| Revere Health | |
|
1055 N 500 W Provo UT 84604-3305 | |
| (801) 429-8000 | |
| (801) 429-8150 |
| Full Name | Revere Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 1055 N 500 W, Provo, Utah |
| Authorized Official Name and Position | Scott D Barlow (CHIEF EXECUITIVE OFFICER) |
| Authorized Official Contact | 8014298034 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revere Health 1055 N 500 W Credentialing Department Provo UT 84604-3305 Ph: (801) 354-8225 | Revere Health 1055 N 500 W Provo UT 84604-3305 Ph: (801) 429-8000 |
| NPI Number | 1093764805 |
|---|---|
| Provider Enumeration Date | 05/09/2006 |
| Last Update Date | 03/07/2018 |
| Medicare PECOS PAC ID | 7517868508 |
|---|---|
| Medicare Enrollment ID | O20040113000805 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093764805 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Joseph Derit Te |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1700946423 PECOS PAC ID: 6507770427 Enrollment ID: I20031114000684 |
| Provider Name | David C Boorman |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1659344471 PECOS PAC ID: 7618874082 Enrollment ID: I20031215000391 |
| Provider Name | Paul W Sagers |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457378259 PECOS PAC ID: 9638077019 Enrollment ID: I20031222000929 |
| Provider Name | Richard Wayne Bennett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407871510 PECOS PAC ID: 6406757392 Enrollment ID: I20040114000598 |
| Provider Name | Craig M Grose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003854878 PECOS PAC ID: 2466345087 Enrollment ID: I20040205001317 |
| Provider Name | Peter Blaine Hathaway |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730187824 PECOS PAC ID: 4284521808 Enrollment ID: I20040228000572 |
| Provider Name | Steven B Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629075684 PECOS PAC ID: 8820985443 Enrollment ID: I20040228000576 |
| Provider Name | Karl N Weenig |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1740242973 PECOS PAC ID: 0648167700 Enrollment ID: I20040303000074 |
| Provider Name | Christina P Linton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427074905 PECOS PAC ID: 9830087311 Enrollment ID: I20040306000306 |
| Provider Name | Jonathan Pharis Hubbard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609894922 PECOS PAC ID: 3173411519 Enrollment ID: I20040308001122 |
| Provider Name | Deborah D Barton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548234222 PECOS PAC ID: 3375433816 Enrollment ID: I20040317001578 |
| Provider Name | Jonathan Craig Bowman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619047362 PECOS PAC ID: 6709776800 Enrollment ID: I20040319000818 |
| Provider Name | Marvin R Allen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831154566 PECOS PAC ID: 0446242192 Enrollment ID: I20040401000777 |
| Provider Name | Valerie Jean Juarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407967979 PECOS PAC ID: 2860485323 Enrollment ID: I20040408000460 |
| Provider Name | Terry Craig Hammond |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1124064845 PECOS PAC ID: 2769476431 Enrollment ID: I20040414000631 |
| Provider Name | Payam Tristani-firouzi |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1407943921 PECOS PAC ID: 6406841923 Enrollment ID: I20040415000597 |
| Provider Name | Mohammad Modar Alsolaiman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1215986484 PECOS PAC ID: 6507852894 Enrollment ID: I20040422000490 |
| Provider Name | Charles Frelen Dahl |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912965344 PECOS PAC ID: 7315935079 Enrollment ID: I20040503001120 |
| Provider Name | Scott E Bingham |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1487612214 PECOS PAC ID: 2860483096 Enrollment ID: I20040518001211 |
| Provider Name | James G Carlisle |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1750478707 PECOS PAC ID: 0840271771 Enrollment ID: I20040526001602 |
| Provider Name | Mark C Sanderson |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1073604609 PECOS PAC ID: 0446159933 Enrollment ID: I20040611000559 |
| Provider Name | John T Wells |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1740371376 PECOS PAC ID: 4082513577 Enrollment ID: I20040614000849 |
| Provider Name | Mckay L Platt |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1336230085 PECOS PAC ID: 4688651482 Enrollment ID: I20040630000433 |
| Provider Name | Walstir Henriques Fonseca |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013933506 PECOS PAC ID: 0547247223 Enrollment ID: I20040630000977 |
| Provider Name | Jeffrey Wallentine |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1124121934 PECOS PAC ID: 0143208538 Enrollment ID: I20040712001081 |
| Provider Name | Michael Burton Anderson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093792210 PECOS PAC ID: 1557349677 Enrollment ID: I20040714001215 |
| Provider Name | Bruce Darrell Larsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922189372 PECOS PAC ID: 2769452275 Enrollment ID: I20040730000244 |
| Provider Name | Scott Alvarus Parry |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1285611475 PECOS PAC ID: 0547160707 Enrollment ID: I20040730000961 |
| Provider Name | Kent Merrill Gledhill |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871539833 PECOS PAC ID: 7315918794 Enrollment ID: I20040802000599 |
| Provider Name | Todd R Parry |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1114905932 PECOS PAC ID: 9931171790 Enrollment ID: I20040811000944 |
| Provider Name | Jason D Okerlund |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649313677 PECOS PAC ID: 7214900455 Enrollment ID: I20040817000212 |
| Provider Name | Dalton H Wright |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174569131 PECOS PAC ID: 0749253680 Enrollment ID: I20040818000434 |
| Provider Name | Paul K Ritchie |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1720021678 PECOS PAC ID: 3577469618 Enrollment ID: I20040819000606 |
| Provider Name | Brent T Layton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346286317 PECOS PAC ID: 8224002555 Enrollment ID: I20040823001283 |
| Provider Name | Peter Duros |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669498119 PECOS PAC ID: 3870560824 Enrollment ID: I20040910000633 |
| Provider Name | Gregory Blake Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255377222 PECOS PAC ID: 2062489768 Enrollment ID: I20040913000915 |
| Provider Name | Stephen Jason Tomlinson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1043325715 PECOS PAC ID: 2961479126 Enrollment ID: I20040916000143 |
| Provider Name | Cary J Judy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013078344 PECOS PAC ID: 2466420351 Enrollment ID: I20040920000006 |
| Provider Name | Kirt M Kimball |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548363419 PECOS PAC ID: 9537120969 Enrollment ID: I20041020000198 |
| Provider Name | Michael Scott Major |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1558394783 PECOS PAC ID: 7214999804 Enrollment ID: I20041027000063 |
| Provider Name | Sean R Curzon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780600247 PECOS PAC ID: 5991769770 Enrollment ID: I20041112000520 |
| Provider Name | Paul Russell Jensen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528049335 PECOS PAC ID: 6901864115 Enrollment ID: I20041220000900 |
| Provider Name | Christopher J Parr |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063410157 PECOS PAC ID: 7214995422 Enrollment ID: I20041220000940 |
| Provider Name | Cole J Panushka |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053392050 PECOS PAC ID: 4789642901 Enrollment ID: I20041220001003 |
| Provider Name | Nolan B Money |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194759027 PECOS PAC ID: 7517912132 Enrollment ID: I20050316001022 |
| Provider Name | Clarene Hansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114985553 PECOS PAC ID: 4486609898 Enrollment ID: I20050318000393 |
| Provider Name | Mark L Donaldson |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1982662102 PECOS PAC ID: 5496701328 Enrollment ID: I20050323001424 |
| Provider Name | Thomas A Dickinson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376591354 PECOS PAC ID: 8123016847 Enrollment ID: I20050323001435 |
| Provider Name | Jeffrey W Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285692400 PECOS PAC ID: 3476509308 Enrollment ID: I20050323001441 |
| Provider Name | Chun Hwang |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1649238080 PECOS PAC ID: 5193771020 Enrollment ID: I20050323001450 |
| Provider Name | Brian Richard Bradshaw |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1811955800 PECOS PAC ID: 6002862935 Enrollment ID: I20050323001451 |
| Provider Name | Richard K Olsen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932157138 PECOS PAC ID: 7911953849 Enrollment ID: I20050323001452 |
| Provider Name | Robert Edmond Corniea |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447218664 PECOS PAC ID: 8820044753 Enrollment ID: I20050323001453 |
| Provider Name | Kurt Olsen Bodily |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780600312 PECOS PAC ID: 9739135666 Enrollment ID: I20050323001454 |
| Provider Name | John K Staheli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275591620 PECOS PAC ID: 0648226571 Enrollment ID: I20050323001455 |
| Provider Name | Rodney H Newman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588622013 PECOS PAC ID: 3870549553 Enrollment ID: I20050324001343 |
| Provider Name | Steven F Larsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699877316 PECOS PAC ID: 9335195999 Enrollment ID: I20050325000756 |
| Provider Name | James Christian Biesinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205885472 PECOS PAC ID: 6305892969 Enrollment ID: I20050325000782 |
| Provider Name | Lawrence K Nobuhara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740399385 PECOS PAC ID: 0941256168 Enrollment ID: I20050330000617 |
| Provider Name | Rachelle Frost |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730105214 PECOS PAC ID: 6103872320 Enrollment ID: I20050330000631 |
| Provider Name | Curtis C Johnson |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1205939089 PECOS PAC ID: 4587601661 Enrollment ID: I20050411000533 |
| Provider Name | Mitchell Williams Larsen |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1205928546 PECOS PAC ID: 4082654561 Enrollment ID: I20050504000167 |
| Provider Name | Bradford Kelly Ence |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1588766299 PECOS PAC ID: 8224078696 Enrollment ID: I20050504001103 |
| Provider Name | Brian A Clements |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265540009 PECOS PAC ID: 7719927854 Enrollment ID: I20050506000785 |
| Provider Name | Jason Anthony Kirkham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164421798 PECOS PAC ID: 9436136678 Enrollment ID: I20050509000772 |
| Provider Name | Kent G Marshall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962422543 PECOS PAC ID: 2668412313 Enrollment ID: I20050511001085 |
| Provider Name | David F Bennion |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255435244 PECOS PAC ID: 0547204828 Enrollment ID: I20050616001248 |
| Provider Name | Carl William Bacon |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962505750 PECOS PAC ID: 4082658364 Enrollment ID: I20050616001255 |
| Provider Name | Richard T Jackson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1144323163 PECOS PAC ID: 8628012903 Enrollment ID: I20050616001258 |
| Provider Name | Jonathan Robert Faux |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1538250287 PECOS PAC ID: 9537103817 Enrollment ID: I20050616001259 |
| Provider Name | Scott Taylor Jackson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1578666533 PECOS PAC ID: 7214971324 Enrollment ID: I20050618000193 |
| Provider Name | Alan L Colledge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629169370 PECOS PAC ID: 5597709626 Enrollment ID: I20050620000177 |
| Provider Name | Mark Boyack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750323986 PECOS PAC ID: 4385688431 Enrollment ID: I20050620000313 |
| Provider Name | Glenn T Etzel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083727408 PECOS PAC ID: 9032154547 Enrollment ID: I20050624000814 |
| Provider Name | Shiloh D Manning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972536001 PECOS PAC ID: 1759365927 Enrollment ID: I20050708000720 |
| Provider Name | Edward J Prince |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1659306975 PECOS PAC ID: 5193755163 Enrollment ID: I20050818000942 |
| Provider Name | Ryan A Richards |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1427149178 PECOS PAC ID: 9931131547 Enrollment ID: I20050902000741 |
| Provider Name | Gus C Pendleton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649361874 PECOS PAC ID: 4880645506 Enrollment ID: I20051008000195 |
| Provider Name | Scott D Barton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376690180 PECOS PAC ID: 5799736419 Enrollment ID: I20051101000467 |
| Provider Name | Russell Wayne Rhoades |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1164436507 PECOS PAC ID: 6507884004 Enrollment ID: I20051103000279 |
| Provider Name | Allen Merrill Day |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518908110 PECOS PAC ID: 2062431695 Enrollment ID: I20051114000432 |
| Provider Name | Kristen Vaughn Nielson Jones |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568457000 PECOS PAC ID: 6507885324 Enrollment ID: I20051121001071 |
| Provider Name | Heather R Harrison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487760138 PECOS PAC ID: 9638191117 Enrollment ID: I20051227000515 |
| Provider Name | Alan Ross Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518069020 PECOS PAC ID: 6901829498 Enrollment ID: I20060111000224 |
| Provider Name | Michael Cary Peterson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902827322 PECOS PAC ID: 2062436207 Enrollment ID: I20060116000082 |
| Provider Name | Brad A Mangum |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1316992548 PECOS PAC ID: 2668486440 Enrollment ID: I20060131000922 |
| Provider Name | James N Anderson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932201647 PECOS PAC ID: 3779597448 Enrollment ID: I20060201000848 |
| Provider Name | Braden J Taylor |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1598788036 PECOS PAC ID: 0547275851 Enrollment ID: I20060208000066 |
| Provider Name | Richard K Sharp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508817453 PECOS PAC ID: 2163437682 Enrollment ID: I20060222000695 |
| Provider Name | Melvin Eric Carter |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1700815834 PECOS PAC ID: 1850295775 Enrollment ID: I20060719000118 |
| Provider Name | Talaat A Al Shuqairat |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1104875574 PECOS PAC ID: 7113920299 Enrollment ID: I20060809000497 |
| Provider Name | Brett Lear Thorpe |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1962432583 PECOS PAC ID: 3274536107 Enrollment ID: I20060816000046 |
| Provider Name | Bruce Craig Mcallister |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1144223835 PECOS PAC ID: 1759386998 Enrollment ID: I20060922000113 |
| Provider Name | Scott D Valadez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114900206 PECOS PAC ID: 5698688828 Enrollment ID: I20061104000055 |
| Provider Name | Steven Lee Wallentine |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1790736122 PECOS PAC ID: 9931106903 Enrollment ID: I20061104000056 |
| Provider Name | Ann Marie Schmitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346358546 PECOS PAC ID: 4688672579 Enrollment ID: I20061202000012 |
| Provider Name | Yun Ling |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063475341 PECOS PAC ID: 6507869088 Enrollment ID: I20070207000017 |
| Provider Name | Christine Kay Foster |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205875747 PECOS PAC ID: 7113998360 Enrollment ID: I20070404000438 |
| Provider Name | David Turley Cragun |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1821005349 PECOS PAC ID: 4284536087 Enrollment ID: I20070517000274 |
| Provider Name | Jason M Huddleston |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619908001 PECOS PAC ID: 1456452309 Enrollment ID: I20070723000698 |
| Provider Name | Troy A Lunceford |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194842286 PECOS PAC ID: 8325149727 Enrollment ID: I20070730000573 |
| Provider Name | Douglas A Allen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659575686 PECOS PAC ID: 3072604214 Enrollment ID: I20070802000348 |
| Provider Name | David T Brockbank |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1093822561 PECOS PAC ID: 0345331443 Enrollment ID: I20070803000153 |
| Provider Name | Jeffrey William Groves |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629196399 PECOS PAC ID: 4587755939 Enrollment ID: I20070814000482 |
| Provider Name | Peter H Frech |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558584235 PECOS PAC ID: 7719079425 Enrollment ID: I20070827000458 |
| Provider Name | Stacey Townsend |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962554568 PECOS PAC ID: 1254427214 Enrollment ID: I20071022000752 |
| Provider Name | Ian B Mcmaster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598799462 PECOS PAC ID: 1052400272 Enrollment ID: I20071211000127 |
| Provider Name | Thu Anh Nguyen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649204389 PECOS PAC ID: 3476643909 Enrollment ID: I20071220000154 |
| Provider Name | Steven Wayne Shamo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235231747 PECOS PAC ID: 2365341377 Enrollment ID: I20080404000200 |
| Provider Name | Elizabeth A Larsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093770562 PECOS PAC ID: 3072691773 Enrollment ID: I20080422000231 |
| Provider Name | Kraig Lynn Packer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518959535 PECOS PAC ID: 3779471412 Enrollment ID: I20080520000842 |
| Provider Name | Rex Heaton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477627917 PECOS PAC ID: 9638249055 Enrollment ID: I20080528000283 |
| Provider Name | David C Wang |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1649491440 PECOS PAC ID: 7416022702 Enrollment ID: I20080821000200 |
| Provider Name | Curtis Allan Carter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245225325 PECOS PAC ID: 3375512866 Enrollment ID: I20080919000017 |
| Provider Name | Mohammed Soubhi Nizam |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1326203514 PECOS PAC ID: 2062571938 Enrollment ID: I20081106000565 |
| Provider Name | Darren H Averett |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1548232549 PECOS PAC ID: 1254491814 Enrollment ID: I20081201000080 |
| Provider Name | Ian W Blatter |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1801057567 PECOS PAC ID: 0941364459 Enrollment ID: I20090128000384 |
| Provider Name | Steven Timothy Garrard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366636854 PECOS PAC ID: 3779550801 Enrollment ID: I20090129000625 |
| Provider Name | Steven L Berry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528095312 PECOS PAC ID: 9436213469 Enrollment ID: I20090205000372 |
| Provider Name | Adrienne G Shaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659595742 PECOS PAC ID: 9436215241 Enrollment ID: I20090303000531 |
| Provider Name | Matthew S Frazier |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1598977944 PECOS PAC ID: 5092864777 Enrollment ID: I20090602000597 |
| Provider Name | Marc T Nuttall |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1144497322 PECOS PAC ID: 1951451160 Enrollment ID: I20090610000136 |
| Provider Name | Jamison Cullimore Jones |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1205031549 PECOS PAC ID: 4587715867 Enrollment ID: I20090626000116 |
| Provider Name | Darlene L Petersen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376744433 PECOS PAC ID: 1557413903 Enrollment ID: I20090715000402 |
| Provider Name | Sanford Todd Hamilton |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1356488126 PECOS PAC ID: 9638245459 Enrollment ID: I20090722000532 |
| Provider Name | Casey Ray Owens |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437348943 PECOS PAC ID: 2163575077 Enrollment ID: I20090724000330 |
| Provider Name | David B Young |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679756852 PECOS PAC ID: 6002962859 Enrollment ID: I20090918000394 |
| Provider Name | Gale J Skousen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053305391 PECOS PAC ID: 5496891806 Enrollment ID: I20091014000781 |
| Provider Name | Stephen Kirk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578737979 PECOS PAC ID: 3173661881 Enrollment ID: I20091117000154 |
| Provider Name | David S Devenport |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245258425 PECOS PAC ID: 8628119930 Enrollment ID: I20100108000715 |
| Provider Name | Scott David Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427008812 PECOS PAC ID: 3779676564 Enrollment ID: I20100119000608 |
| Provider Name | Thomas R Carn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194774588 PECOS PAC ID: 1052404845 Enrollment ID: I20100126000473 |
| Provider Name | Howard L Chamberlain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306951504 PECOS PAC ID: 8426009143 Enrollment ID: I20100127000614 |
| Provider Name | C Kerry Stratford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275688228 PECOS PAC ID: 1052362779 Enrollment ID: I20100127000632 |
| Provider Name | Douglas K Bagley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1538155411 PECOS PAC ID: 1658406772 Enrollment ID: I20100315000764 |
| Provider Name | Ekaete Sunday Udodong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083676647 PECOS PAC ID: 5799810479 Enrollment ID: I20100319000487 |
| Provider Name | Amy Ruth Hawks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396958369 PECOS PAC ID: 4981732542 Enrollment ID: I20100503000623 |
| Provider Name | Jim D Crowley |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1083697957 PECOS PAC ID: 3971584681 Enrollment ID: I20100510000573 |
| Provider Name | Judd D Hunter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831428705 PECOS PAC ID: 0648309989 Enrollment ID: I20100526000107 |
| Provider Name | Lauren V Zollinger |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548443716 PECOS PAC ID: 9335279637 Enrollment ID: I20100614000219 |
| Provider Name | Elizabeth Dayton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598799421 PECOS PAC ID: 7719017896 Enrollment ID: I20100616000629 |
| Provider Name | Robert B Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689692071 PECOS PAC ID: 7810087020 Enrollment ID: I20100616000684 |
| Provider Name | David J Tipton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811915051 PECOS PAC ID: 2466542675 Enrollment ID: I20100616000747 |
| Provider Name | Justin Earl Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760547699 PECOS PAC ID: 7517042385 Enrollment ID: I20100624000156 |
| Provider Name | Adam Michael Jensen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609072651 PECOS PAC ID: 0749343390 Enrollment ID: I20100702000048 |
| Provider Name | Aaron Newey Weaver |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1750594222 PECOS PAC ID: 7911038021 Enrollment ID: I20100706000103 |
| Provider Name | Abraham Robert Tomco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033320791 PECOS PAC ID: 9032261979 Enrollment ID: I20100907000483 |
| Provider Name | Jennifer Lynn Osborne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013230598 PECOS PAC ID: 9335264654 Enrollment ID: I20100909001207 |
| Provider Name | Orrin B Hansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104916543 PECOS PAC ID: 0749478311 Enrollment ID: I20101223000158 |
| Provider Name | Kipp M Robins |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1396741476 PECOS PAC ID: 2062600653 Enrollment ID: I20101227000157 |
| Provider Name | Bradley D Root |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1154312197 PECOS PAC ID: 2466544655 Enrollment ID: I20101227000427 |
| Provider Name | Max Robert Root |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1295725380 PECOS PAC ID: 8224226840 Enrollment ID: I20101227000446 |
| Provider Name | Ryan Slater |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346478476 PECOS PAC ID: 7214125830 Enrollment ID: I20101227000456 |
| Provider Name | Nicole Lejeune Rawle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669777314 PECOS PAC ID: 7911188065 Enrollment ID: I20110222000861 |
| Provider Name | Adam Stanley Green |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801946975 PECOS PAC ID: 8022296938 Enrollment ID: I20110623000681 |
| Provider Name | Richard Taylor Jackson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922248202 PECOS PAC ID: 2860670171 Enrollment ID: I20110708000316 |
| Provider Name | Garry Tim Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053568592 PECOS PAC ID: 5092983502 Enrollment ID: I20110727000254 |
| Provider Name | Lance O Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609188713 PECOS PAC ID: 2264604784 Enrollment ID: I20111005000656 |
| Provider Name | Scott Karl Summers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174808596 PECOS PAC ID: 5799959763 Enrollment ID: I20111201000415 |
| Provider Name | Brad S Huber |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1689757973 PECOS PAC ID: 1254484397 Enrollment ID: I20120305000298 |
| Provider Name | Gordon H Stock |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1932149895 PECOS PAC ID: 6406017763 Enrollment ID: I20120412000486 |
| Provider Name | Darrin S Brandt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538347687 PECOS PAC ID: 7315108644 Enrollment ID: I20120413000349 |
| Provider Name | Randy Ray Clark |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679781140 PECOS PAC ID: 7416127527 Enrollment ID: I20120809000659 |
| Provider Name | Randall Pace |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932337466 PECOS PAC ID: 7618124173 Enrollment ID: I20120906000198 |
| Provider Name | David Frantz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1700092004 PECOS PAC ID: 9133398100 Enrollment ID: I20120906000815 |
| Provider Name | Richard M Bird |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1063767879 PECOS PAC ID: 2668620162 Enrollment ID: I20120912000000 |
| Provider Name | Joseph G Mcgovern |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710240734 PECOS PAC ID: 1658529557 Enrollment ID: I20120919000086 |
| Provider Name | Nestor Almeida |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1891089926 PECOS PAC ID: 8022267400 Enrollment ID: I20120928000092 |
| Provider Name | Michael Jonathan Carlson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1407076193 PECOS PAC ID: 1153591557 Enrollment ID: I20121012000276 |
| Provider Name | Jerry G Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659651750 PECOS PAC ID: 2567625395 Enrollment ID: I20121025000773 |
| Provider Name | Brady Cade Blackham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679701197 PECOS PAC ID: 6204086119 Enrollment ID: I20121030000087 |
| Provider Name | Christopher David Westover |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891000790 PECOS PAC ID: 0749432755 Enrollment ID: I20121219000551 |
| Provider Name | William Edward Barager |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1962444638 PECOS PAC ID: 0042116568 Enrollment ID: I20130128000200 |
| Provider Name | William Fay Esplin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093923393 PECOS PAC ID: 2567527633 Enrollment ID: I20130617000114 |
| Provider Name | Katherine Anne Lemke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235473687 PECOS PAC ID: 6507005899 Enrollment ID: I20130618000179 |
| Provider Name | Tomeika Ann Ulett-garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780027722 PECOS PAC ID: 7719112697 Enrollment ID: I20131030001862 |
| Provider Name | Kim Cranney Houle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457784944 PECOS PAC ID: 7416184601 Enrollment ID: I20131213001390 |
| Provider Name | Benjamin Steven Crouch |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1336302546 PECOS PAC ID: 3971750886 Enrollment ID: I20140226001367 |
| Provider Name | James Bradley Macdonald |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1750517736 PECOS PAC ID: 3173649001 Enrollment ID: I20140508001467 |
| Provider Name | Evangeline K Lindorf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760623466 PECOS PAC ID: 5991928210 Enrollment ID: I20140514000135 |
| Provider Name | Bryce Donald Haslem |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1124286133 PECOS PAC ID: 7517123862 Enrollment ID: I20140603002429 |
| Provider Name | Chad Barrett Kawa |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1962654681 PECOS PAC ID: 6305060773 Enrollment ID: I20140605001216 |
| Provider Name | Joseph A Garcia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841496338 PECOS PAC ID: 2264613421 Enrollment ID: I20140611001620 |
| Provider Name | Matthew Brent Clark |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851619076 PECOS PAC ID: 2668697996 Enrollment ID: I20140630001907 |
| Provider Name | Daniel Matthew Hoopes |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1255505582 PECOS PAC ID: 0547400772 Enrollment ID: I20140723000497 |
| Provider Name | Ronald T Draper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013004498 PECOS PAC ID: 8921045287 Enrollment ID: I20140730001207 |
| Provider Name | Jarrett Hammer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417152026 PECOS PAC ID: 7618139296 Enrollment ID: I20140804002411 |
| Provider Name | Jerrica Elizabeth Stoddard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144584228 PECOS PAC ID: 5092966812 Enrollment ID: I20141002001416 |
| Provider Name | Rulon L Hardman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225219421 PECOS PAC ID: 7012071350 Enrollment ID: I20141006000606 |
| Provider Name | Jeffrey Blaine Winger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154686467 PECOS PAC ID: 1153572409 Enrollment ID: I20141212002142 |
| Provider Name | John T Nielsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477965275 PECOS PAC ID: 8123343506 Enrollment ID: I20150205001229 |
| Provider Name | Rosanne Johnson Oliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073903720 PECOS PAC ID: 0840516720 Enrollment ID: I20150312000809 |
| Provider Name | Diana Lee |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1093112914 PECOS PAC ID: 0941527204 Enrollment ID: I20150325001238 |
| Provider Name | Bryce Reed Swenson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528329299 PECOS PAC ID: 6709107998 Enrollment ID: I20150529001895 |
| Provider Name | Douglas Roy Langford |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659343564 PECOS PAC ID: 0749423473 Enrollment ID: I20150602001241 |
| Provider Name | Fred Jeston Dawson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316106131 PECOS PAC ID: 2365680519 Enrollment ID: I20150604000550 |
| Provider Name | Aaron Michael O'brien |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1114155074 PECOS PAC ID: 4486871464 Enrollment ID: I20150805009271 |
| Provider Name | Tammy T Jacobs |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1538397518 PECOS PAC ID: 7214156363 Enrollment ID: I20150805009494 |
| Provider Name | Don D Williams |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942526819 PECOS PAC ID: 5799901617 Enrollment ID: I20150910000364 |
| Provider Name | Ann Rogerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770953317 PECOS PAC ID: 4981912268 Enrollment ID: I20151006003094 |
| Provider Name | Kierstin Petersen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295106581 PECOS PAC ID: 1254641293 Enrollment ID: I20151104000556 |
| Provider Name | Ryan Samuel Francis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962873281 PECOS PAC ID: 8224338967 Enrollment ID: I20151201003024 |
| Provider Name | Amy Lynne Paugh Handley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255760773 PECOS PAC ID: 1456652098 Enrollment ID: I20151223001551 |
| Provider Name | Lorin Jerome Leithead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164852745 PECOS PAC ID: 5395969653 Enrollment ID: I20160427001330 |
| Provider Name | Michael Scott Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437585155 PECOS PAC ID: 8921234931 Enrollment ID: I20160613000996 |
| Provider Name | Christopher Connor Gessel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851732655 PECOS PAC ID: 9436392784 Enrollment ID: I20160614001040 |
| Provider Name | Benjamin Clark Jacobs |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982846119 PECOS PAC ID: 0446477848 Enrollment ID: I20160713002028 |
| Provider Name | Aaron Keith Starbuck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336288034 PECOS PAC ID: 6901124163 Enrollment ID: I20160725003089 |
| Provider Name | Jason H Eves |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700877131 PECOS PAC ID: 7315087947 Enrollment ID: I20160811001681 |
| Provider Name | Zachary Turley Freestone |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1790070449 PECOS PAC ID: 6103058714 Enrollment ID: I20160815002675 |
| Provider Name | Evan S Nielsen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1043527260 PECOS PAC ID: 8022323765 Enrollment ID: I20160919001956 |
| Provider Name | Toby Paulson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1235264169 PECOS PAC ID: 7719081579 Enrollment ID: I20160922001363 |
| Provider Name | Levi Richard Kohler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841748258 PECOS PAC ID: 3678851680 Enrollment ID: I20161026001258 |
| Provider Name | Christina Thacker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699225730 PECOS PAC ID: 3476832262 Enrollment ID: I20161118000870 |
| Provider Name | Emily Frandsen Meidell |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1841749215 PECOS PAC ID: 9335428879 Enrollment ID: I20161128001037 |
| Provider Name | Aaron Bennion |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659709848 PECOS PAC ID: 9133357171 Enrollment ID: I20170106001009 |
| Provider Name | Per Amundson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619940863 PECOS PAC ID: 5294788204 Enrollment ID: I20170518001319 |
| Provider Name | Nicholas Henry Laffely |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1801981410 PECOS PAC ID: 8022161397 Enrollment ID: I20170525002087 |
| Provider Name | Bryson J Hollingshead |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124432992 PECOS PAC ID: 0547486284 Enrollment ID: I20170612002282 |
| Provider Name | Drake Scott Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194131516 PECOS PAC ID: 8224306170 Enrollment ID: I20170616001535 |
| Provider Name | Grant Logan Blatter |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558377309 PECOS PAC ID: 3870862659 Enrollment ID: I20170711001306 |
| Provider Name | Reed Michael Garza |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1669715819 PECOS PAC ID: 7719256445 Enrollment ID: I20170711003376 |
| Provider Name | Hayley Lundeen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316477342 PECOS PAC ID: 5799055976 Enrollment ID: I20170720001634 |
| Provider Name | Brandt Esplin |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1285929430 PECOS PAC ID: 1557519980 Enrollment ID: I20170725003988 |
| Provider Name | David Earl Perry |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1295029528 PECOS PAC ID: 6305069501 Enrollment ID: I20170811002287 |
| Provider Name | Arthur Boltz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215281118 PECOS PAC ID: 6103077086 Enrollment ID: I20171005000318 |
| Provider Name | Megan Mcfall Kennedy |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1851802490 PECOS PAC ID: 4981970290 Enrollment ID: I20171031002218 |
| Provider Name | Jill D Cronin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649780495 PECOS PAC ID: 5698031979 Enrollment ID: I20171102003133 |
| Provider Name | Elizabeth Smith Harding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467962290 PECOS PAC ID: 2062779408 Enrollment ID: I20171120003026 |
| Provider Name | Valynn Christina Haslam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093220386 PECOS PAC ID: 8224397567 Enrollment ID: I20180112002322 |
| Provider Name | Catherine L Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568960250 PECOS PAC ID: 5799048385 Enrollment ID: I20180412001869 |
| Provider Name | Eric Innes |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841618444 PECOS PAC ID: 8224332424 Enrollment ID: I20180716002228 |
| Provider Name | David V Kimball |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730325143 PECOS PAC ID: 5799834016 Enrollment ID: I20180718002106 |
| Provider Name | Bryce Curtis Lunt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396127635 PECOS PAC ID: 5496061236 Enrollment ID: I20180727002686 |
| Provider Name | Phillip James Fairbourn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801182357 PECOS PAC ID: 7810288669 Enrollment ID: I20180807003995 |
| Provider Name | Richard Blair Willis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366883324 PECOS PAC ID: 0042514457 Enrollment ID: I20180809005232 |
| Provider Name | Shellie Marie Norton |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1417490079 PECOS PAC ID: 6406105949 Enrollment ID: I20180816002672 |
| Provider Name | Adam Scott Ireland |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1134573926 PECOS PAC ID: 8729046628 Enrollment ID: I20180817002891 |
| Provider Name | Joshua Graham Burkhardt |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1922363001 PECOS PAC ID: 1850602608 Enrollment ID: I20180817003104 |
| Provider Name | Kevin D. Christensen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1871855197 PECOS PAC ID: 6002189859 Enrollment ID: I20180911003924 |
| Provider Name | Eric J Root |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528445202 PECOS PAC ID: 0648572719 Enrollment ID: I20180919003775 |
| Provider Name | Caitlin B Mallory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124509070 PECOS PAC ID: 9133471675 Enrollment ID: I20181010002005 |
| Provider Name | Joni Michelle Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699261081 PECOS PAC ID: 5698028421 Enrollment ID: I20181025000081 |
| Provider Name | Emily Elizabeth Robbins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073094702 PECOS PAC ID: 3173876836 Enrollment ID: I20181025001862 |
| Provider Name | Shannon Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891289427 PECOS PAC ID: 0840548640 Enrollment ID: I20181116001685 |
| Provider Name | Kimball Lael Christianson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316113228 PECOS PAC ID: 1456482306 Enrollment ID: I20181212003735 |
| Provider Name | Rebekah Mae Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437625548 PECOS PAC ID: 1456697945 Enrollment ID: I20190103001764 |
| Provider Name | Kristen Leany |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396238630 PECOS PAC ID: 4688913163 Enrollment ID: I20190227002142 |
| Provider Name | Morgan Ann Bateman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639648660 PECOS PAC ID: 8325388713 Enrollment ID: I20190321001788 |
| Provider Name | Amanda Louise Hood Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467935882 PECOS PAC ID: 7911248950 Enrollment ID: I20190401001472 |
| Provider Name | Michelle Ann Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790259968 PECOS PAC ID: 4284975699 Enrollment ID: I20190412000948 |
| Provider Name | Jedidiah Dunbar Oldham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467891903 PECOS PAC ID: 2567735798 Enrollment ID: I20190619001683 |
| Provider Name | Sarah H Epling |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861912693 PECOS PAC ID: 0143581108 Enrollment ID: I20190625001649 |
| Provider Name | Derek Vanhille |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1205254885 PECOS PAC ID: 8325336993 Enrollment ID: I20190703001489 |
| Provider Name | Margaret Kincaid |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174866305 PECOS PAC ID: 7416190848 Enrollment ID: I20190709002070 |
| Provider Name | Alan B Erdmann |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1457693608 PECOS PAC ID: 5092082594 Enrollment ID: I20190709002979 |
| Provider Name | Lonny Dee Krause |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528523206 PECOS PAC ID: 0547595522 Enrollment ID: I20190712001685 |
| Provider Name | Chaz Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932672011 PECOS PAC ID: 8325373236 Enrollment ID: I20190715003454 |
| Provider Name | John Ryan Taylor |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1437418217 PECOS PAC ID: 9931471034 Enrollment ID: I20190716000681 |
| Provider Name | Ami Stucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750942637 PECOS PAC ID: 0042547630 Enrollment ID: I20190805002389 |
| Provider Name | Alan K Sutak |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679915847 PECOS PAC ID: 3173766268 Enrollment ID: I20190807002633 |
| Provider Name | Dustin K Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083274724 PECOS PAC ID: 2567790215 Enrollment ID: I20190820001824 |
| Provider Name | Spencer Gordon Nielson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962992768 PECOS PAC ID: 5193054039 Enrollment ID: I20190903000644 |
| Provider Name | Ryan Paul Thurston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932752615 PECOS PAC ID: 6305175266 Enrollment ID: I20190903001466 |
| Provider Name | Daniel Noall Bennett |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1013200997 PECOS PAC ID: 7719264431 Enrollment ID: I20190904003073 |
| Provider Name | Raschelle Davis Shoultes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578115044 PECOS PAC ID: 8628307212 Enrollment ID: I20190906001853 |
| Provider Name | Robbi Kim Harvey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194383588 PECOS PAC ID: 1052640570 Enrollment ID: I20190909003707 |
| Provider Name | Sarah Roseman Slater |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386106698 PECOS PAC ID: 2163752643 Enrollment ID: I20190925004052 |
| Provider Name | Alex Steven Moore |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528426988 PECOS PAC ID: 2062710205 Enrollment ID: I20191017000480 |
| Provider Name | Deanna Tolman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285857094 PECOS PAC ID: 6507956281 Enrollment ID: I20191022001956 |
| Provider Name | Jasmine Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144870866 PECOS PAC ID: 6204268451 Enrollment ID: I20191109000102 |
| Provider Name | Traci Michelle Allison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801448790 PECOS PAC ID: 3173955176 Enrollment ID: I20191113000769 |
| Provider Name | Cameran Rachelle Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730734203 PECOS PAC ID: 9032541982 Enrollment ID: I20191114000059 |
| Provider Name | Derek Joseph Davenport |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346484581 PECOS PAC ID: 7911140058 Enrollment ID: I20191205001032 |
| Provider Name | Heather Condley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194377176 PECOS PAC ID: 1456786680 Enrollment ID: I20200116002323 |
| Provider Name | Andrea Garcia Alfandre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164069050 PECOS PAC ID: 1658707872 Enrollment ID: I20200207000258 |
| Provider Name | Lilian Silva Dana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922641448 PECOS PAC ID: 2365870110 Enrollment ID: I20200310002103 |
| Provider Name | Mandy Lynn Lemmon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922638618 PECOS PAC ID: 6800224221 Enrollment ID: I20200319000097 |
| Provider Name | Marissa Larson Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639704471 PECOS PAC ID: 3173952652 Enrollment ID: I20200403002164 |
| Provider Name | Kindra Karoline Hunt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902436611 PECOS PAC ID: 2264861624 Enrollment ID: I20200406001889 |
| Provider Name | Michael Max Adam |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1740608272 PECOS PAC ID: 2466883343 Enrollment ID: I20200508000907 |
| Provider Name | William P Berg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437594421 PECOS PAC ID: 1759675374 Enrollment ID: I20200508002898 |
| Provider Name | Beverly L Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033745393 PECOS PAC ID: 9335560325 Enrollment ID: I20200529000812 |
| Provider Name | Nathan Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295190189 PECOS PAC ID: 1355762121 Enrollment ID: I20200603000321 |
| Provider Name | Brandon Thomas Dickinson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1770825713 PECOS PAC ID: 9436475993 Enrollment ID: I20200605001414 |
| Provider Name | Shane Nicholas Weber |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467865329 PECOS PAC ID: 7315276037 Enrollment ID: I20200617000705 |
| Provider Name | Kathryn Everton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336313519 PECOS PAC ID: 1254597420 Enrollment ID: I20200617003060 |
| Provider Name | Jordan P Barker |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1861835274 PECOS PAC ID: 5092017251 Enrollment ID: I20200625000647 |
| Provider Name | Dana Hollis Munn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689195380 PECOS PAC ID: 5890054167 Enrollment ID: I20200629001208 |
| Provider Name | Todd Michael Gilbert |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1427463330 PECOS PAC ID: 0345460838 Enrollment ID: I20200701000470 |
| Provider Name | Gregory Lee Winger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235661745 PECOS PAC ID: 4082967096 Enrollment ID: I20200707001310 |
| Provider Name | Jacob Aaron Barlow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669002150 PECOS PAC ID: 9032532924 Enrollment ID: I20200710001468 |
| Provider Name | Nicholas Thomson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891106936 PECOS PAC ID: 3274810197 Enrollment ID: I20200716003541 |
| Provider Name | Collin Chase Barber |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942628300 PECOS PAC ID: 9931467768 Enrollment ID: I20200722000015 |
| Provider Name | Bradley J Olsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750927927 PECOS PAC ID: 5698109262 Enrollment ID: I20200724001218 |
| Provider Name | Katelyn Siano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780209668 PECOS PAC ID: 0547685620 Enrollment ID: I20200806001441 |
| Provider Name | Ann Marie Ahee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417575564 PECOS PAC ID: 7810080876 Enrollment ID: I20200810003512 |
| Provider Name | Brent Wells Lambson |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1548729734 PECOS PAC ID: 4789000589 Enrollment ID: I20200811002014 |
| Provider Name | Faraz Khan Luni |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1891070942 PECOS PAC ID: 1850512567 Enrollment ID: I20200827003127 |
| Provider Name | Sejong Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942610381 PECOS PAC ID: 7810221421 Enrollment ID: I20200908000514 |
| Provider Name | Matthew C Irvin |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1043644040 PECOS PAC ID: 7416260294 Enrollment ID: I20200910002686 |
| Provider Name | Ryan L Cooley |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1255308813 PECOS PAC ID: 8820032527 Enrollment ID: I20200914002304 |
| Provider Name | Krystal Jennifer Kerr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386258119 PECOS PAC ID: 1557780871 Enrollment ID: I20201006000409 |
| Provider Name | Luke M Wendt |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841618972 PECOS PAC ID: 9032413141 Enrollment ID: I20201006002374 |
| Provider Name | Elizabeth Elouise Willmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730788761 PECOS PAC ID: 5193135267 Enrollment ID: I20201030000362 |
| Provider Name | Erin Elizabeth Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700426228 PECOS PAC ID: 7315357456 Enrollment ID: I20201102000430 |
| Provider Name | Jocelyn Bunker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205448479 PECOS PAC ID: 6103236740 Enrollment ID: I20201110001376 |
| Provider Name | Aubree Mckell Earnest |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184221095 PECOS PAC ID: 7618388034 Enrollment ID: I20201116001448 |
| Provider Name | Alana Jeanne Bradbury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982202446 PECOS PAC ID: 2769893072 Enrollment ID: I20201117002828 |
| Provider Name | Jesse David Ballard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629675699 PECOS PAC ID: 3870904600 Enrollment ID: I20201130000280 |
| Provider Name | Hanford Blitch Shuman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013518828 PECOS PAC ID: 5890106454 Enrollment ID: I20201203000390 |
| Provider Name | Kristi Kay Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235741042 PECOS PAC ID: 3072925122 Enrollment ID: I20201214001075 |
| Provider Name | Kaitlyn Miller Albrecht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174141964 PECOS PAC ID: 8224442074 Enrollment ID: I20210208000029 |
| Provider Name | Amy Lynn Dalton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104433606 PECOS PAC ID: 5395150874 Enrollment ID: I20210215001718 |
| Provider Name | Maria Myers Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932740651 PECOS PAC ID: 9830505742 Enrollment ID: I20210301001617 |
| Provider Name | Lindsey Gray Mortensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033702832 PECOS PAC ID: 6901213743 Enrollment ID: I20210324000187 |
| Provider Name | Emily Coreen Ball |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295342913 PECOS PAC ID: 4880001577 Enrollment ID: I20210324002873 |
| Provider Name | Joshua Truman Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790378917 PECOS PAC ID: 4082021514 Enrollment ID: I20210330002514 |
| Provider Name | Michelle Spilker |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1992397251 PECOS PAC ID: 9133537145 Enrollment ID: I20210412002054 |
| Provider Name | Cammi Jo Fruin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275127490 PECOS PAC ID: 9931517687 Enrollment ID: I20210416001523 |
| Provider Name | Rafael Sanchez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477079812 PECOS PAC ID: 2769891100 Enrollment ID: I20210514001007 |
| Provider Name | Reed Parkinson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831693027 PECOS PAC ID: 3072912120 Enrollment ID: I20210524000853 |
| Provider Name | Erin N Bertelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134710338 PECOS PAC ID: 8921407875 Enrollment ID: I20210525002750 |
| Provider Name | Nicole Justine Wagner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942627484 PECOS PAC ID: 2860625290 Enrollment ID: I20210526003226 |
| Provider Name | Kylie Nicole Willson |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1891374344 PECOS PAC ID: 0840699682 Enrollment ID: I20210526003430 |
| Provider Name | Zachary George |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1548215825 PECOS PAC ID: 1355356080 Enrollment ID: I20210611002179 |
| Provider Name | Joseph Matthew Armstrong |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1801258892 PECOS PAC ID: 2860892734 Enrollment ID: I20210615000349 |
| Provider Name | Staycha Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346817061 PECOS PAC ID: 5597165241 Enrollment ID: I20210617000011 |
| Provider Name | Jonathan Gray Holbrook |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1710307384 PECOS PAC ID: 3274896964 Enrollment ID: I20210617000807 |
| Provider Name | Kristen Lile |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1780038638 PECOS PAC ID: 6709129133 Enrollment ID: I20210709002762 |
| Provider Name | Adam Wing |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1649703828 PECOS PAC ID: 8224387329 Enrollment ID: I20210712000505 |
| Provider Name | Michael Joseph Heder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629563572 PECOS PAC ID: 1153723218 Enrollment ID: I20210712002893 |
| Provider Name | Ronald Chong-yik |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1497199228 PECOS PAC ID: 2769602648 Enrollment ID: I20210713001805 |
| Provider Name | Jonathan Shumway |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982108650 PECOS PAC ID: 3072916626 Enrollment ID: I20210720004076 |
| Provider Name | Kaitlyn Wittwer |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1215551601 PECOS PAC ID: 0648673053 Enrollment ID: I20210722002717 |
| Provider Name | Toby R. Johnson |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1144203258 PECOS PAC ID: 0042247298 Enrollment ID: I20210804001542 |
| Provider Name | Brook Danyel Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447821749 PECOS PAC ID: 9830594647 Enrollment ID: I20210817002172 |
| Provider Name | Jacquelyn Marie Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861061632 PECOS PAC ID: 1759786502 Enrollment ID: I20210817004115 |
| Provider Name | Darin Usher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689348336 PECOS PAC ID: 0446655799 Enrollment ID: I20210824003146 |
| Provider Name | Ammon Douglas Lott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902489032 PECOS PAC ID: 3173928256 Enrollment ID: I20210827001544 |
| Provider Name | Kashley Nicole Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740857804 PECOS PAC ID: 0345646808 Enrollment ID: I20210908002536 |
| Provider Name | Travis Brandon Charles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255643136 PECOS PAC ID: 7416183819 Enrollment ID: I20210909002737 |
| Provider Name | Michelle Catherine Ballard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114599289 PECOS PAC ID: 1052717378 Enrollment ID: I20210910001638 |
| Provider Name | Sean Lawless |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1720475122 PECOS PAC ID: 6406149236 Enrollment ID: I20211014001385 |
| Provider Name | Melissa Keith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205507951 PECOS PAC ID: 5698163749 Enrollment ID: I20211022001483 |
| Provider Name | Spencer Taylor Priest |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942962998 PECOS PAC ID: 3870981327 Enrollment ID: I20211102002492 |
| Provider Name | Eileen M Amari Vaught |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740464197 PECOS PAC ID: 3577635416 Enrollment ID: I20211104002363 |
| Provider Name | Johnny Downard |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215386768 PECOS PAC ID: 5890184329 Enrollment ID: I20211122002495 |
| Provider Name | Kavya I Rao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164800496 PECOS PAC ID: 1052701927 Enrollment ID: I20211208001531 |
| Provider Name | Ryan Michael Pulham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437811585 PECOS PAC ID: 2163812983 Enrollment ID: I20211209000149 |
| Provider Name | Scott Innes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275899643 PECOS PAC ID: 5799176145 Enrollment ID: I20211220001859 |
| Provider Name | Maria Ruth Hoegh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053085050 PECOS PAC ID: 9830580075 Enrollment ID: I20211227000598 |
| Provider Name | Talisha Hern |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275100703 PECOS PAC ID: 2062803976 Enrollment ID: I20220104001949 |
| Provider Name | Mohamed Dafalla |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1730507625 PECOS PAC ID: 2365834025 Enrollment ID: I20220110001976 |
| Provider Name | Andrew Paul Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972264018 PECOS PAC ID: 1456744960 Enrollment ID: I20220204001973 |
| Provider Name | Kristin Brooke Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982364196 PECOS PAC ID: 9234522608 Enrollment ID: I20220207001915 |
| Provider Name | Ashley Oldroyd Radmall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346824950 PECOS PAC ID: 5799171880 Enrollment ID: I20220329000734 |
| Provider Name | April Dawn Jensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821746256 PECOS PAC ID: 9931595600 Enrollment ID: I20220405002438 |
| Provider Name | Annette Lowery-klingler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588207369 PECOS PAC ID: 7012325210 Enrollment ID: I20220412002566 |
| Provider Name | Tanner J Harmon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821483389 PECOS PAC ID: 3971903550 Enrollment ID: I20220419000754 |
| Provider Name | Derek Bergeson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164641387 PECOS PAC ID: 5597753137 Enrollment ID: I20220422002314 |
| Provider Name | Justin Sevy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194106898 PECOS PAC ID: 0547547424 Enrollment ID: I20220509000780 |
| Provider Name | David Pratt |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1851492003 PECOS PAC ID: 8022160753 Enrollment ID: I20220510001812 |
| Provider Name | Ralph Christopher Reed |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144428459 PECOS PAC ID: 0749311926 Enrollment ID: I20220517001477 |
| Provider Name | Gary E Brundage |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861707036 PECOS PAC ID: 2264701481 Enrollment ID: I20220701000643 |
| Provider Name | Andrew Kenneth Ence |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1184072902 PECOS PAC ID: 9335429760 Enrollment ID: I20220706003453 |
| Provider Name | Vendla Lorene Hatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861143711 PECOS PAC ID: 2163803545 Enrollment ID: I20220715002142 |
| Provider Name | Kevin E Larkin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548651540 PECOS PAC ID: 2163786518 Enrollment ID: I20220719004004 |
| Provider Name | Diego Hugo Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982378543 PECOS PAC ID: 8527449578 Enrollment ID: I20220721002437 |
| Provider Name | Atalie M Bradshaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962148072 PECOS PAC ID: 0345621231 Enrollment ID: I20220725000951 |
| Provider Name | Justin Babbel |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1922531003 PECOS PAC ID: 1052730603 Enrollment ID: I20220809002321 |
| Provider Name | Leslie Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639750169 PECOS PAC ID: 0446634976 Enrollment ID: I20220901002877 |
| Provider Name | Matthew Shelton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982265161 PECOS PAC ID: 4486980216 Enrollment ID: I20220914002435 |
| Provider Name | Lindsay Leonard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053039008 PECOS PAC ID: 4880070796 Enrollment ID: I20220929003406 |
| Provider Name | Debra Mei Lam Mccann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720710478 PECOS PAC ID: 8527444223 Enrollment ID: I20221004001676 |
| Provider Name | Amber Dawn Barker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700505062 PECOS PAC ID: 8527434638 Enrollment ID: I20221014000653 |
| Provider Name | Mark A Richey |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1962562157 PECOS PAC ID: 3678632155 Enrollment ID: I20221017001745 |
| Provider Name | Daven Scott Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538808746 PECOS PAC ID: 2668848557 Enrollment ID: I20221018001104 |
| Provider Name | Scott Ward Webster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275916785 PECOS PAC ID: 9537474911 Enrollment ID: I20221019001607 |
| Provider Name | Lance Dustin Edmonds |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124214374 PECOS PAC ID: 8729132048 Enrollment ID: I20221026000712 |
| Provider Name | Kelsie Faith Beddes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275250235 PECOS PAC ID: 3072982685 Enrollment ID: I20221202001957 |
| Provider Name | Megan Shepherd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437881406 PECOS PAC ID: 8527437938 Enrollment ID: I20221207000626 |
| Provider Name | Curtis Shepherd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538879515 PECOS PAC ID: 9638548647 Enrollment ID: I20221214002391 |
| Provider Name | Ashley Brianne Gonzalez |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1104538990 PECOS PAC ID: 7416329016 Enrollment ID: I20230208000863 |
| Provider Name | Con Kaleb Newman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689396723 PECOS PAC ID: 3779955141 Enrollment ID: I20230213000239 |
| Provider Name | Whitney Sommers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518321702 PECOS PAC ID: 9931571080 Enrollment ID: I20230217002060 |
| Provider Name | Meagan Ruth Demers Hardy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083322150 PECOS PAC ID: 0749652840 Enrollment ID: I20230220001238 |
| Provider Name | Scott Evans |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033435045 PECOS PAC ID: 7214164631 Enrollment ID: I20230405002342 |
| Provider Name | Todd Karl Haacke |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1154023513 PECOS PAC ID: 2466818828 Enrollment ID: I20230510001746 |
| Provider Name | Lacey Rose Winkel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003517913 PECOS PAC ID: 3870959869 Enrollment ID: I20230517001895 |
| Provider Name | Penny J Mader |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518247758 PECOS PAC ID: 6901070184 Enrollment ID: I20230524000735 |
| Provider Name | Corrinne Erickson Uvejzovic |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1346931011 PECOS PAC ID: 9537525035 Enrollment ID: I20230524003274 |
| Provider Name | Aubrey Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952015273 PECOS PAC ID: 2365800786 Enrollment ID: I20230616001388 |
| Provider Name | Brooke Draper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255021994 PECOS PAC ID: 8123486024 Enrollment ID: I20230626001638 |
| Provider Name | Allie S Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619673498 PECOS PAC ID: 1355701509 Enrollment ID: I20230719001695 |
| Provider Name | Colby L Barber |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1336675016 PECOS PAC ID: 8729359377 Enrollment ID: I20230719002756 |
| Provider Name | Gregory Jay Wing |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1568783819 PECOS PAC ID: 0547574097 Enrollment ID: I20230719003369 |
| Provider Name | Kaitlyn Hansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467140905 PECOS PAC ID: 1658732904 Enrollment ID: I20230802002749 |
| Provider Name | Robert M Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619526621 PECOS PAC ID: 1759735863 Enrollment ID: I20230922002771 |
| Provider Name | Paula Jean Barney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912782012 PECOS PAC ID: 1052765500 Enrollment ID: I20231002003214 |
| Provider Name | Terah Elizabeth Schiess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912685041 PECOS PAC ID: 5092160358 Enrollment ID: I20231006002255 |
| Provider Name | Mccall Jewett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841970662 PECOS PAC ID: 4981059524 Enrollment ID: I20231017001475 |
| Provider Name | Amanda Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922709047 PECOS PAC ID: 5890140396 Enrollment ID: I20231018000254 |
| Provider Name | Chelsie A Taylor |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1720868540 PECOS PAC ID: 9032565551 Enrollment ID: I20231019001930 |
| Provider Name | Sophia Elaine Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205613056 PECOS PAC ID: 4486000742 Enrollment ID: I20231024001349 |
| Provider Name | Mark Jonathan Devenport |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962453688 PECOS PAC ID: 5890141592 Enrollment ID: I20231101002426 |
| Provider Name | Desaree Fowler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124566179 PECOS PAC ID: 2567748551 Enrollment ID: I20231115003648 |
| Provider Name | Christina Tipton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750485181 PECOS PAC ID: 6305294018 Enrollment ID: I20231117003163 |
| Provider Name | Ashley Saunders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003680117 PECOS PAC ID: 4981053667 Enrollment ID: I20231206001971 |
| Provider Name | Noelle Teske |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1043765134 PECOS PAC ID: 5698191674 Enrollment ID: I20240111003397 |
| Provider Name | Allan K. Pauole |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942450317 PECOS PAC ID: 6901258573 Enrollment ID: I20240118003992 |
| Provider Name | Andrea Chavez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679256960 PECOS PAC ID: 8224481486 Enrollment ID: I20240124003072 |
| Provider Name | Judy De La Vega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376242644 PECOS PAC ID: 0143673467 Enrollment ID: I20240201004270 |
| Provider Name | Caroline Grace Knight |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821638925 PECOS PAC ID: 9234572355 Enrollment ID: I20240206002180 |
| Provider Name | Jennifer Brimhall Rigby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912695388 PECOS PAC ID: 7719322999 Enrollment ID: I20240227003445 |
Thyroid Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1055 N 300 W Ste 315, Provo, UT 84604 Phone: 385-205-6510 Fax: 385-375-6112 | |
Ingegrative Medical Assicates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3650 N University Ave, Suite 200, Provo, UT 84604 Phone: 801-375-7100 Fax: 801-375-7102 | |
The Body Hackers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3210 N Canyon Rd Ste 307, Provo, UT 84604 Phone: 801-310-5385 | |
Utah Valley Specialty Hospital Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 306 River Bend Ln, Provo, UT 84604 Phone: 801-226-8880 | |
Atlas Epigenetics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3311 N University Ave Ste 150, Provo, UT 84604 Phone: 801-655-1801 Fax: 385-225-8201 | |
Life Integrative Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 777 N 500 W, Suite 104, Provo, UT 84601 Phone: 801-869-8199 Fax: 801-705-0436 |