| Verne Gibbs Health Center | |
|
107 H Street East Poplar MT 59255 | |
| (406) 768-3491 | |
| (406) 768-3491 |
| Full Name | Verne Gibbs Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 107 H Street East, Poplar, Montana |
| Authorized Official Name and Position | Marjorie Spotted Bird (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4067683491 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Verne Gibbs Health Center Po Box 67 Poplar MT 59255-0067 Ph: (406) 768-3491 | Verne Gibbs Health Center 107 H Street East Poplar MT 59255 Ph: (406) 768-3491 |
| NPI Number | 1972694602 |
|---|---|
| Provider Enumeration Date | 09/27/2006 |
| Last Update Date | 12/21/2023 |
| Certification Date | 09/14/2023 |
| Medicare PECOS PAC ID | 9638081623 |
|---|---|
| Medicare Enrollment ID | O20031106000399 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972694602 | NPI | - | NPPES |
| 2210068 | Medicaid | MT | |
| 000009301 | Other | MT | BC/BS OF MONTANA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
| 344600000X | Taxi | () | Secondary |
| Provider Name | David J Langford |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1255337549 PECOS PAC ID: 7719883404 Enrollment ID: I20031211001145 |
| Provider Name | David a Mark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023166840 PECOS PAC ID: 4981502010 Enrollment ID: I20031226000240 |
| Provider Name | Thomas J Schreiner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922062967 PECOS PAC ID: 8527058338 Enrollment ID: I20040513001598 |
| Provider Name | John F Calf Looking |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083774293 PECOS PAC ID: 0547248478 Enrollment ID: I20040708000727 |
| Provider Name | Stephen W Wegner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114088259 PECOS PAC ID: 8426027137 Enrollment ID: I20040929000879 |
| Provider Name | James B Whitworth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629065891 PECOS PAC ID: 6507824646 Enrollment ID: I20041221000805 |
| Provider Name | Varghese Parambi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1386645257 PECOS PAC ID: 2961498704 Enrollment ID: I20050104000993 |
| Provider Name | John W Randall |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982695524 PECOS PAC ID: 8820074156 Enrollment ID: I20050107000114 |
| Provider Name | Mark a Kearns |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841314705 PECOS PAC ID: 9335039965 Enrollment ID: I20050413000955 |
| Provider Name | Mary Clair Mcguire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386764819 PECOS PAC ID: 6103863832 Enrollment ID: I20050413000984 |
| Provider Name | Theresa C Shieh |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1912016270 PECOS PAC ID: 2769465129 Enrollment ID: I20050519000749 |
| Provider Name | Dwayne a Booth |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1427110022 PECOS PAC ID: 9335178730 Enrollment ID: I20050805000597 |
| Provider Name | Leroy a Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578527115 PECOS PAC ID: 0446223325 Enrollment ID: I20050808001065 |
| Provider Name | Samir Vinodkumar Joshi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528036787 PECOS PAC ID: 3274508874 Enrollment ID: I20050928000820 |
| Provider Name | Rosaline K Begay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134291479 PECOS PAC ID: 3274559331 Enrollment ID: I20051018000690 |
| Provider Name | Ernest J Gray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922168012 PECOS PAC ID: 8820017908 Enrollment ID: I20051117000630 |
| Provider Name | Brent M Long |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508808528 PECOS PAC ID: 6406877604 Enrollment ID: I20051215000545 |
| Provider Name | Laurel a Christians |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114933876 PECOS PAC ID: 7810965480 Enrollment ID: I20060109000822 |
| Provider Name | Keith B Johnston |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1265589402 PECOS PAC ID: 1254341795 Enrollment ID: I20060428000202 |
| Provider Name | Angel L Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164430658 PECOS PAC ID: 1153327788 Enrollment ID: I20061004000583 |
| Provider Name | David H Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205894417 PECOS PAC ID: 4688672850 Enrollment ID: I20061122000299 |
| Provider Name | Thomas E Shields |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1306955471 PECOS PAC ID: 2860491370 Enrollment ID: I20061211000535 |
| Provider Name | Cynthia C Chapman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689698722 PECOS PAC ID: 1254332901 Enrollment ID: I20070123000270 |
| Provider Name | Jennifer S Gannon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194721241 PECOS PAC ID: 7416958129 Enrollment ID: I20070124000140 |
| Provider Name | Barbara S Cohn |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003918384 PECOS PAC ID: 9335246438 Enrollment ID: I20070524000529 |
| Provider Name | Shannelle S Rico |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023078623 PECOS PAC ID: 0648231373 Enrollment ID: I20071101000703 |
| Provider Name | Mary a Gookin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104000827 PECOS PAC ID: 3476637331 Enrollment ID: I20080301000095 |
| Provider Name | Kurt S Gustavson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1225255086 PECOS PAC ID: 6305924754 Enrollment ID: I20080424000773 |
| Provider Name | Lynelle N Noisy Hawk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881894152 PECOS PAC ID: 8325127822 Enrollment ID: I20080508000803 |
| Provider Name | Sandra Beeman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003837493 PECOS PAC ID: 9739070145 Enrollment ID: I20080912000543 |
| Provider Name | Jerry L Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053574772 PECOS PAC ID: 0042388969 Enrollment ID: I20081006000298 |
| Provider Name | Duane M Chase |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992844906 PECOS PAC ID: 7719045806 Enrollment ID: I20081017000486 |
| Provider Name | Tarik Qasim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962608646 PECOS PAC ID: 1355415647 Enrollment ID: I20081203000206 |
| Provider Name | Peter a De Schweinitz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427085711 PECOS PAC ID: 1951375088 Enrollment ID: I20090327000456 |
| Provider Name | Jennifer M Lachapell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396773594 PECOS PAC ID: 6305844481 Enrollment ID: I20090514000481 |
| Provider Name | Robert M Kirk |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1922045012 PECOS PAC ID: 2264333871 Enrollment ID: I20090709000458 |
| Provider Name | Neil a Sun Rhodes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184894727 PECOS PAC ID: 6709963606 Enrollment ID: I20090728000607 |
| Provider Name | Gregory M Smith |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396758017 PECOS PAC ID: 6608920822 Enrollment ID: I20090821000258 |
| Provider Name | Thomas H Barrows |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790795342 PECOS PAC ID: 5193870889 Enrollment ID: I20090901000665 |
| Provider Name | Bella M Gentry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154598746 PECOS PAC ID: 2163578295 Enrollment ID: I20090915000450 |
| Provider Name | Nicholas J Lyons |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1619105509 PECOS PAC ID: 1456407592 Enrollment ID: I20090915000536 |
| Provider Name | Lori G Byron |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992731566 PECOS PAC ID: 2769538818 Enrollment ID: I20090915000602 |
| Provider Name | Kimberly D Studiner |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609058411 PECOS PAC ID: 0941119606 Enrollment ID: I20090930000328 |
| Provider Name | Mark T Sullivan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952393514 PECOS PAC ID: 7113063470 Enrollment ID: I20090930000456 |
| Provider Name | Erin E Neibauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760621544 PECOS PAC ID: 3375689508 Enrollment ID: I20091001000429 |
| Provider Name | Deborah L Russell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447307830 PECOS PAC ID: 0941346555 Enrollment ID: I20091013000558 |
| Provider Name | Arthur R Sakakihara-chavarria |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003050261 PECOS PAC ID: 0749326239 Enrollment ID: I20091014000523 |
| Provider Name | Joni D Renbarger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629238365 PECOS PAC ID: 1254470602 Enrollment ID: I20091125000251 |
| Provider Name | Jenaneta S Hampton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396817516 PECOS PAC ID: 2769546472 Enrollment ID: I20091202000233 |
| Provider Name | Jacqueline Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548333206 PECOS PAC ID: 7113066929 Enrollment ID: I20091207000622 |
| Provider Name | Darlene Marie Wilcox |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730412867 PECOS PAC ID: 5496880890 Enrollment ID: I20100323000789 |
| Provider Name | Michael Durant Murphy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891812921 PECOS PAC ID: 2163559063 Enrollment ID: I20100426000225 |
| Provider Name | Mary a Schneider |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1568610491 PECOS PAC ID: 2365596236 Enrollment ID: I20100510000219 |
| Provider Name | Tara L Salley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598835811 PECOS PAC ID: 1557369808 Enrollment ID: I20100519000394 |
| Provider Name | Jeffrey E Smith |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427009570 PECOS PAC ID: 7517978885 Enrollment ID: I20100615000858 |
| Provider Name | Garth E Reber |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1417029950 PECOS PAC ID: 3476687690 Enrollment ID: I20100810000507 |
| Provider Name | Mark S Cardinal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508931981 PECOS PAC ID: 0547384604 Enrollment ID: I20100826000998 |
| Provider Name | William a Calder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275605412 PECOS PAC ID: 1254455728 Enrollment ID: I20100907000202 |
| Provider Name | Paul T Downey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144537945 PECOS PAC ID: 9436275542 Enrollment ID: I20100927000712 |
| Provider Name | Peter J Arosemena |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265532907 PECOS PAC ID: 1951593102 Enrollment ID: I20101007000154 |
| Provider Name | Connie M Sherer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851352736 PECOS PAC ID: 8820016975 Enrollment ID: I20101012000423 |
| Provider Name | Mark N Pierson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508858234 PECOS PAC ID: 9234186453 Enrollment ID: I20101129001019 |
| Provider Name | Martha E Burton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497828768 PECOS PAC ID: 6901093343 Enrollment ID: I20101210000062 |
| Provider Name | Steven B. Sonntag |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215005335 PECOS PAC ID: 0143127639 Enrollment ID: I20101221001071 |
| Provider Name | Mary C Desrosier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467672287 PECOS PAC ID: 8527247956 Enrollment ID: I20110131001011 |
| Provider Name | Kendall S Flint |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154504199 PECOS PAC ID: 4082677364 Enrollment ID: I20110224000556 |
| Provider Name | Luis Millan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497068183 PECOS PAC ID: 2264619949 Enrollment ID: I20110606000594 |
| Provider Name | Hanan Fahmy |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1659387413 PECOS PAC ID: 0547274243 Enrollment ID: I20110615000491 |
| Provider Name | Kelly Jo Dalton |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1932365137 PECOS PAC ID: 2668650144 Enrollment ID: I20110705000296 |
| Provider Name | Joan Tapper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285815720 PECOS PAC ID: 0840332821 Enrollment ID: I20110720000809 |
| Provider Name | Robert P Drewelow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073760393 PECOS PAC ID: 3375714363 Enrollment ID: I20110923000162 |
| Provider Name | James Tripp |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1669776670 PECOS PAC ID: 3779741210 Enrollment ID: I20120229000884 |
| Provider Name | Robert S Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538108204 PECOS PAC ID: 3173782950 Enrollment ID: I20120314000546 |
| Provider Name | Michael F Ksycki |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194975334 PECOS PAC ID: 3971665530 Enrollment ID: I20120314000686 |
| Provider Name | Cheryl C Portwood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639246044 PECOS PAC ID: 0840394219 Enrollment ID: I20120402000260 |
| Provider Name | Elizabeth Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003183252 PECOS PAC ID: 1456512557 Enrollment ID: I20120417000726 |
| Provider Name | Jeffrey Lynn Schaffer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1124131255 PECOS PAC ID: 8921902768 Enrollment ID: I20120611000061 |
| Provider Name | Samuel C Covington |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063694461 PECOS PAC ID: 8022193267 Enrollment ID: I20120813000325 |
| Provider Name | Robert H Martin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316954860 PECOS PAC ID: 8022008143 Enrollment ID: I20120816000632 |
| Provider Name | Michael Mccormick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710069737 PECOS PAC ID: 7214184837 Enrollment ID: I20120904000186 |
| Provider Name | Lynda-marie S George |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962471847 PECOS PAC ID: 5890730063 Enrollment ID: I20120924000435 |
| Provider Name | Carmel F Bonnaig |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558331272 PECOS PAC ID: 1456337229 Enrollment ID: I20130212000156 |
| Provider Name | Charles J Mcmullin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215049788 PECOS PAC ID: 9032136270 Enrollment ID: I20130320000259 |
| Provider Name | Karen L Zoller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730357377 PECOS PAC ID: 8022195361 Enrollment ID: I20130712000607 |
| Provider Name | Brigid Morgan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1093782773 PECOS PAC ID: 2163609785 Enrollment ID: I20131206001289 |
| Provider Name | Kenneth a Freeman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750714754 PECOS PAC ID: 4284861220 Enrollment ID: I20131218001028 |
| Provider Name | Deidra C Zorn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821421728 PECOS PAC ID: 1052548948 Enrollment ID: I20131223000256 |
| Provider Name | Jose R Lopez |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922178128 PECOS PAC ID: 6901035062 Enrollment ID: I20140212001469 |
| Provider Name | Jonathan M Gilbert |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033140686 PECOS PAC ID: 6305935511 Enrollment ID: I20140225000330 |
| Provider Name | Luz E Rodriguez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649332578 PECOS PAC ID: 0143450254 Enrollment ID: I20140310001971 |
| Provider Name | Alan C Ostby |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912019951 PECOS PAC ID: 0749312734 Enrollment ID: I20140311001198 |
| Provider Name | Melanie a Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083948889 PECOS PAC ID: 0840479879 Enrollment ID: I20140327000941 |
| Provider Name | Navtejpal Singh Kahlon |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1750715777 PECOS PAC ID: 1355577958 Enrollment ID: I20140505001436 |
| Provider Name | Mary L Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174846216 PECOS PAC ID: 7214163567 Enrollment ID: I20140509001881 |
| Provider Name | Tina M Berg |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1407906381 PECOS PAC ID: 7012982077 Enrollment ID: I20140718001512 |
| Provider Name | Thomas Riney |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457341307 PECOS PAC ID: 6901863307 Enrollment ID: I20140825002357 |
| Provider Name | Laurel Matthews |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801960471 PECOS PAC ID: 0840298766 Enrollment ID: I20140915000784 |
| Provider Name | Lisa S Sun Rhodes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932495686 PECOS PAC ID: 9234376096 Enrollment ID: I20140930002298 |
| Provider Name | Tyler Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912227125 PECOS PAC ID: 9335311059 Enrollment ID: I20140930002925 |
| Provider Name | Wendy S Killham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114336351 PECOS PAC ID: 3870713001 Enrollment ID: I20141009002051 |
| Provider Name | Nipa H Sinh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073740288 PECOS PAC ID: 9335360858 Enrollment ID: I20141027002408 |
| Provider Name | Linda M Smith |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1770843252 PECOS PAC ID: 5294956470 Enrollment ID: I20141103000480 |
| Provider Name | Gabriele Knierim |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366420499 PECOS PAC ID: 7012957004 Enrollment ID: I20141112000939 |
| Provider Name | Ali Mastali |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821401258 PECOS PAC ID: 2567688179 Enrollment ID: I20141119001894 |
| Provider Name | Pauline J King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700127743 PECOS PAC ID: 3173760220 Enrollment ID: I20141125000332 |
| Provider Name | Richard P Nery |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1114101789 PECOS PAC ID: 5193047009 Enrollment ID: I20141204000315 |
| Provider Name | Kenneth Wallenfelsz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457649998 PECOS PAC ID: 0749433506 Enrollment ID: I20141230000263 |
| Provider Name | Michael R Jarvis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902845936 PECOS PAC ID: 0042283582 Enrollment ID: I20141230002098 |
| Provider Name | Sarah Cruse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861744252 PECOS PAC ID: 8426277757 Enrollment ID: I20150107001691 |
| Provider Name | Ragavan Mahadevan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194955542 PECOS PAC ID: 8820315617 Enrollment ID: I20150316000190 |
| Provider Name | Jason K Kane |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1639459068 PECOS PAC ID: 9335366285 Enrollment ID: I20150402000595 |
| Provider Name | Erin M Imeson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275818270 PECOS PAC ID: 5698933893 Enrollment ID: I20150413000249 |
| Provider Name | Kenneth H Susman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1891720645 PECOS PAC ID: 0446140784 Enrollment ID: I20150421000138 |
| Provider Name | Marie R Greenspan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184616765 PECOS PAC ID: 1850561929 Enrollment ID: I20150427000473 |
| Provider Name | Ashton Tyler Redstone |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1568868610 PECOS PAC ID: 0143549071 Enrollment ID: I20150428000092 |
| Provider Name | Janet M Thurston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235211962 PECOS PAC ID: 8628126091 Enrollment ID: I20150430000583 |
| Provider Name | Keri Sanchez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134557663 PECOS PAC ID: 3971727561 Enrollment ID: I20150504000086 |
| Provider Name | Tony Underwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558759530 PECOS PAC ID: 5496076440 Enrollment ID: I20150603001162 |
| Provider Name | Jae Dell M Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215361787 PECOS PAC ID: 8123349610 Enrollment ID: I20150609002469 |
| Provider Name | Scott L Diering |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083633465 PECOS PAC ID: 7719936988 Enrollment ID: I20150624002615 |
| Provider Name | Kyle Debenham |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225067325 PECOS PAC ID: 1759341183 Enrollment ID: I20150701000753 |
| Provider Name | Earle M Taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487607578 PECOS PAC ID: 8921001983 Enrollment ID: I20150827001584 |
| Provider Name | Pierrette Toussaint |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1396159240 PECOS PAC ID: 0749598852 Enrollment ID: I20151008002276 |
| Provider Name | Wally Jean |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1346654167 PECOS PAC ID: 4688982721 Enrollment ID: I20151009000241 |
| Provider Name | Janet L Erickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730348327 PECOS PAC ID: 7719296193 Enrollment ID: I20151026002367 |
| Provider Name | Anthony P Tranchita |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437139847 PECOS PAC ID: 1052621208 Enrollment ID: I20151030001606 |
| Provider Name | Vishal Jariwala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316209190 PECOS PAC ID: 6608184312 Enrollment ID: I20151107000004 |
| Provider Name | Urooj Saeed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710272588 PECOS PAC ID: 2163732801 Enrollment ID: I20151109000254 |
| Provider Name | Emily Dorr Mathiak |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1790047819 PECOS PAC ID: 4688820723 Enrollment ID: I20151202002667 |
| Provider Name | Catherine G Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609280833 PECOS PAC ID: 0941521124 Enrollment ID: I20151211000697 |
| Provider Name | Jade D Small |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1023304417 PECOS PAC ID: 8921232133 Enrollment ID: I20151217001334 |
| Provider Name | Rebecca Filipowicz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013319391 PECOS PAC ID: 4981905502 Enrollment ID: I20151223000873 |
| Provider Name | Basem Z Fanous |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1336173871 PECOS PAC ID: 9638194442 Enrollment ID: I20160108000378 |
| Provider Name | Rajesh a Persaud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023384179 PECOS PAC ID: 3375861057 Enrollment ID: I20160111002659 |
| Provider Name | Luke Altenhofen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1407221708 PECOS PAC ID: 2466756960 Enrollment ID: I20160203001465 |
| Provider Name | John J Shufeldt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114955440 PECOS PAC ID: 9638083215 Enrollment ID: I20160212001096 |
| Provider Name | Adnan Habib |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699088864 PECOS PAC ID: 2769618172 Enrollment ID: I20160218002287 |
| Provider Name | Brian E Reynolds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407810963 PECOS PAC ID: 6406936970 Enrollment ID: I20160223001453 |
| Provider Name | Thu K Tran |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1225479918 PECOS PAC ID: 1355646761 Enrollment ID: I20160223001974 |
| Provider Name | Katherine Garnett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033471842 PECOS PAC ID: 5799081832 Enrollment ID: I20160315002700 |
| Provider Name | Lindsey a Gauderer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477936961 PECOS PAC ID: 2769788777 Enrollment ID: I20160316001963 |
| Provider Name | Peter Erigoyen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013997667 PECOS PAC ID: 8527037167 Enrollment ID: I20160419000568 |
| Provider Name | Wesley Lewis |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1386873180 PECOS PAC ID: 3577602697 Enrollment ID: I20160513000458 |
| Provider Name | Dhakshayani Sundaralingam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942289780 PECOS PAC ID: 5890753107 Enrollment ID: I20160525000732 |
| Provider Name | Mary E Pauzauskie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184675399 PECOS PAC ID: 6305899600 Enrollment ID: I20160707001004 |
| Provider Name | Shelley P Rickett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437510807 PECOS PAC ID: 2961628326 Enrollment ID: I20161203000128 |
| Provider Name | Melissa S Kuntz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831565423 PECOS PAC ID: 6103127584 Enrollment ID: I20161209000380 |
| Provider Name | Kayla S Mckinney |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346798840 PECOS PAC ID: 8325328297 Enrollment ID: I20161212000528 |
| Provider Name | Elisadel Figueroa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154725273 PECOS PAC ID: 8325321367 Enrollment ID: I20170216002245 |
| Provider Name | Christina M Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265980544 PECOS PAC ID: 6800179797 Enrollment ID: I20170221000028 |
| Provider Name | Stacy L Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740510528 PECOS PAC ID: 6204073737 Enrollment ID: I20170412001763 |
| Provider Name | Lori Flis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154457117 PECOS PAC ID: 1759464548 Enrollment ID: I20170419002641 |
| Provider Name | Richard J Donlick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528238987 PECOS PAC ID: 4486817186 Enrollment ID: I20170420002029 |
| Provider Name | Angelia M Frederick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518409887 PECOS PAC ID: 1658648423 Enrollment ID: I20170526000215 |
| Provider Name | Shelley J Butler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619493657 PECOS PAC ID: 9436417268 Enrollment ID: I20171227000944 |
| Provider Name | Georgia Matt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386952190 PECOS PAC ID: 5991064099 Enrollment ID: I20180118000787 |
| Provider Name | Pierre G Latortue |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1962926980 PECOS PAC ID: 7911266754 Enrollment ID: I20180124000308 |
| Provider Name | Anh T Pham |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609325711 PECOS PAC ID: 5193086106 Enrollment ID: I20180307001194 |
| Provider Name | Robert L Holman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225083587 PECOS PAC ID: 7517919095 Enrollment ID: I20180308002306 |
| Provider Name | Jon Sands Tyrell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033129945 PECOS PAC ID: 2264565449 Enrollment ID: I20180402000500 |
| Provider Name | Jin Ping Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770981839 PECOS PAC ID: 8729343702 Enrollment ID: I20180522000394 |
| Provider Name | Tara Van Drunen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598787442 PECOS PAC ID: 1557685757 Enrollment ID: I20180713000476 |
| Provider Name | Queenta E Teko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114451937 PECOS PAC ID: 5698022135 Enrollment ID: I20180716001637 |
| Provider Name | Farah Lazarre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699264663 PECOS PAC ID: 0446501332 Enrollment ID: I20180914001212 |
| Provider Name | Caroline Fichter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124534235 PECOS PAC ID: 9537410477 Enrollment ID: I20180917000977 |
| Provider Name | Alfonso Torres Garcia |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1992714190 PECOS PAC ID: 1850549692 Enrollment ID: I20180917001792 |
| Provider Name | Michelle Ligonde-merisio |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1023109931 PECOS PAC ID: 5799885588 Enrollment ID: I20180920002188 |
| Provider Name | Mark Krich |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144238767 PECOS PAC ID: 4789585985 Enrollment ID: I20180924000921 |
| Provider Name | Charmaine G Etienne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114461902 PECOS PAC ID: 0648521039 Enrollment ID: I20180925000213 |
| Provider Name | Erin R Gockel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548740368 PECOS PAC ID: 2466703871 Enrollment ID: I20180925001201 |
| Provider Name | Christopher Q May |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073847695 PECOS PAC ID: 6204951544 Enrollment ID: I20181016000608 |
| Provider Name | Pablo a Serrano-lopez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1730598004 PECOS PAC ID: 8022316306 Enrollment ID: I20181030000370 |
| Provider Name | Ashley Akhter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134570245 PECOS PAC ID: 7315219144 Enrollment ID: I20181108001580 |
| Provider Name | Marjorie P Turner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447565635 PECOS PAC ID: 8123372695 Enrollment ID: I20181120000383 |
| Provider Name | Sandra Wilson |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1235348962 PECOS PAC ID: 4587989033 Enrollment ID: I20181130000481 |
| Provider Name | Kim L Wilde |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891744140 PECOS PAC ID: 3375686173 Enrollment ID: I20190123000471 |
| Provider Name | Nicholas Patrick Sheridan |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1144209917 PECOS PAC ID: 4880931922 Enrollment ID: I20190128000490 |
| Provider Name | Kyle J Baker |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1780171298 PECOS PAC ID: 1951649045 Enrollment ID: I20190215000123 |
| Provider Name | William P Lunger |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1285073684 PECOS PAC ID: 4183957418 Enrollment ID: I20190531000719 |
| Provider Name | James Gabriel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821450784 PECOS PAC ID: 4587957675 Enrollment ID: I20190724001635 |
| Provider Name | Marc D Mclaughlin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164726766 PECOS PAC ID: 2860671666 Enrollment ID: I20190923001237 |
| Provider Name | Ming T Lin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427088947 PECOS PAC ID: 9133186125 Enrollment ID: I20200124000272 |
| Provider Name | Raichell Lynn Dorland-roan |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1568841658 PECOS PAC ID: 4880915735 Enrollment ID: I20200303000184 |
| Provider Name | Matthew T Graf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215374905 PECOS PAC ID: 2163743337 Enrollment ID: I20200303000781 |
| Provider Name | Louisa Benson Mook |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710229810 PECOS PAC ID: 6901126036 Enrollment ID: I20200303002015 |
| Provider Name | Sarah E Hardwick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053973198 PECOS PAC ID: 3173951951 Enrollment ID: I20200309001749 |
| Provider Name | Jun He |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376704213 PECOS PAC ID: 1557537412 Enrollment ID: I20200323000401 |
| Provider Name | Himabindu Borra |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1710936596 PECOS PAC ID: 4981848983 Enrollment ID: I20200327002098 |
| Provider Name | Nisha J Manek |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1437139151 PECOS PAC ID: 4486798097 Enrollment ID: I20200401001340 |
| Provider Name | Janet L Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205137270 PECOS PAC ID: 1850587254 Enrollment ID: I20200406002566 |
| Provider Name | Peter J Lloyd |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1962717918 PECOS PAC ID: 2769775568 Enrollment ID: I20200407003506 |
| Provider Name | Alexis Gadwah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891263877 PECOS PAC ID: 7113349820 Enrollment ID: I20200626000003 |
| Provider Name | Conor Daniel Cahalan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1588273338 PECOS PAC ID: 1557786340 Enrollment ID: I20200811001446 |
| Provider Name | Vikram S Shankar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821443276 PECOS PAC ID: 5294154894 Enrollment ID: I20201001000468 |
| Provider Name | Meeri Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467081513 PECOS PAC ID: 9739590068 Enrollment ID: I20201118000100 |
| Provider Name | Sumita Mehta |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1568768828 PECOS PAC ID: 8426234493 Enrollment ID: I20201222000313 |
| Provider Name | John a Gnassi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629066105 PECOS PAC ID: 2365488715 Enrollment ID: I20210119001789 |
| Provider Name | Mitchell J Relf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245886746 PECOS PAC ID: 0446664106 Enrollment ID: I20210121000799 |
| Provider Name | Kenna Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073167953 PECOS PAC ID: 3173937844 Enrollment ID: I20210121001245 |
| Provider Name | Collin Block |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982231510 PECOS PAC ID: 2567886575 Enrollment ID: I20210202002537 |
| Provider Name | Davida Hemmy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053724351 PECOS PAC ID: 7416172556 Enrollment ID: I20210429002729 |
| Provider Name | Kimberly Hanners |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962057166 PECOS PAC ID: 2961804018 Enrollment ID: I20210712002440 |
| Provider Name | Zean Chen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871090670 PECOS PAC ID: 1052717592 Enrollment ID: I20210916002460 |
| Provider Name | Mary Elizabeth Braham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508176694 PECOS PAC ID: 9638497944 Enrollment ID: I20211115000295 |
| Provider Name | Evan Scott |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669735494 PECOS PAC ID: 1052603107 Enrollment ID: I20211117000889 |
| Provider Name | James B Levenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548726003 PECOS PAC ID: 0143551804 Enrollment ID: I20220304001080 |
| Provider Name | Adrienne Highhouse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609459106 PECOS PAC ID: 0941694905 Enrollment ID: I20220308002267 |
| Provider Name | Richard Esham |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1801221601 PECOS PAC ID: 9638472459 Enrollment ID: I20220317000143 |
| Provider Name | Hannah a Sexton |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942376595 PECOS PAC ID: 5395747547 Enrollment ID: I20220321000029 |
| Provider Name | Nicole C Gore |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1710208079 PECOS PAC ID: 9537341169 Enrollment ID: I20220329000598 |
| Provider Name | Deborah Obryan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033151824 PECOS PAC ID: 7012067002 Enrollment ID: I20220330001196 |
| Provider Name | Jeffrey Yellow Owl |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629436639 PECOS PAC ID: 2961898945 Enrollment ID: I20220330001901 |
| Provider Name | Sara Lynn Bonanini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801275037 PECOS PAC ID: 1759777634 Enrollment ID: I20220331002604 |
| Provider Name | Amanda Marie Sipp |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1730442765 PECOS PAC ID: 0143563163 Enrollment ID: I20220414000720 |
| Provider Name | Amy Fleck |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1598712515 PECOS PAC ID: 4385646694 Enrollment ID: I20220419000181 |
| Provider Name | Andrew J Langfield |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952835092 PECOS PAC ID: 2466879358 Enrollment ID: I20220503000127 |
| Provider Name | Robert Eugene Roe |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528173630 PECOS PAC ID: 2264588581 Enrollment ID: I20220510002154 |
| Provider Name | Elena K Phoutrides |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093149429 PECOS PAC ID: 2466877758 Enrollment ID: I20220517000025 |
| Provider Name | Michelle Daya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790120343 PECOS PAC ID: 4981820123 Enrollment ID: I20220520000683 |
| Provider Name | Sandra Bailey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396772067 PECOS PAC ID: 4880697499 Enrollment ID: I20220526000445 |
| Provider Name | James L Kuhn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033775176 PECOS PAC ID: 2769864388 Enrollment ID: I20220728003648 |
| Provider Name | Michael Jones |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215956768 PECOS PAC ID: 3971674862 Enrollment ID: I20220805001710 |
| Provider Name | Lisa M Scheresky Oneil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821585209 PECOS PAC ID: 4284016155 Enrollment ID: I20220809002879 |
| Provider Name | Tiffani F Methvien |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1093368854 PECOS PAC ID: 7012245210 Enrollment ID: I20220812000385 |
| Provider Name | James M Cowan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598207862 PECOS PAC ID: 8729499561 Enrollment ID: I20220812001587 |
| Provider Name | Sophie Baxter |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972961266 PECOS PAC ID: 6204133416 Enrollment ID: I20220820000226 |
| Provider Name | Trevor Quandt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346852068 PECOS PAC ID: 9739562927 Enrollment ID: I20220822001169 |
| Provider Name | Amy a Pittman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972567600 PECOS PAC ID: 8628013380 Enrollment ID: I20220906000729 |
| Provider Name | Kayla Janae Luhrs |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538429964 PECOS PAC ID: 9638312705 Enrollment ID: I20220926002013 |
| Provider Name | David Charles Randall |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1952842742 PECOS PAC ID: 3476899519 Enrollment ID: I20221013003382 |
| Provider Name | Paul S Strait |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821054651 PECOS PAC ID: 4284994328 Enrollment ID: I20221108000323 |
| Provider Name | Paul Llobet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518020502 PECOS PAC ID: 5193826543 Enrollment ID: I20221122002185 |
| Provider Name | Lawrence Kent Harrington |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1689662454 PECOS PAC ID: 1951770189 Enrollment ID: I20221212000286 |
| Provider Name | Hannah M Huddleston |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1023285335 PECOS PAC ID: 1951479773 Enrollment ID: I20221221002494 |
| Provider Name | Mintoria Lynette Stockton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316561178 PECOS PAC ID: 6002225927 Enrollment ID: I20230119000264 |
| Provider Name | Shyam Kumar R Injety |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063886984 PECOS PAC ID: 1456650167 Enrollment ID: I20230203002360 |
| Provider Name | Arthur F Wang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548498751 PECOS PAC ID: 0244496966 Enrollment ID: I20230215000885 |
| Provider Name | Sheila Middagh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164076741 PECOS PAC ID: 7618206756 Enrollment ID: I20230221001861 |
| Provider Name | Ronald Browne |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154511046 PECOS PAC ID: 3274626882 Enrollment ID: I20230221002176 |
| Provider Name | Augustine Alifo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114926375 PECOS PAC ID: 8729077151 Enrollment ID: I20230309001047 |
| Provider Name | Yoldez a Meroueh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578096723 PECOS PAC ID: 7315298569 Enrollment ID: I20230314000287 |
| Provider Name | Paul M Castle |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265095236 PECOS PAC ID: 2163757550 Enrollment ID: I20230320000376 |
| Provider Name | Maria Kofas |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1154860013 PECOS PAC ID: 4688048341 Enrollment ID: I20230320001363 |
| Provider Name | Derek V Chan |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1932488574 PECOS PAC ID: 9032346200 Enrollment ID: I20230329000461 |
| Provider Name | Alyssa R Hartman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215571146 PECOS PAC ID: 1355762675 Enrollment ID: I20230428000245 |
| Provider Name | Kelly Donnelly Mueller |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932369923 PECOS PAC ID: 3375778723 Enrollment ID: I20230506000104 |
| Provider Name | Thomas M Doran |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881004489 PECOS PAC ID: 4183948953 Enrollment ID: I20230516000512 |
| Provider Name | Kathy Robison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366195083 PECOS PAC ID: 4082073432 Enrollment ID: I20230705000010 |
| Provider Name | Fatoumatta Sissoho |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518452556 PECOS PAC ID: 5597011270 Enrollment ID: I20230815003068 |
| Provider Name | Linda G Clark |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659390029 PECOS PAC ID: 6002908167 Enrollment ID: I20230816000020 |
| Provider Name | Rosaly Cartagena |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841737400 PECOS PAC ID: 9931561230 Enrollment ID: I20230818000686 |
| Provider Name | Theodore C Weatherwax |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144882879 PECOS PAC ID: 3577894096 Enrollment ID: I20230823001878 |
| Provider Name | Sosena Kebede |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790780195 PECOS PAC ID: 5991843914 Enrollment ID: I20230907000969 |
| Provider Name | Karen Kennedy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932175734 PECOS PAC ID: 3577501188 Enrollment ID: I20230919002868 |
| Provider Name | Kate Teresa Brizzi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659664373 PECOS PAC ID: 7517129208 Enrollment ID: I20231007000658 |
| Provider Name | Joseph Ciano |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871944843 PECOS PAC ID: 7113252214 Enrollment ID: I20231021000068 |
| Provider Name | David D Beversluis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326363789 PECOS PAC ID: 3476710252 Enrollment ID: I20231104000054 |
| Provider Name | Wesley a Johnson |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1467867895 PECOS PAC ID: 9931495090 Enrollment ID: I20231106001374 |
| Provider Name | Steven Joseph Bachini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720392210 PECOS PAC ID: 5597112037 Enrollment ID: I20231106001811 |
| Provider Name | Kevin Jenkins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164783452 PECOS PAC ID: 6507175684 Enrollment ID: I20231108000297 |
| Provider Name | Jeffrey S Kennedy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063450369 PECOS PAC ID: 2466606850 Enrollment ID: I20231108002638 |
| Provider Name | Tiffany Stensvad |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1770034472 PECOS PAC ID: 0547549529 Enrollment ID: I20231115000106 |
| Provider Name | Ryan Christopher Upham |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1720330442 PECOS PAC ID: 0042464174 Enrollment ID: I20231130001320 |
| Provider Name | Nathaniel Rieb |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508068834 PECOS PAC ID: 9234324179 Enrollment ID: I20231204001705 |
| Provider Name | Nadia Boulghassoul-pietrzykowska |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346401528 PECOS PAC ID: 8224296157 Enrollment ID: I20231206000639 |
| Provider Name | Barbara Lee |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1306958566 PECOS PAC ID: 7214095231 Enrollment ID: I20231212000101 |
| Provider Name | Bethany Helm |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235605999 PECOS PAC ID: 2567702616 Enrollment ID: I20240102001315 |
| Provider Name | Stephen Noe |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881605368 PECOS PAC ID: 1052585809 Enrollment ID: I20240109000351 |
| Provider Name | Oleg V Sinyavskiy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316177157 PECOS PAC ID: 6901038298 Enrollment ID: I20240110004687 |
| Provider Name | Jennifer Rosanna Hill |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1063545333 PECOS PAC ID: 8921451642 Enrollment ID: I20240130001430 |
| Provider Name | David Evan Mccracken |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1013327618 PECOS PAC ID: 6406299635 Enrollment ID: I20240205003342 |
| Provider Name | Leila Abidi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093449902 PECOS PAC ID: 5890138721 Enrollment ID: I20240208000560 |
| Provider Name | Julia Blanks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497481576 PECOS PAC ID: 1254774896 Enrollment ID: I20240209003391 |
| Provider Name | Robert Eric Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306037445 PECOS PAC ID: 5395145288 Enrollment ID: I20240212002020 |
| Provider Name | Eugene R. Aquino |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952663122 PECOS PAC ID: 6800041104 Enrollment ID: I20240212002346 |
| Provider Name | Jimmy Gray |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437191699 PECOS PAC ID: 6204893480 Enrollment ID: I20240305002652 |
| Provider Name | Chelsae L May |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1174144810 PECOS PAC ID: 4284046830 Enrollment ID: I20240305002744 |
| Provider Name | Anne Ruggles Pariser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003487687 PECOS PAC ID: 6103263314 Enrollment ID: I20240325000127 |
| Provider Name | Byron V Etta |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174971402 PECOS PAC ID: 2961804067 Enrollment ID: I20240409003099 |
| Provider Name | Anna Vertkin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346579364 PECOS PAC ID: 4587672910 Enrollment ID: I20240419002228 |
| Provider Name | Jean M Ehrhardt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720264294 PECOS PAC ID: 0244309979 Enrollment ID: I20240422001596 |
| Provider Name | Linda M Unger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992336440 PECOS PAC ID: 9739500406 Enrollment ID: I20240503001649 |
| Provider Name | Sylvia F Longknife |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942490511 PECOS PAC ID: 5991247231 Enrollment ID: I20240603000975 |
| Provider Name | Joy Williams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912959404 PECOS PAC ID: 4981672268 Enrollment ID: I20240705002973 |
| Provider Name | Douglas Crosby |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548207707 PECOS PAC ID: 9638134208 Enrollment ID: I20240708004164 |
| Provider Name | Tyler Hoyt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558955690 PECOS PAC ID: 3870901440 Enrollment ID: I20240717004221 |
| Provider Name | Holly M Teng |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932737244 PECOS PAC ID: 8325460512 Enrollment ID: I20250122002382 |
| Provider Name | Norman G Kruedelbach |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306044466 PECOS PAC ID: 9133202575 Enrollment ID: I20250123001744 |
| Provider Name | John a Giglio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528130036 PECOS PAC ID: 7416024120 Enrollment ID: I20250128003404 |
| Provider Name | Bradley Opitz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1588411037 PECOS PAC ID: 6800325283 Enrollment ID: I20250130000856 |
| Provider Name | Rebecca a Shriver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538376397 PECOS PAC ID: 0345770194 Enrollment ID: I20250207002313 |
| Provider Name | Sureka B Reddy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427256528 PECOS PAC ID: 6103014360 Enrollment ID: I20250219000347 |
| Provider Name | Christopher D Milan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477529782 PECOS PAC ID: 1658408273 Enrollment ID: I20250221003062 |
| Provider Name | Mark Molnar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548618036 PECOS PAC ID: 5597057448 Enrollment ID: I20250228002222 |
| Provider Name | Maudeen Cassandra Scott |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396149464 PECOS PAC ID: 0840503470 Enrollment ID: I20250228002338 |
| Provider Name | Gerald B Pevow |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1558611087 PECOS PAC ID: 5890089585 Enrollment ID: I20250321003124 |
| Provider Name | Bilal Sadiq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225529894 PECOS PAC ID: 8527315233 Enrollment ID: I20250328001677 |
| Provider Name | Victoria Kou |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972541621 PECOS PAC ID: 8022038165 Enrollment ID: I20250401000911 |
| Provider Name | Charles Kaczmarski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1285280701 PECOS PAC ID: 0143232405 Enrollment ID: I20250408002924 |
| Provider Name | Kara Heist Francis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962081919 PECOS PAC ID: 8527449487 Enrollment ID: I20250411002097 |
| Provider Name | Danton Schudlich |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669644290 PECOS PAC ID: 0446570667 Enrollment ID: I20250411002987 |
| Provider Name | Olakunle Folorunso |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1336634484 PECOS PAC ID: 8325396575 Enrollment ID: I20250417000757 |
| Provider Name | Mandy R Blume |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134378433 PECOS PAC ID: 0244395168 Enrollment ID: I20250417001833 |
| Provider Name | Molly West Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275776080 PECOS PAC ID: 9032018981 Enrollment ID: I20250424000885 |
| Provider Name | Adam a Levine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124127063 PECOS PAC ID: 0941244032 Enrollment ID: I20250505001295 |
| Provider Name | Alfred J Holm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326123555 PECOS PAC ID: 4789580333 Enrollment ID: I20250516001012 |
| Provider Name | Lisa Ann Kelty |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649210808 PECOS PAC ID: 7113207804 Enrollment ID: I20250527000526 |
| Provider Name | Megan Cole Rogers |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235713934 PECOS PAC ID: 3072908706 Enrollment ID: I20250618000237 |
| Provider Name | Shawn P Thurston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326883273 PECOS PAC ID: 0749714715 Enrollment ID: I20250714001123 |
| Provider Name | Rebecca Nicole Stacey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1215406897 PECOS PAC ID: 6901144047 Enrollment ID: I20250715000139 |
| Provider Name | Scott R Cheever |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1376522953 PECOS PAC ID: 5092218958 Enrollment ID: I20250915002996 |
| Provider Name | Kate Hellenga |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881982650 PECOS PAC ID: 3072017839 Enrollment ID: I20250916003158 |
| Provider Name | John S Paige |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1003897950 PECOS PAC ID: 0345542205 Enrollment ID: I20250925001551 |
| Provider Name | Carl Harris |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1326000548 PECOS PAC ID: 8628964749 Enrollment ID: I20250929000959 |
| Provider Name | Jason Lasry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205940756 PECOS PAC ID: 7810890720 Enrollment ID: I20251021000150 |
| Provider Name | Jany E Marques Youngs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003610619 PECOS PAC ID: 6103317821 Enrollment ID: I20251111001361 |
| Provider Name | Quetcy Oquendo De Los Santos |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952616252 PECOS PAC ID: 9436300191 Enrollment ID: I20251111001539 |
| Provider Name | Jake Dodge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114410784 PECOS PAC ID: 0840540621 Enrollment ID: I20251111001554 |
| Provider Name | Ginger G Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851926968 PECOS PAC ID: 2163851676 Enrollment ID: I20251112002732 |
| Provider Name | Andre T Creese |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689670135 PECOS PAC ID: 9335137736 Enrollment ID: I20251113003061 |
| Provider Name | Dumbuos Asigri |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1477927713 PECOS PAC ID: 1456843739 Enrollment ID: I20251124003376 |
| Provider Name | Robert Matthew Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316460256 PECOS PAC ID: 0143594309 Enrollment ID: I20251126001821 |
| Provider Name | April Olsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972945228 PECOS PAC ID: 5193952950 Enrollment ID: I20251230004137 |
| Provider Name | Sheryl Helena Holmes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962087361 PECOS PAC ID: 0042796088 Enrollment ID: I20260109001392 |
| Provider Name | Scott M Doherty |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689075889 PECOS PAC ID: 0446472401 Enrollment ID: I20260115000907 |
| Provider Name | Erin M Davis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528544293 PECOS PAC ID: 2961988332 Enrollment ID: I20260115002190 |
| Provider Name | Eric C Chenworth |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1700859907 PECOS PAC ID: 0446164313 Enrollment ID: I20260116000438 |
| Provider Name | Luis Emilio Gomez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134168636 PECOS PAC ID: 6608837273 Enrollment ID: I20260204000275 |
| Provider Name | Kristi a Mahlmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215568357 PECOS PAC ID: 4284062241 Enrollment ID: I20260219001538 |
| Provider Name | Dwayne Chance |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508121567 PECOS PAC ID: 6608004825 Enrollment ID: I20260220003916 |
| Provider Name | Ryan Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447879259 PECOS PAC ID: 5597178988 Enrollment ID: I20260319000158 |
| Provider Name | Juliann Mendes |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1972036234 PECOS PAC ID: 9739540048 Enrollment ID: I20260327002105 |
| Provider Name | Asha Choudhury |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053873695 PECOS PAC ID: 5193129112 Enrollment ID: I20260415004104 |
| Provider Name | Matthew Tripp |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326255621 PECOS PAC ID: 3577662832 Enrollment ID: I20260505001498 |
| Provider Name | Susan Turner |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1013753425 PECOS PAC ID: 7618449638 Enrollment ID: I20260610003536 |
| Provider Name | Robert F Boll |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548217466 PECOS PAC ID: 5799750303 Enrollment ID: I20260615000091 |
| Provider Name | Arlene Page |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1265787832 PECOS PAC ID: 9234387168 Enrollment ID: I20260615000306 |
Riverside Family Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 209 H St East, Poplar, MT 59255 Phone: 406-768-5171 Fax: 406-768-6161 |