| Se Virginia Value Based Care, LLC | |
|
6160 Kempsville Cir Ste 325a Norfolk VA 23502-3933 | |
| (757) 354-2885 | |
| (757) 917-5141 |
| Full Name | Se Virginia Value Based Care, LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 6160 Kempsville Cir Ste 325a, Norfolk, Virginia |
| Authorized Official Name and Position | Christine Kroetsch (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 7579175246 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Se Virginia Value Based Care, LLC 6160 Kempsville Cir Ste 325a Norfolk VA 23502-3933 Ph: (757) 354-2885 | Se Virginia Value Based Care, LLC 6160 Kempsville Cir Ste 325a Norfolk VA 23502-3933 Ph: (757) 354-2885 |
| NPI Number | 1225720501 |
|---|---|
| Provider Enumeration Date | 05/24/2023 |
| Last Update Date | 06/08/2023 |
| Certification Date | 06/08/2023 |
| Medicare PECOS PAC ID | 6103288170 |
|---|---|
| Medicare Enrollment ID | O20230809000204 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225720501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | () | Primary |
| Provider Name | Gregg a Shivers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578502142 PECOS PAC ID: 6800792375 Enrollment ID: I20031208000654 |
| Provider Name | Raina Nyomi Winfrey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407893811 PECOS PAC ID: 4385543099 Enrollment ID: I20031231000687 |
| Provider Name | Mark Anthony Fusco |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962457010 PECOS PAC ID: 4789570078 Enrollment ID: I20040224000842 |
| Provider Name | Amir Hajimomenian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497735112 PECOS PAC ID: 3577558527 Enrollment ID: I20040419000622 |
| Provider Name | Glenn R Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851439061 PECOS PAC ID: 2961492087 Enrollment ID: I20040512001133 |
| Provider Name | Niraj Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932145422 PECOS PAC ID: 8628069382 Enrollment ID: I20040520001316 |
| Provider Name | Cherise P Weldon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801876511 PECOS PAC ID: 1850382466 Enrollment ID: I20040521000889 |
| Provider Name | Nabil T. M. Tadros |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982684692 PECOS PAC ID: 8921088352 Enrollment ID: I20040724000351 |
| Provider Name | Neoma S George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376630988 PECOS PAC ID: 9830169192 Enrollment ID: I20040727000007 |
| Provider Name | Rodrigo L C Romulo |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1467565614 PECOS PAC ID: 3870561590 Enrollment ID: I20040921000539 |
| Provider Name | Martha Mooney |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1902872203 PECOS PAC ID: 2466405188 Enrollment ID: I20050222000981 |
| Provider Name | Richard Montague Hatch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871533448 PECOS PAC ID: 5395783385 Enrollment ID: I20050420000738 |
| Provider Name | Baher a Basta |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1538130257 PECOS PAC ID: 6305878372 Enrollment ID: I20050910000074 |
| Provider Name | Kathryn M Klump |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093736464 PECOS PAC ID: 8123028800 Enrollment ID: I20070102000484 |
| Provider Name | Vikas Thakral |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407939713 PECOS PAC ID: 7719989367 Enrollment ID: I20070209000521 |
| Provider Name | Gilda Niknezhad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245330190 PECOS PAC ID: 0941303507 Enrollment ID: I20070320000233 |
| Provider Name | Stephanie a Mills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598817090 PECOS PAC ID: 4486750973 Enrollment ID: I20070430000301 |
| Provider Name | Virginia Knight |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053455055 PECOS PAC ID: 5991801375 Enrollment ID: I20070501000516 |
| Provider Name | Kevin F Rebeck |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972551695 PECOS PAC ID: 8820194897 Enrollment ID: I20070508000442 |
| Provider Name | Sharon Petitjean |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497731301 PECOS PAC ID: 2264513100 Enrollment ID: I20080116000538 |
| Provider Name | Lee Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831308964 PECOS PAC ID: 2163505272 Enrollment ID: I20080215000591 |
| Provider Name | Robin E Wallace |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942497631 PECOS PAC ID: 2668557992 Enrollment ID: I20080311000596 |
| Provider Name | Denise Ann Griffin Spigle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003027186 PECOS PAC ID: 5890874200 Enrollment ID: I20080509000091 |
| Provider Name | Huy Anthony Tran |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235316936 PECOS PAC ID: 0547331688 Enrollment ID: I20080618000272 |
| Provider Name | Siddharth Khanna |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1225238611 PECOS PAC ID: 8628144433 Enrollment ID: I20080902000374 |
| Provider Name | Leena S Khanna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033319421 PECOS PAC ID: 8224104039 Enrollment ID: I20080902000411 |
| Provider Name | Sarala Krishnagiri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598778664 PECOS PAC ID: 6406832187 Enrollment ID: I20081103000742 |
| Provider Name | Simon J Rivera |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700096963 PECOS PAC ID: 4082708383 Enrollment ID: I20090330000503 |
| Provider Name | Julie a Mclean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265630933 PECOS PAC ID: 6901999861 Enrollment ID: I20090520000299 |
| Provider Name | Sharon a Goretsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093974214 PECOS PAC ID: 9739232752 Enrollment ID: I20090807000466 |
| Provider Name | Michelle H Mobley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386744258 PECOS PAC ID: 3476609827 Enrollment ID: I20090925000517 |
| Provider Name | Rahel T Amare |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1982618211 PECOS PAC ID: 8325134653 Enrollment ID: I20091210000137 |
| Provider Name | Cynthia Blain Bettinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548239916 PECOS PAC ID: 8527108125 Enrollment ID: I20091211000451 |
| Provider Name | Marilyn S Kellam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497740641 PECOS PAC ID: 1951482421 Enrollment ID: I20100225000438 |
| Provider Name | William Hovland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932189644 PECOS PAC ID: 5890728703 Enrollment ID: I20100428000558 |
| Provider Name | Sean Regan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356321061 PECOS PAC ID: 5496883464 Enrollment ID: I20100512000643 |
| Provider Name | Olukayode Oludapo Ojo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1588835839 PECOS PAC ID: 0143351262 Enrollment ID: I20100706000176 |
| Provider Name | Colleen Erica Corbett |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1447565361 PECOS PAC ID: 4688869027 Enrollment ID: I20101111000744 |
| Provider Name | Mustafa M Alaska |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609086362 PECOS PAC ID: 3072795921 Enrollment ID: I20110314000601 |
| Provider Name | Kavitha Tatineni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568754604 PECOS PAC ID: 5799961249 Enrollment ID: I20110517000617 |
| Provider Name | Shirley Dodson-mcadoo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285873315 PECOS PAC ID: 7416005319 Enrollment ID: I20110518000451 |
| Provider Name | Carolyn E Ingram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659660538 PECOS PAC ID: 9335326362 Enrollment ID: I20110531000558 |
| Provider Name | Raymond K Amankona |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1184807877 PECOS PAC ID: 0840344412 Enrollment ID: I20110607000255 |
| Provider Name | Daniel Cohen |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1780694448 PECOS PAC ID: 1153509146 Enrollment ID: I20110621000809 |
| Provider Name | Andrea C Degiorgi |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235423237 PECOS PAC ID: 0042489023 Enrollment ID: I20110808000874 |
| Provider Name | Natalie Taylor |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114156031 PECOS PAC ID: 7618023946 Enrollment ID: I20110923000357 |
| Provider Name | Michelle Marie Adams |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942596291 PECOS PAC ID: 9436320223 Enrollment ID: I20110928000314 |
| Provider Name | Kara a Kelton |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1558641415 PECOS PAC ID: 7315112463 Enrollment ID: I20111219000726 |
| Provider Name | Robert E Walters |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174503890 PECOS PAC ID: 2668559337 Enrollment ID: I20120105000247 |
| Provider Name | Kathleen Marie Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104157650 PECOS PAC ID: 3375700446 Enrollment ID: I20120201000021 |
| Provider Name | Richard L Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528331121 PECOS PAC ID: 8224299821 Enrollment ID: I20120407000008 |
| Provider Name | Sarah Kimberly Kosinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982987301 PECOS PAC ID: 3274799184 Enrollment ID: I20120723000021 |
| Provider Name | Rebecca E Zachary |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952659211 PECOS PAC ID: 9335398122 Enrollment ID: I20121011000647 |
| Provider Name | Ruth M Pence |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598085177 PECOS PAC ID: 9739332289 Enrollment ID: I20130111000116 |
| Provider Name | Ian Persaud |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770761793 PECOS PAC ID: 7618112186 Enrollment ID: I20130404000284 |
| Provider Name | Caitlin a Jacobson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376880179 PECOS PAC ID: 4486891629 Enrollment ID: I20130508000167 |
| Provider Name | Shannon Morris |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366775470 PECOS PAC ID: 5698913986 Enrollment ID: I20130528000448 |
| Provider Name | Ashlee L Hughes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1588002885 PECOS PAC ID: 1254575871 Enrollment ID: I20130923000310 |
| Provider Name | Monica S Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841533627 PECOS PAC ID: 2163659236 Enrollment ID: I20131217000297 |
| Provider Name | Cindee J Hawkins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689920654 PECOS PAC ID: 6204065212 Enrollment ID: I20140213001536 |
| Provider Name | James Thompson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1568890473 PECOS PAC ID: 4486883329 Enrollment ID: I20140218001812 |
| Provider Name | Michael Adam Gil |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487987475 PECOS PAC ID: 1759511421 Enrollment ID: I20140224002163 |
| Provider Name | Christopher L Zachary |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1881957306 PECOS PAC ID: 5991952665 Enrollment ID: I20140225001555 |
| Provider Name | Nathan J Davenport |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700156320 PECOS PAC ID: 8123269339 Enrollment ID: I20140618000930 |
| Provider Name | Adam Wali Hamidi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215241377 PECOS PAC ID: 4587836689 Enrollment ID: I20140730000339 |
| Provider Name | Ameanthea RT Blanco Knezovich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003032095 PECOS PAC ID: 9830314400 Enrollment ID: I20140910002465 |
| Provider Name | Sharon Nicola Bishop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326479031 PECOS PAC ID: 9335368505 Enrollment ID: I20140920000277 |
| Provider Name | Nir Horev |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366860967 PECOS PAC ID: 0345469458 Enrollment ID: I20140922001393 |
| Provider Name | Stephanie C Grimaldi |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730149022 PECOS PAC ID: 9830225879 Enrollment ID: I20140923002308 |
| Provider Name | Craig Simmons Toxey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750670162 PECOS PAC ID: 1456571827 Enrollment ID: I20141007000888 |
| Provider Name | Amanda F Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215215009 PECOS PAC ID: 9436370152 Enrollment ID: I20141022001772 |
| Provider Name | Donnamarie Lillian Mandara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679982177 PECOS PAC ID: 2365664315 Enrollment ID: I20141107000573 |
| Provider Name | Kelli C Kneisel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477955367 PECOS PAC ID: 3173845799 Enrollment ID: I20141209001394 |
| Provider Name | Valarie Evette Moorer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285070219 PECOS PAC ID: 0648598094 Enrollment ID: I20150414002508 |
| Provider Name | Theresa M Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376933754 PECOS PAC ID: 9638497852 Enrollment ID: I20150417001297 |
| Provider Name | Tatsiana Khalmanskaya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952725822 PECOS PAC ID: 0749501336 Enrollment ID: I20150608002371 |
| Provider Name | Terrinda Stevette Alston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144601980 PECOS PAC ID: 1355654138 Enrollment ID: I20150722005971 |
| Provider Name | Dawn R Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831570340 PECOS PAC ID: 8022323344 Enrollment ID: I20150817000576 |
| Provider Name | Kristin K Shepherd |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801276456 PECOS PAC ID: 7416266325 Enrollment ID: I20151015001706 |
| Provider Name | Leila Olivia Bumanglag |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396177713 PECOS PAC ID: 9830408251 Enrollment ID: I20151026000065 |
| Provider Name | Heather Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992175095 PECOS PAC ID: 5496065849 Enrollment ID: I20151116000041 |
| Provider Name | Jewel D Burden |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1073996070 PECOS PAC ID: 4880994151 Enrollment ID: I20151118002965 |
| Provider Name | Holly Jane Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205000718 PECOS PAC ID: 9830262633 Enrollment ID: I20151209002123 |
| Provider Name | Sasha a Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942665054 PECOS PAC ID: 4284939307 Enrollment ID: I20160226000740 |
| Provider Name | Juanita M Norwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043616741 PECOS PAC ID: 4486948148 Enrollment ID: I20160803002787 |
| Provider Name | Renee L Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861945164 PECOS PAC ID: 3173810637 Enrollment ID: I20160927001310 |
| Provider Name | Caprice D Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821543257 PECOS PAC ID: 8628366531 Enrollment ID: I20161010000811 |
| Provider Name | Ryan Allen Lusk |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487099701 PECOS PAC ID: 6709196470 Enrollment ID: I20161012002152 |
| Provider Name | Rocco J Basciano |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1952484651 PECOS PAC ID: 1658569066 Enrollment ID: I20161102002801 |
| Provider Name | Kevin Wolf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285071233 PECOS PAC ID: 9931349891 Enrollment ID: I20161109000300 |
| Provider Name | Lindsay M Webster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700328234 PECOS PAC ID: 5092090720 Enrollment ID: I20170321001193 |
| Provider Name | Maria Karen C Picardo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427501741 PECOS PAC ID: 8628353828 Enrollment ID: I20170331000352 |
| Provider Name | Kristel Denise Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841641503 PECOS PAC ID: 2466729991 Enrollment ID: I20170605000021 |
| Provider Name | James K Radike |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1619948833 PECOS PAC ID: 2365622909 Enrollment ID: I20170619000446 |
| Provider Name | Allison S Emerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902332828 PECOS PAC ID: 5799055927 Enrollment ID: I20170721000009 |
| Provider Name | Kiriaki Anthis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144756909 PECOS PAC ID: 9830460351 Enrollment ID: I20170802000710 |
| Provider Name | Tia Barr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740715549 PECOS PAC ID: 7719258938 Enrollment ID: I20170807002756 |
| Provider Name | Jennifer Taylor |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609397835 PECOS PAC ID: 1254604499 Enrollment ID: I20170908002846 |
| Provider Name | Mary Mallory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629587530 PECOS PAC ID: 1951667450 Enrollment ID: I20171201000098 |
| Provider Name | Jacqueline Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124109624 PECOS PAC ID: 8123393956 Enrollment ID: I20180104000585 |
| Provider Name | Kasey Harper Maurice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932611449 PECOS PAC ID: 5991065617 Enrollment ID: I20180129000002 |
| Provider Name | Shirley Turner Hartman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467634139 PECOS PAC ID: 5799049706 Enrollment ID: I20180427001023 |
| Provider Name | Millicent E Pyka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770070195 PECOS PAC ID: 9335494624 Enrollment ID: I20180608000567 |
| Provider Name | Ien a Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417448796 PECOS PAC ID: 8628327483 Enrollment ID: I20180828001475 |
| Provider Name | Chassitie Gomez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720574726 PECOS PAC ID: 1153671011 Enrollment ID: I20180913003435 |
| Provider Name | Temeka Shavonne Hathaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346739141 PECOS PAC ID: 2567713191 Enrollment ID: I20180920003136 |
| Provider Name | Nikhila Nagavelli |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326428384 PECOS PAC ID: 8224389218 Enrollment ID: I20181002001340 |
| Provider Name | Danielle Alicia Cutler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083109581 PECOS PAC ID: 9335491604 Enrollment ID: I20181015002708 |
| Provider Name | Lauren Michelle Feeney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669967832 PECOS PAC ID: 3274887823 Enrollment ID: I20181116001639 |
| Provider Name | Jennifer Rose Valentin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962786442 PECOS PAC ID: 3971847443 Enrollment ID: I20181211000593 |
| Provider Name | Kathleen Stornelli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275695793 PECOS PAC ID: 3577689959 Enrollment ID: I20190325000195 |
| Provider Name | Tracy Newsome |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760946172 PECOS PAC ID: 9638419823 Enrollment ID: I20190326002018 |
| Provider Name | Kathryn Ann Ripley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952881948 PECOS PAC ID: 7315289220 Enrollment ID: I20190424003251 |
| Provider Name | Zia Ann Khould |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033545371 PECOS PAC ID: 7214161835 Enrollment ID: I20190603001249 |
| Provider Name | Kristi M Cartwright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922360718 PECOS PAC ID: 9638402381 Enrollment ID: I20190611003286 |
| Provider Name | Katerina Basiliadis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760941587 PECOS PAC ID: 5294068789 Enrollment ID: I20190617000838 |
| Provider Name | Christina Eks Holloway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215493119 PECOS PAC ID: 2769711647 Enrollment ID: I20190903002402 |
| Provider Name | Victoria Mari Cornelius |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568925998 PECOS PAC ID: 7911237672 Enrollment ID: I20190923001563 |
| Provider Name | Erica Jane Canaday |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114575750 PECOS PAC ID: 4981935822 Enrollment ID: I20191008002277 |
| Provider Name | Margaret Newton Sassorossi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679128185 PECOS PAC ID: 9931439981 Enrollment ID: I20191021001010 |
| Provider Name | Jennifer Mays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942209069 PECOS PAC ID: 5890741532 Enrollment ID: I20191021002270 |
| Provider Name | Ashley Leigh Riffe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952962060 PECOS PAC ID: 3274864194 Enrollment ID: I20191021002455 |
| Provider Name | Jerry Burden |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1407317837 PECOS PAC ID: 5496087843 Enrollment ID: I20191104003152 |
| Provider Name | Leigh Rhondell Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225673585 PECOS PAC ID: 8022442623 Enrollment ID: I20200107000122 |
| Provider Name | Jaime Lyn Dail |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073089249 PECOS PAC ID: 9537594783 Enrollment ID: I20200115002095 |
| Provider Name | Tiniki R. White |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962627521 PECOS PAC ID: 0749362523 Enrollment ID: I20200204003023 |
| Provider Name | Alfreda Curtis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356997613 PECOS PAC ID: 4587091780 Enrollment ID: I20200228000669 |
| Provider Name | Heather Berlin Richardson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1558822981 PECOS PAC ID: 6002243052 Enrollment ID: I20200303002818 |
| Provider Name | Carrie Marie Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104464551 PECOS PAC ID: 7315375813 Enrollment ID: I20200317000057 |
| Provider Name | Jennifer L Lemasters-stover |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497385033 PECOS PAC ID: 9537597596 Enrollment ID: I20200325002209 |
| Provider Name | Sandra Walker Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770749202 PECOS PAC ID: 0547304412 Enrollment ID: I20200330002712 |
| Provider Name | Ohad Sheffy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295087005 PECOS PAC ID: 3476797598 Enrollment ID: I20200427001227 |
| Provider Name | Carlita Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275170417 PECOS PAC ID: 6406286046 Enrollment ID: I20200506002183 |
| Provider Name | Jessica Loren Rosa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083234637 PECOS PAC ID: 2365873106 Enrollment ID: I20200512002611 |
| Provider Name | Amjad Minhas |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1568982155 PECOS PAC ID: 6608148853 Enrollment ID: I20200603002962 |
| Provider Name | Kathryn Mccloskey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679952113 PECOS PAC ID: 6507170370 Enrollment ID: I20200622000048 |
| Provider Name | Aatika Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215562574 PECOS PAC ID: 6406278126 Enrollment ID: I20200624003433 |
| Provider Name | Avani D Rajpoot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689158537 PECOS PAC ID: 0143560094 Enrollment ID: I20200629002033 |
| Provider Name | Eva Marie Mcewen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194357863 PECOS PAC ID: 7810310315 Enrollment ID: I20200630002326 |
| Provider Name | Holly Kristin Whiting |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760008825 PECOS PAC ID: 5698192961 Enrollment ID: I20200901001881 |
| Provider Name | Alyssa Joyce Jessup |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477161610 PECOS PAC ID: 4789003955 Enrollment ID: I20201007003198 |
| Provider Name | Laura Murphy Kitchens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710508734 PECOS PAC ID: 4587084330 Enrollment ID: I20201015001968 |
| Provider Name | Christine Elaine Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790322097 PECOS PAC ID: 5294155933 Enrollment ID: I20201019000305 |
| Provider Name | Jason Rowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699385849 PECOS PAC ID: 5799105227 Enrollment ID: I20201021001983 |
| Provider Name | Jae Anaza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891311213 PECOS PAC ID: 8527478635 Enrollment ID: I20201104002890 |
| Provider Name | Haley Moniuszko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295338952 PECOS PAC ID: 9032521166 Enrollment ID: I20201215001411 |
| Provider Name | Angela Nichole Whiteside |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316570518 PECOS PAC ID: 2365856978 Enrollment ID: I20210121002944 |
| Provider Name | Whitney Witt Irvine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841893351 PECOS PAC ID: 2466866223 Enrollment ID: I20210208000272 |
| Provider Name | Rondeshya Cosby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184209777 PECOS PAC ID: 2567861412 Enrollment ID: I20210525002757 |
| Provider Name | John Charles Rowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508498676 PECOS PAC ID: 6507267218 Enrollment ID: I20210701000109 |
| Provider Name | Doris Marie Chance |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1861661506 PECOS PAC ID: 7719055193 Enrollment ID: I20210813000116 |
| Provider Name | Hayley Hawkins Fletcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750954848 PECOS PAC ID: 8820493505 Enrollment ID: I20210818001603 |
| Provider Name | Brittney Jansen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1497213813 PECOS PAC ID: 6608271358 Enrollment ID: I20210819000087 |
| Provider Name | Andrew Phillip Johnson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1407426034 PECOS PAC ID: 6002214806 Enrollment ID: I20211008000968 |
| Provider Name | Diana Leigh Webster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861000440 PECOS PAC ID: 1557750163 Enrollment ID: I20211119000011 |
| Provider Name | Todd Feldman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639655426 PECOS PAC ID: 9931453511 Enrollment ID: I20220415000190 |
| Provider Name | Alice Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043811144 PECOS PAC ID: 2860807005 Enrollment ID: I20220425002356 |
| Provider Name | Lisa Alane Fermil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033864392 PECOS PAC ID: 2163801226 Enrollment ID: I20220620001497 |
| Provider Name | Kushangi Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538816947 PECOS PAC ID: 8820471733 Enrollment ID: I20220810000497 |
| Provider Name | Jennifer Leigh Armijo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285282368 PECOS PAC ID: 0446633192 Enrollment ID: I20220813000628 |
| Provider Name | Christy Sorey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891427357 PECOS PAC ID: 4880077338 Enrollment ID: I20220816000728 |
| Provider Name | Sarah J Mcbride |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780321992 PECOS PAC ID: 1355726639 Enrollment ID: I20220922003032 |
| Provider Name | Megan a Boswell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164178349 PECOS PAC ID: 6103292925 Enrollment ID: I20221019003050 |
| Provider Name | Arnel Agravante Lacerna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912636481 PECOS PAC ID: 9830565464 Enrollment ID: I20221021001658 |
| Provider Name | Sierra Berg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902524929 PECOS PAC ID: 4284002395 Enrollment ID: I20221122000142 |
| Provider Name | Darya Belyayeva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265160683 PECOS PAC ID: 3173991015 Enrollment ID: I20221123002593 |
| Provider Name | Crystal Schwartzbeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982312088 PECOS PAC ID: 3072982917 Enrollment ID: I20221215000574 |
| Provider Name | Melanie R De Jesus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346978475 PECOS PAC ID: 4183093974 Enrollment ID: I20221219001025 |
| Provider Name | Lena Villanueva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912617812 PECOS PAC ID: 0143691741 Enrollment ID: I20230118001833 |
| Provider Name | Ashley Maddrey-boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811618697 PECOS PAC ID: 6002292927 Enrollment ID: I20230222000624 |
| Provider Name | Christina Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578202818 PECOS PAC ID: 5698151157 Enrollment ID: I20230222002340 |
| Provider Name | Carri Jo Mcknight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851005276 PECOS PAC ID: 9638542475 Enrollment ID: I20230227001681 |
| Provider Name | Elina Sergeyevna Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912472713 PECOS PAC ID: 6305210105 Enrollment ID: I20230317001625 |
| Provider Name | Colette Lavoy |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1427561786 PECOS PAC ID: 1153682307 Enrollment ID: I20230410000891 |
| Provider Name | Lawanda Judge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932696861 PECOS PAC ID: 9133512205 Enrollment ID: I20230426000511 |
| Provider Name | Gabrielle Knight |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831850338 PECOS PAC ID: 3476919812 Enrollment ID: I20230510000548 |
| Provider Name | Alisa Patrice Mcmillan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326765405 PECOS PAC ID: 7012373996 Enrollment ID: I20230518002299 |
| Provider Name | Sarah Burbidge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013623743 PECOS PAC ID: 5799143525 Enrollment ID: I20230626002991 |
| Provider Name | Camille Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518645282 PECOS PAC ID: 0749641231 Enrollment ID: I20230731003739 |
| Provider Name | Doreen K Boateng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467151373 PECOS PAC ID: 1658732797 Enrollment ID: I20230804001880 |
| Provider Name | Sarah Willard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831870286 PECOS PAC ID: 8628430337 Enrollment ID: I20230811002970 |
| Provider Name | Anthony M Kangea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841917226 PECOS PAC ID: 9335503580 Enrollment ID: I20230907000398 |
| Provider Name | Alice Baillio-hanchey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700669363 PECOS PAC ID: 7618322926 Enrollment ID: I20231005003619 |
| Provider Name | Wondimu Shanko Yirga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881321891 PECOS PAC ID: 3779930888 Enrollment ID: I20231111000064 |
| Provider Name | Jennifer L Hodge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073025599 PECOS PAC ID: 2961850508 Enrollment ID: I20231121001303 |
| Provider Name | Therese Nicole Morin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316721608 PECOS PAC ID: 1355790908 Enrollment ID: I20231208000757 |
| Provider Name | Tracy M Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467150342 PECOS PAC ID: 2961851415 Enrollment ID: I20231211000290 |
| Provider Name | Sherri Lynn Sapp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942088919 PECOS PAC ID: 2668822503 Enrollment ID: I20231219001352 |
| Provider Name | Eyvis G Padin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790562932 PECOS PAC ID: 7113377573 Enrollment ID: I20231227001595 |
| Provider Name | Tara Higginbotham Rouse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790555621 PECOS PAC ID: 9931550043 Enrollment ID: I20240112001227 |
| Provider Name | Taneisha Patrice Gayles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396512950 PECOS PAC ID: 4587016068 Enrollment ID: I20240119003166 |
| Provider Name | Maya Payne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235577701 PECOS PAC ID: 3173809126 Enrollment ID: I20240321000583 |
| Provider Name | Gilbert Abare |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508623646 PECOS PAC ID: 1557700952 Enrollment ID: I20240418001057 |
| Provider Name | Naghmana Masood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912950361 PECOS PAC ID: 6204803687 Enrollment ID: I20240430000173 |
| Provider Name | Shannon Flynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699526004 PECOS PAC ID: 1759722671 Enrollment ID: I20240509002051 |
| Provider Name | Christiana Adu Boakye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487283982 PECOS PAC ID: 0941745475 Enrollment ID: I20240709002882 |
| Provider Name | Elizabeth Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649012303 PECOS PAC ID: 4082150479 Enrollment ID: I20240722002457 |
| Provider Name | Natasha Rene Gallon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295598068 PECOS PAC ID: 1658817523 Enrollment ID: I20240726003626 |
| Provider Name | Tara Sharay Woods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225671027 PECOS PAC ID: 9133463664 Enrollment ID: I20240814004196 |
| Provider Name | Farrah Yuille |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942059662 PECOS PAC ID: 8022557016 Enrollment ID: I20240821004991 |
| Provider Name | Suprit Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457932246 PECOS PAC ID: 8820538937 Enrollment ID: I20240904001197 |
| Provider Name | Kevin Rojeh Ismair |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093393126 PECOS PAC ID: 9133650799 Enrollment ID: I20241007002401 |
| Provider Name | Lafran C. Hawkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396204897 PECOS PAC ID: 4981136496 Enrollment ID: I20241022000602 |
| Provider Name | Karen Banks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356901037 PECOS PAC ID: 4789117789 Enrollment ID: I20241030000032 |
| Provider Name | Caroline Adhiambo Choka Ochieng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881448868 PECOS PAC ID: 8022542265 Enrollment ID: I20241112000479 |
| Provider Name | Tania Modeliste |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346984606 PECOS PAC ID: 9739567215 Enrollment ID: I20241202000423 |
| Provider Name | Monique Whitehurst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669116828 PECOS PAC ID: 4486181963 Enrollment ID: I20241223000431 |
| Provider Name | Lauren Elizabeth Ritz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174025134 PECOS PAC ID: 9133657133 Enrollment ID: I20250103001338 |
| Provider Name | Orlene Hope Sharp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083324966 PECOS PAC ID: 4880122597 Enrollment ID: I20250108004293 |
| Provider Name | Amy Lam Gilligan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952164709 PECOS PAC ID: 8921537044 Enrollment ID: I20250117002044 |
| Provider Name | Sarah Witter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740955418 PECOS PAC ID: 0042600843 Enrollment ID: I20250117003641 |
| Provider Name | Utam Lekhraj |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740007715 PECOS PAC ID: 4981134194 Enrollment ID: I20250203003113 |
| Provider Name | Shaquivia Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790596286 PECOS PAC ID: 7315467263 Enrollment ID: I20250221000952 |
| Provider Name | Amutallah Abdussalaam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396553780 PECOS PAC ID: 5496270241 Enrollment ID: I20250415001335 |
| Provider Name | Barbara Macdonald |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679377402 PECOS PAC ID: 2163947433 Enrollment ID: I20250418001456 |
| Provider Name | Natasha F Rambharack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255084240 PECOS PAC ID: 3870011075 Enrollment ID: I20250520003871 |
| Provider Name | Amanda Vanbenthuysen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497648646 PECOS PAC ID: 7517477938 Enrollment ID: I20250605003097 |
| Provider Name | Brittany Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558859314 PECOS PAC ID: 1355695768 Enrollment ID: I20250606000058 |
| Provider Name | Judith Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184399131 PECOS PAC ID: 3375932759 Enrollment ID: I20250806001129 |
| Provider Name | Jack Patrick Osullivan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649845264 PECOS PAC ID: 6204219942 Enrollment ID: I20250815001578 |
| Provider Name | Angela Bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003793134 PECOS PAC ID: 6406358407 Enrollment ID: I20250908004288 |
| Provider Name | Ariana Montemayor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366226979 PECOS PAC ID: 7810491768 Enrollment ID: I20250916000579 |
| Provider Name | Danieal Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205718228 PECOS PAC ID: 5698264190 Enrollment ID: I20251026000223 |
| Provider Name | Deshawna Sade Oxendine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730066697 PECOS PAC ID: 3072005529 Enrollment ID: I20251122000600 |
| Provider Name | Amanda Celia Escobar Smailes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619869963 PECOS PAC ID: 6002300274 Enrollment ID: I20251215002365 |
| Provider Name | Myecha Nichelle Kitchen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831080282 PECOS PAC ID: 6800377243 Enrollment ID: I20260224004145 |
| Provider Name | Vincent Francis Carr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821090895 PECOS PAC ID: 6608358353 Enrollment ID: I20260303003039 |
| Provider Name | Tamba Sam-manimoi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831936350 PECOS PAC ID: 2769900018 Enrollment ID: I20260505003294 |
Sentara Urgent Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1326 E Little Creek Rd, Norfolk, VA 23518 Phone: 757-772-6122 Fax: 757-267-9194 |
Long Term Care of Tidewater PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6160 Kempsville Cir Ste 325a, Norfolk, VA 23502 Phone: 757-917-5356 Fax: 757-917-5141 |
E Haque LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 Kingsley Ln, Suite 209, Norfolk, VA 23505 Phone: 757-489-3911 |
Bon Secours Ghent Station Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 930 W 21st St Ste 100, Norfolk, VA 23517 Phone: 757-622-8358 Fax: 757-622-9662 |
Hendon Family Chiropractic, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 957 W 21st St Ste F, Norfolk, VA 23517 Phone: 757-305-9996 |
Bruce J Kleiman MD PC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 533 Front St Apt 203, Norfolk, VA 23510 Phone: 757-685-6151 Fax: 757-961-8385 |