| St Lukes Clinic - Magic Valley/jerome | |
|
775 Pole Line Rd W Twin Falls ID 83301-5814 | |
| (208) 814-1000 | |
| Not Available |
| Full Name | St Lukes Clinic - Magic Valley/jerome |
|---|---|
| Speciality | Family Medicine |
| Location | 775 Pole Line Rd W, Twin Falls, Idaho |
| Authorized Official Name and Position | Kathryn Fowler (SENIOR VP, CFO) |
| Authorized Official Contact | 2083818717 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Lukes Clinic - Magic Valley/jerome Po Box 640 Boise ID 83701-0640 Ph: (208) 706-5000 | St Lukes Clinic - Magic Valley/jerome 775 Pole Line Rd W Twin Falls ID 83301-5814 Ph: (208) 814-1000 |
| NPI Number | 1790718229 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 12/08/2022 |
| Medicare PECOS PAC ID | 1052217478 |
|---|---|
| Medicare Enrollment ID | O20031208000899 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790718229 | NPI | - | NPPES |
| 806593000 | Medicaid | ID | |
| 1257846 | Other | ID | MEDICARE - CLINIC |
| 133992 | Other | ID | MEDICARE - RHC |
| DA1879 | Other | ID | RR MEDICARE |
| Provider Name | John A Baker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124061262 PECOS PAC ID: 6901702166 Enrollment ID: I20031209000507 |
| Provider Name | Blake G Johnson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1619913381 PECOS PAC ID: 9537060199 Enrollment ID: I20040116000269 |
| Provider Name | Laura M Fall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518924026 PECOS PAC ID: 9032005368 Enrollment ID: I20040224001062 |
| Provider Name | Richard J Hammond |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558306589 PECOS PAC ID: 7113819756 Enrollment ID: I20040327000260 |
| Provider Name | Brian W Fortuin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740221191 PECOS PAC ID: 5496647034 Enrollment ID: I20040331000674 |
| Provider Name | Mark B Wright |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1295778223 PECOS PAC ID: 9133114994 Enrollment ID: I20040420000312 |
| Provider Name | Rex Emerson Wortham |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679580492 PECOS PAC ID: 0749278760 Enrollment ID: I20040511001242 |
| Provider Name | William F May |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1720016231 PECOS PAC ID: 7113908237 Enrollment ID: I20040602000459 |
| Provider Name | Robert Wasserstrom |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982638037 PECOS PAC ID: 8527041599 Enrollment ID: I20040610000870 |
| Provider Name | Jared P Walker |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558490698 PECOS PAC ID: 4082692660 Enrollment ID: I20040709001190 |
| Provider Name | Randal L Wraalstad |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1255334066 PECOS PAC ID: 0244218469 Enrollment ID: I20040713000512 |
| Provider Name | Kim Wiggins |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1962419770 PECOS PAC ID: 8729040027 Enrollment ID: I20041029000177 |
| Provider Name | Joseph L Waters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578503926 PECOS PAC ID: 5496704868 Enrollment ID: I20050113000114 |
| Provider Name | David A Mcclusky |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1407896855 PECOS PAC ID: 0143278796 Enrollment ID: I20050113000143 |
| Provider Name | Heather M Kohring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285742452 PECOS PAC ID: 2062463292 Enrollment ID: I20050204000659 |
| Provider Name | David C Allen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225045693 PECOS PAC ID: 3072552249 Enrollment ID: I20050427000583 |
| Provider Name | Darren W Coleman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1568479301 PECOS PAC ID: 1456390673 Enrollment ID: I20050427000993 |
| Provider Name | Matthew E Williamson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467428540 PECOS PAC ID: 5395785935 Enrollment ID: I20050503001161 |
| Provider Name | Brian L Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336138783 PECOS PAC ID: 1557301892 Enrollment ID: I20050505001228 |
| Provider Name | Bruce C Mccomas |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235167198 PECOS PAC ID: 9234174277 Enrollment ID: I20050621000861 |
| Provider Name | Elizabeth H Sugden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356485767 PECOS PAC ID: 4284670795 Enrollment ID: I20050706001097 |
| Provider Name | Anna P Hawker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730189036 PECOS PAC ID: 9133159445 Enrollment ID: I20050816001198 |
| Provider Name | Joann W Rulien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750377313 PECOS PAC ID: 1759309362 Enrollment ID: I20051102000758 |
| Provider Name | John F Trotter |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649213729 PECOS PAC ID: 3577583632 Enrollment ID: I20051205000034 |
| Provider Name | Victorija D Laucius |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780624122 PECOS PAC ID: 8325061708 Enrollment ID: I20060111001124 |
| Provider Name | Rohn T Mckee |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306899646 PECOS PAC ID: 5496767006 Enrollment ID: I20060623000229 |
| Provider Name | Tyler R Wayment |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1669423539 PECOS PAC ID: 8325053630 Enrollment ID: I20060804000117 |
| Provider Name | Michael P Dixon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245264399 PECOS PAC ID: 7012948961 Enrollment ID: I20060908000346 |
| Provider Name | Akavaram N Reddy |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1407816986 PECOS PAC ID: 5890714349 Enrollment ID: I20060911000311 |
| Provider Name | Michael J Cannon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033131495 PECOS PAC ID: 4486659307 Enrollment ID: I20060928000266 |
| Provider Name | Eric S Cassidy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982647830 PECOS PAC ID: 4880699594 Enrollment ID: I20060930000009 |
| Provider Name | Elva M Mcnurlin |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1295772549 PECOS PAC ID: 4981602976 Enrollment ID: I20061130000205 |
| Provider Name | Dennis M Enomoto |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1649226127 PECOS PAC ID: 7416968656 Enrollment ID: I20061214000541 |
| Provider Name | Daniel C Alder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336111269 PECOS PAC ID: 4082689716 Enrollment ID: I20061215000235 |
| Provider Name | Robert L Coray |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104938182 PECOS PAC ID: 2062414147 Enrollment ID: I20070201000516 |
| Provider Name | Seth N Wheeler |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1548222516 PECOS PAC ID: 5193708980 Enrollment ID: I20070319000311 |
| Provider Name | David J Jensen |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1407808983 PECOS PAC ID: 7416931795 Enrollment ID: I20070411000137 |
| Provider Name | David L Kemp |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366474918 PECOS PAC ID: 7315904182 Enrollment ID: I20070413000265 |
| Provider Name | Blake B Jensen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1316060890 PECOS PAC ID: 2769582584 Enrollment ID: I20070710000215 |
| Provider Name | Lance G Hubsmith |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1013037522 PECOS PAC ID: 8820198641 Enrollment ID: I20070710000237 |
| Provider Name | Lisa Burgett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891731139 PECOS PAC ID: 1153220934 Enrollment ID: I20070723000842 |
| Provider Name | Jacqueline E Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487876793 PECOS PAC ID: 6608967674 Enrollment ID: I20070806000166 |
| Provider Name | John D Steffens |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871683409 PECOS PAC ID: 0941262455 Enrollment ID: I20070827000556 |
| Provider Name | Jennifer L Preucil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922042209 PECOS PAC ID: 2769575026 Enrollment ID: I20070904000210 |
| Provider Name | Kathryn G Reese |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386688802 PECOS PAC ID: 6002909363 Enrollment ID: I20070904000232 |
| Provider Name | Gregory P Jones |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568406692 PECOS PAC ID: 4789777947 Enrollment ID: I20070904000278 |
| Provider Name | Darin K Powell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1255454732 PECOS PAC ID: 3476646480 Enrollment ID: I20070907000242 |
| Provider Name | Daniel G Preucil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215971593 PECOS PAC ID: 0749373611 Enrollment ID: I20070908000031 |
| Provider Name | Patricia A Billings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235173493 PECOS PAC ID: 8729171608 Enrollment ID: I20070908000178 |
| Provider Name | David M Spritzer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245272970 PECOS PAC ID: 0143314203 Enrollment ID: I20070919000964 |
| Provider Name | Mitchell J Moffitt |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093895229 PECOS PAC ID: 2466548268 Enrollment ID: I20071009000851 |
| Provider Name | Richard A Sandison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649216961 PECOS PAC ID: 5092802934 Enrollment ID: I20071024000660 |
| Provider Name | Christopher R Rhead |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487664959 PECOS PAC ID: 9537174073 Enrollment ID: I20080318000719 |
| Provider Name | Ronald F Miciak |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235179052 PECOS PAC ID: 7416027321 Enrollment ID: I20080604000416 |
| Provider Name | Randall J Skeem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699717066 PECOS PAC ID: 0446322861 Enrollment ID: I20080630000612 |
| Provider Name | Lucie A Dimaggio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336188267 PECOS PAC ID: 3577646199 Enrollment ID: I20080702000617 |
| Provider Name | Mark Edlund |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699850966 PECOS PAC ID: 8123129913 Enrollment ID: I20080714000549 |
| Provider Name | Jeffrey W Grossman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083751366 PECOS PAC ID: 7113027871 Enrollment ID: I20080717000640 |
| Provider Name | Blake Pedersen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790994283 PECOS PAC ID: 0547334146 Enrollment ID: I20080730000661 |
| Provider Name | Robert T Lewis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1326200734 PECOS PAC ID: 8628142668 Enrollment ID: I20080808000354 |
| Provider Name | Joshua E Hall |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477675726 PECOS PAC ID: 5698869915 Enrollment ID: I20080811000451 |
| Provider Name | Russell Holliday |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598884900 PECOS PAC ID: 6507871845 Enrollment ID: I20080822000544 |
| Provider Name | Joshua W Kern |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366486003 PECOS PAC ID: 2062588791 Enrollment ID: I20080904000215 |
| Provider Name | Heather Shaw |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1962445817 PECOS PAC ID: 1355419268 Enrollment ID: I20081006000251 |
| Provider Name | Jeffrey L Mulert |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790988509 PECOS PAC ID: 3375601446 Enrollment ID: I20081017000346 |
| Provider Name | Russell W Mayes |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1316162704 PECOS PAC ID: 8224196357 Enrollment ID: I20081018000142 |
| Provider Name | Ryan C Melvin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679519276 PECOS PAC ID: 6800954934 Enrollment ID: I20081018000193 |
| Provider Name | Steven A Kohtz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093830598 PECOS PAC ID: 2163512559 Enrollment ID: I20081018000198 |
| Provider Name | Aaron B Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326128612 PECOS PAC ID: 7214039031 Enrollment ID: I20081018000206 |
| Provider Name | Brian A Johns |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1003876137 PECOS PAC ID: 9032279328 Enrollment ID: I20081117000336 |
| Provider Name | Robert M Ward |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508894262 PECOS PAC ID: 6305837576 Enrollment ID: I20090112000157 |
| Provider Name | Dean A Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285749101 PECOS PAC ID: 0941295323 Enrollment ID: I20090427000332 |
| Provider Name | Melissa D Merrill |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1043459696 PECOS PAC ID: 0446308019 Enrollment ID: I20090508000431 |
| Provider Name | Trevor Y Satterfield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619169299 PECOS PAC ID: 3870687023 Enrollment ID: I20090706000656 |
| Provider Name | Jonathan D Myers |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1346436367 PECOS PAC ID: 5890849269 Enrollment ID: I20090819000593 |
| Provider Name | Matthew H Packham |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578502589 PECOS PAC ID: 6204849276 Enrollment ID: I20090822000175 |
| Provider Name | Michelle L Myers |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1962533083 PECOS PAC ID: 5698749539 Enrollment ID: I20090902000481 |
| Provider Name | Trevor J Crapo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114082260 PECOS PAC ID: 7719033828 Enrollment ID: I20090915000251 |
| Provider Name | Matthew J Larsen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194916049 PECOS PAC ID: 4789742347 Enrollment ID: I20091015000589 |
| Provider Name | Daryl G Ficklin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346213303 PECOS PAC ID: 0042209702 Enrollment ID: I20091112000543 |
| Provider Name | Jared R Helms |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407035371 PECOS PAC ID: 8426146705 Enrollment ID: I20100217000397 |
| Provider Name | James S Irwin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023007465 PECOS PAC ID: 2365482965 Enrollment ID: I20100420000975 |
| Provider Name | Alice R Trabert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245229558 PECOS PAC ID: 6406984426 Enrollment ID: I20100512001094 |
| Provider Name | Timothy A Enders |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063632495 PECOS PAC ID: 3173660289 Enrollment ID: I20100715000653 |
| Provider Name | Gregory R Ball |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407985278 PECOS PAC ID: 8325171689 Enrollment ID: I20100806000484 |
| Provider Name | Heidi M Houser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700191913 PECOS PAC ID: 2961695341 Enrollment ID: I20101018000885 |
| Provider Name | Kenneth C Romney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831272772 PECOS PAC ID: 2567422389 Enrollment ID: I20101209000541 |
| Provider Name | James P Westberry |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548233570 PECOS PAC ID: 1052371960 Enrollment ID: I20110808000818 |
| Provider Name | Janet E Renaldi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831481233 PECOS PAC ID: 0941471221 Enrollment ID: I20110916000250 |
| Provider Name | Gregory D Walton |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1871881375 PECOS PAC ID: 2163694753 Enrollment ID: I20111003000664 |
| Provider Name | Ryan J Roberts |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093982910 PECOS PAC ID: 2466624259 Enrollment ID: I20111021000227 |
| Provider Name | Adam R Bowman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073766226 PECOS PAC ID: 1759423551 Enrollment ID: I20111114000434 |
| Provider Name | Ronald D Wells |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1568492155 PECOS PAC ID: 2567636061 Enrollment ID: I20111118000367 |
| Provider Name | Chad Momberger |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356626980 PECOS PAC ID: 0345416723 Enrollment ID: I20120106000202 |
| Provider Name | Amy Jo Offret |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821372343 PECOS PAC ID: 0244406627 Enrollment ID: I20120106000216 |
| Provider Name | Thomas C Ashby |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1962421800 PECOS PAC ID: 7517133838 Enrollment ID: I20120106000712 |
| Provider Name | John Brandon Cory |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1053682229 PECOS PAC ID: 6103086863 Enrollment ID: I20120404000674 |
| Provider Name | Jason D Rojas |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215208152 PECOS PAC ID: 0244491652 Enrollment ID: I20120411000798 |
| Provider Name | Eric L Bailey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881966885 PECOS PAC ID: 1951562370 Enrollment ID: I20120411000832 |
| Provider Name | Thomas H Zepeda |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083833933 PECOS PAC ID: 1557385820 Enrollment ID: I20120425000769 |
| Provider Name | Charles Kaiser |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477834109 PECOS PAC ID: 1355514910 Enrollment ID: I20120612000016 |
| Provider Name | Mark A Crandall |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1619096278 PECOS PAC ID: 0840381570 Enrollment ID: I20120807000827 |
| Provider Name | Matthew W Dopp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255575619 PECOS PAC ID: 9335395292 Enrollment ID: I20120808000403 |
| Provider Name | Jarom Frederick Lamb |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306006101 PECOS PAC ID: 5890977409 Enrollment ID: I20120810000655 |
| Provider Name | Justin Moroni Dazley |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1851531289 PECOS PAC ID: 9830369255 Enrollment ID: I20121016000682 |
| Provider Name | Kimberlee Hunsaker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1396076048 PECOS PAC ID: 3971638040 Enrollment ID: I20121023000737 |
| Provider Name | Thomas W Dirocco |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1689948572 PECOS PAC ID: 0345490587 Enrollment ID: I20121023000790 |
| Provider Name | Amy T Kirk |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043330723 PECOS PAC ID: 1355398231 Enrollment ID: I20121025000626 |
| Provider Name | Cheryl L Beaumont |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184653016 PECOS PAC ID: 4284884396 Enrollment ID: I20121026000304 |
| Provider Name | Heather E Ellsworth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942473335 PECOS PAC ID: 1355467341 Enrollment ID: I20121113000138 |
| Provider Name | Stanley L Greene |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467763953 PECOS PAC ID: 2668665035 Enrollment ID: I20121126000365 |
| Provider Name | Jonathan L Hanowell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427255959 PECOS PAC ID: 2365630142 Enrollment ID: I20121126000439 |
| Provider Name | Kathleen M Couch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255687521 PECOS PAC ID: 6709030026 Enrollment ID: I20130213000386 |
| Provider Name | Jacob C Langston |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922309244 PECOS PAC ID: 1759568785 Enrollment ID: I20130308000147 |
| Provider Name | John R Anderson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366490773 PECOS PAC ID: 4284879446 Enrollment ID: I20130319000093 |
| Provider Name | Susan M Marzolf |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1568447019 PECOS PAC ID: 3375596034 Enrollment ID: I20130521000141 |
| Provider Name | Bonnie L Steffens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407136823 PECOS PAC ID: 3678730140 Enrollment ID: I20130524000377 |
| Provider Name | Brendan M Petersen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043569056 PECOS PAC ID: 4688813959 Enrollment ID: I20130617000671 |
| Provider Name | Kylan D Peterson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1750542452 PECOS PAC ID: 6608061676 Enrollment ID: I20130802000550 |
| Provider Name | Kurtis B Reed |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1245484096 PECOS PAC ID: 7810041852 Enrollment ID: I20130826000096 |
| Provider Name | Liang Wu |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1073776258 PECOS PAC ID: 4284766932 Enrollment ID: I20130828000009 |
| Provider Name | Nathan K Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881908366 PECOS PAC ID: 1355585449 Enrollment ID: I20130911000085 |
| Provider Name | Michelle G Stradley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235158270 PECOS PAC ID: 9436152063 Enrollment ID: I20131022000802 |
| Provider Name | Bryan C Mason |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316268295 PECOS PAC ID: 3375797111 Enrollment ID: I20131028000466 |
| Provider Name | Brett J Buican |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013005446 PECOS PAC ID: 0446247084 Enrollment ID: I20131126000624 |
| Provider Name | Jerri L Bingham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063834224 PECOS PAC ID: 3779706593 Enrollment ID: I20140523001995 |
| Provider Name | Nichole S Halverson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164629887 PECOS PAC ID: 4981675600 Enrollment ID: I20140606001134 |
| Provider Name | Aaron A Fearday |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1952543118 PECOS PAC ID: 2668604729 Enrollment ID: I20140617001666 |
| Provider Name | Maria R Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871914168 PECOS PAC ID: 7214152560 Enrollment ID: I20140701000446 |
| Provider Name | Erik N Meyers |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598828378 PECOS PAC ID: 5496970691 Enrollment ID: I20140702000172 |
| Provider Name | Scott A Knight |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710917398 PECOS PAC ID: 1456577931 Enrollment ID: I20140717002403 |
| Provider Name | Michael R Mcentire |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1477875094 PECOS PAC ID: 4284827684 Enrollment ID: I20140801002362 |
| Provider Name | Brad L Hyatt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932420783 PECOS PAC ID: 0840445185 Enrollment ID: I20140905000709 |
| Provider Name | Carolyn S Doedyns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851328504 PECOS PAC ID: 8426058355 Enrollment ID: I20141006002004 |
| Provider Name | Tina C Aubuchon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1659695476 PECOS PAC ID: 0446445605 Enrollment ID: I20141013002516 |
| Provider Name | Chase A Stringam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811286131 PECOS PAC ID: 3173745916 Enrollment ID: I20141112001133 |
| Provider Name | Amanda J Weston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609278886 PECOS PAC ID: 7315269461 Enrollment ID: I20141201001471 |
| Provider Name | Jeremiah W Neibling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154723120 PECOS PAC ID: 8729301783 Enrollment ID: I20141223000957 |
| Provider Name | Cody J Davies |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417377870 PECOS PAC ID: 7214252733 Enrollment ID: I20150204001260 |
| Provider Name | Joshua M Hutchinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134460918 PECOS PAC ID: 4880919315 Enrollment ID: I20150204001606 |
| Provider Name | Candise A Ramsey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326313271 PECOS PAC ID: 4789904871 Enrollment ID: I20150513000012 |
| Provider Name | David E Frankl |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1699758318 PECOS PAC ID: 7214064336 Enrollment ID: I20150514000024 |
| Provider Name | Scott A Snyder |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629000716 PECOS PAC ID: 7012237084 Enrollment ID: I20150515000563 |
| Provider Name | Joseph M Strobel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013271899 PECOS PAC ID: 3274845599 Enrollment ID: I20150629003173 |
| Provider Name | Joseph C Hymas |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1942490578 PECOS PAC ID: 6406081512 Enrollment ID: I20150713002052 |
| Provider Name | Vaughn A Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447519160 PECOS PAC ID: 1951614494 Enrollment ID: I20150713003002 |
| Provider Name | Joseph Rosenblum |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609861509 PECOS PAC ID: 9931011244 Enrollment ID: I20150717002619 |
| Provider Name | Brad Q Starley |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1669443909 PECOS PAC ID: 9739346131 Enrollment ID: I20150729009835 |
| Provider Name | Thomas B Duff |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326302449 PECOS PAC ID: 9436465267 Enrollment ID: I20150825003283 |
| Provider Name | Chad J Johnson |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1871881052 PECOS PAC ID: 6608021159 Enrollment ID: I20150825003434 |
| Provider Name | Wilmer T Jones |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1487666319 PECOS PAC ID: 1153329313 Enrollment ID: I20150827002458 |
| Provider Name | Makay T Oakey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1952780090 PECOS PAC ID: 3577871979 Enrollment ID: I20151005002605 |
| Provider Name | Kelly Curtis Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548523020 PECOS PAC ID: 9436394327 Enrollment ID: I20151016001279 |
| Provider Name | James M Dunn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700108040 PECOS PAC ID: 5597991760 Enrollment ID: I20151111001301 |
| Provider Name | Marla J Van Tassell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801266572 PECOS PAC ID: 1355644964 Enrollment ID: I20160114001151 |
| Provider Name | David V Dick |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1053649855 PECOS PAC ID: 8628107844 Enrollment ID: I20160209002751 |
| Provider Name | Jennifer R Shepard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114382207 PECOS PAC ID: 1658676622 Enrollment ID: I20160229002865 |
| Provider Name | Anne Fullmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891165569 PECOS PAC ID: 9739485616 Enrollment ID: I20160303001150 |
| Provider Name | Jerald D King |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215016886 PECOS PAC ID: 7012968860 Enrollment ID: I20160318002057 |
| Provider Name | William J Malone |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1568658250 PECOS PAC ID: 3779658109 Enrollment ID: I20160322002240 |
| Provider Name | John James D Angelo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124221023 PECOS PAC ID: 1052443215 Enrollment ID: I20160401001429 |
| Provider Name | Sonya S Orr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982061826 PECOS PAC ID: 0648578724 Enrollment ID: I20160406002219 |
| Provider Name | Charles B Larson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497120349 PECOS PAC ID: 6406154749 Enrollment ID: I20160419002907 |
| Provider Name | Adam M Robison |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811335615 PECOS PAC ID: 7810207131 Enrollment ID: I20160621001965 |
| Provider Name | Catherine A Doyle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952712242 PECOS PAC ID: 6204152036 Enrollment ID: I20160621002787 |
| Provider Name | Michael O Pratt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497098891 PECOS PAC ID: 4082858022 Enrollment ID: I20160629002426 |
| Provider Name | Paul K Stevens |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376809202 PECOS PAC ID: 3375774516 Enrollment ID: I20160728001379 |
| Provider Name | Declan P O'riordan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629016043 PECOS PAC ID: 0941594790 Enrollment ID: I20160802002454 |
| Provider Name | Robert Jensen |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1629424171 PECOS PAC ID: 8022302215 Enrollment ID: I20160810002949 |
| Provider Name | Rafferty C Sorensen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609176338 PECOS PAC ID: 7719167139 Enrollment ID: I20160824000613 |
| Provider Name | Amra Suljevic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811354640 PECOS PAC ID: 1850686163 Enrollment ID: I20160825002278 |
| Provider Name | Jordan M Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609320126 PECOS PAC ID: 9335437987 Enrollment ID: I20161013001745 |
| Provider Name | Nicolas J Hayes |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518164334 PECOS PAC ID: 7810128493 Enrollment ID: I20161019001671 |
| Provider Name | Briana Odonnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457704249 PECOS PAC ID: 6709164999 Enrollment ID: I20161021001497 |
| Provider Name | Jeffrey Hobbs |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1700248002 PECOS PAC ID: 9234417866 Enrollment ID: I20161101002292 |
| Provider Name | Nichole P Horrocks |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1952690745 PECOS PAC ID: 7416125927 Enrollment ID: I20161123000599 |
| Provider Name | Ashley A Rood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881140283 PECOS PAC ID: 3476833666 Enrollment ID: I20161205001510 |
| Provider Name | Joseph A Bradbury |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073717989 PECOS PAC ID: 5496802811 Enrollment ID: I20170104000388 |
| Provider Name | Sean P Mcfadden |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073953808 PECOS PAC ID: 8628203478 Enrollment ID: I20170116000077 |
| Provider Name | Murvat Usmanova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790227783 PECOS PAC ID: 3971886359 Enrollment ID: I20170208003075 |
| Provider Name | Marci L Ahlquist |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376084673 PECOS PAC ID: 7214214352 Enrollment ID: I20170427001744 |
| Provider Name | Jason Chesley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427214543 PECOS PAC ID: 8729252598 Enrollment ID: I20170524000758 |
| Provider Name | Timothy J Ulrich |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619263563 PECOS PAC ID: 1254587041 Enrollment ID: I20170530001588 |
| Provider Name | Stephen N Sherwood |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427375260 PECOS PAC ID: 6406080522 Enrollment ID: I20170613002282 |
| Provider Name | Corine R Faught |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285165399 PECOS PAC ID: 2668740416 Enrollment ID: I20170620000609 |
| Provider Name | Leslie Jacob Benny |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780002717 PECOS PAC ID: 2163791500 Enrollment ID: I20170628002755 |
| Provider Name | Umesh C Bhandari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548572274 PECOS PAC ID: 4183944648 Enrollment ID: I20170710002816 |
| Provider Name | Peter B Ferrara |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457799215 PECOS PAC ID: 8921390675 Enrollment ID: I20170714001716 |
| Provider Name | Jonathan King |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891114666 PECOS PAC ID: 2961705074 Enrollment ID: I20170718003700 |
| Provider Name | Paul W Dunlavy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598028797 PECOS PAC ID: 2264683507 Enrollment ID: I20170726000212 |
| Provider Name | Amanda J Prestigiacomo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043747579 PECOS PAC ID: 6103197355 Enrollment ID: I20170807000202 |
| Provider Name | William R Sullivan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154483477 PECOS PAC ID: 4183605884 Enrollment ID: I20170807001456 |
| Provider Name | Hailey Spevak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851826580 PECOS PAC ID: 4284905498 Enrollment ID: I20170807002261 |
| Provider Name | Sindy K Byington |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1134532476 PECOS PAC ID: 0244458040 Enrollment ID: I20170814002352 |
| Provider Name | Lesley D Goulding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043730302 PECOS PAC ID: 8820361033 Enrollment ID: I20170911002328 |
| Provider Name | Casie L Spearing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780115048 PECOS PAC ID: 7810262623 Enrollment ID: I20171004002258 |
| Provider Name | Nicole Lee Ruske |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750721148 PECOS PAC ID: 3375869225 Enrollment ID: I20171012003418 |
| Provider Name | Kelsie L Hendrickson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205203064 PECOS PAC ID: 8628334232 Enrollment ID: I20171115002228 |
| Provider Name | Mark P Murphy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033554464 PECOS PAC ID: 9739448481 Enrollment ID: I20180125002260 |
| Provider Name | Richard A Pierson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811283211 PECOS PAC ID: 8325309867 Enrollment ID: I20180226002267 |
| Provider Name | Chet R Dansie |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003335209 PECOS PAC ID: 2264793629 Enrollment ID: I20180227000885 |
| Provider Name | Michael C Garbett |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528576089 PECOS PAC ID: 1951662931 Enrollment ID: I20180308001096 |
| Provider Name | Donna D Krapf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215444856 PECOS PAC ID: 1557626314 Enrollment ID: I20180525001334 |
| Provider Name | Scott J Parker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730447186 PECOS PAC ID: 9830340264 Enrollment ID: I20180618002240 |
| Provider Name | Todd G Hastings |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1386955060 PECOS PAC ID: 4789948308 Enrollment ID: I20180619001325 |
| Provider Name | Michael Reed Fry |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285011577 PECOS PAC ID: 1951617190 Enrollment ID: I20180619001971 |
| Provider Name | Artur S Narkiewicz-jodko |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104188879 PECOS PAC ID: 3678846011 Enrollment ID: I20180621002250 |
| Provider Name | Jessica Lynn Mendez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447632948 PECOS PAC ID: 0648585547 Enrollment ID: I20180627000858 |
| Provider Name | Ryan K Callahan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962765222 PECOS PAC ID: 0244503522 Enrollment ID: I20180731002730 |
| Provider Name | Pamela D Mills |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750794913 PECOS PAC ID: 7113222472 Enrollment ID: I20180801000361 |
| Provider Name | Skyler S Shippen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194174995 PECOS PAC ID: 3173815180 Enrollment ID: I20180816000317 |
| Provider Name | Garrett A Bentley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558709121 PECOS PAC ID: 6305087693 Enrollment ID: I20180828002679 |
| Provider Name | Jedediah Hunter May |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1255624441 PECOS PAC ID: 4688802879 Enrollment ID: I20181003000641 |
| Provider Name | Joel C Wagstaff |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154702090 PECOS PAC ID: 4880986439 Enrollment ID: I20181011001463 |
| Provider Name | Ruth Kornmueller |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1619458114 PECOS PAC ID: 0244583359 Enrollment ID: I20181018002626 |
| Provider Name | Oswaldo Bisbal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1487686242 PECOS PAC ID: 6901965847 Enrollment ID: I20181204002679 |
| Provider Name | Julie P Wilson |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1790759215 PECOS PAC ID: 5294760682 Enrollment ID: I20181214000771 |
| Provider Name | Tamara D Schulz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881188035 PECOS PAC ID: 8628314754 Enrollment ID: I20190110003194 |
| Provider Name | Joshua Scoville |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285101097 PECOS PAC ID: 9436496890 Enrollment ID: I20190123004182 |
| Provider Name | Stephanie R Gorringe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053801456 PECOS PAC ID: 6507103967 Enrollment ID: I20190123004258 |
| Provider Name | Martha A Taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306871090 PECOS PAC ID: 3274629217 Enrollment ID: I20190123004385 |
| Provider Name | Jennifer J Quesnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194291823 PECOS PAC ID: 3072851765 Enrollment ID: I20190204002906 |
| Provider Name | Rachel M Kaschmitter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275913451 PECOS PAC ID: 5991043648 Enrollment ID: I20190205002541 |
| Provider Name | Lauren A Schoessler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720559404 PECOS PAC ID: 0042558470 Enrollment ID: I20190211001638 |
| Provider Name | Janice L Preuit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104318690 PECOS PAC ID: 3779822572 Enrollment ID: I20190221002190 |
| Provider Name | William E Turgoose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477039261 PECOS PAC ID: 3274873716 Enrollment ID: I20190320002837 |
| Provider Name | Aaron E Packham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912356718 PECOS PAC ID: 4486946266 Enrollment ID: I20190327001620 |
| Provider Name | Matthew F Silvers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467918698 PECOS PAC ID: 1456693688 Enrollment ID: I20190508001611 |
| Provider Name | Lisa C Reeves |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528441631 PECOS PAC ID: 7810230026 Enrollment ID: I20190509001926 |
| Provider Name | Jared R Henderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336597152 PECOS PAC ID: 0648563403 Enrollment ID: I20190618001797 |
| Provider Name | Michelle S Harcourt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780150979 PECOS PAC ID: 7517291818 Enrollment ID: I20190620000005 |
| Provider Name | Bryan L Gourley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629500947 PECOS PAC ID: 8921346727 Enrollment ID: I20190625001960 |
| Provider Name | Charles C Burtis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992060057 PECOS PAC ID: 7214164565 Enrollment ID: I20190627003138 |
| Provider Name | Kyle P Noorlander |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1023672318 PECOS PAC ID: 0143555029 Enrollment ID: I20190715002617 |
| Provider Name | John J Burk |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407216716 PECOS PAC ID: 7214263458 Enrollment ID: I20190725003653 |
| Provider Name | Kyle G Wong |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063897395 PECOS PAC ID: 6002142874 Enrollment ID: I20190731003598 |
| Provider Name | Patricia A Conner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982269973 PECOS PAC ID: 9032446687 Enrollment ID: I20190806001246 |
| Provider Name | Mary C Konneker |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1376100966 PECOS PAC ID: 9234468745 Enrollment ID: I20190909003656 |
| Provider Name | Brian T Olsen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487060687 PECOS PAC ID: 9335367275 Enrollment ID: I20190913001880 |
| Provider Name | Paula P Griffith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013336197 PECOS PAC ID: 8729381389 Enrollment ID: I20190924002713 |
| Provider Name | Kimberly A Hartrick Buechle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699282558 PECOS PAC ID: 6002147626 Enrollment ID: I20191014001293 |
| Provider Name | Lauren A Gale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730482431 PECOS PAC ID: 4082945449 Enrollment ID: I20191016001071 |
| Provider Name | Corey V Boren |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1326378019 PECOS PAC ID: 5395871933 Enrollment ID: I20191105000780 |
| Provider Name | Rialey M Hawkes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700430113 PECOS PAC ID: 9739511890 Enrollment ID: I20191112002222 |
| Provider Name | Sonamarivell V Granados |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1215420591 PECOS PAC ID: 4688008022 Enrollment ID: I20191218001133 |
| Provider Name | Devin L Merritt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568859650 PECOS PAC ID: 9931533304 Enrollment ID: I20191230000934 |
| Provider Name | Craig Jones |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1043501349 PECOS PAC ID: 1052625035 Enrollment ID: I20200107002940 |
| Provider Name | Robert E Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255970976 PECOS PAC ID: 3577990696 Enrollment ID: I20200302000966 |
| Provider Name | William Cheung |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1255775797 PECOS PAC ID: 0244559730 Enrollment ID: I20200303002812 |
| Provider Name | Lynn Rice |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952645426 PECOS PAC ID: 9032540562 Enrollment ID: I20200515001804 |
| Provider Name | Corey Alan Lindberg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790133296 PECOS PAC ID: 4183911639 Enrollment ID: I20200518001680 |
| Provider Name | Stefani L Campa-macfee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508336900 PECOS PAC ID: 4183045735 Enrollment ID: I20200605002317 |
| Provider Name | Bing G Parkinson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932620481 PECOS PAC ID: 7315273158 Enrollment ID: I20200624002792 |
| Provider Name | Marc T Allan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073043337 PECOS PAC ID: 6103195920 Enrollment ID: I20200626001845 |
| Provider Name | Weston J Caywood |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013352814 PECOS PAC ID: 4385990738 Enrollment ID: I20200715002920 |
| Provider Name | Jonathan R Muretisch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023543899 PECOS PAC ID: 9133499932 Enrollment ID: I20200716002336 |
| Provider Name | Robert W Tonks |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1902197866 PECOS PAC ID: 7618119322 Enrollment ID: I20200729002348 |
| Provider Name | Justo Gonzalez-trapaga |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477553865 PECOS PAC ID: 6608899232 Enrollment ID: I20200810002667 |
| Provider Name | Skylar Muniz |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1710502281 PECOS PAC ID: 8325465917 Enrollment ID: I20200827001663 |
| Provider Name | Margo Jane Simon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487000642 PECOS PAC ID: 8426340696 Enrollment ID: I20200904000596 |
| Provider Name | Andrew N Monson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366836843 PECOS PAC ID: 8224309802 Enrollment ID: I20200909001996 |
| Provider Name | Jose M Pena |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770013583 PECOS PAC ID: 7911271598 Enrollment ID: I20200914002562 |
| Provider Name | Samuel Taylor |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073051884 PECOS PAC ID: 1254616469 Enrollment ID: I20201015001244 |
| Provider Name | Greggory S Flint |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306238605 PECOS PAC ID: 9537438593 Enrollment ID: I20201022004242 |
| Provider Name | Andrew Lee Jones |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386057859 PECOS PAC ID: 4486960796 Enrollment ID: I20201026002690 |
| Provider Name | Katy S Konkle |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1467749978 PECOS PAC ID: 2163730417 Enrollment ID: I20201109001528 |
| Provider Name | Kassandra L Kostecki |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467800797 PECOS PAC ID: 0547694416 Enrollment ID: I20201116002577 |
| Provider Name | Rita Woodman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639787054 PECOS PAC ID: 9739590878 Enrollment ID: I20201123000573 |
| Provider Name | Alok Desh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780979823 PECOS PAC ID: 7618193194 Enrollment ID: I20201221001706 |
| Provider Name | Nikolai Anton Sopko |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1013283472 PECOS PAC ID: 1355599747 Enrollment ID: I20210204002229 |
| Provider Name | Lisa R Jensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528656725 PECOS PAC ID: 5193132793 Enrollment ID: I20210326001546 |
| Provider Name | Jennifer N Welch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932790995 PECOS PAC ID: 5294143921 Enrollment ID: I20210419002641 |
| Provider Name | Michael A Mccormick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922423532 PECOS PAC ID: 2769601210 Enrollment ID: I20210602000606 |
| Provider Name | Michael G Higbee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770730939 PECOS PAC ID: 8729487244 Enrollment ID: I20210602002685 |
| Provider Name | Faryab Frank Lohrasbi |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1982660437 PECOS PAC ID: 0941371363 Enrollment ID: I20210610002456 |
| Provider Name | Marshall Andersen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013383009 PECOS PAC ID: 2062717937 Enrollment ID: I20210616001824 |
| Provider Name | Peter J Hinckley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073907556 PECOS PAC ID: 1153638614 Enrollment ID: I20210706003046 |
| Provider Name | Creighton Lewis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376920553 PECOS PAC ID: 6305157421 Enrollment ID: I20210719001261 |
| Provider Name | Cade R Call |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235634452 PECOS PAC ID: 9032512033 Enrollment ID: I20210728003298 |
| Provider Name | Kayla L Johnson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1477179646 PECOS PAC ID: 1658775960 Enrollment ID: I20210809003626 |
| Provider Name | Erin M Goodfellow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417540741 PECOS PAC ID: 5092110130 Enrollment ID: I20210826003516 |
| Provider Name | Michael Zammit |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1841251188 PECOS PAC ID: 5496658213 Enrollment ID: I20210830001226 |
| Provider Name | Peter S Shashy |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1477515971 PECOS PAC ID: 1557341856 Enrollment ID: I20210907002107 |
| Provider Name | Bethany Sappington |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780010934 PECOS PAC ID: 3870889363 Enrollment ID: I20211101000816 |
| Provider Name | Carah Cornelia Quigley |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1891469565 PECOS PAC ID: 0042608440 Enrollment ID: I20211103001556 |
| Provider Name | Benjamin Crawley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508424896 PECOS PAC ID: 9335538040 Enrollment ID: I20211118002513 |
| Provider Name | Imad Jaafar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1821418120 PECOS PAC ID: 4385944081 Enrollment ID: I20211122001489 |
| Provider Name | Brian J Coates |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578769683 PECOS PAC ID: 3274789417 Enrollment ID: I20211129002456 |
| Provider Name | Derek Mcdowell |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1083110712 PECOS PAC ID: 1759639834 Enrollment ID: I20211201002036 |
| Provider Name | Jennifer Salame |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871027094 PECOS PAC ID: 0941629943 Enrollment ID: I20211202000026 |
| Provider Name | William R Lowe |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1114110608 PECOS PAC ID: 4284728213 Enrollment ID: I20211202001252 |
| Provider Name | Emina Mustafic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861862625 PECOS PAC ID: 9931599784 Enrollment ID: I20211209001585 |
| Provider Name | Melissa A Sleight |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1821463563 PECOS PAC ID: 0648662965 Enrollment ID: I20220119001066 |
| Provider Name | Rauli Jo Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144982190 PECOS PAC ID: 8527450717 Enrollment ID: I20220120001486 |
| Provider Name | Olivia Debra Cox |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1376215905 PECOS PAC ID: 4284026246 Enrollment ID: I20220125000690 |
| Provider Name | Amanda S Turner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578853032 PECOS PAC ID: 2860636339 Enrollment ID: I20220125001058 |
| Provider Name | Steven Kurtz |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1538254453 PECOS PAC ID: 8426095639 Enrollment ID: I20220128000422 |
| Provider Name | Edward Martinez |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1578983524 PECOS PAC ID: 9739304478 Enrollment ID: I20220331000584 |
| Provider Name | Juan Carhuas |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508529694 PECOS PAC ID: 4284021429 Enrollment ID: I20220418002470 |
| Provider Name | Amanda P. Braga |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871098137 PECOS PAC ID: 7517354046 Enrollment ID: I20220429002191 |
| Provider Name | Jessica A Bagby |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093161473 PECOS PAC ID: 3072944313 Enrollment ID: I20220601000706 |
| Provider Name | Luke Sugden |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1760972780 PECOS PAC ID: 5991053498 Enrollment ID: I20220601002032 |
| Provider Name | Brian L Stucki |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588867477 PECOS PAC ID: 8022173533 Enrollment ID: I20220613002303 |
| Provider Name | Elliot Adams |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1033597232 PECOS PAC ID: 3274849625 Enrollment ID: I20220701000506 |
| Provider Name | Stuart Bergman |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1992859805 PECOS PAC ID: 4587608112 Enrollment ID: I20220708002269 |
| Provider Name | Eugene S Lee |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1518943265 PECOS PAC ID: 4789663444 Enrollment ID: I20220801000409 |
| Provider Name | Jessicca Crismor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508513375 PECOS PAC ID: 6901288380 Enrollment ID: I20220802000243 |
| Provider Name | Nathan Kelsey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184943789 PECOS PAC ID: 1052640265 Enrollment ID: I20220805001400 |
| Provider Name | Sarah Beck |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629310370 PECOS PAC ID: 1850698812 Enrollment ID: I20220805001825 |
| Provider Name | Katherine Elizabeth Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861146326 PECOS PAC ID: 7113309196 Enrollment ID: I20220808002250 |
| Provider Name | Emily Nicole Montague |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316683790 PECOS PAC ID: 8123401932 Enrollment ID: I20220811001488 |
| Provider Name | Rebekah Salles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710464136 PECOS PAC ID: 6507119278 Enrollment ID: I20220818001298 |
| Provider Name | Logan Perkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487218814 PECOS PAC ID: 4789911249 Enrollment ID: I20220826000281 |
| Provider Name | Justin Michael Belin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992430177 PECOS PAC ID: 7719361294 Enrollment ID: I20220901000741 |
| Provider Name | Mackenzie Gustafson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669101234 PECOS PAC ID: 1658755038 Enrollment ID: I20220902001315 |
| Provider Name | Emmalee Calvert |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1124754825 PECOS PAC ID: 9335524552 Enrollment ID: I20220923000707 |
| Provider Name | Abbigail Jean Sundell |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1023745056 PECOS PAC ID: 3274919899 Enrollment ID: I20221005003350 |
| Provider Name | Shelly Ann Abell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528791969 PECOS PAC ID: 7911373980 Enrollment ID: I20221017000153 |
| Provider Name | Danielle Doucet |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1962654814 PECOS PAC ID: 6204063837 Enrollment ID: I20221018003599 |
| Provider Name | Gary Drizin |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1700848140 PECOS PAC ID: 5991767568 Enrollment ID: I20221028000645 |
| Provider Name | Joseph Ezer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083637300 PECOS PAC ID: 0446307573 Enrollment ID: I20221101002460 |
| Provider Name | Jamie Poulsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235798356 PECOS PAC ID: 1850769035 Enrollment ID: I20221118001379 |
| Provider Name | Joshua Hansen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730542143 PECOS PAC ID: 2163717992 Enrollment ID: I20221202002846 |
| Provider Name | Shawn French |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1124238449 PECOS PAC ID: 5496984569 Enrollment ID: I20221212002401 |
| Provider Name | Andrew Mazzone |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1619402286 PECOS PAC ID: 2264785575 Enrollment ID: I20221216002535 |
| Provider Name | Megan Lynn Gully |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952023905 PECOS PAC ID: 2961872270 Enrollment ID: I20230103001213 |
| Provider Name | Mohamed Khalifa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528467552 PECOS PAC ID: 0446536080 Enrollment ID: I20230109000907 |
| Provider Name | Jonas Dravland |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134164502 PECOS PAC ID: 0042645244 Enrollment ID: I20230110000615 |
| Provider Name | Jessica Rose Adamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174240139 PECOS PAC ID: 7113397928 Enrollment ID: I20230111002368 |
| Provider Name | David Shafran |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1568480606 PECOS PAC ID: 9830125210 Enrollment ID: I20230116000098 |
| Provider Name | Ismael Grachico |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881055705 PECOS PAC ID: 7618263872 Enrollment ID: I20230120000310 |
| Provider Name | Amanda Overacre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821343815 PECOS PAC ID: 9830501642 Enrollment ID: I20230208000368 |
| Provider Name | Kara Marie Wheeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952026791 PECOS PAC ID: 2163894718 Enrollment ID: I20230208002725 |
| Provider Name | Karl T Schroeder |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1003097114 PECOS PAC ID: 9133367279 Enrollment ID: I20230213000636 |
| Provider Name | Nathan Oehrlein |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1922399583 PECOS PAC ID: 4688961733 Enrollment ID: I20230217001070 |
| Provider Name | Austen Slade |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1467815530 PECOS PAC ID: 0941566459 Enrollment ID: I20230306002099 |
| Provider Name | William Lefler |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1023235058 PECOS PAC ID: 8325172711 Enrollment ID: I20230313002863 |
| Provider Name | Holly A Lasure |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659649945 PECOS PAC ID: 8729452644 Enrollment ID: I20230316000405 |
| Provider Name | Travis Christopher Allemang |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1841586120 PECOS PAC ID: 0840591137 Enrollment ID: I20230321002394 |
| Provider Name | Jasdeep Dalawari |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1215986807 PECOS PAC ID: 1759275167 Enrollment ID: I20230323000744 |
| Provider Name | Robin Louise Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942912738 PECOS PAC ID: 3173997400 Enrollment ID: I20230328000534 |
| Provider Name | Haramandeep Singh |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1154410967 PECOS PAC ID: 8224199815 Enrollment ID: I20230405001660 |
| Provider Name | John E Goodrich |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124449442 PECOS PAC ID: 8729413695 Enrollment ID: I20230412002813 |
| Provider Name | Errol Singh |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1629141577 PECOS PAC ID: 6901793942 Enrollment ID: I20230518002463 |
| Provider Name | Joseph M Sturdivant |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053514455 PECOS PAC ID: 7517123342 Enrollment ID: I20230522000631 |
| Provider Name | Kennett Bruce Murdock |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1629772371 PECOS PAC ID: 6608232293 Enrollment ID: I20230524002370 |
| Provider Name | Jaime Ivan Delgado Caldera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710680103 PECOS PAC ID: 2264899244 Enrollment ID: I20230606003637 |
| Provider Name | Christopher Gibson |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1922501733 PECOS PAC ID: 4981954518 Enrollment ID: I20230612002920 |
| Provider Name | Kameron King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386341311 PECOS PAC ID: 5991163248 Enrollment ID: I20230620001654 |
| Provider Name | Talmage Barth |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083141097 PECOS PAC ID: 8224392725 Enrollment ID: I20230621001485 |
| Provider Name | Prabhakorn Kitbhoka |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1679703045 PECOS PAC ID: 9739300146 Enrollment ID: I20230622001018 |
| Provider Name | Jerry Greenberg |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1780643015 PECOS PAC ID: 9133213887 Enrollment ID: I20230628002397 |
| Provider Name | Joseph Ostler |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1235524802 PECOS PAC ID: 5496081192 Enrollment ID: I20230721002502 |
| Provider Name | Lindsey Blamires |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376259770 PECOS PAC ID: 4981065323 Enrollment ID: I20230801002149 |
| Provider Name | Lauren Clelland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336761063 PECOS PAC ID: 8325461841 Enrollment ID: I20230810003375 |
| Provider Name | Heather Mcguire |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1508806100 PECOS PAC ID: 4082644638 Enrollment ID: I20230811002959 |
| Provider Name | Raemi Dawn Nolevanko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063119212 PECOS PAC ID: 3971965211 Enrollment ID: I20230817002410 |
| Provider Name | Eric J Allen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508494071 PECOS PAC ID: 3375905557 Enrollment ID: I20230821001395 |
| Provider Name | Jill G Byers |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1902846629 PECOS PAC ID: 2567428279 Enrollment ID: I20230905003105 |
| Provider Name | Bradley Meyer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073074720 PECOS PAC ID: 1557725587 Enrollment ID: I20230911000178 |
| Provider Name | Nichole B Shumway |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386263796 PECOS PAC ID: 2769809417 Enrollment ID: I20230912001070 |
| Provider Name | Hillary Ruhl Duenas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871056523 PECOS PAC ID: 7719341213 Enrollment ID: I20230918001627 |
| Provider Name | Nathan Todd Sparks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710669874 PECOS PAC ID: 7517311764 Enrollment ID: I20230921004346 |
| Provider Name | Samantha Gonzales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962105429 PECOS PAC ID: 3173977253 Enrollment ID: I20230922001528 |
| Provider Name | Autumn Lin Parizek |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568149060 PECOS PAC ID: 8022462951 Enrollment ID: I20230927000703 |
| Provider Name | Timothy Strong |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013354703 PECOS PAC ID: 7911148580 Enrollment ID: I20230927002904 |
| Provider Name | Bruce E. Gollub |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508855917 PECOS PAC ID: 0941464986 Enrollment ID: I20231019002085 |
| Provider Name | Stephanie B Duff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851076251 PECOS PAC ID: 4587010558 Enrollment ID: I20231026003887 |
| Provider Name | Ryan Delgatti |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1811419047 PECOS PAC ID: 0840564555 Enrollment ID: I20231030002457 |
| Provider Name | Miriah Jean Graybill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831973064 PECOS PAC ID: 0244687556 Enrollment ID: I20231108001650 |
| Provider Name | Nathan Frohne |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760876676 PECOS PAC ID: 5395059182 Enrollment ID: I20231109001443 |
| Provider Name | Roxanne Mickelson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1295081248 PECOS PAC ID: 3971977018 Enrollment ID: I20231122001020 |
| Provider Name | Elisabeth Stephens |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1639876345 PECOS PAC ID: 1557711934 Enrollment ID: I20231227002079 |
| Provider Name | Lacey Haggan-galloway |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1508486481 PECOS PAC ID: 3375994122 Enrollment ID: I20240105003522 |
| Provider Name | Caitlin Iorio |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1861923088 PECOS PAC ID: 5496026668 Enrollment ID: I20240208002877 |
| Provider Name | Benjamin H. Feldman |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1588829402 PECOS PAC ID: 6103046297 Enrollment ID: I20240219000878 |
| Provider Name | Kaitlin R Munns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083498554 PECOS PAC ID: 1153765946 Enrollment ID: I20240220003916 |
Tripp Family Medicine, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1411 Fillmore St, Suite 600, Twin Falls, ID 83301 Phone: 208-933-4400 Fax: 208-933-4401 | |
Warren Dopson Md, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 706 N College Rd Ste A, Twin Falls, ID 83301 Phone: 208-736-8006 Fax: 208-736-8007 | |
Twin Falls Imaging & Diagnostic Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1330 Filer Ave E, Twin Falls, ID 83301 Phone: 208-732-1205 Fax: 208-736-2413 | |
Twin Falls Imaging & Diagnostic Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 562 Shoup Ave W, Twin Falls, ID 83301 Phone: 208-732-1205 Fax: 208-736-2413 | |
Blue Lakes Gastroenterology, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 775 Pole Line Rd W, Suite 203, Twin Falls, ID 83301 Phone: 208-814-8300 Fax: 208-733-8970 | |
Caldwell Immediate Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2701 Carriage Way, Twin Falls, ID 83301 Phone: 208-320-0258 | |
Gem State Ent, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2114 Village Park Ave # 200, Twin Falls, ID 83301 Phone: 208-804-1717 Fax: 208-804-1707 |