| Logan Health Breast Center | |
|
310 Sunnyview Ln Kalispell MT 59901-3129 | |
| (406) 751-6488 | |
| (406) 758-3157 |
| Full Name | Logan Health Breast Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 310 Sunnyview Ln, Kalispell, Montana |
| Authorized Official Name and Position | Craig J Lambrecht (PRESIDENT/CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4067521724 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Logan Health Breast Center 310 Sunnyview Ln Kalispell MT 59901-3129 Ph: (406) 751-6488 | Logan Health Breast Center 310 Sunnyview Ln Kalispell MT 59901-3129 Ph: (406) 751-6488 |
| NPI Number | 1235333139 |
|---|---|
| Provider Enumeration Date | 06/13/2007 |
| Last Update Date | 06/01/2021 |
| Medicare PECOS PAC ID | 5294644381 |
|---|---|
| Medicare Enrollment ID | O20031122000142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235333139 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Mark T Welch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164561619 PECOS PAC ID: 3476467143 Enrollment ID: I20031121000845 |
| Provider Name | Nancy J Knaff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346344751 PECOS PAC ID: 4688578370 Enrollment ID: I20031124000615 |
| Provider Name | Niall P Madigan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407803208 PECOS PAC ID: 5991601544 Enrollment ID: I20031212000315 |
| Provider Name | Terry A Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285740290 PECOS PAC ID: 7719881432 Enrollment ID: I20031216000439 |
| Provider Name | Lisa A Fleischer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659327120 PECOS PAC ID: 7214835081 Enrollment ID: I20031230000783 |
| Provider Name | Mae O Berentson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972558120 PECOS PAC ID: 7416855291 Enrollment ID: I20031230000808 |
| Provider Name | Jonathan M Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356397533 PECOS PAC ID: 4284532060 Enrollment ID: I20031230000827 |
| Provider Name | John Lavin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316962731 PECOS PAC ID: 5395644595 Enrollment ID: I20040107000462 |
| Provider Name | Lisa M Spors-murphy |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255388229 PECOS PAC ID: 0749181436 Enrollment ID: I20040115001017 |
| Provider Name | Jon J Johnson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1619902012 PECOS PAC ID: 5395647267 Enrollment ID: I20040129001077 |
| Provider Name | Lon L Savik |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1467501460 PECOS PAC ID: 2769385046 Enrollment ID: I20040202000862 |
| Provider Name | Timothy F Obermiller |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1720011927 PECOS PAC ID: 6204740400 Enrollment ID: I20040205001005 |
| Provider Name | Robert C Sherrick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619076122 PECOS PAC ID: 6103726096 Enrollment ID: I20040217001129 |
| Provider Name | Mary Ann Evans |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649245937 PECOS PAC ID: 5496641953 Enrollment ID: I20040223001199 |
| Provider Name | Daniel P Rausch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245269810 PECOS PAC ID: 7113818949 Enrollment ID: I20040322001701 |
| Provider Name | Scot E Born |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831298348 PECOS PAC ID: 5193616696 Enrollment ID: I20040323001687 |
| Provider Name | Dennis L Peterson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205986460 PECOS PAC ID: 4789575945 Enrollment ID: I20040324001493 |
| Provider Name | Bruce F Gray |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619038601 PECOS PAC ID: 7416849179 Enrollment ID: I20040326001107 |
| Provider Name | Eric M Brandeberry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992747836 PECOS PAC ID: 3971591595 Enrollment ID: I20040503001618 |
| Provider Name | Michael T Henson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306907308 PECOS PAC ID: 0840261848 Enrollment ID: I20040803001569 |
| Provider Name | Judith Neal Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730120858 PECOS PAC ID: 2466426002 Enrollment ID: I20040820000498 |
| Provider Name | Donald A Stone |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447299037 PECOS PAC ID: 2769457613 Enrollment ID: I20040901001488 |
| Provider Name | R Dennis Winkel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740225333 PECOS PAC ID: 5092777680 Enrollment ID: I20041027000097 |
| Provider Name | Roger J Diegel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770660896 PECOS PAC ID: 4880675859 Enrollment ID: I20041027001035 |
| Provider Name | Stanley H Makman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1730290610 PECOS PAC ID: 2062476518 Enrollment ID: I20041115001277 |
| Provider Name | Matthew K Bailey |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396896577 PECOS PAC ID: 7012973159 Enrollment ID: I20041209000568 |
| Provider Name | Jose C Desouza |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1275534158 PECOS PAC ID: 8921057324 Enrollment ID: I20050112000812 |
| Provider Name | Leonard B Desmul |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588618086 PECOS PAC ID: 1355307372 Enrollment ID: I20050217000958 |
| Provider Name | Thomas A Konen |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1740342583 PECOS PAC ID: 4880649409 Enrollment ID: I20050316001020 |
| Provider Name | Eve Lynn Gillespie |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1922038520 PECOS PAC ID: 8426041948 Enrollment ID: I20050412001021 |
| Provider Name | Michelle L Hellwig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164478657 PECOS PAC ID: 3375587124 Enrollment ID: I20050614000124 |
| Provider Name | Bret D Lindsay |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518913250 PECOS PAC ID: 6002893260 Enrollment ID: I20050714000525 |
| Provider Name | Paul B Coats |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093761652 PECOS PAC ID: 2466489497 Enrollment ID: I20050721000540 |
| Provider Name | Amy K Mckerrow |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1376598433 PECOS PAC ID: 0446283006 Enrollment ID: I20050914000486 |
| Provider Name | Robert M Rogers |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982633475 PECOS PAC ID: 4183694508 Enrollment ID: I20050914000667 |
| Provider Name | Kimberly S Damrow |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548267347 PECOS PAC ID: 1355376880 Enrollment ID: I20051003000829 |
| Provider Name | William W Rowe |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1164414595 PECOS PAC ID: 6608763479 Enrollment ID: I20051010000530 |
| Provider Name | Richard W Briles |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891750220 PECOS PAC ID: 2961420005 Enrollment ID: I20051107000736 |
| Provider Name | Perry K Birky |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437239282 PECOS PAC ID: 2668403262 Enrollment ID: I20051201000825 |
| Provider Name | Dana C Ducote |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922060037 PECOS PAC ID: 0143241711 Enrollment ID: I20051209000738 |
| Provider Name | Kim D Stimpson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1215983937 PECOS PAC ID: 5698677474 Enrollment ID: I20060306000812 |
| Provider Name | Christopher J Holdhusen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033177134 PECOS PAC ID: 8729062906 Enrollment ID: I20060314000631 |
| Provider Name | Jonathan M Hayden |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841242807 PECOS PAC ID: 6204897457 Enrollment ID: I20060322000357 |
| Provider Name | Marise K Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013958537 PECOS PAC ID: 3375575020 Enrollment ID: I20060323000824 |
| Provider Name | John V Vanarendonk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801833421 PECOS PAC ID: 6800799982 Enrollment ID: I20060331000395 |
| Provider Name | Brentley A Buchele |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1922052976 PECOS PAC ID: 9234037425 Enrollment ID: I20060601000175 |
| Provider Name | John R Craig |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1013957695 PECOS PAC ID: 1456363084 Enrollment ID: I20060626000159 |
| Provider Name | Julie E Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386682821 PECOS PAC ID: 1355354861 Enrollment ID: I20060731000431 |
| Provider Name | Leah J Carlburg |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1356386437 PECOS PAC ID: 3971516352 Enrollment ID: I20060802000103 |
| Provider Name | Timothy J Stutzman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538104195 PECOS PAC ID: 2860495751 Enrollment ID: I20060815000137 |
| Provider Name | Scott D Burry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134196298 PECOS PAC ID: 7517861396 Enrollment ID: I20070410000704 |
| Provider Name | Tobin James Hoppes |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1013952118 PECOS PAC ID: 8921011586 Enrollment ID: I20070806000788 |
| Provider Name | John L Willcut |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568669877 PECOS PAC ID: 8325131824 Enrollment ID: I20070829000384 |
| Provider Name | John M Tollerson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467446773 PECOS PAC ID: 9537194691 Enrollment ID: I20070906000601 |
| Provider Name | Adam T Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194949628 PECOS PAC ID: 7214967330 Enrollment ID: I20070918000434 |
| Provider Name | Daniel F Zlogar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588611230 PECOS PAC ID: 6709788771 Enrollment ID: I20071018000860 |
| Provider Name | Richard D Goulah |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1114934387 PECOS PAC ID: 3173518990 Enrollment ID: I20071112000275 |
| Provider Name | Melanie M Zander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598815425 PECOS PAC ID: 0547358665 Enrollment ID: I20071126000527 |
| Provider Name | Kelly L Redfield |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700844941 PECOS PAC ID: 7416981907 Enrollment ID: I20080329000090 |
| Provider Name | Ned C Kneeland |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1841388725 PECOS PAC ID: 1355428715 Enrollment ID: I20080630000652 |
| Provider Name | Paul M Berkram |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952469140 PECOS PAC ID: 3971678608 Enrollment ID: I20080814000767 |
| Provider Name | Kelly Kristine Berkram |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497825178 PECOS PAC ID: 0547286171 Enrollment ID: I20080827000537 |
| Provider Name | Mona L Cuthbert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497859987 PECOS PAC ID: 7810087574 Enrollment ID: I20080924000486 |
| Provider Name | Dawn M Murray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457336471 PECOS PAC ID: 5597720672 Enrollment ID: I20081006000258 |
| Provider Name | Sarah P Robinson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881740413 PECOS PAC ID: 9436227725 Enrollment ID: I20081105000852 |
| Provider Name | Mark D Weber |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1346283702 PECOS PAC ID: 8022178722 Enrollment ID: I20081126000214 |
| Provider Name | Michelle Nail Noftsinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962685610 PECOS PAC ID: 2567524176 Enrollment ID: I20081216000279 |
| Provider Name | Bennett J Dykstra |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1003979550 PECOS PAC ID: 9234293887 Enrollment ID: I20090127000555 |
| Provider Name | Stephen G Milheim |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1962565432 PECOS PAC ID: 7416925961 Enrollment ID: I20090130000234 |
| Provider Name | Anthony R Dal Nogare |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811966393 PECOS PAC ID: 3274699020 Enrollment ID: I20090304000213 |
| Provider Name | Leslie A Coates |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1467692657 PECOS PAC ID: 5092872960 Enrollment ID: I20090319000440 |
| Provider Name | Kathleen F Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760535777 PECOS PAC ID: 5799833455 Enrollment ID: I20090507000066 |
| Provider Name | Denise L Zander |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881835502 PECOS PAC ID: 0840348512 Enrollment ID: I20090507000121 |
| Provider Name | Justine Arden Gavagan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477533164 PECOS PAC ID: 1850322041 Enrollment ID: I20090805000704 |
| Provider Name | Theodore J Losey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104016567 PECOS PAC ID: 5597831875 Enrollment ID: I20090807000663 |
| Provider Name | George C Nadasi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699838342 PECOS PAC ID: 2163576182 Enrollment ID: I20090810000672 |
| Provider Name | Rachelle W Losey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366612152 PECOS PAC ID: 5890849699 Enrollment ID: I20090813000132 |
| Provider Name | Melissa Lundbeck Kaptanian |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1982860300 PECOS PAC ID: 3375697477 Enrollment ID: I20090824000287 |
| Provider Name | Nicholas Cade Cantrell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114185303 PECOS PAC ID: 2567536899 Enrollment ID: I20090828000259 |
| Provider Name | Robert G Mitchell |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1750399564 PECOS PAC ID: 3173523768 Enrollment ID: I20090904000569 |
| Provider Name | Kurt D Lindsay |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043456361 PECOS PAC ID: 7113065046 Enrollment ID: I20091112000425 |
| Provider Name | Linda G Sterry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629070198 PECOS PAC ID: 1254226830 Enrollment ID: I20091207000416 |
| Provider Name | Laura J Csaplar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497760185 PECOS PAC ID: 5496881831 Enrollment ID: I20100324001237 |
| Provider Name | Anders G Engdahl |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841369295 PECOS PAC ID: 4385532407 Enrollment ID: I20100422001095 |
| Provider Name | William R Benedetto |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750452983 PECOS PAC ID: 6204867807 Enrollment ID: I20100429000659 |
| Provider Name | Richard G Friedman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033270012 PECOS PAC ID: 3476545179 Enrollment ID: I20100429000677 |
| Provider Name | Christopher H Gill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417998568 PECOS PAC ID: 5294648523 Enrollment ID: I20100512000999 |
| Provider Name | David C Habel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992747927 PECOS PAC ID: 6103739438 Enrollment ID: I20100512001019 |
| Provider Name | Douglas A Nelson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427091065 PECOS PAC ID: 9830002179 Enrollment ID: I20100512001039 |
| Provider Name | Dawn M Peters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386687267 PECOS PAC ID: 4284763814 Enrollment ID: I20100520000175 |
| Provider Name | Sydney R Lillard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619082336 PECOS PAC ID: 9537165527 Enrollment ID: I20100831000216 |
| Provider Name | Melanie A Klawiter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164630547 PECOS PAC ID: 1153445879 Enrollment ID: I20100902000349 |
| Provider Name | John R Means |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528099017 PECOS PAC ID: 5395748644 Enrollment ID: I20100910000958 |
| Provider Name | Donald P Ericksen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386755395 PECOS PAC ID: 0648201251 Enrollment ID: I20100922001055 |
| Provider Name | Jana Sund |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1740421023 PECOS PAC ID: 7012068596 Enrollment ID: I20100922001113 |
| Provider Name | Larry J Iwersen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1013028950 PECOS PAC ID: 3072588284 Enrollment ID: I20101018001202 |
| Provider Name | Karen N Perser |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1568576189 PECOS PAC ID: 8022201441 Enrollment ID: I20101018001320 |
| Provider Name | Brittany J Coburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033427935 PECOS PAC ID: 1153515036 Enrollment ID: I20101104000915 |
| Provider Name | Jessica C Glover |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275862625 PECOS PAC ID: 2466648605 Enrollment ID: I20101130000354 |
| Provider Name | Craig A Harrison |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1265493910 PECOS PAC ID: 7315981834 Enrollment ID: I20101130000938 |
| Provider Name | Drew L Kirshner |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1093718389 PECOS PAC ID: 0648224832 Enrollment ID: I20101213000958 |
| Provider Name | Howard L Tice |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1215998505 PECOS PAC ID: 6305880824 Enrollment ID: I20101216000238 |
| Provider Name | Renee M Iverson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992782056 PECOS PAC ID: 0143227066 Enrollment ID: I20101222000830 |
| Provider Name | Jeffrey A Tjaden |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1164583373 PECOS PAC ID: 5294915286 Enrollment ID: I20110208000797 |
| Provider Name | Peter Wagner |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1245440841 PECOS PAC ID: 0446343784 Enrollment ID: I20110511000801 |
| Provider Name | Carrie A Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841493350 PECOS PAC ID: 6608967906 Enrollment ID: I20110516000021 |
| Provider Name | Daniel A Korb |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649298357 PECOS PAC ID: 2365530177 Enrollment ID: I20110526000015 |
| Provider Name | Tyler C Hoppes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235394180 PECOS PAC ID: 3072700319 Enrollment ID: I20110621000448 |
| Provider Name | Thomas Dehoop |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720023138 PECOS PAC ID: 4183665003 Enrollment ID: I20110816000637 |
| Provider Name | Thomas C Origitano |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1841277720 PECOS PAC ID: 7810809027 Enrollment ID: I20110824000665 |
| Provider Name | Martha A Jessop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801123534 PECOS PAC ID: 7810168770 Enrollment ID: I20110926000432 |
| Provider Name | Amy M Ramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336417005 PECOS PAC ID: 8820255821 Enrollment ID: I20120202000453 |
| Provider Name | Mary P Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679511547 PECOS PAC ID: 7012952773 Enrollment ID: I20120605000288 |
| Provider Name | Herman O Lyle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245386846 PECOS PAC ID: 3173787553 Enrollment ID: I20120614000764 |
| Provider Name | Elise N Anderes |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1558535997 PECOS PAC ID: 1153474697 Enrollment ID: I20120727000361 |
| Provider Name | Dennis Gee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962678805 PECOS PAC ID: 4082785456 Enrollment ID: I20120803000296 |
| Provider Name | Michelle Lynn Boltz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194843870 PECOS PAC ID: 3274684451 Enrollment ID: I20120803000715 |
| Provider Name | Thomas E Flass |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770639387 PECOS PAC ID: 8527230960 Enrollment ID: I20120809000555 |
| Provider Name | Daniel C Short |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942443197 PECOS PAC ID: 4981851540 Enrollment ID: I20120904000621 |
| Provider Name | Charles Tate Woodward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760606917 PECOS PAC ID: 5395839294 Enrollment ID: I20120904000638 |
| Provider Name | Edward Carl Bergen |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1760454391 PECOS PAC ID: 6002064581 Enrollment ID: I20120907000744 |
| Provider Name | Todd A Shumard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801046818 PECOS PAC ID: 0648420760 Enrollment ID: I20121026000441 |
| Provider Name | Seth W Clemens |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1740494913 PECOS PAC ID: 6507966777 Enrollment ID: I20121102000265 |
| Provider Name | Laura K Mirch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366686651 PECOS PAC ID: 9436300787 Enrollment ID: I20121113000698 |
| Provider Name | Delinda Wills |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1063531804 PECOS PAC ID: 4880848118 Enrollment ID: I20130213000519 |
| Provider Name | Summer E Monforte |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1194927293 PECOS PAC ID: 5890966436 Enrollment ID: I20130325000442 |
| Provider Name | Joseph G Sramek |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1891763439 PECOS PAC ID: 1850347618 Enrollment ID: I20130626000142 |
| Provider Name | Christian H Butcher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831116805 PECOS PAC ID: 9234191891 Enrollment ID: I20130705000314 |
| Provider Name | Joshua L Krass |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1275654386 PECOS PAC ID: 1052575743 Enrollment ID: I20130717000098 |
| Provider Name | Kevin Lee Keeton |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1659578052 PECOS PAC ID: 8820153752 Enrollment ID: I20130718000127 |
| Provider Name | Courtney L Stout Paterson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205982824 PECOS PAC ID: 5597819862 Enrollment ID: I20130807000515 |
| Provider Name | John S Cole |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508181454 PECOS PAC ID: 6901048719 Enrollment ID: I20130807000521 |
| Provider Name | Rob K Perkins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326087867 PECOS PAC ID: 2567531601 Enrollment ID: I20130815000950 |
| Provider Name | Joseph H Boyle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003808478 PECOS PAC ID: 8224011069 Enrollment ID: I20130911000151 |
| Provider Name | Marcus S Wheeler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750544490 PECOS PAC ID: 4284878828 Enrollment ID: I20130920000243 |
| Provider Name | Elizabeth L King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073954863 PECOS PAC ID: 0244474815 Enrollment ID: I20130920000592 |
| Provider Name | Mitchell C Marzo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851594626 PECOS PAC ID: 9133301591 Enrollment ID: I20130926000864 |
| Provider Name | Ryan P Roop |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457541799 PECOS PAC ID: 3375777881 Enrollment ID: I20131015002074 |
| Provider Name | Benjamin D Ward |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1285839894 PECOS PAC ID: 7517125206 Enrollment ID: I20131025001609 |
| Provider Name | Alrich L Gray |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1952372294 PECOS PAC ID: 6608820238 Enrollment ID: I20131026000145 |
| Provider Name | Melissa Ln Basford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972770592 PECOS PAC ID: 8628205218 Enrollment ID: I20131205000032 |
| Provider Name | Grzegorz G Cieslewicz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780634055 PECOS PAC ID: 5597736165 Enrollment ID: I20140327000917 |
| Provider Name | John D Andenoro |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1518058551 PECOS PAC ID: 3678504271 Enrollment ID: I20140423002419 |
| Provider Name | Neal W Wilkinson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083616643 PECOS PAC ID: 2062553795 Enrollment ID: I20140508001078 |
| Provider Name | Margaret Bortko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518062892 PECOS PAC ID: 2264336908 Enrollment ID: I20140521002023 |
| Provider Name | John D Erickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285056234 PECOS PAC ID: 0143443762 Enrollment ID: I20140528001413 |
| Provider Name | Suzy M Buckmaster |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972797066 PECOS PAC ID: 2163560301 Enrollment ID: I20140630001789 |
| Provider Name | Michael T Rutherford |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912140435 PECOS PAC ID: 2264657824 Enrollment ID: I20140715002653 |
| Provider Name | Joseph H Bergman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1285898569 PECOS PAC ID: 9931342474 Enrollment ID: I20140717002141 |
| Provider Name | Kimberly L Longcake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891990081 PECOS PAC ID: 1153404736 Enrollment ID: I20140717002549 |
| Provider Name | Joseph T Krezowski |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1811149818 PECOS PAC ID: 6709910698 Enrollment ID: I20140725002125 |
| Provider Name | Marisa S Hoyne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821382151 PECOS PAC ID: 8527287366 Enrollment ID: I20140910000744 |
| Provider Name | Todd A Johnson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912296989 PECOS PAC ID: 4183856081 Enrollment ID: I20140917001270 |
| Provider Name | Nancy K Huus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447659792 PECOS PAC ID: 2062634132 Enrollment ID: I20141105002632 |
| Provider Name | Deborah L Lessmeier |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1730298852 PECOS PAC ID: 2769499664 Enrollment ID: I20141230001238 |
| Provider Name | Ivory D Drendel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194984039 PECOS PAC ID: 3577737238 Enrollment ID: I20150115001656 |
| Provider Name | Maria R Vogel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619378668 PECOS PAC ID: 5496070021 Enrollment ID: I20150202002094 |
| Provider Name | Paul A Merguerian |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1700895000 PECOS PAC ID: 3577533470 Enrollment ID: I20150326001823 |
| Provider Name | Anna Robbins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093977217 PECOS PAC ID: 1557495363 Enrollment ID: I20150327002589 |
| Provider Name | Nicole Mandala |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699064055 PECOS PAC ID: 8628380375 Enrollment ID: I20150708003061 |
| Provider Name | Andrew Joseph Ferdinand |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801026737 PECOS PAC ID: 8325276108 Enrollment ID: I20150725012727 |
| Provider Name | Shawn Dale Barrong |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497775837 PECOS PAC ID: 2365568623 Enrollment ID: I20150807014232 |
| Provider Name | Alexis Harrison |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861646382 PECOS PAC ID: 8123250875 Enrollment ID: I20150813011155 |
| Provider Name | Kevin Kropp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093157760 PECOS PAC ID: 2668788829 Enrollment ID: I20150902001704 |
| Provider Name | Ashleigh Magill |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477879385 PECOS PAC ID: 7618115502 Enrollment ID: I20150903000441 |
| Provider Name | Austine K Siomos |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952543571 PECOS PAC ID: 6709029036 Enrollment ID: I20150911001465 |
| Provider Name | Mark E Magill |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1659514149 PECOS PAC ID: 7719101757 Enrollment ID: I20150914000526 |
| Provider Name | Vassilis J Siomos |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1598907149 PECOS PAC ID: 2264753466 Enrollment ID: I20150914001570 |
| Provider Name | Alison E Schneider |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124184411 PECOS PAC ID: 5799830527 Enrollment ID: I20150917002341 |
| Provider Name | Jonathan M Brunson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184823643 PECOS PAC ID: 9032341979 Enrollment ID: I20150918001095 |
| Provider Name | Casey C Cole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487849352 PECOS PAC ID: 7618011180 Enrollment ID: I20150921000391 |
| Provider Name | Amber L Lavin |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1508242678 PECOS PAC ID: 7911214994 Enrollment ID: I20150924000033 |
| Provider Name | James Heath Miller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447246731 PECOS PAC ID: 7911193651 Enrollment ID: I20150930002923 |
| Provider Name | Katarine V Egressy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1871760736 PECOS PAC ID: 7214167865 Enrollment ID: I20151020002148 |
| Provider Name | Jose Ness |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1265411359 PECOS PAC ID: 9830261023 Enrollment ID: I20151102000679 |
| Provider Name | Steven Lewis Goldberg |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548345374 PECOS PAC ID: 8123163169 Enrollment ID: I20151116001874 |
| Provider Name | Kelly T Kieper |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083888390 PECOS PAC ID: 7618101015 Enrollment ID: I20151119001203 |
| Provider Name | Philip E Jaffe |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1477534337 PECOS PAC ID: 2062497944 Enrollment ID: I20151215001658 |
| Provider Name | Mary Irene Beatrice C Feria |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1447244454 PECOS PAC ID: 6204848062 Enrollment ID: I20151221001010 |
| Provider Name | Paige L Sadowski |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1205208477 PECOS PAC ID: 4981905767 Enrollment ID: I20151221001591 |
| Provider Name | Shuang Li |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013262492 PECOS PAC ID: 1658599014 Enrollment ID: I20160211002480 |
| Provider Name | Kerry J Eby |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023194800 PECOS PAC ID: 4880664226 Enrollment ID: I20160218001834 |
| Provider Name | Kendall A Babb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417204710 PECOS PAC ID: 3779732359 Enrollment ID: I20160225000302 |
| Provider Name | Tony L Lloyd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497732754 PECOS PAC ID: 3173542933 Enrollment ID: I20160312000034 |
| Provider Name | Deborah A Hoffman |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1811907215 PECOS PAC ID: 3274667951 Enrollment ID: I20160422001850 |
| Provider Name | Mark G Ochenrider |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154465839 PECOS PAC ID: 5799858031 Enrollment ID: I20160607000325 |
| Provider Name | Wallace D Prophet |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1942294426 PECOS PAC ID: 9638270200 Enrollment ID: I20160614000607 |
| Provider Name | Jeffrey Scott Eshleman |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1770561433 PECOS PAC ID: 4486636263 Enrollment ID: I20160615001165 |
| Provider Name | Heidi Shors |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1982899795 PECOS PAC ID: 7911093539 Enrollment ID: I20160616002123 |
| Provider Name | Nathaniel L Hall |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063695948 PECOS PAC ID: 5092958561 Enrollment ID: I20160620002304 |
| Provider Name | Scott Rogers |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1902124084 PECOS PAC ID: 2062630312 Enrollment ID: I20160708002143 |
| Provider Name | Jared H Heimbigner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063405777 PECOS PAC ID: 5092723809 Enrollment ID: I20160714000921 |
| Provider Name | Chelsey L Spence |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992148308 PECOS PAC ID: 8628204070 Enrollment ID: I20160719002594 |
| Provider Name | Ramon Generoso |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1326029281 PECOS PAC ID: 3678579240 Enrollment ID: I20160726001460 |
| Provider Name | Rachel A Desimone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073864492 PECOS PAC ID: 8527212455 Enrollment ID: I20160803002355 |
| Provider Name | Mayank Agrawal |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1831308063 PECOS PAC ID: 5799816096 Enrollment ID: I20160805002035 |
| Provider Name | Nicole Desiree Haats |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093260986 PECOS PAC ID: 8426343641 Enrollment ID: I20160825002812 |
| Provider Name | Daniel Gardner Lustig |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952458747 PECOS PAC ID: 9830266410 Enrollment ID: I20160829000711 |
| Provider Name | Mallory E Novack |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427324185 PECOS PAC ID: 6507152550 Enrollment ID: I20160831001330 |
| Provider Name | Margaret A Satchell |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1205892742 PECOS PAC ID: 2668557125 Enrollment ID: I20160913001377 |
| Provider Name | Katherine Kasavana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780946954 PECOS PAC ID: 4082847181 Enrollment ID: I20160919001766 |
| Provider Name | Venkatachala Mohan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1194704106 PECOS PAC ID: 9537252754 Enrollment ID: I20160920001390 |
| Provider Name | Jennifer Steele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427502384 PECOS PAC ID: 9537456348 Enrollment ID: I20160922000577 |
| Provider Name | Dallas T Koperski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023320009 PECOS PAC ID: 6103069489 Enrollment ID: I20161003001672 |
| Provider Name | Juan L Martinez-poyer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598748519 PECOS PAC ID: 7214126374 Enrollment ID: I20161222000769 |
| Provider Name | Heidi M Woxland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396008231 PECOS PAC ID: 5092962571 Enrollment ID: I20170116000088 |
| Provider Name | Juergen Mueller |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376636043 PECOS PAC ID: 9234161589 Enrollment ID: I20170210001247 |
| Provider Name | Michele Taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730483033 PECOS PAC ID: 7911177050 Enrollment ID: I20170412000428 |
| Provider Name | Kelly Suzanne Schmidt |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1811199235 PECOS PAC ID: 8628123312 Enrollment ID: I20170612002469 |
| Provider Name | Brendon Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720490907 PECOS PAC ID: 0840518502 Enrollment ID: I20170613001526 |
| Provider Name | Jennifer J Jamrog |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1225466022 PECOS PAC ID: 1658668132 Enrollment ID: I20170616002070 |
| Provider Name | Crystal D Zomer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639598717 PECOS PAC ID: 2365711181 Enrollment ID: I20170710002161 |
| Provider Name | Austin R Johnston |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1366865149 PECOS PAC ID: 1759651870 Enrollment ID: I20170724001158 |
| Provider Name | Justin Linam |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1750727152 PECOS PAC ID: 0143590026 Enrollment ID: I20170726000739 |
| Provider Name | Timothy Joyce |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1740571777 PECOS PAC ID: 7416251798 Enrollment ID: I20170726002228 |
| Provider Name | Megan L Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730578477 PECOS PAC ID: 9739406158 Enrollment ID: I20170807002975 |
| Provider Name | Constance E Mash |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114283918 PECOS PAC ID: 6901195130 Enrollment ID: I20170823002497 |
| Provider Name | Jenna R Huff |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154565570 PECOS PAC ID: 8628212347 Enrollment ID: I20171013002538 |
| Provider Name | Kira Kitchens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699292615 PECOS PAC ID: 7012273725 Enrollment ID: I20171114001159 |
| Provider Name | Laura L Wharton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861851743 PECOS PAC ID: 7416243993 Enrollment ID: I20180105001289 |
| Provider Name | Gabor Bodonyi-kovacs |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1821288051 PECOS PAC ID: 4789757881 Enrollment ID: I20180125001321 |
| Provider Name | Edgar Alberto Trevino |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033370176 PECOS PAC ID: 4385700434 Enrollment ID: I20180212001730 |
| Provider Name | Nicole Lynn Dyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053499426 PECOS PAC ID: 8729971189 Enrollment ID: I20180213002413 |
| Provider Name | Aimee Zupicich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609377803 PECOS PAC ID: 7012279888 Enrollment ID: I20180315001724 |
| Provider Name | Edmund J Brennan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1003812660 PECOS PAC ID: 0749478683 Enrollment ID: I20180409002603 |
| Provider Name | Pamela A Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629149950 PECOS PAC ID: 3375707573 Enrollment ID: I20180413002112 |
| Provider Name | Bethany Weiler-lisowski |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1275822405 PECOS PAC ID: 9739478405 Enrollment ID: I20180614001643 |
| Provider Name | Timothy Stidham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548460504 PECOS PAC ID: 7911190475 Enrollment ID: I20180615002387 |
| Provider Name | Samantha Baker Dooley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649680893 PECOS PAC ID: 9133413651 Enrollment ID: I20180618001264 |
| Provider Name | Andrew D Craig |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336528298 PECOS PAC ID: 6204134638 Enrollment ID: I20180706000886 |
| Provider Name | Ellen M Kirschbaum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760827315 PECOS PAC ID: 6901020056 Enrollment ID: I20180706002280 |
| Provider Name | Robert E Love |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1952676157 PECOS PAC ID: 7113229543 Enrollment ID: I20180727001503 |
| Provider Name | Allie J Maffit |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639434376 PECOS PAC ID: 0446488373 Enrollment ID: I20180731002935 |
| Provider Name | Thomas A Molloy |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1023000395 PECOS PAC ID: 3678471240 Enrollment ID: I20181010002271 |
| Provider Name | Alexandria R Rutherford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528347796 PECOS PAC ID: 6204145048 Enrollment ID: I20181031003087 |
| Provider Name | Deborah Jo Fjelstrom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386605053 PECOS PAC ID: 4284661109 Enrollment ID: I20181108002107 |
| Provider Name | Erica L Case |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285889519 PECOS PAC ID: 1153483714 Enrollment ID: I20181108002233 |
| Provider Name | Lori Gerber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871002303 PECOS PAC ID: 7113262635 Enrollment ID: I20190102001819 |
| Provider Name | Julia M Muonio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720554488 PECOS PAC ID: 8628314143 Enrollment ID: I20190103002942 |
| Provider Name | Jennifer L Shipley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972752566 PECOS PAC ID: 9335394212 Enrollment ID: I20190213001675 |
| Provider Name | Claire Alexandra Steinberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417424425 PECOS PAC ID: 5092054718 Enrollment ID: I20190225001359 |
| Provider Name | Michael G Barker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811250392 PECOS PAC ID: 9234384785 Enrollment ID: I20190305001077 |
| Provider Name | Olamide J. Oladipo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1902125768 PECOS PAC ID: 2264670801 Enrollment ID: I20190306001573 |
| Provider Name | Kelley Ford Shippey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245431105 PECOS PAC ID: 0345302949 Enrollment ID: I20190312003203 |
| Provider Name | Diane Warner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497835482 PECOS PAC ID: 3779867155 Enrollment ID: I20190321003110 |
| Provider Name | Jennifer V Ting |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922276153 PECOS PAC ID: 8123179256 Enrollment ID: I20190325001031 |
| Provider Name | David Andrews |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821196825 PECOS PAC ID: 5597804377 Enrollment ID: I20190402000464 |
| Provider Name | Christie Weseman |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1225593064 PECOS PAC ID: 5698016574 Enrollment ID: I20190402000942 |
| Provider Name | Wendy Monen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467918086 PECOS PAC ID: 1456692334 Enrollment ID: I20190402001186 |
| Provider Name | Desiree Caro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104386374 PECOS PAC ID: 2365783479 Enrollment ID: I20190417001691 |
| Provider Name | Richard Zachary Betters |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285926238 PECOS PAC ID: 4688997497 Enrollment ID: I20190603001826 |
| Provider Name | Kimberly Ann Hill |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205221181 PECOS PAC ID: 6204169337 Enrollment ID: I20190605000816 |
| Provider Name | Nicholas Hamilton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811013840 PECOS PAC ID: 0143384370 Enrollment ID: I20190619000735 |
| Provider Name | Ruben Hipolito |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053761007 PECOS PAC ID: 2365776960 Enrollment ID: I20190702002200 |
| Provider Name | Verneeda Spencer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124054655 PECOS PAC ID: 9436144888 Enrollment ID: I20190722002108 |
| Provider Name | Gareth Loosle |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508252800 PECOS PAC ID: 5092043554 Enrollment ID: I20190821002543 |
| Provider Name | Sarabeth Martin |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1336466861 PECOS PAC ID: 1355657636 Enrollment ID: I20190903001880 |
| Provider Name | William Y Childs |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083648000 PECOS PAC ID: 1355395021 Enrollment ID: I20190926002481 |
| Provider Name | John T Deel |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1013116946 PECOS PAC ID: 5294822755 Enrollment ID: I20191004001992 |
| Provider Name | Joel Kavanagh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740391390 PECOS PAC ID: 7315098530 Enrollment ID: I20191010000498 |
| Provider Name | James M Mckee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669444733 PECOS PAC ID: 7810228509 Enrollment ID: I20191010001478 |
| Provider Name | Joseph C Fox |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1164867370 PECOS PAC ID: 4082960034 Enrollment ID: I20191024001352 |
| Provider Name | Erik Peltz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1669528287 PECOS PAC ID: 1759535297 Enrollment ID: I20191029002320 |
| Provider Name | Valerie E K Stine |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639514003 PECOS PAC ID: 0840591053 Enrollment ID: I20191105000121 |
| Provider Name | Daniel Hanba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497142681 PECOS PAC ID: 2062714249 Enrollment ID: I20191112001964 |
| Provider Name | Christianne Jaffe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225350879 PECOS PAC ID: 2769512540 Enrollment ID: I20191112002279 |
| Provider Name | Robert M Valleau |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720298169 PECOS PAC ID: 7810026309 Enrollment ID: I20191112003636 |
| Provider Name | Evelyn C Peterson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306809520 PECOS PAC ID: 1658467279 Enrollment ID: I20191113002220 |
| Provider Name | Hilary A Hanba |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285020263 PECOS PAC ID: 1658672423 Enrollment ID: I20191119001466 |
| Provider Name | Keelin Maire White Sweeney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659915775 PECOS PAC ID: 3173957586 Enrollment ID: I20191217003400 |
| Provider Name | Jessie Cady-kauffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962987834 PECOS PAC ID: 9537593637 Enrollment ID: I20191226000508 |
| Provider Name | Amy M Dear-ruel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396123659 PECOS PAC ID: 0749615201 Enrollment ID: I20200110002641 |
| Provider Name | Mark P Cain |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912993320 PECOS PAC ID: 1052381084 Enrollment ID: I20200115001570 |
| Provider Name | Diana Villazana-kretzer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578791190 PECOS PAC ID: 0143655837 Enrollment ID: I20200128000756 |
| Provider Name | Russell W Campbell |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1104880160 PECOS PAC ID: 7618920380 Enrollment ID: I20200226001196 |
| Provider Name | Duane D Webb |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881637742 PECOS PAC ID: 4789641044 Enrollment ID: I20200311001171 |
| Provider Name | Marian Menninger Adams |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457452740 PECOS PAC ID: 2769588722 Enrollment ID: I20200326003395 |
| Provider Name | William G Simpson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1487655346 PECOS PAC ID: 9234129313 Enrollment ID: I20200406001127 |
| Provider Name | Cindy Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891321543 PECOS PAC ID: 8628408721 Enrollment ID: I20200413002072 |
| Provider Name | Chao Li |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194981126 PECOS PAC ID: 1951567635 Enrollment ID: I20200414000519 |
| Provider Name | Brian P Bost |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013125939 PECOS PAC ID: 3173711322 Enrollment ID: I20200427002236 |
| Provider Name | Timothy S Corson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386100535 PECOS PAC ID: 1153345939 Enrollment ID: I20200521000654 |
| Provider Name | Jeremy S Bedtelyon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235340605 PECOS PAC ID: 1153475892 Enrollment ID: I20200601001198 |
| Provider Name | Jerilyn Bodey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932670866 PECOS PAC ID: 5991048993 Enrollment ID: I20200608000304 |
| Provider Name | Amelia L Durling |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790138121 PECOS PAC ID: 6800161142 Enrollment ID: I20200611001450 |
| Provider Name | Nathan C Bingham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922279512 PECOS PAC ID: 7315125911 Enrollment ID: I20200721002665 |
| Provider Name | Corey Gaul |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992230239 PECOS PAC ID: 5698030104 Enrollment ID: I20200722000267 |
| Provider Name | Geoffrey Baker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285084764 PECOS PAC ID: 8921393679 Enrollment ID: I20200722000726 |
| Provider Name | Christopher J Molloy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639426935 PECOS PAC ID: 2860785417 Enrollment ID: I20200831000580 |
| Provider Name | Wilbert Fortson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942381223 PECOS PAC ID: 6709813215 Enrollment ID: I20200902001102 |
| Provider Name | Tanya Mitchell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255861514 PECOS PAC ID: 5991074502 Enrollment ID: I20200909003280 |
| Provider Name | Ramin Jamshidi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720190408 PECOS PAC ID: 4486655792 Enrollment ID: I20200910000673 |
| Provider Name | Erin C Lauer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326493727 PECOS PAC ID: 8426346743 Enrollment ID: I20200910003565 |
| Provider Name | Emily L Hanson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1205255494 PECOS PAC ID: 6709004252 Enrollment ID: I20200915000473 |
| Provider Name | Chadwick Garner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609281807 PECOS PAC ID: 8224397807 Enrollment ID: I20200915001431 |
| Provider Name | Stella Hutchins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376074096 PECOS PAC ID: 0446678965 Enrollment ID: I20200916000563 |
| Provider Name | Walter Andrews |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700836046 PECOS PAC ID: 3971543836 Enrollment ID: I20200918001840 |
| Provider Name | Rebecca J Milligan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720540677 PECOS PAC ID: 6406274562 Enrollment ID: I20200922001730 |
| Provider Name | Chelsea Dunshee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295346823 PECOS PAC ID: 5294154514 Enrollment ID: I20201006000388 |
| Provider Name | Stefani L Tsirigotis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346785052 PECOS PAC ID: 2163707720 Enrollment ID: I20201020002691 |
| Provider Name | Maren Erpelding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619584216 PECOS PAC ID: 9234549593 Enrollment ID: I20201028000813 |
| Provider Name | Rhonda K Nitschelm |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1174655294 PECOS PAC ID: 1456762533 Enrollment ID: I20201120000847 |
| Provider Name | Daniel Paul Meigs |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700062288 PECOS PAC ID: 0840362521 Enrollment ID: I20201124001240 |
| Provider Name | Kevin Scott Carpenter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821226531 PECOS PAC ID: 1456500255 Enrollment ID: I20201204000327 |
| Provider Name | Anna Coles |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1639565005 PECOS PAC ID: 5991018335 Enrollment ID: I20201208003295 |
| Provider Name | Ginger A Jensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174895353 PECOS PAC ID: 2365760600 Enrollment ID: I20201209002358 |
| Provider Name | Laura Pierson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558992198 PECOS PAC ID: 0547672552 Enrollment ID: I20201216001809 |
| Provider Name | Taylor M Miles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043665987 PECOS PAC ID: 5890032353 Enrollment ID: I20210119001571 |
| Provider Name | Mark Barnett Johnson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740623818 PECOS PAC ID: 6305149766 Enrollment ID: I20210122000518 |
| Provider Name | Tara T Bellamkonda |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1841435211 PECOS PAC ID: 2163640319 Enrollment ID: I20210125000903 |
| Provider Name | Sue A Fessler |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1174512636 PECOS PAC ID: 7618982927 Enrollment ID: I20210211003196 |
| Provider Name | Meghan Elizabeth Degroot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215523816 PECOS PAC ID: 0749695237 Enrollment ID: I20210215001757 |
| Provider Name | Dmitry Tchapyjnikov |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740547496 PECOS PAC ID: 7214287333 Enrollment ID: I20210216002523 |
| Provider Name | Amy Queen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275026072 PECOS PAC ID: 3173874682 Enrollment ID: I20210222001770 |
| Provider Name | Scott A Alexander |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033236963 PECOS PAC ID: 8921104217 Enrollment ID: I20210224001933 |
| Provider Name | Kristin M Melli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679997548 PECOS PAC ID: 5890926232 Enrollment ID: I20210225003080 |
| Provider Name | Isaac M Bromberg |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1710957428 PECOS PAC ID: 5698703494 Enrollment ID: I20210227000155 |
| Provider Name | Nicholas Lino Fleming |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1578856779 PECOS PAC ID: 0840505566 Enrollment ID: I20210301000344 |
| Provider Name | Bradley C Linden |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1578762357 PECOS PAC ID: 7719079102 Enrollment ID: I20210302001520 |
| Provider Name | Rona L Norelius |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821103466 PECOS PAC ID: 7416126453 Enrollment ID: I20210419001752 |
| Provider Name | Andrew J Purcell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932472487 PECOS PAC ID: 3375702384 Enrollment ID: I20210428002128 |
| Provider Name | Garren M Allred |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1396106985 PECOS PAC ID: 8921416116 Enrollment ID: I20210428002276 |
| Provider Name | Clay I Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952497810 PECOS PAC ID: 4789589714 Enrollment ID: I20210503002349 |
| Provider Name | Peter E. Nielsen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669444295 PECOS PAC ID: 3577887207 Enrollment ID: I20210520001798 |
| Provider Name | Henrique Fernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174770614 PECOS PAC ID: 4789872425 Enrollment ID: I20210520001962 |
| Provider Name | Michael A Schwaller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659474666 PECOS PAC ID: 6507006103 Enrollment ID: I20210527000850 |
| Provider Name | Valerie Beebe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306866157 PECOS PAC ID: 9032518857 Enrollment ID: I20210527002937 |
| Provider Name | Kenneth J Graham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720069875 PECOS PAC ID: 0547294282 Enrollment ID: I20210601002523 |
| Provider Name | Srinivasan Kasturirangan |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1184891483 PECOS PAC ID: 1254576879 Enrollment ID: I20210604000299 |
| Provider Name | James F Cromie |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508062894 PECOS PAC ID: 1850542549 Enrollment ID: I20210618002076 |
| Provider Name | Lynn A Dykstra |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285654020 PECOS PAC ID: 1658771175 Enrollment ID: I20210621000973 |
| Provider Name | Daphne M Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427472786 PECOS PAC ID: 4587889936 Enrollment ID: I20210630002845 |
| Provider Name | William M Gilbert |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083690440 PECOS PAC ID: 9739105578 Enrollment ID: I20210706002185 |
| Provider Name | Peyton P Faganel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104311604 PECOS PAC ID: 0143622720 Enrollment ID: I20210706002692 |
| Provider Name | Victor York Levy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396824496 PECOS PAC ID: 9234154493 Enrollment ID: I20210707001005 |
| Provider Name | Ana Do |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891958310 PECOS PAC ID: 1850563040 Enrollment ID: I20210707003102 |
| Provider Name | Britni N Looper |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063670669 PECOS PAC ID: 9830332386 Enrollment ID: I20210709002586 |
| Provider Name | Tyler Hill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871957100 PECOS PAC ID: 8224311535 Enrollment ID: I20210719002027 |
| Provider Name | Joshua C Vogt |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1639433568 PECOS PAC ID: 8527204478 Enrollment ID: I20210719002711 |
| Provider Name | Tanner L Ferderer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124472964 PECOS PAC ID: 1658665302 Enrollment ID: I20210719003399 |
| Provider Name | Chelsie L Russig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225534100 PECOS PAC ID: 4981039609 Enrollment ID: I20210811003572 |
| Provider Name | Terasa L Prock |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1528288974 PECOS PAC ID: 2062661119 Enrollment ID: I20210826003359 |
| Provider Name | Kristin Allexan |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871937466 PECOS PAC ID: 2961808662 Enrollment ID: I20210903001728 |
| Provider Name | Monica Franklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932775863 PECOS PAC ID: 7911303029 Enrollment ID: I20210914003304 |
| Provider Name | Shamyne H Dumouchel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164708103 PECOS PAC ID: 9537320742 Enrollment ID: I20210915001260 |
| Provider Name | Joshua H Duchesne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154749992 PECOS PAC ID: 7012136823 Enrollment ID: I20210915003391 |
| Provider Name | Adam Spring |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023502051 PECOS PAC ID: 4880091537 Enrollment ID: I20210922001353 |
| Provider Name | Mark V Mazziotti |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1306809918 PECOS PAC ID: 6901805571 Enrollment ID: I20211005002980 |
| Provider Name | Allison R Alberton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598194342 PECOS PAC ID: 7618285891 Enrollment ID: I20211011002874 |
| Provider Name | Luis F Alberton |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1588051494 PECOS PAC ID: 9032423389 Enrollment ID: I20211012003090 |
| Provider Name | Adam Gorra |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1730260803 PECOS PAC ID: 0345419917 Enrollment ID: I20211013001943 |
| Provider Name | Joshua T Napier |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013981539 PECOS PAC ID: 2062509953 Enrollment ID: I20211019001453 |
| Provider Name | Steven Yung |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1457518128 PECOS PAC ID: 7911192786 Enrollment ID: I20211102001496 |
| Provider Name | Marni A Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154353118 PECOS PAC ID: 7618972373 Enrollment ID: I20211110000724 |
| Provider Name | Jessica Lynn Cromie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528533700 PECOS PAC ID: 8729477872 Enrollment ID: I20211111002278 |
| Provider Name | Jerrod Heermans |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1063866796 PECOS PAC ID: 6709171069 Enrollment ID: I20211202002689 |
| Provider Name | Nastastia B Han |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588254171 PECOS PAC ID: 7214327089 Enrollment ID: I20211209002121 |
| Provider Name | Kiley R Wensel |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1710522677 PECOS PAC ID: 2264822048 Enrollment ID: I20211209002893 |
| Provider Name | Jeffrey Leonard Halleck |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760825822 PECOS PAC ID: 5698996213 Enrollment ID: I20211221002852 |
| Provider Name | Timothy John Fuller |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1104153063 PECOS PAC ID: 5092137224 Enrollment ID: I20220105001993 |
| Provider Name | Stephene C Hertwig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306379607 PECOS PAC ID: 4880935998 Enrollment ID: I20220106002553 |
| Provider Name | Justin Barnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730842527 PECOS PAC ID: 4183016843 Enrollment ID: I20220110001978 |
| Provider Name | Norman E Damron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275034845 PECOS PAC ID: 1456616895 Enrollment ID: I20220112000567 |
| Provider Name | Lindsey M Jordan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205349032 PECOS PAC ID: 1951793223 Enrollment ID: I20220118001815 |
| Provider Name | Laurel I Skeek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487073813 PECOS PAC ID: 4385949882 Enrollment ID: I20220119001960 |
| Provider Name | Sylvia Rojas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851344329 PECOS PAC ID: 3870599335 Enrollment ID: I20220126002774 |
| Provider Name | Kurt A Hales |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811952617 PECOS PAC ID: 8224008834 Enrollment ID: I20220208002584 |
| Provider Name | Srinivasan Kasturirangan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184891483 PECOS PAC ID: 1254576879 Enrollment ID: I20220218000295 |
| Provider Name | Michael Marcotte |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326046889 PECOS PAC ID: 5890751457 Enrollment ID: I20220311000364 |
| Provider Name | Frederick Pascual |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821193582 PECOS PAC ID: 6507991528 Enrollment ID: I20220316003346 |
| Provider Name | Jennifer Cannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699212779 PECOS PAC ID: 9133160476 Enrollment ID: I20220317000130 |
| Provider Name | Brooke Taylor Foth |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1932850245 PECOS PAC ID: 8820484959 Enrollment ID: I20220329002600 |
| Provider Name | William Harrison Woodberry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851359400 PECOS PAC ID: 9638180334 Enrollment ID: I20220330000794 |
| Provider Name | Tanya Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598259343 PECOS PAC ID: 9436545076 Enrollment ID: I20220406002291 |
| Provider Name | Laura Sage |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093070278 PECOS PAC ID: 4587890710 Enrollment ID: I20220406003020 |
| Provider Name | Robert Mansfield |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396701389 PECOS PAC ID: 7214187376 Enrollment ID: I20220427000002 |
| Provider Name | Michael F Reidy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609950500 PECOS PAC ID: 1557363223 Enrollment ID: I20220510001670 |
| Provider Name | Anjanette Ostrom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003213745 PECOS PAC ID: 3274835798 Enrollment ID: I20220525001555 |
| Provider Name | Brenda Morris |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1154358844 PECOS PAC ID: 8325119910 Enrollment ID: I20220526001155 |
| Provider Name | Barbara Sterry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215578562 PECOS PAC ID: 5698109726 Enrollment ID: I20220601001686 |
| Provider Name | Kim M Almodovar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1831160316 PECOS PAC ID: 7618031782 Enrollment ID: I20220613000793 |
| Provider Name | Traci S Granston |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1023089075 PECOS PAC ID: 6608868948 Enrollment ID: I20220616002885 |
| Provider Name | Lauren Gary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093285884 PECOS PAC ID: 2466882857 Enrollment ID: I20220621003091 |
| Provider Name | Rodney James Sorrell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841284049 PECOS PAC ID: 4486615648 Enrollment ID: I20220622000000 |
| Provider Name | Bridgit Bell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063525426 PECOS PAC ID: 2264482868 Enrollment ID: I20220622002060 |
| Provider Name | Stephen Gregorius |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1760660062 PECOS PAC ID: 4183875420 Enrollment ID: I20220727003163 |
| Provider Name | Brie Proctor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003379868 PECOS PAC ID: 7012329956 Enrollment ID: I20220729001390 |
| Provider Name | Benjamin I Enav |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083885214 PECOS PAC ID: 0042386989 Enrollment ID: I20220810000558 |
| Provider Name | James C Mendez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578051447 PECOS PAC ID: 4688057599 Enrollment ID: I20220810000781 |
| Provider Name | Saurabh Deepak Patel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447440573 PECOS PAC ID: 4880865484 Enrollment ID: I20220810000919 |
| Provider Name | Annie Laurie Heermans |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386098465 PECOS PAC ID: 6608161963 Enrollment ID: I20220811002300 |
| Provider Name | Perry Jake Proctor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184287849 PECOS PAC ID: 6002233228 Enrollment ID: I20220812001409 |
| Provider Name | Rachel Brennan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982760989 PECOS PAC ID: 2466693080 Enrollment ID: I20220815002052 |
| Provider Name | Steven Condron |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1043423536 PECOS PAC ID: 0143390088 Enrollment ID: I20220816000388 |
| Provider Name | Jordan Vaughan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386141083 PECOS PAC ID: 5597198374 Enrollment ID: I20220816000529 |
| Provider Name | Martin Majer |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1376749234 PECOS PAC ID: 4486609476 Enrollment ID: I20220816002893 |
| Provider Name | Meghan Duvall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336765379 PECOS PAC ID: 9931582459 Enrollment ID: I20220816003795 |
| Provider Name | Amy Skeel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407410988 PECOS PAC ID: 6406267947 Enrollment ID: I20220817000248 |
| Provider Name | Jennifer Gemmill |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891938551 PECOS PAC ID: 7113175563 Enrollment ID: I20220818000681 |
| Provider Name | Nicole Sung Nghi Hoang Murray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932839172 PECOS PAC ID: 7618970344 Enrollment ID: I20220829001749 |
| Provider Name | Ahmet Sayan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508864844 PECOS PAC ID: 8921074154 Enrollment ID: I20220829002657 |
| Provider Name | Michael Cathey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952371023 PECOS PAC ID: 2163662586 Enrollment ID: I20220916003347 |
| Provider Name | Emily Kempf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346667128 PECOS PAC ID: 6305168295 Enrollment ID: I20220922001765 |
| Provider Name | Eric A Wingerson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295738797 PECOS PAC ID: 4789618679 Enrollment ID: I20220922002313 |
| Provider Name | Heather Riley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043966120 PECOS PAC ID: 4486039641 Enrollment ID: I20220923002344 |
| Provider Name | Linda Boylan-starks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447238548 PECOS PAC ID: 9234151804 Enrollment ID: I20220923002621 |
| Provider Name | Jeffrey W Watkins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053349860 PECOS PAC ID: 8123910452 Enrollment ID: I20220926002487 |
| Provider Name | Sreekanth Chintamaneni |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1427118280 PECOS PAC ID: 5597801639 Enrollment ID: I20221004003418 |
| Provider Name | Jeffrey Lull |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386207645 PECOS PAC ID: 0648608588 Enrollment ID: I20221004003659 |
| Provider Name | Shahram Javaheri |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1497861439 PECOS PAC ID: 8921080847 Enrollment ID: I20221006001534 |
| Provider Name | Rebecca Arneson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912560269 PECOS PAC ID: 5597198457 Enrollment ID: I20221006003030 |
| Provider Name | Mary Beth Dunn |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1922463009 PECOS PAC ID: 2264735042 Enrollment ID: I20221010000762 |
| Provider Name | Becky Frogge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316214307 PECOS PAC ID: 8123404431 Enrollment ID: I20221010001682 |
| Provider Name | Robert Kanard |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1073777934 PECOS PAC ID: 6204950355 Enrollment ID: I20221013000220 |
| Provider Name | John Olsen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215017132 PECOS PAC ID: 9638214117 Enrollment ID: I20221014002107 |
| Provider Name | Lauren Kathleen Cox |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619469467 PECOS PAC ID: 3375919434 Enrollment ID: I20221014002526 |
| Provider Name | Joy Tenpenny |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548440795 PECOS PAC ID: 8921284324 Enrollment ID: I20221017003128 |
| Provider Name | Lindsey Mcanear |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790114700 PECOS PAC ID: 5991171787 Enrollment ID: I20221019001953 |
| Provider Name | Lindsey M Wheatley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932601630 PECOS PAC ID: 5092070201 Enrollment ID: I20221019002030 |
| Provider Name | Nicholas Sich |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1538570338 PECOS PAC ID: 2668699919 Enrollment ID: I20221019002399 |
| Provider Name | Chase Lambrecht |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174747778 PECOS PAC ID: 6305815549 Enrollment ID: I20221020001783 |
| Provider Name | Melchor Gonzalez |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1902806151 PECOS PAC ID: 4486648672 Enrollment ID: I20221020001832 |
| Provider Name | Daniel P Davis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548204423 PECOS PAC ID: 5799810974 Enrollment ID: I20221027001237 |
| Provider Name | Sara Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912655127 PECOS PAC ID: 3375910417 Enrollment ID: I20221103000075 |
| Provider Name | Amy Cheeks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770001745 PECOS PAC ID: 9931474053 Enrollment ID: I20221109001910 |
| Provider Name | Mallory Pursley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508273590 PECOS PAC ID: 7911220579 Enrollment ID: I20221114000702 |
| Provider Name | Vatsala Ramprasad |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306936604 PECOS PAC ID: 5092089045 Enrollment ID: I20221116000298 |
| Provider Name | Richard Mcneilly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093087611 PECOS PAC ID: 0547568586 Enrollment ID: I20221129003543 |
| Provider Name | Kara Heuvelhorst |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932558962 PECOS PAC ID: 3476813346 Enrollment ID: I20221207002714 |
| Provider Name | Callie Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407159809 PECOS PAC ID: 0749410967 Enrollment ID: I20221216002448 |
| Provider Name | Worawute Supaongprapa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205913951 PECOS PAC ID: 4385638386 Enrollment ID: I20230104001212 |
| Provider Name | Kari Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134127640 PECOS PAC ID: 6002845153 Enrollment ID: I20230104002058 |
| Provider Name | Kandis Leigh Strickland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669100350 PECOS PAC ID: 8325418551 Enrollment ID: I20230105000487 |
| Provider Name | Peter Henning |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861584641 PECOS PAC ID: 7214106707 Enrollment ID: I20230106002749 |
| Provider Name | Andrew J Ziegert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770526980 PECOS PAC ID: 1355441411 Enrollment ID: I20230113001285 |
| Provider Name | Adam Michael O'toole |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1467795575 PECOS PAC ID: 4587961230 Enrollment ID: I20230127002334 |
| Provider Name | Christine Kelli Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821712944 PECOS PAC ID: 5395118095 Enrollment ID: I20230228001221 |
| Provider Name | Jamie Alice Corwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770281297 PECOS PAC ID: 5890168165 Enrollment ID: I20230307002678 |
| Provider Name | Amber Christine Keefer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477268274 PECOS PAC ID: 2163896903 Enrollment ID: I20230320000331 |
| Provider Name | Patricia Valusek |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295913457 PECOS PAC ID: 7719022920 Enrollment ID: I20230322001457 |
| Provider Name | Cheryl Burnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467019141 PECOS PAC ID: 9537578000 Enrollment ID: I20230331001179 |
| Provider Name | Brittany Sara Schoenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902446511 PECOS PAC ID: 0244605830 Enrollment ID: I20230413000609 |
| Provider Name | Kenneth Lindsey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649454257 PECOS PAC ID: 1355337999 Enrollment ID: I20230413001870 |
| Provider Name | Katrina Lee Weaver |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689804759 PECOS PAC ID: 5698912277 Enrollment ID: I20230414000853 |
| Provider Name | Michael Ring |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467455543 PECOS PAC ID: 1153310693 Enrollment ID: I20230417000435 |
| Provider Name | David Kovar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770536179 PECOS PAC ID: 9638151400 Enrollment ID: I20230518003066 |
| Provider Name | Roxanne Nicole Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881304970 PECOS PAC ID: 8426417932 Enrollment ID: I20230630002057 |
| Provider Name | Erik Jacobson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114389897 PECOS PAC ID: 2769727536 Enrollment ID: I20230703002836 |
| Provider Name | Julie Adams |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033195284 PECOS PAC ID: 2365344355 Enrollment ID: I20230705002872 |
| Provider Name | Jason Hibbard |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235491846 PECOS PAC ID: 1355700386 Enrollment ID: I20230707003166 |
| Provider Name | Clayton Vaughan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1326484403 PECOS PAC ID: 9335420488 Enrollment ID: I20230713001432 |
| Provider Name | Kelsey Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679084305 PECOS PAC ID: 9739449828 Enrollment ID: I20230727000944 |
| Provider Name | Tayler Shea Carolan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144936634 PECOS PAC ID: 9436510906 Enrollment ID: I20230731002841 |
| Provider Name | Nathaniel Fogel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1417480542 PECOS PAC ID: 4183006661 Enrollment ID: I20230802001326 |
| Provider Name | Katelyn Marsden |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891282315 PECOS PAC ID: 7113279951 Enrollment ID: I20230802003927 |
| Provider Name | Robert V Curtis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649630526 PECOS PAC ID: 9739471715 Enrollment ID: I20230807003064 |
| Provider Name | Thomas Joseph Wright |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1649624925 PECOS PAC ID: 8022374669 Enrollment ID: I20230809003375 |
| Provider Name | Stephen Kuehn |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1750317533 PECOS PAC ID: 7315911799 Enrollment ID: I20230811000371 |
| Provider Name | Maggie J Ahmad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396253704 PECOS PAC ID: 6901167006 Enrollment ID: I20230911001782 |
| Provider Name | Josephine Wright |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164884391 PECOS PAC ID: 1254697907 Enrollment ID: I20230921003375 |
| Provider Name | Ida Mays Wilson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235660663 PECOS PAC ID: 5395013510 Enrollment ID: I20230929002412 |
| Provider Name | Julie Campbell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578095808 PECOS PAC ID: 8224306378 Enrollment ID: I20231107003289 |
| Provider Name | Michael Heilman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316993546 PECOS PAC ID: 0749238806 Enrollment ID: I20231122002974 |
| Provider Name | Jonathan Lin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1578668927 PECOS PAC ID: 3375540404 Enrollment ID: I20231128002325 |
| Provider Name | Samuel Sim |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275633844 PECOS PAC ID: 8224029830 Enrollment ID: I20231206000498 |
| Provider Name | Elizabeth Jaffe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306809843 PECOS PAC ID: 7911925888 Enrollment ID: I20231211000372 |
| Provider Name | James Maxwell |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1932137213 PECOS PAC ID: 3870533110 Enrollment ID: I20231213002230 |
| Provider Name | James Novick |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184664807 PECOS PAC ID: 1456321959 Enrollment ID: I20231220001546 |
| Provider Name | Elizabeth Hemingway |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1114611944 PECOS PAC ID: 7810347523 Enrollment ID: I20231221000438 |
| Provider Name | Hannah Schorer |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1568077964 PECOS PAC ID: 9032569231 Enrollment ID: I20240101000241 |
| Provider Name | Trishia Ann Pollard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538793260 PECOS PAC ID: 6709238272 Enrollment ID: I20240119002989 |
| Provider Name | Albert Deibele |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1033151766 PECOS PAC ID: 8022919414 Enrollment ID: I20240123003037 |
| Provider Name | Douglas Berglund |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1396708418 PECOS PAC ID: 9436054038 Enrollment ID: I20240131003361 |
| Provider Name | Cory Kohm |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104368992 PECOS PAC ID: 9537512025 Enrollment ID: I20240131004335 |
| Provider Name | Kenneth Sigman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780660142 PECOS PAC ID: 5496821167 Enrollment ID: I20240219001343 |
| Provider Name | Stephanie Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457438400 PECOS PAC ID: 7911048335 Enrollment ID: I20240219003604 |
| Provider Name | Megan Shaver |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1598528713 PECOS PAC ID: 3971948472 Enrollment ID: I20240223002169 |
Logan Health Children's Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1273 Burns Way, Kalispell, MT 59901 Phone: 406-752-8300 Fax: 406-752-3542 | |
Premise Health Of Montana Medical, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 340 W Center St, Kalispell, MT 59901 Phone: 406-751-9300 Fax: 601-500-5708 | |
Ryan Chiropractic Clinic Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 690 N Meridian Rd, Ste 108, Kalispell, MT 59901 Phone: 406-755-6030 | |
Logan Health Imaging Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 310 Sunnyview Ln, Kalispell, MT 59901 Phone: 406-751-7519 Fax: 406-751-7529 | |
Glacier Neuroscience & Spine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Commons Way, Kalispell, MT 59901 Phone: 406-752-5095 Fax: 406-752-5098 | |
Logan Health Wound Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 210 Sunnyview Ln Ste 105, Kalispell, MT 59901 Phone: 406-756-4727 Fax: 406-751-7570 | |
Kalispell Regional Medical Center, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1273 Burns Way, Kalispell, MT 59901 Phone: 406-752-8300 Fax: 406-752-3542 |