| Redbird Smith Health Center | |
|
301 S J T Stites St Sallisaw OK 74955-9302 | |
| (918) 775-9150 | |
| (918) 775-4778 |
| Full Name | Redbird Smith Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 301 S J T Stites St, Sallisaw, Oklahoma |
| Authorized Official Name and Position | Stephen Robert Jones (EXECUTIVE DIRECTOR, HEALTH SERVICES) |
| Authorized Official Contact | 9187759150 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Redbird Smith Health Center Po Box 1069 Tahlequah OK 74465-1069 Ph: (539) 234-2694 | Redbird Smith Health Center 301 S J T Stites St Sallisaw OK 74955-9302 Ph: (918) 775-9150 |
| NPI Number | 1780692723 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 11/21/2022 |
| Medicare PECOS PAC ID | 5799698742 |
|---|---|
| Medicare Enrollment ID | O20031106000628 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780692723 | NPI | - | NPPES |
| 370171 | Other | OK | MEDICARE PART A |
| 100689220O | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Jennifer R Holman |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1417069782 PECOS PAC ID: 7719890219 Enrollment ID: I20031111000193 |
| Provider Name | Denise M Goss |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1225026008 PECOS PAC ID: 8820901184 Enrollment ID: I20031112000059 |
| Provider Name | Schuyler T Steelberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528052875 PECOS PAC ID: 6608789961 Enrollment ID: I20031112000085 |
| Provider Name | Migdalia Muriel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770573404 PECOS PAC ID: 0648183830 Enrollment ID: I20031112000707 |
| Provider Name | Michael Underwood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528050085 PECOS PAC ID: 8022922210 Enrollment ID: I20031112000735 |
| Provider Name | Terrie L Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407849193 PECOS PAC ID: 0840104006 Enrollment ID: I20031113000210 |
| Provider Name | Rachel A Rhodes |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1003804733 PECOS PAC ID: 7911802871 Enrollment ID: I20031203000733 |
| Provider Name | Timothy M Hsieh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265423883 PECOS PAC ID: 4789580655 Enrollment ID: I20031210001056 |
| Provider Name | Henricus G Vanveen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1871510461 PECOS PAC ID: 5890681605 Enrollment ID: I20040226000910 |
| Provider Name | Latricia D Pack |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1043230477 PECOS PAC ID: 7517854987 Enrollment ID: I20040301000914 |
| Provider Name | Jeff M Miller |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144240573 PECOS PAC ID: 5092602482 Enrollment ID: I20040301001019 |
| Provider Name | Justin R Lindsey |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1578554515 PECOS PAC ID: 9133016538 Enrollment ID: I20040301001112 |
| Provider Name | Bryan L Young |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1962422394 PECOS PAC ID: 0547157950 Enrollment ID: I20040301001157 |
| Provider Name | Heidi A Thoden |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1295754299 PECOS PAC ID: 2860389285 Enrollment ID: I20040301001196 |
| Provider Name | Wesley J Derosier |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1760401764 PECOS PAC ID: 9234026170 Enrollment ID: I20040303001294 |
| Provider Name | Douglas K Penisten |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1487673489 PECOS PAC ID: 6103713052 Enrollment ID: I20040303001320 |
| Provider Name | John Lindsay |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1134149560 PECOS PAC ID: 1153219225 Enrollment ID: I20040309001266 |
| Provider Name | Tracy L Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639162704 PECOS PAC ID: 6305736604 Enrollment ID: I20040318001824 |
| Provider Name | James C King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235207713 PECOS PAC ID: 9931195831 Enrollment ID: I20040424000451 |
| Provider Name | Nakita Brite |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1902008022 PECOS PAC ID: 4688658875 Enrollment ID: I20040615001580 |
| Provider Name | Alan G Mckee |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1326068750 PECOS PAC ID: 8921099292 Enrollment ID: I20040830000761 |
| Provider Name | Earlena F Mckee |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1235159666 PECOS PAC ID: 6406742980 Enrollment ID: I20041116000222 |
| Provider Name | Charles D Knife Chief |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760405740 PECOS PAC ID: 9638134240 Enrollment ID: I20041123000567 |
| Provider Name | Matthew C Headrick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922183631 PECOS PAC ID: 3870543606 Enrollment ID: I20050128000414 |
| Provider Name | Nathan Tillotson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770670473 PECOS PAC ID: 3274589064 Enrollment ID: I20050324000552 |
| Provider Name | Rebel D Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659373223 PECOS PAC ID: 5294648978 Enrollment ID: I20050413000848 |
| Provider Name | Laura Jean Strickland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124011242 PECOS PAC ID: 9830136662 Enrollment ID: I20050413000894 |
| Provider Name | Timothy T Mccay |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245221761 PECOS PAC ID: 2961456538 Enrollment ID: I20050621000935 |
| Provider Name | Dean Roy Fullingim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770574253 PECOS PAC ID: 5193710929 Enrollment ID: I20050712000568 |
| Provider Name | Sheila Malone Taber |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447241971 PECOS PAC ID: 1557311495 Enrollment ID: I20050715000344 |
| Provider Name | George E Erbacher |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326039801 PECOS PAC ID: 5991755829 Enrollment ID: I20050720000214 |
| Provider Name | Felino A Pascual |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801877055 PECOS PAC ID: 6002801834 Enrollment ID: I20050728000628 |
| Provider Name | John S Dennis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871584060 PECOS PAC ID: 3173594389 Enrollment ID: I20050728000739 |
| Provider Name | Elaine Kennedy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083634935 PECOS PAC ID: 2365474665 Enrollment ID: I20050907001257 |
| Provider Name | Gary W Earp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497726533 PECOS PAC ID: 1658305370 Enrollment ID: I20050922000385 |
| Provider Name | Christen D Leal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144426628 PECOS PAC ID: 3870519606 Enrollment ID: I20051020000484 |
| Provider Name | Alissa K Proctor |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972523751 PECOS PAC ID: 4385679919 Enrollment ID: I20051022000248 |
| Provider Name | Kent Edward Ward |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1295703411 PECOS PAC ID: 4486673431 Enrollment ID: I20051118000271 |
| Provider Name | Seth D Yandell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730389396 PECOS PAC ID: 7315967486 Enrollment ID: I20051205000238 |
| Provider Name | James Richard Taylor |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1760406896 PECOS PAC ID: 6608897723 Enrollment ID: I20051215000801 |
| Provider Name | Leah A Bailey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790760171 PECOS PAC ID: 3072536895 Enrollment ID: I20060109001080 |
| Provider Name | Thomas Kincade |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104897719 PECOS PAC ID: 2163490442 Enrollment ID: I20060602000216 |
| Provider Name | Jana L Jordan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497764328 PECOS PAC ID: 2163421041 Enrollment ID: I20061204000652 |
| Provider Name | Myeong S Yoon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497722342 PECOS PAC ID: 0042227266 Enrollment ID: I20070219000272 |
| Provider Name | Jamie S Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508800707 PECOS PAC ID: 9133137003 Enrollment ID: I20070301000440 |
| Provider Name | Patricia Dianne Hudson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1700865649 PECOS PAC ID: 0446232458 Enrollment ID: I20070419000682 |
| Provider Name | Sharon C Smallwood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154377125 PECOS PAC ID: 0345149357 Enrollment ID: I20070505000028 |
| Provider Name | Bryson Harris |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669555041 PECOS PAC ID: 7719086859 Enrollment ID: I20070630000010 |
| Provider Name | Judith A Riley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609879238 PECOS PAC ID: 4082656640 Enrollment ID: I20070630000022 |
| Provider Name | Laura J Chalmers |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1710046156 PECOS PAC ID: 5193791879 Enrollment ID: I20070703000677 |
| Provider Name | William G Worthington |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1548461239 PECOS PAC ID: 5991806168 Enrollment ID: I20070718000784 |
| Provider Name | Jennifer L Claycomb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144323353 PECOS PAC ID: 7517058191 Enrollment ID: I20070810000673 |
| Provider Name | Leslie J Rebtoy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376526889 PECOS PAC ID: 2668385055 Enrollment ID: I20071025000231 |
| Provider Name | Rebecca A Enloe |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1578753216 PECOS PAC ID: 0446347959 Enrollment ID: I20071213000425 |
| Provider Name | Juliet Colyer |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1932104676 PECOS PAC ID: 4183673387 Enrollment ID: I20080212000492 |
| Provider Name | Jennifer I Newton |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1114109816 PECOS PAC ID: 5496831646 Enrollment ID: I20080327000711 |
| Provider Name | Penny M Wilkie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861557977 PECOS PAC ID: 9234217936 Enrollment ID: I20080422000251 |
| Provider Name | Mark E Mitchell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689634479 PECOS PAC ID: 4183643372 Enrollment ID: I20080430000375 |
| Provider Name | Roberto Suarez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881779445 PECOS PAC ID: 9436228749 Enrollment ID: I20080513000189 |
| Provider Name | Dante Perez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689856254 PECOS PAC ID: 7618046020 Enrollment ID: I20080527000100 |
| Provider Name | Douglas L Young |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1306820550 PECOS PAC ID: 2264431709 Enrollment ID: I20080625000263 |
| Provider Name | Ryan E Fenska |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1730342684 PECOS PAC ID: 8022184985 Enrollment ID: I20080829000436 |
| Provider Name | Laura L Arrowsmith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083654800 PECOS PAC ID: 9638123631 Enrollment ID: I20081014000674 |
| Provider Name | Judith Wolfstein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013914456 PECOS PAC ID: 0345135232 Enrollment ID: I20081203000298 |
| Provider Name | David J Wilson |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1427168566 PECOS PAC ID: 5193887354 Enrollment ID: I20081222000463 |
| Provider Name | David Gahn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275523839 PECOS PAC ID: 9234166588 Enrollment ID: I20090102000224 |
| Provider Name | Sharon R James-schmidt |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1376550236 PECOS PAC ID: 0547323123 Enrollment ID: I20090107000646 |
| Provider Name | James A Lewis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992786768 PECOS PAC ID: 5991868572 Enrollment ID: I20090107000649 |
| Provider Name | Douglas C Nolan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700893898 PECOS PAC ID: 6709949381 Enrollment ID: I20090107000656 |
| Provider Name | Anna Lee Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780691980 PECOS PAC ID: 5698838050 Enrollment ID: I20090112000033 |
| Provider Name | Cheryl D Tarver |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1043294994 PECOS PAC ID: 8820151285 Enrollment ID: I20090112000086 |
| Provider Name | Nanetta B Lowe |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417058215 PECOS PAC ID: 8820151293 Enrollment ID: I20090112000096 |
| Provider Name | Brett M Howell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558527168 PECOS PAC ID: 2961565031 Enrollment ID: I20090115000489 |
| Provider Name | Owen B Gilmore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194727198 PECOS PAC ID: 7315955846 Enrollment ID: I20090116000129 |
| Provider Name | Sean W Poe |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710905039 PECOS PAC ID: 7113080193 Enrollment ID: I20090117000016 |
| Provider Name | Sherri L Trammel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619900727 PECOS PAC ID: 8527121490 Enrollment ID: I20090120000714 |
| Provider Name | Phyllis C Nolan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700803616 PECOS PAC ID: 8224192208 Enrollment ID: I20090206000063 |
| Provider Name | Jason Pack |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861549743 PECOS PAC ID: 3375623887 Enrollment ID: I20090305000362 |
| Provider Name | Ralph Noah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669458741 PECOS PAC ID: 6800966284 Enrollment ID: I20090326000463 |
| Provider Name | Peter Ramzy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457596645 PECOS PAC ID: 8224186945 Enrollment ID: I20090506000193 |
| Provider Name | Hope M Baluh |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932294642 PECOS PAC ID: 6608925920 Enrollment ID: I20090515000506 |
| Provider Name | Daniel L Pablo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558449116 PECOS PAC ID: 8628122967 Enrollment ID: I20090820000380 |
| Provider Name | Mallorre R Dill |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588819569 PECOS PAC ID: 8729133319 Enrollment ID: I20090903000255 |
| Provider Name | Jeremy Scott Fullingim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255537304 PECOS PAC ID: 5092867762 Enrollment ID: I20090917000124 |
| Provider Name | Damon L Brooks |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558583963 PECOS PAC ID: 4587715354 Enrollment ID: I20090917000269 |
| Provider Name | John Kirk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518167543 PECOS PAC ID: 4981752409 Enrollment ID: I20091020000324 |
| Provider Name | Nathan R Lighthizer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1366671497 PECOS PAC ID: 6608913694 Enrollment ID: I20091030000098 |
| Provider Name | Catherine Mercer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902037252 PECOS PAC ID: 6103965405 Enrollment ID: I20091130000076 |
| Provider Name | Jenna M Lighthizer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154586501 PECOS PAC ID: 4981759479 Enrollment ID: I20091202000254 |
| Provider Name | Tony A Little |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336131242 PECOS PAC ID: 8628971462 Enrollment ID: I20091230000604 |
| Provider Name | Lori L Enlow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700875598 PECOS PAC ID: 0345254314 Enrollment ID: I20100209000446 |
| Provider Name | Jacquelyn James |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1811136112 PECOS PAC ID: 6608911458 Enrollment ID: I20100303001084 |
| Provider Name | George S Miller |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487685715 PECOS PAC ID: 2668413568 Enrollment ID: I20100416000415 |
| Provider Name | Michelle M Ponder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447399415 PECOS PAC ID: 4880787217 Enrollment ID: I20100428000166 |
| Provider Name | Dominic J Totani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396734646 PECOS PAC ID: 5294863841 Enrollment ID: I20100503000469 |
| Provider Name | Sylvia Soto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063422814 PECOS PAC ID: 3173651411 Enrollment ID: I20100507000259 |
| Provider Name | James Stallcup |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821008046 PECOS PAC ID: 7911909734 Enrollment ID: I20100714000867 |
| Provider Name | Christos Vassiliou |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053567784 PECOS PAC ID: 8820120454 Enrollment ID: I20100719000117 |
| Provider Name | Spencer D Johnson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1487747408 PECOS PAC ID: 1254365034 Enrollment ID: I20100721000589 |
| Provider Name | Brett M Gray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538158969 PECOS PAC ID: 5294631180 Enrollment ID: I20100805000905 |
| Provider Name | Tracy L Canant |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1578550364 PECOS PAC ID: 5496888703 Enrollment ID: I20100805001034 |
| Provider Name | Elizabeth Kate Couch-harris |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831366574 PECOS PAC ID: 1658405329 Enrollment ID: I20100817000516 |
| Provider Name | Kenneth L Watts |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1790992261 PECOS PAC ID: 9133213531 Enrollment ID: I20100913000727 |
| Provider Name | Christopher M Mcdaniels |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861705659 PECOS PAC ID: 8729103874 Enrollment ID: I20100914000462 |
| Provider Name | Melissa Horn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750373312 PECOS PAC ID: 4183749088 Enrollment ID: I20100915001124 |
| Provider Name | Sarah G Krein |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1841503919 PECOS PAC ID: 0345365094 Enrollment ID: I20100917000576 |
| Provider Name | Luis M Taveras |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447298278 PECOS PAC ID: 3173420239 Enrollment ID: I20101108000151 |
| Provider Name | Tammy Dexter |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1013147842 PECOS PAC ID: 6507902640 Enrollment ID: I20101117001427 |
| Provider Name | Stephen Snell |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1083616247 PECOS PAC ID: 7315994852 Enrollment ID: I20101122000135 |
| Provider Name | Nazhone P Yazzie |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164694220 PECOS PAC ID: 1153502372 Enrollment ID: I20110222000418 |
| Provider Name | Ryan M Freeman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1811282395 PECOS PAC ID: 5496936015 Enrollment ID: I20110301001113 |
| Provider Name | Angeline M Wickliffe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427351519 PECOS PAC ID: 6204017825 Enrollment ID: I20110301001128 |
| Provider Name | Nina C Jones |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003877754 PECOS PAC ID: 6901833367 Enrollment ID: I20110414000371 |
| Provider Name | Sarah E Horton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093017204 PECOS PAC ID: 2567647902 Enrollment ID: I20110428000086 |
| Provider Name | Judith A James |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1871561068 PECOS PAC ID: 4284658618 Enrollment ID: I20110719000796 |
| Provider Name | Van Pho |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740437284 PECOS PAC ID: 1052580651 Enrollment ID: I20110817000214 |
| Provider Name | Stephen A Back |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639302060 PECOS PAC ID: 3476723594 Enrollment ID: I20110829000547 |
| Provider Name | Eugene B Garber |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1508861378 PECOS PAC ID: 7416125422 Enrollment ID: I20111123000175 |
| Provider Name | Tonya Swim |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1316234321 PECOS PAC ID: 2961678024 Enrollment ID: I20111220000842 |
| Provider Name | Bobbi G Fishinghawk |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134249808 PECOS PAC ID: 3072789064 Enrollment ID: I20111221000453 |
| Provider Name | Emma Beth Harp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730477043 PECOS PAC ID: 3678749165 Enrollment ID: I20120104000897 |
| Provider Name | Jorge Mera |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1275597031 PECOS PAC ID: 5395749162 Enrollment ID: I20120210000515 |
| Provider Name | Melissa J Mcintosh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366465817 PECOS PAC ID: 4486782950 Enrollment ID: I20120228000558 |
| Provider Name | Lindsey B Schultheiss-harris |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225394638 PECOS PAC ID: 0446413389 Enrollment ID: I20120514000073 |
| Provider Name | Roger Desprez |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1154391993 PECOS PAC ID: 2860395886 Enrollment ID: I20120516000684 |
| Provider Name | Henry D Haskell |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1619994522 PECOS PAC ID: 6103829858 Enrollment ID: I20120524000607 |
| Provider Name | Whitney E Essex |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972877892 PECOS PAC ID: 3870757875 Enrollment ID: I20120601000440 |
| Provider Name | Tamar Windsor |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1922129253 PECOS PAC ID: 7214192202 Enrollment ID: I20120625000428 |
| Provider Name | Barinder P Bassi |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1013922772 PECOS PAC ID: 5991769945 Enrollment ID: I20120706000520 |
| Provider Name | Tschantre Eujeania Dorsett |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417117565 PECOS PAC ID: 8527224039 Enrollment ID: I20120727000712 |
| Provider Name | Patrick B O Hayre |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518134352 PECOS PAC ID: 2264695402 Enrollment ID: I20120730000568 |
| Provider Name | Leila Danielle See |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013164268 PECOS PAC ID: 6800059064 Enrollment ID: I20120810000291 |
| Provider Name | Roger C Montgomery |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902834898 PECOS PAC ID: 3476522798 Enrollment ID: I20120813000442 |
| Provider Name | Jessica Weber |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528397106 PECOS PAC ID: 1456514694 Enrollment ID: I20120822000334 |
| Provider Name | Jeffrey W Shelton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194864074 PECOS PAC ID: 7719141639 Enrollment ID: I20120823000396 |
| Provider Name | Christopher N Thompson |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1366741910 PECOS PAC ID: 2264680776 Enrollment ID: I20120906000851 |
| Provider Name | Jonathan M Hatley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770839979 PECOS PAC ID: 0840448601 Enrollment ID: I20120919000797 |
| Provider Name | Amanda Anne Whytal |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215191432 PECOS PAC ID: 7416105192 Enrollment ID: I20120921000470 |
| Provider Name | Kathryn B Hughes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801171590 PECOS PAC ID: 8729237318 Enrollment ID: I20120925000338 |
| Provider Name | Samuel Mcarthur |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1154577146 PECOS PAC ID: 1850540378 Enrollment ID: I20120927000197 |
| Provider Name | Terrina Brashear |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922299072 PECOS PAC ID: 9931280385 Enrollment ID: I20121017000117 |
| Provider Name | Sarah Dawn Mcauliff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174879548 PECOS PAC ID: 4486804663 Enrollment ID: I20121024000410 |
| Provider Name | Charles Neal Whittle |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427304799 PECOS PAC ID: 5799933636 Enrollment ID: I20121025000732 |
| Provider Name | Dustin R Beck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902179534 PECOS PAC ID: 9133370638 Enrollment ID: I20121109000369 |
| Provider Name | Kimberly Kaye Mulanax |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437224144 PECOS PAC ID: 4880864107 Enrollment ID: I20130123000464 |
| Provider Name | Joseph Leon Shetler |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1952362139 PECOS PAC ID: 4486609831 Enrollment ID: I20130206000140 |
| Provider Name | Carolyn E Majcher |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1033407127 PECOS PAC ID: 6406025733 Enrollment ID: I20130206000496 |
| Provider Name | Fred M Ruefer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1174528806 PECOS PAC ID: 5395634760 Enrollment ID: I20130214000045 |
| Provider Name | Lucinda L Sparks |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1891071924 PECOS PAC ID: 6800040163 Enrollment ID: I20130214000189 |
| Provider Name | Loni D Pearish |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811213879 PECOS PAC ID: 7012161391 Enrollment ID: I20130214000370 |
| Provider Name | Tasha A Sandersfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508118720 PECOS PAC ID: 7719132976 Enrollment ID: I20130220000097 |
| Provider Name | Maureen Haley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1750483970 PECOS PAC ID: 2769478981 Enrollment ID: I20130405000203 |
| Provider Name | Amy E Slama |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1962758078 PECOS PAC ID: 4385892272 Enrollment ID: I20130409000533 |
| Provider Name | Matthew H Wiley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1376830356 PECOS PAC ID: 0244476943 Enrollment ID: I20130425000349 |
| Provider Name | Emmanuel Samedi |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1174862783 PECOS PAC ID: 0840436366 Enrollment ID: I20130429000207 |
| Provider Name | Larissa M Hancock |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1790024800 PECOS PAC ID: 9133367758 Enrollment ID: I20130521000292 |
| Provider Name | Mark H Thai |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1235397845 PECOS PAC ID: 0446305940 Enrollment ID: I20130524000468 |
| Provider Name | Nicole R Willis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831428143 PECOS PAC ID: 1355589128 Enrollment ID: I20130606000405 |
| Provider Name | Kendra D Round |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033459763 PECOS PAC ID: 6103065263 Enrollment ID: I20130620000522 |
| Provider Name | Thomas A Digiovanna |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396735148 PECOS PAC ID: 4486624962 Enrollment ID: I20130621000088 |
| Provider Name | Jonathon D Kirkland |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639315260 PECOS PAC ID: 4789823139 Enrollment ID: I20130726000027 |
| Provider Name | John D Leever |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912149261 PECOS PAC ID: 0042473738 Enrollment ID: I20130807000187 |
| Provider Name | Pamela K Rusco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194996397 PECOS PAC ID: 1557502291 Enrollment ID: I20130827000379 |
| Provider Name | James N Pham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306089578 PECOS PAC ID: 4284876558 Enrollment ID: I20130911000061 |
| Provider Name | John W Mooring |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1174734495 PECOS PAC ID: 9830330216 Enrollment ID: I20131030000671 |
| Provider Name | Jana R Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427360437 PECOS PAC ID: 7810147683 Enrollment ID: I20131112000053 |
| Provider Name | Roy P Ward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902197049 PECOS PAC ID: 2860642170 Enrollment ID: I20131218001705 |
| Provider Name | April J Parker |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609218056 PECOS PAC ID: 8022245760 Enrollment ID: I20131230000290 |
| Provider Name | Jason Keith Miles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174889448 PECOS PAC ID: 8820226103 Enrollment ID: I20140113000767 |
| Provider Name | Julie M Gaskins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023444619 PECOS PAC ID: 6800024654 Enrollment ID: I20140124000910 |
| Provider Name | Justin Keith Hamlin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174883607 PECOS PAC ID: 5991935355 Enrollment ID: I20140304000689 |
| Provider Name | Elizabeth Pepe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700874039 PECOS PAC ID: 8426288713 Enrollment ID: I20140306001384 |
| Provider Name | Jari Jill Frazier |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1326087636 PECOS PAC ID: 4587791041 Enrollment ID: I20140310000651 |
| Provider Name | Stephanie D Bunch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497196497 PECOS PAC ID: 4486884491 Enrollment ID: I20140312001722 |
| Provider Name | Brooke White |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558679035 PECOS PAC ID: 4688807464 Enrollment ID: I20140516000548 |
| Provider Name | Dianne K Hardy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376765842 PECOS PAC ID: 3476607243 Enrollment ID: I20140624000659 |
| Provider Name | Michael J Golden |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952527012 PECOS PAC ID: 9032353313 Enrollment ID: I20140701000579 |
| Provider Name | Michael William Gaydos |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1225301443 PECOS PAC ID: 7113144098 Enrollment ID: I20140818000708 |
| Provider Name | Matthew Cameron Rumsey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326334657 PECOS PAC ID: 3274774203 Enrollment ID: I20140818001052 |
| Provider Name | Nicholas Bull |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487968756 PECOS PAC ID: 6507099389 Enrollment ID: I20140821001827 |
| Provider Name | Peter J Mostert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326346875 PECOS PAC ID: 2860635844 Enrollment ID: I20140828001578 |
| Provider Name | Patricia A Mahoney |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1861470007 PECOS PAC ID: 7416956073 Enrollment ID: I20140904001760 |
| Provider Name | Kyle A Ryff |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1790193597 PECOS PAC ID: 5991924979 Enrollment ID: I20140924002026 |
| Provider Name | Bo Yon Choi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053551721 PECOS PAC ID: 5890920870 Enrollment ID: I20140925002205 |
| Provider Name | Shannon Dawn Swayne |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396154522 PECOS PAC ID: 9739309584 Enrollment ID: I20140930001799 |
| Provider Name | Andrea K Smith-gray |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740583442 PECOS PAC ID: 1850511502 Enrollment ID: I20141001002235 |
| Provider Name | Jennifer Larie Renard |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1699183061 PECOS PAC ID: 0143440552 Enrollment ID: I20141007002339 |
| Provider Name | Usha Kanakamedala |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801840236 PECOS PAC ID: 8820054182 Enrollment ID: I20141016000760 |
| Provider Name | Holly J Dawson |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1265761381 PECOS PAC ID: 9830369099 Enrollment ID: I20141017001656 |
| Provider Name | Tasha S Lunsford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225438682 PECOS PAC ID: 1254552086 Enrollment ID: I20141021001024 |
| Provider Name | Andrea Kristine Horne |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1083027957 PECOS PAC ID: 8729209788 Enrollment ID: I20141028000249 |
| Provider Name | Dierdre A Mcauley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649566720 PECOS PAC ID: 8820231699 Enrollment ID: I20141104001188 |
| Provider Name | Cynthia L Holmes |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1104887488 PECOS PAC ID: 1557263787 Enrollment ID: I20141106000878 |
| Provider Name | Sigrid Wayne |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1902016397 PECOS PAC ID: 0840367769 Enrollment ID: I20141106000969 |
| Provider Name | Damaris G Deutsch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699862573 PECOS PAC ID: 2163473208 Enrollment ID: I20141106001423 |
| Provider Name | Neil E Fuehrer |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1487835757 PECOS PAC ID: 0446381842 Enrollment ID: I20141106001647 |
| Provider Name | Ashley D Gable |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1255531562 PECOS PAC ID: 4183792096 Enrollment ID: I20141106001994 |
| Provider Name | Heidi L Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477952976 PECOS PAC ID: 1658693965 Enrollment ID: I20141122000100 |
| Provider Name | Deborah J Moreau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164754008 PECOS PAC ID: 4981733482 Enrollment ID: I20141205001672 |
| Provider Name | Adam G Sprankell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306051677 PECOS PAC ID: 2264591080 Enrollment ID: I20141218002103 |
| Provider Name | Aaron Q Lane |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669431169 PECOS PAC ID: 0547160319 Enrollment ID: I20141230002372 |
| Provider Name | Rose D Gilman Kline |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1639101066 PECOS PAC ID: 1153381116 Enrollment ID: I20141231000687 |
| Provider Name | Marshall Walker |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1033554118 PECOS PAC ID: 6103149083 Enrollment ID: I20150106000838 |
| Provider Name | Alan D Grover |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1760672331 PECOS PAC ID: 7810077419 Enrollment ID: I20150109000775 |
| Provider Name | David Herbert Jelley |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1649257569 PECOS PAC ID: 5799862520 Enrollment ID: I20150112000618 |
| Provider Name | Brian H Rodgers |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1093737280 PECOS PAC ID: 4082754585 Enrollment ID: I20150113002479 |
| Provider Name | Amy Np Meigs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760885628 PECOS PAC ID: 3375867013 Enrollment ID: I20150128001498 |
| Provider Name | Jeremy Garrard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386871895 PECOS PAC ID: 2365674645 Enrollment ID: I20150218000185 |
| Provider Name | Deborah G Kauffman |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1659623601 PECOS PAC ID: 8022334655 Enrollment ID: I20150226000133 |
| Provider Name | Christopher M Sacilowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215278668 PECOS PAC ID: 3476870098 Enrollment ID: I20150319001344 |
| Provider Name | Kelly A Hokit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043609340 PECOS PAC ID: 3274852280 Enrollment ID: I20150424000576 |
| Provider Name | Manuel I Salmeron |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053344507 PECOS PAC ID: 0547245433 Enrollment ID: I20150521000313 |
| Provider Name | Christopher Addison Prince |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902989635 PECOS PAC ID: 4880648237 Enrollment ID: I20150522000599 |
| Provider Name | Daniel D Owen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1962758201 PECOS PAC ID: 5698921690 Enrollment ID: I20150527002181 |
| Provider Name | Kyle G Flowers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063710580 PECOS PAC ID: 2769703107 Enrollment ID: I20150610001387 |
| Provider Name | Carl R Duncan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700835139 PECOS PAC ID: 1951406958 Enrollment ID: I20150615001113 |
| Provider Name | Tanakorn Songrug |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073847455 PECOS PAC ID: 7416184478 Enrollment ID: I20150615002064 |
| Provider Name | Laura M Stoiber |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831117159 PECOS PAC ID: 9638243983 Enrollment ID: I20150616001537 |
| Provider Name | Donald Von Borstel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275887663 PECOS PAC ID: 3779894860 Enrollment ID: I20150617001059 |
| Provider Name | Michael J Mckinney |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1033372701 PECOS PAC ID: 2668783689 Enrollment ID: I20150617002370 |
| Provider Name | Amanda Dorough |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205157179 PECOS PAC ID: 3779744545 Enrollment ID: I20150622001217 |
| Provider Name | Renee D Doherty |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1336408103 PECOS PAC ID: 1052622727 Enrollment ID: I20150622001994 |
| Provider Name | Kathryn D Holloway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508262957 PECOS PAC ID: 7214248897 Enrollment ID: I20150623002800 |
| Provider Name | Gary D Raleigh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336333442 PECOS PAC ID: 8224125117 Enrollment ID: I20150702001001 |
| Provider Name | James R Madison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447231311 PECOS PAC ID: 3779568597 Enrollment ID: I20150709001131 |
| Provider Name | Amie M Marsh |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1265817902 PECOS PAC ID: 6800102922 Enrollment ID: I20150903000636 |
| Provider Name | Nicole C Stout |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285019893 PECOS PAC ID: 3577879592 Enrollment ID: I20150915000514 |
| Provider Name | Abigail C Gillogly Harsch |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1649655549 PECOS PAC ID: 0941516975 Enrollment ID: I20150916002797 |
| Provider Name | Heaven S Frisbie |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1801277603 PECOS PAC ID: 6901113026 Enrollment ID: I20150922000387 |
| Provider Name | Mark Rader |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396734950 PECOS PAC ID: 1254223720 Enrollment ID: I20151012000878 |
| Provider Name | Gerie L Glidden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104200476 PECOS PAC ID: 2668781667 Enrollment ID: I20151014000232 |
| Provider Name | Emily J Lambeth |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1659753739 PECOS PAC ID: 7214246537 Enrollment ID: I20151027001384 |
| Provider Name | Joshua Priddle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154736346 PECOS PAC ID: 8022327311 Enrollment ID: I20151028000919 |
| Provider Name | Dustin L Little |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548675036 PECOS PAC ID: 5193035251 Enrollment ID: I20151103000290 |
| Provider Name | Elizabeth A Hosselkus |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720309123 PECOS PAC ID: 9931419819 Enrollment ID: I20151104002650 |
| Provider Name | Amanda Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750713335 PECOS PAC ID: 8022234889 Enrollment ID: I20151106001672 |
| Provider Name | Rayetta Eaton |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1467407056 PECOS PAC ID: 3577520592 Enrollment ID: I20151109002107 |
| Provider Name | James H Baker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306814983 PECOS PAC ID: 8022328400 Enrollment ID: I20151116000838 |
| Provider Name | Bobbi L Mangrum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720359318 PECOS PAC ID: 1355565268 Enrollment ID: I20151118001576 |
| Provider Name | Stephen R Parden |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982618260 PECOS PAC ID: 2062490527 Enrollment ID: I20151205000022 |
| Provider Name | Douglas Wiseman |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1003137803 PECOS PAC ID: 7214238583 Enrollment ID: I20151211000503 |
| Provider Name | Marti S Velez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508031659 PECOS PAC ID: 2264733476 Enrollment ID: I20151214000075 |
| Provider Name | Janel H Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861807091 PECOS PAC ID: 0547561532 Enrollment ID: I20151216001597 |
| Provider Name | Heather Loyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679824197 PECOS PAC ID: 2163677360 Enrollment ID: I20160111002462 |
| Provider Name | Matthew D Krein |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1316250459 PECOS PAC ID: 5799950697 Enrollment ID: I20160114001387 |
| Provider Name | Stephn W Drywater |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598175309 PECOS PAC ID: 0143523266 Enrollment ID: I20160125000789 |
| Provider Name | Cathy M Sellers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548239692 PECOS PAC ID: 1850376088 Enrollment ID: I20160201001482 |
| Provider Name | Lisa Gale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245646389 PECOS PAC ID: 6608193313 Enrollment ID: I20160321001496 |
| Provider Name | Ramesh S Pundi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508099508 PECOS PAC ID: 0749327716 Enrollment ID: I20160405001794 |
| Provider Name | Tracie J Asbill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891176566 PECOS PAC ID: 2264731090 Enrollment ID: I20160429000994 |
| Provider Name | Clifford B Rotton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1922056985 PECOS PAC ID: 8820010994 Enrollment ID: I20160504000687 |
| Provider Name | Nepistance Shoko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780861880 PECOS PAC ID: 3870623986 Enrollment ID: I20160510002134 |
| Provider Name | Janet Susan Mccarthy Mcauliffe |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750473013 PECOS PAC ID: 9537342498 Enrollment ID: I20160512001452 |
| Provider Name | Shelly D Mansker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639436348 PECOS PAC ID: 4082864715 Enrollment ID: I20160616002539 |
| Provider Name | Bret R Seamons |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548512882 PECOS PAC ID: 8729379078 Enrollment ID: I20160617000118 |
| Provider Name | Beatrice O Newell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821011925 PECOS PAC ID: 7618903329 Enrollment ID: I20160623000575 |
| Provider Name | Lane Salazar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821419094 PECOS PAC ID: 7214228469 Enrollment ID: I20160629001297 |
| Provider Name | Tara D Brown |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1093824195 PECOS PAC ID: 1254622426 Enrollment ID: I20160706002382 |
| Provider Name | Jennifer Ann Wilkerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437414562 PECOS PAC ID: 2567610355 Enrollment ID: I20160708000292 |
| Provider Name | George Polanco |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326019332 PECOS PAC ID: 0244210755 Enrollment ID: I20160713002114 |
| Provider Name | Christin B Willis |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1316303571 PECOS PAC ID: 8426341470 Enrollment ID: I20160728000224 |
| Provider Name | Nickcole N Munoz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679932586 PECOS PAC ID: 3779877816 Enrollment ID: I20160811001858 |
| Provider Name | Daniel T Heard |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1780825182 PECOS PAC ID: 0547555658 Enrollment ID: I20160827000328 |
| Provider Name | Alex R Conley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1568816635 PECOS PAC ID: 5890081301 Enrollment ID: I20160909001288 |
| Provider Name | Jena S Rogers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831167139 PECOS PAC ID: 5193818722 Enrollment ID: I20160913000632 |
| Provider Name | Tyler W Kitzman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164875787 PECOS PAC ID: 7416243563 Enrollment ID: I20160916002147 |
| Provider Name | Gara L Tramel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760836258 PECOS PAC ID: 8426345455 Enrollment ID: I20160920000267 |
| Provider Name | Benjamin Christopher Konig |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1497108070 PECOS PAC ID: 9830486885 Enrollment ID: I20160920002486 |
| Provider Name | Talara K Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528421005 PECOS PAC ID: 4587951108 Enrollment ID: I20160926002155 |
| Provider Name | Clement I Nwadozi |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548713456 PECOS PAC ID: 6406143825 Enrollment ID: I20160928000680 |
| Provider Name | Mark Weissman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336365568 PECOS PAC ID: 3072735810 Enrollment ID: I20160928000827 |
| Provider Name | Yvonne Teresa Sands-sako |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326302647 PECOS PAC ID: 0446409544 Enrollment ID: I20161026000806 |
| Provider Name | Kelly E Glass |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023425675 PECOS PAC ID: 7416273529 Enrollment ID: I20161027002508 |
| Provider Name | Roman Gabriel Venegas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467704783 PECOS PAC ID: 0840579991 Enrollment ID: I20161114002079 |
| Provider Name | Ronald A Stillerman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679549166 PECOS PAC ID: 7214958370 Enrollment ID: I20161122000168 |
| Provider Name | Natasha Bray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285840660 PECOS PAC ID: 2163516881 Enrollment ID: I20161123000368 |
| Provider Name | Amy L Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568841286 PECOS PAC ID: 6608156583 Enrollment ID: I20161212000963 |
| Provider Name | Lorrie A White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679880876 PECOS PAC ID: 1456583806 Enrollment ID: I20161229000245 |
| Provider Name | Melissa A Gastorf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164426847 PECOS PAC ID: 8426084708 Enrollment ID: I20170119001217 |
| Provider Name | Melaine Dawn Mosier |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1629431051 PECOS PAC ID: 6800178781 Enrollment ID: I20170130001631 |
| Provider Name | Therese M.b. Amigo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235107814 PECOS PAC ID: 8628113750 Enrollment ID: I20170210001244 |
| Provider Name | Jeffrey A Gastorf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275537953 PECOS PAC ID: 2769471440 Enrollment ID: I20170215001517 |
| Provider Name | Bart M Rowlett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104945526 PECOS PAC ID: 5092602102 Enrollment ID: I20170215002368 |
| Provider Name | Leslie A Williams |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1124562756 PECOS PAC ID: 1456634450 Enrollment ID: I20170217001754 |
| Provider Name | Randi J Elrod |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114460326 PECOS PAC ID: 0446533343 Enrollment ID: I20170217001812 |
| Provider Name | Drew A Brodsky |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437116589 PECOS PAC ID: 9638159833 Enrollment ID: I20170227001862 |
| Provider Name | Hannah K Labounty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801345384 PECOS PAC ID: 8224312459 Enrollment ID: I20170307000417 |
| Provider Name | Jackie J Odell-miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427125194 PECOS PAC ID: 2567463235 Enrollment ID: I20170327001130 |
| Provider Name | Trisha L Reynolds |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1356892145 PECOS PAC ID: 3173809704 Enrollment ID: I20170417000680 |
| Provider Name | Carrie L Haney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437695632 PECOS PAC ID: 0547546996 Enrollment ID: I20170419001011 |
| Provider Name | Mohamed Y Elsagga |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649551607 PECOS PAC ID: 9830475235 Enrollment ID: I20170420000268 |
| Provider Name | Kristin E Meyers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093166688 PECOS PAC ID: 8729364906 Enrollment ID: I20170425001040 |
| Provider Name | Joe C Russell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396126041 PECOS PAC ID: 6002193711 Enrollment ID: I20170508000301 |
| Provider Name | Kenneth E Mann |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851398713 PECOS PAC ID: 7113985441 Enrollment ID: I20170519000382 |
| Provider Name | Jack W Casas |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1194836684 PECOS PAC ID: 3375541378 Enrollment ID: I20170524002196 |
| Provider Name | Adam Boice Foster |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811230311 PECOS PAC ID: 6406123504 Enrollment ID: I20170526000322 |
| Provider Name | Michael S Reed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346470606 PECOS PAC ID: 1759542624 Enrollment ID: I20170526000803 |
| Provider Name | Stacy Ann Nichols-byll |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487624607 PECOS PAC ID: 9830295005 Enrollment ID: I20170607001204 |
| Provider Name | Robert Bryan Dorman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1740423839 PECOS PAC ID: 7911022009 Enrollment ID: I20170621002428 |
| Provider Name | Blake Edward Weaver |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497785893 PECOS PAC ID: 6103890975 Enrollment ID: I20170629001468 |
| Provider Name | Wanda J Lewis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245252782 PECOS PAC ID: 7113993437 Enrollment ID: I20170804000774 |
| Provider Name | James M Hayden |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1023116936 PECOS PAC ID: 1254603608 Enrollment ID: I20170818001513 |
| Provider Name | Christina L Hynes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104287713 PECOS PAC ID: 3678872819 Enrollment ID: I20170824001164 |
| Provider Name | Brittany L Ebers |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1346601317 PECOS PAC ID: 6800169335 Enrollment ID: I20170906000900 |
| Provider Name | Myra A Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730544305 PECOS PAC ID: 8628371754 Enrollment ID: I20170923000139 |
| Provider Name | Diego Sebastian Humphrey |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073525515 PECOS PAC ID: 6002980893 Enrollment ID: I20170927002568 |
| Provider Name | David C Martin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689765455 PECOS PAC ID: 8123106747 Enrollment ID: I20171003005249 |
| Provider Name | Anita J George |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588191886 PECOS PAC ID: 2163797747 Enrollment ID: I20171006002784 |
| Provider Name | Jonathan M Janzen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1275056574 PECOS PAC ID: 8628342037 Enrollment ID: I20171007000048 |
| Provider Name | Jeremy J Hauptman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1487177721 PECOS PAC ID: 1052686649 Enrollment ID: I20171007000173 |
| Provider Name | Kevin L Hamm |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578657623 PECOS PAC ID: 8022919620 Enrollment ID: I20171014000017 |
| Provider Name | Nicholas Green |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922532811 PECOS PAC ID: 3274807797 Enrollment ID: I20171016000249 |
| Provider Name | Pamela Martin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1538682992 PECOS PAC ID: 0143594572 Enrollment ID: I20171016001392 |
| Provider Name | Ruth A Blash |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295849545 PECOS PAC ID: 0749282580 Enrollment ID: I20171016002053 |
| Provider Name | Curtis A Dubois |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1689197915 PECOS PAC ID: 2062788060 Enrollment ID: I20171018003100 |
| Provider Name | Jessica L White |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1386167435 PECOS PAC ID: 5991079352 Enrollment ID: I20171018003486 |
| Provider Name | Ashlin Martin Paz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306206081 PECOS PAC ID: 9032484639 Enrollment ID: I20171024003095 |
| Provider Name | Bobbie R Stamps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235667833 PECOS PAC ID: 2264708957 Enrollment ID: I20171025000349 |
| Provider Name | Phillip C Ford |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1932585106 PECOS PAC ID: 3678857745 Enrollment ID: I20171031003398 |
| Provider Name | Roxanna Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740515311 PECOS PAC ID: 6608023304 Enrollment ID: I20171101001284 |
| Provider Name | Stephanie Stanley Moss |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1043747595 PECOS PAC ID: 0941566947 Enrollment ID: I20171108000162 |
| Provider Name | Elizabeth Escobedo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1235652553 PECOS PAC ID: 2860766391 Enrollment ID: I20171109003355 |
| Provider Name | Derek Brandon Bolt |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1881147882 PECOS PAC ID: 3072887447 Enrollment ID: I20171115002560 |
| Provider Name | Jose Marquez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609162668 PECOS PAC ID: 4587803903 Enrollment ID: I20171208002055 |
| Provider Name | Meghan R Pennington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093253056 PECOS PAC ID: 1658639133 Enrollment ID: I20171212000768 |
| Provider Name | Adam Jon Summers |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437546728 PECOS PAC ID: 7618259813 Enrollment ID: I20171228002234 |
| Provider Name | Gary T Sturtevant |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1649314204 PECOS PAC ID: 2264493154 Enrollment ID: I20171228002459 |
| Provider Name | Rebecca Heath |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1851814180 PECOS PAC ID: 3173881844 Enrollment ID: I20171229002320 |
| Provider Name | Laila Sakina Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679924484 PECOS PAC ID: 9638437221 Enrollment ID: I20180104000317 |
| Provider Name | Craig White |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417278573 PECOS PAC ID: 2365757481 Enrollment ID: I20180104000432 |
| Provider Name | Trina Dea Jones |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1568545606 PECOS PAC ID: 6305803693 Enrollment ID: I20180109001039 |
| Provider Name | Darylin Doublehead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275063497 PECOS PAC ID: 2769741206 Enrollment ID: I20180109001256 |
| Provider Name | Chad Tyler Hollifield |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1215450671 PECOS PAC ID: 6305118423 Enrollment ID: I20180110000428 |
| Provider Name | Laith K Salih |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023484144 PECOS PAC ID: 4880953223 Enrollment ID: I20180111000127 |
| Provider Name | Andrew S Young |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1447773452 PECOS PAC ID: 5092089573 Enrollment ID: I20180122001132 |
| Provider Name | Amy E Estes |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1649799693 PECOS PAC ID: 3274892963 Enrollment ID: I20180126000982 |
| Provider Name | William Seid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174563233 PECOS PAC ID: 1052370285 Enrollment ID: I20180129000134 |
| Provider Name | Erelda Gene |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1801319041 PECOS PAC ID: 9931473154 Enrollment ID: I20180205001550 |
| Provider Name | Amanda Leigh May |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063930386 PECOS PAC ID: 1254691413 Enrollment ID: I20180207002379 |
| Provider Name | Vicki J Keck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225009376 PECOS PAC ID: 8426070350 Enrollment ID: I20180214002344 |
| Provider Name | Andrew S White |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063892529 PECOS PAC ID: 4385950468 Enrollment ID: I20180313001344 |
| Provider Name | Ray Shofner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336241728 PECOS PAC ID: 6507877222 Enrollment ID: I20180320000365 |
| Provider Name | Daniel Lee Nicoll |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487625505 PECOS PAC ID: 1355446220 Enrollment ID: I20180403002773 |
| Provider Name | Cherie Darlene Ertha |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629090600 PECOS PAC ID: 7315955457 Enrollment ID: I20180404000855 |
| Provider Name | Sarah Elizabeth Cole |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1679072995 PECOS PAC ID: 9234492893 Enrollment ID: I20180412000418 |
| Provider Name | Ama L Lacy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831274075 PECOS PAC ID: 4385642354 Enrollment ID: I20180412000725 |
| Provider Name | Jamie Doreen Alexander |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619330099 PECOS PAC ID: 6406119775 Enrollment ID: I20180419001346 |
| Provider Name | Brett Aric Nelson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417076290 PECOS PAC ID: 6103912092 Enrollment ID: I20180503001262 |
| Provider Name | Natalia Solomon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003173915 PECOS PAC ID: 6709141328 Enrollment ID: I20180601001555 |
| Provider Name | Samuel B Hancock |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063672608 PECOS PAC ID: 3577699073 Enrollment ID: I20180614000232 |
| Provider Name | Lynn M Mcclintock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366411282 PECOS PAC ID: 3173719200 Enrollment ID: I20180615001434 |
| Provider Name | Aaron Wittenberg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164486338 PECOS PAC ID: 0547298036 Enrollment ID: I20180619000638 |
| Provider Name | Julia D Knarreborg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952662363 PECOS PAC ID: 3173828803 Enrollment ID: I20180703001304 |
| Provider Name | Constance Ann Rogers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508218959 PECOS PAC ID: 1557617438 Enrollment ID: I20180706001802 |
| Provider Name | Elizabeth Marie Hart |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1740667039 PECOS PAC ID: 8224385976 Enrollment ID: I20180726000566 |
| Provider Name | Samantha Phoua Vang-cheng |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1497011563 PECOS PAC ID: 6002101789 Enrollment ID: I20180726000777 |
| Provider Name | Kristen N Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356842140 PECOS PAC ID: 3577811041 Enrollment ID: I20180801000114 |
| Provider Name | Laura M Young |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720048267 PECOS PAC ID: 9436109477 Enrollment ID: I20180813001041 |
| Provider Name | Alfred C Degner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891755294 PECOS PAC ID: 4082675996 Enrollment ID: I20180822000860 |
| Provider Name | Catherine Anne Shaeffer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811251499 PECOS PAC ID: 4385872175 Enrollment ID: I20180830000526 |
| Provider Name | Calin L Kirk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255718607 PECOS PAC ID: 9931402146 Enrollment ID: I20180830002595 |
| Provider Name | Calvin Anthony Selwyn |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1750359725 PECOS PAC ID: 4688560022 Enrollment ID: I20180830003144 |
| Provider Name | Imran Tahir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194012229 PECOS PAC ID: 3173827631 Enrollment ID: I20180911002196 |
| Provider Name | Brian Carter Elliott |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427291418 PECOS PAC ID: 7214089994 Enrollment ID: I20180911002417 |
| Provider Name | Steven Matthew Wright |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366733404 PECOS PAC ID: 0042536575 Enrollment ID: I20180912003056 |
| Provider Name | Caitlin B Chevalier |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548747272 PECOS PAC ID: 1456602002 Enrollment ID: I20180921000524 |
| Provider Name | Stephanie Megan Choate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720570609 PECOS PAC ID: 4183975733 Enrollment ID: I20180921000531 |
| Provider Name | Misti Ballew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821481334 PECOS PAC ID: 7113245739 Enrollment ID: I20181011001445 |
| Provider Name | Seth Allen Rich |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467939330 PECOS PAC ID: 2769734136 Enrollment ID: I20181012000943 |
| Provider Name | Ronald Stephen Pritchard |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1417998774 PECOS PAC ID: 2668426578 Enrollment ID: I20181016001073 |
| Provider Name | Lonnie E Orman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659863496 PECOS PAC ID: 5799038550 Enrollment ID: I20181024000573 |
| Provider Name | Lindsay K Zuck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932543113 PECOS PAC ID: 2567706567 Enrollment ID: I20181203000552 |
| Provider Name | Timothy P Green |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457739039 PECOS PAC ID: 9931497914 Enrollment ID: I20181206002915 |
| Provider Name | Christina Louise Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528424306 PECOS PAC ID: 0042516577 Enrollment ID: I20181206003444 |
| Provider Name | Shawn D Grant |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043214497 PECOS PAC ID: 6204877079 Enrollment ID: I20181211000646 |
| Provider Name | Moriah S Krason |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265513683 PECOS PAC ID: 7618125733 Enrollment ID: I20181219000913 |
| Provider Name | Ann-elise Zarkower |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548480981 PECOS PAC ID: 7416104799 Enrollment ID: I20181221000435 |
| Provider Name | Terri Amanda Pruitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538654405 PECOS PAC ID: 0547505109 Enrollment ID: I20181231000841 |
| Provider Name | Alexandria Micae Trentman |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1134697485 PECOS PAC ID: 7315283363 Enrollment ID: I20190111000645 |
| Provider Name | Crystal M White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417327545 PECOS PAC ID: 1254641699 Enrollment ID: I20190117000898 |
| Provider Name | Anne V Herdman Royal |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1407060999 PECOS PAC ID: 0446325955 Enrollment ID: I20190125002250 |
| Provider Name | Dana Michelle Caviness |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336658053 PECOS PAC ID: 3577826460 Enrollment ID: I20190227001993 |
| Provider Name | Carla Renee Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891189726 PECOS PAC ID: 9335460450 Enrollment ID: I20190315000914 |
| Provider Name | Imad Uddin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245498906 PECOS PAC ID: 3870764285 Enrollment ID: I20190402001625 |
| Provider Name | Justin Thankachan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1851433221 PECOS PAC ID: 8123186103 Enrollment ID: I20190403002330 |
| Provider Name | Suraj Suku |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891833505 PECOS PAC ID: 9133293178 Enrollment ID: I20190405000040 |
| Provider Name | Eric Timothy Hogan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144343435 PECOS PAC ID: 5193894301 Enrollment ID: I20190408000415 |
| Provider Name | Lisa Gay Woodworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861968364 PECOS PAC ID: 1759623614 Enrollment ID: I20190425002325 |
| Provider Name | Anna Wanahita |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073650537 PECOS PAC ID: 7214037860 Enrollment ID: I20190501003324 |
| Provider Name | James Rooks |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841269792 PECOS PAC ID: 7012918915 Enrollment ID: I20190506001995 |
| Provider Name | Maggie S W Law |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760450480 PECOS PAC ID: 6800064122 Enrollment ID: I20190506002195 |
| Provider Name | Martha Michelle Barlow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780797456 PECOS PAC ID: 3779622527 Enrollment ID: I20190530001740 |
| Provider Name | Kristina Marie Harvell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588958896 PECOS PAC ID: 3870737034 Enrollment ID: I20190604000099 |
| Provider Name | Kimberly E Vogelsang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265895684 PECOS PAC ID: 0244510238 Enrollment ID: I20190607001450 |
| Provider Name | Pavankumar Bommasamudram |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639306293 PECOS PAC ID: 3779749478 Enrollment ID: I20190617000508 |
| Provider Name | Stephen E Paquelet |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1669696167 PECOS PAC ID: 7517068836 Enrollment ID: I20190620001554 |
| Provider Name | Michael J Walters |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962768341 PECOS PAC ID: 6901198951 Enrollment ID: I20190621000329 |
| Provider Name | Charity Catrina Gritts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467919191 PECOS PAC ID: 3173857372 Enrollment ID: I20190621000974 |
| Provider Name | Betty L Seeley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356587786 PECOS PAC ID: 1254455215 Enrollment ID: I20190625000145 |
| Provider Name | Natosha Monfore |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912343435 PECOS PAC ID: 6800129651 Enrollment ID: I20190709001084 |
| Provider Name | Rebecca C Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174582407 PECOS PAC ID: 8325373228 Enrollment ID: I20190715003091 |
| Provider Name | Cynthia Myrhl Keel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750848297 PECOS PAC ID: 7810222411 Enrollment ID: I20190717004062 |
| Provider Name | Amanda Ruth Gorden Green |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740514306 PECOS PAC ID: 8527215573 Enrollment ID: I20190725001843 |
| Provider Name | Stephen Mikus |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598086050 PECOS PAC ID: 7719121938 Enrollment ID: I20190814002773 |
| Provider Name | Austin Thomas Mcardle |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1114304623 PECOS PAC ID: 8729388806 Enrollment ID: I20190816002494 |
| Provider Name | Bilal Aziz |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1063725901 PECOS PAC ID: 3971814229 Enrollment ID: I20190816003076 |
| Provider Name | Matthew Wood Cummens |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1669937793 PECOS PAC ID: 8527396746 Enrollment ID: I20190827001027 |
| Provider Name | Marie L Duan Meservy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699018424 PECOS PAC ID: 0749588374 Enrollment ID: I20190830002587 |
| Provider Name | Pamela Grafton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568967602 PECOS PAC ID: 5294064127 Enrollment ID: I20190903000208 |
| Provider Name | Angela M Wiggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114424942 PECOS PAC ID: 3678837952 Enrollment ID: I20190919000387 |
| Provider Name | Eugenio Erquiaga |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528005048 PECOS PAC ID: 6002947033 Enrollment ID: I20190923000256 |
| Provider Name | Ragan R Birckel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619533700 PECOS PAC ID: 2264763762 Enrollment ID: I20191015001805 |
| Provider Name | David Christopher Atchley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1720076201 PECOS PAC ID: 8527009554 Enrollment ID: I20191021000013 |
| Provider Name | Edward D Overholt |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1457329773 PECOS PAC ID: 8325062672 Enrollment ID: I20191025001030 |
| Provider Name | Chester W Jenkins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184622201 PECOS PAC ID: 6406822741 Enrollment ID: I20191031000905 |
| Provider Name | Micheal Scott Feuerborn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740842053 PECOS PAC ID: 9133551179 Enrollment ID: I20191113002594 |
| Provider Name | Prashant Kaushik |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1073615324 PECOS PAC ID: 9234039215 Enrollment ID: I20191115001101 |
| Provider Name | Michael N Hitsman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306387907 PECOS PAC ID: 9931531787 Enrollment ID: I20191115001193 |
| Provider Name | Nicholas A Strle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851703185 PECOS PAC ID: 4587999354 Enrollment ID: I20191115001941 |
| Provider Name | Ernest P Luczkowski |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1457764375 PECOS PAC ID: 4082986112 Enrollment ID: I20191209000043 |
| Provider Name | Duane Gerard Koehler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811976566 PECOS PAC ID: 8022911577 Enrollment ID: I20191218001366 |
| Provider Name | Ashleigh Dae Coser |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083144554 PECOS PAC ID: 9335573443 Enrollment ID: I20191226000994 |
| Provider Name | Jayna Y Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225564040 PECOS PAC ID: 1456620913 Enrollment ID: I20200106000533 |
| Provider Name | Hollye L Smith |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1619237682 PECOS PAC ID: 5193030534 Enrollment ID: I20200114001009 |
| Provider Name | Robert L Valentine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528388717 PECOS PAC ID: 5597908194 Enrollment ID: I20200115000266 |
| Provider Name | April Dawn Miggletto |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1891190823 PECOS PAC ID: 9335574664 Enrollment ID: I20200115001153 |
| Provider Name | Dawn Pewitt |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1942248323 PECOS PAC ID: 1850670266 Enrollment ID: I20200117001043 |
| Provider Name | Anton A Surja |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437296001 PECOS PAC ID: 0749373496 Enrollment ID: I20200121000824 |
| Provider Name | Robert Hilton Mcdonald |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1992743066 PECOS PAC ID: 7315973682 Enrollment ID: I20200127000168 |
| Provider Name | Louis Allen Blowers |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1487144424 PECOS PAC ID: 7214362920 Enrollment ID: I20200127000324 |
| Provider Name | Melanie Hooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023430683 PECOS PAC ID: 2466887138 Enrollment ID: I20200128000202 |
| Provider Name | Eric D Engles |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1750321824 PECOS PAC ID: 1456256197 Enrollment ID: I20200128002579 |
| Provider Name | Megan Nicole Kirk |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1982103883 PECOS PAC ID: 6103252499 Enrollment ID: I20200205000351 |
| Provider Name | Robert J Oly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134455157 PECOS PAC ID: 8729267463 Enrollment ID: I20200207000565 |
| Provider Name | Shereen S Al-rashdan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831506229 PECOS PAC ID: 0840570099 Enrollment ID: I20200302001764 |
| Provider Name | Jeff Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073933289 PECOS PAC ID: 2567899552 Enrollment ID: I20200304001706 |
| Provider Name | Alexis Nicole Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1235762600 PECOS PAC ID: 1557799418 Enrollment ID: I20200309000680 |
| Provider Name | Kelsey L Buford |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821641267 PECOS PAC ID: 1658609664 Enrollment ID: I20200318000604 |
| Provider Name | Danielle Nicole Hendrick |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285088203 PECOS PAC ID: 5991134967 Enrollment ID: I20200327000145 |
| Provider Name | Jay W Vazquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942797238 PECOS PAC ID: 1355698788 Enrollment ID: I20200402000123 |
| Provider Name | Magdalena Santos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285608091 PECOS PAC ID: 2567644677 Enrollment ID: I20200415000102 |
| Provider Name | Kristen T Vazquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205325487 PECOS PAC ID: 7315270162 Enrollment ID: I20200415000701 |
| Provider Name | Jason Ellen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1962405928 PECOS PAC ID: 7214036821 Enrollment ID: I20200420000661 |
| Provider Name | Cheryl Hodges |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649465139 PECOS PAC ID: 2769532365 Enrollment ID: I20200422000156 |
| Provider Name | Henry Jake Whitener |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1508248089 PECOS PAC ID: 6901237148 Enrollment ID: I20200504001048 |
| Provider Name | Gulam Khan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528055001 PECOS PAC ID: 4183519812 Enrollment ID: I20200513002332 |
| Provider Name | Catherine E. Porter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154564409 PECOS PAC ID: 9537302740 Enrollment ID: I20200515000341 |
| Provider Name | Mary Sturm |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1437279924 PECOS PAC ID: 9133269574 Enrollment ID: I20200519000777 |
| Provider Name | Thomas Chilton Fruits |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053803130 PECOS PAC ID: 5597186569 Enrollment ID: I20200529000026 |
| Provider Name | Amber Ruth Tiehen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881096477 PECOS PAC ID: 3072934025 Enrollment ID: I20200601000349 |
| Provider Name | Lesley Diane Fain |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1578008322 PECOS PAC ID: 1456772326 Enrollment ID: I20200601001679 |
| Provider Name | Nora M Wisdom |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457540411 PECOS PAC ID: 7810318722 Enrollment ID: I20200602000551 |
| Provider Name | Jacqueline S Manus |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083085377 PECOS PAC ID: 1153742994 Enrollment ID: I20200602002092 |
| Provider Name | Luis Soto |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1679872329 PECOS PAC ID: 4587955232 Enrollment ID: I20200603002111 |
| Provider Name | Elise Caroline Williams |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1619598703 PECOS PAC ID: 9335560069 Enrollment ID: I20200604000127 |
| Provider Name | Steven Andrew Egleston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508838038 PECOS PAC ID: 7315937018 Enrollment ID: I20200604000418 |
| Provider Name | Allison L Snider |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881902179 PECOS PAC ID: 7719118306 Enrollment ID: I20200604000661 |
| Provider Name | Mckinley C Lawson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104137181 PECOS PAC ID: 6103056759 Enrollment ID: I20200609000592 |
| Provider Name | Nabil A Yassa |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467438911 PECOS PAC ID: 8729020839 Enrollment ID: I20200609000648 |
| Provider Name | Nathan Kyle Mann |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1205242526 PECOS PAC ID: 0042632473 Enrollment ID: I20200612000396 |
| Provider Name | Molly Marie Asher |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831633866 PECOS PAC ID: 8921420241 Enrollment ID: I20200615002162 |
| Provider Name | Bradan Miller O Dell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730703760 PECOS PAC ID: 5193147114 Enrollment ID: I20200622000726 |
| Provider Name | Shawn Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083670566 PECOS PAC ID: 2668384298 Enrollment ID: I20200624000044 |
| Provider Name | Kevin Dale |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619599511 PECOS PAC ID: 6002238862 Enrollment ID: I20200624000695 |
| Provider Name | Cassie Brooke Rumsey |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033633987 PECOS PAC ID: 7416379987 Enrollment ID: I20200630000709 |
| Provider Name | Christopher D Roman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033266838 PECOS PAC ID: 1850482761 Enrollment ID: I20200701000532 |
| Provider Name | Stacy Lynn Rutherford |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1548882103 PECOS PAC ID: 9830512581 Enrollment ID: I20200714000672 |
| Provider Name | Kathleen F Elliott |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558378794 PECOS PAC ID: 6103998919 Enrollment ID: I20200715000403 |
| Provider Name | Glen R Owen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1174613715 PECOS PAC ID: 2860423043 Enrollment ID: I20200715003183 |
| Provider Name | Janet Poole Naguib |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992330534 PECOS PAC ID: 8123442779 Enrollment ID: I20200716000181 |
| Provider Name | Kelsey Kitchens |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1033739354 PECOS PAC ID: 4183048929 Enrollment ID: I20200727000744 |
| Provider Name | Carissa Chesser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750824348 PECOS PAC ID: 1153747654 Enrollment ID: I20200814000403 |
| Provider Name | Brandy D Ponder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689290694 PECOS PAC ID: 7618393091 Enrollment ID: I20200817000186 |
| Provider Name | Rachel Howard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245436161 PECOS PAC ID: 6305263799 Enrollment ID: I20200831002202 |
| Provider Name | Perry Jake Proctor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184287849 PECOS PAC ID: 6002233228 Enrollment ID: I20200902000326 |
| Provider Name | Karlee Jo Wortham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750917019 PECOS PAC ID: 9830517630 Enrollment ID: I20200910001676 |
| Provider Name | Neil Hecker |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417577719 PECOS PAC ID: 2769800879 Enrollment ID: I20200922000160 |
| Provider Name | Barbara Stegmann |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588759864 PECOS PAC ID: 1951475243 Enrollment ID: I20200929000366 |
| Provider Name | Mohamad Mahayni |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1750465506 PECOS PAC ID: 2961566963 Enrollment ID: I20200929000450 |
| Provider Name | Ann Ovbiye Idemundia |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235233545 PECOS PAC ID: 2860468071 Enrollment ID: I20201013002345 |
| Provider Name | Brock W Helfrich |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1295356186 PECOS PAC ID: 8123448917 Enrollment ID: I20201016000508 |
| Provider Name | Katherine L Horn |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1871113878 PECOS PAC ID: 5092135673 Enrollment ID: I20201020003566 |
| Provider Name | Kristen Lantz |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073132395 PECOS PAC ID: 7911325444 Enrollment ID: I20201021000609 |
| Provider Name | Kathryn Nicole Martin |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1679183404 PECOS PAC ID: 6608296132 Enrollment ID: I20201021001986 |
| Provider Name | David Ryan Markes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154985869 PECOS PAC ID: 0941620405 Enrollment ID: I20201022000112 |
| Provider Name | Jennifer L Dryden |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588285613 PECOS PAC ID: 2668890096 Enrollment ID: I20201029000929 |
| Provider Name | Amy Burcham |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023637360 PECOS PAC ID: 5496173676 Enrollment ID: I20201102001249 |
| Provider Name | Tyler James Nelson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770104069 PECOS PAC ID: 3870903883 Enrollment ID: I20201103001493 |
| Provider Name | Dillon R Jarrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932514734 PECOS PAC ID: 2860618097 Enrollment ID: I20201119002240 |
| Provider Name | Shelbi Denise Kulchinski |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1831705532 PECOS PAC ID: 3476964198 Enrollment ID: I20201201000892 |
| Provider Name | Brie Proctor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003379868 PECOS PAC ID: 7012329956 Enrollment ID: I20201217000110 |
| Provider Name | Darren Lawrence Vargas |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386184877 PECOS PAC ID: 1355753161 Enrollment ID: I20201221001930 |
| Provider Name | Jordyn Elizabeth Temple |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346804812 PECOS PAC ID: 7517370851 Enrollment ID: I20210106001245 |
| Provider Name | Stephen C Dobratz |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023011194 PECOS PAC ID: 0648253237 Enrollment ID: I20210106002048 |
| Provider Name | Dimple Shah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306023809 PECOS PAC ID: 5991952178 Enrollment ID: I20210114000460 |
| Provider Name | Andrea Grieve |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376146761 PECOS PAC ID: 2062825805 Enrollment ID: I20210115000646 |
| Provider Name | Lisa Diane Meyers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699363002 PECOS PAC ID: 2567876576 Enrollment ID: I20210203001853 |
| Provider Name | Frank Patrick Goodman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336641828 PECOS PAC ID: 3971918673 Enrollment ID: I20210210001133 |
| Provider Name | Clint Raymer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245822931 PECOS PAC ID: 1456766971 Enrollment ID: I20210216001038 |
| Provider Name | Rebecca S Daily |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659379360 PECOS PAC ID: 4587627294 Enrollment ID: I20210323001239 |
| Provider Name | Hayley Beth Shenberger |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1679052856 PECOS PAC ID: 3577801414 Enrollment ID: I20210504000097 |
| Provider Name | Lauren B Sims |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1154615987 PECOS PAC ID: 9133410954 Enrollment ID: I20210504000243 |
| Provider Name | Arlan K Andrews |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1962421420 PECOS PAC ID: 5991097891 Enrollment ID: I20210504001883 |
| Provider Name | Deandra B Hayes |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1518443738 PECOS PAC ID: 9133464597 Enrollment ID: I20210504002264 |
| Provider Name | Sam Blake Campbell |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1275190688 PECOS PAC ID: 1759790702 Enrollment ID: I20210504002538 |
| Provider Name | Justin Roberts |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1548754054 PECOS PAC ID: 8224447107 Enrollment ID: I20210505001086 |
| Provider Name | Matthew Glenn Reece |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1396129557 PECOS PAC ID: 5799076311 Enrollment ID: I20210505002625 |
| Provider Name | Benjamin D Hall |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1447391297 PECOS PAC ID: 2365851201 Enrollment ID: I20210506000656 |
| Provider Name | Christopher P Mckinney |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1740257724 PECOS PAC ID: 8426349432 Enrollment ID: I20210506001342 |
| Provider Name | Jason A Holland |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1477937100 PECOS PAC ID: 9830480722 Enrollment ID: I20210506001666 |
| Provider Name | Sara M Reed |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114305901 PECOS PAC ID: 8123437985 Enrollment ID: I20210506001959 |
| Provider Name | Daniel F Skender |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1720427693 PECOS PAC ID: 1850682642 Enrollment ID: I20210507000210 |
| Provider Name | Christopher Bryan Essex |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437767308 PECOS PAC ID: 1254740053 Enrollment ID: I20210507000409 |
| Provider Name | Ande B Willeford |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1073869137 PECOS PAC ID: 7719278324 Enrollment ID: I20210511002051 |
| Provider Name | Jocelyn L Couch |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1528686664 PECOS PAC ID: 8224449236 Enrollment ID: I20210512001501 |
| Provider Name | Joel William Erickson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881197325 PECOS PAC ID: 4284983669 Enrollment ID: I20210513000402 |
| Provider Name | David Webber Merrell |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1285913343 PECOS PAC ID: 2365851623 Enrollment ID: I20210518000141 |
| Provider Name | Henri J Casey |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1912544735 PECOS PAC ID: 1759796691 Enrollment ID: I20210519002183 |
| Provider Name | Emily Wauneka Berg Ikahihifo |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1992052674 PECOS PAC ID: 0749689958 Enrollment ID: I20210520000459 |
| Provider Name | Brian Drouillard |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1326342254 PECOS PAC ID: 2961709811 Enrollment ID: I20210526002850 |
| Provider Name | Akash Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871858548 PECOS PAC ID: 7618297441 Enrollment ID: I20210526002968 |
| Provider Name | Stephan J Zigo |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1760404107 PECOS PAC ID: 2769773894 Enrollment ID: I20210527001134 |
| Provider Name | Crystal L Phillips |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1124100243 PECOS PAC ID: 3779874649 Enrollment ID: I20210601002381 |
| Provider Name | Ann E Riley |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1154483774 PECOS PAC ID: 8224329149 Enrollment ID: I20210602000298 |
| Provider Name | Joshua C Looney |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1922090695 PECOS PAC ID: 5395036305 Enrollment ID: I20210602000312 |
| Provider Name | David E Henry |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1033558234 PECOS PAC ID: 0244521243 Enrollment ID: I20210602001660 |
| Provider Name | Charles R Beavers |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1083654644 PECOS PAC ID: 8325330038 Enrollment ID: I20210607000121 |
| Provider Name | Lyman Colin Foster |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1396808762 PECOS PAC ID: 0547660938 Enrollment ID: I20210607000551 |
| Provider Name | Matthew B Mcshane |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1518232727 PECOS PAC ID: 1456632207 Enrollment ID: I20210614000252 |
| Provider Name | Diana B Drvostep |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1962738328 PECOS PAC ID: 4789966409 Enrollment ID: I20210614001288 |
| Provider Name | Chelsey Morgan Beathard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124683578 PECOS PAC ID: 0446650287 Enrollment ID: I20210615002814 |
| Provider Name | Kevin J Madden |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1225447881 PECOS PAC ID: 6305068909 Enrollment ID: I20210616000053 |
| Provider Name | Jess C Parker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063688232 PECOS PAC ID: 9638242167 Enrollment ID: I20210616001486 |
| Provider Name | Sherri L Sanders |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568432938 PECOS PAC ID: 7315848546 Enrollment ID: I20210623003174 |
| Provider Name | Tj Little |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699147868 PECOS PAC ID: 1557664505 Enrollment ID: I20210623004060 |
| Provider Name | Matthew Bledsoe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295116721 PECOS PAC ID: 6608188024 Enrollment ID: I20210702000599 |
| Provider Name | Rafel Alvarez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215383005 PECOS PAC ID: 7618247586 Enrollment ID: I20210706000944 |
| Provider Name | John R Stanley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659397677 PECOS PAC ID: 0143201129 Enrollment ID: I20210706002790 |
| Provider Name | Tyler Braaten |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134507957 PECOS PAC ID: 3577964352 Enrollment ID: I20210708000016 |
| Provider Name | Scott Stringer |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1841630126 PECOS PAC ID: 7517360993 Enrollment ID: I20210722001485 |
| Provider Name | Stephanie M Moses |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134796774 PECOS PAC ID: 0648674226 Enrollment ID: I20210804000532 |
| Provider Name | Bailee Rowlett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023697042 PECOS PAC ID: 4880098227 Enrollment ID: I20210809000253 |
| Provider Name | Jaylen Z Green |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891290599 PECOS PAC ID: 2365846680 Enrollment ID: I20210810000180 |
| Provider Name | David Deschamps |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700107869 PECOS PAC ID: 8921227901 Enrollment ID: I20210810000507 |
| Provider Name | Kendall Marie Harris |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1184253403 PECOS PAC ID: 2961806872 Enrollment ID: I20210813000952 |
| Provider Name | Rhonda Denise James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336668383 PECOS PAC ID: 4284909896 Enrollment ID: I20210818003244 |
| Provider Name | William Kyle Dixon |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1386993525 PECOS PAC ID: 2668877119 Enrollment ID: I20210820001297 |
| Provider Name | Leslie Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316564743 PECOS PAC ID: 8325444011 Enrollment ID: I20210903001215 |
| Provider Name | Gentry Henry |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1346617313 PECOS PAC ID: 7315238326 Enrollment ID: I20210908000766 |
| Provider Name | Jason J Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932723954 PECOS PAC ID: 2163828518 Enrollment ID: I20210909002397 |
| Provider Name | Paige E Taylor |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1356910178 PECOS PAC ID: 8729483565 Enrollment ID: I20210915001401 |
| Provider Name | Roy A Reed |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548764467 PECOS PAC ID: 1254762792 Enrollment ID: I20210922003062 |
| Provider Name | Athena Chatzigiannidis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952930257 PECOS PAC ID: 1759788227 Enrollment ID: I20210927000287 |
| Provider Name | Rhett Brandon Rains |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1184647653 PECOS PAC ID: 5799076667 Enrollment ID: I20210930000413 |
| Provider Name | Hannah R Sanders |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396310637 PECOS PAC ID: 3274938998 Enrollment ID: I20211012000557 |
| Provider Name | Adam Daye Maxwell |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275133316 PECOS PAC ID: 8123431483 Enrollment ID: I20211013000397 |
| Provider Name | Grace Yoon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518454511 PECOS PAC ID: 6800126293 Enrollment ID: I20211019002010 |
| Provider Name | Jacob J Dufour |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1730556580 PECOS PAC ID: 8224326640 Enrollment ID: I20211021001824 |
| Provider Name | Jordan H Fleming |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003489527 PECOS PAC ID: 0042608028 Enrollment ID: I20211025000595 |
| Provider Name | Andrew S Whitley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588096432 PECOS PAC ID: 9436377678 Enrollment ID: I20211025001726 |
| Provider Name | Mary Elizabeth Hefley |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1417536798 PECOS PAC ID: 8820486756 Enrollment ID: I20211027000022 |
| Provider Name | Samme Jo-lynne Fairchild |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1265021299 PECOS PAC ID: 9335537109 Enrollment ID: I20211027002194 |
| Provider Name | Angela Dawn Bowden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992474696 PECOS PAC ID: 8325436843 Enrollment ID: I20211102001137 |
| Provider Name | Brandon Edward Rawlinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437788452 PECOS PAC ID: 5890184899 Enrollment ID: I20211112001551 |
| Provider Name | Michael Amir Young |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1891378535 PECOS PAC ID: 9537558481 Enrollment ID: I20211115000826 |
| Provider Name | Taylor Breann Forman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336715408 PECOS PAC ID: 1052700887 Enrollment ID: I20211116001368 |
| Provider Name | David Melvin Williams |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1609214113 PECOS PAC ID: 0840581856 Enrollment ID: I20211117000415 |
| Provider Name | Riley Zane Laster |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548842693 PECOS PAC ID: 8628467107 Enrollment ID: I20211123001486 |
| Provider Name | Chenying Yang |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1366022436 PECOS PAC ID: 1153711213 Enrollment ID: I20211203000118 |
| Provider Name | Ashley Sourjohn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144831017 PECOS PAC ID: 1052730355 Enrollment ID: I20211203000957 |
| Provider Name | Cody Hume Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538798178 PECOS PAC ID: 1052701901 Enrollment ID: I20211208000656 |
| Provider Name | Amanda Brooke Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285303446 PECOS PAC ID: 2062802879 Enrollment ID: I20211210000762 |
| Provider Name | Hannah H Munyan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1063092468 PECOS PAC ID: 1052701869 Enrollment ID: I20211210000803 |
| Provider Name | Sweta K Das |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1245758150 PECOS PAC ID: 1658777305 Enrollment ID: I20211214001701 |
| Provider Name | Soumya Vempalle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134514896 PECOS PAC ID: 9032500392 Enrollment ID: I20211220002762 |
| Provider Name | Brian Lane |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1568442184 PECOS PAC ID: 6103892450 Enrollment ID: I20211221000525 |
| Provider Name | Komal Patel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1306417308 PECOS PAC ID: 6204231897 Enrollment ID: I20211222000531 |
| Provider Name | Toni Griffin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205283678 PECOS PAC ID: 2466873179 Enrollment ID: I20211230001209 |
| Provider Name | James H Le |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447748959 PECOS PAC ID: 4385041862 Enrollment ID: I20220111001778 |
| Provider Name | Keira A Mccrary |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1508465428 PECOS PAC ID: 2961803358 Enrollment ID: I20220114001090 |
| Provider Name | Amaya Basta |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457589699 PECOS PAC ID: 0042434524 Enrollment ID: I20220118001954 |
| Provider Name | Robert Alan Pendley |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750370029 PECOS PAC ID: 2163487968 Enrollment ID: I20220120002346 |
| Provider Name | Donald L Sawyer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780604876 PECOS PAC ID: 1850286360 Enrollment ID: I20220121000642 |
| Provider Name | Emily Suku |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922622869 PECOS PAC ID: 4789002221 Enrollment ID: I20220127000346 |
| Provider Name | Jamin P Brown |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649777095 PECOS PAC ID: 0941632699 Enrollment ID: I20220127001259 |
| Provider Name | Jennifer M Briggs |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215430251 PECOS PAC ID: 7416287248 Enrollment ID: I20220131000153 |
| Provider Name | Madison L Collins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801188248 PECOS PAC ID: 9537303599 Enrollment ID: I20220201000176 |
| Provider Name | Amy M Prince |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972700193 PECOS PAC ID: 9032430624 Enrollment ID: I20220201000480 |
| Provider Name | Lisa M Unruh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497932032 PECOS PAC ID: 0345386140 Enrollment ID: I20220202000979 |
| Provider Name | Joel Herschler |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1952515967 PECOS PAC ID: 2860713955 Enrollment ID: I20220210002601 |
| Provider Name | Melody Emerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184074528 PECOS PAC ID: 9032498050 Enrollment ID: I20220215000759 |
| Provider Name | Derek Matheson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780765719 PECOS PAC ID: 2668651118 Enrollment ID: I20220221001457 |
| Provider Name | Kayla Lynn Hickelheim |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1477207967 PECOS PAC ID: 5294129094 Enrollment ID: I20220221001555 |
| Provider Name | Lesley Ann Milton |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1346634813 PECOS PAC ID: 9032413869 Enrollment ID: I20220222001070 |
| Provider Name | Leah G Baxter |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1336113281 PECOS PAC ID: 6204869803 Enrollment ID: I20220310000112 |
| Provider Name | Christopher Lawlis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013183482 PECOS PAC ID: 1456660869 Enrollment ID: I20220318000094 |
| Provider Name | Jenny S Walsh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861835142 PECOS PAC ID: 9032417431 Enrollment ID: I20220318000129 |
| Provider Name | Philip Robert Larson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1568116309 PECOS PAC ID: 5991190332 Enrollment ID: I20220321002293 |
| Provider Name | Dustin W Cheney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225492606 PECOS PAC ID: 9133523418 Enrollment ID: I20220324000946 |
| Provider Name | Daniel Pennington |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033284955 PECOS PAC ID: 8921909458 Enrollment ID: I20220325000061 |
| Provider Name | Kyle J Bielefeld |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821268707 PECOS PAC ID: 5092067801 Enrollment ID: I20220328000127 |
| Provider Name | Jack L Morgan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851387930 PECOS PAC ID: 0446295752 Enrollment ID: I20220407001343 |
| Provider Name | Jack E Weaver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902802101 PECOS PAC ID: 4486543865 Enrollment ID: I20220412001224 |
| Provider Name | Lea S Humphrey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649584855 PECOS PAC ID: 3173836871 Enrollment ID: I20220504000403 |
| Provider Name | Christine R Beeson |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1215396056 PECOS PAC ID: 5597142620 Enrollment ID: I20220511001444 |
| Provider Name | Samuel Sanchez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780693861 PECOS PAC ID: 2264338714 Enrollment ID: I20220516000777 |
| Provider Name | Tara Dawn Gartling |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1417519018 PECOS PAC ID: 2365774171 Enrollment ID: I20220517000224 |
| Provider Name | Alexandria K Crocker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033674049 PECOS PAC ID: 4284975889 Enrollment ID: I20220518000225 |
| Provider Name | Jeffrey B Hensley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184860975 PECOS PAC ID: 0547327504 Enrollment ID: I20220519000392 |
| Provider Name | Alan Fortenberry |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1700048345 PECOS PAC ID: 7618355926 Enrollment ID: I20220527000336 |
| Provider Name | Major Kinsey Chase Parnell |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669073177 PECOS PAC ID: 1759769979 Enrollment ID: I20220531002053 |
| Provider Name | Robert E Sanders |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932188216 PECOS PAC ID: 7012802820 Enrollment ID: I20220616000087 |
| Provider Name | Jennie Alexa Dawn Barnes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831536812 PECOS PAC ID: 0648658989 Enrollment ID: I20220621002847 |
| Provider Name | Frank Hebroni |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437509494 PECOS PAC ID: 0941609754 Enrollment ID: I20220706002718 |
| Provider Name | Nancy Emelife |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992124093 PECOS PAC ID: 6608298245 Enrollment ID: I20220708000678 |
| Provider Name | Adam S Mednick |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922015643 PECOS PAC ID: 8426140617 Enrollment ID: I20220708003322 |
| Provider Name | David I Settle |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1902911498 PECOS PAC ID: 5991802506 Enrollment ID: I20220711001177 |
| Provider Name | Courtney Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235586371 PECOS PAC ID: 8426478306 Enrollment ID: I20220712001641 |
| Provider Name | Lindsey M Parnell |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497396576 PECOS PAC ID: 5698156263 Enrollment ID: I20220714001117 |
| Provider Name | James George Steyer |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1598742751 PECOS PAC ID: 5991186389 Enrollment ID: I20220716000050 |
| Provider Name | Taylor Waugh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124656343 PECOS PAC ID: 9739560095 Enrollment ID: I20220718001914 |
| Provider Name | Regina M Mellen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245332634 PECOS PAC ID: 6709868383 Enrollment ID: I20220719001040 |
| Provider Name | Lauren J Latta |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699404046 PECOS PAC ID: 4587045646 Enrollment ID: I20220720002565 |
| Provider Name | Cyriece Jones |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154984995 PECOS PAC ID: 8224410659 Enrollment ID: I20220803000398 |
| Provider Name | Angel Ogbeide |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1619438652 PECOS PAC ID: 5092112912 Enrollment ID: I20220803000558 |
| Provider Name | Trang H Nguyen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790006591 PECOS PAC ID: 6406007848 Enrollment ID: I20220803001345 |
| Provider Name | Sarah S Turner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1689721565 PECOS PAC ID: 6507950961 Enrollment ID: I20220803003326 |
| Provider Name | Judd W Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235628918 PECOS PAC ID: 8628478369 Enrollment ID: I20220806000512 |
| Provider Name | Ryan M Shaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679053813 PECOS PAC ID: 0244584027 Enrollment ID: I20220808000048 |
| Provider Name | Martha C Yanci Torres |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306040902 PECOS PAC ID: 7810060316 Enrollment ID: I20220809000441 |
| Provider Name | Casady Jo Deason |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1851048920 PECOS PAC ID: 2264815158 Enrollment ID: I20220809003849 |
| Provider Name | Philip E Ferguson |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1437283470 PECOS PAC ID: 5698862423 Enrollment ID: I20220816002434 |
| Provider Name | Arthur Harold Hulbert |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1578890281 PECOS PAC ID: 1759395825 Enrollment ID: I20220818001369 |
| Provider Name | Bradley R Dilday |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1023081171 PECOS PAC ID: 9436221322 Enrollment ID: I20220819000304 |
| Provider Name | Rebecca A Levy |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1396940607 PECOS PAC ID: 6507084845 Enrollment ID: I20220819002494 |
| Provider Name | Matthew A Jeffreys |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1790103521 PECOS PAC ID: 7911222666 Enrollment ID: I20220820000020 |
| Provider Name | Gregory A Mckenzie |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1093836066 PECOS PAC ID: 3678601721 Enrollment ID: I20220822002144 |
| Provider Name | Emily Jordan Ernst |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275140592 PECOS PAC ID: 2567845647 Enrollment ID: I20220823001695 |
| Provider Name | John C Leatherman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295779460 PECOS PAC ID: 6709843386 Enrollment ID: I20220823003807 |
| Provider Name | Thomas F Whiteside |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1457324055 PECOS PAC ID: 0345312237 Enrollment ID: I20220824003786 |
| Provider Name | Baylee R Moles |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104561851 PECOS PAC ID: 8921481730 Enrollment ID: I20220825001791 |
| Provider Name | Kevin D Branch |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1417034984 PECOS PAC ID: 7810013638 Enrollment ID: I20220829000594 |
| Provider Name | Lizhen Gui |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1417920570 PECOS PAC ID: 1850326885 Enrollment ID: I20220830001583 |
| Provider Name | Kyle C Ward |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720216898 PECOS PAC ID: 1052732534 Enrollment ID: I20220831000774 |
| Provider Name | Omar F Guimaraes |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497867873 PECOS PAC ID: 8729165550 Enrollment ID: I20220831000855 |
| Provider Name | Roger L Fink |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1467425512 PECOS PAC ID: 0648295410 Enrollment ID: I20220831002159 |
| Provider Name | Lucas K Campbell |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1851593990 PECOS PAC ID: 9537231899 Enrollment ID: I20220901000997 |
| Provider Name | Anthony L Likes |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1588769186 PECOS PAC ID: 9830481100 Enrollment ID: I20220902001046 |
| Provider Name | Jon E Rolston |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386912392 PECOS PAC ID: 4385805258 Enrollment ID: I20220907000921 |
| Provider Name | Janet L Hulbert |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1326323296 PECOS PAC ID: 0143605253 Enrollment ID: I20220909001647 |
| Provider Name | Deena E Winham |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558913228 PECOS PAC ID: 2567799075 Enrollment ID: I20220923001124 |
| Provider Name | Roblyn Thompson Smith |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1528273323 PECOS PAC ID: 8224414438 Enrollment ID: I20220926001317 |
| Provider Name | Cedrick K Mah |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1093447898 PECOS PAC ID: 5597148460 Enrollment ID: I20220927000361 |
| Provider Name | Veronica Avila |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316174964 PECOS PAC ID: 5294991725 Enrollment ID: I20221005000947 |
| Provider Name | Bailey Kemp |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245977008 PECOS PAC ID: 0547646846 Enrollment ID: I20221010001372 |
| Provider Name | Caleb Hentges |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326545161 PECOS PAC ID: 7911255245 Enrollment ID: I20221011000114 |
| Provider Name | Ruben Michael Barroso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922673243 PECOS PAC ID: 6305212655 Enrollment ID: I20221012000941 |
| Provider Name | Gregory Bradley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881135804 PECOS PAC ID: 6608207824 Enrollment ID: I20221013000072 |
| Provider Name | Courtney D Simon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114663085 PECOS PAC ID: 5193108975 Enrollment ID: I20221013002248 |
| Provider Name | Sean Klufa |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1306317078 PECOS PAC ID: 8729326186 Enrollment ID: I20221017000506 |
| Provider Name | Aatish M Patel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1154611457 PECOS PAC ID: 6507098118 Enrollment ID: I20221018001236 |
| Provider Name | Christopher Jason Guinn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144858358 PECOS PAC ID: 8022484757 Enrollment ID: I20221020000369 |
| Provider Name | Jacob Edward Dickerson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013659960 PECOS PAC ID: 8628445939 Enrollment ID: I20221028002492 |
| Provider Name | Merry Huber |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1720499585 PECOS PAC ID: 2860710894 Enrollment ID: I20221114000988 |
| Provider Name | Jessica B Cornell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932692209 PECOS PAC ID: 3870960354 Enrollment ID: I20221114001475 |
| Provider Name | Anthony N Hui |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1538132592 PECOS PAC ID: 8729045588 Enrollment ID: I20221115000928 |
| Provider Name | Paul Stanton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407841794 PECOS PAC ID: 7416935333 Enrollment ID: I20221118000095 |
| Provider Name | Jeffery J Blonsky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609896596 PECOS PAC ID: 4880881861 Enrollment ID: I20221118001507 |
| Provider Name | Tyler Ray Wilson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1447986062 PECOS PAC ID: 6507234549 Enrollment ID: I20221122001633 |
| Provider Name | Taylor Russell |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1659021707 PECOS PAC ID: 3375911241 Enrollment ID: I20221128000087 |
| Provider Name | Cindy Le |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1265179055 PECOS PAC ID: 3476921248 Enrollment ID: I20221129001219 |
| Provider Name | Okreipan Kaping |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1487209417 PECOS PAC ID: 6103294905 Enrollment ID: I20221129002481 |
| Provider Name | Kathryn Muzljakovich |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437750734 PECOS PAC ID: 6002227725 Enrollment ID: I20221130000269 |
| Provider Name | Alexander Finley Kinsinger |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1679214308 PECOS PAC ID: 3476936352 Enrollment ID: I20221130001300 |
| Provider Name | Oliver Cvitanic |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538267208 PECOS PAC ID: 2567490204 Enrollment ID: I20221205003181 |
| Provider Name | Shilpa Murthy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952545519 PECOS PAC ID: 7911145834 Enrollment ID: I20221213002894 |
| Provider Name | Teuta N Shemshedini |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760774178 PECOS PAC ID: 9133413727 Enrollment ID: I20221216001896 |
| Provider Name | Anastasia N Jackson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740835966 PECOS PAC ID: 6406282789 Enrollment ID: I20221220000713 |
| Provider Name | Dolly B Roy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053469072 PECOS PAC ID: 9436245891 Enrollment ID: I20221220001740 |
| Provider Name | Callie L Merriott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932789898 PECOS PAC ID: 1355711078 Enrollment ID: I20221221001044 |
| Provider Name | Jennifer Lee Callaway |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619557964 PECOS PAC ID: 3476923145 Enrollment ID: I20221222000143 |
| Provider Name | Tess N Hanner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508158841 PECOS PAC ID: 5193943348 Enrollment ID: I20221227000193 |
| Provider Name | Dania Amina Hatahet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548581978 PECOS PAC ID: 0941421606 Enrollment ID: I20221228000574 |
| Provider Name | Hannah Pierce |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1053069278 PECOS PAC ID: 1153791694 Enrollment ID: I20221228001323 |
| Provider Name | Elise N Branstetter |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457732679 PECOS PAC ID: 8325418767 Enrollment ID: I20221230000060 |
| Provider Name | Joseph Eble |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972766806 PECOS PAC ID: 9436205952 Enrollment ID: I20230102000149 |
| Provider Name | Mackenzie S Williams |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1427771963 PECOS PAC ID: 1951771039 Enrollment ID: I20230106000163 |
| Provider Name | Cole M Sutherland |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1639801434 PECOS PAC ID: 7911380753 Enrollment ID: I20230113000980 |
| Provider Name | Mark Borsody |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215179767 PECOS PAC ID: 5890844575 Enrollment ID: I20230118000282 |
| Provider Name | Ryan D Stone |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1316682719 PECOS PAC ID: 2860863164 Enrollment ID: I20230124003532 |
| Provider Name | Kimberly Ann Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033844865 PECOS PAC ID: 9537530555 Enrollment ID: I20230130000497 |
| Provider Name | Sarah Lynn Close |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649908930 PECOS PAC ID: 7214308295 Enrollment ID: I20230131000284 |
| Provider Name | Jennifer Cheyanne Wilkie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912586462 PECOS PAC ID: 9931571361 Enrollment ID: I20230214000637 |
| Provider Name | Tyler W Snyder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326626458 PECOS PAC ID: 6305218686 Enrollment ID: I20230215000040 |
| Provider Name | Jessica M Klingeman |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1710530688 PECOS PAC ID: 1355714379 Enrollment ID: I20230222001184 |
| Provider Name | Patrick Sharp |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003494972 PECOS PAC ID: 8729451489 Enrollment ID: I20230227003034 |
| Provider Name | Joshua Dee Burton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720588239 PECOS PAC ID: 3173955853 Enrollment ID: I20230228001055 |
| Provider Name | George Kenneth Rains |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1346298635 PECOS PAC ID: 7113390832 Enrollment ID: I20230228002213 |
| Provider Name | Johnathon K Lowe |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962903963 PECOS PAC ID: 9133553787 Enrollment ID: I20230301000044 |
| Provider Name | Celeste L Bidwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184394751 PECOS PAC ID: 4486033156 Enrollment ID: I20230302000930 |
| Provider Name | Douglas B Kliewer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174518906 PECOS PAC ID: 9335127257 Enrollment ID: I20230308000063 |
| Provider Name | Patrick R Volak |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1174518336 PECOS PAC ID: 5496733313 Enrollment ID: I20230308000809 |
| Provider Name | Nikita M Layson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1447616768 PECOS PAC ID: 5092019703 Enrollment ID: I20230316000539 |
| Provider Name | Nathan J Barney |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1992115166 PECOS PAC ID: 6608125901 Enrollment ID: I20230316002483 |
| Provider Name | Taber A Wright |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689075392 PECOS PAC ID: 9537381355 Enrollment ID: I20230320000770 |
| Provider Name | Andrew Hawthorn Dodd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245804921 PECOS PAC ID: 1153795885 Enrollment ID: I20230321001341 |
| Provider Name | Lauren H Andrews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821752825 PECOS PAC ID: 5890186068 Enrollment ID: I20230327000564 |
| Provider Name | Melissa C Jones |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497985386 PECOS PAC ID: 6103137906 Enrollment ID: I20230327002124 |
| Provider Name | Megan Rae Tucker |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1134857279 PECOS PAC ID: 8921472242 Enrollment ID: I20230328000345 |
| Provider Name | Candice Craig |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356719660 PECOS PAC ID: 6901270149 Enrollment ID: I20230329003020 |
| Provider Name | Islam Fayed |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316300320 PECOS PAC ID: 3072922806 Enrollment ID: I20230403000723 |
| Provider Name | William D Bright |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1548982242 PECOS PAC ID: 6608247648 Enrollment ID: I20230410002023 |
| Provider Name | Shawna R Segraves Duncan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568431328 PECOS PAC ID: 0345378360 Enrollment ID: I20230411000221 |
| Provider Name | April L Phillips |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124494901 PECOS PAC ID: 8426367376 Enrollment ID: I20230412000335 |
| Provider Name | Mackenzie F Brubaker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558081166 PECOS PAC ID: 8123403946 Enrollment ID: I20230419000129 |
| Provider Name | Natalie Gilbert |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033109673 PECOS PAC ID: 4981656808 Enrollment ID: I20230420001990 |
| Provider Name | Jessica L Poteet |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598102808 PECOS PAC ID: 2860763760 Enrollment ID: I20230425000599 |
| Provider Name | Hernan N Aguilos |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124473665 PECOS PAC ID: 9032499595 Enrollment ID: I20230426000059 |
| Provider Name | Alicia Dawn Campanella |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1891409033 PECOS PAC ID: 4082079868 Enrollment ID: I20230501000762 |
| Provider Name | Jennifer Pettit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114599081 PECOS PAC ID: 9537524368 Enrollment ID: I20230502000098 |
| Provider Name | Joanne Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063119113 PECOS PAC ID: 1355706052 Enrollment ID: I20230503000104 |
| Provider Name | Al L Mamaril |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497246342 PECOS PAC ID: 7719232479 Enrollment ID: I20230503003229 |
| Provider Name | Frederick S Das |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1346670106 PECOS PAC ID: 1557584687 Enrollment ID: I20230516000826 |
| Provider Name | Taylor O Ampleford |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1437570876 PECOS PAC ID: 5597994632 Enrollment ID: I20230531002624 |
| Provider Name | Elizabeth Anne Amos |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1477855849 PECOS PAC ID: 6901034669 Enrollment ID: I20230531003225 |
| Provider Name | Paige N Roberts |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811666852 PECOS PAC ID: 0547627754 Enrollment ID: I20230602001768 |
| Provider Name | Nigel Naman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184069080 PECOS PAC ID: 8921392333 Enrollment ID: I20230613002700 |
| Provider Name | Chadwick Nathan Webster |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1073613204 PECOS PAC ID: 4284092685 Enrollment ID: I20230616000457 |
| Provider Name | Hilary Jo Smiley |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1346943982 PECOS PAC ID: 8123486388 Enrollment ID: I20230620002252 |
| Provider Name | Austin Hinds |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1083300107 PECOS PAC ID: 0840658886 Enrollment ID: I20230622002848 |
| Provider Name | Austin Marsh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346773850 PECOS PAC ID: 7911389002 Enrollment ID: I20230624000094 |
| Provider Name | Myo Win |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053321653 PECOS PAC ID: 0446449706 Enrollment ID: I20230624000133 |
| Provider Name | Smaranda A Galis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386611473 PECOS PAC ID: 8820012875 Enrollment ID: I20230630000166 |
| Provider Name | Mehyar Hefazi Torghabeh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548655343 PECOS PAC ID: 9830586767 Enrollment ID: I20230701000263 |
| Provider Name | Blake E Carr |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407279235 PECOS PAC ID: 0749413854 Enrollment ID: I20230706000394 |
| Provider Name | Shane W Cashman |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1609137876 PECOS PAC ID: 2961792783 Enrollment ID: I20230710002186 |
| Provider Name | Elizabeth J Potts |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1467199919 PECOS PAC ID: 2062892177 Enrollment ID: I20230711002256 |
| Provider Name | Gery Hsu |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1134163652 PECOS PAC ID: 0042124851 Enrollment ID: I20230712001646 |
| Provider Name | Kristy Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184084097 PECOS PAC ID: 1850699059 Enrollment ID: I20230714000120 |
| Provider Name | Cindy Lee Matthiesen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1578737748 PECOS PAC ID: 2961862230 Enrollment ID: I20230718002848 |
| Provider Name | Dustin P Renfro |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760900955 PECOS PAC ID: 1658647169 Enrollment ID: I20230719000494 |
| Provider Name | Haley Faith Stewart |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1316646920 PECOS PAC ID: 5294195475 Enrollment ID: I20230719003009 |
| Provider Name | Christopher A Webber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689056996 PECOS PAC ID: 3375852445 Enrollment ID: I20230724000089 |
| Provider Name | Aaron Rashae Mcjunkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023380953 PECOS PAC ID: 9537534557 Enrollment ID: I20230726001236 |
| Provider Name | Kayla J Cagle-colon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134582034 PECOS PAC ID: 8921345976 Enrollment ID: I20230727002768 |
| Provider Name | Jerrod Douglas Spring |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811331432 PECOS PAC ID: 9638487150 Enrollment ID: I20230731000929 |
| Provider Name | Shelly Folta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417293911 PECOS PAC ID: 4183085657 Enrollment ID: I20230731002768 |
| Provider Name | Megan S Ballew |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982627733 PECOS PAC ID: 1557554094 Enrollment ID: I20230802002093 |
| Provider Name | Tina Qualls |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710492558 PECOS PAC ID: 9638431430 Enrollment ID: I20230803003066 |
| Provider Name | Drake K Sellmeyer |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1285666750 PECOS PAC ID: 4880055813 Enrollment ID: I20230807002239 |
| Provider Name | Michelle L Clift |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1669165304 PECOS PAC ID: 2163883109 Enrollment ID: I20230807002572 |
| Provider Name | Kevin M Mcnamara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770744575 PECOS PAC ID: 9133344880 Enrollment ID: I20230809001995 |
| Provider Name | Robert M Crittenden |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1437144458 PECOS PAC ID: 2264505874 Enrollment ID: I20230811001298 |
| Provider Name | Jessica Tarka |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811628613 PECOS PAC ID: 5799147476 Enrollment ID: I20230811001506 |
| Provider Name | Ethan Wohlgemuth |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104506419 PECOS PAC ID: 8921460627 Enrollment ID: I20230811002265 |
| Provider Name | Zachary A Cockrell |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1982283990 PECOS PAC ID: 8820450562 Enrollment ID: I20230814000686 |
| Provider Name | Jennifer L Duroy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225458813 PECOS PAC ID: 7416204169 Enrollment ID: I20230814003706 |
| Provider Name | Ethan Joseph Gerstein |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1386330603 PECOS PAC ID: 5799147252 Enrollment ID: I20230815002721 |
| Provider Name | Cassandra Lynn Clay |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841711504 PECOS PAC ID: 6800138397 Enrollment ID: I20230824002838 |
| Provider Name | Gretchan B Lopez |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1629605258 PECOS PAC ID: 6901269653 Enrollment ID: I20230828003276 |
| Provider Name | Jeffrey E Cull |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1003830381 PECOS PAC ID: 7214391184 Enrollment ID: I20230911002497 |
| Provider Name | Aubrey J Slaughter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851596936 PECOS PAC ID: 4486898145 Enrollment ID: I20230913000750 |
| Provider Name | Janet L Pruitt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568562700 PECOS PAC ID: 6507848512 Enrollment ID: I20230920002407 |
| Provider Name | Jessi Michaela Stidham |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1326729971 PECOS PAC ID: 9537513726 Enrollment ID: I20230921001518 |
| Provider Name | Rachel F Mauldin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326674458 PECOS PAC ID: 0345636908 Enrollment ID: I20230921003427 |
| Provider Name | Charity Jones |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1164700241 PECOS PAC ID: 4486008521 Enrollment ID: I20230925000013 |
| Provider Name | Caitlin Erin Mcarthur |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902106206 PECOS PAC ID: 7810251865 Enrollment ID: I20230925000140 |
| Provider Name | Leaanna Dawn Zibell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184310591 PECOS PAC ID: 5890149819 Enrollment ID: I20230926000115 |
| Provider Name | Mary Rosenthal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114040656 PECOS PAC ID: 8022298629 Enrollment ID: I20230929000218 |
| Provider Name | Troy A Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518599646 PECOS PAC ID: 4082026299 Enrollment ID: I20231002001795 |
| Provider Name | Wendy Carmel Mcclain |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1154640878 PECOS PAC ID: 0446432520 Enrollment ID: I20231004000272 |
| Provider Name | Anna Amaris Samuel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316576747 PECOS PAC ID: 9436572047 Enrollment ID: I20231009000253 |
| Provider Name | Aubry Tackett |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1871289173 PECOS PAC ID: 5597129098 Enrollment ID: I20231016000062 |
| Provider Name | Hester I Ferguson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104372275 PECOS PAC ID: 5799065827 Enrollment ID: I20231017003025 |
| Provider Name | Brooke Nicole Bergman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861069544 PECOS PAC ID: 0446605992 Enrollment ID: I20231018002534 |
| Provider Name | Erica Marie Herman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205410248 PECOS PAC ID: 4880040393 Enrollment ID: I20231019001253 |
| Provider Name | Aleece Marie Kanai Dietz |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194415190 PECOS PAC ID: 6709232184 Enrollment ID: I20231020000888 |
| Provider Name | Amanda D Combs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053787283 PECOS PAC ID: 0244548444 Enrollment ID: I20231023000834 |
| Provider Name | Jacalyn Jonea Hulsey |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1992497291 PECOS PAC ID: 5193171924 Enrollment ID: I20231030003270 |
| Provider Name | Audrey Elise Carter |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639745664 PECOS PAC ID: 9032519277 Enrollment ID: I20231031001588 |
| Provider Name | Samuel Ross Holloway |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1740983121 PECOS PAC ID: 5890141519 Enrollment ID: I20231031003165 |
| Provider Name | Donavon M Baldridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134800964 PECOS PAC ID: 2668828302 Enrollment ID: I20231101000209 |
| Provider Name | Troy M Scott |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770288151 PECOS PAC ID: 3577919166 Enrollment ID: I20231102002957 |
| Provider Name | Alisa M Koyama |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588340608 PECOS PAC ID: 6608223086 Enrollment ID: I20231107000230 |
| Provider Name | Zakary B Rose-reneau |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629654744 PECOS PAC ID: 9931578150 Enrollment ID: I20231110000259 |
| Provider Name | Elizabeth G Armstrong |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467142240 PECOS PAC ID: 8820445976 Enrollment ID: I20231110000505 |
| Provider Name | Haley Lynn Liberty |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1659066256 PECOS PAC ID: 5294182069 Enrollment ID: I20231116000097 |
| Provider Name | Catherine Cudnoski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821225483 PECOS PAC ID: 9537324926 Enrollment ID: I20231116002585 |
| Provider Name | Mary Elizabeth Jones |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831888445 PECOS PAC ID: 5890144794 Enrollment ID: I20231216000253 |
| Provider Name | Lisa D Tidwell-mckay |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629375761 PECOS PAC ID: 6002265915 Enrollment ID: I20231218000481 |
| Provider Name | Angela J Sumter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124315130 PECOS PAC ID: 4082063045 Enrollment ID: I20231222000561 |
| Provider Name | Chris D Wofford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922203355 PECOS PAC ID: 6406206010 Enrollment ID: I20231222000983 |
| Provider Name | Adam M O'daniel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568593085 PECOS PAC ID: 8527417872 Enrollment ID: I20231222002638 |
| Provider Name | Ashley B Hopper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558855031 PECOS PAC ID: 3375993843 Enrollment ID: I20231223000194 |
| Provider Name | Kimberly D King |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487958336 PECOS PAC ID: 9739538927 Enrollment ID: I20231227000884 |
| Provider Name | Ashley Daryl Robertson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700359239 PECOS PAC ID: 5991155343 Enrollment ID: I20231227001010 |
| Provider Name | Kandra J Napier |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699716456 PECOS PAC ID: 1153770391 Enrollment ID: I20231227002296 |
| Provider Name | Holly Caddell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548759327 PECOS PAC ID: 1052760121 Enrollment ID: I20231228000107 |
| Provider Name | Mika F Goff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407258544 PECOS PAC ID: 7911356118 Enrollment ID: I20231228000384 |
| Provider Name | Brittany Nicole Lamont |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558829028 PECOS PAC ID: 5991154817 Enrollment ID: I20231228000750 |
| Provider Name | Christen Eve Pruet |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225551476 PECOS PAC ID: 3678923919 Enrollment ID: I20231228001378 |
| Provider Name | Jesse D Craighead |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558722652 PECOS PAC ID: 9638528920 Enrollment ID: I20231228002139 |
| Provider Name | Robert V Stewart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780889105 PECOS PAC ID: 4880044189 Enrollment ID: I20231228003738 |
| Provider Name | James Weatherford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881196251 PECOS PAC ID: 4688023633 Enrollment ID: I20231229000276 |
| Provider Name | Taylor Ray Tanner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215688247 PECOS PAC ID: 7113377342 Enrollment ID: I20231229000946 |
| Provider Name | Davetta Kaye Alexander |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538527361 PECOS PAC ID: 6002266236 Enrollment ID: I20231229001070 |
| Provider Name | Allison Meisenheimer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760949762 PECOS PAC ID: 2860842002 Enrollment ID: I20231229001287 |
| Provider Name | Portia Kay Wickliffe-herron |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285805614 PECOS PAC ID: 4284084450 Enrollment ID: I20231229002263 |
| Provider Name | Eddie C. Melton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679579353 PECOS PAC ID: 5193880714 Enrollment ID: I20231229002620 |
| Provider Name | John Edward Robinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316081664 PECOS PAC ID: 7517317787 Enrollment ID: I20240102000586 |
| Provider Name | Meghan Alicia Sue |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831962554 PECOS PAC ID: 6709236391 Enrollment ID: I20240103001139 |
| Provider Name | Jessica Millsap |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710207451 PECOS PAC ID: 1759527559 Enrollment ID: I20240103003939 |
| Provider Name | Mesheila D Flaming |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770859555 PECOS PAC ID: 0143671180 Enrollment ID: I20240104000316 |
| Provider Name | Wendi A Esposito-worthington |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962596544 PECOS PAC ID: 4486698438 Enrollment ID: I20240104001374 |
| Provider Name | Amanda Blair Webb |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477749588 PECOS PAC ID: 6305297458 Enrollment ID: I20240112002363 |
| Provider Name | Heather Anne Abreu |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306099106 PECOS PAC ID: 5294188330 Enrollment ID: I20240125001226 |
| Provider Name | Joy Alice Wahnee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669644605 PECOS PAC ID: 8224481791 Enrollment ID: I20240131003713 |
| Provider Name | Ikechukwu D Ozoigbo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992770440 PECOS PAC ID: 3870627193 Enrollment ID: I20240206002626 |
| Provider Name | Sally R Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780774976 PECOS PAC ID: 4587014337 Enrollment ID: I20240206003193 |
| Provider Name | Bethany M Winters |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932558046 PECOS PAC ID: 9830522606 Enrollment ID: I20240207000741 |
| Provider Name | James David Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770740748 PECOS PAC ID: 6305289240 Enrollment ID: I20240208000698 |
| Provider Name | Jim Lee Trammell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316283245 PECOS PAC ID: 2365885175 Enrollment ID: I20240208003023 |
| Provider Name | Candace L Lawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568125201 PECOS PAC ID: 1254725245 Enrollment ID: I20240208003134 |
| Provider Name | Megan Elizabeth Dinnel |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1164706669 PECOS PAC ID: 7911340740 Enrollment ID: I20240208003785 |
| Provider Name | Sheri Robertson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1245564251 PECOS PAC ID: 9830532506 Enrollment ID: I20240209000635 |
| Provider Name | Dalton Ryan Pickering |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811587801 PECOS PAC ID: 5991148611 Enrollment ID: I20240209002615 |
| Provider Name | Michael F Fisher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295908945 PECOS PAC ID: 7315380870 Enrollment ID: I20240212003102 |
| Provider Name | Kevin Alan Williams |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1700937422 PECOS PAC ID: 4082057427 Enrollment ID: I20240213001580 |
| Provider Name | Johanna C Greenwood |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1548036791 PECOS PAC ID: 1254775653 Enrollment ID: I20240213003928 |
| Provider Name | Lior N Shamai |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1093963563 PECOS PAC ID: 7315189016 Enrollment ID: I20240219002535 |
| Provider Name | Rebecca A Cotney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336426436 PECOS PAC ID: 3476729377 Enrollment ID: I20240226002763 |
| Provider Name | Scott R Bland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285131383 PECOS PAC ID: 3375942634 Enrollment ID: I20240229000703 |
| Provider Name | Suzanne Pavlos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760513261 PECOS PAC ID: 3779552997 Enrollment ID: I20240301000481 |
| Provider Name | Rachel Rycroft |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821635590 PECOS PAC ID: 9537502893 Enrollment ID: I20240307001849 |
| Provider Name | Catherine Mary Mcmahon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548535164 PECOS PAC ID: 3678919081 Enrollment ID: I20240307003275 |
| Provider Name | Kendal G Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013686328 PECOS PAC ID: 4082050356 Enrollment ID: I20240308000933 |
Vitality Primary Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 209 N Oak St, Sallisaw, OK 74955 Phone: 918-636-3930 Fax: 918-636-3930 | |
Medz Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 210 E Creek A And B, Sallisaw, OK 74955 Phone: 918-485-0068 | |
Northeastern Health System Sequoyah Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 511 E Redwood Ave, Sallisaw, OK 74955 Phone: 918-775-1619 Fax: 918-775-1618 | |
Williams Medical Group Practice, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 W Ruth Ave, Sallisaw, OK 74955 Phone: 405-445-1210 | |
Smh Primary Health Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 409 E Redwood Ave, Sallisaw, OK 74955 Phone: 918-790-3309 Fax: 918-775-0587 | |
Your Best Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102780 Us Highway 59, Sallisaw, OK 74955 Phone: 660-281-0018 | |
Wellspring Family Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 S Oak St, Ste. B, Sallisaw, OK 74955 Phone: 918-775-0075 Fax: 918-775-0063 |