Other Provider Identifier Issuer 7
DEA CONTROLLED SUBSTANCE REGISTRATION CERTIFICATE, US DEPARTMENT OF JUSTICE
GROUP MEDICARE PIN PTAN FOR WILLIAMSBURG
EASTERN CAROLINA PHYSICIANS GROUP MEDICAID NUMBER FOR KINSTON
PA DRUG & DEVICE LICENSE - WHOLESALER/DISTRIBUTOR
BLUE CROSS OF NE PA / FIRST PRIORITY HEALTH
LABOR AND INDUSTRIES-MEDICAL IMAGING ON 1ST
CBHNP VENDOR ID - BLAIR/CUMBERLAND/PERRY
UNITED HEALTH CARE/MAMSI (EVMS HEALTH SERVICES)
GREAT LAKES HEALTH PLAN/UNITED HEALTHCARE
ONCOLOGICS LLC MEDICARE PTAN EFFECTIVE 05/19/2012
BUTLER HOSPITAL PROFESSIONAL BILLING OFFICE NPI
GROUP NPI - UPPER MARLBORO FAMILY MEDICAL CENTER
MEDICARE GROUP # RURAL HEALTH CLINICS OF WEST TN, PLLC
BUTLER HOSPITAL PROFESSIONAL BILLING OFFICE
PARTNERS PHYSICIAN GROUP MEDICARE GROUP #
ANTHEM BLUE CROSS BLUE SHIELD OF INDIANA
BCBS MARYLAND FOR MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND
DURABLE MEDICAL EQUIPMENT OUTLET REGISTRATION
OPTUM BEHAVIORAL HEALTH- AWAKEN THE POWER THERAPY, LLC
M. MAITLAND DELAND MEDICARE PTAN EFFECTIVE 05/19/2012
HUMANA- CARDIOTHORACIC SURGERY OF LOUISVILLE
GROUP NPI - FORT WASHINGTON FAMILY MEDICAL CENTER
HIGHMARK BLUE SHIELD FOR FEDERAL EMPLOYEES
UBH OXFORD HEALTH LIBERTY/FREEDOM WELLMORE GRP/FACILITY
NATIONAL ASSOCIATION OF FORENSIC COUNSELORS
IC&RC CERTIFIED ALCOHOL AND DRUG COUNSELOR
HEALTHY INDIANA PLAN- KENTUCKY CHILDREN'S RADIOLOGISTS
THE LICENSED PROFESSIONAL COUNSELORS ASSOCIATION OF GEORGIA (LPCAGA MEMBERSHIP)
GEORGIA MEDICAID AT CHILDRENS MEDICAL CENTER
MEDICAID INDIANA- KENTUCKY CHILDREN'S RADIOLOGISTS
GROUP NPI - MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND
PTAN WHEN AT NORTH TEXAS DIABETES & ENDO
HEALTH & WELLNESS FAMILY PRACTICE SERVICE PC EIN #
FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION-LICENSE
UBH- UNITED HEALTHCARE WELLMORE GRP/FACILITY
GROUP MEDICAID-NORTH BEND MEDICAL CENTER INC
CAPITAL BLUE CROSS & KEYSTONE HEALTH PLAN CENTRAL
COLLEGE STATION CHC/ABC CLINIC FACILITY NPI
BLUE CROSS-URGENT CARE OF GREEN COUNTRY-BIXBY
STATE OF CALIFORNIA DEPARTMENT OF PUBLIC HEALTH
FIRST PRIORITY HEALTH (FOR THE WOUND CTR)
TIN-SPECIAL HEALTH RESOURCES FOR TEXAS, INC.
AGMC - CENTER FOR FAMILY MEDICINE MEDICARE GROUP #
SIHO- NORTON COMMUNITY MEDICAL ASSOCIATES
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
AMERICAN COLLEGE OF CERTIFIED FORENSIC COUNSELORS
200 LURAY DRIVE WINTERSVILLE OH MEDICARE SITE #
BLUE CROSS BLUE SHIELD OF TENNESSEE PROVIDER #
PREVIOUS-DEPARTMENT OF PUBLIC SAFETY -CONTROLLED SUBSTANCE REGISTRATION
HEALTHY INDIANA PLAN (THRU ANTHEM)- CARDIOTHORACIC SURGERY OF LOUISVILLE
GROUP MEDICARE NORTH BEND MEDICAL CENTER
STATE OF COLORADO DURABLE MEDICAL EQUIPMENT SUPPLIER LICENSE
PODIATRY MEDICAL LICENSE - VOLUTARILLY PLACED ON INNACTIVE STATUS
LICENSED MARRIAGE & FAMILY THERAPIST, LICENSED PROFESSIONAL COUNSELOR-SUPERVISOR
EASTERN CAROLINA PHYSICIANS MEDICAID GROUP NUMBER FOR KINSTON
NPI #1992982169 LORETTA DE KOSTER,O.D.,LTD. DBA MELROSE EYECARE CENTER
NEW ORGANIZATION NPI LINKED TO THIS INDIVIDUAL NPI
ANTHEM PIN / ARNETT CLINIC, LLC URGENT CARE
CLIA CERTIFICATE OF WAIVER FOR NEWBERRY FOOT CLINIC LOCATION
MEDICARE - RR CABELL HUNTINGTON HOSPITAL
BCBS KCMO SMMC EMERGENCY PHYSICIANS GROUP 01674018
PARTNERS PHYSICIAN GROUP MEDICAID GROUP #
MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND INC - MEDICARE GOUP
HOSPITAL PHYSICIAN SERVICES OF CENTRAL ALABAMA
ANTHEM BC/BS (PORTSMOUTH FAMILY MEDICINE)
COUNTY OF SANTA CRUZ MEDICARE GROUP PTAN#
AFFINITY HEALTH PLAN(S) MEDICARE AND MEDICAID
UBH-UNITED HEALTH CARE WELLMORE GRP/FACILITY
MEDICARE B PTAN FOR RIVER VALLEY FAMILY HEALTH CENTER
HUMANA- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY
MEDICAID/MAGELLAN PROVIDER # @ COUNSELING AFFILIATES
MAGELLAN HEALTH CHOICES BUCKS/MONTGOMERY COUNTIES
PACIFICARE DENTAL & VISION ADMINISTRATORS
STATE OF WA L&I CRIME VICTIMS COMPENSATION PROGRAM
CLIA LICENSE FOR 3317 US HWY 98 SOUTH STE 9
MEDICARE PROVIDER TRANSACTION ACCESS NUMBER
HEART RHYTHM ASSOCIATES MEDICAID GROUP #
BLUE CROSS AND BLUE SHIELD OF MASSACHUSETTS
NEW MEXICO BOARD OF PHARMACY, PRACTITIONER LICENSE
WELLCARE - PULMONARY SPECIALISTS OF LOUISVILLE
TIN - BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.
MEDICARE GROUP # - MD/DO FEE LOCALITY 99
HEART CARE CENTERS OF ILLINOIS GROUP NPI
LABOR AND INDUSTRIES CRIME VICTIMS-UNION AVENUE OPEN MRI
GROUP TAX ID NUMBER NORTH BEND MEDICAL CENTER
RAILROAD MEDICARE- NORTON ORTHO TRAUMA CARE
MEDICARE PTAN - REGENTS OF THE UNIVERSITY OF CALIFORNIA
MHS PHYS OF TX GRP PTAN - MONTGOMERY COUNTY
NORTH BASIN MEDICAL REARDAN CLINIC MEDICAID RURAL HEALTH CORE PROVIDER #
NORTH BEND MEDICAL CENTER GROUP MEDICAID
CARE FIRST BC/BS (GHMSI PARTICIPATING PROVIDER-BLUE CHOICE)
SIHO- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY
BLUE SHIELD NORTHEASTERN NY GROUP PIN/IDENTIFIER
GA MEDICARE WELLCARE AND GA MEDICAID WELLCARE
MEDICAID- NORTON LEATHERMAN SPINE CENTER
GROUP PTAN FOR PHYSICIAN READING TELERADIOLOGY FROM WA
OPTUM HEALTH PHYSICAL THERAPY- OXFORD HEALTH PLAN-FREEDOM/LIBERTY
BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC. - AGENCY NPI
AARP MEDICARE SUPPLEMENT PLANS INSURED BY UNITEDHEALTHCARE INSURANCE CO
GENERAL MEDICAL ELDERLY, YOUTH, ADULT TX PLAN SUPPORTIVE CARE
PROVIDER CHILDRENS MEDICAL SECURITY PLAN #
NORTH CAROLINA MEDICAL BOARD LICENSE NUMBER
MEDICARE PROVIDER CIRILO SERALDE FOR FAIRMOUNT CLINIC
COMMUNITY CHOICE OF MICHIGAN/CARE SOURCE
BLUD CROSS BLUE SHIELD FEDERAL EMPLOYEE PROGRAM
GOMEZ, KOZAR, MCELREATH, AND SMITH PROFESSIONAL CORPORATION
ANTHEM- CARDIOTHORACIC SURGERY OF LOUISVILLE
MEDICARE PENDING FOR ACCESS COUNSELING SERVICES, LLC
S. TEXAS MEDICAL CLINICS-TRAVELERS MEDICARE
UNION CERTIFICATION BY HYPNOTHERAPISTS LOCAL NO. 472
BLUE CROSS BLUE SHIELD /BLUE CARE NETWORK
MEDICARE ACTIVE PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
HEALTH 1ST, HEALTH1ST MEDICARE, HEALTH1ST COMPLETECARE, HEALTH1ST COMMERCIAL
BOARD CERTIFICATION AADP (AMERICAN ASSOCIATION OF DRUGLESS PRACTITIONERS)
ANTHEM- CMA- CHILDREN'S ORTHPAEDICS OF LOUISVILLE
RAILROAD MEDICARE INDIVIDUAL PROVIDER NUMBER
CERTIFIED GERONTOLOGICAL NURSE (RN-BC), ANCC
FEDERAL DEA CONTROLLED SUBSTANCE REGISTRATION
CURRY GEN. HOSP./BROOKINGS MED. CTR PART B
PRIORITY PARTNERS ( JOHN HOPKINS HEALTH PLAN)
ANTHEM BLUE CROSS & BLUE SHIELD PIN NUMBER
UPDATED KY LICENSE PROFESSIONAL COUNSELOR NUMBER
OPTUM BEHAVIORAL HEALTH- UHC AWAKEN THE POWER THERAPY, LLC
WEST VIRGINIA PODIATRY LICENSE NUMBER DAVID FRANKE, DPM
GROUP NPI NUMBER FOR CONSULTANTS IN CARDIOVASCULAR MEDICINE S C
ANTHEM BCBS OF CT- WELLMORE GRP/FACILITY
IND. MEDICARE PIN - PARTNERS PHYSICIAN GROUP
BLUE CROSS BLUE SHIELD OF ALABAMA / STRINGFELLOW HOSP
CC SYSTEMS/BLUE PLUS FOR DATES PRIOR TO 9-1-07
BOSTON MEDICAL CENTER THROUGH VALLEY HEALTH PHO
BCBSTN/BLUECARE/TENNCARE FOR DR. STEPHEN MCKINLEY
ANTHEM BCBS THRU CENTRAL INDIANA CHIROPRACTIC
IOWA CONTROLLED SUBSTANCE ACT LICENSE (EXPIRED)
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
ARCIS HEALTHCARE MEDICAID GROUP LEGACY NO.
CONTROLLED SUBSTANCE REGISTRATION FOR PRACTICIONER
PASSPORT ADVANTAGE- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY
PALMETTO GBA MEDICARE EFFECTIVE 2/25/2013
PASSPORT- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY
OKLAHOMA STATE BUREAU OF NARCOTICS AND DANGEROUS DRUGS CONTROL
PASSPORT ADVANTAGE- LOUISVILLE ARM AND HAND
BLUE CROSS BLUE SHIELD/BLUE CARE NETWORK OF MICHIGAN
MEDICAID-GROUP PROVIDER (DOCTOR CHAN MEDICAL PRACTICE, PC)
DEA - GREENEVILLE IN SHAPE HEALTH CENTER
BLUE CROSS BLUE SHIELD FEDERAL EMPLOYEE PROGRAM
MEDICARE PTAN - THREE RIVERS MEDICAL GROUP
RAILROAD MEDICARE INDIVIDUAL PROVIDER ID
PSYCHOLOGIST EDUCATOR ADVOCATE CONSULTANT ERUDITE TASK FORCE
RAILROAD MEDICARE- NORTON LOUISVILLE PRIMARY CARE CENTER
MEDICARE PART B FOR EYE ASSOCIATES OF OVERLAND PARK
GROUP MEDICAID NORTH BEND MEDICAL CENTER
OPTUM BEHAVIORAL HEALTH/UBH WELLMORE GRP/FACILITY
UBH UNITED HEALTHCARE WELLMORE GRP/FACILITY
MEDICARE- NORTON MATERNAL FETAL MEDICINE SPECIALISTS
AMERICAN OSTEOPATHIC BOARD OF FAMILY PHYSICIANS (AOBFP) OSTEOPATHIC MANIPULATION
RI MEDICAL CENTER GENERAL HOSPITAL PHYSICIAN GROUP
BEACON HEALTH STRATEGIES WELLMORE GRP/FACILITY
GROUP NPI - WALDORF FAMILY MEDICAL CENTER
RAILROAD MEDICARE ATTACHED TO GRP# DR6927
USCG CERTIFICATE OF REGISTRY - MEDICAL DOCTOR
DAVIESS COUNTY HOSPITAL MEDICARE PROVIDER #
FIRST HEALTH COMMERCIAL/COVENTRY HEALTH/SOUTHERN HEALTH
ANTHEM PROVIDER NUMBER - FAMILY MEDICINE
COVENTRY NATIONAL NETWORK/SOUTHERN HEALTH/FIRST HEALTH
LABOR AND INDUSTRIES CRIME VICTIMS-MEDICAL IMAGING ON 1ST