| Peak Vista Community Health Centers | |
|
3205 N Academy Blvd Suite 130 Colorado Springs CO 80917 | |
| (719) 632-5700 | |
| (719) 344-7865 |
| Full Name | Peak Vista Community Health Centers |
|---|---|
| Speciality | Clinic/Center |
| Location | 3205 N Academy Blvd, Colorado Springs, Colorado |
| Authorized Official Name and Position | Ryan Spillane (INTERIM CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7193447135 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peak Vista Community Health Centers 3205 N Academy Blvd Suite 130 Colorado Springs CO 80917 Ph: (719) 632-5700 | Peak Vista Community Health Centers 3205 N Academy Blvd Suite 130 Colorado Springs CO 80917 Ph: (719) 632-5700 |
| NPI Number | 1730166034 |
|---|---|
| Provider Enumeration Date | 12/28/2005 |
| Last Update Date | 01/30/2023 |
| Medicare PECOS PAC ID | 4688583974 |
|---|---|
| Medicare Enrollment ID | O20031110000337 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730166034 | NPI | - | NPPES |
| 05638267 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Colorado) | Primary |
| Provider Name | David M Salter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982700910 PECOS PAC ID: 8426047408 Enrollment ID: I20040506001331 |
| Provider Name | Peter A Liehr |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437129822 PECOS PAC ID: 6709868417 Enrollment ID: I20040607000001 |
| Provider Name | Angela York |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063457612 PECOS PAC ID: 5890773774 Enrollment ID: I20040708000331 |
| Provider Name | Stephanie D Ring |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316046907 PECOS PAC ID: 4385623446 Enrollment ID: I20040714000605 |
| Provider Name | Lucinda E Tacha |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063415560 PECOS PAC ID: 3274509740 Enrollment ID: I20040907000406 |
| Provider Name | Jeffery D Mccutcheon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821068651 PECOS PAC ID: 8820051782 Enrollment ID: I20041111000034 |
| Provider Name | John L Kucera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841455417 PECOS PAC ID: 4587554233 Enrollment ID: I20050512000798 |
| Provider Name | Jonathan Peter Weston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710072905 PECOS PAC ID: 2668382748 Enrollment ID: I20050519000075 |
| Provider Name | Kenneth A Moss |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184685075 PECOS PAC ID: 5991741043 Enrollment ID: I20050629000758 |
| Provider Name | Michael R Wilbourn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508980152 PECOS PAC ID: 0446283204 Enrollment ID: I20050913001086 |
| Provider Name | Elizabeth A Trexler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831161553 PECOS PAC ID: 2365475449 Enrollment ID: I20050919000406 |
| Provider Name | Dale A Spencer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558334011 PECOS PAC ID: 1759306889 Enrollment ID: I20051007000705 |
| Provider Name | Michael E Gilbert |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1669566345 PECOS PAC ID: 0648295097 Enrollment ID: I20051013001070 |
| Provider Name | Thomas A Henderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740371020 PECOS PAC ID: 5496776163 Enrollment ID: I20051208000871 |
| Provider Name | Steven F Maher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407811011 PECOS PAC ID: 2567405152 Enrollment ID: I20060130000269 |
| Provider Name | George R Athey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982602801 PECOS PAC ID: 3577579572 Enrollment ID: I20060228000777 |
| Provider Name | Bret A Kort |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801846514 PECOS PAC ID: 0749293215 Enrollment ID: I20060731000019 |
| Provider Name | Amir A Salek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831278480 PECOS PAC ID: 2860594223 Enrollment ID: I20070303000069 |
| Provider Name | Carleen R Innes |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1366475147 PECOS PAC ID: 0547366213 Enrollment ID: I20070426000588 |
| Provider Name | Eileen M Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780741777 PECOS PAC ID: 4385741073 Enrollment ID: I20070514000546 |
| Provider Name | Darvi C Rahaman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801849773 PECOS PAC ID: 7012009400 Enrollment ID: I20070815000100 |
| Provider Name | Julie M Klaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215134705 PECOS PAC ID: 2365535077 Enrollment ID: I20070911000239 |
| Provider Name | Della Lane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417151630 PECOS PAC ID: 9234222894 Enrollment ID: I20070912000707 |
| Provider Name | Amy D Clauss |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497957823 PECOS PAC ID: 2466546056 Enrollment ID: I20070913000080 |
| Provider Name | Svetlana L Tsirkin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992998967 PECOS PAC ID: 7618061060 Enrollment ID: I20070917000482 |
| Provider Name | Sara E Tisdale |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467668798 PECOS PAC ID: 3476641721 Enrollment ID: I20071120000237 |
| Provider Name | Sara J Martin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659410645 PECOS PAC ID: 3678662954 Enrollment ID: I20071210000410 |
| Provider Name | Thomas O Weber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548233976 PECOS PAC ID: 5092805796 Enrollment ID: I20071219000115 |
| Provider Name | James B Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346284742 PECOS PAC ID: 2062592330 Enrollment ID: I20071228000230 |
| Provider Name | Tamara L Willis-buckley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669413126 PECOS PAC ID: 6406840636 Enrollment ID: I20080721000766 |
| Provider Name | Dallas Thompson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447259767 PECOS PAC ID: 4082789920 Enrollment ID: I20080812000658 |
| Provider Name | Mary J Shaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912061466 PECOS PAC ID: 1153497169 Enrollment ID: I20080827000340 |
| Provider Name | Heather Welfare |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639168925 PECOS PAC ID: 8123054616 Enrollment ID: I20081208000741 |
| Provider Name | Mary V Mebane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457551012 PECOS PAC ID: 4981795887 Enrollment ID: I20090127000487 |
| Provider Name | Michael A Reisig |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588662639 PECOS PAC ID: 0345307468 Enrollment ID: I20090317000372 |
| Provider Name | Deepak Honaganahalli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619114337 PECOS PAC ID: 8426109547 Enrollment ID: I20090701000465 |
| Provider Name | Sheryl C Belanger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497772495 PECOS PAC ID: 0244325637 Enrollment ID: I20091119000426 |
| Provider Name | Sonia Alers Seufer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609807957 PECOS PAC ID: 7315087442 Enrollment ID: I20091221000307 |
| Provider Name | Marsha A Alger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902840028 PECOS PAC ID: 8820124258 Enrollment ID: I20100324001157 |
| Provider Name | Judith M Brinkman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356330617 PECOS PAC ID: 0244366326 Enrollment ID: I20100327000614 |
| Provider Name | Lawrence P O Connell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215984885 PECOS PAC ID: 6002911401 Enrollment ID: I20100426000071 |
| Provider Name | Scott D Robinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972545176 PECOS PAC ID: 6204839525 Enrollment ID: I20100526000603 |
| Provider Name | Mihir V Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619074382 PECOS PAC ID: 2062412653 Enrollment ID: I20100615000426 |
| Provider Name | Diana Gue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972821783 PECOS PAC ID: 6507990280 Enrollment ID: I20100817000747 |
| Provider Name | Michael D Welch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912979618 PECOS PAC ID: 6103941752 Enrollment ID: I20100920000377 |
| Provider Name | Karen C Campbell-munch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922085182 PECOS PAC ID: 2961527544 Enrollment ID: I20100920000725 |
| Provider Name | Debra Garcia |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174500243 PECOS PAC ID: 6507982915 Enrollment ID: I20100922001276 |
| Provider Name | Camilla A Bicknell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023014495 PECOS PAC ID: 2860518271 Enrollment ID: I20100922001286 |
| Provider Name | Lorraine D Lalonde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255377677 PECOS PAC ID: 1052308962 Enrollment ID: I20110203000773 |
| Provider Name | Frank M Samarin |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1629037395 PECOS PAC ID: 0941480495 Enrollment ID: I20110215001046 |
| Provider Name | James J Steigerwald |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447259452 PECOS PAC ID: 9638250996 Enrollment ID: I20110315000633 |
| Provider Name | Sidney Nichols |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689827198 PECOS PAC ID: 0547430183 Enrollment ID: I20110908002210 |
| Provider Name | Elisabeth Susan Vanse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952563702 PECOS PAC ID: 2466627146 Enrollment ID: I20111207000631 |
| Provider Name | Lisa Ramey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134152325 PECOS PAC ID: 9830391895 Enrollment ID: I20111230000607 |
| Provider Name | Erin E Luna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174737787 PECOS PAC ID: 5092981662 Enrollment ID: I20120103000284 |
| Provider Name | Valerie D Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629379409 PECOS PAC ID: 4981864691 Enrollment ID: I20120404000150 |
| Provider Name | John C Ronning |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346284536 PECOS PAC ID: 8820073604 Enrollment ID: I20120608000257 |
| Provider Name | Patrick Scott Pevoto |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376550731 PECOS PAC ID: 4385783182 Enrollment ID: I20120711000505 |
| Provider Name | Donna M Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740536176 PECOS PAC ID: 5890942460 Enrollment ID: I20120904000749 |
| Provider Name | Autumn J Orser |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740422138 PECOS PAC ID: 4385892744 Enrollment ID: I20120911000108 |
| Provider Name | Paul W Cump |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235193343 PECOS PAC ID: 8527008325 Enrollment ID: I20120918000765 |
| Provider Name | Jane E Switzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154643989 PECOS PAC ID: 3779735246 Enrollment ID: I20121207000167 |
| Provider Name | Susan Ann Varady |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427217991 PECOS PAC ID: 2365496114 Enrollment ID: I20130219000009 |
| Provider Name | Kasey Cruz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457686941 PECOS PAC ID: 1456535616 Enrollment ID: I20130412000585 |
| Provider Name | Kathleen L Moehring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396089603 PECOS PAC ID: 1759527385 Enrollment ID: I20130426000108 |
| Provider Name | Kelli J Neely |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1033351325 PECOS PAC ID: 8426107129 Enrollment ID: I20130522000195 |
| Provider Name | Kelly L Sandberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538408729 PECOS PAC ID: 0840439956 Enrollment ID: I20130621000375 |
| Provider Name | Connie C Stewart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316002504 PECOS PAC ID: 6204838030 Enrollment ID: I20130913000615 |
| Provider Name | Joseph J Kezeor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578683223 PECOS PAC ID: 3476646407 Enrollment ID: I20131223000662 |
| Provider Name | Kathleen L Moehring |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1396089603 PECOS PAC ID: 1759527385 Enrollment ID: I20140603000279 |
| Provider Name | Emily Macindoe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023439569 PECOS PAC ID: 9436374303 Enrollment ID: I20140709000745 |
| Provider Name | Caroline A Hedges |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528389368 PECOS PAC ID: 6901020460 Enrollment ID: I20140829000583 |
| Provider Name | Patricia D Bursnall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134535586 PECOS PAC ID: 3274752480 Enrollment ID: I20140922001277 |
| Provider Name | Laurri D Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508260019 PECOS PAC ID: 5395067912 Enrollment ID: I20141209001633 |
| Provider Name | Susan Marie Swayne |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184618928 PECOS PAC ID: 4789908195 Enrollment ID: I20150113000941 |
| Provider Name | Sherri Sharp |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508191867 PECOS PAC ID: 0941524219 Enrollment ID: I20150114001045 |
| Provider Name | Emily J Sandbach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033289285 PECOS PAC ID: 9739132184 Enrollment ID: I20150204000319 |
| Provider Name | Kaleen A Cullen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972784957 PECOS PAC ID: 2466777925 Enrollment ID: I20150205000182 |
| Provider Name | Tara M Melborne |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1588088942 PECOS PAC ID: 2163747882 Enrollment ID: I20150220000747 |
| Provider Name | Monica L Miller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275594749 PECOS PAC ID: 4789698093 Enrollment ID: I20150311000270 |
| Provider Name | Babu Chalam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598051633 PECOS PAC ID: 3173746500 Enrollment ID: I20150312001889 |
| Provider Name | Gregory A Feucht |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407160344 PECOS PAC ID: 8325281405 Enrollment ID: I20150319000624 |
| Provider Name | Carrie J Claar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538594742 PECOS PAC ID: 0345565081 Enrollment ID: I20150415001638 |
| Provider Name | Bridget M Coyne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417032368 PECOS PAC ID: 8426129586 Enrollment ID: I20150416001407 |
| Provider Name | Miriam Hughes |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1063827442 PECOS PAC ID: 7113246653 Enrollment ID: I20150505000090 |
| Provider Name | Brian Scott Michaud |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346554813 PECOS PAC ID: 7810138799 Enrollment ID: I20150507000454 |
| Provider Name | Aron Hull |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700219003 PECOS PAC ID: 1850610197 Enrollment ID: I20150507001618 |
| Provider Name | Janice Sandra Lumnitz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780757500 PECOS PAC ID: 5193852986 Enrollment ID: I20150514001655 |
| Provider Name | Alexis Chryse Michopoulos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073878146 PECOS PAC ID: 0143541391 Enrollment ID: I20150601000776 |
| Provider Name | Tracee Nelson Yarborough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407259617 PECOS PAC ID: 6507187366 Enrollment ID: I20150604001642 |
| Provider Name | Jess G Adams |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1033315627 PECOS PAC ID: 2769795319 Enrollment ID: I20150724011965 |
| Provider Name | Predrag Pavlovic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659695625 PECOS PAC ID: 1557525938 Enrollment ID: I20150819007310 |
| Provider Name | Kendra Back |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437408093 PECOS PAC ID: 5597916940 Enrollment ID: I20150824000668 |
| Provider Name | Alyssa June Mcclurg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639316003 PECOS PAC ID: 5496062218 Enrollment ID: I20150911000026 |
| Provider Name | Julie M Sandoval |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851779227 PECOS PAC ID: 0446568174 Enrollment ID: I20150930001125 |
| Provider Name | Thomas R Avonda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407920101 PECOS PAC ID: 0941202295 Enrollment ID: I20151001001890 |
| Provider Name | Martina A Taylor |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932335924 PECOS PAC ID: 7113151499 Enrollment ID: I20151020002039 |
| Provider Name | Nancy Prantl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205203098 PECOS PAC ID: 7214246545 Enrollment ID: I20151027001955 |
| Provider Name | Suemarie S Mendez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114004553 PECOS PAC ID: 7911988662 Enrollment ID: I20151027002633 |
| Provider Name | Ee-leng Dejesus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558620260 PECOS PAC ID: 6305073255 Enrollment ID: I20151103002210 |
| Provider Name | Stephanie A Danos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467821538 PECOS PAC ID: 6608186259 Enrollment ID: I20151110002722 |
| Provider Name | Stephanie W Butler Cleland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740659432 PECOS PAC ID: 2163732751 Enrollment ID: I20151111001377 |
| Provider Name | Ann M Tompkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275898587 PECOS PAC ID: 0244531770 Enrollment ID: I20151229000247 |
| Provider Name | Kristin Sekelsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699148544 PECOS PAC ID: 7315249950 Enrollment ID: I20160113001993 |
| Provider Name | Patrice D Kiesling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790158723 PECOS PAC ID: 3375846462 Enrollment ID: I20160123000093 |
| Provider Name | Katherine R Caulk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942601984 PECOS PAC ID: 5597068205 Enrollment ID: I20160129000118 |
| Provider Name | Amber M Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225175607 PECOS PAC ID: 4082718242 Enrollment ID: I20160225000341 |
| Provider Name | Sarah M O'keeffe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407227671 PECOS PAC ID: 2860799236 Enrollment ID: I20160330000861 |
| Provider Name | Sharon Glocker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326405978 PECOS PAC ID: 6901196054 Enrollment ID: I20160602001519 |
| Provider Name | Lawrence W Andrews |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659387587 PECOS PAC ID: 1557303658 Enrollment ID: I20160720001243 |
| Provider Name | Amelia Prado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598830069 PECOS PAC ID: 4880779032 Enrollment ID: I20160804000872 |
| Provider Name | Shannon Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255785515 PECOS PAC ID: 2163716291 Enrollment ID: I20160811001478 |
| Provider Name | Molly M Ulrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912354291 PECOS PAC ID: 8628363678 Enrollment ID: I20160830000756 |
| Provider Name | Christina D Nelms |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376995357 PECOS PAC ID: 7618264318 Enrollment ID: I20160923000934 |
| Provider Name | Victoria L Zachary |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184076564 PECOS PAC ID: 2264729474 Enrollment ID: I20160930001492 |
| Provider Name | Kyle C Voget |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336589027 PECOS PAC ID: 3173811395 Enrollment ID: I20161004000811 |
| Provider Name | Elizabeth A Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396172417 PECOS PAC ID: 1951531227 Enrollment ID: I20161202000501 |
| Provider Name | Diana L Lujan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184649543 PECOS PAC ID: 5496035412 Enrollment ID: I20161209000459 |
| Provider Name | Tracey A Haas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346264561 PECOS PAC ID: 8527096478 Enrollment ID: I20170120000716 |
| Provider Name | Lauren E Clements |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1063886331 PECOS PAC ID: 8527362466 Enrollment ID: I20170201000670 |
| Provider Name | Mary Ann Figueroa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215485974 PECOS PAC ID: 1951684737 Enrollment ID: I20170202001097 |
| Provider Name | Lillian G Schnitzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093260549 PECOS PAC ID: 4284917972 Enrollment ID: I20170202002123 |
| Provider Name | Daniel Bruce Kramer |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1336502293 PECOS PAC ID: 3870876782 Enrollment ID: I20170218000216 |
| Provider Name | Dawn Louise Delahousse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053768457 PECOS PAC ID: 9234412164 Enrollment ID: I20170220000753 |
| Provider Name | Nicola Gigante |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194276980 PECOS PAC ID: 3173806080 Enrollment ID: I20170222000515 |
| Provider Name | Shenelle Schoenfeld |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881056703 PECOS PAC ID: 5698059574 Enrollment ID: I20170222000610 |
| Provider Name | Matthew J Schippers |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164883302 PECOS PAC ID: 5991089773 Enrollment ID: I20170222000876 |
| Provider Name | Kara L Novak |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1659811404 PECOS PAC ID: 7315222700 Enrollment ID: I20170327002516 |
| Provider Name | Laurie A Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043751860 PECOS PAC ID: 5597041715 Enrollment ID: I20170424001049 |
| Provider Name | Leah N Holland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710938105 PECOS PAC ID: 2163717687 Enrollment ID: I20170503000618 |
| Provider Name | John P Krueger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972588929 PECOS PAC ID: 8022022193 Enrollment ID: I20170508001426 |
| Provider Name | Elisabeth M Almond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033645700 PECOS PAC ID: 9234406497 Enrollment ID: I20170519000085 |
| Provider Name | Jennifer Lyn Wall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538327143 PECOS PAC ID: 2264601814 Enrollment ID: I20170525000544 |
| Provider Name | Kelli Greenleaf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326599119 PECOS PAC ID: 0345517066 Enrollment ID: I20170601000612 |
| Provider Name | Elesa Lynee Ignowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942685151 PECOS PAC ID: 3971813650 Enrollment ID: I20170601000719 |
| Provider Name | Rhonda Sims |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043477649 PECOS PAC ID: 1658425301 Enrollment ID: I20170602001780 |
| Provider Name | Jordan P Christensen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871955815 PECOS PAC ID: 0446527980 Enrollment ID: I20170605000450 |
| Provider Name | Valerie Ann Colegrove |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144322785 PECOS PAC ID: 0244507713 Enrollment ID: I20170605001853 |
| Provider Name | Judith Wanyama |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265977466 PECOS PAC ID: 8628346277 Enrollment ID: I20170622001994 |
| Provider Name | Michael J Morgan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144752957 PECOS PAC ID: 8628348356 Enrollment ID: I20170727003263 |
| Provider Name | Daniel W Burke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609308311 PECOS PAC ID: 1759651433 Enrollment ID: I20170728001116 |
| Provider Name | Royce James Toffol |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609308436 PECOS PAC ID: 0143591834 Enrollment ID: I20170728001859 |
| Provider Name | Michael K Neilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306378823 PECOS PAC ID: 1355612946 Enrollment ID: I20170731002550 |
| Provider Name | Albert J Gerathy |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1568424281 PECOS PAC ID: 9436420858 Enrollment ID: I20170803001851 |
| Provider Name | Ncocbich L Florentino |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1649700089 PECOS PAC ID: 8628349065 Enrollment ID: I20170803002694 |
| Provider Name | Amanda Johnson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073046330 PECOS PAC ID: 1254602964 Enrollment ID: I20170828001237 |
| Provider Name | Joshua S Bender |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1912429168 PECOS PAC ID: 7214200898 Enrollment ID: I20170901000986 |
| Provider Name | Chintan Harish Kumar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235543638 PECOS PAC ID: 5991079501 Enrollment ID: I20170920003479 |
| Provider Name | Summair Motiwala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396158176 PECOS PAC ID: 4385918929 Enrollment ID: I20170921000661 |
| Provider Name | Brenda J Burdick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871532119 PECOS PAC ID: 3577577600 Enrollment ID: I20171003004141 |
| Provider Name | Miranda Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790203446 PECOS PAC ID: 5890061071 Enrollment ID: I20171017001177 |
| Provider Name | Tyler Backlas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598185381 PECOS PAC ID: 8426372939 Enrollment ID: I20171018000301 |
| Provider Name | Jessica Sena |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285162644 PECOS PAC ID: 4082980941 Enrollment ID: I20171019002106 |
| Provider Name | La Tasha M Bruner-hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386161032 PECOS PAC ID: 7517233471 Enrollment ID: I20171019002168 |
| Provider Name | Kae P Mccaffery |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043296148 PECOS PAC ID: 9537435151 Enrollment ID: I20171026003099 |
| Provider Name | Kimberly S Stein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679091383 PECOS PAC ID: 3971879479 Enrollment ID: I20171028000297 |
| Provider Name | Amanda Kay Judd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497208607 PECOS PAC ID: 7618265505 Enrollment ID: I20171031003440 |
| Provider Name | Bruce Machaffie |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871595173 PECOS PAC ID: 5799041331 Enrollment ID: I20171114002647 |
| Provider Name | Richard Tsambikos |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467985713 PECOS PAC ID: 6901163310 Enrollment ID: I20171120001277 |
| Provider Name | Bonnie M Baxter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346285095 PECOS PAC ID: 3779586193 Enrollment ID: I20171129000915 |
| Provider Name | Melinda K Hoffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164415006 PECOS PAC ID: 4082701487 Enrollment ID: I20171129001035 |
| Provider Name | Joshua Jewell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124481320 PECOS PAC ID: 2264716356 Enrollment ID: I20171221000306 |
| Provider Name | Devin M Gamundoy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730593518 PECOS PAC ID: 9931418183 Enrollment ID: I20180118000954 |
| Provider Name | Gordon H Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265546014 PECOS PAC ID: 2365442373 Enrollment ID: I20180220002634 |
| Provider Name | Rebeckah L Hansom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992130900 PECOS PAC ID: 8820359052 Enrollment ID: I20180302000605 |
| Provider Name | Timothy L Brininger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124008164 PECOS PAC ID: 9537247630 Enrollment ID: I20180312001273 |
| Provider Name | Alicia Ruth Apple |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730441783 PECOS PAC ID: 4688985476 Enrollment ID: I20180315001718 |
| Provider Name | Nicole Taylor |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1528518669 PECOS PAC ID: 1557623980 Enrollment ID: I20180326000179 |
| Provider Name | Sonya Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396821849 PECOS PAC ID: 8820305253 Enrollment ID: I20180326000180 |
| Provider Name | Ursula Charlton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437582061 PECOS PAC ID: 6608009675 Enrollment ID: I20180417000901 |
| Provider Name | Leslie Ann Renz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215909726 PECOS PAC ID: 9830452283 Enrollment ID: I20180417001633 |
| Provider Name | Stephen Kimball Stacey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407120702 PECOS PAC ID: 0446513816 Enrollment ID: I20180417002251 |
| Provider Name | Michelle E Kolb |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972570828 PECOS PAC ID: 4789956699 Enrollment ID: I20180419001826 |
| Provider Name | Lisa Marie Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326440439 PECOS PAC ID: 3971825308 Enrollment ID: I20180504001857 |
| Provider Name | Leah J Blake |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558757724 PECOS PAC ID: 0749544252 Enrollment ID: I20180509002784 |
| Provider Name | Melissa Nicole Mitton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568962850 PECOS PAC ID: 5698020956 Enrollment ID: I20180611000948 |
| Provider Name | Brian Adam Failla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275039992 PECOS PAC ID: 8325394059 Enrollment ID: I20180710002842 |
| Provider Name | Melissa Ann Schwartz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376043976 PECOS PAC ID: 2668728395 Enrollment ID: I20180710002953 |
| Provider Name | David Emilio Falcocchia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639671977 PECOS PAC ID: 3577819200 Enrollment ID: I20180710002955 |
| Provider Name | Julia Watson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417452384 PECOS PAC ID: 1850647454 Enrollment ID: I20180712001702 |
| Provider Name | Michelle Renee Myers |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457461048 PECOS PAC ID: 8628252772 Enrollment ID: I20180717002187 |
| Provider Name | Melissa O'meara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518346378 PECOS PAC ID: 6103134721 Enrollment ID: I20180723000580 |
| Provider Name | Eric Ellis Bybee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265965925 PECOS PAC ID: 0244588481 Enrollment ID: I20180806000533 |
| Provider Name | Mack Arthur Whitehead |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578067906 PECOS PAC ID: 2567710593 Enrollment ID: I20180807002349 |
| Provider Name | Andrea Rose Vincent |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1861998023 PECOS PAC ID: 7911257647 Enrollment ID: I20180830000826 |
| Provider Name | Sarah Danielle Schadewald |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831403336 PECOS PAC ID: 4587978598 Enrollment ID: I20180925002043 |
| Provider Name | Brandi Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134601149 PECOS PAC ID: 9931451739 Enrollment ID: I20181005000920 |
| Provider Name | Kaitlin Alexandra Veselicky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891276044 PECOS PAC ID: 5193077634 Enrollment ID: I20181010002246 |
| Provider Name | Kathleen Marie Spencer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871083972 PECOS PAC ID: 4587916929 Enrollment ID: I20181011002677 |
| Provider Name | Robin Bangasser Bentley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235612185 PECOS PAC ID: 9436401742 Enrollment ID: I20181016000502 |
| Provider Name | Norie Kirtley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346785839 PECOS PAC ID: 6204189152 Enrollment ID: I20181023003492 |
| Provider Name | Michael Kevlyn |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1538387337 PECOS PAC ID: 8527312735 Enrollment ID: I20181106002583 |
| Provider Name | Anne Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518451350 PECOS PAC ID: 0941554851 Enrollment ID: I20181113000682 |
| Provider Name | Maria Irma Santos Leonard |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205823234 PECOS PAC ID: 2466614243 Enrollment ID: I20181129002994 |
| Provider Name | Nicholas Joseph Kaslin |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1184119604 PECOS PAC ID: 2264776210 Enrollment ID: I20181203002864 |
| Provider Name | Katherine Duggleby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508336942 PECOS PAC ID: 4880930700 Enrollment ID: I20190115001104 |
| Provider Name | Cari Marie Lynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295278620 PECOS PAC ID: 1850673872 Enrollment ID: I20190131002304 |
| Provider Name | Cynthia Tucker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366437998 PECOS PAC ID: 2860482122 Enrollment ID: I20190201000753 |
| Provider Name | Bradley Jay Stokes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740627488 PECOS PAC ID: 9739408840 Enrollment ID: I20190204002529 |
| Provider Name | Megan Mavety |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164933578 PECOS PAC ID: 8921358565 Enrollment ID: I20190206003024 |
| Provider Name | Tram Huynh |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1831611573 PECOS PAC ID: 8729353487 Enrollment ID: I20190208000062 |
| Provider Name | Kazunari Kuno |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790721199 PECOS PAC ID: 9335296581 Enrollment ID: I20190514001064 |
| Provider Name | Javier Antonio Aguirre |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366731770 PECOS PAC ID: 1658687645 Enrollment ID: I20190516000806 |
| Provider Name | Amanda Marie Tompkins |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1982120218 PECOS PAC ID: 7315270022 Enrollment ID: I20190612002064 |
| Provider Name | Ann E Treisman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093243982 PECOS PAC ID: 5597034157 Enrollment ID: I20190709003061 |
| Provider Name | Kathleen Ann Gates |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1619906187 PECOS PAC ID: 1153656327 Enrollment ID: I20190710001349 |
| Provider Name | Gretchen Marie Nonawzki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871159392 PECOS PAC ID: 3577898766 Enrollment ID: I20190710002280 |
| Provider Name | Lisa Marie Reimer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396206488 PECOS PAC ID: 7618202847 Enrollment ID: I20190710003401 |
| Provider Name | Matthew Bonello |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831686955 PECOS PAC ID: 4082958582 Enrollment ID: I20190711000406 |
| Provider Name | Richard Lyle Leensvaart |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1528356532 PECOS PAC ID: 8921333055 Enrollment ID: I20190711003103 |
| Provider Name | Nicholas Sloan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093276065 PECOS PAC ID: 5799010633 Enrollment ID: I20190715001039 |
| Provider Name | Victoria Mae Rachel Zielinski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194386714 PECOS PAC ID: 7618202482 Enrollment ID: I20190716002600 |
| Provider Name | Stacy Lynn Romero Willson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851746275 PECOS PAC ID: 5799011037 Enrollment ID: I20190724003876 |
| Provider Name | Emily Jeanne Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033565908 PECOS PAC ID: 1355635871 Enrollment ID: I20190730000929 |
| Provider Name | Kendal Nylas Carlson |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1972501369 PECOS PAC ID: 5991032179 Enrollment ID: I20190809002940 |
| Provider Name | Dawn Dimitri |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1932265501 PECOS PAC ID: 6608104419 Enrollment ID: I20190817000088 |
| Provider Name | Amanda Neidermyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154984466 PECOS PAC ID: 7719215177 Enrollment ID: I20190822001917 |
| Provider Name | Shizuka Buckner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306324751 PECOS PAC ID: 5193054492 Enrollment ID: I20190912000054 |
| Provider Name | Julio C Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174179816 PECOS PAC ID: 5193054351 Enrollment ID: I20190912002900 |
| Provider Name | Seth Adam Carley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326693375 PECOS PAC ID: 9335478536 Enrollment ID: I20190913000932 |
| Provider Name | Nathaniel Hock |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1134614688 PECOS PAC ID: 1658601554 Enrollment ID: I20190919000269 |
| Provider Name | Meredith Marie Hudson |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1154412351 PECOS PAC ID: 0840520631 Enrollment ID: I20190920001411 |
| Provider Name | Dwayne Preston Hall |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1003933847 PECOS PAC ID: 9537499348 Enrollment ID: I20190920002403 |
| Provider Name | Jennifer J Berrier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992262414 PECOS PAC ID: 6002146461 Enrollment ID: I20190926003419 |
| Provider Name | Shelby Sheldon Deuser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386099497 PECOS PAC ID: 8527351402 Enrollment ID: I20190930002013 |
| Provider Name | Jaclyn Workman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790331387 PECOS PAC ID: 0345571444 Enrollment ID: I20191003001486 |
| Provider Name | Kerry Mark Simon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205823762 PECOS PAC ID: 4688733819 Enrollment ID: I20191010001470 |
| Provider Name | Amelia Truesdale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629590146 PECOS PAC ID: 4688905201 Enrollment ID: I20191014001097 |
| Provider Name | Lindsay Orr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073009288 PECOS PAC ID: 0143552950 Enrollment ID: I20191029000672 |
| Provider Name | Emily Dill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801309224 PECOS PAC ID: 5698007433 Enrollment ID: I20191029001742 |
| Provider Name | Hannah Pienciak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790249993 PECOS PAC ID: 0749512580 Enrollment ID: I20191029001967 |
| Provider Name | Tina M Nance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659928562 PECOS PAC ID: 1254663693 Enrollment ID: I20191104002635 |
| Provider Name | Elena Mikhailovna Z Ollis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407123581 PECOS PAC ID: 1759546575 Enrollment ID: I20191106003218 |
| Provider Name | Shannon N Roberts |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1740535814 PECOS PAC ID: 4789980962 Enrollment ID: I20191108002335 |
| Provider Name | Ravi Gupta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437600624 PECOS PAC ID: 1254763881 Enrollment ID: I20191119002540 |
| Provider Name | Samantha Rae Didomenico |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1891241527 PECOS PAC ID: 2062790173 Enrollment ID: I20191121001858 |
| Provider Name | Patrick Murphy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700429198 PECOS PAC ID: 9133552870 Enrollment ID: I20191210002618 |
| Provider Name | Joel T Tanaka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356361950 PECOS PAC ID: 4183977168 Enrollment ID: I20191220001084 |
| Provider Name | Neida L. Blondet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669014593 PECOS PAC ID: 8921432147 Enrollment ID: I20191221000622 |
| Provider Name | Amber B Carriveau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851522502 PECOS PAC ID: 6204981681 Enrollment ID: I20200103000823 |
| Provider Name | Heather R Despard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467094581 PECOS PAC ID: 6800220690 Enrollment ID: I20200103000876 |
| Provider Name | Dennis Lynn Kuik |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023241726 PECOS PAC ID: 8224465463 Enrollment ID: I20200227001171 |
| Provider Name | Lisa Marie Reed |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770117822 PECOS PAC ID: 2466880919 Enrollment ID: I20200316000842 |
| Provider Name | Rachel Pehrson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811231301 PECOS PAC ID: 5193003101 Enrollment ID: I20200401002451 |
| Provider Name | Sharon Oates |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679002984 PECOS PAC ID: 9436588670 Enrollment ID: I20200409000142 |
| Provider Name | Joda Lynn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497929376 PECOS PAC ID: 9739255605 Enrollment ID: I20200526000782 |
| Provider Name | Michelle E Easton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043692734 PECOS PAC ID: 1254752694 Enrollment ID: I20200610002636 |
| Provider Name | John Epperly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457578171 PECOS PAC ID: 9739258138 Enrollment ID: I20200625001207 |
| Provider Name | Chasity Shea Epperly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609095470 PECOS PAC ID: 3577695592 Enrollment ID: I20200625001536 |
| Provider Name | Stephanie Lombardi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619400421 PECOS PAC ID: 5092138818 Enrollment ID: I20200713000032 |
| Provider Name | Taylor Elise Morrison |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1174019871 PECOS PAC ID: 1254756372 Enrollment ID: I20200806002749 |
| Provider Name | Alexander Mark Hoelscher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073133344 PECOS PAC ID: 6406271204 Enrollment ID: I20200810002520 |
| Provider Name | Ashley Delaney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447815220 PECOS PAC ID: 5597180349 Enrollment ID: I20200811000277 |
| Provider Name | Austin West |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790305589 PECOS PAC ID: 1153746946 Enrollment ID: I20200811001357 |
| Provider Name | Shannon L Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376169763 PECOS PAC ID: 5092131888 Enrollment ID: I20200811001870 |
| Provider Name | Meng King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790313591 PECOS PAC ID: 5991121758 Enrollment ID: I20200811003927 |
| Provider Name | Dylan Richard Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730702580 PECOS PAC ID: 9537586326 Enrollment ID: I20200825001222 |
| Provider Name | Ann Belanger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700415031 PECOS PAC ID: 6204253909 Enrollment ID: I20200826002110 |
| Provider Name | John Henson Rivera Caparas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962730002 PECOS PAC ID: 8123445863 Enrollment ID: I20200826003362 |
| Provider Name | Amy Lynn Rickman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003072307 PECOS PAC ID: 2365768496 Enrollment ID: I20200831001583 |
| Provider Name | Trissana Deleon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417566183 PECOS PAC ID: 1254750425 Enrollment ID: I20201008000096 |
| Provider Name | Daniel O'shea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497085989 PECOS PAC ID: 1850711953 Enrollment ID: I20201012000495 |
| Provider Name | Anna Marie Coleman Otte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366057424 PECOS PAC ID: 0547680613 Enrollment ID: I20201013000132 |
| Provider Name | Elyze Wermel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194334698 PECOS PAC ID: 6709296908 Enrollment ID: I20201028003231 |
| Provider Name | Larisa A. Sychova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992147169 PECOS PAC ID: 5698902286 Enrollment ID: I20201110001713 |
| Provider Name | Meghan Stich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669828141 PECOS PAC ID: 2365794971 Enrollment ID: I20201202000591 |
| Provider Name | Amy G Dowling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659939650 PECOS PAC ID: 7719399179 Enrollment ID: I20201209002382 |
| Provider Name | Barbara Franklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023362894 PECOS PAC ID: 1759534795 Enrollment ID: I20210202000674 |
| Provider Name | Alyssa Marie Lantiere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942885009 PECOS PAC ID: 0941617708 Enrollment ID: I20210324000994 |
| Provider Name | Martha Greth Greth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619153335 PECOS PAC ID: 7416365515 Enrollment ID: I20210408002040 |
| Provider Name | Narlin Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407325244 PECOS PAC ID: 4587907779 Enrollment ID: I20210420000033 |
| Provider Name | Michael Joseph Swain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710560784 PECOS PAC ID: 9234538943 Enrollment ID: I20210601000705 |
| Provider Name | Jacan Simon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669969085 PECOS PAC ID: 5294082624 Enrollment ID: I20210614002031 |
| Provider Name | Erika L Willetts |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1235507310 PECOS PAC ID: 8224346457 Enrollment ID: I20210616000357 |
| Provider Name | Rachel Deak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184088726 PECOS PAC ID: 3072913797 Enrollment ID: I20210616002272 |
| Provider Name | Manuel Rodriguez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326301474 PECOS PAC ID: 5294135752 Enrollment ID: I20210621002345 |
| Provider Name | Marina Alyssa Wagner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073190773 PECOS PAC ID: 7113328303 Enrollment ID: I20210625000205 |
| Provider Name | Gretchen D Sonnenberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295227627 PECOS PAC ID: 6305194192 Enrollment ID: I20210628000914 |
| Provider Name | Michael Ray Wentzel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851881122 PECOS PAC ID: 8224387030 Enrollment ID: I20210628001591 |
| Provider Name | Natalie Lee Gould |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861072548 PECOS PAC ID: 4486055449 Enrollment ID: I20210628002778 |
| Provider Name | Hanna Mackie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043897853 PECOS PAC ID: 8224439096 Enrollment ID: I20210630002751 |
| Provider Name | Benjamin David Reiswig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962080432 PECOS PAC ID: 2860894128 Enrollment ID: I20210708001902 |
| Provider Name | Ellis Beardsley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497332100 PECOS PAC ID: 3375945579 Enrollment ID: I20210712000035 |
| Provider Name | Alexandrea Mae Villalobos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710550470 PECOS PAC ID: 4284038928 Enrollment ID: I20210803002365 |
| Provider Name | Darielle Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063095594 PECOS PAC ID: 8426452384 Enrollment ID: I20210813003259 |
| Provider Name | Sally Abell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699356733 PECOS PAC ID: 6507261435 Enrollment ID: I20210816002749 |
| Provider Name | Katharine R Davenport |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1225443757 PECOS PAC ID: 0042529281 Enrollment ID: I20210819000028 |
| Provider Name | Hannah Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962075036 PECOS PAC ID: 6002211596 Enrollment ID: I20210820002935 |
| Provider Name | Arely Dominguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548826670 PECOS PAC ID: 1355675703 Enrollment ID: I20210901001528 |
| Provider Name | Rebecca Paul Ivins |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1356838221 PECOS PAC ID: 9931507654 Enrollment ID: I20211011003155 |
| Provider Name | Vincent D Markovitz |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1124694898 PECOS PAC ID: 3971901513 Enrollment ID: I20211012000980 |
| Provider Name | Nikki Leigh Aragona |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1770848012 PECOS PAC ID: 0143628701 Enrollment ID: I20211012001977 |
| Provider Name | Heather Nicole Matejka |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1609424837 PECOS PAC ID: 9436481561 Enrollment ID: I20211020001396 |
| Provider Name | Kristyn Joanne Duffy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366061046 PECOS PAC ID: 0244628196 Enrollment ID: I20211026000243 |
| Provider Name | David J Franckum |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1265768527 PECOS PAC ID: 6901117886 Enrollment ID: I20211102001669 |
| Provider Name | Mildred Sullivan Nelson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952318545 PECOS PAC ID: 2062464696 Enrollment ID: I20220208000050 |
| Provider Name | Geoffroy Destenaves |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1043759384 PECOS PAC ID: 0648663591 Enrollment ID: I20220217000545 |
| Provider Name | Dawn O'keefe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477022135 PECOS PAC ID: 3870835713 Enrollment ID: I20220221000201 |
| Provider Name | Meghan Lea Keane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528528098 PECOS PAC ID: 2062742844 Enrollment ID: I20220428000339 |
| Provider Name | Nicole Lynn Norris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316585607 PECOS PAC ID: 9830579028 Enrollment ID: I20220706000988 |
| Provider Name | Claudia Marshall Margiotta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487385993 PECOS PAC ID: 9335520865 Enrollment ID: I20220715000012 |
| Provider Name | Elya Hess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083140263 PECOS PAC ID: 6608140421 Enrollment ID: I20220718003249 |
| Provider Name | Emily Catherine Ptaszek |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821027814 PECOS PAC ID: 6406803600 Enrollment ID: I20220725003383 |
| Provider Name | Arlene Canchola |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1881328979 PECOS PAC ID: 1254717051 Enrollment ID: I20221003000297 |
| Provider Name | Emmeline Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154040574 PECOS PAC ID: 8123404803 Enrollment ID: I20221004000922 |
| Provider Name | Colleen A Rose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205436854 PECOS PAC ID: 3577949098 Enrollment ID: I20221005003725 |
| Provider Name | Jennifer Whitney Fehr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205554797 PECOS PAC ID: 5092181651 Enrollment ID: I20221021002721 |
| Provider Name | Catherine Ann Pheasant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043471865 PECOS PAC ID: 7416323936 Enrollment ID: I20221024002629 |
| Provider Name | Tarika Gyawali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992432991 PECOS PAC ID: 9830565365 Enrollment ID: I20221025000273 |
| Provider Name | Anna Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184354847 PECOS PAC ID: 6901272483 Enrollment ID: I20221025002288 |
| Provider Name | Simonique Jessie-allean Grissom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710623012 PECOS PAC ID: 7113393513 Enrollment ID: I20221025003356 |
| Provider Name | Alexis Mascarenas |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1245906437 PECOS PAC ID: 5193195261 Enrollment ID: I20230105002743 |
| Provider Name | Manuel Lugo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316992332 PECOS PAC ID: 7618953852 Enrollment ID: I20230106001111 |
| Provider Name | Bhavna Bali |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164691788 PECOS PAC ID: 9335313253 Enrollment ID: I20230113002549 |
| Provider Name | Stephanie Np Guerrero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881361624 PECOS PAC ID: 1153792338 Enrollment ID: I20230126000883 |
| Provider Name | Hannah E Pilla |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215642855 PECOS PAC ID: 2466827332 Enrollment ID: I20230406000338 |
| Provider Name | Kristin M Montgomery |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1528340189 PECOS PAC ID: 0648635961 Enrollment ID: I20230420000681 |
| Provider Name | Krystlynn A Grundtner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669801114 PECOS PAC ID: 8729219258 Enrollment ID: I20230428001522 |
| Provider Name | Marshal E Ash |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255829719 PECOS PAC ID: 9234487430 Enrollment ID: I20230511002102 |
| Provider Name | Jacqueline R Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184080707 PECOS PAC ID: 1850750019 Enrollment ID: I20230706000972 |
| Provider Name | Jennifer Stobbs Vergara |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1215678636 PECOS PAC ID: 2365801313 Enrollment ID: I20230708000090 |
| Provider Name | Samantha A. Lawson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1780199927 PECOS PAC ID: 8921357054 Enrollment ID: I20230731002200 |
| Provider Name | Whitney C Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568066868 PECOS PAC ID: 5890149165 Enrollment ID: I20230921000595 |
| Provider Name | Beth M Jones |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1073787420 PECOS PAC ID: 5597110999 Enrollment ID: I20231004002346 |
| Provider Name | Malory K Splawn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235805136 PECOS PAC ID: 1052718558 Enrollment ID: I20231024000323 |
| Provider Name | Shannon Webb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144204405 PECOS PAC ID: 8729079850 Enrollment ID: I20231026000780 |
| Provider Name | Rachel S Hanauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588322358 PECOS PAC ID: 4284024407 Enrollment ID: I20231030000048 |
| Provider Name | Crystal D Gutierrez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225812738 PECOS PAC ID: 1456707330 Enrollment ID: I20231030000335 |
| Provider Name | Sarika Muir Steinhaus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386320414 PECOS PAC ID: 3072969658 Enrollment ID: I20231102002584 |
| Provider Name | Candace C Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255116430 PECOS PAC ID: 0941657068 Enrollment ID: I20231111000606 |
| Provider Name | Margaret S Croslen |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1619462868 PECOS PAC ID: 7012261662 Enrollment ID: I20231213000485 |
| Provider Name | Eileen M Montoya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861106221 PECOS PAC ID: 5890144950 Enrollment ID: I20231214001276 |
| Provider Name | Linda M Corum |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154426278 PECOS PAC ID: 4183074628 Enrollment ID: I20231227000569 |
| Provider Name | Jennifer A Higler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154462919 PECOS PAC ID: 1951751288 Enrollment ID: I20231228000968 |
| Provider Name | Kelly J Echols |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003469511 PECOS PAC ID: 6103276431 Enrollment ID: I20231228001063 |
| Provider Name | Danielle M Gamboa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053080184 PECOS PAC ID: 8820448178 Enrollment ID: I20231228001521 |
| Provider Name | Kathryn Foote |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437766144 PECOS PAC ID: 8820448020 Enrollment ID: I20240101000354 |
| Provider Name | Maria Rodriguez-roa |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1114013653 PECOS PAC ID: 2860842077 Enrollment ID: I20240102000163 |
| Provider Name | Amber Vance |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821514704 PECOS PAC ID: 4486004694 Enrollment ID: I20240102000230 |
| Provider Name | Miranda J Jackson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750683447 PECOS PAC ID: 6709017924 Enrollment ID: I20240102001083 |
| Provider Name | Christian Sharpe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518683671 PECOS PAC ID: 1850741992 Enrollment ID: I20240102001597 |
| Provider Name | Eric A Attard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255784021 PECOS PAC ID: 7416307467 Enrollment ID: I20240103001699 |
| Provider Name | Joy F Brewer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235338773 PECOS PAC ID: 9638529605 Enrollment ID: I20240103002426 |
| Provider Name | Jeffrey D Derry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528359734 PECOS PAC ID: 9335599307 Enrollment ID: I20240103002516 |
| Provider Name | Carrie A Duepmann |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225358690 PECOS PAC ID: 2567813512 Enrollment ID: I20240104000493 |
| Provider Name | Samantha L Miller |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1598148504 PECOS PAC ID: 4880045715 Enrollment ID: I20240104003878 |
| Provider Name | Cheryl A Spice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285288639 PECOS PAC ID: 3072965920 Enrollment ID: I20240117000932 |
| Provider Name | Mai Anne Q Musni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972388643 PECOS PAC ID: 9032561725 Enrollment ID: I20240118001263 |
| Provider Name | Ned Becker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518915339 PECOS PAC ID: 9436592375 Enrollment ID: I20240208000565 |
| Provider Name | Jennifer M Berger-vernace |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114275021 PECOS PAC ID: 4385893452 Enrollment ID: I20240215000552 |
Amazing Medicine Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5777 N Academy Blvd, Colorado Springs, CO 80918 Phone: 719-266-5800 Fax: 719-960-2039 | |
Peakmed Colorado, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 321 S Tejon St Ste 100, Colorado Springs, CO 80903 Phone: 719-623-3068 | |
Kids Are Great Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 320 E Fontanero St, Suite 308, Colorado Springs, CO 80907 Phone: 719-577-4200 Fax: 719-442-6595 | |
Dcs Internal Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5550 Vessey Rd, Colorado Springs, CO 80908 Phone: 623-680-0539 | |
Northwest Internal Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5390 N Academy Blvd, #300, Colorado Springs, CO 80918 Phone: 719-884-1210 | |
Peak Gastroenterology Associates Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2920 N Cascade Ave Ste 301, Colorado Springs, CO 80907 Phone: 719-636-1201 Fax: 719-955-0986 | |
Security Chiropractic, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1825 Main St Ste C, Colorado Springs, CO 80911 Phone: 719-390-5008 Fax: 719-390-9321 |