| Shell Knob Family Medicine | |
|
25376 State Hwy 39 Ste 301 Shell Knob MO 65747 | |
| (417) 269-2470 | |
| (417) 858-6910 |
| Full Name | Shell Knob Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 25376 State Hwy 39, Shell Knob, Missouri |
| Authorized Official Name and Position | David P. Taylor (VICE PRESIDENT) |
| Authorized Official Contact | 4172694320 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shell Knob Family Medicine 3800 S National Ave Ste 540 Springfield MO 65807-5209 Ph: (417) 269-5712 | Shell Knob Family Medicine 25376 State Hwy 39 Ste 301 Shell Knob MO 65747 Ph: (417) 269-2470 |
| NPI Number | 1538334396 |
|---|---|
| Provider Enumeration Date | 04/23/2008 |
| Last Update Date | 04/23/2008 |
| Medicare PECOS PAC ID | 1254248917 |
|---|---|
| Medicare Enrollment ID | O20050624000293 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538334396 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Mark S Ross |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881678365 PECOS PAC ID: 0547153280 Enrollment ID: I20040205000729 |
| Provider Name | Jock D Porter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801870324 PECOS PAC ID: 2365335015 Enrollment ID: I20040205000803 |
| Provider Name | Martin R Jones |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154310738 PECOS PAC ID: 5193610046 Enrollment ID: I20040218001090 |
| Provider Name | Howard E Jarvis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518956127 PECOS PAC ID: 7719872662 Enrollment ID: I20040218001107 |
| Provider Name | Robert S Kensel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811978505 PECOS PAC ID: 5698660546 Enrollment ID: I20040218001126 |
| Provider Name | David C Lee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841271723 PECOS PAC ID: 8921993874 Enrollment ID: I20040218001161 |
| Provider Name | Bradley P Messner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376524215 PECOS PAC ID: 4385539246 Enrollment ID: I20040218001166 |
| Provider Name | Camala C Porter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144204611 PECOS PAC ID: 2567357429 Enrollment ID: I20040218001173 |
| Provider Name | Joseph A Craigmyle |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992792030 PECOS PAC ID: 1254323892 Enrollment ID: I20040401001439 |
| Provider Name | Joseph D Cooper |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679560080 PECOS PAC ID: 3779495965 Enrollment ID: I20040401001490 |
| Provider Name | Matthew D Brandt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710974118 PECOS PAC ID: 0840282455 Enrollment ID: I20040402000056 |
| Provider Name | Mark J Brady |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366439630 PECOS PAC ID: 5092707604 Enrollment ID: I20040402000072 |
| Provider Name | Sam L Alexander |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780670463 PECOS PAC ID: 6406848910 Enrollment ID: I20040402000126 |
| Provider Name | Jacob W Baltz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174519821 PECOS PAC ID: 4284626797 Enrollment ID: I20040402000150 |
| Provider Name | Nolan C Snider |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124007653 PECOS PAC ID: 3274519343 Enrollment ID: I20040629000083 |
| Provider Name | Lorri A Julian-trotter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275599599 PECOS PAC ID: 5799757951 Enrollment ID: I20040809000536 |
| Provider Name | James B Rice |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1417991894 PECOS PAC ID: 6406752633 Enrollment ID: I20040813000328 |
| Provider Name | Stephen Kuehn |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1750317533 PECOS PAC ID: 7315911799 Enrollment ID: I20040823000205 |
| Provider Name | Louis P Krenn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528071263 PECOS PAC ID: 3072589126 Enrollment ID: I20040909000445 |
| Provider Name | Robert G Marsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679570287 PECOS PAC ID: 3274501713 Enrollment ID: I20040922000310 |
| Provider Name | Jeanne I Rodman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700876059 PECOS PAC ID: 1153390315 Enrollment ID: I20040927000004 |
| Provider Name | Brian Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073578159 PECOS PAC ID: 8921067380 Enrollment ID: I20041011000179 |
| Provider Name | Jill Rude |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063513182 PECOS PAC ID: 3072573419 Enrollment ID: I20041012000231 |
| Provider Name | Julia L Flax |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053421875 PECOS PAC ID: 5698735744 Enrollment ID: I20041013001148 |
| Provider Name | Stephanie M Lewis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427061514 PECOS PAC ID: 8729049267 Enrollment ID: I20041019000909 |
| Provider Name | Steven L Williams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871535864 PECOS PAC ID: 8820054240 Enrollment ID: I20041208000016 |
| Provider Name | Robert Arnce |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316989536 PECOS PAC ID: 3678539855 Enrollment ID: I20041209000098 |
| Provider Name | James M Schmitt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730165531 PECOS PAC ID: 8527026160 Enrollment ID: I20041229000139 |
| Provider Name | Randal T Qualls |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922108422 PECOS PAC ID: 5294784740 Enrollment ID: I20050121000548 |
| Provider Name | Rex E Taber |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144337403 PECOS PAC ID: 8527005198 Enrollment ID: I20050414000859 |
| Provider Name | Lawrence L Dybedock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952411860 PECOS PAC ID: 2365482767 Enrollment ID: I20050505000056 |
| Provider Name | Jonben D Svoboda |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1831198993 PECOS PAC ID: 5092755033 Enrollment ID: I20050509000842 |
| Provider Name | Jess L Lyon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912010851 PECOS PAC ID: 5294776415 Enrollment ID: I20050518000768 |
| Provider Name | Zachary C Schmittling |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1043254519 PECOS PAC ID: 0042254690 Enrollment ID: I20050614001055 |
| Provider Name | Mark R Ellis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982714804 PECOS PAC ID: 3375589302 Enrollment ID: I20050630000049 |
| Provider Name | Clifford Costley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134237308 PECOS PAC ID: 2567373723 Enrollment ID: I20050728000740 |
| Provider Name | John Waites |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326082124 PECOS PAC ID: 4587694989 Enrollment ID: I20050816000506 |
| Provider Name | Mark Anderson |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1073557922 PECOS PAC ID: 4587694385 Enrollment ID: I20050820000076 |
| Provider Name | Danny Penick |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1033153614 PECOS PAC ID: 9234169046 Enrollment ID: I20050820000140 |
| Provider Name | Carl Price |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1336182476 PECOS PAC ID: 4688604499 Enrollment ID: I20050820000145 |
| Provider Name | James Ceaser |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1578500120 PECOS PAC ID: 0749210557 Enrollment ID: I20050822000022 |
| Provider Name | William C Moore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700829819 PECOS PAC ID: 0345270179 Enrollment ID: I20050822000163 |
| Provider Name | Maria C Spurling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881720407 PECOS PAC ID: 1153353297 Enrollment ID: I20050909000024 |
| Provider Name | Sherrie Ament-sturtevant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396769766 PECOS PAC ID: 8123051273 Enrollment ID: I20050919000145 |
| Provider Name | Ovais Zubair |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1598862567 PECOS PAC ID: 5496772691 Enrollment ID: I20051027000414 |
| Provider Name | William P Triplett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730196080 PECOS PAC ID: 8224056247 Enrollment ID: I20051108001108 |
| Provider Name | Nabil S Kamel |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1326080276 PECOS PAC ID: 3577584283 Enrollment ID: I20051209000143 |
| Provider Name | Christopher R Spinelli |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205806312 PECOS PAC ID: 2668495110 Enrollment ID: I20060110001117 |
| Provider Name | Anthony A Cauchi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235168451 PECOS PAC ID: 4284651720 Enrollment ID: I20060720000348 |
| Provider Name | Lisa K Reno |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588686653 PECOS PAC ID: 9234132614 Enrollment ID: I20060825000098 |
| Provider Name | Robin L Trotman |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1205897857 PECOS PAC ID: 5698795516 Enrollment ID: I20061116000044 |
| Provider Name | John Moll |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275506099 PECOS PAC ID: 4486652534 Enrollment ID: I20061128000144 |
| Provider Name | Linda R Macgorman |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1124023726 PECOS PAC ID: 6002818044 Enrollment ID: I20070205000494 |
| Provider Name | Larry K Chase |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1891790408 PECOS PAC ID: 0446252480 Enrollment ID: I20070205000518 |
| Provider Name | Kristen F Glover |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316045602 PECOS PAC ID: 8224030051 Enrollment ID: I20070208000023 |
| Provider Name | James L Hutchison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275546012 PECOS PAC ID: 7214939040 Enrollment ID: I20070208000029 |
| Provider Name | Timothy L Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780784306 PECOS PAC ID: 6103828645 Enrollment ID: I20070213000010 |
| Provider Name | Donna M Roberts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780784298 PECOS PAC ID: 6709888282 Enrollment ID: I20070213000371 |
| Provider Name | Jamie C Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174536940 PECOS PAC ID: 8426050741 Enrollment ID: I20070215000128 |
| Provider Name | Boyd D Crockett |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1427166537 PECOS PAC ID: 7012019391 Enrollment ID: I20070219000056 |
| Provider Name | Patrick W Gilbreth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396708913 PECOS PAC ID: 7315049814 Enrollment ID: I20070302000007 |
| Provider Name | Rachel A Hankins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326181991 PECOS PAC ID: 2668576885 Enrollment ID: I20070328000382 |
| Provider Name | Diana L Roe |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851357834 PECOS PAC ID: 2264537992 Enrollment ID: I20070425000059 |
| Provider Name | Tyler D Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982789384 PECOS PAC ID: 6305871013 Enrollment ID: I20070911000557 |
| Provider Name | Bryan A Finke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780773689 PECOS PAC ID: 6800896630 Enrollment ID: I20071026000096 |
| Provider Name | Michael A Galindo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265638142 PECOS PAC ID: 5991888547 Enrollment ID: I20080206000188 |
| Provider Name | Mandy J Schlesselmann |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1023132057 PECOS PAC ID: 5092898700 Enrollment ID: I20080218000512 |
| Provider Name | Susan Graves |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861581084 PECOS PAC ID: 4183709371 Enrollment ID: I20080312000331 |
| Provider Name | William S Kelly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093805087 PECOS PAC ID: 2961587167 Enrollment ID: I20080312000380 |
| Provider Name | David K Showers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356474753 PECOS PAC ID: 9032294236 Enrollment ID: I20080312000397 |
| Provider Name | Kyle W Griffin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710076948 PECOS PAC ID: 7012092216 Enrollment ID: I20080312000411 |
| Provider Name | Christine E Wester |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366401457 PECOS PAC ID: 2961590807 Enrollment ID: I20080509000075 |
| Provider Name | Kate P Kilgo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841466265 PECOS PAC ID: 7517037690 Enrollment ID: I20080602000107 |
| Provider Name | William K Rosen |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1437240520 PECOS PAC ID: 2567535859 Enrollment ID: I20080719000069 |
| Provider Name | Crystal A Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154465466 PECOS PAC ID: 9436222668 Enrollment ID: I20080722000394 |
| Provider Name | Donna C Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164523403 PECOS PAC ID: 2961575972 Enrollment ID: I20080724000438 |
| Provider Name | James T Bonucchi |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1225054109 PECOS PAC ID: 0749286607 Enrollment ID: I20080801000046 |
| Provider Name | Kayce Morton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558463620 PECOS PAC ID: 1254408578 Enrollment ID: I20080927000222 |
| Provider Name | Staci Dawn Farner Rogers |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043428121 PECOS PAC ID: 1557438793 Enrollment ID: I20080930000281 |
| Provider Name | Carol J Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124274857 PECOS PAC ID: 1052489408 Enrollment ID: I20081013000107 |
| Provider Name | Juliah C Tiedemann |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366605149 PECOS PAC ID: 0648338897 Enrollment ID: I20081017000068 |
| Provider Name | Brian R Knopf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952306110 PECOS PAC ID: 2466510516 Enrollment ID: I20081020000099 |
| Provider Name | Michael A Albritton |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1548264971 PECOS PAC ID: 1951462514 Enrollment ID: I20081202000261 |
| Provider Name | Bradley M Gillespie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083856892 PECOS PAC ID: 1759438229 Enrollment ID: I20090421000129 |
| Provider Name | Matthew J Loutzenhiser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538258348 PECOS PAC ID: 6002911252 Enrollment ID: I20090505000120 |
| Provider Name | Laird E Jones |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922004605 PECOS PAC ID: 2961550421 Enrollment ID: I20090511000549 |
| Provider Name | Logan J Banks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750589867 PECOS PAC ID: 4688723893 Enrollment ID: I20090519000176 |
| Provider Name | William Micka |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1376689729 PECOS PAC ID: 2163573999 Enrollment ID: I20090707000640 |
| Provider Name | Tommy Aric Trent |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265642227 PECOS PAC ID: 9537211990 Enrollment ID: I20090806000065 |
| Provider Name | Corbin S Van De Wege |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174713564 PECOS PAC ID: 0345395000 Enrollment ID: I20090901000370 |
| Provider Name | Jeremy Sturgell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376741173 PECOS PAC ID: 6002961612 Enrollment ID: I20090903000440 |
| Provider Name | Shawn N Usery |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659535219 PECOS PAC ID: 6709932148 Enrollment ID: I20090925000449 |
| Provider Name | Steven E Newbold |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447347729 PECOS PAC ID: 5092704338 Enrollment ID: I20100118000109 |
| Provider Name | Patricia M Dix |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801906714 PECOS PAC ID: 6406870583 Enrollment ID: I20100118000146 |
| Provider Name | Damon J Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023100773 PECOS PAC ID: 0345383782 Enrollment ID: I20100206000156 |
| Provider Name | Levent Akduman |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1245344605 PECOS PAC ID: 2860529260 Enrollment ID: I20100415000881 |
| Provider Name | Robert Shaw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184715724 PECOS PAC ID: 8820909088 Enrollment ID: I20100422000166 |
| Provider Name | Laurie A Clarkston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346358579 PECOS PAC ID: 9638206766 Enrollment ID: I20100422000195 |
| Provider Name | Cameron A Crymes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992969554 PECOS PAC ID: 0547390577 Enrollment ID: I20100617000283 |
| Provider Name | Amanda J Milligan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770807737 PECOS PAC ID: 2466583935 Enrollment ID: I20100628000038 |
| Provider Name | Thomas M Shultz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073630109 PECOS PAC ID: 9032241039 Enrollment ID: I20100712000621 |
| Provider Name | Emily H Mebruer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912043316 PECOS PAC ID: 7517090756 Enrollment ID: I20100809000557 |
| Provider Name | Paul M Kidder |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730395179 PECOS PAC ID: 2567596737 Enrollment ID: I20100810001129 |
| Provider Name | Gregory S Stamps |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922125079 PECOS PAC ID: 8628102514 Enrollment ID: I20100813000618 |
| Provider Name | Shelby R Hahn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881875771 PECOS PAC ID: 4880728674 Enrollment ID: I20100816000636 |
| Provider Name | Louis B Hakan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366553653 PECOS PAC ID: 1456485127 Enrollment ID: I20100817000543 |
| Provider Name | Audrey M Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215118195 PECOS PAC ID: 5698809366 Enrollment ID: I20100817000604 |
| Provider Name | Kelly D Wright |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710089685 PECOS PAC ID: 8224162995 Enrollment ID: I20100817000608 |
| Provider Name | Rachael J Winston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205010022 PECOS PAC ID: 0941376321 Enrollment ID: I20100902000671 |
| Provider Name | Gregory J Kutter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003929621 PECOS PAC ID: 2860517166 Enrollment ID: I20100909000981 |
| Provider Name | Ronda D Azelton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679510358 PECOS PAC ID: 9032265004 Enrollment ID: I20100917000135 |
| Provider Name | Edgar Galinanes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134125081 PECOS PAC ID: 6002008398 Enrollment ID: I20101005000568 |
| Provider Name | Laura J Isaacson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760611917 PECOS PAC ID: 3678769494 Enrollment ID: I20101118001392 |
| Provider Name | Shana K Plaster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902108830 PECOS PAC ID: 0648459974 Enrollment ID: I20110119000575 |
| Provider Name | Kathryn L. Egly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518900869 PECOS PAC ID: 4688636871 Enrollment ID: I20110317000057 |
| Provider Name | Andrew A Post |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538159421 PECOS PAC ID: 6305886581 Enrollment ID: I20110318000662 |
| Provider Name | Angela D Standefer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376841205 PECOS PAC ID: 7214113786 Enrollment ID: I20110517000897 |
| Provider Name | Kristin A Crymes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528222189 PECOS PAC ID: 9335326602 Enrollment ID: I20110614000582 |
| Provider Name | Jacqueline L Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609066950 PECOS PAC ID: 9830377738 Enrollment ID: I20110623000584 |
| Provider Name | Kevin Baehl |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659597136 PECOS PAC ID: 3476685967 Enrollment ID: I20110719000858 |
| Provider Name | Jennifer L Pharris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508020165 PECOS PAC ID: 4688842040 Enrollment ID: I20110729000512 |
| Provider Name | Cory J Bethmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538321898 PECOS PAC ID: 8628247723 Enrollment ID: I20110805000651 |
| Provider Name | Scott W Ferreira |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1134221393 PECOS PAC ID: 7517061187 Enrollment ID: I20110811000883 |
| Provider Name | Amy L Mccroskey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508020652 PECOS PAC ID: 7315117488 Enrollment ID: I20110826000728 |
| Provider Name | Brian J Duff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447411145 PECOS PAC ID: 6507037512 Enrollment ID: I20110923000332 |
| Provider Name | Kofi Asare-bawuah |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730345323 PECOS PAC ID: 1759552672 Enrollment ID: I20110923000599 |
| Provider Name | Heather Haley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891078499 PECOS PAC ID: 4587839758 Enrollment ID: I20111216000336 |
| Provider Name | Jennifer L Aldridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437444031 PECOS PAC ID: 2567633241 Enrollment ID: I20111228000054 |
| Provider Name | Mark L Carlson |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1528192150 PECOS PAC ID: 9739356239 Enrollment ID: I20120125000057 |
| Provider Name | Frederick Emge |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013984517 PECOS PAC ID: 5991874893 Enrollment ID: I20120210000811 |
| Provider Name | Cassandra B Cole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821360256 PECOS PAC ID: 4789843749 Enrollment ID: I20120309000654 |
| Provider Name | Jason Greer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992729974 PECOS PAC ID: 3870508427 Enrollment ID: I20120402000128 |
| Provider Name | Laci M Donnelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467727321 PECOS PAC ID: 7810158144 Enrollment ID: I20120413000406 |
| Provider Name | Minh Thu N Le |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1174559116 PECOS PAC ID: 0143485235 Enrollment ID: I20120621000679 |
| Provider Name | Kathy A. Palen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649530825 PECOS PAC ID: 8426214198 Enrollment ID: I20120724000857 |
| Provider Name | John R Tyler |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1982650016 PECOS PAC ID: 7911928858 Enrollment ID: I20120727000783 |
| Provider Name | Brett W Hronek |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1275791568 PECOS PAC ID: 5799963054 Enrollment ID: I20120820000975 |
| Provider Name | Kelley R Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275896326 PECOS PAC ID: 2860649746 Enrollment ID: I20120828000775 |
| Provider Name | Kari L Cooper |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992930580 PECOS PAC ID: 8628238425 Enrollment ID: I20121008000472 |
| Provider Name | Erik T Cochran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306192323 PECOS PAC ID: 2163671983 Enrollment ID: I20121010000443 |
| Provider Name | Jennifer W Kimbrell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316180953 PECOS PAC ID: 5698924371 Enrollment ID: I20121012000835 |
| Provider Name | John A Washburn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578792644 PECOS PAC ID: 6507016607 Enrollment ID: I20121026000116 |
| Provider Name | Jonathan P Etheridge |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063674661 PECOS PAC ID: 4789861238 Enrollment ID: I20121110000163 |
| Provider Name | Rebecca L. Wiley |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1124264825 PECOS PAC ID: 8820242811 Enrollment ID: I20130128000435 |
| Provider Name | Jaclyn D Curnutt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306192729 PECOS PAC ID: 9638324247 Enrollment ID: I20130306000118 |
| Provider Name | Rosanne M Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730427345 PECOS PAC ID: 9436395985 Enrollment ID: I20130429000479 |
| Provider Name | Nicola W Gathaiya |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1154513752 PECOS PAC ID: 9032259791 Enrollment ID: I20130812000263 |
| Provider Name | Nagib Chowdhury |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184851792 PECOS PAC ID: 8325281207 Enrollment ID: I20130823001251 |
| Provider Name | Deborah J Jarrett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417183484 PECOS PAC ID: 7113041278 Enrollment ID: I20130828000976 |
| Provider Name | Stephanie E Pendergrass |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902119290 PECOS PAC ID: 5395988844 Enrollment ID: I20130830000594 |
| Provider Name | Jamie D Durfey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407169881 PECOS PAC ID: 4981847209 Enrollment ID: I20130905000136 |
| Provider Name | James A Hunter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487974036 PECOS PAC ID: 2668616194 Enrollment ID: I20130923000583 |
| Provider Name | Anette D Mozier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184056087 PECOS PAC ID: 9436383627 Enrollment ID: I20131001000109 |
| Provider Name | Latoya M Compton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922430065 PECOS PAC ID: 8022242775 Enrollment ID: I20131011000440 |
| Provider Name | Ramana Reddy Kankanala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679756381 PECOS PAC ID: 2062604960 Enrollment ID: I20131014001586 |
| Provider Name | Sheri L Bethmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841427515 PECOS PAC ID: 0547495335 Enrollment ID: I20131104000161 |
| Provider Name | John Plowden |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003814856 PECOS PAC ID: 2466534318 Enrollment ID: I20140804000141 |
| Provider Name | Kristin L Torgerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255749511 PECOS PAC ID: 9133347453 Enrollment ID: I20140828001762 |
| Provider Name | Phillip G Kelchen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154612588 PECOS PAC ID: 5294964037 Enrollment ID: I20140908002187 |
| Provider Name | Christopher W Morrison |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598022642 PECOS PAC ID: 1951520246 Enrollment ID: I20140918001616 |
| Provider Name | Gerri L Stuppy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518369396 PECOS PAC ID: 7315168119 Enrollment ID: I20141020002721 |
| Provider Name | Pratibha Agarwal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669761706 PECOS PAC ID: 4385966035 Enrollment ID: I20141208001134 |
| Provider Name | Suzette Tramposh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679971766 PECOS PAC ID: 7416272463 Enrollment ID: I20150213001436 |
| Provider Name | Stacey L Fawbush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104215854 PECOS PAC ID: 1254659089 Enrollment ID: I20150407002297 |
| Provider Name | Jean M Kelchen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336430768 PECOS PAC ID: 7517198880 Enrollment ID: I20150416001616 |
| Provider Name | Chelsea K Burnett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992144877 PECOS PAC ID: 1557682234 Enrollment ID: I20150605002223 |
| Provider Name | Sateesh K Gunda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134407844 PECOS PAC ID: 2466764881 Enrollment ID: I20150626001460 |
| Provider Name | Dayna R Jett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942640305 PECOS PAC ID: 2668785825 Enrollment ID: I20150716001518 |
| Provider Name | Sarah Duda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508206152 PECOS PAC ID: 5092028860 Enrollment ID: I20150722005582 |
| Provider Name | Lora L Schauer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912098997 PECOS PAC ID: 2860304896 Enrollment ID: I20150729008512 |
| Provider Name | Katie L Davenport-kabonic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205190931 PECOS PAC ID: 9133434707 Enrollment ID: I20150812007368 |
| Provider Name | Michael C Kabonic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174887806 PECOS PAC ID: 0446565584 Enrollment ID: I20150818005067 |
| Provider Name | Mehdi M Tajouri |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1891135430 PECOS PAC ID: 2365758810 Enrollment ID: I20150831000590 |
| Provider Name | Cynthia L Armstrong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083080022 PECOS PAC ID: 4486960408 Enrollment ID: I20150904001022 |
| Provider Name | Jessica E Sears |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265534341 PECOS PAC ID: 5890938096 Enrollment ID: I20151013001884 |
| Provider Name | Andrew Benbow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073953626 PECOS PAC ID: 3779887021 Enrollment ID: I20160404000055 |
| Provider Name | Brett A Mossberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720493497 PECOS PAC ID: 2264739440 Enrollment ID: I20160404000575 |
| Provider Name | Timothy K Kessinger-mccroskey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811356751 PECOS PAC ID: 8123326600 Enrollment ID: I20160418000060 |
| Provider Name | Steven E Zinter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902211675 PECOS PAC ID: 9234438128 Enrollment ID: I20160505002103 |
| Provider Name | Gwen C Pead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316303993 PECOS PAC ID: 9830498757 Enrollment ID: I20160512001630 |
| Provider Name | Darryl W Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548675218 PECOS PAC ID: 3173814217 Enrollment ID: I20160621002710 |
| Provider Name | Sridevi Durga |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1013175389 PECOS PAC ID: 9234448960 Enrollment ID: I20160711000525 |
| Provider Name | Rachel M Archer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841558921 PECOS PAC ID: 3375846157 Enrollment ID: I20160729000635 |
| Provider Name | John Brian Garner |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1093861601 PECOS PAC ID: 5294996237 Enrollment ID: I20160804001285 |
| Provider Name | Jessica Lynn Ellis |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1124571690 PECOS PAC ID: 9830483205 Enrollment ID: I20160808001545 |
| Provider Name | Melissa A Gaines |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376557264 PECOS PAC ID: 4789689191 Enrollment ID: I20160816002981 |
| Provider Name | Michael C Eastman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194768903 PECOS PAC ID: 8729044961 Enrollment ID: I20160817000061 |
| Provider Name | Lacy A Reeves |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518304971 PECOS PAC ID: 0244525798 Enrollment ID: I20160823000397 |
| Provider Name | Tia Renee Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669926770 PECOS PAC ID: 1850686387 Enrollment ID: I20160823002807 |
| Provider Name | Meghan E Guthrie-baker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982085189 PECOS PAC ID: 7911292149 Enrollment ID: I20160826000257 |
| Provider Name | Jessica D Standeford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326482530 PECOS PAC ID: 8820384431 Enrollment ID: I20160908000703 |
| Provider Name | Stacy L Rohrbaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265985543 PECOS PAC ID: 8527355114 Enrollment ID: I20160926001354 |
| Provider Name | Catharine E Sellers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457326738 PECOS PAC ID: 1850342825 Enrollment ID: I20161011000604 |
| Provider Name | Teresa A Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407308554 PECOS PAC ID: 2163701665 Enrollment ID: I20161123001416 |
| Provider Name | Cortni Stratton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477808848 PECOS PAC ID: 3274812789 Enrollment ID: I20161123001755 |
| Provider Name | Asif Saeed Choudhary |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134560865 PECOS PAC ID: 4183850548 Enrollment ID: I20170131001288 |
| Provider Name | Suthipong Soontrapa |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1841511052 PECOS PAC ID: 2769780113 Enrollment ID: I20170724001554 |
| Provider Name | Sooin Lee |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073986576 PECOS PAC ID: 7911278106 Enrollment ID: I20170807001418 |
| Provider Name | Justin S Legris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952715716 PECOS PAC ID: 5395041321 Enrollment ID: I20170810000072 |
| Provider Name | Ryan K Adkins |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1497013304 PECOS PAC ID: 0749507911 Enrollment ID: I20170811000106 |
| Provider Name | Kyle Christopher Fink |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457790230 PECOS PAC ID: 1355648841 Enrollment ID: I20170817003685 |
| Provider Name | Shawn M Stranckmeyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558776229 PECOS PAC ID: 4688946064 Enrollment ID: I20170818002923 |
| Provider Name | Adam J Stuppy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427475409 PECOS PAC ID: 4789985417 Enrollment ID: I20170821002329 |
| Provider Name | Stacy L Tomlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912423781 PECOS PAC ID: 6103190038 Enrollment ID: I20170915002338 |
| Provider Name | Lindsey M Krawczuk |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902156839 PECOS PAC ID: 7012281421 Enrollment ID: I20170925000978 |
| Provider Name | Ibrahim A Alahmad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467828202 PECOS PAC ID: 7113291204 Enrollment ID: I20170928002096 |
| Provider Name | Tatyana Lehman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124543483 PECOS PAC ID: 0547536575 Enrollment ID: I20171019000579 |
| Provider Name | Jonathan A Mikail |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205196912 PECOS PAC ID: 2860794112 Enrollment ID: I20171019002529 |
| Provider Name | Kara Landon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619496148 PECOS PAC ID: 2769748946 Enrollment ID: I20171103000081 |
| Provider Name | Nancy C Boss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386163244 PECOS PAC ID: 3577829134 Enrollment ID: I20171114003356 |
| Provider Name | Lisa Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619480704 PECOS PAC ID: 7719244789 Enrollment ID: I20171129001195 |
| Provider Name | Joseph Evan Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982054854 PECOS PAC ID: 3173881661 Enrollment ID: I20171208002706 |
| Provider Name | Marlana M Bray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437565223 PECOS PAC ID: 5890018873 Enrollment ID: I20180123003314 |
| Provider Name | Tyler Bray |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790191807 PECOS PAC ID: 9234456146 Enrollment ID: I20180201000709 |
| Provider Name | Faye Albrecht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942702907 PECOS PAC ID: 0345502837 Enrollment ID: I20180321001125 |
| Provider Name | Erin R Carlile |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255733895 PECOS PAC ID: 9638491855 Enrollment ID: I20180406002066 |
| Provider Name | Jonathan Kirk Vashaw |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982752085 PECOS PAC ID: 2365707692 Enrollment ID: I20180607000756 |
| Provider Name | Charnell Sue Allan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144749748 PECOS PAC ID: 1951661081 Enrollment ID: I20180618001081 |
| Provider Name | Eric Funk |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730567165 PECOS PAC ID: 8921329285 Enrollment ID: I20180705003005 |
| Provider Name | John Kendall Ethridge |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306042619 PECOS PAC ID: 5496939894 Enrollment ID: I20180706000145 |
| Provider Name | Shari Angela Chang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467833582 PECOS PAC ID: 4688986391 Enrollment ID: I20180710001541 |
| Provider Name | Temotea D Torre-hilotin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972530830 PECOS PAC ID: 0143263202 Enrollment ID: I20180717001545 |
| Provider Name | Lisa Y Requena |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164761946 PECOS PAC ID: 9032435441 Enrollment ID: I20180717002073 |
| Provider Name | Judith R Gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346323102 PECOS PAC ID: 9234130204 Enrollment ID: I20180720000229 |
| Provider Name | Kellie Soles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104302256 PECOS PAC ID: 7315295789 Enrollment ID: I20180801000415 |
| Provider Name | Blake Alan Fulks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528440534 PECOS PAC ID: 1951659325 Enrollment ID: I20180801000446 |
| Provider Name | Matthew D Dalke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861842726 PECOS PAC ID: 2668721671 Enrollment ID: I20180824001627 |
| Provider Name | Robert A Lien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821578956 PECOS PAC ID: 5496004368 Enrollment ID: I20180827000882 |
| Provider Name | Terra R Vestal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477033603 PECOS PAC ID: 5991055758 Enrollment ID: I20180829002288 |
| Provider Name | Taylor M Jennings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831678671 PECOS PAC ID: 2365792009 Enrollment ID: I20180830001339 |
| Provider Name | Sofia Iqbal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154707511 PECOS PAC ID: 2062702970 Enrollment ID: I20180905003270 |
| Provider Name | Brittney Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407218712 PECOS PAC ID: 2062762453 Enrollment ID: I20180905003312 |
| Provider Name | Hassan Ali |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629454087 PECOS PAC ID: 2860782711 Enrollment ID: I20180917000109 |
| Provider Name | Cathy Jane Greenlee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427537307 PECOS PAC ID: 3870844715 Enrollment ID: I20180917001090 |
| Provider Name | Trudi Valynn Marbough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417438748 PECOS PAC ID: 4385995539 Enrollment ID: I20180926003635 |
| Provider Name | Teresa M Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114401312 PECOS PAC ID: 6507118379 Enrollment ID: I20181004002478 |
| Provider Name | Heather Linn Bridges |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568757730 PECOS PAC ID: 8729232103 Enrollment ID: I20181023000976 |
| Provider Name | Evan Branscum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437679651 PECOS PAC ID: 7719231141 Enrollment ID: I20181121000225 |
| Provider Name | Jamshid Nikbakht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437488657 PECOS PAC ID: 4688716210 Enrollment ID: I20181213001572 |
| Provider Name | Vincen Gene Barnes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093870875 PECOS PAC ID: 5294814893 Enrollment ID: I20190114002966 |
| Provider Name | Vincent A Manning |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558777086 PECOS PAC ID: 5294029799 Enrollment ID: I20190225000056 |
| Provider Name | Carla J Clinton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790279693 PECOS PAC ID: 3476892027 Enrollment ID: I20190227000425 |
| Provider Name | Ellen Kathleen Pitts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346708625 PECOS PAC ID: 5698016400 Enrollment ID: I20190404000865 |
| Provider Name | Trevor Conner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083134902 PECOS PAC ID: 0244571990 Enrollment ID: I20190408001416 |
| Provider Name | Scott Dooley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598165565 PECOS PAC ID: 0648512939 Enrollment ID: I20190507002858 |
| Provider Name | Philipp Alexander Wiesner |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1609162817 PECOS PAC ID: 8224371885 Enrollment ID: I20190522001650 |
| Provider Name | Steven Lee Propst |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134578933 PECOS PAC ID: 1456642727 Enrollment ID: I20190613001892 |
| Provider Name | Alyssa Easter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265882120 PECOS PAC ID: 4789919945 Enrollment ID: I20190710001064 |
| Provider Name | Tanna Crawford |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144600768 PECOS PAC ID: 6901101575 Enrollment ID: I20190723001987 |
| Provider Name | Chelsy A Mccall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881246171 PECOS PAC ID: 2466788583 Enrollment ID: I20190729000177 |
| Provider Name | Jason W Engel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851385264 PECOS PAC ID: 2567363476 Enrollment ID: I20190731000278 |
| Provider Name | Derek Lee Snodgrass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699327023 PECOS PAC ID: 9133456916 Enrollment ID: I20190816001749 |
| Provider Name | Lori Renee Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508419979 PECOS PAC ID: 5597093245 Enrollment ID: I20190820001715 |
| Provider Name | James Ganus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245680107 PECOS PAC ID: 6204164643 Enrollment ID: I20190823000835 |
| Provider Name | Cody Stark Rogers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063943587 PECOS PAC ID: 8426315300 Enrollment ID: I20190830000671 |
| Provider Name | Kyle Gillett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942720065 PECOS PAC ID: 0547599201 Enrollment ID: I20190906000585 |
| Provider Name | Rebecca Lynn Smading |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982245767 PECOS PAC ID: 7911239272 Enrollment ID: I20191106000948 |
| Provider Name | Brittani Nicole Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336784032 PECOS PAC ID: 2062845696 Enrollment ID: I20191211003189 |
| Provider Name | Hannah Lynn Savage |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336787399 PECOS PAC ID: 6507292208 Enrollment ID: I20200128001770 |
| Provider Name | Ashley Ray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386275154 PECOS PAC ID: 5395172969 Enrollment ID: I20200219002870 |
| Provider Name | Emily Jean Redus |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1841832011 PECOS PAC ID: 4587094297 Enrollment ID: I20200421001356 |
| Provider Name | Stephanie N Hart |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1861881229 PECOS PAC ID: 4981034691 Enrollment ID: I20200421001647 |
| Provider Name | Mallory Moore |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1306474796 PECOS PAC ID: 3971933474 Enrollment ID: I20200424000884 |
| Provider Name | Brandi Clary |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1003394362 PECOS PAC ID: 9537599048 Enrollment ID: I20200424001296 |
| Provider Name | Cortney O'daniel |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1881075703 PECOS PAC ID: 9234569666 Enrollment ID: I20200424002561 |
| Provider Name | Linda Terry |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1649758913 PECOS PAC ID: 0547690984 Enrollment ID: I20200424002886 |
| Provider Name | Christopher A Odehnal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477046415 PECOS PAC ID: 8022448331 Enrollment ID: I20200428000504 |
| Provider Name | Terri Myers |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1811525215 PECOS PAC ID: 0042640229 Enrollment ID: I20200501000762 |
| Provider Name | Jamie M Sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801425319 PECOS PAC ID: 3375973563 Enrollment ID: I20200501001426 |
| Provider Name | Melissa Reed |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1881059558 PECOS PAC ID: 2668803883 Enrollment ID: I20200504000259 |
| Provider Name | Sherri Jo Newell-sorrell |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1487873592 PECOS PAC ID: 4183055205 Enrollment ID: I20200505002155 |
| Provider Name | Sara Perry |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1568017150 PECOS PAC ID: 1759712599 Enrollment ID: I20200512002484 |
| Provider Name | Emiliy Mesecher |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669981841 PECOS PAC ID: 0941631626 Enrollment ID: I20200513001179 |
| Provider Name | David Chamberlain Brown |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831727189 PECOS PAC ID: 3476984006 Enrollment ID: I20200514000403 |
| Provider Name | Kalle Carr |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245626506 PECOS PAC ID: 5890116180 Enrollment ID: I20200521001455 |
| Provider Name | Susan Gail Stephenson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1598392763 PECOS PAC ID: 0345661948 Enrollment ID: I20200608002002 |
| Provider Name | April Dawn Bailey |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1770637985 PECOS PAC ID: 1456772938 Enrollment ID: I20200609002774 |
| Provider Name | Dianne Journey |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1962953588 PECOS PAC ID: 8820410392 Enrollment ID: I20200630000884 |
| Provider Name | Ross Keesling |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740631852 PECOS PAC ID: 9032469234 Enrollment ID: I20200709003477 |
| Provider Name | Quade Vickers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477178564 PECOS PAC ID: 6507289378 Enrollment ID: I20200713001491 |
| Provider Name | Gabriela Cox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497249189 PECOS PAC ID: 2860815552 Enrollment ID: I20200714001997 |
| Provider Name | Michelle Lyn Mccoy |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841827136 PECOS PAC ID: 4688098064 Enrollment ID: I20200717001344 |
| Provider Name | Molly Elizabeth Vahldick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689299588 PECOS PAC ID: 5193140663 Enrollment ID: I20200730002301 |
| Provider Name | Lauren Branham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407376619 PECOS PAC ID: 2668897604 Enrollment ID: I20200807000323 |
| Provider Name | Fernando Alada Bayanin |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1306475793 PECOS PAC ID: 0547685547 Enrollment ID: I20200807002465 |
| Provider Name | John Pharris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891224697 PECOS PAC ID: 6204107535 Enrollment ID: I20200821000489 |
| Provider Name | Matthew Olney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437687159 PECOS PAC ID: 5294151296 Enrollment ID: I20200821000520 |
| Provider Name | Elizabeth Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972787711 PECOS PAC ID: 1557440955 Enrollment ID: I20200824003527 |
| Provider Name | Robert Wilson Fleming |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1851920474 PECOS PAC ID: 8729405345 Enrollment ID: I20200827002970 |
| Provider Name | Marc D Carrigan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225295223 PECOS PAC ID: 1951456623 Enrollment ID: I20200930000670 |
| Provider Name | Tri Le |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053671743 PECOS PAC ID: 4385881465 Enrollment ID: I20201007002300 |
| Provider Name | Alexandra Caitlin Philpott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275136665 PECOS PAC ID: 7012320773 Enrollment ID: I20210119002588 |
| Provider Name | Darcy Meghan Zinter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578156824 PECOS PAC ID: 3577978659 Enrollment ID: I20210223002274 |
| Provider Name | Hailey Alyse Tettenhorst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063999795 PECOS PAC ID: 7012266208 Enrollment ID: I20210512002059 |
| Provider Name | Marvin Douglas Hanner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083105449 PECOS PAC ID: 1052712569 Enrollment ID: I20210622000997 |
| Provider Name | Andrew J Wylie |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609363571 PECOS PAC ID: 4880944636 Enrollment ID: I20210712000567 |
| Provider Name | Dayana Arteaga |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881048593 PECOS PAC ID: 6204123516 Enrollment ID: I20210728003466 |
| Provider Name | Samuel Robinson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558922849 PECOS PAC ID: 9638404866 Enrollment ID: I20210823001030 |
| Provider Name | Mark Jeffrey Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134791411 PECOS PAC ID: 4284030487 Enrollment ID: I20210914002532 |
| Provider Name | Christopher Wiles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104371467 PECOS PAC ID: 3173819968 Enrollment ID: I20210917001382 |
| Provider Name | Claira Hardy |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1942978259 PECOS PAC ID: 5698164168 Enrollment ID: I20211123000788 |
| Provider Name | Victor Meier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396008595 PECOS PAC ID: 3476851528 Enrollment ID: I20220301001828 |
| Provider Name | Stephanie Paige Rich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255081253 PECOS PAC ID: 8022405620 Enrollment ID: I20220429000730 |
| Provider Name | Sophia Rae Denning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689319899 PECOS PAC ID: 6901285824 Enrollment ID: I20220623002948 |
| Provider Name | Syed S Naqvi |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1669993416 PECOS PAC ID: 5991121022 Enrollment ID: I20220629003025 |
| Provider Name | Hanna Wagoner |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1285369249 PECOS PAC ID: 5890178073 Enrollment ID: I20220822000940 |
| Provider Name | Madison Bay |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1962139691 PECOS PAC ID: 7214313196 Enrollment ID: I20220929002087 |
| Provider Name | Matthew Robert Brown |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255969184 PECOS PAC ID: 4082080155 Enrollment ID: I20221013002580 |
| Provider Name | Samantha Jean Hampton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700500592 PECOS PAC ID: 7810363744 Enrollment ID: I20221018003172 |
| Provider Name | Kyle Douglas Gronberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427773852 PECOS PAC ID: 2668848292 Enrollment ID: I20221021001615 |
| Provider Name | Sarah Volk Jones |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558416248 PECOS PAC ID: 4183091838 Enrollment ID: I20221109001060 |
| Provider Name | Brittany Lauren Knebel |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1265147110 PECOS PAC ID: 5597137232 Enrollment ID: I20230207001074 |
| Provider Name | James Sumners |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588649115 PECOS PAC ID: 2062434301 Enrollment ID: I20230320001417 |
| Provider Name | Zachary S Randall |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871121103 PECOS PAC ID: 6305269473 Enrollment ID: I20230621002747 |
| Provider Name | Samantha E Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639725823 PECOS PAC ID: 5193145696 Enrollment ID: I20230712002683 |
| Provider Name | Siri K Erickson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437771912 PECOS PAC ID: 4981029782 Enrollment ID: I20230714001675 |
| Provider Name | Gerrit Wayne Montgomery |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1548944788 PECOS PAC ID: 4880054188 Enrollment ID: I20230718003900 |
| Provider Name | Anthony Nepusz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699333112 PECOS PAC ID: 8921331604 Enrollment ID: I20230803003981 |
| Provider Name | Katelyn Morris |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1497432678 PECOS PAC ID: 8426411372 Enrollment ID: I20230825001057 |
| Provider Name | Jessica Gilkey |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1750065553 PECOS PAC ID: 9436512852 Enrollment ID: I20230831002584 |
| Provider Name | Michaela Marie Brown |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710671664 PECOS PAC ID: 2769846617 Enrollment ID: I20230912001437 |
| Provider Name | Nichole Norgard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780213181 PECOS PAC ID: 7618365396 Enrollment ID: I20230925002674 |
| Provider Name | Rebekah Feemster |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1477827178 PECOS PAC ID: 3274796321 Enrollment ID: I20231012000984 |
| Provider Name | Jake Isaac Armstrong |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1518736370 PECOS PAC ID: 7113379629 Enrollment ID: I20240120000324 |
| Provider Name | Haylee Netemeyer |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1326809005 PECOS PAC ID: 9032552237 Enrollment ID: I20240205002348 |
| Provider Name | Laura Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891115663 PECOS PAC ID: 7113147406 Enrollment ID: I20240206000336 |
Mercy Clinic Family Medicine-shell Knob Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 22361 Oak Ridge Dr, Shell Knob, MO 65747 Phone: 417-858-3731 Fax: 417-858-2562 | |
Cox Health Center Shell Knob Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 25376 State Hwy 39, Suite 301, Shell Knob, MO 65747 Phone: 417-269-2470 Fax: 417-858-6910 | |
Coxhealth Center Shell Knob Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 25376 State Highway 39, Suite 301, Shell Knob, MO 65747 Phone: 417-236-2680 Fax: 417-236-2683 | |
Shell Knob Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Hwy 39 & Yy, Shell Knob, MO 65747 Phone: 417-269-2470 Fax: 417-858-6910 |