| Peachtree Immediate Care Fp, Llc | |
|
3827 Jimmy Lee Smith Pkwy Hiram GA 30141-2630 | |
| (770) 222-8900 | |
| (770) 222-2757 |
| Full Name | Peachtree Immediate Care Fp, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3827 Jimmy Lee Smith Pkwy, Hiram, Georgia |
| Authorized Official Name and Position | Andrea Malik-roe (CFO) |
| Authorized Official Contact | 6785046392 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peachtree Immediate Care Fp, Llc 3827 Jimmy Lee Smith Pkwy Hiram GA 30141-2630 Ph: (770) 222-8900 | Peachtree Immediate Care Fp, Llc 3827 Jimmy Lee Smith Pkwy Hiram GA 30141-2630 Ph: (770) 222-8900 |
| NPI Number | 1437194156 |
|---|---|
| Provider Enumeration Date | 06/17/2006 |
| Last Update Date | 02/20/2017 |
| Medicare PECOS PAC ID | 3274559323 |
|---|---|
| Medicare Enrollment ID | O20051019000049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437194156 | NPI | - | NPPES |
| 003137060A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Wayne Hodges |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942233705 PECOS PAC ID: 2769376417 Enrollment ID: I20040212000263 |
| Provider Name | Catherine K Dickens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770670259 PECOS PAC ID: 3577451012 Enrollment ID: I20040308000374 |
| Provider Name | Alan Bannett Miller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073770046 PECOS PAC ID: 0749178978 Enrollment ID: I20040309000298 |
| Provider Name | Martha A Schuh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629046768 PECOS PAC ID: 0143212407 Enrollment ID: I20040331000197 |
| Provider Name | David N Isaac |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093765067 PECOS PAC ID: 1254321268 Enrollment ID: I20040513000140 |
| Provider Name | Robert Van Gallera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881872000 PECOS PAC ID: 3375443252 Enrollment ID: I20040519000801 |
| Provider Name | Michael D Mudrey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376574863 PECOS PAC ID: 0042292120 Enrollment ID: I20040602001450 |
| Provider Name | David Asrael |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386694511 PECOS PAC ID: 3577547058 Enrollment ID: I20040614000845 |
| Provider Name | Kenneth S Jago |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538133905 PECOS PAC ID: 3375515406 Enrollment ID: I20040810000520 |
| Provider Name | Karen B Ivey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760463517 PECOS PAC ID: 7810961232 Enrollment ID: I20040823000472 |
| Provider Name | Gregory J Matechak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851492672 PECOS PAC ID: 2769456946 Enrollment ID: I20040824000130 |
| Provider Name | Salvatore C Assorgi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083662241 PECOS PAC ID: 2062488588 Enrollment ID: I20040907000888 |
| Provider Name | Darryl S Gross |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1649228594 PECOS PAC ID: 2365411261 Enrollment ID: I20041004000510 |
| Provider Name | Henry Ngo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518954627 PECOS PAC ID: 7618926239 Enrollment ID: I20050120000503 |
| Provider Name | Catherine Z Puckett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538281407 PECOS PAC ID: 9133171820 Enrollment ID: I20050210000369 |
| Provider Name | Allison Ventura |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518011568 PECOS PAC ID: 7315985488 Enrollment ID: I20050419001364 |
| Provider Name | Paula Hardy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912956061 PECOS PAC ID: 1052352952 Enrollment ID: I20050520000717 |
| Provider Name | Bradford M Gould |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396895033 PECOS PAC ID: 6406871615 Enrollment ID: I20051006000847 |
| Provider Name | Angela L Muhammad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689622516 PECOS PAC ID: 1850316670 Enrollment ID: I20051011000783 |
| Provider Name | Joseph Pafumy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992762314 PECOS PAC ID: 6901822055 Enrollment ID: I20051019000070 |
| Provider Name | John S Lammert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699727909 PECOS PAC ID: 2668499708 Enrollment ID: I20051028000259 |
| Provider Name | Shameka H Mcelhaney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144231598 PECOS PAC ID: 6204854425 Enrollment ID: I20051107000449 |
| Provider Name | Jodi W Vann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154496693 PECOS PAC ID: 4789692120 Enrollment ID: I20060328000071 |
| Provider Name | Kris Manlove Simmons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649369422 PECOS PAC ID: 0345251252 Enrollment ID: I20060508000039 |
| Provider Name | Lonny E Horowitz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1568475515 PECOS PAC ID: 2163433830 Enrollment ID: I20060509000524 |
| Provider Name | Kerry Nagel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376589119 PECOS PAC ID: 1658374699 Enrollment ID: I20060814000155 |
| Provider Name | Mark E Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538190012 PECOS PAC ID: 8325044829 Enrollment ID: I20061005000457 |
| Provider Name | Carol J Scully |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952383192 PECOS PAC ID: 0446356794 Enrollment ID: I20070502000294 |
| Provider Name | Brandi Willard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619083797 PECOS PAC ID: 2264523828 Enrollment ID: I20070810000459 |
| Provider Name | Erin D London |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851359038 PECOS PAC ID: 7719079243 Enrollment ID: I20070913000295 |
| Provider Name | Hicham Churbaji |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629023924 PECOS PAC ID: 6103809025 Enrollment ID: I20080130000378 |
| Provider Name | Tracey Patrice Sills |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629154067 PECOS PAC ID: 6800979477 Enrollment ID: I20080206000340 |
| Provider Name | Christian Wojciech Jansen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245201144 PECOS PAC ID: 1153404215 Enrollment ID: I20080212000634 |
| Provider Name | Joseph G Saulsbury |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1447376058 PECOS PAC ID: 7315021730 Enrollment ID: I20080225000271 |
| Provider Name | Amy E Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326264904 PECOS PAC ID: 8527142942 Enrollment ID: I20080225000341 |
| Provider Name | Nadine S Halliburton-foster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578596029 PECOS PAC ID: 5890730469 Enrollment ID: I20080326000009 |
| Provider Name | Theron W Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033185681 PECOS PAC ID: 9638258924 Enrollment ID: I20080512000743 |
| Provider Name | Sharon M Haynes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467413013 PECOS PAC ID: 5890864870 Enrollment ID: I20080516000144 |
| Provider Name | Kenneth Macleod Rice |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831148063 PECOS PAC ID: 0547251126 Enrollment ID: I20080520000099 |
| Provider Name | Steven C Leuallen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942346838 PECOS PAC ID: 3678643632 Enrollment ID: I20080603000044 |
| Provider Name | Christopher J Mathews |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306845458 PECOS PAC ID: 2668542580 Enrollment ID: I20080604000546 |
| Provider Name | Helen C Medlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053572172 PECOS PAC ID: 1951474501 Enrollment ID: I20080716000029 |
| Provider Name | Verona Andrea Reid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548422421 PECOS PAC ID: 8921174202 Enrollment ID: I20080910000568 |
| Provider Name | Tracy A Cartledge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750532669 PECOS PAC ID: 9537229281 Enrollment ID: I20081125000516 |
| Provider Name | Camille P Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356545586 PECOS PAC ID: 1456415603 Enrollment ID: I20090203000112 |
| Provider Name | Jennifer Shannon Chimento |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326280900 PECOS PAC ID: 3072662055 Enrollment ID: I20090715000271 |
| Provider Name | George J Petro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164522330 PECOS PAC ID: 9931253713 Enrollment ID: I20090812000924 |
| Provider Name | Shannon Heath Trowell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528283520 PECOS PAC ID: 2961564224 Enrollment ID: I20091020000101 |
| Provider Name | Rashante Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063660223 PECOS PAC ID: 1456498955 Enrollment ID: I20091102000061 |
| Provider Name | Robert J Norris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932183845 PECOS PAC ID: 0345384707 Enrollment ID: I20100223000498 |
| Provider Name | Philip N Henderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316963358 PECOS PAC ID: 3678617982 Enrollment ID: I20100224000188 |
| Provider Name | Shashank C Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598716995 PECOS PAC ID: 1456317031 Enrollment ID: I20100329000965 |
| Provider Name | Joseangel Bedoya |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265645907 PECOS PAC ID: 8527110436 Enrollment ID: I20100414000475 |
| Provider Name | Terry L Robinson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205964657 PECOS PAC ID: 0547391260 Enrollment ID: I20100624000493 |
| Provider Name | Judith F Donnan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740253756 PECOS PAC ID: 8820129323 Enrollment ID: I20100628000418 |
| Provider Name | James Yost |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295910073 PECOS PAC ID: 0042402471 Enrollment ID: I20101004001439 |
| Provider Name | Leanne D Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407152838 PECOS PAC ID: 1951584705 Enrollment ID: I20110331000783 |
| Provider Name | Tyra Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477727543 PECOS PAC ID: 4688850175 Enrollment ID: I20110518000247 |
| Provider Name | Melvin Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962511535 PECOS PAC ID: 9830367879 Enrollment ID: I20110719000486 |
| Provider Name | Johnetta G Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609952688 PECOS PAC ID: 9739278870 Enrollment ID: I20110809000371 |
| Provider Name | Shawna M Berg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598047730 PECOS PAC ID: 7911179221 Enrollment ID: I20111011000114 |
| Provider Name | Haroon Mian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326210899 PECOS PAC ID: 9830385244 Enrollment ID: I20111109000639 |
| Provider Name | Torrence T Drakeford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619911344 PECOS PAC ID: 9133384639 Enrollment ID: I20120709000248 |
| Provider Name | Marilyn Elaine Whitening |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730448564 PECOS PAC ID: 2365607868 Enrollment ID: I20120709000306 |
| Provider Name | Solomon I Teckle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154582971 PECOS PAC ID: 1456480698 Enrollment ID: I20120927000422 |
| Provider Name | Fidias E De Leon |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1871756155 PECOS PAC ID: 6507909835 Enrollment ID: I20121024000231 |
| Provider Name | Patrice Y Marshall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518083617 PECOS PAC ID: 6002067394 Enrollment ID: I20121114000378 |
| Provider Name | Thomas Federico |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114035243 PECOS PAC ID: 8729139357 Enrollment ID: I20121218000139 |
| Provider Name | Douglas Ray White |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568683506 PECOS PAC ID: 1658516661 Enrollment ID: I20130322000120 |
| Provider Name | Omari Hodge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538470646 PECOS PAC ID: 2062690340 Enrollment ID: I20130807000200 |
| Provider Name | Jennifer E Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942520093 PECOS PAC ID: 9830346618 Enrollment ID: I20130904000806 |
| Provider Name | Amie P May |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710310479 PECOS PAC ID: 0345474052 Enrollment ID: I20131014000413 |
| Provider Name | Bennie L Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770570236 PECOS PAC ID: 5597749333 Enrollment ID: I20131119000949 |
| Provider Name | Joni Baumann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083038012 PECOS PAC ID: 3577795962 Enrollment ID: I20140417001616 |
| Provider Name | Camille S Lundi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649611104 PECOS PAC ID: 4082847488 Enrollment ID: I20140509002109 |
| Provider Name | Larissa A Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063832731 PECOS PAC ID: 8729202593 Enrollment ID: I20140617002336 |
| Provider Name | Sonia Mccallister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093069775 PECOS PAC ID: 1254585060 Enrollment ID: I20140619002373 |
| Provider Name | Jessica L Courson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972914497 PECOS PAC ID: 3577789726 Enrollment ID: I20140723001917 |
| Provider Name | Meredith Keeley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306250121 PECOS PAC ID: 7113145285 Enrollment ID: I20140903000105 |
| Provider Name | Babak Saadatmand |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114973450 PECOS PAC ID: 5092711697 Enrollment ID: I20140911001331 |
| Provider Name | Sharmin Banu Anam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922307610 PECOS PAC ID: 9931328036 Enrollment ID: I20140923001564 |
| Provider Name | Mary Kathleen Humphries |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578862173 PECOS PAC ID: 8224258991 Enrollment ID: I20140930002574 |
| Provider Name | Lauren Leblanc Herriot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912314451 PECOS PAC ID: 6901027614 Enrollment ID: I20141022001181 |
| Provider Name | Blessing Ikonne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780091983 PECOS PAC ID: 3375765753 Enrollment ID: I20141119002700 |
| Provider Name | Murray M Van Lear |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568865509 PECOS PAC ID: 1254655152 Enrollment ID: I20150126000710 |
| Provider Name | Muhammad S Hashmi |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1467762815 PECOS PAC ID: 8921323874 Enrollment ID: I20150217001037 |
| Provider Name | Jeremy W Beck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952708984 PECOS PAC ID: 1951627744 Enrollment ID: I20150314000164 |
| Provider Name | Robyn Lance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609217108 PECOS PAC ID: 7810216132 Enrollment ID: I20150507000926 |
| Provider Name | Bryce Alain Moody |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396189403 PECOS PAC ID: 9638312002 Enrollment ID: I20150713001571 |
| Provider Name | Kinzi Shewmake |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568473809 PECOS PAC ID: 3577633791 Enrollment ID: I20150716000494 |
| Provider Name | Nihinlolawa Oreoluwa Ijamakinwa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174843833 PECOS PAC ID: 8426284571 Enrollment ID: I20151012001271 |
| Provider Name | Adebowale Akintayo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902148752 PECOS PAC ID: 8527377043 Enrollment ID: I20151023002099 |
| Provider Name | Marjorie Burnette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265802649 PECOS PAC ID: 9234448499 Enrollment ID: I20151029000912 |
| Provider Name | Joshua Stauffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427027325 PECOS PAC ID: 5092851345 Enrollment ID: I20151116001442 |
| Provider Name | Autherine N Abiri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679948525 PECOS PAC ID: 1254632722 Enrollment ID: I20151229001678 |
| Provider Name | Christopher James Cottle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740647312 PECOS PAC ID: 4082919733 Enrollment ID: I20160218000762 |
| Provider Name | Foroogh Narmani-mohammadi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447659347 PECOS PAC ID: 3678878758 Enrollment ID: I20160226002154 |
| Provider Name | Hiroyuki Tada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710346895 PECOS PAC ID: 7911203708 Enrollment ID: I20160303001946 |
| Provider Name | Dorothy Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104298900 PECOS PAC ID: 3779889035 Enrollment ID: I20160311001874 |
| Provider Name | Kristin Nd Oliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114388378 PECOS PAC ID: 9830498948 Enrollment ID: I20160425000433 |
| Provider Name | Miriam Layne Vohrer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114381282 PECOS PAC ID: 4789983222 Enrollment ID: I20160504001419 |
| Provider Name | Kelly M Boyette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053771923 PECOS PAC ID: 5799084083 Enrollment ID: I20160509002094 |
| Provider Name | John R Destito |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1770540841 PECOS PAC ID: 3476455312 Enrollment ID: I20160523000917 |
| Provider Name | Yusef Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699904243 PECOS PAC ID: 5597911487 Enrollment ID: I20160613000609 |
| Provider Name | Dongjin Yoon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851501266 PECOS PAC ID: 5799964136 Enrollment ID: I20160705000198 |
| Provider Name | Kelsey G Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770942245 PECOS PAC ID: 7618269523 Enrollment ID: I20160713002814 |
| Provider Name | Iti Kansal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588021299 PECOS PAC ID: 3173816048 Enrollment ID: I20160729001588 |
| Provider Name | Angela Rivers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033571047 PECOS PAC ID: 6204124456 Enrollment ID: I20161004001799 |
| Provider Name | Dionne Tehsheen Bravo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215385992 PECOS PAC ID: 5991093395 Enrollment ID: I20161018003034 |
| Provider Name | Lucy Bibisi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356715726 PECOS PAC ID: 4486951720 Enrollment ID: I20161028000420 |
| Provider Name | Margaret Adofo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164845780 PECOS PAC ID: 1254653793 Enrollment ID: I20161031001161 |
| Provider Name | Kelly Pearce Mccarter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194092601 PECOS PAC ID: 7618299165 Enrollment ID: I20161118002243 |
| Provider Name | Sydney R Deal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790198919 PECOS PAC ID: 0143501858 Enrollment ID: I20170111000688 |
| Provider Name | Steven Gunter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164965141 PECOS PAC ID: 2466733100 Enrollment ID: I20170111002050 |
| Provider Name | Amber C Pittman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235689217 PECOS PAC ID: 8921380130 Enrollment ID: I20170124001529 |
| Provider Name | Petrenia A Davis-jenkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710143128 PECOS PAC ID: 4486957123 Enrollment ID: I20170206000283 |
| Provider Name | Crystal Branch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295272532 PECOS PAC ID: 2961786355 Enrollment ID: I20170302002167 |
| Provider Name | Purnima Bansal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992955736 PECOS PAC ID: 1850541962 Enrollment ID: I20170615001286 |
| Provider Name | Vaughn D Tatum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841309994 PECOS PAC ID: 8224079223 Enrollment ID: I20170615002170 |
| Provider Name | Nikisha Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154868404 PECOS PAC ID: 2062780513 Enrollment ID: I20170626000398 |
| Provider Name | Clifton Blayne Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659799757 PECOS PAC ID: 4688953037 Enrollment ID: I20170725002556 |
| Provider Name | Jonathan Daniel Bailey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780986570 PECOS PAC ID: 0244501112 Enrollment ID: I20170810003184 |
| Provider Name | Christopher L Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225565393 PECOS PAC ID: 2163793936 Enrollment ID: I20170814000522 |
| Provider Name | Riliwanu Aliu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619397197 PECOS PAC ID: 1355643552 Enrollment ID: I20170830000270 |
| Provider Name | Nancy D. Sellars |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770003097 PECOS PAC ID: 8022381490 Enrollment ID: I20170906003157 |
| Provider Name | Tony Bullon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881089993 PECOS PAC ID: 8921302399 Enrollment ID: I20170926002684 |
| Provider Name | Gentry E Tolbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144517038 PECOS PAC ID: 7012282924 Enrollment ID: I20171003005590 |
| Provider Name | Candace L Colston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730574450 PECOS PAC ID: 7810253218 Enrollment ID: I20171116002728 |
| Provider Name | Kacie Parrish Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003287533 PECOS PAC ID: 6002173242 Enrollment ID: I20171127001736 |
| Provider Name | Dominique J Mcintosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689198798 PECOS PAC ID: 5294092268 Enrollment ID: I20171129001609 |
| Provider Name | Tanya Renee Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619323482 PECOS PAC ID: 3779840756 Enrollment ID: I20171129001866 |
| Provider Name | Maliha Beg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790171643 PECOS PAC ID: 2668778929 Enrollment ID: I20171205001562 |
| Provider Name | Miranda D Fincher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669982161 PECOS PAC ID: 1951668581 Enrollment ID: I20171206001839 |
| Provider Name | Jasmine Mcdaniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255721122 PECOS PAC ID: 5092074336 Enrollment ID: I20180113000019 |
| Provider Name | Rachel Warburton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083133300 PECOS PAC ID: 8527327634 Enrollment ID: I20180118001334 |
| Provider Name | Ochuko A Odjegba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871785006 PECOS PAC ID: 8628261658 Enrollment ID: I20180529001673 |
| Provider Name | Davon L Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396126397 PECOS PAC ID: 4880902907 Enrollment ID: I20180604003088 |
| Provider Name | Claudia Lewis Comrie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437664463 PECOS PAC ID: 5890040083 Enrollment ID: I20180611003000 |
| Provider Name | Lisa Roseberry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871969469 PECOS PAC ID: 5799031860 Enrollment ID: I20180702003356 |
| Provider Name | Pamela Rubio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114473857 PECOS PAC ID: 1658627724 Enrollment ID: I20180702003561 |
| Provider Name | Thuy T Doan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508277559 PECOS PAC ID: 6305148586 Enrollment ID: I20180705002333 |
| Provider Name | Martin Asberry Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770082620 PECOS PAC ID: 5799033262 Enrollment ID: I20180731004201 |
| Provider Name | Brandon Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053801860 PECOS PAC ID: 8628327236 Enrollment ID: I20180815001085 |
| Provider Name | Kavita S Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700143849 PECOS PAC ID: 2163746173 Enrollment ID: I20180905002177 |
| Provider Name | Darione Jean-charles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093197154 PECOS PAC ID: 3971811092 Enrollment ID: I20180905003886 |
| Provider Name | Kristin D Carver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174921100 PECOS PAC ID: 9133479280 Enrollment ID: I20180911001754 |
| Provider Name | Lise-stephana Francois |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336510205 PECOS PAC ID: 9931450749 Enrollment ID: I20180918002256 |
| Provider Name | Elizabeth Noland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831692979 PECOS PAC ID: 8022369636 Enrollment ID: I20180920002202 |
| Provider Name | Olga Kukharchuk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699278705 PECOS PAC ID: 7810248440 Enrollment ID: I20180920003154 |
| Provider Name | Phuong Dinh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760846216 PECOS PAC ID: 8224389234 Enrollment ID: I20181001001358 |
| Provider Name | Lynei Woodard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407366107 PECOS PAC ID: 7517219538 Enrollment ID: I20181002002838 |
| Provider Name | Margaret Rene Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609324631 PECOS PAC ID: 2466704689 Enrollment ID: I20181016001955 |
| Provider Name | Jessica Haney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366927766 PECOS PAC ID: 3971856816 Enrollment ID: I20181023003289 |
| Provider Name | Angelique Letrell Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790298222 PECOS PAC ID: 0042563793 Enrollment ID: I20181025001527 |
| Provider Name | Ross Jameson Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790200087 PECOS PAC ID: 7810240207 Enrollment ID: I20181101001641 |
| Provider Name | Morine Woodhouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467765628 PECOS PAC ID: 1355685405 Enrollment ID: I20181130001858 |
| Provider Name | Brandee M Mcdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548769151 PECOS PAC ID: 7113261728 Enrollment ID: I20181210001260 |
| Provider Name | Krystal Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740782002 PECOS PAC ID: 1254676406 Enrollment ID: I20181218000004 |
| Provider Name | Noushin Vastani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457829806 PECOS PAC ID: 2567707722 Enrollment ID: I20181218000218 |
| Provider Name | Laura M Avila |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346738655 PECOS PAC ID: 4082959242 Enrollment ID: I20181218000351 |
| Provider Name | Beverly Denise Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316451735 PECOS PAC ID: 9436494572 Enrollment ID: I20181218004024 |
| Provider Name | Jeanne B Talbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841777208 PECOS PAC ID: 6507101524 Enrollment ID: I20181219003484 |
| Provider Name | Kimberly D Hoffman Goodson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548231681 PECOS PAC ID: 2961429808 Enrollment ID: I20181220000362 |
| Provider Name | Billie Clark Cathey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710452685 PECOS PAC ID: 3577809649 Enrollment ID: I20190110000636 |
| Provider Name | Elizabeth M Sipple |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972010452 PECOS PAC ID: 7315283413 Enrollment ID: I20190110001903 |
| Provider Name | Charles A Mcelveen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487139739 PECOS PAC ID: 8325384449 Enrollment ID: I20190110002406 |
| Provider Name | John L Schoenwald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992734446 PECOS PAC ID: 7113061052 Enrollment ID: I20190111001408 |
| Provider Name | Robin Woodberry |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1205009636 PECOS PAC ID: 2365788130 Enrollment ID: I20190115003639 |
| Provider Name | Nikki F Govner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730666025 PECOS PAC ID: 5799023693 Enrollment ID: I20190220000184 |
| Provider Name | Victoria Louise Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740755941 PECOS PAC ID: 8123367802 Enrollment ID: I20190222002812 |
| Provider Name | Seth Hanson Garrett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396290946 PECOS PAC ID: 7214276500 Enrollment ID: I20190304002499 |
| Provider Name | Ronalda Barie Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457855108 PECOS PAC ID: 3072852987 Enrollment ID: I20190311001292 |
| Provider Name | Stacy M Hendrix |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386120889 PECOS PAC ID: 6002154317 Enrollment ID: I20190311002136 |
| Provider Name | Nneka L Okpara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063964039 PECOS PAC ID: 8527328467 Enrollment ID: I20190313003083 |
| Provider Name | Nycole Ashley Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497232383 PECOS PAC ID: 0749520021 Enrollment ID: I20190323000062 |
| Provider Name | Shaune I Fuller-gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386127744 PECOS PAC ID: 6103166111 Enrollment ID: I20190328001601 |
| Provider Name | Megan T Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760946511 PECOS PAC ID: 6406196450 Enrollment ID: I20190329000352 |
| Provider Name | Ugochi Nneka Adewumi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396104659 PECOS PAC ID: 4789926049 Enrollment ID: I20190507001536 |
| Provider Name | Colleen E Mccaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780149518 PECOS PAC ID: 3173866712 Enrollment ID: I20190522000691 |
| Provider Name | Hedayah Scoon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962866392 PECOS PAC ID: 2062706286 Enrollment ID: I20190529002534 |
| Provider Name | Avantika Varma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760825905 PECOS PAC ID: 4688815749 Enrollment ID: I20190603002819 |
| Provider Name | Lisa R Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730679051 PECOS PAC ID: 3375876535 Enrollment ID: I20190604001100 |
| Provider Name | Uwa Amoji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265910608 PECOS PAC ID: 0345574299 Enrollment ID: I20190626001237 |
| Provider Name | Christopher Scott Holladay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831544717 PECOS PAC ID: 6800181983 Enrollment ID: I20190729002232 |
| Provider Name | Abiodun Adebisi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245714963 PECOS PAC ID: 3678800307 Enrollment ID: I20190802003122 |
| Provider Name | Dwidgelyne Mccall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598139826 PECOS PAC ID: 0345537619 Enrollment ID: I20190814001189 |
| Provider Name | Nida Rupani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720527096 PECOS PAC ID: 7911234901 Enrollment ID: I20190814001299 |
| Provider Name | Johnny Mulliniks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427511260 PECOS PAC ID: 5092043406 Enrollment ID: I20190822004179 |
| Provider Name | Nisha Bhika |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639632318 PECOS PAC ID: 5496084345 Enrollment ID: I20190903000978 |
| Provider Name | Marissa L Gamble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255997847 PECOS PAC ID: 7416286034 Enrollment ID: I20190906003338 |
| Provider Name | Darren Dillard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497100697 PECOS PAC ID: 6103110481 Enrollment ID: I20190919000023 |
| Provider Name | Lawrence Michael Bruner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083104350 PECOS PAC ID: 7214267137 Enrollment ID: I20190919001027 |
| Provider Name | Carletta Petronella Weatherspoon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720328362 PECOS PAC ID: 1759529258 Enrollment ID: I20190923003283 |
| Provider Name | Lauren Thornton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306498548 PECOS PAC ID: 9830420892 Enrollment ID: I20191007001696 |
| Provider Name | Aline Bayard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972961068 PECOS PAC ID: 2466756291 Enrollment ID: I20191009001084 |
| Provider Name | Linda M Leiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801362140 PECOS PAC ID: 9234461468 Enrollment ID: I20191021003069 |
| Provider Name | Jacqueline Alford Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376104802 PECOS PAC ID: 8123350535 Enrollment ID: I20191104001350 |
| Provider Name | Jamie Renee Slump |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245889443 PECOS PAC ID: 2769814763 Enrollment ID: I20191113001021 |
| Provider Name | Feng Zheng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407209463 PECOS PAC ID: 1850670787 Enrollment ID: I20191114002199 |
| Provider Name | Mali Khamissi Sobi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831622984 PECOS PAC ID: 6002249372 Enrollment ID: I20191130000050 |
| Provider Name | Dana M Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699248260 PECOS PAC ID: 3971836529 Enrollment ID: I20191202002607 |
| Provider Name | Timothy Wayne Franklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114586096 PECOS PAC ID: 1759714793 Enrollment ID: I20191205002724 |
| Provider Name | Jordan Billings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295290427 PECOS PAC ID: 4587097431 Enrollment ID: I20191206000258 |
| Provider Name | Amanda J Hammonds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558753525 PECOS PAC ID: 6901101716 Enrollment ID: I20191209002064 |
| Provider Name | Sandeep Singh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831740794 PECOS PAC ID: 9739512484 Enrollment ID: I20191210002845 |
| Provider Name | Ashley Riddle Flo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932757994 PECOS PAC ID: 2163855750 Enrollment ID: I20191212002485 |
| Provider Name | Jodene Nagel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275198400 PECOS PAC ID: 1153755681 Enrollment ID: I20191216002936 |
| Provider Name | Charmaine Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659921625 PECOS PAC ID: 0840624391 Enrollment ID: I20191217000449 |
| Provider Name | Ashley Norman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548611429 PECOS PAC ID: 0042644130 Enrollment ID: I20191226000217 |
| Provider Name | Grady Alexander White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689187130 PECOS PAC ID: 8426482118 Enrollment ID: I20200106002318 |
| Provider Name | Cindy Liberal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659922508 PECOS PAC ID: 1658706239 Enrollment ID: I20200109001471 |
| Provider Name | Daniel K Ralston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710333257 PECOS PAC ID: 7911332275 Enrollment ID: I20200114001906 |
| Provider Name | Jacent Barbara Nakigudde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902306780 PECOS PAC ID: 3375978489 Enrollment ID: I20200120000236 |
| Provider Name | Nichelle Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972154722 PECOS PAC ID: 6901231729 Enrollment ID: I20200123002478 |
| Provider Name | Kelsey Berkner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730725276 PECOS PAC ID: 2365877123 Enrollment ID: I20200124000996 |
| Provider Name | Lynsey Amanda Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881839116 PECOS PAC ID: 2365700705 Enrollment ID: I20200124001920 |
| Provider Name | Andrew R Clementz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689171621 PECOS PAC ID: 5193074920 Enrollment ID: I20200206002993 |
| Provider Name | Jerakhine Mills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780181834 PECOS PAC ID: 9133557929 Enrollment ID: I20200309002288 |
| Provider Name | Upasna Sharma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164989265 PECOS PAC ID: 2961831763 Enrollment ID: I20200330003100 |
| Provider Name | Summer Dixon Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215581392 PECOS PAC ID: 0446689913 Enrollment ID: I20200403001706 |
| Provider Name | Teon Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487287116 PECOS PAC ID: 7719316074 Enrollment ID: I20200407003804 |
| Provider Name | Patricia Coquillon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386956357 PECOS PAC ID: 0446470637 Enrollment ID: I20200413000546 |
| Provider Name | Priscilla Peay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508324526 PECOS PAC ID: 3577993559 Enrollment ID: I20200414003093 |
| Provider Name | Varsha Whitmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295369957 PECOS PAC ID: 0840620282 Enrollment ID: I20200425000211 |
| Provider Name | John Childree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841821501 PECOS PAC ID: 9335570753 Enrollment ID: I20200518003102 |
| Provider Name | Halei Alise Kirkland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063043651 PECOS PAC ID: 1658792940 Enrollment ID: I20200521001792 |
| Provider Name | Nicole Shupe Fullard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225660491 PECOS PAC ID: 6406277722 Enrollment ID: I20200522000059 |
| Provider Name | Zachary Tippens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760003842 PECOS PAC ID: 8426479783 Enrollment ID: I20200522001835 |
| Provider Name | Peggy Darlene Troyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720622921 PECOS PAC ID: 5597186783 Enrollment ID: I20200526000682 |
| Provider Name | Marisa K Blake-raut |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528532272 PECOS PAC ID: 0648691113 Enrollment ID: I20200609002109 |
| Provider Name | Ajoke S James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982180469 PECOS PAC ID: 9032533450 Enrollment ID: I20200717002806 |
| Provider Name | Erin Kathleen Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548892474 PECOS PAC ID: 3274959333 Enrollment ID: I20200819003065 |
| Provider Name | Deanna Renee Hodges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619596418 PECOS PAC ID: 9335566728 Enrollment ID: I20200831002446 |
| Provider Name | Monique F Pugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750999363 PECOS PAC ID: 2062830441 Enrollment ID: I20200916003177 |
| Provider Name | Kimberley B Weatherford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972114502 PECOS PAC ID: 0941629208 Enrollment ID: I20201006001542 |
| Provider Name | Brandy L Bentley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922620798 PECOS PAC ID: 0042630089 Enrollment ID: I20201013003164 |
| Provider Name | Heidi Reese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376167601 PECOS PAC ID: 7618387135 Enrollment ID: I20201111001811 |
| Provider Name | Kendranique S Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952940470 PECOS PAC ID: 0547671265 Enrollment ID: I20201201000981 |
| Provider Name | Kayla Ulmer-deloach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275175689 PECOS PAC ID: 9032522263 Enrollment ID: I20210107002823 |
| Provider Name | Jimmequia Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043826241 PECOS PAC ID: 6800209859 Enrollment ID: I20210112000366 |
| Provider Name | Kevin Pharris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801321104 PECOS PAC ID: 9931513637 Enrollment ID: I20210120001854 |
| Provider Name | Thuy Ha Bao Trinh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477172641 PECOS PAC ID: 5092121806 Enrollment ID: I20210302002624 |
| Provider Name | Victoria Oluyemi O'babatunde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881224657 PECOS PAC ID: 8022424720 Enrollment ID: I20210304000000 |
| Provider Name | Glenda Le |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871187567 PECOS PAC ID: 2062829013 Enrollment ID: I20210318002429 |
| Provider Name | William Chung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043809031 PECOS PAC ID: 7810304706 Enrollment ID: I20210319001050 |
| Provider Name | David Tyler Shields Neuberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205399169 PECOS PAC ID: 1052646858 Enrollment ID: I20210402000551 |
| Provider Name | Sylvia Akenji |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558866558 PECOS PAC ID: 1658625827 Enrollment ID: I20210406001933 |
| Provider Name | Junienne Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740839513 PECOS PAC ID: 0345657441 Enrollment ID: I20210407000327 |
| Provider Name | Laura S Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922621069 PECOS PAC ID: 0749698876 Enrollment ID: I20210409000431 |
| Provider Name | Nimota Akintoye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295382182 PECOS PAC ID: 7911315080 Enrollment ID: I20210412000067 |
| Provider Name | Karen F Frazier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033710298 PECOS PAC ID: 0648688226 Enrollment ID: I20210420001843 |
| Provider Name | Ronald James Mirenda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023599404 PECOS PAC ID: 2860810819 Enrollment ID: I20210421002913 |
| Provider Name | Robert O Calvert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912508540 PECOS PAC ID: 4183032436 Enrollment ID: I20210426002263 |
| Provider Name | Maria Decastro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861849085 PECOS PAC ID: 6709295512 Enrollment ID: I20210507000908 |
| Provider Name | Muhammad Usman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710373816 PECOS PAC ID: 4880997717 Enrollment ID: I20210507001494 |
| Provider Name | Aruna Marri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659819811 PECOS PAC ID: 6507275203 Enrollment ID: I20210510002852 |
| Provider Name | Raynard Sterling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780191353 PECOS PAC ID: 1557770260 Enrollment ID: I20210511000154 |
| Provider Name | Russell W Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902497142 PECOS PAC ID: 6204236664 Enrollment ID: I20210607003136 |
| Provider Name | Antoinette N Williams |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1215494299 PECOS PAC ID: 3971903642 Enrollment ID: I20210617000681 |
| Provider Name | Samuel Ikechukwu Ogbuchi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912403320 PECOS PAC ID: 0042610537 Enrollment ID: I20210621003384 |
| Provider Name | Myoshi Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386038099 PECOS PAC ID: 0941517189 Enrollment ID: I20210623001903 |
| Provider Name | Carmen M Bradshaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679185342 PECOS PAC ID: 4587066360 Enrollment ID: I20210715003931 |
| Provider Name | Brittany N Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184295750 PECOS PAC ID: 3577966878 Enrollment ID: I20210723002470 |
| Provider Name | Holly Tuyls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700321841 PECOS PAC ID: 6608144035 Enrollment ID: I20210727001382 |
| Provider Name | Alisa M Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255946133 PECOS PAC ID: 0345643441 Enrollment ID: I20210727003549 |
| Provider Name | Kimberly A Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598391302 PECOS PAC ID: 1850722976 Enrollment ID: I20210803003204 |
| Provider Name | Lonnie Nicholas Russell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053873612 PECOS PAC ID: 3870828692 Enrollment ID: I20210812002014 |
| Provider Name | Zoey Violet Oropallo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730771155 PECOS PAC ID: 3577968494 Enrollment ID: I20210816002411 |
| Provider Name | Joyce R Murigu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346702982 PECOS PAC ID: 0547665481 Enrollment ID: I20210816003034 |
| Provider Name | Angelique Lacavera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760071484 PECOS PAC ID: 6002212545 Enrollment ID: I20210908001904 |
| Provider Name | Manda Lynn Barnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215099700 PECOS PAC ID: 6204233190 Enrollment ID: I20210920002145 |
| Provider Name | Pooja Sharma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427510056 PECOS PAC ID: 0648509547 Enrollment ID: I20210923000000 |
| Provider Name | Tonya L Vogel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699266809 PECOS PAC ID: 7911139555 Enrollment ID: I20211004002875 |
| Provider Name | Lisa Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396206678 PECOS PAC ID: 8628308939 Enrollment ID: I20211008001839 |
| Provider Name | Tara Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134890023 PECOS PAC ID: 7810385135 Enrollment ID: I20211019001498 |
| Provider Name | Sunday O Yusuf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760943146 PECOS PAC ID: 5294123741 Enrollment ID: I20211102002264 |
| Provider Name | Larry Michael Day |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629440607 PECOS PAC ID: 8729477542 Enrollment ID: I20211117002126 |
| Provider Name | Emma Rossio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114689866 PECOS PAC ID: 1850780560 Enrollment ID: I20211118002634 |
| Provider Name | Amanda Tison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164088977 PECOS PAC ID: 6103151147 Enrollment ID: I20211201000884 |
| Provider Name | Kourtney Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932864477 PECOS PAC ID: 4789074048 Enrollment ID: I20211201001708 |
| Provider Name | Jessica Fuentes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508396755 PECOS PAC ID: 0143589705 Enrollment ID: I20211202002052 |
| Provider Name | Tatiyana Luke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366119653 PECOS PAC ID: 9830589522 Enrollment ID: I20211213001602 |
| Provider Name | Kodjo Vivien Aziamadji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134703705 PECOS PAC ID: 9032500640 Enrollment ID: I20211215001031 |
| Provider Name | Anna Kennedy Lavender |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659840916 PECOS PAC ID: 6103217583 Enrollment ID: I20211217002204 |
| Provider Name | Zoe Mcghee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154092070 PECOS PAC ID: 5496147183 Enrollment ID: I20220107001655 |
| Provider Name | Kathleen Mathews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346918455 PECOS PAC ID: 9638561483 Enrollment ID: I20220128000016 |
| Provider Name | Akiysha Collins Caine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174141873 PECOS PAC ID: 4880087204 Enrollment ID: I20220208001633 |
| Provider Name | Nicole Elizabeth Jansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124645957 PECOS PAC ID: 2668865098 Enrollment ID: I20220208001837 |
| Provider Name | Kathryn Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700329687 PECOS PAC ID: 8628351780 Enrollment ID: I20220215002316 |
| Provider Name | Monica Richardson Ademola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679226807 PECOS PAC ID: 1850785783 Enrollment ID: I20220218001168 |
| Provider Name | Trinity Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427722495 PECOS PAC ID: 8527452374 Enrollment ID: I20220222000972 |
| Provider Name | Tee Jeter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417481896 PECOS PAC ID: 7911339171 Enrollment ID: I20220225000524 |
| Provider Name | Bernard Agnew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679514392 PECOS PAC ID: 8022402460 Enrollment ID: I20220228002122 |
| Provider Name | Melanie Kline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104571033 PECOS PAC ID: 2961896295 Enrollment ID: I20220302000138 |
| Provider Name | Ruth Moze |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205206893 PECOS PAC ID: 9830503069 Enrollment ID: I20220307000104 |
| Provider Name | Jeena Kurian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962921650 PECOS PAC ID: 3577820778 Enrollment ID: I20220308001744 |
| Provider Name | Angela Dawn Greene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104574821 PECOS PAC ID: 2961897467 Enrollment ID: I20220321000618 |
| Provider Name | Shekayla Hooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801262712 PECOS PAC ID: 6608184510 Enrollment ID: I20220325000300 |
| Provider Name | Christabel Sarfo Adomako |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295154573 PECOS PAC ID: 7113314980 Enrollment ID: I20220426000266 |
| Provider Name | Bernadette Baker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447711437 PECOS PAC ID: 7416283650 Enrollment ID: I20220520001159 |
| Provider Name | Temeka L Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316518475 PECOS PAC ID: 0143493999 Enrollment ID: I20220523001857 |
| Provider Name | John Roger Rowell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396490025 PECOS PAC ID: 6406234137 Enrollment ID: I20220608000711 |
| Provider Name | Nirali M Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659020519 PECOS PAC ID: 7012395650 Enrollment ID: I20220609001779 |
| Provider Name | Yvette Ash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053676536 PECOS PAC ID: 3072760073 Enrollment ID: I20220610002154 |
| Provider Name | Kimberly Nichole Eide |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659908937 PECOS PAC ID: 5294158556 Enrollment ID: I20220620000741 |
| Provider Name | Richardson Desmangles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467100487 PECOS PAC ID: 8820478365 Enrollment ID: I20220630001425 |
| Provider Name | Corinne Marcia Anthony-manswell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538793443 PECOS PAC ID: 0547640542 Enrollment ID: I20220708000708 |
| Provider Name | Clayton Roelle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609527423 PECOS PAC ID: 7810379476 Enrollment ID: I20220729001762 |
| Provider Name | Tehseen Rupani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104550656 PECOS PAC ID: 3375925795 Enrollment ID: I20220802002115 |
| Provider Name | Jarrett Hayles-patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902542152 PECOS PAC ID: 3173905064 Enrollment ID: I20220809003823 |
| Provider Name | Dena Altaira Mccarthy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619613486 PECOS PAC ID: 1759765100 Enrollment ID: I20220902000301 |
| Provider Name | Jackline Wanga Gates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801432216 PECOS PAC ID: 4587077375 Enrollment ID: I20220907001656 |
| Provider Name | Emmalyn Newman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407324593 PECOS PAC ID: 2567706294 Enrollment ID: I20220930001789 |
| Provider Name | Irlonda Poindexter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598380958 PECOS PAC ID: 5799199097 Enrollment ID: I20221005001076 |
| Provider Name | Christine Covaci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740906114 PECOS PAC ID: 4688041544 Enrollment ID: I20221104002570 |
| Provider Name | Melissa Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073239935 PECOS PAC ID: 6103293808 Enrollment ID: I20221109003033 |
| Provider Name | Stephanie Dawn Merritt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114505922 PECOS PAC ID: 8022485739 Enrollment ID: I20221109003428 |
| Provider Name | Lary Korn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255578860 PECOS PAC ID: 2264580190 Enrollment ID: I20221205000496 |
| Provider Name | Ariana Taylor Trujillo-ortega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427778265 PECOS PAC ID: 0042689614 Enrollment ID: I20221205000808 |
| Provider Name | Elizabeth Nadra Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942948369 PECOS PAC ID: 6709255862 Enrollment ID: I20221212001854 |
| Provider Name | Terresa Ann Dorsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679031751 PECOS PAC ID: 0840669933 Enrollment ID: I20221212002968 |
| Provider Name | Stephanie Gentry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740999176 PECOS PAC ID: 3577932417 Enrollment ID: I20221215000762 |
| Provider Name | Latersha S St Louis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992955181 PECOS PAC ID: 9133355613 Enrollment ID: I20221221001992 |
| Provider Name | Tanyetta Michelle Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619506532 PECOS PAC ID: 2769853167 Enrollment ID: I20230123001393 |
| Provider Name | Melanie Marie Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063020428 PECOS PAC ID: 4385016476 Enrollment ID: I20230220000758 |
| Provider Name | Michael Brooks Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033824941 PECOS PAC ID: 2062886971 Enrollment ID: I20230316000222 |
| Provider Name | Renee Kimberley Chambers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528783750 PECOS PAC ID: 2163896994 Enrollment ID: I20230319000093 |
| Provider Name | Ashley Monique Trawick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255002531 PECOS PAC ID: 8325412174 Enrollment ID: I20230320000409 |
| Provider Name | Kaylah Regine Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194438390 PECOS PAC ID: 4587038153 Enrollment ID: I20230322000551 |
| Provider Name | Mary Anna Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598479966 PECOS PAC ID: 6406220094 Enrollment ID: I20230322001534 |
| Provider Name | Joanne Marie Zanetos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609580695 PECOS PAC ID: 3173988045 Enrollment ID: I20230427002002 |
| Provider Name | Dionne M Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346763521 PECOS PAC ID: 4587020987 Enrollment ID: I20230509002146 |
| Provider Name | Rhonda R. Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013603547 PECOS PAC ID: 8426414517 Enrollment ID: I20230516000576 |
| Provider Name | Sheena Makerrin Mceachin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477242634 PECOS PAC ID: 9133585086 Enrollment ID: I20230518001184 |
| Provider Name | Jennifer Mandhai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134686207 PECOS PAC ID: 1456771062 Enrollment ID: I20230518003336 |
| Provider Name | Katherine Blanchard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336838051 PECOS PAC ID: 7113383027 Enrollment ID: I20230519000150 |
| Provider Name | Heba Gill Chaudhry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508363763 PECOS PAC ID: 6901159250 Enrollment ID: I20230519002096 |
| Provider Name | Maria Montrice Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477190189 PECOS PAC ID: 7315304888 Enrollment ID: I20230530000670 |
| Provider Name | Kimberly Alexis Stillwachs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770947004 PECOS PAC ID: 2769779701 Enrollment ID: I20230613000988 |
| Provider Name | Jessica Ashley Gaydos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558051888 PECOS PAC ID: 0143680983 Enrollment ID: I20230712002310 |
| Provider Name | Victoria Marie Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861021420 PECOS PAC ID: 4688097702 Enrollment ID: I20230718000474 |
| Provider Name | Christopher Lander Drummond |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619288529 PECOS PAC ID: 3870732704 Enrollment ID: I20230721002056 |
| Provider Name | Hannah Hyunwoo Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073192589 PECOS PAC ID: 3678975125 Enrollment ID: I20230728000152 |
| Provider Name | Diana Rodgers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104404888 PECOS PAC ID: 1658772363 Enrollment ID: I20230731000595 |
| Provider Name | Alisha A Donohoe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548999402 PECOS PAC ID: 0547622441 Enrollment ID: I20230809001522 |
| Provider Name | Chloe Kidd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508546979 PECOS PAC ID: 4587026190 Enrollment ID: I20230814004090 |
| Provider Name | Heather M Mancebo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689802068 PECOS PAC ID: 3476798745 Enrollment ID: I20230829000996 |
| Provider Name | Michelle Fischer-short |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477115319 PECOS PAC ID: 4880924448 Enrollment ID: I20230907004233 |
| Provider Name | Shanekia Marsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942870241 PECOS PAC ID: 3375907678 Enrollment ID: I20230919002651 |
| Provider Name | Sophia Thuy Vi Brune-herrera Le |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447945167 PECOS PAC ID: 4486008752 Enrollment ID: I20230921000408 |
| Provider Name | Michelle Suzanne Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396521910 PECOS PAC ID: 9335593391 Enrollment ID: I20230925001161 |
| Provider Name | Jeannette Frei |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679549125 PECOS PAC ID: 9133170541 Enrollment ID: I20231004002741 |
| Provider Name | Makayla A Carson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902589237 PECOS PAC ID: 1658726997 Enrollment ID: I20231006001094 |
| Provider Name | Angela Denise Batenko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306526561 PECOS PAC ID: 8123475225 Enrollment ID: I20231110002432 |
| Provider Name | Angela Markley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720590565 PECOS PAC ID: 1850650292 Enrollment ID: I20231115002596 |
| Provider Name | Kaitlin Z Ervin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639758311 PECOS PAC ID: 0547662777 Enrollment ID: I20231120003543 |
| Provider Name | Jennifer Hobbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518481050 PECOS PAC ID: 0345509915 Enrollment ID: I20231129003331 |
| Provider Name | Amanda Gayle Petty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174301386 PECOS PAC ID: 1557711272 Enrollment ID: I20231221000829 |
| Provider Name | Jenna Cottrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003698408 PECOS PAC ID: 0345690897 Enrollment ID: I20231222002623 |
| Provider Name | Mary Kate Mcbee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710657861 PECOS PAC ID: 9335599315 Enrollment ID: I20240103002546 |
| Provider Name | Teresa Johan Colon-asumu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922688852 PECOS PAC ID: 3072915214 Enrollment ID: I20240104003315 |
| Provider Name | Whitney Gladieux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275194557 PECOS PAC ID: 8022347251 Enrollment ID: I20240110001240 |
| Provider Name | Savannah Marie Gregory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467148668 PECOS PAC ID: 5597117044 Enrollment ID: I20240119002319 |
| Provider Name | Pamela Rosemarie Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912586892 PECOS PAC ID: 3476905662 Enrollment ID: I20240124000588 |
| Provider Name | Jacob Kim |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710993324 PECOS PAC ID: 9335179829 Enrollment ID: I20240129000970 |
| Provider Name | Alexandria Hodges |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134602568 PECOS PAC ID: 2365885522 Enrollment ID: I20240205004287 |
| Provider Name | Stacie Brooker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043849359 PECOS PAC ID: 9335583681 Enrollment ID: I20240215000319 |
| Provider Name | Tedra Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821586645 PECOS PAC ID: 5890049902 Enrollment ID: I20240221000754 |
| Provider Name | Andrew Peoples |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699541730 PECOS PAC ID: 4183068786 Enrollment ID: I20240222002487 |
| Provider Name | Yejin Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841053568 PECOS PAC ID: 9739524364 Enrollment ID: I20240305001541 |
Wellstar East Paulding Primary Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 176 Charles Hardy Pkwy, Unit C, Hiram, GA 30141 Phone: 678-945-8200 Fax: 678-945-8209 | |
Benchmark Physical Therapy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 45 Enterprise Path Ste 101, Hiram, GA 30141 Phone: 770-439-4045 Fax: 770-439-4085 | |
West Ga Family Medicine, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1899 Lake Rd, 212, Hiram, GA 30141 Phone: 770-222-5488 Fax: 770-222-5491 | |
Dr. Jay Rosa, Chiropractor Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 76 Highland Pavilion Ct, Hiram, GA 30141 Phone: 770-439-6997 Fax: 636-707-9772 | |
First Doctors Weight Loss Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6794 Bill Carruth Pkwy, Hiram, GA 30141 Phone: 678-567-5918 | |
Turning Point Chiropractic Center, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 44 Darbys Crossing Dr, Suite C, Hiram, GA 30141 Phone: 770-439-8393 Fax: 770-439-8395 | |
Agape Family Chiropractic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 44 Darbys Crossing Dr Ste 212, Hiram, GA 30141 Phone: 678-653-2689 |