1154397537 PECOS PAC ID: 7012019094 Enrollment ID: I20070221000575 |
| Provider Name | Kelly Dawn Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447329404 PECOS PAC ID: 1355444522 Enrollment ID: I20070307000640 |
| Provider Name | Christopher Rowlett |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1184756280 PECOS PAC ID: 8123128212 Enrollment ID: I20070702000406 |
| Provider Name | Brannon Anthony Treece |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588783666 PECOS PAC ID: 0345340956 Enrollment ID: I20070712000014 |
| Provider Name | Ronald D Smith |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1245421247 PECOS PAC ID: 9537258587 Enrollment ID: I20071129000111 |
| Provider Name | Amy E Bailey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427277755 PECOS PAC ID: 0840389607 Enrollment ID: I20071130000419 |
| Provider Name | Matthew Baker Wilson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578538575 PECOS PAC ID: 9133213275 Enrollment ID: I20080205000662 |
| Provider Name | Muhammad I Shakir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952352213 PECOS PAC ID: 0446336408 Enrollment ID: I20080401000167 |
| Provider Name | Wolf E Heberlein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922121698 PECOS PAC ID: 8123199387 Enrollment ID: I20080616000180 |
| Provider Name | Jennifer Dawn Jarrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386819654 PECOS PAC ID: 2567534951 Enrollment ID: I20080630000369 |
| Provider Name | Pittman D Moore |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811018880 PECOS PAC ID: 0547335721 Enrollment ID: I20080822000357 |
| Provider Name | Amy Stein |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1114181617 PECOS PAC ID: 3870660673 Enrollment ID: I20080919000571 |
| Provider Name | Dave D Weems |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710974944 PECOS PAC ID: 9638136914 Enrollment ID: I20081008000716 |
| Provider Name | Amber N Toombs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497910624 PECOS PAC ID: 7618035015 Enrollment ID: I20081028000646 |
| Provider Name | Matthew A Quick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376739854 PECOS PAC ID: 1153485123 Enrollment ID: I20090206000032 |
| Provider Name | Heidi Cohn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821065715 PECOS PAC ID: 4183789134 Enrollment ID: I20090209000194 |
| Provider Name | David Lance Phillips |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285605816 PECOS PAC ID: 9931182722 Enrollment ID: I20090302000398 |
| Provider Name | Mark Wendel |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1659494334 PECOS PAC ID: 3072679679 Enrollment ID: I20090306000032 |
| Provider Name | Jennifer Lynn Williams Malone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730334376 PECOS PAC ID: 7416014485 Enrollment ID: I20090318000229 |
| Provider Name | Owen Criner |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1790909943 PECOS PAC ID: 4183772833 Enrollment ID: I20090506000401 |
| Provider Name | Sara Beth Culbreath |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1215170121 PECOS PAC ID: 8022160738 Enrollment ID: I20090710000059 |
| Provider Name | Christopher Mcgrath |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962609826 PECOS PAC ID: 7416009519 Enrollment ID: I20090721000620 |
| Provider Name | Aaron J Wallace |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1275701963 PECOS PAC ID: 1254487903 Enrollment ID: I20090922000009 |
| Provider Name | Chad Hill |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861503062 PECOS PAC ID: 4981740628 Enrollment ID: I20091009000109 |
| Provider Name | Gregory D Wood |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225040645 PECOS PAC ID: 9032255609 Enrollment ID: I20091013000206 |
| Provider Name | Scott Alan Dorroh |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1124231816 PECOS PAC ID: 6103964168 Enrollment ID: I20091111000502 |
| Provider Name | Stacy Emmanuel Richardson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1891968293 PECOS PAC ID: 1850430943 Enrollment ID: I20091202000732 |
| Provider Name | Adam B Woodruff |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1538383799 PECOS PAC ID: 2365583564 Enrollment ID: I20100111000332 |
| Provider Name | Sandra Carole Stubblefield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215971338 PECOS PAC ID: 8022151034 Enrollment ID: I20100318000413 |
| Provider Name | Douglas Maglothin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104887215 PECOS PAC ID: 8224173885 Enrollment ID: I20100324000736 |
| Provider Name | Kenneth B Jones |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871557041 PECOS PAC ID: 0042355604 Enrollment ID: I20100324001093 |
| Provider Name | Bryan K Lansford |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1265498091 PECOS PAC ID: 9133150592 Enrollment ID: I20100324001154 |
| Provider Name | Michael D Hightower |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1053389353 PECOS PAC ID: 6002942216 Enrollment ID: I20100326000711 |
| Provider Name | Michael E Tedder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962463091 PECOS PAC ID: 6103952338 Enrollment ID: I20100326000936 |
| Provider Name | Beata Filip-majewski |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1083670749 PECOS PAC ID: 5698801835 Enrollment ID: I20100326001017 |
| Provider Name | Deborah Fairchild |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851315352 PECOS PAC ID: 3971639600 Enrollment ID: I20100331001137 |
| Provider Name | Arnold E Gilliam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679535108 PECOS PAC ID: 5496881120 Enrollment ID: I20100331001182 |
| Provider Name | Mark Stripling |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073575148 PECOS PAC ID: 1850429937 Enrollment ID: I20100511000577 |
| Provider Name | Wojcieh T Majewski |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1861458531 PECOS PAC ID: 9436287521 Enrollment ID: I20100511000659 |
| Provider Name | Wallace Hoke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386605475 PECOS PAC ID: 1658409768 Enrollment ID: I20100511000872 |
| Provider Name | Charles Dunn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215990668 PECOS PAC ID: 5496786857 Enrollment ID: I20100511000978 |
| Provider Name | Norbert Delacey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861457590 PECOS PAC ID: 6204964208 Enrollment ID: I20100512000874 |
| Provider Name | Margaret Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750305702 PECOS PAC ID: 9133257140 Enrollment ID: I20100512000950 |
| Provider Name | Robert Abraham |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1780641563 PECOS PAC ID: 7416034129 Enrollment ID: I20100513000494 |
| Provider Name | Kevin Ganong |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1699730762 PECOS PAC ID: 9133264799 Enrollment ID: I20100513000598 |
| Provider Name | Bing Xie Behrens |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841256609 PECOS PAC ID: 4486646148 Enrollment ID: I20100513000643 |
| Provider Name | Randall Carlton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295791523 PECOS PAC ID: 9436287307 Enrollment ID: I20100513000687 |
| Provider Name | Timothy C Goodson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1578538252 PECOS PAC ID: 7416845979 Enrollment ID: I20100601000835 |
| Provider Name | Richard Thomas Sheppard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255659546 PECOS PAC ID: 2163554098 Enrollment ID: I20100713000266 |
| Provider Name | Ron Dean Schechter |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972575264 PECOS PAC ID: 8628100278 Enrollment ID: I20100716000232 |
| Provider Name | Haris Zafarullah |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1841370475 PECOS PAC ID: 6406988500 Enrollment ID: I20100723000812 |
| Provider Name | Roy Edward Cooper |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922179522 PECOS PAC ID: 1153233119 Enrollment ID: I20100728000728 |
| Provider Name | Shane R Smith |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1538134572 PECOS PAC ID: 1557428364 Enrollment ID: I20100728001183 |
| Provider Name | Jemeca D Edwards |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306059753 PECOS PAC ID: 3274666060 Enrollment ID: I20100730000234 |
| Provider Name | Veryl Hodges |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013903269 PECOS PAC ID: 0941237309 Enrollment ID: I20100803000258 |
| Provider Name | Brian Mcdonald Cate |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083619456 PECOS PAC ID: 5799751574 Enrollment ID: I20100818001374 |
| Provider Name | Leslye D Mcgrath |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326245291 PECOS PAC ID: 6305961202 Enrollment ID: I20100915001083 |
| Provider Name | Roddy Smart Lochala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417922667 PECOS PAC ID: 7315924040 Enrollment ID: I20100927001225 |
| Provider Name | Richard A Wyatt |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912948902 PECOS PAC ID: 1759300254 Enrollment ID: I20101011000608 |
| Provider Name | Brooke Nicole Pruitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093021826 PECOS PAC ID: 9133312572 Enrollment ID: I20101019000217 |
| Provider Name | Phuong C Ly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265512982 PECOS PAC ID: 1759576242 Enrollment ID: I20101110000372 |
| Provider Name | Brock F Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538134200 PECOS PAC ID: 9436165461 Enrollment ID: I20101204000089 |
| Provider Name | Trent R Lamb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144225020 PECOS PAC ID: 9739162892 Enrollment ID: I20110504000281 |
| Provider Name | Matthew P Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083689855 PECOS PAC ID: 2860479599 Enrollment ID: I20110504000795 |
| Provider Name | Charles Cesare |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144414707 PECOS PAC ID: 8426226192 Enrollment ID: I20110725000123 |
| Provider Name | Matthew Haustein |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1154545309 PECOS PAC ID: 0446428122 Enrollment ID: I20110725000230 |
| Provider Name | Thomas Nix |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1417098153 PECOS PAC ID: 8628151909 Enrollment ID: I20110818000140 |
| Provider Name | Megan Aaryn Spurlock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982992830 PECOS PAC ID: 9032380696 Enrollment ID: I20110913000044 |
| Provider Name | William Rice |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780911768 PECOS PAC ID: 9234317587 Enrollment ID: I20111101000235 |
| Provider Name | Michael L Suminski |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1578606109 PECOS PAC ID: 0345413621 Enrollment ID: I20111102000089 |
| Provider Name | James K Weeks |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801099130 PECOS PAC ID: 3678607611 Enrollment ID: I20111116000420 |
| Provider Name | John M Allen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1568505543 PECOS PAC ID: 0749294932 Enrollment ID: I20120224000621 |
| Provider Name | Mark Phillip Wright |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1558576041 PECOS PAC ID: 4789848482 Enrollment ID: I20120608000399 |
| Provider Name | Daniel A Craven |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114244001 PECOS PAC ID: 0042475501 Enrollment ID: I20120706000546 |
| Provider Name | Melanie Renee New |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1982982542 PECOS PAC ID: 9133377757 Enrollment ID: I20120924000286 |
| Provider Name | Valari A Landrum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811246127 PECOS PAC ID: 4385893817 Enrollment ID: I20120927000238 |
| Provider Name | Leif Lovins |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336499078 PECOS PAC ID: 6608026356 Enrollment ID: I20121016000153 |
| Provider Name | Christopher John Enger |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1396091823 PECOS PAC ID: 1254581028 Enrollment ID: I20121101000599 |
| Provider Name | Corey N Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487944617 PECOS PAC ID: 8224281019 Enrollment ID: I20130103000036 |
| Provider Name | Steven Dean Stroud |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1205093283 PECOS PAC ID: 7618113325 Enrollment ID: I20130425000448 |
| Provider Name | Angela V Casciano |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356516330 PECOS PAC ID: 0547401945 Enrollment ID: I20130727000267 |
| Provider Name | Agnes V Kwo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215224704 PECOS PAC ID: 9638313166 Enrollment ID: I20130923000517 |
| Provider Name | John Gregory Stanfill |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831364330 PECOS PAC ID: 3971738451 Enrollment ID: I20131109000318 |
| Provider Name | Crystal Janine Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649604141 PECOS PAC ID: 3971739194 Enrollment ID: I20131118001773 |
| Provider Name | Nephertiti Efeovbokhan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679738538 PECOS PAC ID: 7719123397 Enrollment ID: I20131220001293 |
| Provider Name | Paul Levy |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1699779686 PECOS PAC ID: 5496813446 Enrollment ID: I20140106000188 |
| Provider Name | Rodney Lee Clark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649590886 PECOS PAC ID: 8325287733 Enrollment ID: I20140108000356 |
| Provider Name | Anna E Lawrence |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811052640 PECOS PAC ID: 5294798468 Enrollment ID: I20140122000475 |
| Provider Name | Christian Orji |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700172145 PECOS PAC ID: 0143459909 Enrollment ID: I20140128000503 |
| Provider Name | Bhavika P Albee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316232648 PECOS PAC ID: 9739318965 Enrollment ID: I20140210000628 |
| Provider Name | Stefanie Rust |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154684355 PECOS PAC ID: 9537398573 Enrollment ID: I20140214001065 |
| Provider Name | Michael S Lyerly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851682694 PECOS PAC ID: 1153551049 Enrollment ID: I20140219001682 |
| Provider Name | Lee M Lefler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902801384 PECOS PAC ID: 5193795631 Enrollment ID: I20140311001364 |
| Provider Name | Kevin B Collins |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1174611511 PECOS PAC ID: 2062567175 Enrollment ID: I20140313000976 |
| Provider Name | Rendi W Kahoun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942626049 PECOS PAC ID: 6709019367 Enrollment ID: I20140506000753 |
| Provider Name | Aron K Chary |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316181662 PECOS PAC ID: 9234352485 Enrollment ID: I20140516000041 |
| Provider Name | David Mb Dean |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144462300 PECOS PAC ID: 4880819853 Enrollment ID: I20140807001753 |
| Provider Name | Jimmy R Carroll Jr |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477796241 PECOS PAC ID: 1850523325 Enrollment ID: I20140825000655 |
| Provider Name | Ronald Wayne Barnett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730403262 PECOS PAC ID: 4183842305 Enrollment ID: I20140902000761 |
| Provider Name | Jeffrey Allen Myhill |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1326200775 PECOS PAC ID: 6608095062 Enrollment ID: I20140917000228 |
| Provider Name | Teri Nicole Horne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942615422 PECOS PAC ID: 6103045562 Enrollment ID: I20140917000373 |
| Provider Name | Manikandan Rajagopal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053575597 PECOS PAC ID: 3072783406 Enrollment ID: I20140917000784 |
| Provider Name | Meghan Lindsay Lyerly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740572387 PECOS PAC ID: 1456570845 Enrollment ID: I20140917001254 |
| Provider Name | Jiang Cui |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1447331152 PECOS PAC ID: 2860596244 Enrollment ID: I20140917002122 |
| Provider Name | Johnathan James Ledet |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1346476975 PECOS PAC ID: 6103011234 Enrollment ID: I20141014000611 |
| Provider Name | Jason Charles Coletta |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265753008 PECOS PAC ID: 2466672555 Enrollment ID: I20141014000645 |
| Provider Name | Duston Seth Jones |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1659784957 PECOS PAC ID: 3476774290 Enrollment ID: I20141021000476 |
| Provider Name | Cina Joseph Ali |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356508600 PECOS PAC ID: 7810130556 Enrollment ID: I20141021001455 |
| Provider Name | Tiffany N Woodard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649686148 PECOS PAC ID: 4183845365 Enrollment ID: I20141103000545 |
| Provider Name | Ivan Spengler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629471685 PECOS PAC ID: 7517189178 Enrollment ID: I20141114000985 |
| Provider Name | Cindy Lou Norman |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265835136 PECOS PAC ID: 0840412425 Enrollment ID: I20141114001613 |
| Provider Name | Gary M Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962844522 PECOS PAC ID: 4486898905 Enrollment ID: I20141219000103 |
| Provider Name | Sonya K Goode |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700171600 PECOS PAC ID: 7113240631 Enrollment ID: I20150108000152 |
| Provider Name | David Zhiqiang Lan |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1588641526 PECOS PAC ID: 7618940776 Enrollment ID: I20150219001631 |
| Provider Name | Adaora S Udekwu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487880373 PECOS PAC ID: 9436477957 Enrollment ID: I20150414000906 |
| Provider Name | Ashley S Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780099614 PECOS PAC ID: 1850611633 Enrollment ID: I20150519000507 |
| Provider Name | Paul Daniel Silveri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487917811 PECOS PAC ID: 6608196373 Enrollment ID: I20150520000959 |
| Provider Name | Courtney L Sick |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437477189 PECOS PAC ID: 8224342381 Enrollment ID: I20150803001189 |
| Provider Name | Tracie L. Krob |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104968171 PECOS PAC ID: 8921041591 Enrollment ID: I20150804004151 |
| Provider Name | Rex L Porte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801235783 PECOS PAC ID: 4284940917 Enrollment ID: I20150826001118 |
| Provider Name | Rachael Nambusi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003255985 PECOS PAC ID: 8729394267 Enrollment ID: I20150831000222 |
| Provider Name | Jonathan R Berger |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598086712 PECOS PAC ID: 1658689955 Enrollment ID: I20151007000590 |
| Provider Name | Carie C Wells |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1104201482 PECOS PAC ID: 5597074310 Enrollment ID: I20151019000998 |
| Provider Name | James Randall Horton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831418821 PECOS PAC ID: 3779899448 Enrollment ID: I20151020000626 |
| Provider Name | Kelsey M Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366833709 PECOS PAC ID: 1658680244 Enrollment ID: I20151021003176 |
| Provider Name | Emily Joyce |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194041996 PECOS PAC ID: 3971817396 Enrollment ID: I20151110001448 |
| Provider Name | Stephanie Lynn Wiggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457721359 PECOS PAC ID: 4183924913 Enrollment ID: I20151201002197 |
| Provider Name | Ashley Nicole House |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1679949457 PECOS PAC ID: 8527368133 Enrollment ID: I20151204000111 |
| Provider Name | Tonna Dement |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952784829 PECOS PAC ID: 0749581692 Enrollment ID: I20151217001521 |
| Provider Name | Erika L Vance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366816670 PECOS PAC ID: 2264735240 Enrollment ID: I20160126000384 |
| Provider Name | Richard Green |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447355540 PECOS PAC ID: 0446153894 Enrollment ID: I20160223001008 |
| Provider Name | Michelle W Schofield |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104874056 PECOS PAC ID: 2062437106 Enrollment ID: I20160414000367 |
| Provider Name | Dennis Kolokolo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477575355 PECOS PAC ID: 5092788471 Enrollment ID: I20160427001348 |
| Provider Name | Emem B Udo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1801073465 PECOS PAC ID: 0749476299 Enrollment ID: I20160429000441 |
| Provider Name | James B Winblad |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821229709 PECOS PAC ID: 8325296007 Enrollment ID: I20160509000128 |
| Provider Name | Andrew W Walters |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659638625 PECOS PAC ID: 6103141858 Enrollment ID: I20160607000398 |
| Provider Name | Ahmed Halal |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1447495569 PECOS PAC ID: 8527184381 Enrollment ID: I20160613000973 |
| Provider Name | Kirk H Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821449372 PECOS PAC ID: 3779877741 Enrollment ID: I20160815000633 |
| Provider Name | Teresa A Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235585563 PECOS PAC ID: 1355637695 Enrollment ID: I20160913000152 |
| Provider Name | Joy D Escue |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1497208508 PECOS PAC ID: 9931495249 Enrollment ID: I20160913002565 |
| Provider Name | Nomathamsanqa Moyo-peters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811336423 PECOS PAC ID: 7113214248 Enrollment ID: I20160916002111 |
| Provider Name | Chukwuemeka Ezeume |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629361340 PECOS PAC ID: 9830318088 Enrollment ID: I20161012000366 |
| Provider Name | David B Blount |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265884910 PECOS PAC ID: 2668760190 Enrollment ID: I20161015000012 |
| Provider Name | Eva Jeanette Lopez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730279068 PECOS PAC ID: 6204998206 Enrollment ID: I20161111000072 |
| Provider Name | Kelechi U Iwuji |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548524861 PECOS PAC ID: 6709190465 Enrollment ID: I20161119000001 |
| Provider Name | Devn A Frandsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730316043 PECOS PAC ID: 9032344064 Enrollment ID: I20161219001343 |
| Provider Name | Jennifer R Smith |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1659822211 PECOS PAC ID: 8224319868 Enrollment ID: I20161220000529 |
| Provider Name | Samuel Maghidman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821086703 PECOS PAC ID: 0547296907 Enrollment ID: I20161220000789 |
| Provider Name | Tracy Mullis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558813352 PECOS PAC ID: 7517248081 Enrollment ID: I20161222000118 |
| Provider Name | Billie L Barnes-wills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659814739 PECOS PAC ID: 3870874241 Enrollment ID: I20161222000546 |
| Provider Name | Amara F Elochukwu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841507944 PECOS PAC ID: 6800039744 Enrollment ID: I20170105001171 |
| Provider Name | Harold E Parsons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598916942 PECOS PAC ID: 8426339185 Enrollment ID: I20170111003330 |
| Provider Name | Cherechi C Ogwo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720321060 PECOS PAC ID: 8729226600 Enrollment ID: I20170112003220 |
| Provider Name | Christopher M Bruno |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104111442 PECOS PAC ID: 0446543698 Enrollment ID: I20170117002426 |
| Provider Name | David P Jones |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891923918 PECOS PAC ID: 1355661505 Enrollment ID: I20170125002186 |
| Provider Name | Garrett T Wray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063957546 PECOS PAC ID: 9436431491 Enrollment ID: I20170126002423 |
| Provider Name | Scott D Didier |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902926264 PECOS PAC ID: 1254431737 Enrollment ID: I20170201000205 |
| Provider Name | Virginia S Owen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588779987 PECOS PAC ID: 4981655891 Enrollment ID: I20170201000450 |
| Provider Name | James E Machin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801901293 PECOS PAC ID: 5193763100 Enrollment ID: I20170201000889 |
| Provider Name | Allen K Tonkin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306951702 PECOS PAC ID: 2567400302 Enrollment ID: I20170207000793 |
| Provider Name | Shannon M Gulla |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225182637 PECOS PAC ID: 0941378582 Enrollment ID: I20170207002685 |
| Provider Name | Dexter H Witte |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982707410 PECOS PAC ID: 7214976588 Enrollment ID: I20170208000589 |
| Provider Name | Alan J Mcleod |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063527455 PECOS PAC ID: 0941248975 Enrollment ID: I20170208001146 |
| Provider Name | Paul R Tanner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003921404 PECOS PAC ID: 9133167935 Enrollment ID: I20170208002115 |
| Provider Name | Craig L Lipman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164537551 PECOS PAC ID: 6901989730 Enrollment ID: I20170208002632 |
| Provider Name | Phillip T Zeni |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982719381 PECOS PAC ID: 9638252463 Enrollment ID: I20170209000149 |
| Provider Name | Michael R Poppy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801332002 PECOS PAC ID: 3870876279 Enrollment ID: I20170209000868 |
| Provider Name | Ranganathan Parthasarathy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831204239 PECOS PAC ID: 8123066958 Enrollment ID: I20170209001464 |
| Provider Name | Daniel J Becker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467567875 PECOS PAC ID: 8224053749 Enrollment ID: I20170210000454 |
| Provider Name | John Andrew Ellzey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447365846 PECOS PAC ID: 0547208332 Enrollment ID: I20170213000824 |
| Provider Name | Dewey D Garner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366557779 PECOS PAC ID: 3476591306 Enrollment ID: I20170213001164 |
| Provider Name | Eric J Tiner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326306879 PECOS PAC ID: 2163669672 Enrollment ID: I20170217000830 |
| Provider Name | Brennan A Weeks |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1962947200 PECOS PAC ID: 7810271327 Enrollment ID: I20170301000992 |
| Provider Name | Keith A Tonkin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114184298 PECOS PAC ID: 0143393710 Enrollment ID: I20170316000820 |
| Provider Name | Heidi R Umphrey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801001680 PECOS PAC ID: 8820149958 Enrollment ID: I20170405002331 |
| Provider Name | Daniel P Luster |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1609314921 PECOS PAC ID: 7214213958 Enrollment ID: I20170413000236 |
| Provider Name | Henry J Dalsania |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144462896 PECOS PAC ID: 2668524588 Enrollment ID: I20170425000243 |
| Provider Name | Adam G Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548467376 PECOS PAC ID: 9739374497 Enrollment ID: I20170509000277 |
| Provider Name | Robbie L Hurtt |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1386908762 PECOS PAC ID: 3678897568 Enrollment ID: I20170725002189 |
| Provider Name | Adrian Jefferson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376785543 PECOS PAC ID: 9335395839 Enrollment ID: I20170731001800 |
| Provider Name | Cheryl D Givens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871746800 PECOS PAC ID: 1850558768 Enrollment ID: I20170801003481 |
| Provider Name | Travis D Ewing |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376980367 PECOS PAC ID: 2567752371 Enrollment ID: I20170809001566 |
| Provider Name | Lyndon R Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750804530 PECOS PAC ID: 4284907544 Enrollment ID: I20170907002805 |
| Provider Name | Jonathan A Holt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487061149 PECOS PAC ID: 3678847654 Enrollment ID: I20170915000024 |
| Provider Name | Jeffrey Guirand |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639532666 PECOS PAC ID: 3274807078 Enrollment ID: I20170918001557 |
| Provider Name | Joseph C Sullivan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043303548 PECOS PAC ID: 9436135910 Enrollment ID: I20170918003605 |
| Provider Name | Gift Eze |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457384588 PECOS PAC ID: 8224017736 Enrollment ID: I20170919003681 |
| Provider Name | Priscilla Fortner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710402870 PECOS PAC ID: 8022383512 Enrollment ID: I20171010000675 |
| Provider Name | Jennifer L Maley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639595788 PECOS PAC ID: 3779887732 Enrollment ID: I20171103000107 |
| Provider Name | Mahesh Aradhya |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437380904 PECOS PAC ID: 7214152396 Enrollment ID: I20171108000096 |
| Provider Name | Heather Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346769155 PECOS PAC ID: 7719243476 Enrollment ID: I20171113002377 |
| Provider Name | Wanda Lakeisha Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720212350 PECOS PAC ID: 1355592916 Enrollment ID: I20171115003278 |
| Provider Name | David L Martineau |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184935447 PECOS PAC ID: 2163713124 Enrollment ID: I20171121001950 |
| Provider Name | Jodi A Turano |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639340599 PECOS PAC ID: 1153495916 Enrollment ID: I20171127000958 |
| Provider Name | Michael C Ketcham |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912910191 PECOS PAC ID: 3476736919 Enrollment ID: I20171127002300 |
| Provider Name | Maria Shih-kwang Li |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1235203415 PECOS PAC ID: 9537139639 Enrollment ID: I20171205000908 |
| Provider Name | Stephen D Morris |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1508971995 PECOS PAC ID: 9234177254 Enrollment ID: I20180103000730 |
| Provider Name | Jessica Rogers Walls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396252482 PECOS PAC ID: 0941561401 Enrollment ID: I20180223001500 |
| Provider Name | Jennifer L Dorris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356857015 PECOS PAC ID: 7618238981 Enrollment ID: I20180301000246 |
| Provider Name | Paul Klimo |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1336127968 PECOS PAC ID: 0941246383 Enrollment ID: I20180316001743 |
| Provider Name | Gerren P Hobby |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1346508470 PECOS PAC ID: 6608138722 Enrollment ID: I20180329000228 |
| Provider Name | Samuel Leibovici |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063585164 PECOS PAC ID: 4183727753 Enrollment ID: I20180410002341 |
| Provider Name | Aaron M Winterstern |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1881034460 PECOS PAC ID: 9537454541 Enrollment ID: I20180424002510 |
| Provider Name | Gregory R Renck |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275645400 PECOS PAC ID: 2668557455 Enrollment ID: I20180510000114 |
| Provider Name | Zhangliang Ma |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1508158106 PECOS PAC ID: 1951617430 Enrollment ID: I20180611001656 |
| Provider Name | Gregory A Szych |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1841268521 PECOS PAC ID: 4688655467 Enrollment ID: I20180626003343 |
| Provider Name | Jacob Jones |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1174036917 PECOS PAC ID: 4082978796 Enrollment ID: I20180703003286 |
| Provider Name | Ali Haydar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487049953 PECOS PAC ID: 7113233123 Enrollment ID: I20180725001528 |
| Provider Name | Navin Mangroo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457748683 PECOS PAC ID: 7113233644 Enrollment ID: I20180730003465 |
| Provider Name | Kristin E Owens |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487074969 PECOS PAC ID: 0042532897 Enrollment ID: I20180803002536 |
| Provider Name | Christopher A Bellamy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447676937 PECOS PAC ID: 4880900521 Enrollment ID: I20180806001578 |
| Provider Name | Katie J Hutton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023503869 PECOS PAC ID: 5597013516 Enrollment ID: I20180808001847 |
| Provider Name | Megan A Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538654538 PECOS PAC ID: 5496004681 Enrollment ID: I20180821003349 |
| Provider Name | Heather Ditto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346736717 PECOS PAC ID: 2264781137 Enrollment ID: I20180827001150 |
| Provider Name | Morgan T Winningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073884276 PECOS PAC ID: 3375894892 Enrollment ID: I20180924000205 |
| Provider Name | Daniel C Grantham |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508261546 PECOS PAC ID: 1153672118 Enrollment ID: I20181002000253 |
| Provider Name | Jordan L Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598244394 PECOS PAC ID: 7810240918 Enrollment ID: I20181018001964 |
| Provider Name | Stefanie Renee Brackin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225512635 PECOS PAC ID: 5092068205 Enrollment ID: I20181105001071 |
| Provider Name | Kyle J Stroup |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932686896 PECOS PAC ID: 5799038956 Enrollment ID: I20181106000097 |
| Provider Name | Natalie N Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194291336 PECOS PAC ID: 9032463203 Enrollment ID: I20181107001900 |
| Provider Name | Justin K Martin |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093283798 PECOS PAC ID: 2466796917 Enrollment ID: I20181210003151 |
| Provider Name | Aimee M Hatch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457836298 PECOS PAC ID: 9931445160 Enrollment ID: I20190109001997 |
| Provider Name | Brandi L Mays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811462138 PECOS PAC ID: 1355687955 Enrollment ID: I20190117001947 |
| Provider Name | Steven D Vanderbilt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063977965 PECOS PAC ID: 4183963432 Enrollment ID: I20190304001063 |
| Provider Name | Jessica M Womble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851858773 PECOS PAC ID: 0143560490 Enrollment ID: I20190322001317 |
| Provider Name | Angela M Pugsley |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1548672413 PECOS PAC ID: 1355668872 Enrollment ID: I20190401002084 |
| Provider Name | Joel Evan Perchik |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1073674875 PECOS PAC ID: 4385792837 Enrollment ID: I20190404002525 |
| Provider Name | Neal E Tice |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013428671 PECOS PAC ID: 5496096075 Enrollment ID: I20190409000322 |
| Provider Name | Michael W Ball |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295259224 PECOS PAC ID: 5799038501 Enrollment ID: I20190507002444 |
| Provider Name | Jeffrey P Mccartney |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1902820004 PECOS PAC ID: 2264331644 Enrollment ID: I20190613002367 |
| Provider Name | John D Braun |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760820625 PECOS PAC ID: 9234486614 Enrollment ID: I20190617000684 |
| Provider Name | Kimberly M Crosskno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033771969 PECOS PAC ID: 1850628520 Enrollment ID: I20190805001063 |
| Provider Name | Jeffery F Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780244517 PECOS PAC ID: 8022345412 Enrollment ID: I20190807003572 |
| Provider Name | Ana Milosevic Michunovich |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1033596663 PECOS PAC ID: 1658648159 Enrollment ID: I20190808003369 |
| Provider Name | Helen F Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801448592 PECOS PAC ID: 5092043893 Enrollment ID: I20190816002625 |
| Provider Name | Vijay Reddy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1164480802 PECOS PAC ID: 4981662400 Enrollment ID: I20190909002959 |
| Provider Name | Jordan Brooke Fletcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336793611 PECOS PAC ID: 3678803624 Enrollment ID: I20190918001263 |
| Provider Name | Jarryd A Dempsey |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013564525 PECOS PAC ID: 1658601737 Enrollment ID: I20191003000400 |
| Provider Name | Brent A Davis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1982254710 PECOS PAC ID: 0749512796 Enrollment ID: I20191024002332 |
| Provider Name | Vemana Jampala |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1538509385 PECOS PAC ID: 4587950274 Enrollment ID: I20191118001039 |
| Provider Name | Danny Lee Ricker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154965036 PECOS PAC ID: 0042642498 Enrollment ID: I20191122002727 |
| Provider Name | Ryan Scott Anderson |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1679117659 PECOS PAC ID: 5698108892 Enrollment ID: I20191202001364 |
| Provider Name | Jennifer L Turnbow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366086787 PECOS PAC ID: 4486087418 Enrollment ID: I20191205002293 |
| Provider Name | Udaykamal Harisinh Barad |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568697522 PECOS PAC ID: 4486819554 Enrollment ID: I20200102000260 |
| Provider Name | Steve M Cordina |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972777290 PECOS PAC ID: 6002084498 Enrollment ID: I20200303002149 |
| Provider Name | Michael Katsnelson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013170067 PECOS PAC ID: 6406989177 Enrollment ID: I20200304000095 |
| Provider Name | Leonard Dasilva |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902873185 PECOS PAC ID: 9830096718 Enrollment ID: I20200402000387 |
| Provider Name | Chasity S Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568000503 PECOS PAC ID: 0749619054 Enrollment ID: I20200408003003 |
| Provider Name | Amirhossein Zangiabadi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326294562 PECOS PAC ID: 8628233517 Enrollment ID: I20200416002546 |
| Provider Name | Kyle A Smith |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1194081232 PECOS PAC ID: 2466770912 Enrollment ID: I20200617001014 |
| Provider Name | Matthew D Harvison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003278052 PECOS PAC ID: 8921390444 Enrollment ID: I20200625000829 |
| Provider Name | Lattimore Madison Michael |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1164413928 PECOS PAC ID: 3476590894 Enrollment ID: I20200625003312 |
| Provider Name | Dexter N Rich |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700270600 PECOS PAC ID: 4880018704 Enrollment ID: I20200723002614 |
| Provider Name | Bassem Koleilat |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578680831 PECOS PAC ID: 1456410349 Enrollment ID: I20200727001548 |
| Provider Name | Clara L Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528686870 PECOS PAC ID: 7911322680 Enrollment ID: I20200729002021 |
| Provider Name | Wanda Faye Mooney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316557705 PECOS PAC ID: 5698190684 Enrollment ID: I20200807001805 |
| Provider Name | Lauren Danielle Lance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982228995 PECOS PAC ID: 3870727381 Enrollment ID: I20200812000178 |
| Provider Name | Daniel Eastlack |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538514971 PECOS PAC ID: 0042500688 Enrollment ID: I20200903000591 |
| Provider Name | Dexter Witte |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174978449 PECOS PAC ID: 6305135989 Enrollment ID: I20200903001209 |
| Provider Name | Enid Burnett |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1750368932 PECOS PAC ID: 8628149051 Enrollment ID: I20200910003596 |
| Provider Name | William Woodruff |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487018768 PECOS PAC ID: 3375835234 Enrollment ID: I20200921000777 |
| Provider Name | Faisal Tawwab |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285927277 PECOS PAC ID: 8921255530 Enrollment ID: I20200921002740 |
| Provider Name | Joe Edd Looney |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942814355 PECOS PAC ID: 2567882632 Enrollment ID: I20201013000056 |
| Provider Name | David Brian Cohen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891912556 PECOS PAC ID: 0446328132 Enrollment ID: I20201026002315 |
| Provider Name | Abby E Grubb |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1548876014 PECOS PAC ID: 4880004621 Enrollment ID: I20201105000680 |
| Provider Name | Katelyn Danielle Lumpkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477154771 PECOS PAC ID: 9739590050 Enrollment ID: I20201117003084 |
| Provider Name | Emily M Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316546138 PECOS PAC ID: 6204247406 Enrollment ID: I20201119000594 |
| Provider Name | Phillip Wayne Stokes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063010874 PECOS PAC ID: 3678984192 Enrollment ID: I20201204000333 |
| Provider Name | Krystyn C Vaughan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932702354 PECOS PAC ID: 6305258781 Enrollment ID: I20201208002142 |
| Provider Name | Ravi D Chauhan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1588621254 PECOS PAC ID: 2163467754 Enrollment ID: I20201228000757 |
| Provider Name | Alan Michael Alabaster |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1295840510 PECOS PAC ID: 7214955830 Enrollment ID: I20210113000466 |
| Provider Name | Aleshia G Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407463938 PECOS PAC ID: 3577977123 Enrollment ID: I20210122001396 |
| Provider Name | Joseph Yates |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518348549 PECOS PAC ID: 8022301621 Enrollment ID: I20210125000789 |
| Provider Name | Tanner Robert Nichols |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053846857 PECOS PAC ID: 5597179408 Enrollment ID: I20210203002187 |
| Provider Name | Todd L Andrews |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407894215 PECOS PAC ID: 7810189073 Enrollment ID: I20210225001515 |
| Provider Name | Amanda L Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073173324 PECOS PAC ID: 0840626214 Enrollment ID: I20210312000600 |
| Provider Name | Balreet Kaur Dhami |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457848384 PECOS PAC ID: 4183971922 Enrollment ID: I20210316000486 |
| Provider Name | Andrew Russell |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326509365 PECOS PAC ID: 1052648169 Enrollment ID: I20210326000245 |
| Provider Name | Angel Y Ramos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912392986 PECOS PAC ID: 8820380413 Enrollment ID: I20210504000411 |
| Provider Name | Amy Jo Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295372233 PECOS PAC ID: 7012316888 Enrollment ID: I20210527000631 |
| Provider Name | Zachary Nahmias |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1093129397 PECOS PAC ID: 9133479363 Enrollment ID: I20210604001953 |
| Provider Name | Ryan Matthew Hamlin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417444050 PECOS PAC ID: 6709134117 Enrollment ID: I20210615000524 |
| Provider Name | James C Lamousin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043227606 PECOS PAC ID: 8022000215 Enrollment ID: I20210709002887 |
| Provider Name | Jeffrey F Liubicich |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730576257 PECOS PAC ID: 4486957867 Enrollment ID: I20210716001344 |
| Provider Name | Sundeep Mummaneni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831693076 PECOS PAC ID: 8123421674 Enrollment ID: I20210721004274 |
| Provider Name | Shoaib Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548767130 PECOS PAC ID: 4385909951 Enrollment ID: I20210722000565 |
| Provider Name | Manuel Ramos Ramirez |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1790190296 PECOS PAC ID: 5395046296 Enrollment ID: I20210722002410 |
| Provider Name | Stephen Hurwitz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134145592 PECOS PAC ID: 0749213221 Enrollment ID: I20210723001429 |
| Provider Name | Jourdan Aromin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598150955 PECOS PAC ID: 4082942776 Enrollment ID: I20210727002524 |
| Provider Name | Dwayne A Narayan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083619951 PECOS PAC ID: 5597909192 Enrollment ID: I20210728000554 |
| Provider Name | Ruth Ann Griffith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316611247 PECOS PAC ID: 1153726005 Enrollment ID: I20210816003660 |
| Provider Name | Shawna R Ferguson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679246219 PECOS PAC ID: 6507261450 Enrollment ID: I20210816003770 |
| Provider Name | William B Roth |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033615737 PECOS PAC ID: 4880099308 Enrollment ID: I20210823000622 |
| Provider Name | Elizabeth Jean Sneed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710588462 PECOS PAC ID: 1850797408 Enrollment ID: I20210907001122 |
| Provider Name | Purushothaman Muthusamy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1033473285 PECOS PAC ID: 8426287871 Enrollment ID: I20210913000846 |
| Provider Name | Alexis J Pilgrim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316618309 PECOS PAC ID: 0547667776 Enrollment ID: I20210930000746 |
| Provider Name | Kyle Madden |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093480550 PECOS PAC ID: 3779981139 Enrollment ID: I20211015000411 |
| Provider Name | Ashley N Featherston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144836347 PECOS PAC ID: 6406254762 Enrollment ID: I20211018001662 |
| Provider Name | Courtney L Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255901963 PECOS PAC ID: 8921496209 Enrollment ID: I20211020000575 |
| Provider Name | Allison P Swanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972532570 PECOS PAC ID: 8325041965 Enrollment ID: I20211020003148 |
| Provider Name | Abteen Moshref |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538657457 PECOS PAC ID: 0446648166 Enrollment ID: I20211030000019 |
| Provider Name | Ernest Spiotto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902331747 PECOS PAC ID: 2961772314 Enrollment ID: I20211208000392 |
| Provider Name | Benjamin Dwight Mills |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477119543 PECOS PAC ID: 1759618861 Enrollment ID: I20220131001717 |
| Provider Name | John Austin Turner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699238964 PECOS PAC ID: 8527395540 Enrollment ID: I20220131002342 |
| Provider Name | Dylan Jeffrey Hooks |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285197798 PECOS PAC ID: 9234466202 Enrollment ID: I20220201002223 |
| Provider Name | Ashok A Jayashankar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154509206 PECOS PAC ID: 3375618929 Enrollment ID: I20220215002073 |
| Provider Name | Jesse Ray Barnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881348779 PECOS PAC ID: 3274928130 Enrollment ID: I20220312000030 |
| Provider Name | Stephen Bowie |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235585480 PECOS PAC ID: 5092007948 Enrollment ID: I20220516001643 |
| Provider Name | Emilio Cazano |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1780037382 PECOS PAC ID: 3375920135 Enrollment ID: I20220517000143 |
| Provider Name | Lena Z Awar |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1346660727 PECOS PAC ID: 0345590865 Enrollment ID: I20220519000409 |
| Provider Name | Nathan G Perrin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033857628 PECOS PAC ID: 4183003932 Enrollment ID: I20220624000642 |
| Provider Name | Edwin Suarez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588169965 PECOS PAC ID: 4284968926 Enrollment ID: I20220628002993 |
| Provider Name | Joel A Whipple |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679006787 PECOS PAC ID: 3072995752 Enrollment ID: I20220727001901 |
| Provider Name | Jared L Burks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104388081 PECOS PAC ID: 6204161664 Enrollment ID: I20220806000020 |
| Provider Name | Rachel D Orozco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821720160 PECOS PAC ID: 4587046586 Enrollment ID: I20220808003171 |
| Provider Name | Marc Luckett |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881667608 PECOS PAC ID: 4587602966 Enrollment ID: I20220809001774 |
| Provider Name | Christopher R Malone |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1184343329 PECOS PAC ID: 9830573153 Enrollment ID: I20220905000017 |
| Provider Name | Brian Quigley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063617033 PECOS PAC ID: 6507966207 Enrollment ID: I20221012000070 |
| Provider Name | Katherine D Mellow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629791009 PECOS PAC ID: 9830565993 Enrollment ID: I20221014002480 |
| Provider Name | Andrew G Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295171734 PECOS PAC ID: 9537420245 Enrollment ID: I20221117002958 |
| Provider Name | Jeremiah H Wright |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437288016 PECOS PAC ID: 8729244017 Enrollment ID: I20221118001966 |
| Provider Name | Charles L Perkins |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851346621 PECOS PAC ID: 3971516147 Enrollment ID: I20221206002921 |
| Provider Name | Carolyn M Armstrong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487391306 PECOS PAC ID: 7012385008 Enrollment ID: I20221222002080 |
| Provider Name | Christian Paige Parnell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538797709 PECOS PAC ID: 5092130401 Enrollment ID: I20230112000713 |
| Provider Name | Javed Syed Iqbal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649614462 PECOS PAC ID: 2769609957 Enrollment ID: I20230113000924 |
| Provider Name | Sharon M Dowell |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1225214463 PECOS PAC ID: 8123277589 Enrollment ID: I20230124003548 |
| Provider Name | Magdy F Giurgius |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184878555 PECOS PAC ID: 3779704259 Enrollment ID: I20230218000492 |
| Provider Name | Jonathan P Vecchiarelli |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1760833123 PECOS PAC ID: 4688099989 Enrollment ID: I20230309000170 |
| Provider Name | Jackson Benjamin Troxel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255950069 PECOS PAC ID: 5395160196 Enrollment ID: I20230322001055 |
| Provider Name | Amber D Ray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881394526 PECOS PAC ID: 0941675516 Enrollment ID: I20230413000027 |
| Provider Name | Fabio Alberto Barrera Pena |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487038105 PECOS PAC ID: 8325397516 Enrollment ID: I20230420000230 |
| Provider Name | Mary Kate Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669176251 PECOS PAC ID: 5496110751 Enrollment ID: I20230420002661 |
| Provider Name | Anna Kathryn Easterling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134579758 PECOS PAC ID: 8921391954 Enrollment ID: I20230424001053 |
| Provider Name | Brian R Decosta |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689620627 PECOS PAC ID: 0143299610 Enrollment ID: I20230525002327 |
| Provider Name | Savannah R Agee |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932893690 PECOS PAC ID: 2769849538 Enrollment ID: I20230609000840 |
| Provider Name | Olayiwola Salmon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457585739 PECOS PAC ID: 7012062029 Enrollment ID: I20230710001433 |
| Provider Name | Christopher Douglas Bonner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740917640 PECOS PAC ID: 0143699280 Enrollment ID: I20230808003303 |
| Provider Name | Kerry Gregory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588267819 PECOS PAC ID: 1658733100 Enrollment ID: I20230815002502 |
| Provider Name | Amber N Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790468833 PECOS PAC ID: 2264895093 Enrollment ID: I20230828001720 |
| Provider Name | Abdallah Malkawi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124505730 PECOS PAC ID: 9133478100 Enrollment ID: I20230912004140 |
| Provider Name | Shravan R Chintalapani |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215431184 PECOS PAC ID: 4183968126 Enrollment ID: I20230913004358 |
| Provider Name | Jianbin Zheng |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1043766538 PECOS PAC ID: 2466748371 Enrollment ID: I20231106000863 |
| Provider Name | Joseph Wesley Bennett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316513443 PECOS PAC ID: 7517369358 Enrollment ID: I20231109002601 |
| Provider Name | John M Triplett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356306716 PECOS PAC ID: 2163328766 Enrollment ID: I20231114003215 |
| Provider Name | Charles K Pringle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356454334 PECOS PAC ID: 6204936669 Enrollment ID: I20231204000899 |
| Provider Name | Scott E Yochim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336341726 PECOS PAC ID: 5092869560 Enrollment ID: I20231204001354 |
| Provider Name | Brian Lain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902265408 PECOS PAC ID: 1254671886 Enrollment ID: I20231218001754 |
| Provider Name | Anudeep Kommineni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730703810 PECOS PAC ID: 1153742655 Enrollment ID: I20231229000670 |
| Provider Name | Lauren Piersall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386133239 PECOS PAC ID: 8022365998 Enrollment ID: I20240117003404 |
| Provider Name | Milap Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285210971 PECOS PAC ID: 3072915768 Enrollment ID: I20240209003882 |
| Provider Name | Muaamar B Baldawi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063031086 PECOS PAC ID: 6305261181 Enrollment ID: I20240227001776 |
| Provider Name | Niki Samir Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275110249 PECOS PAC ID: 2062814866 Enrollment ID: I20240322003922 |
| Provider Name | Basil M Paulus |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1073731592 PECOS PAC ID: 4981762549 Enrollment ID: I20240422002000 |
| Provider Name | Olga Jatskevich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073191359 PECOS PAC ID: 2466891429 Enrollment ID: I20240423004385 |
| Provider Name | Malek Alaiwah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770143232 PECOS PAC ID: 1850626904 Enrollment ID: I20240514000589 |
| Provider Name | Derika Mays |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336722842 PECOS PAC ID: 5395147060 Enrollment ID: I20240812004130 |
| Provider Name | Logan W Best |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972184562 PECOS PAC ID: 1355745498 Enrollment ID: I20240814002741 |
| Provider Name | London P Foulk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629846514 PECOS PAC ID: 8729527619 Enrollment ID: I20240822003714 |
| Provider Name | Heather Rodreiguez Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255735551 PECOS PAC ID: 7517406770 Enrollment ID: I20240831000621 |
| Provider Name | Jordon H Towell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750961363 PECOS PAC ID: 6608270723 Enrollment ID: I20240910004957 |
| Provider Name | Emma Cherry |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1598599789 PECOS PAC ID: 8426598806 Enrollment ID: I20240912000530 |
| Provider Name | Cynthia D Norsworthy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275132474 PECOS PAC ID: 3072927045 Enrollment ID: I20240916000781 |
| Provider Name | Kelsea E Livingston |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1104473529 PECOS PAC ID: 7113354218 Enrollment ID: I20241007000316 |
| Provider Name | Tiffany D Crites |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043030513 PECOS PAC ID: 7719410646 Enrollment ID: I20241030001207 |
| Provider Name | Gemma Toledo |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730906611 PECOS PAC ID: 7618401597 Enrollment ID: I20241114002841 |
| Provider Name | Oreoluwa D Oladiran |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1275057861 PECOS PAC ID: 0143592204 Enrollment ID: I20250121001751 |
| Provider Name | Taylor Justine Rutherford |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598407553 PECOS PAC ID: 7618358938 Enrollment ID: I20250123001682 |
| Provider Name | Damon M Kennedy |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1992733224 PECOS PAC ID: 9739150608 Enrollment ID: I20250127000203 |
| Provider Name | John-paul Maravelias |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952043069 PECOS PAC ID: 7810378213 Enrollment ID: I20250128000116 |
| Provider Name | Grant Robert Conner |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1982346276 PECOS PAC ID: 7315328655 Enrollment ID: I20250129002337 |
| Provider Name | Zachary Craig Peden |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1407598469 PECOS PAC ID: 2264813823 Enrollment ID: I20250220002157 |
| Provider Name | Furqan Syed |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1558742346 PECOS PAC ID: 9133423635 Enrollment ID: I20250404001964 |
| Provider Name | Kassidy Richardson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1184314940 PECOS PAC ID: 1355798844 Enrollment ID: I20250430001571 |
| Provider Name | Joshua Vincent Ackley |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821788647 PECOS PAC ID: 6204295215 Enrollment ID: I20250506003004 |
| Provider Name | Vimal P Amin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1366464497 PECOS PAC ID: 5890771679 Enrollment ID: I20250528003759 |
| Provider Name | Shymeka Maria Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992518245 PECOS PAC ID: 4385153204 Enrollment ID: I20250603000826 |
| Provider Name | Cristy S Phillips |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568441715 PECOS PAC ID: 9335659382 Enrollment ID: I20250609002022 |
Men & Womens Premier Health Solutions Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3410 E Johnson Ave Ste T, Jonesboro, AR 72401 Phone: 870-333-5488 Fax: 870-333-5442 | |
Raising The Standards Of Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 361 Southwest Dr Ste 771, Jonesboro, AR 72401 Phone: 870-559-5006 | |
Jason R. Casey, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 Osler Dr, Suite B, Jonesboro, AR 72401 Phone: 870-931-7383 Fax: 870-931-7353 | |
Gl Cranfill Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 615 E Matthews, Ste C, Jonesboro, AR 72401 Phone: 870-802-3548 Fax: 870-802-2568 | |
Arcare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 416 E Washington Ave, Jonesboro, AR 72401 Phone: 870-333-5476 Fax: 870-333-5475 | |
Arkeaccess Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3024 Red Wolf Blvd, Jonesboro, AR 72401 Phone: 870-926-1198 | |
Northeast Arkansas Community Mental Health Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2707 Browns Ln, Jonesboro, AR 72401 Phone: 870-972-4050 |