npi string | ind_pac_id string | ind_enrl_id string | provider_last_name string | provider_first_name string | provider_middle_name string | suff string | gndr string | cred string | med_sch string | grd_yr string | pri_spec string | sec_spec_1 string | sec_spec_2 string | sec_spec_3 string | sec_spec_4 string | sec_spec_all string | telehlth string | facility_name string | org_pac_id string | num_org_mem string | adr_ln_1 string | adr_ln_2 string | ln_2_sprs string | city_town string | state string | zip_code string | telephone_number string | ind_assgn string | grp_assgn string | adrs_id string |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1003000126 | 7517003643 | I20130530000085 | ENKESHAFI | ARDALAN | null | null | M | MD | OTHER | 1994 | HOSPITALIST | INTERNAL MEDICINE | null | null | null | INTERNAL MEDICINE | null | MEDICAL FACULTY ASSOCIATES, INC | 4082528898 | 672 | 1200 PECAN ST SE | null | null | WASHINGTON | DC | 200322652 | 7714446200 | Y | Y | DC200322652WA1200XSEXX400 |
1003000142 | 9931380672 | I20110801000609 | KHALIL | RASHID | null | null | M | MD | OTHER | 1999 | ANESTHESIOLOGY | null | null | null | null | null | null | MERCY HEALTH PHYSICIANS NORTH SPECIALTY CARE LLC | 1951707884 | 355 | 1360 ARROWHEAD DR | null | null | MAUMEE | OH | 435371728 | null | Y | Y | OH435371728MA1360XDRXX300 |
1003000142 | 9931380672 | I20260305001411 | KHALIL | RASHID | null | null | M | MD | OTHER | 1999 | ANESTHESIOLOGY | PAIN MANAGEMENT | null | null | null | PAIN MANAGEMENT | null | PREMIER PAIN CENTERS PA | 8426312646 | 12 | 2071 N COLLINS BLVD | SUITE 100 | null | RICHARDSON | TX | 750802696 | 4695624188 | Y | Y | TX750802696RI2071XBLVD401 |
1003000142 | 9931380672 | I20110801000609 | KHALIL | RASHID | null | null | M | MD | OTHER | 1999 | ANESTHESIOLOGY | null | null | null | null | null | null | MERCY HEALTH PHYSICIANS NORTH SPECIALTY CARE LLC | 1951707884 | 355 | 2600 NAVARRE AVE | null | null | OREGON | OH | 436163207 | null | Y | Y | OH436163207OR2600XAVEX300 |
1003000142 | 9931380672 | I20110801000609 | KHALIL | RASHID | null | null | M | MD | OTHER | 1999 | ANESTHESIOLOGY | null | null | null | null | null | null | MERCY HEALTH PHYSICIANS NORTH SPECIALTY CARE LLC | 1951707884 | 355 | 3900 SUNFOREST CT | SUITE 240 | null | TOLEDO | OH | 436234481 | 4194751600 | Y | Y | OH436234481TO3900XCTXX301 |
1003000142 | 9931380672 | I20120405000290 | KHALIL | RASHID | null | null | M | MD | OTHER | 1999 | ANESTHESIOLOGY | PAIN MANAGEMENT | null | null | null | PAIN MANAGEMENT | null | UNIVERSITY PAIN CLINIC ASSOCIATES PLLC | 3870894892 | 7 | 4160 JOHN R ST | SUITE 522 | null | DETROIT | MI | 482012021 | 3137451293 | Y | Y | MI482012021DE4160XSTXX405 |
1003000423 | 9133397268 | I20110715000515 | VELOTTA | JENNIFER | A | null | F | MD | TOLEDO MEDICAL COLLEGE | 2007 | OBSTETRICS/GYNECOLOGY | null | null | null | null | null | null | LAKE OBSTETRICS AND GYNECOLOGY, INC | 5799794350 | 6 | 9500 MENTOR AVE | SUITE 220 | null | MENTOR | OH | 440608714 | 4403577100 | Y | Y | OH440608714ME9500XAVEX302 |
1003000480 | 0446348254 | I20071113000017 | ROTHCHILD | KEVIN | B | null | M | MD | OHIO STATE UNIVERSITY COLLEGE OF MEDICINE | 1997 | GENERAL SURGERY | null | null | null | null | null | null | UNIVERSITY PHYSICIANS INCORPORATED | 3476465667 | 3215 | 12605 E 16TH AVE | UCHEALTH ANSCHUTZ MEDICAL CAMPUS | null | AURORA | CO | 800452545 | 7208480000 | Y | Y | CO800452545AU12605AVEX413 |
1003000480 | 0446348254 | I20071113000017 | ROTHCHILD | KEVIN | B | null | M | MD | OHIO STATE UNIVERSITY COLLEGE OF MEDICINE | 1997 | GENERAL SURGERY | null | null | null | null | null | null | UNIVERSITY PHYSICIANS INCORPORATED | 3476465667 | 3215 | 13123 E 16TH AVE | null | Y | AURORA | CO | 800457106 | 7207771234 | Y | Y | CO800457106AU13123AVEX400 |
1003000480 | 0446348254 | I20071113000017 | ROTHCHILD | KEVIN | B | null | M | MD | OHIO STATE UNIVERSITY COLLEGE OF MEDICINE | 1997 | GENERAL SURGERY | null | null | null | null | null | null | UNIVERSITY PHYSICIANS INCORPORATED | 3476465667 | 3215 | 1635 AURORA CT | null | null | AURORA | CO | 800452541 | 7208480000 | Y | Y | CO800452541AU1635XCTXX300 |
1003000530 | 2163575663 | I20090731000112 | SEMONCHE | AMANDA | M | null | F | DO | LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE | 2006 | INTERNAL MEDICINE | null | null | null | null | null | Y | ST LUKES PHYSICIAN GROUP INC | 6709798333 | 2198 | 1021 PARK AVE | null | Y | QUAKERTOWN | PA | 189511573 | 2155384690 | Y | Y | PA189511573QU1021XAVEX300 |
1003000597 | 4082848189 | I20131003000105 | KIM | DAE | null | null | M | MD | STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE | 2007 | UROLOGY | GENERAL SURGERY | null | null | null | GENERAL SURGERY | null | CREEK NATION HOSPITAL AND CLINICS | 5698786226 | 365 | 1101 S BELMONT AVE | null | null | OKMULGEE | OK | 744476315 | null | Y | Y | OK744476315OK1101XAVEX400 |
1003000597 | 4082848189 | I20131003000105 | KIM | DAE | null | null | M | MD | STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE | 2007 | UROLOGY | GENERAL SURGERY | null | null | null | GENERAL SURGERY | null | CREEK NATION HOSPITAL AND CLINICS | 5698786226 | 365 | 1101 S BELMONT AVE | SUITE 204 | null | OKMULGEE | OK | 744476315 | null | Y | Y | OK744476315OK1101XAVEX405 |
1003000597 | 4082848189 | I20150912000130 | KIM | DAE | null | null | M | MD | STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE | 2007 | UROLOGY | null | null | null | null | null | null | AHS OKLAHOMA PHYSICIAN GROUP LLC | 9436122496 | 313 | 1145 S UTICA AVE | SUITE 701 | null | TULSA | OK | 741044019 | 9185826544 | Y | Y | OK741044019TU1145XAVEX401 |
1003000597 | 4082848189 | I20131003000105 | KIM | DAE | null | null | M | MD | STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE | 2007 | UROLOGY | GENERAL SURGERY | null | null | null | GENERAL SURGERY | null | CREEK NATION HOSPITAL AND CLINICS | 5698786226 | 365 | 1313 E 20TH ST | OKMULGEE INDIAN HEALTH CENTER | null | OKMULGEE | OK | 744476303 | 9185915700 | Y | Y | OK744476303OK1313XSTXX401 |
1003000639 | 8527252766 | I20101101001099 | BENHARASH | PEYMAN | null | null | M | MD | UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE | 2002 | CARDIAC SURGERY | null | null | null | null | null | null | THE REGENTS OF THE UNIVERSITY OF CALIFORNIA | 3870573579 | 42 | 100 MEDICAL PLZ | SUITE 630 | null | LOS ANGELES | CA | 900956997 | 3108252631 | Y | Y | CA900956997LO100XXPLZX301 |
1003000639 | 8527252766 | I20101101001099 | BENHARASH | PEYMAN | null | null | M | MD | UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE | 2002 | CARDIAC SURGERY | null | null | null | null | null | null | THE REGENTS OF THE UNIVERSITY OF CALIFORNIA | 3870573579 | 42 | 7300 MEDICAL CTR DR | null | null | WEST HILLS | CA | 913071902 | 8186764000 | Y | Y | CA913071902WE7300XDRXX400 |
1003000639 | 8527252766 | I20101101001099 | BENHARASH | PEYMAN | null | null | M | MD | UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE | 2002 | CARDIAC SURGERY | null | null | null | null | null | null | THE REGENTS OF THE UNIVERSITY OF CALIFORNIA | 3870573579 | 42 | 757 WESTWOOD PLZ | null | null | LOS ANGELES | CA | 900958358 | 3108259111 | Y | Y | CA900958358LO757XXPLZX300 |
1003000704 | 2365611035 | I20110815000351 | GATTON | ZACHARY | M | null | M | MD | OTHER | 2007 | ANESTHESIOLOGY | null | null | null | null | null | null | KNOX COMMUNITY HOSPITAL | 1153301833 | 120 | 1330 COSHOCTON AVE | null | null | MOUNT VERNON | OH | 430501440 | null | Y | Y | OH430501440MO1330XAVEX300 |
1003000795 | 8022320688 | I20150710000013 | ONEILL | MICHAEL | J | null | M | CSW | UNIVERSITY OF MINNESOTA MEDICAL SCHOOL | 2001 | CLINICAL SOCIAL WORKER | null | null | null | null | null | Y | RAMSEY COUNTY MENTAL HEALTH CENTER | 5092627000 | 25 | 1919 UNIVERSITY AVE W | SUITE 200 | null | SAINT PAUL | MN | 551043435 | 6515237999 | Y | Y | MN551043435SA1919XWXXX401 |
1003000829 | 4587977046 | I20150714000118 | KOCHANEK | MICHELLE | R | null | F | PT | OTHER | 2007 | PHYSICAL THERAPIST IN PRIVATE PRACTICE | null | null | null | null | null | null | HEALTHSPARK MEDICAL GROUP PA | 6204352644 | 3 | 3065 CTR GREEN DR | FL 2 | null | BOULDER | CO | 803012251 | 4157077134 | Y | Y | CO803012251BO3065XDRXX401 |
1003000829 | 4587977046 | I20150714000118 | KOCHANEK | MICHELLE | R | null | F | PT | OTHER | 2007 | PHYSICAL THERAPIST IN PRIVATE PRACTICE | null | null | null | null | null | null | COVELL CARE AND REHABILITATION LLC | 9335223429 | 57 | 5716 AKSARBEN DR | null | null | WINDSOR | CO | 805507070 | 9702044331 | Y | Y | CO805507070WI5716XDRXX300 |
1003000902 | 1153415187 | I20070920000606 | LOHANO | JAIVANTI | null | null | F | MD | OTHER | 1996 | FAMILY PRACTICE | null | null | null | null | null | Y | BAPTIST HEALTH MEDICAL GROUP INC | 5597867184 | 2472 | 1373 E STATE RD | null | Y | MADISON | IN | 472507328 | 8128010810 | Y | Y | IN472507328MA1373XRDXX400 |
1003000902 | 1153415187 | I20070920000606 | LOHANO | JAIVANTI | null | null | F | MD | OTHER | 1996 | FAMILY PRACTICE | null | null | null | null | null | Y | BAPTIST HEALTH MEDICAL GROUP INC | 5597867184 | 2472 | 3605 NORTHGATE CT | SUITE 209 | null | NEW ALBANY | IN | 471506422 | 8125424921 | Y | Y | IN471506422NE3605XCTXX306 |
1003000936 | 9739278128 | I20140108000857 | STELLINGWORTH | MARK | null | null | M | MD | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS | 2000 | CARDIOVASCULAR DISEASE (CARDIOLOGY) | INTERNAL MEDICINE | null | null | null | INTERNAL MEDICINE | null | HARTSVILLE MEDICAL GROUP LLC | 7012062714 | 80 | 701 MEDICAL PARK DR | SUITE 302 303 | null | HARTSVILLE | SC | 295504777 | 8433835191 | Y | Y | SC295504777HA701XXDRXX407 |
1003000936 | 9739278128 | I20140108000857 | STELLINGWORTH | MARK | null | null | M | MD | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS | 2000 | CARDIOVASCULAR DISEASE (CARDIOLOGY) | INTERNAL MEDICINE | null | null | null | INTERNAL MEDICINE | null | PRISMA HEALTH MEDICAL GROUP-MIDLANDS | 5991099707 | 1068 | 8 RICHLAND MEDICAL PARK DR | SUITE 100 | null | COLUMBIA | SC | 292038006 | 8034343800 | Y | Y | SC292038006CO8XXXXDRXX501 |
1003001041 | 1355435108 | I20070924000582 | MILLER | KATHLEEN | null | null | F | null | OTHER | 2007 | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) | null | null | null | null | null | null | KBS ANESTHESIA, INC. | 1254719321 | 56 | 1000 DUTCH RIDGE RD | null | null | BEAVER | PA | 150099727 | 7247287000 | Y | Y | PA150099727BE1000XRDXX400 |
1003001041 | 1355435108 | I20070924000582 | MILLER | KATHLEEN | null | null | F | null | OTHER | 2007 | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) | null | null | null | null | null | null | KBS ANESTHESIA, INC. | 1254719321 | 56 | 79 WAGNER RD | null | null | MONACA | PA | 150612337 | 7246249901 | Y | Y | PA150612337MO79XXXRDXX300 |
1003001124 | 9931696259 | I20251013000387 | HOWELL | MYLA | T | null | F | null | OTHER | 2008 | CLINICAL SOCIAL WORKER | null | null | null | null | null | Y | null | null | null | null | null | null | CORONA | CA | 92882 | 7144855433 | Y | M | CA92882XXXXCOXXXXXXXXXX00 |
1003001124 | 9931696259 | I20251013000387 | HOWELL | MYLA | T | null | F | null | OTHER | 2008 | CLINICAL SOCIAL WORKER | null | null | null | null | null | Y | null | null | null | 2621 GREEN RIVER RD | SUITE 181 | null | CORONA | CA | 928827429 | null | Y | M | CA928827429CO2621XRDXX422 |
1003001140 | 7719287481 | I20191030001847 | NICASTRO | JON | null | null | M | null | OTHER | 2014 | PHYSICAL THERAPIST IN PRIVATE PRACTICE | null | null | null | null | null | null | DIGNITY SELECT NEVADA LLC | 0941541155 | 114 | 2650 N TENAYA WAY | SUITE 180 | null | LAS VEGAS | NV | 891281110 | 7022402952 | Y | Y | NV891281110LA2650XWAYX401 |
1003001140 | 7719287481 | I20191030001847 | NICASTRO | JON | null | null | M | null | OTHER | 2014 | PHYSICAL THERAPIST IN PRIVATE PRACTICE | null | null | null | null | null | null | DIGNITY SELECT NEVADA LLC | 0941541155 | 114 | 400 N STEPHANIE ST | SUITE 310 | null | HENDERSON | NV | 890146608 | 7024541162 | Y | Y | NV890146608HE400XXSTXX401 |
1003001249 | 0648220152 | I20050124000025 | DAY | RONNIE | L | null | M | PT | OTHER | 1990 | PHYSICAL THERAPIST IN PRIVATE PRACTICE | null | null | null | null | null | null | PROFESSIONAL PHYSICAL THERAPY, PC | 9537110549 | 2 | 3815 N VERMILION ST | null | null | DANVILLE | IL | 618321159 | 2174467878 | Y | Y | IL618321159DA3815XSTXX400 |
1003001256 | 2365538022 | I20091203000755 | CARAGOL | JENNIFER | A | null | F | MD | UNIVERSITY OF COLORADO SCHOOL OF MEDICINE, DENVER | 2004 | FAMILY PRACTICE | HOSPITALIST | null | null | null | HOSPITALIST | Y | UNIVERSITY PHYSICIANS INCORPORATED | 3476465667 | 3215 | 12605 E 16TH AVE | UCHEALTH ANSCHUTZ MEDICAL CAMPUS | null | AURORA | CO | 800452545 | 7208480000 | Y | Y | CO800452545AU12605AVEX413 |
1003001298 | 2860571270 | I20080509000143 | WARREN | KASEY | W | null | F | OD | UNIVERSITY OF HOUSTON - COLLEGE OF OPTOMETRY | 2007 | OPTOMETRY | null | null | null | null | null | null | GAINESVILLE EYE CARE | 8224319322 | 3 | 311 E CALIFORNIA ST | null | null | GAINESVILLE | TX | 762404036 | 9406687500 | Y | Y | TX762404036GA311XXSTXX400 |
1003001298 | 2860571270 | I20080509000143 | WARREN | KASEY | W | null | F | OD | UNIVERSITY OF HOUSTON - COLLEGE OF OPTOMETRY | 2007 | OPTOMETRY | null | null | null | null | null | null | SANGER EYE CARE, PLLC | 9032439138 | 2 | 410 BOLIVAR ST | null | null | SANGER | TX | 762668961 | 9404583937 | Y | Y | TX762668961SA410XXSTXX300 |
1003001363 | 0446319719 | I20081103000096 | STEVENS | CHARLES | R | null | M | MD | UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE | 2003 | ANESTHESIOLOGY | INTERVENTIONAL PAIN MANAGEMENT | null | null | null | INTERVENTIONAL PAIN MANAGEMENT | Y | null | null | null | 1665 S IMPERIAL AVE | SUITE D | null | EL CENTRO | CA | 922434247 | 7604820212 | Y | M | CA922434247EL1665XAVEX405 |
1003001363 | 0446319719 | I20120216000149 | STEVENS | CHARLES | R | null | M | MD | UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE | 2003 | PAIN MANAGEMENT | ANESTHESIOLOGY | null | null | null | ANESTHESIOLOGY | Y | null | null | null | 1951 W 25TH ST | SUITE B | null | YUMA | AZ | 853646924 | 9282763049 | Y | M | AZ853646924YU1951XSTXX401 |
1003001363 | 0446319719 | I20120718000803 | STEVENS | CHARLES | R | null | M | MD | UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE | 2003 | PAIN MANAGEMENT | ANESTHESIOLOGY | null | null | null | ANESTHESIOLOGY | Y | PARAGON PHYSICAL THERAPY AND REHAB LLC | 4284902339 | 94 | 2585 MIRACLE MILE | null | Y | BULLHEAD CITY | AZ | 864427522 | null | Y | Y | AZ864427522BU2585XMILE300 |
1003001363 | 0446319719 | I20120718000803 | STEVENS | CHARLES | R | null | M | MD | UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE | 2003 | PAIN MANAGEMENT | INTERVENTIONAL PAIN MANAGEMENT | null | null | null | INTERVENTIONAL PAIN MANAGEMENT | Y | PARAGON PHYSICAL THERAPY AND REHAB LLC | 4284902339 | 94 | 2585 MIRACLE MILE | SUITE 107 | null | BULLHEAD CITY | AZ | 864427522 | null | Y | Y | AZ864427522BU2585XMILE301 |
1003001363 | 0446319719 | I20120216000149 | STEVENS | CHARLES | R | null | M | MD | UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE | 2003 | PAIN MANAGEMENT | ANESTHESIOLOGY | null | null | null | ANESTHESIOLOGY | Y | null | null | null | 5717 HWY 95 | SUITE 6 | null | FORT MOHAVE | AZ | 864266050 | 9285772371 | Y | M | AZ864266050FO5717X95XX301 |
1003001371 | 4385734086 | I20071219000090 | KANTER | DAVID | M | null | F | MD | OTHER | 1998 | PHYSICAL MEDICINE AND REHABILITATION | null | null | null | null | null | Y | PHYSICAL MEDICINE AND REHAB MEDICAL SERVICE GROUP | 8123911500 | 19 | 813 FAY RD | null | null | SYRACUSE | NY | 132193009 | 3154882951 | Y | Y | NY132193009SY813XXRDXX300 |
1003001405 | 2062502941 | I20240604002799 | DEVINE RICKERT | KELLY | L | null | F | null | OTHER | 2006 | REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL | null | null | null | null | null | null | null | null | null | 7224 W COLLEGE DR | null | null | PALOS HEIGHTS | IL | 604631171 | 7086089014 | Y | M | IL604631171PA7224XDRXX400 |
1003001462 | 8022273648 | I20170703000589 | WOLSKI | MICHAL | null | null | M | MD | UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE | 2007 | RADIATION ONCOLOGY | null | null | null | null | null | null | HEALTHTEXAS PROVIDER NETWORK | 1355254210 | 2697 | 2380 S I | 35E BAYLOR SCOTT AND WHITE | null | WAXAHACHIE | TX | 75165 | 4698006000 | Y | Y | TX751650000WA2380XIXXX301 |
1003001595 | 8426425364 | I20221115000574 | HILLYER-WRIGHT | NEREIDA | IRENE | null | F | null | OTHER | 1990 | QUALIFIED SPEECH LANGUAGE PATHOLOGIST | null | null | null | null | null | null | ONR NATIONAL SPEECH PATHOLOGY INC | 2668463522 | 59 | 10540 METROPOLITAN AVE | null | null | KENSINGTON | MD | 208952608 | 2405148402 | Y | Y | MD208952608KE10540AVEX300 |
1003001645 | 7517056583 | I20120821000136 | TRIVEDI | VINOD | null | null | M | MD | OTHER | 1995 | INFECTIOUS DISEASE | INTERNAL MEDICINE | null | null | null | INTERNAL MEDICINE | Y | PULMONARY MEDICINE ASSOCIATES MEDICAL GROUP INC. | 4981506730 | 93 | 1485 RIVER PARK DR | SUITE 200 | null | SACRAMENTO | CA | 958154530 | 9163251040 | Y | Y | CA958154530SA1485XDRXX401 |
1003001645 | 7517056583 | I20120821000136 | TRIVEDI | VINOD | null | null | M | MD | OTHER | 1995 | INFECTIOUS DISEASE | INTERNAL MEDICINE | null | null | null | INTERNAL MEDICINE | Y | PULMONARY MEDICINE ASSOCIATES MEDICAL GROUP INC. | 4981506730 | 93 | 5 MEDICAL PLAZA DR | SUITE 190 | null | ROSEVILLE | CA | 956612867 | 9166793590 | Y | Y | CA956612867RO5XXXXDRXX402 |
1003001645 | 7517056583 | I20120821000136 | TRIVEDI | VINOD | null | null | M | MD | OTHER | 1995 | INFECTIOUS DISEASE | INTERNAL MEDICINE | null | null | null | INTERNAL MEDICINE | Y | PULMONARY MEDICINE ASSOCIATES MEDICAL GROUP INC. | 4981506730 | 93 | 6403 COYLE AVE | SUITE 450 | null | CARMICHAEL | CA | 956080361 | 9166793590 | Y | Y | CA956080361CA6403XAVEX303 |
1003001678 | 1456584564 | I20170831000516 | EIRICH | REBECCA | D | null | F | NP | OTHER | 2006 | NURSE PRACTITIONER | null | null | null | null | null | null | REGIONAL WOMENS HEALTH GROUP LLC | 2961316328 | 354 | 188 FRIES MILL RD | N1 | null | TURNERSVILLE | NJ | 080122055 | 8568750505 | Y | Y | NJ080122055TU188XXRDXX402 |
1003001678 | 1456584564 | I20170831000516 | EIRICH | REBECCA | D | null | F | NP | OTHER | 2006 | NURSE PRACTITIONER | null | null | null | null | null | null | REGIONAL WOMENS HEALTH GROUP LLC | 2961316328 | 354 | 247 HURFFVILLE CROSSKEYS RD | null | null | SEWELL | NJ | 080804011 | 8568408017 | Y | Y | NJ080804011SE247XXRDXX400 |
1003001678 | 1456584564 | I20170831000516 | EIRICH | REBECCA | D | null | F | NP | OTHER | 2006 | NURSE PRACTITIONER | null | null | null | null | null | null | REGIONAL WOMENS HEALTH GROUP LLC | 2961316328 | 354 | 247 HURFFVILLE CROSSKEYS RD | SUITE 2 | null | SEWELL | NJ | 080804011 | 8562628300 | Y | Y | NJ080804011SE247XXRDXX401 |
1003001785 | 5799871612 | I20150805009008 | JONES | JACLYN | C | null | F | DO | OTHER | 2005 | ORTHOPEDIC SURGERY | null | null | null | null | null | null | AHS OKLAHOMA PHYSICIAN GROUP LLC | 9436122496 | 313 | 1120 S UTICA AVE | null | null | TULSA | OK | 741044012 | 9185799393 | Y | Y | OK741044012TU1120XAVEX400 |
1003001785 | 5799871612 | I20150805009008 | JONES | JACLYN | C | null | F | DO | OTHER | 2005 | ORTHOPEDIC SURGERY | null | null | null | null | null | null | AHS OKLAHOMA PHYSICIAN GROUP LLC | 9436122496 | 313 | 1305 E TAFT AVE | null | null | SAPULPA | OK | 740666033 | 9185740300 | Y | Y | OK740666033SA1305XAVEX400 |
1003001785 | 5799871612 | I20150805009008 | JONES | JACLYN | C | null | F | DO | OTHER | 2005 | ORTHOPEDIC SURGERY | null | null | null | null | null | null | FANDS PHYSICAL THERAPY, INC | 7810898459 | 221 | 1414 HWY 71 N | null | null | ALMA | AR | 729214723 | 4796320321 | Y | Y | AR729214723AL1414XNXXX400 |
1003001785 | 5799871612 | I20150805009008 | JONES | JACLYN | C | null | F | DO | OTHER | 2005 | ORTHOPEDIC SURGERY | null | null | null | null | null | null | AHS OKLAHOMA PHYSICIAN GROUP LLC | 9436122496 | 313 | 1809 E 13TH ST | null | Y | TULSA | OK | 741044431 | null | Y | Y | OK741044431TU1809XSTXX400 |
1003001785 | 5799871612 | I20150805009008 | JONES | JACLYN | C | null | F | DO | OTHER | 2005 | ORTHOPEDIC SURGERY | null | null | null | null | null | null | AHS OKLAHOMA PHYSICIAN GROUP LLC | 9436122496 | 313 | 20 E 34TH ST | null | null | SAND SPRINGS | OK | 740634001 | 9182459675 | Y | Y | OK740634001SA20XXXSTXX400 |
1003001785 | 5799871612 | I20150805009008 | JONES | JACLYN | C | null | F | DO | OTHER | 2005 | ORTHOPEDIC SURGERY | null | null | null | null | null | null | AHS OKLAHOMA PHYSICIAN GROUP LLC | 9436122496 | 313 | 8801 S 101ST E AVE | null | null | TULSA | OK | 741335716 | 9182944000 | Y | Y | OK741335716TU8801XAVEX500 |
1003001819 | 8123284411 | I20120801000428 | TAVORA | SARA | M | null | F | null | OTHER | 2007 | CLINICAL SOCIAL WORKER | null | null | null | null | null | Y | BLUE WATER MENTAL HEALTH CLINIC | 2769477264 | 25 | 1501 KRAFFT RD | null | null | FORT GRATIOT | MI | 480593565 | 8109855125 | Y | Y | MI480593565FO1501XRDXX300 |
1003001843 | 5597718650 | I20050301000433 | LUECHINGER | INGE | C | null | F | CNS | OTHER | 1998 | CERTIFIED CLINICAL NURSE SPECIALIST (CNS) | null | null | null | null | null | Y | null | null | null | 1269 PARKER RD SE | null | null | CONYERS | GA | 300945957 | null | M | M | GA300945957CO1269XSEXX400 |
1003001843 | 5597718650 | I20050301000433 | LUECHINGER | INGE | C | null | F | CNS | OTHER | 1998 | CERTIFIED CLINICAL NURSE SPECIALIST (CNS) | null | null | null | null | null | Y | null | null | null | 24 CHECHERO ST | SUITE 2 | null | CLAYTON | GA | 305256181 | 6784284233 | M | M | GA305256181CL24XXXSTXX301 |
1003001884 | 3274628870 | I20260420000272 | SAHA | LUCILLE | null | null | F | MD | MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE | 2007 | FAMILY PRACTICE | null | null | null | null | null | null | null | null | null | 400 E RIVULON BLVD | null | Y | GILBERT | AZ | 852970096 | null | Y | M | AZ852970096GI400XXBLVD400 |
1003001884 | 3274628870 | I20260420000272 | SAHA | LUCILLE | null | null | F | MD | MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE | 2007 | FAMILY PRACTICE | null | null | null | null | null | null | null | null | null | 8820 COLUMBIA 100 PKWY | SUITE 430 | null | COLUMBIA | MD | 210452143 | null | Y | M | MD210452143CO8820XPKWY403 |
1003001892 | 6305324914 | I20260203003628 | LOKEY | DAVID | JAMEA | null | M | PT | OTHER | 2000 | PHYSICAL THERAPIST IN PRIVATE PRACTICE | null | null | null | null | null | null | null | null | null | 1920 W POTOMAC AVE | null | null | Chicago | IL | 606223149 | null | M | M | IL606223149Ch1920XAVEX400 |
1003001892 | 6305324914 | I20260203003628 | LOKEY | DAVID | JAMEA | null | M | PT | OTHER | 2000 | PHYSICAL THERAPIST IN PRIVATE PRACTICE | null | null | null | null | null | null | null | null | null | 4501 MISSION BAY DR | SUITE 3K | null | SAN DIEGO | CA | 921094999 | null | M | M | CA921094999SA4501XDRXX406 |
1003001975 | 9638207293 | I20210419002613 | CHRISTIANSON | SHANNON | DIANE | null | F | PT | OTHER | 2007 | PHYSICAL THERAPIST IN PRIVATE PRACTICE | null | null | null | null | null | null | SHELLMAN INC PA | 4981592938 | 41 | 1172 W HAYDEN AVE | null | null | HAYDEN | ID | 838358700 | 2087623332 | Y | Y | ID838358700HA1172XAVEX400 |
1003001975 | 9638207293 | I20210419002613 | CHRISTIANSON | SHANNON | DIANE | null | F | PT | OTHER | 2007 | PHYSICAL THERAPIST IN PRIVATE PRACTICE | null | null | null | null | null | null | SHELLMAN INC PA | 4981592938 | 41 | 1917 N LAKEWOOD DR | null | null | COEUR D ALENE | ID | 838142634 | 2086648194 | Y | Y | ID838142634CO1917XDRXX400 |
1003001983 | 9931535697 | I20250505000891 | SADDHRA | RORIE | null | null | F | PT | OTHER | 2000 | PHYSICAL THERAPIST IN PRIVATE PRACTICE | null | null | null | null | null | null | HEALTHPRO HERITAGE REHAB AND FITNESS LLC | 6507832573 | 969 | 24025 KINGWOOD PLACE DR | null | null | KINGWOOD | TX | 773393862 | 8325367727 | Y | Y | TX773393862KI24025DRXX400 |
1003002049 | 1557412699 | I20090701000132 | SRINIVASAN | LAKSHMI | null | null | F | null | UNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE | 2003 | ENDOCRINOLOGY | null | null | null | null | null | Y | SUTTER BAY MEDICAL FOUNDATION | 4284538778 | 3829 | 3200 KEARNEY ST | null | null | FREMONT | CA | 945382299 | 5104901222 | Y | Y | CA945382299FR3200XSTXX300 |
1003002106 | 1557412756 | I20170413000764 | CASTRO CORDOBA | JUAN LUIS | null | null | M | MD | OTHER | 2001 | PSYCHIATRY | null | null | null | null | null | Y | COMPASS HEALTH SYSTEMS PA | 6204733413 | 65 | 7481 W OAKLAND PARK BLVD | SUITE 100 | null | TAMARAC | FL | 333194985 | 8888526672 | Y | Y | FL333194985TA7481XBLVD501 |
1003002148 | 3274853627 | I20150526002019 | OWENS | JUSTIN | M | null | M | MD | UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE | 2007 | DIAGNOSTIC RADIOLOGY | null | null | null | null | null | null | REGIONAL RADIOLOGY, LLC | 2860404811 | 40 | 1202 S TYLER ST | null | null | COVINGTON | LA | 704332330 | 9858984000 | Y | Y | LA704332330CO1202XSTXX400 |
1003002205 | 0446322309 | I20220302000958 | MAGCALAS | CHARITY | null | null | F | CNA | OTHER | 2007 | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) | null | null | null | null | null | null | JERRY W. LEWIS MD PA | 8123301785 | 3 | 11500 STATE HWY 121 | SUITE 810 | null | FRISCO | TX | 750359347 | 2146189600 | M | Y | TX750359347FR11500121X402 |
1003002205 | 0446322309 | I20220302000958 | MAGCALAS | CHARITY | null | null | F | CNA | OTHER | 2007 | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) | null | null | null | null | null | null | DFW OBA PLLC | 0941684963 | 24 | 3861 LONG PRAIRIE RD | SUITE 109 | null | FLOWER MOUND | TX | 750281799 | 9723500225 | M | M | TX750281799FL3861XRDXX404 |
1003002312 | 0547203192 | I20051018001123 | HOPKINS | PATRICIA | T | null | F | MD | OTHER | 1980 | RHEUMATOLOGY | INTERNAL MEDICINE | null | null | null | INTERNAL MEDICINE | Y | HOPKINS MEDICAL GROUP LLC | 1052671542 | 2 | 571 MAIN ST | null | null | WEYMOUTH | MA | 021901843 | 6177739198 | Y | Y | MA021901843WE571XXSTXX300 |
1003002379 | 5496842486 | I20131101000541 | SHRESTHA | SALONA | null | null | F | MD | OTHER | 2003 | INTERNAL MEDICINE | null | null | null | null | null | null | PROVIDENCE HEALTH AND SERVICES OREGON | 0648183608 | 1433 | 4805 NE GLISAN ST | null | null | PORTLAND | OR | 972132933 | null | Y | Y | OR972132933PO4805XSTXX400 |
1003002379 | 5496842486 | I20131101000541 | SHRESTHA | SALONA | null | null | F | MD | OTHER | 2003 | INTERNAL MEDICINE | null | null | null | null | null | null | PROVIDENCE HEALTH AND SERVICES - OREGON | 5395656284 | 191 | 4805 NE GLISAN ST | null | null | PORTLAND | OR | 972132933 | 5032151111 | Y | Y | OR972132933PO4805XSTXX400 |
1003002379 | 5496842486 | I20131101000541 | SHRESTHA | SALONA | null | null | F | MD | OTHER | 2003 | INTERNAL MEDICINE | null | null | null | null | null | null | PROVIDENCE HEALTH AND SERVICES OREGON | 0648183608 | 1433 | 5050 NE HOYT ST | SUITE 240 | null | PORTLAND | OR | 972132981 | 5032156480 | Y | Y | OR972132981PO5050XSTXX402 |
1003002486 | 4284722240 | I20071109000015 | MINNER | MEGAN | K | null | F | CH | LOGAN COLLEGE OF CHIROPRACTIC | 2007 | CHIROPRACTIC | null | null | null | null | null | null | null | null | null | 1115 E 5TH ST | null | null | WASHINGTON | MO | 630903303 | 6362399997 | Y | M | MO630903303WA1115XSTXX400 |
1003002510 | 7012199425 | I20230209001563 | DEGRAFF | THOMAS | RICHARD | III | M | DO | MID WEST MEDICAL COLLEGE | 2006 | GENERAL PRACTICE | null | null | null | null | null | null | THE CENTERS MEDICAL CLINIC, LLC | 3870975865 | 3 | 1521 MERRILL DR | SUITE D240 | null | LITTLE ROCK | AR | 722111821 | 5016643700 | Y | Y | AR722111821LI1521XDRXX301 |
1003002619 | 2860957826 | I20260720004188 | MILES | DANIELLE | N | null | F | OT | OTHER | 2017 | OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE | null | null | null | null | null | null | ACHIEVE OCCUPATIONAL THERAPY AND PHYSICAL THERAPY OF BROOKLYN PLLC | 2769916592 | 18 | 170 MURRAY ST | null | null | AUBURN | NY | 130211335 | 7186278100 | M | M | NY130211335AU170XXSTXX300 |
1003002627 | 6800954280 | I20091027000539 | KADIYALA | SAMATHA | K | null | F | MD | OTHER | 2001 | OBSTETRICS/GYNECOLOGY | null | null | null | null | null | Y | PRIVIA MEDICAL GROUP GULF COAST PLLC | 4688999022 | 534 | 10970 SHADOW CREEK PKWY | SUITE 100 | null | PEARLAND | TX | 775840166 | 2813988500 | Y | Y | TX775840166PE10970PKWY401 |
1003002627 | 6800954280 | I20091027000539 | KADIYALA | SAMATHA | K | null | F | MD | OTHER | 2001 | OBSTETRICS/GYNECOLOGY | null | null | null | null | null | Y | PRIVIA MEDICAL GROUP GULF COAST PLLC | 4688999022 | 534 | 208 OAK DR S | SUITE 300 | null | LAKE JACKSON | TX | 775665640 | 9792669544 | Y | Y | TX775665640LA208XXSXXX402 |
1003002627 | 6800954280 | I20091027000539 | KADIYALA | SAMATHA | K | null | F | MD | OTHER | 2001 | OBSTETRICS/GYNECOLOGY | null | null | null | null | null | Y | PRIVIA MEDICAL GROUP GULF COAST PLLC | 4688999022 | 534 | 7900 FANNIN ST | SUITE 4000 | null | HOUSTON | TX | 770542935 | 7135127500 | Y | Y | TX770542935HO7900XSTXX302 |
1003002643 | 8527158971 | I20071221000276 | BRADT | CARIE | E | null | F | null | OTHER | 2007 | PHYSICIAN ASSISTANT | null | null | null | null | null | null | UNIVERSITY ORTHOPAEDIC ASSOCIATES OF ROCHESTER | 7012909161 | 149 | 10 MIRACLE MILE DR | null | null | ROCHESTER | NY | 146235851 | 5852755321 | Y | Y | NY146235851RO10XXXDRXX400 |
1003002643 | 8527158971 | I20071221000276 | BRADT | CARIE | E | null | F | null | OTHER | 2007 | PHYSICIAN ASSISTANT | null | null | null | null | null | null | UNIVERSITY ORTHOPAEDIC ASSOCIATES OF ROCHESTER | 7012909161 | 149 | 601 ELMWOOD AVE | null | null | ROCHESTER | NY | 146420001 | null | Y | Y | NY146420001RO601XXAVEX300 |
1003002643 | 8527158971 | I20071221000276 | BRADT | CARIE | E | null | F | null | OTHER | 2007 | PHYSICIAN ASSISTANT | null | null | null | null | null | null | UNIVERSITY ORTHOPAEDIC ASSOCIATES OF ROCHESTER | 7012909161 | 149 | 601 ELMWOOD AVE BOX | null | Y | ROCHESTER | NY | 146420001 | 5852755321 | Y | Y | NY146420001RO601XXBOXX400 |
1003002718 | 8921292921 | I20101103001260 | LA | TRANG | H | null | F | MD | OTHER | 2005 | RADIATION ONCOLOGY | null | null | null | null | null | Y | PERMANENTE MEDICAL GROUP INC | 8921910225 | 10996 | 3701 BROADWAY | null | null | OAKLAND | CA | 946115613 | 5107521000 | Y | Y | CA946115613OA3701XBROA200 |
1003002726 | 4183778368 | I20091013000379 | DIAMOND | ROBERT | D | null | M | CSW | OTHER | 1994 | CLINICAL SOCIAL WORKER | null | null | null | null | null | Y | JGB MENTAL HEALTH AND MENTAL RETARDATION SERVICES INC | 1850349838 | 15 | 250 W 64TH ST | FL 4 | null | NEW YORK | NY | 100236402 | 2127697800 | Y | Y | NY100236402NE250XXSTXX425 |
1003002734 | 9234354077 | I20140710001338 | MCCOLLUM | JONATHAN | P | null | M | CSW | OTHER | 2011 | CLINICAL SOCIAL WORKER | null | null | null | null | null | Y | null | null | null | 111 CTR PARK DR | SUITE 1003 | null | KNOXVILLE | TN | 379222125 | 8287882441 | Y | M | TN379222125KN111XXDRXX401 |
1003002734 | 9234354077 | I20230731003068 | MCCOLLUM | JONATHAN | P | null | M | CSW | OTHER | 2011 | CLINICAL SOCIAL WORKER | null | null | null | null | null | Y | RIVER REGION PSYCHIATRY ASSOCIATES, LLC | 1254491012 | 122 | 1401 APPLEWOOD DR | SUITE 1 | null | DALTON | GA | 307202699 | 7064604100 | Y | Y | GA307202699DA1401XDRXX301 |
1003002734 | 9234354077 | I20140710001338 | MCCOLLUM | JONATHAN | P | null | M | CSW | OTHER | 2011 | CLINICAL SOCIAL WORKER | null | null | null | null | null | Y | RIVER REGION PSYCHIATRY ASSOCIATES, LLC | 1254491012 | 122 | 3010 GREYSTONE SQ | null | null | JACKSON | TN | 383053589 | 7314675515 | Y | Y | TN383053589JA3010XSQXX300 |
1003002734 | 9234354077 | I20140710001338 | MCCOLLUM | JONATHAN | P | null | M | CSW | OTHER | 2011 | CLINICAL SOCIAL WORKER | null | null | null | null | null | Y | RIVER REGION PSYCHIATRY ASSOCIATES, LLC | 1254491012 | 122 | 651 DUNLOP LN | null | null | CLARKSVILLE | TN | 370405015 | 9315021262 | Y | Y | TN370405015CL651XXLNXX300 |
1003002742 | 6103991245 | I20200506002003 | LOCKMAN | BRETT | C. | null | M | DO | MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE | 2003 | PHYSICAL MEDICINE AND REHABILITATION | ADDICTION MEDICINE | INTERVENTIONAL PAIN MANAGEMENT | OSTEOPATHIC MANIPULATIVE MEDICINE | SPORTS MEDICINE | ADDICTION MEDICINE, INTERVENTIONAL PAIN MANAGEMENT, OSTEOPATHIC MANIPULATIVE MEDICINE, SPORTS MEDICINE | null | null | null | null | 19468 VILLAGE DR | null | Y | SONORA | CA | 953709228 | 2147667817 | Y | M | CA953709228SO19468DRXX300 |
1003002742 | 6103991245 | I20200506002003 | LOCKMAN | BRETT | C. | null | M | DO | MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE | 2003 | PHYSICAL MEDICINE AND REHABILITATION | ADDICTION MEDICINE | INTERVENTIONAL PAIN MANAGEMENT | OSTEOPATHIC MANIPULATIVE MEDICINE | SPORTS MEDICINE | ADDICTION MEDICINE, INTERVENTIONAL PAIN MANAGEMENT, OSTEOPATHIC MANIPULATIVE MEDICINE, SPORTS MEDICINE | null | null | null | null | 19468 VILLAGE DR | SUITE 100 | null | SONORA | CA | 953709228 | 2147667817 | Y | M | CA953709228SO19468DRXX301 |
1003002783 | 6507956612 | I20071213000113 | HARTMAN | MATTHEW | S | null | M | MD | UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE | 2002 | DIAGNOSTIC RADIOLOGY | null | null | null | null | null | null | ALLEGHENY CLINIC RADIOLOGY | 8426364738 | 152 | 100 S JACKSON AVE | null | null | PITTSBURGH | PA | 152023428 | 4127346015 | Y | Y | PA152023428PI100XXAVEX400 |
1003002783 | 6507956612 | I20211018002031 | HARTMAN | MATTHEW | S | null | M | MD | UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE | 2002 | DIAGNOSTIC RADIOLOGY | null | null | null | null | null | null | CHAUTAUQUA MEDICAL PRACTICE PC | 5294920203 | 107 | 189 E MAIN ST | null | null | WESTFIELD | NY | 147871104 | 7167932221 | Y | Y | NY147871104WE189XXSTXX400 |
1003002783 | 6507956612 | I20071213000113 | HARTMAN | MATTHEW | S | null | M | MD | UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE | 2002 | DIAGNOSTIC RADIOLOGY | null | null | null | null | null | null | ALLEGHENY CLINIC RADIOLOGY | 8426364738 | 152 | 320 E N AVE | null | null | PITTSBURGH | PA | 152124756 | 4123592459 | Y | Y | PA152124756PI320XXAVEX400 |
1003002809 | 0941350854 | I20100713000088 | GRAZIANO | VINCENT | null | null | M | MD | RUTGERS R W JOHNSON MEDICAL SCHOOL (CAM/NEW BRUNS/PISC) | 2004 | DIAGNOSTIC RADIOLOGY | null | null | null | null | null | null | DENVILLE DIAGNOSTICS IMAGING AND OPEN MRI LLC | 5496779290 | 39 | 0100 28TH ST | IMAGECARE AT FAIR LAWN | null | FAIR LAWN | NJ | 074103786 | 2014751300 | Y | Y | NJ074103786FA0100XSTXX301 |
1003002809 | 0941350854 | I20200401003403 | GRAZIANO | VINCENT | null | null | M | MD | RUTGERS R W JOHNSON MEDICAL SCHOOL (CAM/NEW BRUNS/PISC) | 2004 | DIAGNOSTIC RADIOLOGY | null | null | null | null | null | null | IMAGING SUBSPECIALIST OF NEW YORK | 4688089451 | 4 | 110 CRYSTAL RUN RD | null | null | MIDDLETOWN | NY | 109414040 | 8456736446 | Y | Y | NY109414040MI110XXRDXX400 |
1003002809 | 0941350854 | I20100713000088 | GRAZIANO | VINCENT | null | null | M | MD | RUTGERS R W JOHNSON MEDICAL SCHOOL (CAM/NEW BRUNS/PISC) | 2004 | DIAGNOSTIC RADIOLOGY | null | null | null | null | null | null | MIDDLETOWN VENTURES ASSOCIATES LLC | 6406818236 | 31 | 1275 STATE ROUTE 35 | null | null | MIDDLETOWN | NJ | 077482040 | 7322750999 | Y | Y | NJ077482040MI1275X35XX400 |
1003002809 | 0941350854 | I20200401003403 | GRAZIANO | VINCENT | null | null | M | MD | RUTGERS R W JOHNSON MEDICAL SCHOOL (CAM/NEW BRUNS/PISC) | 2004 | DIAGNOSTIC RADIOLOGY | null | null | null | null | null | null | RG SHERRY MD PLLC | 6002138294 | 2 | 1340 WASHINGTON ST | null | null | WATERTOWN | NY | 136014541 | 3157829003 | Y | Y | NY136014541WA1340XSTXX300 |
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