alabama fy 2017 ce panelist name onsite visit · anne harris ph.d. x arizona center for chest...

CE Panelist Name Onsite Visit

ABNEY, RICHARD SADAMS, CRAIG BADAMS, HOMER GREGORYADAMS, JENNIFER LYNNADEDIJI, OLUYINKA SAGHEDO, OSASERE LAMBERTAL INSTITUTE FOR DEAF & BLIALDAHER, AMMAR SAEMALEXANDER, JENNY SARAHAMAN, MARIO LANDERSON, JUSTINANDRADE, REGAN MAPPEL, MARK ELLIOTTARKIN, LAWRENCE MARNOLD, MARY R YARYANPURE, FAWADASHLEY, CLAUDE THOMAS JRASSAAD, SAMERATKINSON, BONNIE L PHDAZRIN, RICHARD LBAALMANN, CHRISTOPHER GERARBABB, ALAN MARK YBABI, BASSAM MDBADEWA, ABIODUN PHILIPBANNER, SAM RBANOS, JAMES HUBERTBARNES, BRITTANY LETRELLEBARRON, WILLIAM R JRBARTEL, FRANCES KBASDEN, BRETTBASHIR, LOTFIBASS, JEREMY STUARTBATES, HOLLIE LYNN CCCBEATY, STEPHEN LEEBECKER, ERIC GENEBEHAVIORAL HEALTH OF SELMABEHAVIORAL MEDICINEBEIDLEMAN, WILLIAM BBELL, ROSA JBENNETT, THOMAS SBENNETT, WILLIAM LBENTLEY, JACK L JR YBERNSTEIN, MICHAEL RBERRY SAWYER, KIMBERLEE CAR

Alabama FY 2017

BETZ, ROSE MBIRMINGHAM HEALTH CAREBLACKBURN, LINDSEY PAIGE CCBLAKE, JAMES DAVISBLAKEMAN, REBECCA SUSANBLANDFORD, JILL MARIEBLANTON, DONALD WBLAXTON, ANGELA SEARCYBLEICH, STEVEN NEILBLOCK, PATRICIA ANNBLOTCKY, ALAN DBLOUNT, KELLY ABLYTHE, WILLIAM RBODENHEIMER, LUCILEBONDS, TERRY LEONBOOHAKER, HIKEL ALFREDBOOTHE, JULIA LETTBORN, HENRY MBRANTLEY, WARREN GBRAY, VAUGHN GBRAY, VAUGHN GILBERTBRITT, RENE JOFFRIONBRITTON, DAVID MICHAELBROOKS, ALISSA ANTHONY CCCBROWN, KENNETH CBUCKMASTER, CHARLES VANCEBUFF, MELISSA TRAYLOR CCCBURCHFIELD, ASHLEY KEIRBURRUS, A EMBRY CCCBURTTRAM, EMILY CAROL CCCBUTTS WILKERSON, ASHLEIGH DBYNUM, JERRY MCAHABA VALLEY IMAGINGCANNON, STERLING LCARDEN, WHITNEY RACHELLE CCCARPENTER, DARRELL WAYNECARTER, LARRY DCARTER, LE HUONGCASTRO, OSCAR LOPEZCENTER FOR SPEECH & LANGUAGCHADWICK, BRIAN STEPHEN MDCHAMPION, ERNEST JCHATTANOOGA SERVICES LLCCHIVUKULA, KRISHNA KISHORECHOI, YOUNG HCHROMIAK, STEPHEN BLAISECHU, RONNIE T

CITRIN, BENJAMIN SOUTHERCLANCY, PRISCILLA WILSONCLARDY, JOHN WCLARK, DANIEL CCLARK, DOUGLAS CCLARK, MARIEL LAKEITHACLAY COUNTY HOSPITALCLEARMAN, PATSY R CCCCOLEY, JUSTIN ALEXANDERCOLLINS, JACQUELYN OLIVIACOLON, SYLVIA NOEMICONFER, WILLIAM NCOOSA DIAGNOSTIC CENTERCORNELIUS, KIM HUGGINS CCCCOTNER, SHELBY LYNN CCCCRAWFORD, CYNTHIA L CCCCRISLER, MEGAN ELIZABETHCRUMPTON, BRET CCURRAN, EDWARD LDANIEL, LISA BDANIELS, JENNIFER BRIDGESDANNEMANN, ANDREW FDAUM, KENT MICHAELDAVIS, ALLYNDA HEATHER CCCDAVIS, DANA KDAVIS, JOHN WDAVIS, NORMA BONNESSDAVIS, TERASA L PSYDDEERING, JOSEPH ADEFRANCISCO, ROBERT ANTHONYDEKALB REGIONAL MEDICAL CENDEMPSEY, THOMAS RDENES, GABRIEL EDENNIS, MAURICE ERNEST JRDEPARTMENT, LABORATORYDEPARTMENT, NEURO-TESTINGDEPARTMENT, RESPIRATORY CARDEPARTMENT, X-RAYDESAI, SAURABHDEVINE, CYNTHIA LYNNDICKERSON, JASON KDILLON, MARNIE SMITHDIXON, JAMES RICHARD IIDIXON, JOE WDOBBS, RICKI DDOSUNMU OGUNBI, SESI ODOWNEY, D'ANN

DRAKE, BRADLEY ODDRIVER, JOSHUA JDRUMMONDS, MIRIAM REIDEAGAN, DANIEL J JREASTER SEALS CENTRAL ALEASTMAN, KIMBLE MANLEY CCCEATON, LELAND WILMOTEDDINS, CHARLES MARTINEDGE, ROBERT E ODEICH, BRUCE SEICHLER, EDWARD MATTHEW PHDEISCHENS, GEORGE NEKAMBARAM, RAJAPPAELIZA COFFEE MEMORIAL HOSPIELLEDGE, E SCOTTELLIOTT, KIMBERLYELLIS, MARK BRIANENT ASSOCIATES OF AL PCEPPERSON, LARRY WAYNEERIC KEETON, DIAGNOSTIC IMAESLAMI, NASROLLAHESTIS, WILLIS CLEVE LPCEUGENE, DAJUANDRA YVONNE CCFAVA, ANTHONY JFAVROT, STEPHEN RFAYETTEVILLE PSYCHOLOGICAL YFELLERS, PAUL HOKE JRFERGUSON, BILL RYANFEW, GARY CFISCHER, SUZANNE MFLEITAS, DONNA SFLEMING, SAMUEL E IIIFLOWERS HOSPITALFONTANA, ANDRE JFOSHEE, HARRIETT BFOSTER, CARL ANDREWFOSTER, PRIMA RAOFRANKLIN, MONICA SANDERS CCFREEMAN, MICHELLE SFREIJ, WALID WFURR, STEVEN PAULGAFFNEY, JACQUELYN CHRISANAGALLOWAY, MIREYAGAM, JOHNGANDY, ROBERT NEILGANNON, TIMOTHY HUGHGARCIA, RUTILIO

GARVER, ROBERT I JRGASTON, TYLER ELYSEGATLIN, RISHA KAHLIL MDGERMANSON, SARAH WGERSH, JONATHAN BGHOSTLEY, DAVID C PSYDGIBSON, ASHLEY ELIZABETH CCGILL, MARLIN DGILLILAND, RICHARD EGILLMAN, KORTNI GRACEGLASS, A TERESAGLASS, RACHEL CCCGODSIL, RAYMOND DEAN JRGOELZ, KEVIN TYLERGOFF, JOHN RGOLI, PRAMEELA DGOLI, VASUDEVA RAOGORDON, DAVID LGORDON, SALLY A YGOTTHELF, HEATHER GRAY CCCGREEN, GREGORY CHADGRESSARD, TABITHA AILLENEGRIFFIN, JAMIE TARENAGRIFFITH, HENRY RANDALLGRINDLEY, NATOYA NATALEEGUPTA, RITESHHABEL, MARTIN LHAGER, KENNONHAGER, ROY THAKIM, HISHAMHAKIMA, MALAIKAHALL, CHARLES EDWARD JRHALL, DAVID DHAMMACK, CURRY BHAMMAD, IADHANEY, JOHN RHARPER HOGAN, CATHY LORRAINHARRELSON, GARY BRYDENHARRIS, BENJAMINHARRIS, RICHARD REXHARRISON HOLLINGER, KAREN DHARRISON, BOYDE JEROMEHARRISON, HAROLD EUGENEHARRISON, JESSICA CCCHART, JERRY LHARVEY, JAMES SPOTTSWOODHAYDEN, STEVEN MARK

HAYNES, ANDRE VONTRALHEERSINK, MARNIX EHEERSINK, SEBASTIAN BERNHARHERNANDEZ, NATHANIEL DANIELHERNDON, GRACIE THOMANHILL HOSPITAL OF SUMTER COUHILL, CHARLES DAVIDHILL, CHRISTI CHODO, DAVID WARDHOERCHER, MELISSA WHOLCOMB, WILLIAM EHOLLINGSWORTH, SAMUEL FHOLT, MICHAEL MHORTON, RUTH CAROLYNHOUSTON, JAMES THOMASHOVATER, MICHAEL BRIANHUDSON, IKEISHA NICOLE CCCHUDSON, MARY ANN CCCHUNTE, EYSTON AHUNTSVILLE HOSPITAL CENTERHUNTSVILLE IMAGING CENTERHUTTO, JUSTIN ROSSIMC DIAGNOSTIC & MEDICAL CLINTERNAL MEDICINE ASSOC PCIQBAL, FAHEEMIYER, ANAND SATHYANIYER, SATHYAN VIZER, JAMES DJACKSON, FREDRICK JJACKSON, J MJACOBS, ANN LJACOBS, J WALTERJAMPALA, VIJAYANARAYANA RAOJANI, HIRENKUMARJARIWALA, HASMUKH NJEFFERSON, RAY WILLIAMJENNINGS, THOMAS ALANJETT, KATHRYN O'DONNELL CCCJIMMEH, DECONTEE MUSUBAJIN, CHANG KONJOHNSON, E ARNOLDJOHNSON, ERIC J IIJOHNSON, ERNEST VANJOHNSON, JOANN ELIZABETHJOHNSON, JOHN ALEXANDERJOHNSON, NORMAN CJOHNSTON, MICHAEL W

JONES, JOHN ALLEN IIIJONES, JOHN TAYLORJORDAN, RANDALL GREENJOYNER, APRIL CCCJUNKIN, MARY REBECCA CCCKAPLAN, PHILIP LKASMIA, ABDEL HAKIMKASSAMALI, RAHIMKATTA, SADASIVA RKAYL, AMY ELIZABETHKAZI, ABDUL AHADKEYS, KENT CALHOUNKHAN, FARRUKH SHOHABKHAN, KHALID LKHAN, MINA SALEEMKHAN, ZAKIR NAEEMKHDAIR, IMAD ABDELHAFIZKIDD, HUEY RANDOLPHKIDD, KELLI DIANE CCCKING, GLEN DKING, MICHELE M PHDKING, RAEKING, WILLIAM DANNYKIRK, SHANNA FLEMINGKIRKLAND, KALE EDNEYKIRKLAND, KARLKIRSCHBERG, GORDON JOSEPHKLINE, ROBERT JKLINE, ROBERT SAMUEL IIIKNOX, SHELIA BALLEW CCCKUREMSKY, MARSHALL ALEXANDEKURTZ, ROBIN SKYLER, ASHLEY NICOLE CCCL V STABLER MEMORIAL HOSPITLAB CORP OF AMERICA HOLDINGLAB CORPORATION OF AMERICALAB, BRENDA GOOLSBY,LAB, VASCULAR CLINICALLABCORPLABORATORY CORPORATION OFLABORATORY CORPORATION OF ALACONSAY, KENDRA LLADIPO, ADETOKUNBOLAMBERT, AMANDA PATTERSON CLAMKIN, THOMAS GLANCASTER, JOHN WILLIAMLANDRETH, STEVEN RODNEY

LARY, JOHN HOWARD JRLAW, CHERYLLAWRENCE, CHUCK WAYNELESTER, FRANK MARTINLEWALLEN, KATIE CLEWIS, SHERRY ALIEBERMAN, LEWIS ROBERT PHDLINDSEY, JAMES BLINDSEY, LAURA MLIU, JIA CCCLOTT, ALLISON NICOLELOTT, JAMES H IIILOWRY, ASHLEY BROOKEMADDEN, MICHAEL C MDMAIERHOFER, RICHARD AMAJURE, DORN RALPH JRMANASCO, JAMES HMASON, JOHN LAWRENCE JRMATES, AARON KYLEMATIN, FAZLE MDMATTHEWS, BELVIA WMAY, WILLIAM RUSSELLMCATEE, KATHERINE K CCCMCCLAIN, ANNY LMCCLOUD, MARK AMCCLOUD, MARK ALLENMCCLYMONT, ALDENE ANN MARIEMCDADE, CAREY LAVONMCDONALD, WILLIAM DAVIDMCFARLAND, BRIAN ROBERTMCGIVERN, BRENDA LMCKINLEY, JOANNA ANDREWSMCLENDON, JOHN PAULMCNAMARA, CRAIG RICHARDMDSI PHYSICIAN GROUP INC Y Volume ProviderMED PLUS DISABILITY INC Y Volume ProviderMEADOWS, RICHARD VMEDICAL & PSYCHOLOGICALMEKA, SARATMENA, BLANCA LILIANAMERCADO AYERS, LISA NICOLEMILLER, PAUL CAUDILLMIZELL MEMORIAL HOSPITALMOBILE INFIRMARY MEDICAL CTMOHAMED NEMIARY, DEINA SAYEMOHON, DAVID DUANEMOIZUDDIN, SAMIA SANA

MOLLOHAN, ERNEST LEEMORAN, SILVIA GUTIERREZMORGAN, ASHLEY DEALEMORGAN, R KEITHMORRIS, LAUREN BETHMORROW, JEFFERY AMORTON, DAVID ALANMULL, MICHAEL BMULLADY, THOMAS FMUNOZ, GABRIELAMURPHY, RICHARD MMURRAY, DARRELL LEEMYERS, GREGORY JAYMYERS, KENTONNADELLA, RAO RNARO, ANGELENE HANKS MCDNAVARRETE, KELLY MARYNELDER, DOROTHY KNEVILLE, CYNTHIA ANEVILLE, JOHN WNICHOLS, JUNENIX, CYNTHIA PURONOLAN, ROBERT JNORWOOD, ESTON G IIINOVELLI, PATSY GOBLENA, JOSE MACARAIGODEH, STEVE OPITAODI, EMMANUEL OLUSOLAOGUNTUYO, JIMMY APADOVE, STUART JPARISH, TIMOTHY DPARKS, WILLIAM BRIANPARVIN, NATHAN EPATEL, GHANSHYAMPEARL, RICHARD WPEDDADA, RAM RAOPEREZ, SARAH ROBERTSPERRIN, BRIAN THOMASPETERSON, CRAIG RAYMONDPETERSON, RUSSELL DOAKPETTY, BENJAMIN MARTINPIROFSKY, JEFFREY GPLEXICO, LAURA W CCCPLUMB, ALLISON MARGARET CCCPOINTER, ANDREA WALKER CCCPOOLE, JAMES HPOOLE, JAMES H OD

POPE, KELLIE CPOPOV, DIMTCHOPORTER, CHEBON APRESLEY, CYNTHIA CCCPRICE, RYAN CHRISTOPHERPRINCE, CATHERINE CLAYTONPROHASKA, MARK LPUGH, RACHEL MPUGH, VELDA DPULLIAM, JASON BQUALITY OF LIFE HEALTHQUIRK, PATRICK JRAHN, DAWN R CCCRAINS, JAMES C JRRAMER, DANA QUINNEY CCCRAMSEY, MICHAEL JRANDOLPH, CHRISTOPHER SREDDY, A MAHENDERREDUS, MICHAEL JAMESREYNOLDS, DAVID WREYNOLDS, RICHARD STEVENREYNOLDS, TERRY ERICKLESS, MORTON SRIHNER, MICHAEL ANTHONYRIKARD, JULIE ANNRINN, ROGER CRIVERVIEW REGIONAL MEDICALROBBINS, CHARLES NROBERTS, LINDSEY WELLS CCCROBERTSON, ANDREA S CCCROBIDOUX, STEPHEN JRODRIGUEZ, KIMBERLY ZLOMKEROLAND, JENNIFER HICKS CCCROMEO, BRUCE WRONAN, KATHLEEN PHDRONEY, TARA SMITHROSENBAUM, MICHAEL SRUSSELL MEDICAL CENTERRUSSELL, DALLAS M MD YSANDUSKY, PATRICIA MSANDY, JOHN THOMASSAUCIER, K SCOTTSAXENA, SANJEEVSAXON, SAMUEL AUGUSTUSSCARBROUGH, LATANDRA CSCHMITT, LANE S CCCSCHOEL, SUZANNE GRAPHOS

SCOTT, AUBREY LEE JRSEARCY, JOHN ESERVICES, CARDIOPULMONARYSETTLE, HAROLD PSHAIKH, ILYAS ASHARMA, BHAVNASHARPE, DERON VINCILSHARPE, THOMASINA ANDERSONSHELBY BAPTIST MEDICAL CENTSHENESEY, JESSICA WELLSSHERMAN, ALAN JAYSHUBAIR, MOHAMMED KSIDHPURA, JAGDISH RSILLIMAN, KEITH CSKELTON, LARRY OSLAVICH, IVAN LEWIS IIISMITH, ERIN MSMITH, JERRI HENDRIX CCCSMITH, JOE FRANKSMITH, JUSTIN DONALDSMITH, KENNETH RANDALLSMITH, MARK PSMITH, VONCEIL CORNELIUSSNODGRASS, MICHELLE BOUCHERSONG, DAE YONGSTANFORD, SUZANNE BAIRSTARKEY, KENNETH RANDALLSTARKEY, PAMELA MORTELLAROSTEPHENS, PAUL V MSSTEVENS, ERIN NICOLESTEWART, EMILY B CCCSTEWART, SCOTT JSTILES, WARREN ASTORJOHANN, ROBERT ASTOUGH, CAROLINE KIMBROUGHSTRASSBURG, MARK FREDERICKSTROUP, KIMBERLY WATKINSSTUDSTILL, SHERRI LYNETTESTURRIDGE, KIRK ALEXANDERSTUTTS, W LEESULLINS, STEVE LSUMMERLIN, ROBERT G PHDSUON, VANNARITH SSYED, ASHRAF AHSANTALERICO, CHRISTINA MARIETAMBURIN, JEFFREY MTANG, LONI R

TARABEIN, RASSAN MTAYLOR, BRANDON ADRIANTEMPLE, JAMES PTENBRUNSEL, THOMAS WTENCHAVEZ, ALVIN VTHOMAS, BRIAN PSYDTHOMAS, CARLA MDTHORNTON, PEGGY BTOBING RUIZ, BETH HTOCCI, NINA E PHDTODOROV, ALEXANDRE BTRI STATE OCCUPATIONAL MED.TUBRE, KRISTIN RENEETUCKER, KELLY ALLEN CCCTURNER, JOSEPH RYANUKACHI, CHIMA AUSTINUNIVERSITY OF AL BIRMINGHAMUNIVERSITY OF SOUTH ALUSA SPEECH & HEARING CENTERVAKHARIA, BHARAT KVANSICKLE, KAYCIA LYNNEVAPHIADES, MICHAEL SVARDEN, KEVIN KEITHVAUGHAN, WALLACE C JRVEREN, AUDREY CLARK CCCVESTER, ALPHONZAVESTER, TERRY YVONNEOLLENWEIDER, GLEN PAULVORA, AMIT VWADLEY CORNERSTONE CLINICWALKER, ALLISON ELIZABETHWALKER, EDWARD EARLWALKER, PAUL LANCEWALKUP, ROBERT H JRWALTZ, SHARON DIANNE Y Volume ProviderWANG, CHUNLEIWARREN, FERNELLE LEKOYNEWARREN, PAULA PROVINCEWATKINS, PAUL ACKER MACPHERWEBER, ELLEN STAMMERWEBSTER, DESIREEWEEKS, HOPE MCARNWEIHING, MORGAN CCCWELCH, KATHY CCCWELLS, BARBARA KWHATLEY, WESLEY STILESWHEELER, KRISTOPHER SCOTT

WHITCHARD, KIMBERLY AWHITE SPUNNER, SUANNEWHITE, ZANETHA LASHAY CCCWILLIAMS, ASHLEY RWILLIAMS, LUCILE TWILLIAMS, MICHAEL SETHWILLIAMS, TED ALEXANDERWILLIS, LAURA B CCCWRIGHT, CATHY L CCCWRIGHT, CATHY LYNN CCCWRIGHTS, SHARIENNE WADEWYATT, MASSI HUGHYAGER, JOHN GYANCEY, LAUREN WESTYARBROUGH, LINDSAY ANNEYONGKUMA, CALEB YONGKUMAYOUNG KING, MELISSA RENEEYOUNG, CAROLYN ELAINE CCCYOUNG, FRANK C IIIZARZAUR, JOSEPH AZYLLA JONES, ELIZABETH CCC

Active Alaska DDS CE Providers Name Title Speciality Location License Exp Date* Start Year Top 5/Onsite Done

Active Alaska DDS CE Providers

Andreassen, Ray DO Family Practice Delta Junction 12/31/2018 2017

Batchelder, Darlene SLP Speech/Language Anchorage 9/30/2018 pre-2000

Bigelow, Sarah PA-C General Practice Anchorage 12/31/2018 2012 Yes/IPMS

Bock, Jacqueline PhD Psychology Kenai 6/30/2019 2005

Breffeilh, Robert MD Ophthalmologist Juneau 12/31/2018 2001

Campbell, William MD Psychiatry Anchorage 12/31/2018 1981

Christensen, Ron MD General Practice Anchorage 12/31/2018 1990? Yes/IPMS

Coon, Larry OPT Optometry Fairbanks 12/13/2018 2002

Craig, Paul PhD Neuropsychology Anchorage 6/30/2019 pre-2000

Downs, Mary MD Neurologist Anchorage 12/31/2018 2014

Downs, Wayne MD Neurologist Anchorage 12/31/2018 2014

Foelsch, James MD Neurology Fairbanks 12/31/2018 pre-2000

Geeseman, Deborah MD Psychiatry Anchorage 12/31/2018 2016

Gevaert, Michel MD Physical Medicine Anchorage 12/31/2018 2016

Gonzales, Dan PhD Psychology Anchorage 6/30/2019 2011 Yes

Gritzka, Thomas MD Orthopedics Anchorage 12/31/2018 2000

Hammond, Thomas MD Otolaryngology Fairbanks 12/31/2018 2010

Hansen, Michael PA-C General Practice Anchorage 12/31/2018 2012 Yes/IPMS

Hansen, Peter MD Family Practice Kenai 12/31/2018 1990?

Hill, Lani ANP General Practice Ketchikan 11/30/2018 2013

Hunter, Robert MD General Practice Sitka 12/31/2018 2001

Jensen, Welby MD Psychiatry Kodiak 12/31/2018 pre-2000

Johnston, Shawn MD Physical Medicine Anchorage 12/31/2018 2016

Jones, Laura PhD Psychology Anchorage 6/30/2019 pre-2000

Kesselring, John PhD Psychology Juneau 6/30/2019 2003

Kim, Sam MD Otolaryngology Fairbanks 12/31/2018 2009

Klimow, Susan MD Physical Medicine Anchorage 12/31/2018 pre-2000

Langdon, Mary MD Psychiatry ANC/Homer 12/31/2018 2016

Levine, Larry MD Physical Medicine Anchorage 12/31/2018 2016

Lovering, Nancy SLP Speech/Language Anchorage 9/30/2018 2002

Marbarger, Peter MD Internal Medicine Anchorage 12/31/2018 pre-2000

Martin, Karen AuD Audiology Soldotna 9/30/2018 2001

Martino, Ronald MD Psychiatry/Neurology Fairbanks 12/31/2018 pre-2000

Meinhardt, Ernest MD General Practice Anchorage 12/31/2018 1990? Yes/IPMS

Morgan, Charles PhD Psychology Sitka 6/30/2019 pre-2000

Olson, Erik MD Physcial Medicine Anchorage 12/31/2018 2016

Onorato, Janice MD Neurology Fairbanks 12/31/2018 pre-2000

Ragle, William MD Internal Medicine Anchorage 12/31/2018 pre-2000

Rose, Michael PhD Psychology Anchorage 6/30/2019 1990? Yes

Russell, Heather PhD Psychology Anchorage 6/30/2019 2008

Sexton, Joyce AuD Audiologist Anchorage 9/30/2018 2001

Shank, John OPT Optometry Kodiak 12/31/2018 2010

Smith, Douglas MD Psychiatry Anchorage/Juneau 12/31/2018 2007

Smith, Kyle OD Optometry Anchorage 12/31/2018 2016

Totten, Mary MD Otolaryngology Anchorage 12/31/2018 2015

Turner, Paul PhD Psychology Kenai 6/30/2019 pre-2000

Thurston-Hicks, A. MD Psychiatry Fairbanks 12/31/2018 2012

Ver Hoef, Anne SLP Speech/Language Anchorage 9/30/2018 2006

Voigt, Jessica AuD Audiologist Anchorage 9/30/2018 2000

Wendt, Nina PhD Psychology Fairbanks 6/30/2019 2010

White, Rebecca MD Family Practice Palmer 12/31/2018 2016

Winn, Danelle PhD Psychology Anchorage 6/30/2019 2002 Yes

Wiszinckas, Evelyn PhD Psychology Kodiak 6/30/2019 2005

*At the time of License Expiration Date, the State Licensing website is checked for a license renewal and new expiration date.

Concurrently, the SAM website is also queried.

Former Panelists

Preecs, Gordon

Zuelsdorf, Dean

Arizona DDS Providers: FFY 2017Page 1 of 4

Attachment 2: CE Magement Oversight Report; AZ-FFY 2017 Key Providers Onsite Reviews(Per POMS: DI

39545.100)

(Per POMS: DI

39545.500)

TOTAL ARIZONA DDS CE PROVIDERS; FFY 2017 = 181$$= ≧$150k

Phoenix Providers = 141 PP= Primary Practice

Tucson Providers = 40 T5= Top 5

VENDOR NAME PHOENIX

(S03)

TUCSON

(V16)

ADRIANA WEYER PH.D. X

ADVANCED EAR NOSE AND THROAT X

ALEXANDER PIATKA PH.D. X

ALICIA NIETO JACOBS X

ALL ABOUT SPEECH X

ALYSHA TEED PH.D. X

AMANDA NELLIS PH.D. LPC X

AMY D'AMBROSIO PSY.D. (DDSA) X

ANDREW C. JONES, PH.D. X 06/14/17; 06/22/17

ANGEL GOMEZ M.D. X 08/03/17

ANNE HARRIS PH.D. X

ARIZONA CENTER FOR CHEST DISEASE X

ARIZONA PSYCHOLOGICAL ASSESSMENT, INC X $$ PP T5

ARMANDO BENCOMO PH.D X $$ T5 06/14/17

ASHVIN K. SHAH, MD PC X 06/14/17

ASU SPEECH AND HEARING CLINIC X

AZ TECH RADIOLOGY X

BANNER CASA GRANDE MEDICAL CENTER X

BANNER HEALTH PAGE HOSPITAL X

BARNET DULANEY PERKINS EYE CENTER X 06/22/17

BEST MEDICAL GROUP, LLC X

BEVERLY JO YOCHES PSY.D. X

BRENT GEARY PH.D. X

BRIAN BRIGGS M.D. X

CANYON VISTA MEDICAL CENTER X

CARTER IMAGING CENTER X

CATHOLIC COMMUNITY SERVICES OF SOUTHERN ARIZONA X

CELIA DRAKE PH.D. X

CHANGE POINTS COACHING & CONSULTING, LLC X

CHARLES HOUSE PHD X

CHARLES S. GANNON, MD X

CHRISTINA M VASQUEZ, PH.D. X 03/09/17; 04/24/17

CHRISTINE TETZLOFF, PH.D X 08/17/2017

COBRE VALLEY COMMUNITY HOSPITAL X

COMPUDIAGNOSTICS INC X

CONCENTRA URGENT CARE X

CONNIE PYBURN PH.D. X

COOPER LOPEZ AND ASSOCIATES, PLLC X 06/22/17

DANIEL CHATEL PH.D. X

DAVID BEIL-ADASKIN, PSY.D X 06/14/17; 06/22/17


VENDOR NAME PHOENIX

(S03)

TUCSON

(V16)Key Providers Onsite Reviews

DAVID JARMON PHD X

DAVID MCGAREY, MD/THOMAS JOHN X

DESERT VALLEY RADIOLOGY X

DEVELOPMENTAL & EDUCATIONAL PSYCHOLOGICAL SERVICES X

DIAGNOSTIC AND INTERVENTION SVCS, PC X

EAST VALLEY DIAGNOSTIC IMAGING X

EAT TALK AND PLAY THERAPY LLC X

ERIN SOUTH PSY.D. X

FBH PSYCHOLOGICAL SERVICES PLLC X

FLAGSTAFF MEDICAL CENTER X

FOUR CORNERS RADIOLOGY X

FRANCISCO SANCHEZ, PH.D X 03/09/17

FRED WIGGINS, PH.D X

G & K MEDICAL ASSOCIATES PC X

GARY REYES PH.D. X

GEORGE DELONG, PH.D. X 08/18/2017

GLENN MARKS, PH.D X

GREGORY HUNTER MD X $$ PP T5 08/18/2017

GRETCHEN SCHEURICH SLP X

GWENDOLYN W. JOHNSON, PH.D. X

H2 CHANGE, LLC X 06/05/17

HAVASU REGIONAL MEDICAL CENTER X

HEATHER NASH PH.D. X

IMAGING CENTER @ YUMA REGIONAL MEDICAL CENTER X

INSIGHT IMAGING CENTER X

INTERMOUNTAIN HEALTHCARE X

JACQUELINE KAYE MA CCC-SLP X 06/14/17

JACQUELINE WORSLEY PSY.D. X

JAMES ARMSTRONG, PH.D. (YUMA) X 06/14/17

JAMES HUDDLESTON PH.D. X

JASON FRIZZELL PH.D. PLLC X

JEFFREY MOORE, AU.D. X

JERI B. HASSMAN, MD X $$ T5 01/05/17; 06/14/17

JEROME ROTHBAUM, M.D. X PP T5 03/09/17; 04/13/17

JESSICA LECLERC PSY.D. X

JILL M. PLEVELL, PH.D. X

JOHN MATHER PH.D. X

JONATHON GROSS, M.D. X

JONI LONG SLP X

JOSE ABREU PH.D. X $$ PP T5 02/17/17

JOSEPH BENACH, PSY.DX 01/05/17; 06/14/17;

06/22/17

JOSEPH BURRIDGE (JEA ASSESSMENTS) X

JUSTIN JOHNSEN MD X

KARI COELHO PSY,D X

KARIN AHLSTRAND, PH.D. X

KARLAYE RAFINDADI, PH.D X 06/05/17


VENDOR NAME PHOENIX

(S03)

TUCSON


KATHRYN L BROWN DO X

KATHY HANSEN INTERPRETING & TRANSLATION X

KEITH CUNNINGHAM MD X $$ PP T5 03/14/17

KELLY JENKINS SLP X

KENT COX MD X

KIDS HEALTH AND HARMONY X

KIM JOHNSON PH.D. X

KRASNER MEDICAL CONSULTANTS, LLC X 06/14/17

LA PAZ REGIONAL HOSPITAL X

LABCORP X

LANGUAGE CONNECTION X

LITTLE COLORADO MEDICAL CENTE X

LITTLEFIELD PSYCHOLOGICAL SERVICES, INC X

LYNN L. FLOWERS, PH.D. (YUMA) X 06/14/17

MACHELLE MARTINEZ, PH.D. X T5 07/06/17

MAHSA SALEK, SLP X

MARICOPA EAR NOSE AND THROAT, PC X

MARYANNE BELTON, PSY.D. X 08/21/17

MATTHEW HELLER, DO/WARREN HELLER, MD X

MDSI X $$ PP T5

MEDICAL DIAGNOSTIC IMAGING GROUP X

MEDICAL DIAGNOSTIC SERVICES X

MEDICO X $$ PP T5 10/08/16, 06/06/17

MICHAEL CHRISTIANSEN, PH.D. X

MICHAEL P. MOORE, PH.D. X 06/22/17

MICHELE SMITH, SLP X

MINETTE DOSS ED.D X

MOHAVE DESERT RADIOLOGY PLC X

MOUNTAIN WEST MEDICAL IMAGING X

MT GRAHAM COMMUNITY HOSPITAL X

NANCY HOMCO MS X

NEIL HOROWITZ PH.D. X

NEIL STAFFORD PSY.D. X

NICOLE TAYLOR PH.D. X

NOELLE ROHEN, PH.D. X PP T5 01/05/17; 06/14/17

NORTHERN ARIZONA CARDIOPULMONARY X

NORTHERN ARIZONA PULMONARY SPECIALISTS X

NORTHERN ARIZONA RADIOLOGY, PC X

NORTHERN ARIZONA UNIVERSITY X

NORTHLAND-RURAL THERAPY ASSOC X

OASIS URGENT CARE X 06/15/17

OLYMPUS HEALTH SERVICES LLC X

PALMER FAMILY MEDICINE X T5 06/22/17; 08/21/17

PATRICIA FALCON, PSY.D X

PATRICIA ROSE ED.D X

PRECISION EYECARE INC. X

PRESCOTT MEDICAL IMAGING, LLC X


VENDOR NAME PHOENIX

(S03)

TUCSON


PRIORITY MEDICAL CENTER INC X

PROFESSIONAL COURT INTERPRETING & TRANSLATION X

PSYCHOLOGICAL ASSESSMENT ASSOCIATES OF AZX

$$ PP T510/08/16, 12/15/16,

12/17/16

RADIOLOGY LIMITED X

REHOBOTH MCKINLEY CHRISTIAN HOSPITAL X

RICHENS EYE CENTER X

RICK WEBSTER, PSY.D. X

RISA NEWELL PH.D. X

RIVERVIEW VISION CENTER X

ROBIN POTTER PSY.D. X

RONIC PSYCHOLOGICAL SERVICES X $$ T5 06/24/17

RONN LAVIT PH.D X

SAN JUAN REGIONAL MEDICAL CEN X

SANDRA KNIGHT PSY.D. X

SANTA CRUZ RADIOLOGY X

SCOTTSDALE MEDICAL IMAGING X

SENTIENCE PSYCHOLOGICAL SVCS X 09/21/17

SHANNON MCGOVERN, PH.D. X

SHANNON TROMP PH.D. (PRESCOTT X

SHARON STEINGARD DO X

SHELLY WOODWARD PH.D X

SHERRI GALLAGHER PH.D X

SLOAN R. KING, PH.D. X 06/14/17

SONIA ACKERMAN M.ED., CCC-SP. X

SONIA PERALA, PH.D. X

SONORA QUEST LAB X

SOUTHERN ARIZONA RAD ASSOCIAT X

ST GEORGE RADIOLOGY X

ST JOSEPHS HOSPITAL X

STEPHEN GILL PH.D (PRESCOTT) X

STEVEN PATRICK PH.D./SUSAN PATRICK PSY.D. X

SUMMIT HEALTHCARE REGIONAL MEDICAL CTR X

TERRY COLYAR MS CCC X

TRI STATE AUDIOLOGY X

TRILOGY PSYCHOLOGICAL SERVICES X

TUCSON EAR, NOSE AND THROAT X

TUCSON MEDICAL CENTER RESPIRATORY CARE X

UNITED INTERPRETING SERVICES X

UNIVERSITY OF ARIZONA HEARING CLINIC X 05/24/17

VALLEY CENTER OF THE DEAF X

VALLEY EAR NOSE & THROAT X

VALLEY RADIOLOGISTS, LTD X

WAYNE R GENERAL, PH.D. X

WESTERN ARIZONA REGIONAL MEDICAL CTR X

WHITE MOUNTAIN RADIOLOGY X

YAVAPAI REGIONAL MEDICAL HOSP X

YESENIA SPALETA, SLP X

YUMA REGIONAL MEDICAL CENTER X

Name Vendor # City StateWHITE RIVER MEDICAL CENTER BATESVILLE AR

OUACHITA COUNTY MEDICAL CENTER CAMDEN AR

ASHLEY COUNTY MEDICAL CENTER CROSSETT AR

DEWITT HOSPITAL & NURSING HOME, INC. DEWITT AR

CARLTON NEWSOME, M.D. EL DORADO AR

EVERETT C. MOULTON, III, M.D. FORT SMITH AR

G. EDWARD BRYANT, JR., M.D. HELENA AR

NATIONAL PARK MEDICAL CTR. HOT SPRINGS AR

ST. BERNARD'S MEDICAL CENTER JONESBORO AR

DAVID MARK LEWIS, M.D. JONESBORO AR

ANTHONY D. JOHNSON, M.D. LITTLE ROCK AR

CHI ST. VINCENT INFIRMARY LITTLE ROCK AR

MAGNOLIA REGIONAL MEDICAL CENTER MAGNOLIA AR

BAXTER REGIONAL MEDICAL CENTER MOUNTAIN HOME AR

HOWARD MEMORIAL HOSPITAL NASHVILLE AR

MUFIZ A. CHAUHAN, M.D. BIRMINGHAM AL

VERN ANN SHOTTS, M.D. PARAGOULD AR

JEFFERSON REGIONAL MEDICAL CENTER PINE BLUFF AR

TED HONGHIRAN, M.D. RUSSELLVILLE AR

WILLIAM H. NEVINS, M.D. SEARCY AR

DBA NORTHWEST MEDICAL CENTER SPRINGDALE AR

LAWRENCE MEMORIAL HOSPITAL WALNUT RIDGE AR

EDGAR S. FERGUSON, M.D. WEST MEMPHIS AR

MEMPHIS NEUROLOGY MEMPHIS TN

HOT SPRINGS RADIOLOGY SERVICES HOT SPRINGS AR

ASSOCIATED RADIOLOGISTS, LTD JONESBORO AR

PATRICIA L. GRIFFEN, PH.D. LITTLE ROCK AR

EAST ARKANSAS CHILDREN'S CLINIC FORREST CITY AR

RADIOLOGY ASSOCIATES, PA LITTLE ROCK AR

MILLARD HENRY CLINIC OF RUSSELLVILLE RUSSELLVILLE AR

MOUNTAIN HOME RADIOLOGY CONS. MOUNTAIN HOME AR

PINE BLUFF RADIOLOGISTS, LTD. PINE BLUFF AR

DOUGLAS W. MARX, M.D., P.A. MOUNTAIN HOME AR

CHARLES M. SPELLMANN, PH.D. MONTICELLO AR

CHARLES M. SPELLMANN, PH.D. HELENA AR

CHARLES M. SPELLMANN, PH.D. FORREST CITY AR

CHARLES M. SPELLMANN, PH.D. BRINKLEY AR

CHARLES M. SPELLMANN, PH.D PINE BLUFF AR

ROBERT L. SPRAY, JR., PH.D. FORT SMITH AR

NANCY J. TOOMBS, ED.D. CONWAY AR

All Vendor Locations With CEs in FY 2017Arkansas FY 2017

(b) (6)

ARKANSAS PSYCHOLOGICAL SERVICES LITTLE ROCK AR

DIAGNOSTIC ULTRASOUND MEMPHIS TN

RAFAEL F. OTERO, PH.D. TEXARKANA TX

SUSAN STANLEY, MS, CCC-SLP TEXARKANA TX

VAN HOANG, M.D. FORT SMITH AR

ATIYA N. WAHEED, M.D., P.A. PINE BLUFF AR

WILLIAM B. LITTLE, PH.D. MEMPHIS TN

JOHN FLOWERS, SR., M.D. PINE BLUFF AR

JOHN B. JIU, M.D. JONESBORO AR

UCA SPEECH & HEARING CENTER CONWAY AR

DONNA M. EDGMON, MA, CCC-SLP FAYETTEVILLE AR

EDWARD C. KLEITSCH, PH.D. SHERWOOD AR

CARL E. FLINN, M.D., P.C. MEMPHIS TN

SURGICAL CLINIC VASCULAR LAB LITTLE ROCK AR

MELANIE SMITH, M.D. NORTH LITTLE ROCK AR

KENNETH M. KILGORE, M.D. HARRISON AR

KENNETH M. KILGORE, M.D. MOUNTAIN HOME AR

SHAILESH C. VORA, M. D. EL DORADO AR

SIDNEY H. KRIGER, M.D. MEMPHIS TN

DAVID LEE WEBBER, D.O. HELENA AR

ADAM STIBICH, M.D. BRYANT AR

LINDA DYER HARTSFIELD, ED.D. LITTLE ROCK AR

R. SAM BOYD, PH.D. CONWAY AR

LITTLE RED SKIN & EYE CLINIC HEBER SPRINGS AR

GLENDA G. HANSON, CCC-SLP MONTICELLO AR

NILA RENEE BOOTH, MSP-CCC COTTER AR

KENNETH HOBBY, PH.D. SEARCY AR

KENNETH HOBBY, PH.D. NEWPORT AR

WILLIAM LADELL DOUGLAS, M.D. HOPE AR

DON OTT, PSY.D. RUSSELLVILLE AR

GEORGE M. DEROECK, PSY.D. LITTLE ROCK AR

MICHAEL R. WESTBROOK, M.D. OZARK AR

THE EYE GROUP, LLC FORT SMITH AR

G. EDWARD BRYANT, JR., M.D. WEST MEMPHIS AR

BRENDA H. NOBLES, PH.D. BENTON AR

KENNETH B. ROBINSON, MS, CONSULTING SERVICES WHITE HALL AR

KENNETH B. ROBINSON, MS, CONSULTING SERVICES MONTICELLO AR

KENNETH B. ROBINSON, MS, CONSULTING SERVICES HELENA AR

KENNETH B. ROBINSON, MS, CONSULTING SERVICES BRINKLEY AR

ALICE A. ABBOTT, PSY.D. EL DORADO AR

RICHARD D. BACK, PH.D. FAYETTEVILLE AR

KENNETH B. JONES, PH.D. WEST MEMPHIS AR

(b) (6)

KENNETH B. JONES, PH.D. MARKED TREE AR

KENNETH B. JONES, PH.D. FORREST CITY AR

KENNETH B. JONES, PH.D. HELENA AR

HARRIS HEARING CENTER, INC. BATESVILLE AR

CHARLES H. MALLORY, PH.D. LITTLE ROCK AR

BENJAMIN ASAFO-BOAKYE, M.D. BLYTHEVILLE AR

PATRICIA WALZ, PH.D. FORT SMITH AR

CARA K. DEROECK, LPE LITTLE ROCK AR

MERCY HOSPITAL - BERRYVILLE BERRYVILLE AR

SHABBIR DHARAMSEY, M.D. PINE BLUFF AR

A. JACK SOMERS, JR., M.D. LITTLE ROCK AR

R. SAM BOYD, PH.D. LITTLE ROCK AR

W. CHARLES NICHOLS, PSY.D. HARRISON AR

LEE ANN BROSH, CCC-SLP LITTLE ROCK AR

COLLEEN C. ALLEN, CCC-SLP PEARCY AR

UNITY HEALTH HARRIS MEDICAL CENTER NEWPORT AR

NORTH ARKANSAS REGIONAL MEDICAL CENTER HARRISON AR

A+ HEARING SERVICE LITTLE ROCK AR

MEMPHIS HEARING AID AND AUD. SVCS. MARION AR

MERCY CLINIC RADIOLOGY HARRISON AR

BENNETT L. RUDORFER, M.D., FACC WEST MEMPHIS AR

CHRISTOPHER P. LOWRY, MA, CCC-A EL DORADO AR

J. A. ALEMPARTE, M.D. FORT SMITH AR

RONALD L. KANTOLA, M.D. FORT SMITH AR

KELLEY RENEE LINTON, AUD FORT SMITH AR

LORI R. MALONE, CCC-SLP JONESBORO AR

L. JANE BARRETT, CCC-SLP CLARKSVILLE AR

GLEN M. ADAMS, PSY.D. SEARCY AR

JANA RENE FOLEY, CCC-SLP LITTLE ROCK AR

JON HENDRICKSON, M.D. FORT SMITH AR

SUDHIR KUMAR, M.D. FORREST CITY AR

LESLEA ANN CLARK, MS, CCC-SLP CONWAY AR

ANN MARIE PRATHER, PH.D. LITTLE ROCK AR

CLOPTON CLINIC OF JONESBORO, INC. JONESBORO AR

JADA HANDWORK, MCD, CCC-SLP JONESBORO AR

BERNARD G. CROWELL, M.D. LITTLE ROCK AR

NEUROLOGY CLINIC OF SOUTH ARKANSAS WHITE HALL AR

JENNIFER J. LACOMFORA, MS, CCC-SLP HOT SPRINGS AR

KEITH NORWOOD, P.E. CONWAY AR

MICHAEL A. MCGHEE, M.D. BENTON AR

CHRISTINE GOULET, AUD FORT SMITH AR

SPEECH PATHOLOGY SERVICES, PLLC TEXARKANA TX

(b) (6)

KEITH NORWOOD, P.E. NORTH LITTLE ROCK AR

CREDONNA L. MILLER, AU.D. HOT SPRINGS VILLAGE AR

KEITH NORWOOD, P.E. JONESBORO AR

SHARON BETH GOODE, MSP, CCC-SLP MARION AR

SHARON BETH GOODE, MSP, CCC-SLP MARION AR

CHRISTIE BETH COUCH, CCC-SLP POCAHONTAS AR

CHRISTOPHER L. JOHN, M. D. LITTLE ROCK AR

WEIGHT WATCHERS OF GREATER AR SEARCY AR

WEIGHT WATCHERS OF GREATER AR RUSSELLVILLE AR

ARKLATEX ASSESSMENTS TEXARKANA TX

CHAMBERS MEMORIAL HOSPITAL DANVILLE AR

D'ORSAY D. BRYANT, III, M.D. EL DORADO AR

NANCY J. TOOMBS, ED.D. WHITE HALL AR

NANCY J. TOOMBS, ED.D. REDFIELD AR

DIANE ESTES, CCC-SLP WHITE HALL AR

NANCY J. TOOMBS, ED.D. N. LITTLE ROCK AR

SHANNON FRYE, MCD, CCC-SLP BLYTHEVILLE AR

JERRY GRANT, M.D. EL DORADO AR

SHANNON H. BROWNFIELD, M.D. HARRISON AR

WEIGHT WATCHERS OF GREATER AR FAYETTEVILLE AR

THOMAS O. BAILEY, M.D. HELENA AR

JASON FULLER, CCC-SLP SEARCY AR

FAYETTEVILLE DIAGNOSTIC CLINIC FAYETTEVILLE AR

BLAKE NORTON GEREN, M.D. FORT SMITH AR

RONALD ALAN BURKS, O.D. SHERWOOD AR

TIMOTHY OVERLOCK, M.D. TEXARKANA TX

GEM (GERALDENE E.) MOORE, PH.D. LITTLE ROCK AR

SHANNON TANNER SEARCY AR

JAMES A. SIMPSON, M.D. SEARCY AR

STEPHEN P. NICHOLS, PH.D. FAYETTEVILLE AR

DEBORAH LYNN ANDRADE SILOAM SPRINGS AR

DAVID LEE WEBBER, D.O. FORREST CITY AR

INGE RENATE CARTER, M.D. LITTLE ROCK AR

WILLIAM KENNETH CLARY CLARKSVILLE AR

ANDREA SHEA STILLWELL, PSY.D. BENTON AR

KEITH NORWOOD, P.E. PRESCOTT AR

KEITH NORWOOD, P.E. FAYETTEVILLE AR

KEITH NORWOOD, P.E. BRYANT AR

KEITH NORWOOD, P.E. MALVERN AR

LINDA RUNION JOSEF, PH.D. HOT SPRINGS AR

YVONNE H. OSBORNE, PH.D. MEMPHIS TN

ETHAN J. WRIGHT, M.D. MOUNTAIN HOME AR

(b) (6)

ETHAN J. WRIGHT, M.D. HARRISON AR

BRITTANY B. BOYETTE, O.D. SHERWOOD AR

SAMUEL B. HESTER, PH.D., P.A. JONESBORO AR

CHARLES E. REEVES, M.D. HOT SPRINGS AR

DENNIS R. VOWELL, JR., PSY.D. PARAGOULD AR

MATTIE L. IVY, CCC-SLP FORREST CITY AR

MARIA H. BARANDIARAN NASHVILLE AR

SOUTHERN MEDICAL GROUP MONTICELLO AR

SOUTHERN MEDICAL GROUP LITTLE ROCK AR



SOUTHERN MEDICAL GROUP WAKE VILLAGE TX

RICHARD L. SYLVESTER, PH.D. EL DORADO AR

DAI-YUAN WANG, M.D. RUSSELLVILLE AR

SAMUEL B. HESTER, PH.D., P.A. HEBER SPRINGS AR

SAMUEL B. HESTER, PH.D., P.A. WHITE HALL AR

SAMUEL B. HESTER, PH.D., P.A. BLYTHEVILLE AR

SAMUEL B. HESTER, PH.D., P.A. MOUNTAIN HOME AR

SAMUEL B. HESTER, PH.D., P.A. MARION AR

SAMUEL B. HESTER, PH.D, P.A. TEXARKANA AR

SAMUEL B. HESTER, PH.D, P.A. DE QUEEN AR

JOHN M. FAUCETT, PH.D. CONWAY AR

DIANA DRURY CLARK, CCC-SLP CONWAY AR

GARRY STEWART, M.D. CONWAY AR

JULIE LOWE LITTLE ROCK AR

CARA HARTFIELD, PH.D. FAYETTEVILLE AR

JEAN ANNE STONE, O.D. GREERS FERRY AR

AHMAD AL-KHATIB, M.D. BENTONVILLE AR

FORT SMITH HMA LLC FORT SMITH AR

FORT SMITH HMA PBC MGMT, LLC FORT SMITH AR

CHILDREN'S THERAPY TEAM BENTONVILLE AR

KATHRYN L. WEBB, CCC-SLP JONESBORO AR

SOUTHERN MEDICAL GROUP BATESVILLE AR

SOUTHERN MEDICAL GROUP HOT SPRINGS AR


GINNY (VIRGINIA) LYNN YOUNG, CCC-SLP SHERWOOD AR

SUZANNE MCKENNA, PH.D. ROGERS AR

JAVIER SIMANCAS-CHAVEZ LITTLE ROCK AR

JESSICA LEE CONN, CCC-SLP MARION AR

CRYSTAL D. SAVAGE, CCC-SLP TEXARKANA TX

JESSICA WRIGHT, CCC-SLP TEXARKANA TX

CAROL W. PEARCY, CCC-SLP TEXARKANA TX

(b) (6)

FELICIA L. JOHNSON, M.D. SPRINGDALE AR

LANCE A. MANNING, M.D. SPRINGDALE AR

KEVIN W. LOLLAR, M.D. SPRINGDALE AR

JARED R. SPENCER, M.D. SPRINGDALE AR

KATHRYN L. SLAY, CCC-SLP LITTLE ROCK AR

BILL F. MEARS, M.D. HARRISON AR

MEGAN HORNE CAWLFIELD, CCC-SLP FAYETTEVILLE AR

ANANDARAJ SUBRAMANIUM M.D. MOUNTAIN VIEW AR

SUSAN SKINNER HOLT, PH.D. LITTLE ROCK AR

CATHERINE HUBBARD ADAMS, PH.D. JONESBORO AR

CLIFFORD LAMAR EVANS, M.D. MORRILTON AR

ANITA GAIL WELLS, PH.D. PARAGOULD AR

MICHAEL WAYNE PARKER, PH.D. AMITY AR

MICHAEL WAYNE PARKER, PH.D. LITTLE ROCK AR

MICHAEL WAYNE PARKER, PH.D. HAMPTON AR

LEAPS AND BOUNDS THERAPY SERVICES, PLLC CHARLESTON AR

SHANNON DOUGLAS PARSONS, PSY.D. BENTON AR

ARKANSAS FAMILIES FIRST NORTH LITTLE ROCK AR

ARKANSAS FAMILIES FIRST NORTH LITTLE ROCK AR

CYNTHIA W. DUPUIS, PH.D.,PA LITTLE ROCK AR

CYNTHIA W. DUPUIS, PH.D., PA WHITE HALL AR

CYNTHIA W. DUPUIS, PH.D., PA PINE BLUFF AR

KENNAN A. DOAN, O.D. LITTLE ROCK AR

SANFORD P. HOOPER, O.D. LITTLE ROCK AR

STEPHANIE A. WILLETT, O.D. LITTLE ROCK AR

MARK E. LAREY, D.O. HOT SPRINGS AR

JAMES LEE HOOVER, ED.D. TEXARKANA TX

MICHA MORGAN LAMBERSON, CCC-SLP JONESBORO AR

KARAS HEALTH CARE FAYETTEVILLE AR

KARAS HEALTH CARE FAYETTEVILLE AR

BETH LEAH MEYER-BULLEY, PSY.D. MARION AR

MARY JANE SONNTAG, PSY.D., PA BENTONVILLE AR

KARAS HEALTH CARE LOWELL AR

SANDRA J. WILSON, LPE ASHDOWN AR

TRANSITIONS PSYCHOLOGICAL SERVICES, PLLC. DE QUEEN AR

DON BALL, M.D. PORTLAND AR

DAVID BARNETT, M.D. LITTLE ROCK AR

KRISTI KETZ, PH.D. BATESVILLE AR

CATHERINE COON, PSY.D. HOT SPRINGS AR

MARTHA GORE, O.D. FORREST CITY AR

ARKANSAS OCCUPATIONAL HEALTH CLINIC VAN BUREN AR

ARKANSAS OCCUPATIONAL HEALTH CLINIC SPRINGDALE AR

(b) (6)

ARKANSAS OCCUPATIONAL HEALTH CLINIC RUSSELLVILLE AR

DAWN PARSONS, PSY.D. MALVERN AR

SHANNON DOUGLAS PARSONS, PSY.D. MALVERN AR

KRISTEN MADDOX, MS, CCC-SLP SHERWOOD AR

MELISA LAELAN SPRINGDALE AR

HOPE LANDING, INC. EL DORADO AR

MEMPHIS MEDICAL ASSOCIATES, INC. MEMPHIS TN

DYERSBURG MEDICAL ASSOCIATES, INC. DYERSBURG TN

DYERSBURG MEDICAL ASSOCIATES, INC. DYERSBURG TN

WEST TENNESSEE PSYCHOLOGICAL SERVICES, INC. MEMPHIS TN

ELIZABETH FROMAN, M.D. SPRINGDALE AR

RADIOLOGY CONSULTANTS OF LITTLE ROCK LITTLE ROCK AR

SAMUEL G. MEREDITH, M.D. PA MARION AR

SAMUEL G. MEREDITH, M.D. PA HELENA AR

JUAN GALDAMEZ, OD TEXARKANA TX

LITTLE ROCK AUDIOLOGY LITTLE ROCK AR

VICKIE BREWER CASPALL, PH.D., ABPP-CN WALNUT RIDGE AR

LAURA L. WILLIAMS, M.D. LITTLE ROCK AR

TRACEE RAINEY, CCC-SLP HOT SPRINGS AR

RAVIKUMAR EDALUR, M.D. TEXARKANA TX

MARIA C. BANKS FAYETTEVILLE AR

JENNIFER BRUMLEY,CCC-SLP OSCEOLA AR

KIMBERLY FOX, CCC-SLP PINE BLUFF AR

JIVETTE M. DE JESUS BENTONVILLE AR

CASEY MOORE, CCC-SLP JACKSONVILLE AR

VISION SOURCE OF TEXARKANA TEXARKANA TX

CLAUDIA JORDAN, M.D. TEXARKANA TX

CAROLINE HOLT, CCC-SLP LITTLE ROCK AR

MICHAEL D. GREEN, M.D. SPRINGDALE AR

NEXUS DIAGNOSTIC LABORATORIES LITTLE ROCK AR

ERNEST CLIFTON, M.D. LITTLE ROCK AR

JENNIFER DOYLE, M.D. LITTLE ROCK AR

SPEECH PATHOLOGY SERVICES, PLLC TEXARKANA TX

JENNIFER E. LOPEZ, M.S., CCC-SLP SPRINGDALE AR

KATHY L. MORMAN, MS, CCC-SLP WARREN AR

SERENA N. MCKNIGHT, LPE-I SEARCY AR

QUANTUM REHABILITATION MAGNOLIA AR

KRISTAL M. HILL, MS CCC-SLP FAYETTEVILLE AR

BRUCE WENDELL RANDOLPH, M.D. MEMPHIS TN

CHRISTINA L. COUCH, PSY.D. RUSSELLVILLE AR

JAMES W. CARPENTER, PSY.D. ROGERS AR

CHI ST. VINCENT HEART CLINIC ARKANSAS LITTLE ROCK AR

(b) (6)

KIDABILITIES JONESBORO AR

MCFARLAND EYE CENTER HOT SPRINGS AR

RODNEY P. GOODWIN, PSY.D. EL DORADO AR

THE SPEECH PATH OF NEA, LLC WYNNE AR

SAMANTHA S. SHORT, PH.D. CONWAY AR

LAURA M. GORDON BELLA VISTA AR

FELICIA A. WATKINS-BROWN, M.D. HAMBURG AR

RADIOLOGY ASSOCIATES OF THE OZARKS, PLLC RUSSELLVILLE AR

CHESTER L. CARLSON, D.O., PLLC FORT SMITH AR

CHESTER L. CARLSON, D.O., PLLC FORT SMITH AR

BAPTIST HEALTH MEDICAL CENTER - STUTTGART STUTTGART AR




CRYSTAL L. LITTLE, M.D. MONTICELLO AR

CONWAY REGIONAL MEDICAL CLINIC - PRINCE ST. CONWAY AR




BENJAMIN SILBER, PH.D. LITTLE ROCK AR

CARSHINA C. VINCENT, CCC-SLP FORREST CITY AR

CARSHINA C. VINCENT, CCC-SLP LITTLE ROCK AR

CARSHINA C. VINCENT, CCC-SLP PINE BLUFF AR

AHMED A. ALI, M.D. CONWAY AR

PHILIP M. FURR, M.D. MEMPHIS TN

SANDRA THEODORE N. LITTLE ROCK AR

ADVANCED FAMILY EYE CARE SPRINGDALE AR




HOLT THERAPY, INC. STUTTGART AR

HOLT THERAPY, INC. ENGLAND AR




KATHLEEN BECKER CABOT AR

BYRON J. SIMONEAUX, PH.D. BENTON AR



SAMUEL S. BURCHFIELD, M.D. PARAGOULD AR

EMILY BENOIT, MS CCC-SLP FORT SMITH AR

ELITE EYE CARE & OPTICAL LLC JONESBORO AR

(b) (6)

RACHEL D. JOHNSON, CCC-SLP JONESBORO AR(b) (6)

Name Vendor # City State Visit DateVICKIE BREWER CASPALL, PH.D. Walnut Ridge AR 10/12/2016Keith Norwood, P.E. Jonesboro AR 11/14/2016ROBERT SPRAY, JR., PH.D. Fort Smith AR 11/14/2016KEITH NORWOOD P E Fort Smith AR 11/14/2016PATRICIA WALZ, PH.D. Fort Smith AR 11/15/2016Patricia Walz, P H .D Fort Smith AR 11/15/2016PRESCOTT FAMILY CLINIC Prescott AR 11/16/2016ANTHONY JOHNSON, M.D. Little Rock AR 11/23/2016NICHOLAUS PAAL, PH.D. Little Rock AR 11/29/2016CHARLES MALLORY, PH.D. Little Rock AR 11/30/2016MARTHA GORE, O.D. Forrest City AR 12/2/2016DAVID LEE WEBBER, D.O. Forrest City AR 12/2/2016DUPUIS CYNTHIA W Little Rock AR 12/9/2016Michael Wayne Parker, Ph.D. Little Rock AR 12/9/2016R. Sam Boyd, PH.D Little Rock AR 12/9/2016MIRTHA ANARELLA CELLITTI, LPE Little Rock AR 12/9/2016AHMAD AL-KHATIB, M.D. Bentonville AR 1/11/2017MICHAEL E. GREEN, M.D. Springdale AR 1/11/2017ROBERT KARAS, M.D. Fayetteville AR 1/12/2017TERRY EFIRD, PH.D. Springdale AR 1/12/2017Richard Back, PH D Fayetteville AR 1/12/2017J. CHARLES HENRY, M.D. Little Rock AR 1/18/2017SUDHIR KUMAR, M.D. Forrest City AR 2/2/2017HOBBY KENNETH PHD Searcy AR 2/2/2017Kenneth Hobby, Ph.D Searcy AR 2/2/2017SPELLMANN CHARLES M PH D Monticello AR 2/7/2017DR TERRY L EFIRD INC Fort Smith AR 2/23/2017NANCY J. TOOMBS, EDD N. Little Rock AR 2/23/2017Steve Shry, PH.D Russellville AR 2/23/2017MICHAEL W PARKER Little Rock AR 2/24/2017TERRY L. EFIRD, PH.D Fort Smith AR 2/24/2017Shannon Douglas Parsons, PsyD Benton AR 2/27/2017James Simpson, M.D. Searcy AR 2/27/2017JERRY L CUNNINGHAM Blytheville AR 3/2/2017BRUCE WENDELL RANDOLPH, M.D. Memphis TN 3/2/2016MEMPHIS NEUROLOGY Memphis TN 3/3/2017BENNETT L. RUDORFER, M.D. West Memphis AR 3/3/2017DON BALL, M.D. Dermott AR 3/8/2017FELICIA A. WATKINS-BROWN, M.D. Hamburg AR 3/8/2017CRYSTAL L. LITTLE, M.D. Monticello AR 3/8/2017AR OCCUPATIONAL HEALTH - DR. LOYD Russellville AR 3/13/2017Ted Honghiran, MD Russellville AR 3/13/2017SAMUEL B HESTER PHD PA Jonesboro AR 3/17/2017R SAM BOYD PH D Little Rock AR 3/22/2017

All Providers Visited in FY 2017

(b) (6)

SALMAN HASHMI, M.D. Little Rock AR 3/22/2017James Moneypenny,PH.D (AR Pysch. Srvcs) Little Rock AR 3/22/2017BENJAMIN SILBER, PH.D. Little Rock AR 3/22/2017JONES KENNETH B West Memphis AR 3/28/2017Dennis Vowell, Jr. Psy D Paragould AR 3/30/2017JENNIFER DOYLE, M.D. Little Rock AR 3/30/2017Chester L. Carlson, DO Fort Smith AR 4/18/2017ANANDARAJ SUBRAMANIUM, M.D. Mtn. View AR 4/19/2017NANCY A. BUNTING, PH.D. Mtn. Home AR 4/19/2017Clifford L. Evans, MD Morrilton AR 4/21/2017KELLY JARRATT, PH.D. - AR FAMILIES FIRST N. Little Rock AR 4/24/2017GHULAM KHALEEL, M.D. White Hall AR 4/24/2017KENNETH B. ROBINSON, MS White Hall AR 4/24/2017MCFARLAND EYE CENTER Hot Springs AR 4/27/2017LINDA RUNION JOSEF, PH.D. Hot Springs AR 4/27/2017CASEY A. WELLS, O.D. Paragould AR 5/1/2017Catherine Adams Ph.D. Jonesboro AR 5/1/2017AHMED ALI, M.D. Conway AR 6/6/2017SAMANTHA S. SHORT, PH.D. Conway AR 6/6/2017DAVID OBERLANDER, M.D. Conway AR 6/6/2017ROBERT KARAS, M.D. Lowell AR 6/14/2017AHMAD AL-KHATIB, M.D. Bentonville AR 6/14/2017STEPHEN NICHOLS, PH.D. Fayetteville AR 6/15/2017MARY JANE SONNTAG, PSY.D. Bentonville AR 6/15/2017KEVIN W. LOLLAR, M.D. Springdale AR 6/15/2017SOUTHWEST PULMONARY ASSOC. Little Rock AR 6/26/2017DAVID BARNETT, M.D. - ORTHO ARKANSAS Little Rock AR 7/7/2017INGE CARTER, M.D. Little Rock AR 7/7/2017JADA HANDWORK, MCD, CCC-SLP Jonesboro AR 7/10/2017VERYL HODGE, M.D. - CLOPTON CLINIC Jonesboro AR 7/11/2017BRITTANY BOYETTE, OD - BURKS VISION CLINIC Sherwood AR 7/20/2017JEAN ANNE STONE, OD Greers Ferry AR 7/20/2017MELISSA F. JACKSON, PH.D. Pine Bluff AR 7/31/2017BYRON SIMONEAUX, PH.D. Benton AR 7/31/2017PAMELA HOLT - HOLT THERAPY England AR 8/8/2017MARK LAREY, MD - CHI ST VINCENT Hot Springs AR 8/14/2017CHARLES REEVES, MD - CHI ST VINCENT Hot Springs AR 8/14/2017B. BATTLE, MD - SOUTHERN MED. GROUP Hot Springs AR 8/14/2017SOUTHERN MEDICAL GROUP INC Hot Springs AR 8/14/2017ANN MARIE PRATHER, PH.D. Little Rock AR 8/18/2017PHILIP M. FURR, MD Memphis TN 8/21/2017SHANNON BROWNFIELD, MD Harrison AR 8/29/2017ETHAN WRIGHT, MD Mountain Home AR 8/29/2017SERENA NICOLE MCKNIGHT, LPE Searcy AR 9/6/2017

(b) (6)

Name Vendor # City State Visit DateVICKIE BREWER CASPALL, PH.D. Walnut Ridge AR 10/12/2016Keith Norwood, P.E. Jonesboro AR 11/14/2016ROBERT L. SPRAY, JR., PH.D. FORT SMITH AR 11/14/2016KEITH NORWOOD P E Fort Smith AR 11/14/2016Patricia Walz, P H .D Fort Smith AR 11/15/2016Michael Wayne Parker, Ph.D. Little Rock AR 12/9/2016R. Sam Boyd, PH.D Little Rock AR 12/9/2016CYNTHIA W. DUPUIS, PH.D., PA LITTLE ROCK AR 12/9/2016Richard Back, PH D Fayetteville AR 1/12/2017James Simpson, M.D. Searcy AR 2/2/2017HOBBY KENNETH PHD Searcy AR 2/2/2017SPELLMANN CHARLES M PH D Monticello AR 2/7/2017NANCY J. TOOMBS, EDD N. Little Rock AR 2/23/2017Kenneth Hobby, Ph.D Searcy AR 2/23/2017TERRY L. EFIRD, PH.D Fort Smith AR 2/24/2017Shannon Douglas Parsons, PsyD Benton AR 2/27/2017CHARLES M. SPELLMANN, PH.D. MONTICELLO AR 2/27/2017JERRY CUNNINGHAM, PSY.D BLYTHEVILLE AR 3/2/2017Steve Shry, PH.D Russellville AR 3/13/2017Samuel B. Hester, PH.D Jonesboro AR 3/17/2017James Moneypenny,PH.D (AR Pysch. Srvcs) Little Rock AR 3/22/2017R SAM BOYD PH D Little Rock AR 3/22/2017SALMAN HASHMI, M.D. Little Rock AR 3/22/2017KENNETH B. JONES, PH.D. WEST MEMPHIS AR 3/28/2017JONES KENNETH B West Memphis AR 3/28/2017Dennis Vowell, Jr. Psy D Paragould AR 3/30/2017Chester L. Carlson, DO Fort Smith AR 4/18/2017NANCY A. BUNTING, PH.D MOUNTAIN HOME AR 4/19/2017Clifford L. Evans, MD Fort Smith AR 4/21/2017KENNETH B. ROBINSON, MS Forrest City AR 4/24/2017LINDA RUNION JOSEF, PH.D. HOT SPRINGS AR 4/27/2017Ted Honghiran, MD Russellville AR 5/1/2017CATHERINE HUBBARD ADAMS, PH.D. JONESBORO AR 5/1/2017MARY JANE SONNTAG, PSY.D., PA BENTONVILLE AR 6/15/2017SOUTHERN MEDICAL GROUP LITTLE ROCK AR 8/14/2017Joseph Brogdon, M.A. Little Rock AR Deceased

Primary Income Providers Visited in FY 2017

(b) (6)

Name City State Amount Visit DateThere were no vendors who earned over $150,000 in FY 2016

$150,000+ Earners Visited in FY 2017

Name City State Amount Visit DateSOUTHERN MEDICAL GROUP INC Little Rock AR 121,988.49 8/14/2017DR TERRY L EFIRD INC Fort Smith AR 112,915.00 2/23/2017SAMUEL B HESTER PHD PA Jonesboro AR 108,065.00 3/17/2017MICHAEL W PARKER Little Rock AR 102,635.00 2/24/2017DUPUIS CYNTHIA W Little Rock AR 93,840.00 12/9/2016

Top 5 Providers by Dollar Volume Visited in FY 2017

Name Vendor # Date Removed ReasonRegional ENT Center 12787 T 2/9/2017Casey A. Wells 1194326 C 5/10/2017

Nancy Bunting, Ph.D. 38965 D 6/2/2017

Vendors Removed for License, Sanction, or Cause in FY 2017

(b) (6)

CA DDS LIST OF CE PROVIDERS FFY2017

JURIS DDS BRANCH

TOTAL PAID SPEC VENDOR # ORG NAME FIRST NAME LAST NAME SUFF CITY VOLUME AND KEY PROVIDERS (Y/N)

ONSITE REVIEW COMPLETED (Y/N)

REMOVED/ SANCTIONED PROVIDERS

COMMENTS KEY PROVIDER COUNT

VOLUME AND KEY PROVIDER COUNT

TOTAL CE PROVIDER COUNT

KEY PROVIDERS VISITS

KEY AND VOLUME PROVIDERS VISITS

NON-KEY/VOLUME PROVIDERS VISITSS05

S05 $176,348.00 VV PACIFIC HEALTH CLINIC OAKLAND Y Y 1 1 1 1 1 0S05 $157,239.00 VV PRIORITY ANALYSIS SAN FRANCISCO Y Y 1 1 1 1 1 0S05 $147,853.00 VV PACIFIC HEALTH CLINIC HAYWARD Y Y 0 1 1 0 1 0S05 $136,464.00 VV PRIORITY ANALYSIS OAKLAND Y N 0 1 1 0 0 0S05 $133,237.00 VV BAY VIEW MEDICAL CLINIC SAN FRANCISCO Y Y 0 1 1 0 1 0S05 $132,613.00 VV NORTHSTATE CLINIC SAN FRANCISCO Y N 0 1 1 0 0 0S05 $125,804.00 VV BAY VIEW MEDICAL CLINIC RICHMOND Y N 0 1 1 0 0 0S05 $103,924.00 VV BAY VIEW MEDICAL CLINIC SAN LEANDRO Y Y 0 1 1 0 1 0S05 $99,553.00 VV PRIORITY ANALYSIS HAYWARD Y Y 0 1 1 0 1 0S05 $94,372.00 VV HEALTH ANALYSIS/RICHMOND RICHMOND Y N 0 1 1 0 0 0S05 $89,366.00 VV MDSI PHYSICIAN GROUP OAKLAND Y N 0 1 1 0 0 0S05 $83,021.00 VV PRIORITY ANALYSIS SANTA CRUZ Y N 0 1 1 0 0 0S05 $79,191.00 VV AVATAR MEDICAL EXCELLENT NATR NOVATO Y N 0 1 1 0 0 0S05 $70,989.00 VV NORTHSTATE CLINIC SAN MATEO Y N 0 1 1 0 0 0S05 $65,264.00 VV BAY VIEW MEDICAL CLINIC FREMONT Y N 0 1 1 0 0 0S05 $45,215.00 VV MDSI PHYSICIAN GROUP SAN FRANCISCO Y N 0 1 1 0 0 0S05 $43,264.00 VV PRIORITY ANALYSIS FREMONT Y N 0 1 1 0 0 0S05 $39,336.00 VV MDSI PHYSICIAN GROUP HAYWARD Y N 0 1 1 0 0 0S05 $31,438.00 VV BAY VIEW MEDICAL CLINIC OAKLAND Y N 0 1 1 0 0 0S05 $28,302.00 VV MSLA-MOUNTAIN VIEW MOUNTAIN VIEW Y N 0 1 1 0 0 0S05 $27,080.00 VV OCEAN DIAGNOSTICS GROUP SAN FRANCISCO Y N 0 1 1 0 0 0S05 $14,405.00 VV MSLA-ALAMEDA ALAMEDA Y N 0 1 1 0 0 0S05 $5,847.00 VV MDSI PHYSICIAN GROUP REDWOOD CITY Y N 0 1 1 0 0 0S05 $2,298.00 VV PACIFIC HEALTH CLINIC NOVATO Y N 0 1 1 0 0 0S05 $157,496.00 DL BAY VIEW MEDICAL CLINIC OAKLAND Y Y 1 1 1 1 1 0S05 $51,040.00 DL TRANSITIONS SPEECH & LANGUAGEBARBARA VASSER MS OAKLAND N N 0 0 1 0 0 0S05 $39,227.00 DL MDSI PHYSICIAN GROUP REDWOOD CITY N N 0 0 1 0 0 0S05 $33,670.00 DL PRIORITY ANALYSIS OAKLAND N N 0 0 1 0 0 0S05 $18,653.00 DL MDSI PHYSICIAN GROUP HAYWARD N N 0 0 1 0 0 0S05 $3,459.00 DL SOKLEY KHOI PHD HAYWARD N N 0 0 1 0 0 0S05 $2,775.00 DL STEVEN MARTINEZ PHD OAKLAND N N 0 0 1 0 0 0S05 $1,638.00 DL MARGARET JONES PHD OAKLAND N N 0 0 1 0 0 0S05 $1,599.00 DL WADE CARTWRIGHT MD OAKLAND N N 0 0 1 0 0 0S05 $1,491.00 DL SOKLEY KHOI PHD EL CERRITO N N 0 0 1 0 0 0S05 $1,348.00 DL MARIA KEROSKY PHD CASTRO VALLEY N N 0 0 1 0 0 0S05 $1,329.00 DL BE WELL PSYCHOLOGICAL SERVICE OAKLAND N N 0 0 1 0 0 0S05 $763.00 DL STEVEN MARTINEZ PHD SAN FRANCISCO N N 0 0 1 0 0 0S05 $756.00 DL L MEBINE OD SAN FRANCISCO N N 0 0 1 0 0 0S05 $726.00 DL PRIORITY ANALYSIS OAKLAND N N 0 0 1 0 0 0S05 $692.00 DL ARNELL ETHERINGTON PHD HALF MOON BAY N N 0 0 1 0 0 0S05 $667.00 DL BRADFORD PIATT MD OAKLAND N N 0 0 1 0 0 0S05 $566.00 DL BE WELL PSYCHOLOGICAL SERVICE OAKLAND N N 0 0 1 0 0 0S05 $546.00 DL ARNELL ETHERINGTON PHD SAN MATEO N N 0 0 1 0 0 0S05 $291.00 DL MARIA KEROSKY PHD CASTRO VALLEY N N 0 0 1 0 0 0S05 $273.00 DL STEVEN MARTINEZ PHD SAN FRANCISCO N N 0 0 1 0 0 0S05 $266.00 DL STEVEN MARTINEZ PHD OAKLAND N N 0 0 1 0 0 0S05 $236.00 DL JIN KIM MD OAKLAND N N 0 0 1 0 0 0S05 2,163.00 DL SOKLEY KHOI PHD HAYWARD N N 0 0 1 0 0 0S05 $133.00 DL LAURENCE LIEF MD SAN FRANCISCO N N 0 0 1 0 0 0S05 $98.00 DL DUDLEY LUKE PHD LOS ALTOS N N 0 0 1 0 0 0S05 $115.00 BP AFFILIATES IN IMAGING OAKLAND N N 0 0 1 0 0 0S05 $130.00 80 UCSF MT ZION MEDICAL CENTER SAN FRANCISCO N N 0 0 1 0 0 0S05 $530.00 79 UCSF MT ZION MEDICAL CENTER SAN FRANCISCO N N 0 0 1 0 0 0S05 $50.00 73 WASHINGTON HOSPITAL/FREMONT FREMONT N N 0 0 1 0 0 0S05 $2,184.00 72 ARNOLD GOLDSCHLAGER MD BURLINGAME N N 0 0 1 0 0 0S05 $848.00 69 GENERAL VASCULAR SURGERY MED SAN LEANDRO N N 0 0 1 0 0 0S05 $67.00 63 WASHINGTON HOSPITAL/FREMONT FREMONT N N 0 0 1 0 0 0S05 $35,326.00 55 CONNIE BROWN AND ASSOCIATES CONNIE BROWN MS CAMPBELL N N 0 0 1 0 0 0S05 $28,511.00 55 TRANSITIONS SPEECH & LANGUAGEBARBARA VASSER MS RICHMOND N N 0 0 1 0 0 0S05 $15,336.00 55 TRANSITIONS SPEECH & LANGUAGEBARBARA VASSER SLP SAN FRANCISCO N N 0 0 1 0 0 0S05 $14,508.00 55 TRANSITIONS SPEECH & LANGUAGEBARBARA VASSER MS OAKLAND N N 0 0 1 0 0 0S05 $428.00 55 BAY AREA SOUND SPEECH & HEARN SAN FRANCISCO N N 0 0 1 0 0 0S05 $428.00 55 GNC THERAPIES SAN RAFAEL N N 0 0 1 0 0 0

Page 1 of 25

(b) (6)


JURIS DDS BRANCH









NON-KEY/VOLUME PROVIDERS VISITSS05 $153.00 53 MICHAEL CHAN MD SAN FRANCISCO N N 0 0 1 0 0 0

S05 $71.00 51 NORCAL IMAGING SAN LEANDRO N N 0 0 1 0 0 0S05 $26,672.00 47 MARIA KEROSKY PHD OAKLAND N N 0 0 1 0 0 0S05 $24,168.00 47 KIM GOLDMAN PSYD SANTA CRUZ N N 0 0 1 0 0 0S05 $19,873.00 47 ALLIANCE ASSESSMENTS APARNA DIXIT PHD PINOLE N N 0 0 1 0 0 0S05 $16,667.00 47 FAITH TOBIAS PHD HAYWARD N N 0 0 1 0 0 0S05 $16,034.80 47 GARY BALESTIN PHD S SAN FRANCISCO N N 0 0 1 0 0 0S05 $15,810.00 47 FAITH TOBIAS PHD SAN FRANCISCO N N 0 0 1 0 0 0S05 $15,309.00 47 SOKLEY KHOI PHD ALAMEDA N N 0 0 1 0 0 0S05 $14,309.00 47 FAITH TOBIAS PHD SAN LEANDRO N N 0 0 1 0 0 0S05 $10,831.00 47 DEEPA ABRAHAM PHD DUBLIN N N 0 0 1 0 0 0S05 $10,741.00 47 SOKLEY KHOI PHD RICHMOND N N 0 0 1 0 0 0S05 $9,658.00 47 JENNIFER EGGERT PHD SAN FRANCISCO N N 0 0 1 0 0 0S05 $9,468.00 47 HENRY HOEY PHD PLEASANTON N N 0 0 1 0 0 0S05 $9,446.00 47 MARY VIGILANTI EDD BERKELEY N N 0 0 1 0 0 0S05 $8,857.40 47 TELFORD MOORE PHD CORTE MADERA N N 0 0 1 0 0 0S05 $7,101.00 47 LORRAINE SCHNURR PHD BERKELEY N N 0 0 1 0 0 0S05 $6,529.00 47 MARY VIGILANTI EDD HAYWARD N N 0 0 1 0 0 0S05 $3,551.00 47 DAVID PINGITORE PHD OAKLAND N N 0 0 1 0 0 0S05 $2,943.00 47 JENNIFER KIRKLAND PHD ALBANY N N 0 0 1 0 0 0S05 $2,693.00 47 DAVID DAHL PHD CAMPBELL N N 0 0 1 0 0 0S05 $2,273.00 47 NEURO-PSYCH ALLIANCE PLEASANTON N N 0 0 1 0 0 0S05 $1,559.00 47 KIM GOLDMAN PSYD FELTON N N 0 0 1 0 0 0S05 $546.00 47 THOMAS MCCORD PHD LAFAYETTE N N 0 0 1 0 0 0S05 $273.00 47 MARGARET JONES PHD SAN LEANDRO N N 0 0 1 0 0 0S05 $273.00 47 MATTHEW SMITH PSYD FREMONT N N 0 0 1 0 0 0S05 $106.00 47 ASPIRE NEUROPSYCHOLOGICAL SV KEIKO MILLER PSYD WALNUT CREEK N N 0 0 1 0 0 0S05 $667.60 45 LES KALMAN MD SAN FRANCISCO N N 0 0 1 0 0 0S05 $6,827.00 37 CRAGMONT DIAMOND KASSAM MD SAN FRANCISCO N N 0 0 1 0 0 0S05 $11,156.00 36 MARIA KEROSKY PHD OAKLAND N N 0 0 1 0 0 0S05 $5,610.00 36 ALLIANCE ASSESSMENTS APARNA DIXIT PHD PINOLE N N 0 0 1 0 0 0S05 $5,337.00 36 FAITH TOBIAS PHD HAYWARD N N 0 0 1 0 0 0S05 $4,716.00 36 FAITH TOBIAS PHD SAN FRANCISCO N N 0 0 1 0 0 0S05 $3,223.00 36 DAVID PINGITORE PHD OAKLAND N N 0 0 1 0 0 0S05 $3,131.00 36 SOKLEY KHOI PHD ALAMEDA N N 0 0 1 0 0 0S05 $2,598.00 36 GARY BALESTIN PHD S SAN FRANCISCO N N 0 0 1 0 0 0S05 $2,500.00 36 SOKLEY KHOI PHD RICHMOND N N 0 0 1 0 0 0S05 $2,415.00 36 MARY VIGILANTI EDD HAYWARD N N 0 0 1 0 0 0S05 $1,726.00 36 MARY VIGILANTI EDD BERKELEY N N 0 0 1 0 0 0S05 $1,337.00 36 DEEPA ABRAHAM PHD DUBLIN N N 0 0 1 0 0 0S05 $1,176.00 36 JENNIFER EGGERT PHD SAN FRANCISCO N N 0 0 1 0 0 0S05 $1,166.00 36 FAITH TOBIAS PHD SAN LEANDRO N N 0 0 1 0 0 0S05 $1,161.00 36 BARBARA FRANCES PHD SAN FRANCISCO N N 0 0 1 0 0 0S05 $1,086.40 36 TELFORD MOORE PHD CORTE MADERA N N 0 0 1 0 0 0S05 $855.00 36 KIM GOLDMAN PSYD SANTA CRUZ N N 0 0 1 0 0 0S05 $710.00 36 ARNELL ETHERINGTON PHD SAN MATEO N N 0 0 1 0 0 0S05 $670.00 36 DAVID DAHL PHD CAMPBELL N N 0 0 1 0 0 0S05 $302.00 36 KIM GOLDMAN PSYD FELTON N N 0 0 1 0 0 0S05 $22,195.00 35 ADAM MARVIN MD SAN LEANDRO N N 0 0 1 0 0 0S05 $8,115.00 35 KASRA RASTANI MD SAN FRANCISCO N N 0 0 1 0 0 0S05 $781.00 35 IVOR EMANUEL MD SAN FRANCISCO N N 0 0 1 0 0 0S05 $481.00 35 ADAM MARVIN MD OAKLAND N N 0 0 1 0 0 0S05 $10,915.00 33 AUBREY SWARTZ MD OAKLAND N N 0 0 1 0 0 0S05 $3,135.00 31 PACIFIC EYE ASSOCIATES LAURA INGER OD SAN FRANCISCO N N 0 0 1 0 0 0S05 $2,636.00 31 PACIFIC EYE ASSOCIATES MARY KWONG OD SAN FRANCISCO N N 0 0 1 0 0 0S05 $15,149.00 29 BATRA VISION MEDICAL GROUP VINEET BATRA MD SAN LEANDRO N N 0 0 1 0 0 0S05 $13,135.00 29 EYE PHYSICIANS OF THE EAST BAY MICHAEL WANG MD OAKLAND N N 0 0 1 0 0 0S05 $7,786.00 29 EYE PHYSICIANS OF THE EAST BAY JANE LOMAN MD OAKLAND N N 0 0 1 0 0 0S05 $5,338.00 29 EYE PHYSICIANS OF THE EAST BAY STEVEN PASCAL MD OAKLAND N N 0 0 1 0 0 0S05 $4,688.00 29 JOSEPH BARAKEH DO WALNUT CREEK N N 0 0 1 0 0 0S05 $4,416.00 29 MICHAEL GORIN MD ALAMEDA N N 0 0 1 0 0 0S05 $4,349.00 29 BERKELEY OPHTHALMOLOGY MED G BERKELEY N N 0 0 1 0 0 0S05 $3,034.00 29 JAMES COHN MD FREMONT N N 0 0 1 0 0 0S05 $1,878.00 29 MARK DRUCKER MD WALNUT CREEK N N 0 0 1 0 0 0

Page 2 of 25

(b) (6)


JURIS DDS BRANCH









NON-KEY/VOLUME PROVIDERS VISITSS05 $284.00 28 JAMES COHN MD FREMONT N N 0 0 1 0 0 0

S05 $284.00 28 BATRA VISION MEDICAL GROUP VINEET BATRA MD SAN LEANDRO N N 0 0 1 0 0 0S05 $3,917.00 23 THANH TRAN MD SAN FRANCISCO N N 0 0 1 0 0 0S05 $1,942.00 23 THANH TRAN MD OAKLAND N N 0 0 1 0 0 0S05 $1,596.00 23 PAJARO VALLEY NEUROLOGY WATSONVILLE N N 0 0 1 0 0 0S05 $532.00 19 MICHAEL CHAN MD SAN FRANCISCO N N 0 0 1 0 0 0S05 $399.00 19 MICHAEL CHAN MD BURLINGAME N N 0 0 1 0 0 0S05 $17,312.00 05 HEART MEDICINE & CHEST PAIN CL ROLLINGTON FERGUSON MD OAKLAND N N 0 0 1 0 0 0S05 $1,940.00 05 ARNOLD GOLDSCHLAGER MD BURLINGAME N N 0 0 1 0 0 0S05 $5,009.00 03 ADAM MARVIN MD SAN LEANDRO N N 0 0 1 0 0 0S05 $1,050.00 03 MARIN GENERAL HOSPITAL GREENBRAE N N 0 0 1 0 0 0S05 $650.00 03 SAN FRANCISCO HEARING AND SAN FRANCISCO N N 0 0 1 0 0 0

Page 3 of 25

(b) (6)


JURIS DDS BRANCH









NON-KEY/VOLUME PROVIDERS VISITSS06 0 0 0 0 0

S06 $541,382.69 VV ALPHA MEDICAL DIAGNOSTICS SANTA ANA Y Y 1 1 1 1 1 0S06 $418,101.28 VV S & L MEDICAL GROUP ANAHEIM Y Y 1 1 1 1 1 0S06 $400,533.00 VV S & L MEDICAL GROUP EL MONTE Y Y 1 1 1 1 1 0S06 $351,995.00 VV MEDPRO SERVICES FULLERTON Y Y 1 1 1 1 1 0S06 $339,679.00 VV MEDPRO SERVICES GLENDALE Y Y 1 1 1 1 1 0S06 $323,635.00 VV MEDPRO SERVICES PASADENA Y Y 1 1 1 1 1 0S06 $298,433.88 VV S & L MEDICAL GROUP POMONA Y Y 1 1 1 1 1 0S06 $290,099.00 VV ROYALTY MEDICAL GROUP POMONA Y Y 1 1 1 1 1 0S06 $204,264.00 VV AVATAR MEDICAL EXCELLENT NATRL WHITTIER Y Y 1 1 1 1 1 0S06 $200,885.40 VV MCR MEDICAL BUENA PARK Y Y 1 1 1 1 1 0S06 $172,864.00 VV MCR MEDICAL BELL Y Y 1 1 1 1 1 0S06 $134,941.00 VV MCR MEDICAL LOS ANGELES Y Y 0 1 1 0 1 0S06 $100,487.00 VV MSLA-WEST COVINA WEST COVINA Y N 0 1 1 0 0 0S06 $75,641.00 VV SOUTH ATLANTIC MEDICAL GROUP HUNTINGTON PARK Y N 0 1 1 0 0 0S06 $74,204.00 VV MULTI SPECIALTY EVALUATION CLN BELL Y N 0 1 1 0 0 0S06 $72,497.00 VV SANTA ANA MEDICAL SPECIALISTS SANTA ANA Y N 0 1 1 0 0 0S06 $70,965.00 VV SOUTH ATLANTIC MEDICAL GROUP LOS ANGELES Y N 0 1 1 0 0 0S06 $60,792.00 VV METROPOLITAN CENTER MEDICAL GP LOS ANGELES Y N 0 1 1 0 0 0S06 $59,655.00 VV CALIFORNIA CARE MEDICAL GROUP PICO RIVERA Y N 0 1 1 0 0 0S06 $55,322.00 VV MID TOWN DISABILITY EVALUATION PICO RIVERA Y N 0 1 1 0 0 0S06 $50,037.00 VV CALIFORNIA CARE MEDICAL GROUP ARTESIA Y N 0 1 1 0 0 0S06 $46,486.00 VV MSLA-GARDEN GROVE GARDEN GROVE Y N 0 1 1 0 0 0S06 $40,167.00 VV MCR MEDICAL LA PUENTE Y Y 0 1 1 0 1 0S06 $34,102.00 VV MSLA-PASADENA PASADENA Y N 0 1 1 0 0 0

S06 $118,532.00 DL MILLENNIUM MULTISPECIALTY MED LA PUENTE N N removed 0 0 1 0 0 0

S06 $84,634.00 DL MILLENNIUM MULTISPECIALTY MED SANTA ANA N Y removed 0 0 1 0 0 1

S06 $84,527.00 DL MILLENNIUM MULTISPECIALTY MED CERRITOS N Y removed 0 0 1 0 0 1

S06 $32,055.00 DL MILLENNIUM MULTISPECIALTY MED ALHAMBRA N N removed 0 0 1 0 0 0

S06 $15,106.00 DL MILLENNIUM MULTISPECIALTY MED GLENDALE N N removed 0 0 1 0 0 0S06 $9,551.00 DL GNC THERAPIES CERRITOS N N 0 0 1 0 0 0S06 $5,074.00 DL MARTIN GARCIA MD LA PALMA N N 0 0 1 0 0 0S06 $3,912.00 DL METROPOLITAN SPEECH & LANGUAGE CAROL CARLBERG-SNYDER SLP GLENDALE N N 0 0 1 0 0 0S06 $2,311.00 DL ALAN FISHER MD ARCADIA N N 0 0 1 0 0 0S06 $371.00 DL KAYS MEDICAL EVALUATION CENTER WHITTIER N N 0 0 1 0 0 0S06 $286.00 DL SONUS HEARING GLENDALE N N 0 0 1 0 0 0S06 $133.00 DL MARK BERNHARD DO PASADENA N N 0 0 1 0 0 0S06 $103.00 DL SONUS HEARING GLENDALE N N 0 0 1 0 0 0S06 $94.00 DL SOUTHLAND INTERPRETING LILLY ESTRADA DOWNEY N N 0 0 1 0 0 0S06 $43.00 DL ARROWHEAD MEDICAL EVALUATION MONTEREY PARK N N 0 0 1 0 0 0S06 $3,386.00 72 EDWARD ABRAMS MD PARAMOUNT N N 0 0 1 0 0 0S06 $146.00 71 JAMES LIN MD MONTEREY PARK N N 0 0 1 0 0 0S06 $39,670.00 55 TRANSITIONS SPEECH & LANGUAGE LOS ANGELES N N 0 0 1 0 0 0S06 $25,064.00 55 SENSABILITIES SPEECH-LANGUAGE ORANGE N N 0 0 1 0 0 0

Page 4 of 25

(b) (6)

(b) (6)


JURIS DDS BRANCH









NON-KEY/VOLUME PROVIDERS VISITSS06 $17,058.00 55 TALK TO ME BILINGUAL SPEECH MONTEBELLO N N 0 0 1 0 0 0

S06 $2,354.00 55 GNC THERAPIES WEST COVINA N N 0 0 1 0 0 0S06 $446.00 49 JAGMINDER BHALLA MD ANAHEIM N N 0 0 1 0 0 0S06 $384.00 47 MOUNTAIN VIEW ASSESSMENT CTR PASADENA N N 0 0 1 0 0 0S06 $14,524.00 37 EFREN VALENZUELA MD BALDWIN PARK N N 0 0 1 0 0 0S06 $2,023.00 33 SPINE SPECIALTY INSTITUTE KAMBIZ HANNANI MD WEST COVINA N N 0 0 1 0 0 0S06 $19,904.00 29 ORANGE COUNTY OPHTHALMOLOGY GARDEN GROVE N N 0 0 1 0 0 0S06 $13,744.00 29 RICHARD HAVUNJIAN MD GLENDALE N N 0 0 1 0 0 0S06 $12,207.00 29 CALVIN ENG MD ROSEMEAD N N 0 0 1 0 0 0S06 $10,695.00 29 EYE CARE MEDICAL CENTER LILIT ABLABUTYAN MD GLENDALE N N 0 0 1 0 0 0S06 $6,376.00 29 KEITH KENYON MD LOS ANGELES N N 0 0 1 0 0 0S06 $6,373.00 29 WALTER ROBERTS MD LOS ANGELES N N 0 0 1 0 0 0S06 $3,646.00 29 JAN LUKAC MD BREA N N 0 0 1 0 0 0S06 $2,278.00 29 MICHAEL ROBERTS MD LOS ANGELES N N 0 0 1 0 0 0S06 $1,136.00 28 TALIA KOLIN MD LOS ANGELES N N 0 0 1 0 0 0S06 $739.00 28 RICHARD HAVUNJIAN MD GLENDALE N N 0 0 1 0 0 0S06 $5,621.00 23 NEUROLOGY ASSOCIATES MED GROUP B SUBHAS MD ANAHEIM N N 0 0 1 0 0 0S06 $3,072.00 23 JAMES LIN MD MONTEREY PARK N N 0 0 1 0 0 0S06 $532.00 19 MONROVIA INTERNAL MEDICINE AND ULIN SARGEANT MD DUARTE N N 0 0 1 0 0 0S06 $8,712.00 05 EDWARD ABRAMS MD PARAMOUNT N N 0 0 1 0 0 0S06 $7,619.00 05 SAM MOUAZZEN MD GLENDORA N N 0 0 1 0 0 0S06 $228.00 04 TANAKA AUDIOLOGY & HEARING AID LINDA TANAKA MA WEST COVINA N N 0 0 1 0 0 0S06 $1,419.00 03 TANAKA AUDIOLOGY & HEARING AID LINDA TANAKA MA WEST COVINA N N 0 0 1 0 0 0

Page 5 of 25

(b) (6)


JURIS DDS BRANCH










S59 $726,606.00 VV MEDPRO SERVICES SAN BERNARDINO Y Y 1 1 1 1 1 0S59 $487,240.40 VV S & L MEDICAL GROUP SAN DIEGO Y Y 1 1 1 2 2 0S59 $323,305.00 VV S & L MEDICAL GROUP SAN BERNARDINO Y Y 1 1 1 1 1 0S59 $320,495.00 VV ALTO MEDICAL CLINIC SAN BERNARDINO Y Y 1 1 1 1 1 0S59 $300,581.00 VV QTC MEDICAL GROUP OCEANSIDE Y Y 1 1 1 1 1 0S59 $275,388.00 VV MSLA-SAN DIEGO SAN DIEGO Y Y 1 1 1 1 1 0S59 $253,601.00 VV MEDPRO SERVICES HESPERIA Y Y 1 1 1 1 1 0S59 $128,290.00 VV MSLA-HEMET HEMET Y N 0 1 1 0 0 0S59 $67,171.00 VV CALIFORNIA CARE MEDICAL GROUP APPLE VALLEY Y N 0 1 1 0 0 0S59 $58,755.00 VV ALL STATE MEDICAL GROUP BARSTOW Y N 0 1 1 0 0 0S59 $54,427.00 VV MDSI PHYSICIAN GROUP EL CENTRO Y N 0 1 1 0 0 0S59 $50,473.00 VV MSLA-SAN BERNARDINO SAN BERNARDINO Y N 0 1 1 0 0 0S59 $40,568.00 VV ALL STATE MEDICAL GROUP HESPERIA Y N 0 1 1 0 0 0S59 $103,575.80 DL S & L MEDICAL GROUP EL CENTRO N Y 0 0 1 0 0 1S59 $102,823.00 DL S & L MEDICAL GROUP EL CAJON N Y 0 0 1 0 0 2S59 $60,382.26 DL S & L MEDICAL GROUP EL CENTRO N N 0 0 1 0 0 0S59 $43,991.00 DL WILLIAM GORAL MD SAN BERNARDINO N N 0 0 1 0 0 0S59 $18,334.00 DL KENNETH LYNCH PHD CARLSBAD N N 0 0 1 0 0 0

S59 $9,747.00 DL MILLENNIUM MULTISPECIALTY MED SAN BERNARDINO N N removed

0 0 1 0 0 0S59 $9,216.00 DL KARA DODDS AND ASSOCIATES KARA DODDS SANTEE N N 0 0 1 0 0 0S59 $4,889.00 DL KENNETH LYNCH PHD CARLSBAD N N 0 0 1 0 0 0S59 $2,987.00 DL MOYAD ORTHOPEDICS THOMAS MOYAD MD LA MESA N N 0 0 1 0 0 0S59 $2,740.00 DL OLUWAFEMI ADEYEMO MD HEMET N N 0 0 1 0 0 0S59 $2,407.00 DL S & L MEDICAL GROUP SAN BERNARDINO N N 0 0 1 0 0 0S59 $1,064.00 DL LINA SCHEIN MD LA MESA N N 0 0 1 0 0 0S59 $583.00 DL CALIFORNIA RETINA ASSOCIATES MAJID MANI MD EL CENTRO N Y 0 0 1 0 0 1S59 $266.00 DL MICHAEL BRAMS MD APPLE VALLEY N N 0 0 1 0 0 0S59 $266.00 DL CHILDRENS PRIMARY CARE MEDICAL DAVID SCHMOTTLACH MD ENCINITAS N N 0 0 1 0 0 0S59 $266.00 DL MOYAD ORTHOPEDICS THOMAS MOYAD MD LA MESA N N 0 0 1 0 0 0S59 $166.00 DL GOLDEN STATE INTERPRETING SRVC SAN DIEGO N N 0 0 1 0 0 0S59 $103.00 DL JOHN BARKER APPLE VALLEY N N 0 0 1 0 0 0S59 $100.00 DL ST BERNARDINE MEDICAL CENTER SAN BERNARDINO N N 0 0 1 0 0 0S59 $72.00 DL ARIAN CEBREROS SAN DIEGO N N 0 0 1 0 0 0S59 $28,882.00 55 LAKIETA EMANUEL SLP HESPERIA N N 0 0 1 0 0 0S59 $12,244.00 55 KARA DODDS AND ASSOCIATES KARA DODDS SANTEE N Y 0 0 1 0 0 1S59 $84,794.00 47 APPLIED PSYCHOLOGY SERVICES DAN WHITEHEAD PHD EL CAJON N N 0 0 1 0 0 0S59 $4,505.00 47 KENNETH LYNCH PHD CARLSBAD N N 0 0 1 0 0 0S59 $3,597.00 47 SHELDON KRAMER PHD ENCINITAS N N 0 0 1 0 0 0S59 $1,426.00 47 WILLIAM SOLTZ PHD SAN BERNARDINO N N 0 0 1 0 0 0S59 $892.00 47 SHELDON KRAMER PHD LA MESA N N 0 0 1 0 0 0S59 $492.00 47 DOUGLAS LARSON PHD COLTON N N 0 0 1 0 0 0S59 $71,355.00 45 JAGANATH GLASSMAN MD LA MESA N N 0 0 1 0 0 0S59 $50,075.00 45 JAGA NATH GLASSMAN MD LA JOLLA N N 0 0 1 0 0 0S59 $41,664.00 45 SAMUEL ETCHIE MD LA MESA N N 0 0 1 0 0 0S59 $6,039.00 45 DIVYAKANT KIKANI MD SAN BERNARDINO N N 0 0 1 0 0 0S59 $13,221.00 37 EFREN VALENZUELA MD SAN BERNARDINO N N 0 0 1 0 0 0S59 $3,687.00 37 THOMAS SCHWELLER MD BRAWLEY N N 0 0 1 0 0 0S59 $1,366.00 36 SHELDON KRAMER PHD LA MESA N N 0 0 1 0 0 0S59 $1,027.00 36 KENNETH LYNCH PHD CARLSBAD N N 0 0 1 0 0 0S59 $228.00 36 DOUGLAS LARSON PHD COLTON N N 0 0 1 0 0 0S59 $176.00 36 SHELDON KRAMER PHD ENCINITAS N N 0 0 1 0 0 0S59 $7,833.00 35 THEODORE MAZER MD SAN DIEGO N N 0 0 1 0 0 0S59 $15,042.00 29 WEST COAST EYE CARE ASSOCIATES GITANE PATEL MD SAN DIEGO N Y 0 0 1 0 0 1S59 $10,666.00 29 EYE PHYSICIANS MEDICAL GROUP CHRISTOPHER HSU MD EL CAJON N N 0 0 1 0 0 0S59 $8,091.00 29 DESERT EYE INSTITUTE NARENDRA PATEL MD EL CENTRO N N 0 0 1 0 0 0S59 $4,321.00 29 WEST COAST EYE CARE ASSOCIATES GITANE PATEL MD EL CAJON N N 0 0 1 0 0 0S59 $3,802.00 29 NORTH COUNTY EYE CENTER ERWIN OMENS MD ESCONDIDO N N 0 0 1 0 0 0S59 $1,046.00 29 EYE PHYSICIANS MEDICAL GROUP RICHARD LEARN MD EL CAJON N N 0 0 1 0 0 0S59 $930.00 29 WEST COAST EYE CARE ASSOCIATES BARRY KATZMAN MD SAN DIEGO N N 0 0 1 0 0 0

Page 6 of 25

(b) (6)

(b) (6)


JURIS DDS BRANCH









NON-KEY/VOLUME PROVIDERS VISITSS59 $742.00 29 EYE PHYSICIANS MEDICAL GROUP FRANKLIN CRYSTAL MD EL CAJON N N 0 0 1 0 0 0

S59 $5,270.00 23 THOMAS SCHWELLER MD BRAWLEY N N 0 0 1 0 0 0S59 $2,875.80 19 MANORAMA REDDY MD SAN DIEGO N N 0 0 1 0 0 0S59 $2,089.00 19 MANIKANDA RAJA MD HEMET N N 0 0 1 0 0 0

Page 7 of 25

(b) (6)


JURIS DDS BRANCH










S60 $371,000.00 VV EWING DIAGNOSTICS & PSYCH SRVS SACRAMENTO Y Y 1 1 1 1 1 0S60 $280,038.00 VV QTC MEDICAL GROUP SACRAMENTO Y Y 1 1 1 1 1 0S60 $262,813.00 VV MDSI PHYSICIAN GROUP SACRAMENTO Y Y 1 1 1 1 1 0S60 $166,235.00 VV AVATAR MEDICAL EXCELLENT NATRL SANTA ROSA Y Y 1 1 1 1 1 0S60 $160,968.00 VV BAY VIEW HEALTH NET SACRAMENTO Y Y 1 1 1 1 1 0S60 $105,731.00 VV HEALTH ANALYSIS/SACRAMENTO SACRAMENTO Y N 0 1 1 0 0 0S60 $82,882.00 VV PRIORITY ANALYSIS EUREKA Y N 0 1 1 0 0 0S60 $82,010.00 VV MDSI PHYSICIAN GROUP EUREKA Y N 0 1 1 0 0 0S60 $34,810.00 VV MDSI PHYSICIAN GROUP SANTA ROSA Y N 0 1 1 0 0 0S60 $20,907.00 VV PRIORITY ANALYSIS SACRAMENTO Y Y 0 1 1 0 1 0S60 $18,740.00 VV SHAHID AND RUBY ALI MDs SACRAMENTO Y N 0 1 1 0 0 0S60 $7,864.30 VV MDSI PHYSICIAN GROUP MEDFORD Y N 0 1 1 0 0 0S60 $931.00 VV MSLA-SANTA ROSA SANTA ROSA Y N 0 1 1 0 0 0S60 $133.00 VV MSLA-SACRAMENTO SACRAMENTO Y N 0 1 1 0 0 0S60 $107,400.00 DL PRIORITY ANALYSIS SACRAMENTO N N 0 0 1 0 0 0S60 $48,562.00 DL SHAHID AND RUBY ALI MDs SACRAMENTO N N 0 0 1 0 0 0S60 $11,897.00 DL HILLIS WARREN MD SACRAMENTO N N 0 0 1 0 0 0S60 $8,106.00 DL JONATHAN GONICK-HALLOWS PHD SANTA ROSA N N 0 0 1 0 0 0S60 $6,443.00 DL HERBERT TANENHAUS MD EUREKA N N 0 0 1 0 0 0S60 $6,425.00 DL LUMEN HEALTH & PSYCH SERVICES SACRAMENTO N N 0 0 1 0 0 0S60 $4,594.00 DL JEANNE BYERS-SPRAETZ SLP SANTA ROSA N N 0 0 1 0 0 0S60 $3,777.00 DL LUMEN HEALTH & PSYCH SERVICES SACRAMENTO N N 0 0 1 0 0 0S60 $3,160.00 DL HERBERT TANENHAUS MD EUREKA N N 0 0 1 0 0 0S60 $2,795.00 DL JAMES REECE MD SACRAMENTO N N 0 0 1 0 0 0S60 $1,522.00 DL SANFORD BROWN MD FORT BRAGG N N 0 0 1 0 0 0S60 $1,372.00 DL HILLIS WARREN MD SACRAMENTO N N 0 0 1 0 0 0S60 $1,076.00 DL JONATHAN GONICK-HALLOWS PHD SANTA ROSA N N 0 0 1 0 0 0S60 $504.00 DL LANGUAGE WORLD SERVICES SACRAMENTO N N 0 0 1 0 0 0S60 $496.00 DL SARA BOWERMAN PHD CRESCENT CITY N N 0 0 1 0 0 0S60 $333.00 DL AUDIOLOGY ASSOCIATES PETER MARINCOVICH PHD SANTA ROSA N N 0 0 1 0 0 0S60 $323.00 DL KIMEL LIMON PSYD CRESCENT CITY N N 0 0 1 0 0 0S60 $220.00 DL AUDIOLOGY ASSOCIATES SANTA ROSA N N 0 0 1 0 0 0S60 $217.00 DL NORTH COAST AUDIOLOGY EUREKA N N 0 0 1 0 0 0S60 $196.00 DL NORTH COAST OPHTHALMOLOGY ANDREW COCHRANE MD EUREKA N N 0 0 1 0 0 0S60 $171.00 DL JAMES REECE MD SACRAMENTO N N 0 0 1 0 0 0S60 $171.00 DL EYE CARE INSTITUE DAVID LIGHTFOOT MD SANTA ROSA N N 0 0 1 0 0 0S60 $106.00 DL MARCIA HILLARY PHD SACRAMENTO N N 0 0 1 0 0 0S60 $106.00 DL NORTH COAST SURGICAL SPECIALST EUREKA N N 0 0 1 0 0 0S60 $20.00 DL JONATHAN GONICK-HALLOWS PHD SANTA ROSA N N 0 0 1 0 0 0S60 $962.00 BP REDWOOD RADIOLOGY GROUP SANTA ROSA N N 0 0 1 0 0 0S60 $67.00 BP DEL NORTE MEDICAL IMAGING CRESCENT CITY N N 0 0 1 0 0 0S60 $14.00 BP HUMBOLDT RADIOLOGY MEDICAL GRP EUREKA N N 0 0 1 0 0 0S60 $290.00 81 METHODIST HOSPITAL SACRAMENTO N N 0 0 1 0 0 0S60 $75.00 81 SANTA ROSA MEMORIAL HOSPITAL SANTA ROSA N N 0 0 1 0 0 0S60 $254.00 80 MERCY GENERAL HOSPITAL SACRAMENTO N N 0 0 1 0 0 0S60 $1,870.00 79 SANTA ROSA MEMORIAL HOSPITAL SANTA ROSA N N 0 0 1 0 0 0S60 $1,429.00 79 MERCY GENERAL HOSPITAL SACRAMENTO N N 0 0 1 0 0 0S60 $1,265.00 79 METHODIST HOSPITAL SACRAMENTO N N 0 0 1 0 0 0S60 $450.00 79 ST JOSEPH HOSPITAL EUREKA N N 0 0 1 0 0 0S60 $160.00 79 SUTTER TRACY COMMUNITY HOSP TRACY N N 0 0 1 0 0 0S60 $15,521.80 72 METHODIST HOSPITAL SACRAMENTO N N 0 0 1 0 0 0S60 $160.00 72 SUTTER COAST HOSPITAL CRESCENT CITY N N 0 0 1 0 0 0S60 $312.00 71 METHODIST HOSPITAL SACRAMENTO N N 0 0 1 0 0 0S60 $248.00 69 SANTA ROSA MEMORIAL HOSPITAL SANTA ROSA N N 0 0 1 0 0 0S60 $911.78 67 ROBERT THOMAS LCSW SACRAMENTO N N 0 0 1 0 0 0S60 $135.00 63 SANTA ROSA MEMORIAL HOSPITAL SANTA ROSA N N 0 0 1 0 0 0S60 $12,786.00 55 COOK SPEECH AND LANGUAGE SACRAMENTO N N 0 0 1 0 0 0S60 $9,188.00 55 SANTA ROSA SPEECH & LANGUAGE SANTA ROSA N N 0 0 1 0 0 0S60 $7,824.00 55 LUMEN HEALTH & PSYCH SERVICES SACRAMENTO N N 0 0 1 0 0 0S60 $3,036.00 55 NORTH COAST SPEECH & LANGUAGE EUREKA N N 0 0 1 0 0 0S60 $887.56 55 MORE THAN WORDS SPEECH THERAPY MEDFORD N N 0 0 1 0 0 0S60 $3,106.00 51 DIAGNOSTIC RADIOLOGICAL IMGING SACRAMENTO N N 0 0 1 0 0 0S60 $1,871.00 51 SUTTER IMAGING CAMPUS COMMONS SACRAMENTO N N 0 0 1 0 0 0

Page 8 of 25

(b) (6)


JURIS DDS BRANCH









NON-KEY/VOLUME PROVIDERS VISITSS60 $543.00 51 SANTA ROSA MEMORIAL HOSPITAL SANTA ROSA N N 0 0 1 0 0 0

S60 $410.00 51 ST JOSEPH HOSPITAL EUREKA N N 0 0 1 0 0 0S60 $138.00 51 SUTTER COAST HOSPITAL CRESCENT CITY N N 0 0 1 0 0 0S60 $39.00 51 SOUTHERN HUMBOLDT COMMUNITY GARBERVILLE N N 0 0 1 0 0 0S60 $43,317.00 47 SILVIA TORREZ PSYD SACRAMENTO N N 0 0 1 0 0 0S60 $41,804.00 47 PHILIP CUSHMAN PHD CLEARLAKE N N 0 0 1 0 0 0S60 $32,983.08 47 SARA BOWERMAN PHD EUREKA N N 0 0 1 0 0 0S60 $29,074.00 47 J NAKAGAWA PHD SACRAMENTO N N 0 0 1 0 0 0S60 $21,878.00 47 LUMEN HEALTH & PSYCH SERVICES SACRAMENTO N N 0 0 1 0 0 0S60 $21,877.00 47 JENNIFER EGGERT PHD SANTA ROSA N N 0 0 1 0 0 0S60 $20,797.96 47 SARA BOWERMAN PHD CRESCENT CITY N N 0 0 1 0 0 0S60 $17,846.00 47 BARRY FINKEL PHD SACRAMENTO N N 0 0 1 0 0 0S60 $13,794.00 47 KIMEL LIMON PSYD CRESCENT CITY N N 0 0 1 0 0 0S60 $9,278.00 47 EL DORADO HILLS PSYCHOLOGICAL MICHAEL MOLYN PSYD SACRAMENTO N N 0 0 1 0 0 0S60 $6,309.00 47 TELFORD MOORE PHD EUREKA N N 0 0 1 0 0 0S60 $3,780.00 47 ALBERT KASTL PHD SANTA ROSA N N 0 0 1 0 0 0S60 $3,106.00 47 LENORE TATE PHD SACRAMENTO N N 0 0 1 0 0 0S60 $2,774.00 47 THINK PAINT FEEL CREATIVE PSY SHYMA ELSAYED PSYD SACRAMENTO N N 0 0 1 0 0 0S60 $1,152.00 47 LISA PERRINE PHD SACRAMENTO N N 0 0 1 0 0 0S60 $819.00 47 SYLVIA HAMILTON PHD SACRAMENTO N N 0 0 1 0 0 0S60 $584.00 47 CHARLES ODIPO PHD SACRAMENTO N N 0 0 1 0 0 0S60 $430.00 47 EDWIN PEARSON PHD MEDFORD N N 0 0 1 0 0 0S60 $3,152.60 45 LES KALMAN MD SANTA ROSA N N 0 0 1 0 0 0S60 $3,050.40 45 LES KALMAN MD EUREKA N N 0 0 1 0 0 0S60 $20.00 45 LES KALMAN MD CLEARLAKE N N 0 0 1 0 0 0S60 $438.00 37 SANFORD CHILDRENS CLINIC KLAMATH FALLS N N 0 0 1 0 0 0S60 $316.00 37 EUREKA PEDIATRICS EUREKA N N 0 0 1 0 0 0S60 $17,940.00 36 SILVIA TORREZ PSYD SACRAMENTO N N 0 0 1 0 0 0S60 $7,629.00 36 SARA BOWERMAN PHD EUREKA N N 0 0 1 0 0 0S60 $7,432.00 36 EL DORADO HILLS PSYCHOLOGICAL MICHAEL MOLYN PSYD SACRAMENTO N N 0 0 1 0 0 0S60 $6,378.00 36 J NAKAGAWA PHD SACRAMENTO N N 0 0 1 0 0 0S60 $4,920.00 36 JENNIFER EGGERT PHD SANTA ROSA N N 0 0 1 0 0 0S60 $4,772.00 36 LUMEN HEALTH & PSYCH SERVICES SACRAMENTO N N 0 0 1 0 0 0S60 $2,649.00 36 BARRY FINKEL PHD SACRAMENTO N N 0 0 1 0 0 0S60 $1,859.00 36 PHILIP CUSHMAN PHD CLEARLAKE N N 0 0 1 0 0 0S60 $1,362.60 36 TELFORD MOORE PHD EUREKA N N 0 0 1 0 0 0S60 $1,147.00 36 THINK PAINT FEEL CREATIVE PSY SHYMA ELSAYED PSYD SACRAMENTO N N 0 0 1 0 0 0S60 $1,013.80 36 SARA BOWERMAN PHD CRESCENT CITY N N 0 0 1 0 0 0S60 $1,003.00 36 CHARLES ODIPO PHD SACRAMENTO N N 0 0 1 0 0 0S60 $900.00 36 EDWIN PEARSON PHD MEDFORD N N 0 0 1 0 0 0S60 $624.00 36 KIMEL LIMON PSYD CRESCENT CITY N N 0 0 1 0 0 0S60 $512.00 36 SYLVIA HAMILTON PHD SACRAMENTO N N 0 0 1 0 0 0S60 $331.00 36 LISA PERRINE PHD SACRAMENTO N N 0 0 1 0 0 0S60 $256.00 36 ALBERT KASTL PHD SANTA ROSA N N 0 0 1 0 0 0S60 $19,516.00 35 SACRAMENTO EAR NOSE AND THROAT SACRAMENTO N N 0 0 1 0 0 0S60 $266.00 33 RICHARD ANDOLSEN MD HEALDSBURG N N 0 0 1 0 0 0S60 $342.00 30 ROYO EYE CENTER SACRAMENTO N N 0 0 1 0 0 0S60 $5,693.00 29 EYE CARE INSTITUE DAN LIGHTFOOT MD SANTA ROSA N N 0 0 1 0 0 0S60 $4,628.00 29 ROYO EYE CENTER SACRAMENTO N N 0 0 1 0 0 0S60 $684.00 29 MARTEL EYE MEDICAL GROUP CHARLES BRADBROOK MD SACRAMENTO N N 0 0 1 0 0 0S60 $392.00 29 NORTH COAST OPHTHALMOLOGY JOHN MASTRONI MD EUREKA N N 0 0 1 0 0 0S60 $360.03 29 CATARACT & LASER INSTITUTE OF MEDFORD N N 0 0 1 0 0 0S60 $360.03 29 CATARACT & LASER INSTITUTE OF LOREN BARRUS MD MEDFORD N N 0 0 1 0 0 0S60 $196.00 29 NORTH COAST OPHTHALMOLOGY GREGORY GIBB MD EUREKA N N 0 0 1 0 0 0S60 $13,534.60 23 REBECCA JORDAN MD SACRAMENTO N N 0 0 1 0 0 0S60 $1,596.00 23 RICHARD ANDOLSEN MD HEALDSBURG N N 0 0 1 0 0 0S60 $133.00 22 SHAILESH ASAIKAR MD SACRAMENTO N N 0 0 1 0 0 0S60 $15,230.00 19 JANET OBRIEN MD SACRAMENTO N N 0 0 1 0 0 0S60 $810.00 19 JOHN ALCHEMY MD UKIAH N N 0 0 1 0 0 0S60 $153.00 19 RICHARD ANDOLSEN MD HEALDSBURG N N 0 0 1 0 0 0S60 $12,238.00 03 SACRAMENTO EAR NOSE AND THROAT SACRAMENTO N N 0 0 1 0 0 0S60 $183.00 03 HUMBOLDT AUDIOLOGY EUREKA N N 0 0 1 0 0 0S60 $163.86 03 BASIN AUDIOLOGY LOUIS DUBREY AUD KLAMATHA FALLS N N 0 0 1 0 0 0

Page 9 of 25

(b) (6)


JURIS DDS BRANCH










S61 $524,933.00 VV VALLEY HEALTH RESOURCES FRESNO Y Y 1 1 1 1 1 0S61 $506,610.00 VV HEALTH ANALYSIS/MODESTO MODESTO Y Y 1 1 1 1 1 0S61 $409,015.00 VV MDSI PHYSICIAN GROUP FRESNO Y Y 1 1 1 1 1 0S61 $294,327.00 VV HEALTH ANALYSIS/SAN JOSE SAN JOSE Y Y 1 1 1 1 1 0S61 $206,467.00 VV IZZI MEDICAL ASSOCIATES TULARE Y Y 1 1 1 1 1 0S61 $186,651.00 VV MDSI PHYSICIAN GROUP MODESTO Y Y 1 1 1 1 1 0S61 $186,120.00 VV MDSI PHYSICIAN GROUP VISALIA Y Y 1 1 1 1 1 0S61 $178,716.00 VV PRIORITY ANALYSIS SAN JOSE Y Y 1 1 1 1 1 0S61 $104,093.00 VV MSLA-VISALIA VISALIA Y Y 0 1 1 0 1 0S61 $102,908.00 VV BAY VIEW MEDICAL CLINIC SAN JOSE Y Y 0 1 1 0 1 0S61 $72,950.00 VV MDSI PHYSICIAN GROUP SAN JOSE Y Y 0 1 1 0 1 0S61 $72,385.00 VV MSLA-FRESNO FRESNO Y Y 0 1 1 0 1 0S61 $27,755.00 VV MSLA-CLOVIS CLOVIS Y Y 0 1 1 0 1 0S61 $24,825.00 VV EWING DIAGNOSTICS & PSYCH SRVS MODESTO Y Y 0 1 1 0 1 0S61 $31,325.00 DL EWING DIAGNOSTICS & PSYCH SRVS SAN JOSE N N 0 0 1 0 0 0S61 $6,054.00 DL YEN-LINH VU OD GILROY N N 0 0 1 0 0 0S61 $5,790.00 DL ROBERT MORGAN PHD MODESTO N N 0 0 1 0 0 0S61 $4,029.00 DL ROBERT MORGAN PHD MODESTO N N 0 0 1 0 0 0S61 $2,362.00 DL PEGGY JACKSON-SALCEDO PHD FRESNO N N 0 0 1 0 0 0S61 $1,764.00 DL MARY VIGILANTI EDD SAN JOSE N N 0 0 1 0 0 0S61 $1,214.00 DL SUTTER GOULD MEDICAL FNDN MODESTO N N 0 0 1 0 0 0S61 $520.00 DL TERESA FERNANDEZ MODESTO N N 0 0 1 0 0 0S61 $399.00 DL SUTTER GOULD MEDICAL FNDN ANDREA EDGERTON AUD MODESTO N N 0 0 1 0 0 0S61 $291.00 DL MSLA-FRESNO FRESNO N N 0 0 1 0 0 0S61 $212.00 DL EWING DIAGNOSTIC & PSYCH SRVS VISALIA N N 0 0 1 0 0 0S61 $167.00 DL PEGGY JACKSON-SALCEDO PHD FRESNO N N 0 0 1 0 0 0S61 $18.20 BP MINERAL KING RADIOLOGICAL GRP VISALIA N N 0 0 1 0 0 0S61 $847.00 80 KAWEAH DELTA HOSPITAL VISALIA N N 0 0 1 0 0 0S61 $2,250.00 79 KAWEAH DELTA HOSPITAL VISALIA N N 0 0 1 0 0 0S61 $281.00 79 SONORA REGIONAL MEDICAL CENTER SONORA N N 0 0 1 0 0 0S61 $106.00 73 DON GAEDE MD FRESNO N N 0 0 1 0 0 0S61 $1,904.00 72 MOHINDER POONIA MD FRESNO N N 0 0 1 0 0 0S61 $1,242.00 69 DON GAEDE MD FRESNO N N 0 0 1 0 0 0S61 $27.00 63 KAWEAH DELTA HOSPITAL VISALIA N N 0 0 1 0 0 0S61 $48,462.00 55 SPARKMAN SPEECH PATHOLOGISTS MODESTO N N 0 0 1 0 0 0S61 $36,330.00 55 CENTER FOR COMMUNICATION SKILL KATHRYN WAGE MA FRESNO N N 0 0 1 0 0 0S61 $25,746.00 55 CENTER FOR COMMUNICATION SKILL KATHRYN WAGE MA VISALIA N N 0 0 1 0 0 0S61 $5,639.00 51 FRESNO IMAGING CENTER FRESNO N N 0 0 1 0 0 0S61 $4,036.00 51 VALLEY RADIOLOGY MEDICAL ASSOC SAN JOSE N N 0 0 1 0 0 0S61 $369.00 51 WOMENS IMAGING SPECIALISTS IN FRESNO N N 0 0 1 0 0 0S61 $362.00 51 SONORA REGIONAL MEDICAL CENTER SONORA N N 0 0 1 0 0 0S61 $74.00 51 SEQUOIA IMAGING CENTER VISALIA N N 0 0 1 0 0 0S61 $109,371.00 47 STEVEN SWANSON PHD FRESNO N Y 0 0 1 0 0 1S61 $79,907.00 47 JAMES MURPHY PHD FRESNO N N 0 0 1 0 0 0S61 $70,773.00 47 MARY MCDONALD PHD VISALIA N Y 0 0 1 0 0 1S61 $44,614.00 47 PHILIP CUSHMAN PHD MODESTO N N 0 0 1 0 0 0S61 $38,973.20 47 RICHARD ENGELN PHD FRESNO N N 0 0 1 0 0 0S61 $33,522.00 47 ELKE KURPIERS PHD FRESNO N N 0 0 1 0 0 0S61 $16,200.00 47 GREG HIROKAWA PHD VISALIA N N 0 0 1 0 0 0S61 $10,171.00 47 HEALTH & PSYCHOLOGY SOLUTIONS MODESTO N N 0 0 1 0 0 0S61 $8,140.00 47 DAVID PINGITORE PHD MODESTO N N 0 0 1 0 0 0S61 $7,287.00 47 LANCE PORTNOFF PHD VISALIA N N 0 0 1 0 0 0S61 $3,930.00 47 SARA HYATT PSYD SAN JOSE N N 0 0 1 0 0 0S61 $1,676.00 47 LYNNE REINFURT PHD FRESNO N N 0 0 1 0 0 0S61 $745.00 47 MARY VIGILANTI EDD SAN JOSE N N 0 0 1 0 0 0S61 $516.00 47 AIMEE VICKERS-SANCHEZ PHD CLOVIS N N 0 0 1 0 0 0S61 $14,642.00 45 PHILIP CUSHMAN PHD MODESTO N N 0 0 1 0 0 0S61 $78,389.00 36 STEVEN SWANSON PHD FRESNO N N 0 0 1 0 0 0S61 $53,042.00 36 RICHARD ENGELN PHD FRESNO N N 0 0 1 0 0 0S61 $26,896.00 36 MARY MCDONALD PHD VISALIA N N 0 0 1 0 0 0S61 $12,887.00 36 PHILIP CUSHMAN PHD MODESTO N N 0 0 1 0 0 0S61 $11,289.00 36 HEALTH & PSYCHOLOGY SOLUTIONS MODESTO N N 0 0 1 0 0 0S61 $10,674.00 36 SARA HYATT PSYD SAN JOSE N N 0 0 1 0 0 0

Page 10 of 25

(b) (6)


JURIS DDS BRANCH









NON-KEY/VOLUME PROVIDERS VISITSS61 $10,590.00 36 LANCE PORTNOFF PHD VISALIA N N 0 0 1 0 0 0

S61 $7,421.00 36 SEQUOIA PSYCHOTHERAPY CENTER MARK POPPER PHD FRESNO N N 0 0 1 0 0 0S61 $3,277.00 36 DAVID PINGITORE PHD MODESTO N N 0 0 1 0 0 0S61 $512.00 36 AIMEE VICKERS-SANCHEZ PHD CLOVIS N N 0 0 1 0 0 0S61 $17,899.00 35 JAGDEV SINGH MD FRESNO N N 0 0 1 0 0 0S61 $14,683.00 35 RONALD WONG MD HANFORD N N 0 0 1 0 0 0S61 $4,277.00 33 LAKSHMI MADIREDDI MD SAN JOSE N N 0 0 1 0 0 0S61 $113.00 31 ROBERT GILLETT OD PORTERVILLE N N 0 0 1 0 0 0S61 $113.00 31 SAUL MENDELSOHN OD FRESNO N N 0 0 1 0 0 0S61 $2,659.00 30 SYED HASNAIN MD PORTERVILLE N N 0 0 1 0 0 0S61 $19,654.00 29 VISION CARE CENTER SAMUEL HINTON MD CLOVIS N N 0 0 1 0 0 0S61 $13,067.00 29 SYED HASNAIN MD PORTERVILLE N N 0 0 1 0 0 0S61 $2,566.00 29 KHOA NGUYEN MD SAN JOSE N N 0 0 1 0 0 0S61 $2,358.00 29 NATURAL VISION LOAN NGUYEN MD FRESNO N N 0 0 1 0 0 0S61 $1,321.00 29 NATURAL VISION DAVID KAYE MD FRESNO N N 0 0 1 0 0 0S61 $588.00 29 CENTER FOR SIGHT MODESTO N N 0 0 1 0 0 0S61 $359.00 29 NATURAL VISION ARYAN PAZIRANDEH OD FRESNO N N 0 0 1 0 0 0S61 $339.00 29 NATURAL VISION HONG LUU OD FRESNO N N 0 0 1 0 0 0S61 $339.00 29 NATURAL VISION LOAN NGUYEN MD SANGER N N 0 0 1 0 0 0S61 $113.00 29 NATURAL VISION JOHN BARRON OD FRESNO N N 0 0 1 0 0 0S61 $706.00 28 VISION CARE CENTER DERICK HOLT CLOVIS N N 0 0 1 0 0 0S61 $171.00 28 CENTER FOR SIGHT MODESTO N N 0 0 1 0 0 0S61 $11,373.00 23 NEURO PAIN MEDICAL CENTER PERMINDER BHATIA MD FRESNO N N 0 0 1 0 0 0S61 $21,235.00 19 SAMUEL RUSH MD CLOVIS N N 0 0 1 0 0 0S61 $12,563.00 19 VINAY BUTTAN MD PORTERVILLE N N 0 0 1 0 0 0S61 $3,232.00 19 TRI PHAM MD MODESTO N N 0 0 1 0 0 0S61 $7,966.00 05 MOHINDER POONIA MD FRESNO N N 0 0 1 0 0 0S61 $4,231.00 03 JAGDEV SINGH MD FRESNO N N 0 0 1 0 0 0S61 $946.00 03 HEARING SOLUTIONS SAN JOSE N N 0 0 1 0 0 0S61 $686.00 03 LOWE AUDIOLOGY FRESNO N N 0 0 1 0 0 0

Page 11 of 25

(b) (6)


JURIS DDS BRANCH










S62 $228,913.00 VV EWING DIAGNOSTICS & PSYCH SRVS CHICO Y Y 1 1 1 1 1 0S62 $169,417.00 VV EWING DIAGNOSTICS & PSYCH SRVS YUBA CITY Y Y 1 1 1 1 1 0S62 $165,997.00 VV MDSI PHYSICIAN GROUP REDDING Y Y 1 1 1 1 1 0S62 $154,075.00 VV MDSI PHYSICIAN GROUP CHICO Y Y 1 1 1 1 1 0S62 $148,431.00 VV EWING DIAGNOSTICS & PSYCH SRVS ROSEVILLE Y Y 0 1 1 0 1 0S62 $103,295.00 VV MDSI PHYSICIAN GROUP ROSEVILLE Y Y 0 1 1 0 1 0S62 $101,314.00 VV MDSI PHYSICIAN GROUP YUBA CITY Y Y 0 1 1 0 1 0S62 $96,434.00 VV EWING DIAGNOSTICS & PSYCH SRVS EL DORADO HILLS Y Y 0 1 1 0 1 0S62 $91,128.00 VV SHAHID AND RUBY ALI MDS REDDING Y Y 0 1 1 0 1 0S62 $60,793.00 VV MSLA-REDDING REDDING Y Y 0 1 1 0 1 0S62 $41,798.00 VV DIAGNOSTIC EVALUATION SERVICES CHICO Y Y 0 1 1 0 1 0S62 $13,793.00 VV DIAGNOSTIC EVALUATION SERVICES SUSANVILLE Y Y 0 1 1 0 1 0S62 $7,404.00 VV MSLA-CHICO CHICO Y N 0 1 1 0 0 0S62 $6,440.00 VV MSLA-ROSEVILLE ROSEVILLE Y N 0 1 1 0 0 0S62 $3,654.00 VV MSLA-YUBA CITY YUBA CITY Y N 0 1 1 0 0 0S62 $445.00 VV MSLA-LAS VEGAS NV LAS VEGAS Y N 0 1 1 0 0 0S62 $11,317.00 DL ANITA KEMP PHD REDDING N N 0 0 1 0 0 0S62 $10,392.72 DL JANET OBRIEN MD TRUCKEE N N 0 0 1 0 0 0S62 $7,398.00 DL ANITA KEMP PHD MOUNT SHASTA N N 0 0 1 0 0 0S62 $4,922.00 DL MILLER FAMILY MEDICINE WALTER MILLER MD GRASS VALLEY N N 0 0 1 0 0 0S62 $4,203.00 DL RANCHO CORDOVA MEDICAL CLINIC RANCHO CORDOVA N Y 0 0 1 0 0 1S62 $4,122.00 DL MSLA-REDDING REDDING N N 0 0 1 0 0 0S62 $3,678.39 DL SARA BOWERMAN PHD SUSANVILLE N N 0 0 1 0 0 0S62 $2,890.10 DL DEBORAH LACY PSYD S LAKE TAHOE N N 0 0 1 0 0 0S62 $2,002.00 DL SARA BOWERMAN PHD CARMICHAEL N N 0 0 1 0 0 0S62 $1,244.00 DL LANGUAGE WORLD SERVICES ROSEVILLE N N 0 0 1 0 0 0S62 $358.00 DL EWING DIAGNOSTICS & PSYCH SRVS CHICO N N 0 0 1 0 0 0S62 $306.69 DL SARA BOWERMAN PHD SUSANVILLE N N 0 0 1 0 0 0S62 $267.00 DL ENLOE MEDICAL CENTER CHICO N N 0 0 1 0 0 0S62 $248.00 DL SARA BOWERMAN PHD CARMICHAEL N N 0 0 1 0 0 0S62 $216.00 DL CHARLENE CHANG-SMITH MD OROVILLE N N 0 0 1 0 0 0S62 $158.00 DL SURINDER UPPAL MD SUSANVILLE N N 0 0 1 0 0 0S62 $131.00 DL ALEXANDRA CLARFIELD PHD AUBURN N N 0 0 1 0 0 0S62 $120.00 DL FEATHER RIVER HOSPITAL PARADISE N N 0 0 1 0 0 0S62 $107.00 DL NORTH STAR IMAGING MEDICAL GRP SUSANVILLE N N 0 0 1 0 0 0S62 $72.00 DL LANGUAGE WORLD SERVICES EL DORADO HILLS N N 0 0 1 0 0 0S62 $826.67 BP NORTH STATE RADIOLOGY IMAGING CHICO N N 0 0 1 0 0 0S62 $510.00 BP MICHAEL CLEARY MD REDDING N N 0 0 1 0 0 0S62 $103.00 BP PEDIATRIC CARDIOLOGISTS OF NO SACRAMENTO N N 0 0 1 0 0 0S62 $90.00 BP DINESH VERMA MD CHICO N N 0 0 1 0 0 0S62 $72.00 BP MICHAEL MALONEY MD YREKA N N 0 0 1 0 0 0S62 $1,140.00 79 MERCY MEDICAL CENTER REDDING N N 0 0 1 0 0 0S62 $802.00 79 FAIRCHILD MEDICAL CENTER YREKA N N 0 0 1 0 0 0S62 $644.00 79 MERCY SAN JUAN HOSPITAL CARMICHAEL N N 0 0 1 0 0 0S62 $180.00 79 BARTON MEMORIAL HOSPITAL S LAKE TAHOE N N 0 0 1 0 0 0S62 $130.00 79 ENLOE REHABILITATION CENTER CHICO N N 0 0 1 0 0 0S62 $411.00 73 MERCY MEDICAL CENTER REDDING N N 0 0 1 0 0 0S62 $312.00 73 FEATHER RIVER HOSPITAL PARADISE N N 0 0 1 0 0 0S62 $590.20 67 MELINDA ADAMS LCSW REDDING N N 0 0 1 0 0 0S62 $40.00 63 QUEST DIAGNOSTICS UNILAB REDDING N N 0 0 1 0 0 0S62 $33.00 63 ENLOE MEDICAL CENTER CHICO N N 0 0 1 0 0 0S62 $25.00 63 BANNER LASSEN MEDICAL CENTER SUSANVILLE N N 0 0 1 0 0 0S62 $18.00 63 RIDEOUT MEMORIAL HOSPITAL MARYSVILLE N N 0 0 1 0 0 0S62 $5,400.40 55 REDDINGS SPEECH AND LANGUAGE PATRICIA ALBA SLP REDDING N N 0 0 1 0 0 0S62 $4,131.00 55 CHICO SPEECH AND LANGUAGE CHICO N N 0 0 1 0 0 0S62 $514.00 55 THE CONTINUUM RENO N N 0 0 1 0 0 0S62 $428.00 55 LUMEN HEALTH & PSYCH SERVICES CITRUS HEIGHTS N N 0 0 1 0 0 0S62 $298.80 55 BARBARA BIONDO TRUCKEE N N 0 0 1 0 0 0S62 $306.00 53 SIERRA RHEUMATOLOGY DOUGLAS HASELWOOD MD ROSEVILLE N N 0 0 1 0 0 0S62 $1,554.00 51 MEDICAL DOCTORS IMAGING REDDING N N 0 0 1 0 0 0S62 $547.00 51 SUTTER BUTTES IMAGING MEDICAL YUBA CITY N N 0 0 1 0 0 0S62 $461.00 51 SUTTER IMAGING FOLSOM I FOLSOM N N 0 0 1 0 0 0S62 $383.00 51 SUTTER IMAGING ROSEVILLE ROSEVILLE N N 0 0 1 0 0 0

Page 12 of 25

(b) (6)


JURIS DDS BRANCH









NON-KEY/VOLUME PROVIDERS VISITSS62 $374.33 51 FEATHER RIVER HOSPITAL PARADISE N N 0 0 1 0 0 0

S62 $246.00 51 FAIRCHILD MEDICAL CENTER YREKA N N 0 0 1 0 0 0S62 $181.00 51 SUTTER IMAGING AUBURN AUBURN N N 0 0 1 0 0 0S62 $93.00 51 BANNER LASSEN MEDICAL CENTER SUSANVILLE N N 0 0 1 0 0 0S62 $93.00 51 BARTON MEMORIAL HOSPITAL S LAKE TAHOE N N 0 0 1 0 0 0S62 $65.00 51 SIERRA NEVADA MEMORIAL HOSP GRASS VALLEY N N 0 0 1 0 0 0S62 $129,598.00 47 SID CORMIER PHD REDDING N N 0 0 1 0 0 0S62 $70,049.00 47 LUMEN HEALTH & PSYCH SERVICES CITRUS HEIGHTS N N 0 0 1 0 0 0S62 $46,926.00 47 SARA BOWERMAN PHD AUBURN N N 0 0 1 0 0 0S62 $43,232.00 47 JOE AZEVEDO PHD CHICO N N 0 0 1 0 0 0S62 $37,382.97 47 SARA BOWERMAN PHD SUSANVILLE N N 0 0 1 0 0 0S62 $28,030.00 47 LUMEN HEALTH & PSYCH SERVICES YUBA CITY N N 0 0 1 0 0 0S62 $26,559.00 47 VALLEY PSYCHOLOGICAL CENTER ROSEVILLE N N 0 0 1 0 0 0S62 $25,322.00 47 WESTBROOK PSYCHOLOGICAL SVCS CARMICHAEL N N 0 0 1 0 0 0S62 $19,193.00 47 EWING DIAGNOSTICS & PSYCH SRVS PENN VALLEY N N 0 0 1 0 0 0S62 $18,257.00 47 ANITA KEMP PHD MOUNT SHASTA N N 0 0 1 0 0 0S62 $16,074.71 47 SARA BOWERMAN PHD S LAKE TAHOE N N 0 0 1 0 0 0S62 $14,538.40 47 SARA BOWERMAN PHD EL DORADO HILLS N N 0 0 1 0 0 0S62 $14,109.00 47 SARA BOWERMAN PHD CARMICHAEL N N 0 0 1 0 0 0S62 $10,533.00 47 EL DORADO HILLS PSYCHOLOGICAL MICHAEL MOLYN PSYD EL DORADO HILLS N N 0 0 1 0 0 0S62 $10,355.00 47 PSYCHWEST CLINICAL & FORENSIC YUBA CITY N N 0 0 1 0 0 0S62 $10,026.00 47 MAKING A DIFFERENCE COUNSELING GUY WASHINGTON PSYD NORTH HIGHLAND N N 0 0 1 0 0 0S62 $8,177.00 47 MSLA-RENO RENO N N 0 0 1 0 0 0S62 $7,462.00 47 LENORE TATE PHD GOLD RIVER N N 0 0 1 0 0 0S62 $5,879.00 47 KITT MURRISON PHD REDDING N N 0 0 1 0 0 0S62 $4,860.00 47 LEA TATE PSYD REDDING N N 0 0 1 0 0 0S62 $4,224.00 47 EL DORADO HILLS PSYCHOLOGICAL MICHAEL MOLYN PSYD FOLSOM N N 0 0 1 0 0 0S62 $3,976.00 47 DEBORAH LACY PSYD NORTH HIGHLAND N N 0 0 1 0 0 0S62 $3,419.00 47 SUPPORTIVE PSYCHOLOGICAL CARE CYRUS MOAZAM PHD ORANGEVALE N N 0 0 1 0 0 0S62 $2,382.00 47 DEBORAH SCHMIDT PHD AUBURN N N 0 0 1 0 0 0S62 $2,032.00 47 PATRICIA MCVEY PHD FOLSOM N N 0 0 1 0 0 0S62 $1,725.00 47 EL DORADO HILLS PSYCHOLOGICAL MICHAEL MOLYN PSYD AUBURN N N 0 0 1 0 0 0S62 $727.00 47 ALEXANDRA CLARFIELD PHD AUBURN N N 0 0 1 0 0 0S62 $126.00 47 PSYCHWEST CLINICAL & FORENSIC GRANITE BAY N N 0 0 1 0 0 0S62 $14,130.46 45 LES KALMAN MD YREKA N N 0 0 1 0 0 0S62 $3,604.00 45 KULWANT SINGH MD EL DORADO HILLS N N 0 0 1 0 0 0S62 $1,332.00 45 LENORE TATE PHD GOLD RIVER N N 0 0 1 0 0 0S62 $655.00 45 SANDRA BRANTON EDD S LAKE TAHOE N N 0 0 1 0 0 0S62 $725.00 37 NATIVITY PEDIATRICS EULE BIYO MD FOLSOM N N 0 0 1 0 0 0S62 $11,843.00 36 LUMEN HEALTH & PSYCH SERVICES CITRUS HEIGHTS N N 0 0 1 0 0 0S62 $10,225.00 36 SID CORMIER PHD REDDING N N 0 0 1 0 0 0S62 $4,902.00 36 JOE AZEVEDO PHD CHICO N N 0 0 1 0 0 0S62 $3,738.22 36 SARA BOWERMAN PHD SUSANVILLE N N 0 0 1 0 0 0S62 $3,082.00 36 LEA TATE PSYD REDDING N N 0 0 1 0 0 0S62 $3,038.00 36 WESTBROOK PSYCHOLOGICAL SVCS CARMICHAEL N N 0 0 1 0 0 0S62 $2,653.00 36 SARA BOWERMAN PHD CARMICHAEL N N 0 0 1 0 0 0S62 $1,727.00 36 KITT MURRISON PHD REDDING N N 0 0 1 0 0 0S62 $1,649.00 36 PSYCHWEST CLINICAL & FORENSIC YUBA CITY N N 0 0 1 0 0 0S62 $1,521.00 36 LUMEN HEALTH & PSYCH SERVICES YUBA CITY N N 0 0 1 0 0 0S62 $1,496.00 36 SARA BOWERMAN PHD AUBURN N N 0 0 1 0 0 0S62 $913.00 36 SARA BOWERMAN PHD EL DORADO HILLS N N 0 0 1 0 0 0S62 $853.00 36 VALLEY PSYCHOLOGICAL CENTER ROSEVILLE N N 0 0 1 0 0 0S62 $771.00 36 EWING DIAGNOSTICS & PSYCH SRVS PENN VALLEY N N 0 0 1 0 0 0S62 $603.00 36 EL DORADO HILLS PSYCHOLOGICAL MICHAEL MOLYN PSYD AUBURN N N 0 0 1 0 0 0S62 $336.00 36 DEBORAH SCHMIDT PHD AUBURN N N 0 0 1 0 0 0S62 $331.00 36 PATRICIA MCVEY PHD FOLSOM N N 0 0 1 0 0 0S62 $253.00 36 EL DORADO HILLS PSYCHOLOGICAL MICHAEL MOLYN PSYD EL DORADO HILLS N N 0 0 1 0 0 0S62 $241.10 36 SARA BOWERMAN PHD S LAKE TAHOE N N 0 0 1 0 0 0S62 $216.00 30 ASSOCIATED CHICO EYE SPECIALST ROBERT STONE MD CHICO N N 0 0 1 0 0 0S62 $196.00 30 OROVILLE EYE ASSOCIATES OROVILLE N N 0 0 1 0 0 0S62 $171.00 30 ROYO EYE CENTER GABRIEL JACOB MD ROSEVILLE N N 0 0 1 0 0 0S62 $6,434.00 29 ASSOCIATED CHICO EYE SPECIALST ROBERT STONE MD CHICO N N 0 0 1 0 0 0S62 $5,717.00 29 ROYO EYE CENTER GABRIEL JACOB MD ROSEVILLE N N 0 0 1 0 0 0S62 $3,102.00 29 OROVILLE EYE ASSOCIATES OROVILLE N N 0 0 1 0 0 0

Page 13 of 25

(b) (6)


JURIS DDS BRANCH









NON-KEY/VOLUME PROVIDERS VISITSS62 $472.00 29 THOMAS BOWEN DO REDDING N N 0 0 1 0 0 0

S62 $284.00 28 ROYO EYE CENTER GABRIEL JACOB MD ROSEVILLE N N 0 0 1 0 0 0S62 $6,041.00 23 RAJIY PATHAK MD FOLSOM N N 0 0 1 0 0 0S62 $3,012.00 23 RAJIY PATHAK MD PLACERVILLE N N 0 0 1 0 0 0S62 $22,432.00 19 HARI GOYAL MD MARYSVILLE N N 0 0 1 0 0 0S62 $13,786.00 19 RAJIY PATHAK MD PLACERVILLE N N 0 0 1 0 0 0S62 $11,457.00 19 JANET OBRIEN MD ROCKLIN N N 0 0 1 0 0 0S62 $10,200.00 19 JANET OBRIEN MD FOLSOM N N 0 0 1 0 0 0S62 $2,348.00 19 RAJIY PATHAK MD FOLSOM N N 0 0 1 0 0 0S62 $182.24 19 JANET OBRIEN MD TRUCKEE N N 0 0 1 0 0 0S62 $820.00 04 AUDIOLOGICAL HEARING SERVICES CARMICHAEL N N 0 0 1 0 0 0S62 $3,390.00 03 AUDIOLOGICAL HEARING SERVICES CARMICHAEL N N 0 0 1 0 0 0S62 $1,582.00 03 RITA MCWILLIAMS AUD REDDING N N 0 0 1 0 0 0

Page 14 of 25

(b) (6)


JURIS DDS BRANCH










S90 $394,257.00 VV CANYON MEDICAL GROUP CANOGA PARK Y Y 1 1 1 1 1 0S90 $327,994.00 VV MEDPRO SERVICES VAN NUYS Y Y 1 1 1 1 1 0S90 $317,455.00 VV MEDPRO SERVICES SAN FERNANDO Y Y 1 1 1 1 1 0S90 $208,817.00 VV MDSI PHYSICIAN GROUP VENTURA Y Y 1 1 1 1 1 0S90 $147,269.20 VV S & L MEDICAL GROUP SAN FERNANDO Y Y 0 1 1 0 1 0S90 $125,390.68 VV S & L MEDICAL GROUP VAN NUYS Y N 0 1 1 0 0 0S90 $78,671.00 VV MSLA-OXNARD OXNARD Y Y 0 1 1 0 1 0S90 $54,997.00 VV MSLA-RESEDA RESEDA Y N 0 1 1 0 0 0S90 $45,675.00 VV MSLA-VENTURA VENTURA Y N 0 1 1 0 0 0S90 $33,640.00 VV MDSI PHYSICIAN GROUP SANTA BARBARA Y N 0 1 1 0 0 0S90 $31,569.00 VV IZZI MEDICAL ASSOCIATES VENTURA Y N 0 1 1 0 0 0S90 $12,470.00 VV IZZI MEDICAL ASSOCIATES SAN FERNANDO Y Y 0 1 1 0 1 0

S90 $39,292.00 DL MILLENNIUM MULTISPECIALTY MED OXNARD N N removed

0 0 1 0 0 0

S90 $16,882.00 DL MILLENNIUM MULTISPECIALTY MED VAN NUYS N N removed

0 0 1 0 0 0S90 $5,481.00 DL S & L MEDICAL GROUP ENCINO N N 0 0 1 0 0 0S90 $3,329.00 DL EWING DIAGNOSTICS & PSYCH SRVS TARZANA N N 0 0 1 0 0 0S90 $3,250.00 DL METROPOLITAN SPEECH & LANGUAGE CAROL CARLBERG-SNYDER SLP SHERMAN OAKS N N 0 0 1 0 0 0S90 $3,048.00 DL VERA CECILIO MD TARZANA N N 0 0 1 0 0 0S90 $1,159.00 DL JERROLD SHERMAN MD LOS ANGELES N N 0 0 1 0 0 0S90 $956.00 DL JACOB TSADOK MD LOS ANGELES N N 0 0 1 0 0 0S90 $708.00 DL VERA CECILIO MD TARZANA N N 0 0 1 0 0 0S90 $289.00 DL STEVEN BURRES MD LOS ANGELES N N 0 0 1 0 0 0S90 $282.00 DL PRISM PSYCHOLOGY GROUP KIMBERLY SPITZ-MARES PHD SAN FERNANDO N N 0 0 1 0 0 0

S90 $173.00 DL MILLENNIUM MULTISPECIALTY MED- VAN NUYS N N removed 0 0 1 0 0 0S90 $171.00 DL WILLIAM FEIN MD BEVERLY HILLS N N 0 0 1 0 0 0S90 $839.00 83 JULES STEIN EYE INSTITUTE STEVEN NUSINOWITZ LOS ANGELES N N 0 0 1 0 0 0S90 $423.00 81 CEDARS-SINAI MEDICAL CENTER ZAB MOHSENIFAR MD LOS ANGELES N N 0 0 1 0 0 0S90 $220.00 79 SANTA BARBARA COTTAGE HOSPITAL SANTA BARBARA N N 0 0 1 0 0 0S90 $130.00 79 CEDARS-SINAI MEDICAL CENTER ZAB MOHSENIFAR MD LOS ANGELES N N 0 0 1 0 0 0S90 $41,705.77 55 EASTHILLS SPEECH-LANGUAGE SRVC MAXINE RODRIGUEZ SLP OXNARD N N 0 0 1 0 0 0S90 $3,815.00 55 THRIVE & SHINE SPEECH THERAPY NEDA REZAPOOR MS BEVERLY HILLS N N 0 0 1 0 0 0S90 $1,050.00 51 ROLLING OAKS RADIOLOGY VENTURA VENTURA N N 0 0 1 0 0 0S90 $93.00 51 PUEBLO RADIOLOGY MEDICAL GROUP SANTA BARBARA N N 0 0 1 0 0 0S90 $5,430.00 47 STERLING HEALTH CARE SANTA CLARITA N N 0 0 1 0 0 0S90 $4,202.00 47 LANCE PORTNOFF PHD VENTURA N N 0 0 1 0 0 0S90 $3,594.00 47 ISADORE WENDEL PHD CAMARILLO N N 0 0 1 0 0 0S90 $3,095.00 47 DAVID FOX PHD BEVERLY HILLS N N 0 0 1 0 0 0S90 $1,759.00 47 SARA HOUGH PSYD LOS ANGELES N N 0 0 1 0 0 0S90 $1,409.00 47 PSYCH EVAL INC BAHAREH TALEI PHD AGUORA HILLS N N 0 0 1 0 0 0S90 $8,030.00 45 ISADORE WENDEL PHD CAMARILLO N N 0 0 1 0 0 0S90 $969.00 45 MARK SOURIS PSYD WOODLAND HILLS N N 0 0 1 0 0 0S90 $4,443.00 36 LANCE PORTNOFF PHD VENTURA N N 0 0 1 0 0 0S90 $1,370.00 36 SARA HOUGH PSYD LOS ANGELES N N 0 0 1 0 0 0S90 $1,127.00 36 STERLING HEALTH CARE SANTA CLARITA N N 0 0 1 0 0 0S90 $345.00 36 SPECTRUM PSYCHOLOGY NETWORK KIMBERLY SPITZ-MARES PHD SAN FERNANDO N N 0 0 1 0 0 0S90 $280.00 36 DAVID FOX PHD BEVERLY HILLS N N 0 0 1 0 0 0S90 $271.00 36 MICHELLE HARRIMAN PSYD SHERMAN OAKS N N 0 0 1 0 0 0S90 $236.00 36 ROGER IZZI PHD SHERMAN OAKS N N 0 0 1 0 0 0S90 $21,424.00 35 KONSTANTIN SALKINDER MD LOS ANGELES N N 0 0 1 0 0 0S90 $16,070.00 35 LAWRENCE STEIN MD WEST HILLS N N 0 0 1 0 0 0S90 $10,301.00 35 CV ENT SURGICAL GROUP VERA CECILIO MD ENCINO N N 0 0 1 0 0 0S90 $1,546.00 33 ARTHUR GARFINKEL MD SANTA CLARITA N N 0 0 1 0 0 0S90 $1,356.00 33 JERROLD SHERMAN MD LOS ANGELES N N 0 0 1 0 0 0

Page 15 of 25

(b) (6)

(b) (6)

(b) (6)


JURIS DDS BRANCH









NON-KEY/VOLUME PROVIDERS VISITSS90 $552.00 33 KARL EPSTEIN MD WOODLAND HILLS N N 0 0 1 0 0 0

S90 $419.00 33 PARVIZ GALDJIE MD NEWHALL N N 0 0 1 0 0 0S90 $133.00 33 SYLVIA DELALLANA MD VAN NUYS N N 0 0 1 0 0 0S90 $855.00 30 KATHLEEN BEUTTLER MD VENTURA N N 0 0 1 0 0 0S90 $14,701.00 29 BERNARD MONDERER MD VAN NUYS N N 0 0 1 0 0 0S90 $11,769.00 29 JONATHAN MACY MD LOS ANGELES N N 0 0 1 0 0 0S90 $7,248.00 29 NEURO EYE ORBIT SWARAJ BOSE LOS ANGELES N N 0 0 1 0 0 0S90 $4,364.00 29 WILSON WU MD SANTA BARBARA N N 0 0 1 0 0 0S90 $2,049.00 29 KATHLEEN BEUTTLER MD VENTURA N N 0 0 1 0 0 0S90 $568.00 28 NEURO EYE ORBIT SWARAJ BOSE LOS ANGELES N N 0 0 1 0 0 0S90 $705.00 23 SYLVIA DELALLANA MD VAN NUYS N N 0 0 1 0 0 0S90 $665.00 23 SOUTHERN CALIFORNIA NEURO CTR MEHDI MERATEE MD VALENCIA N N 0 0 1 0 0 0S90 $798.00 19 PAUL AIJIAN MD SANTA BARBARA N N 0 0 1 0 0 0S90 $133.00 19 JACOB TSADOK MD CULVER CITY N N 0 0 1 0 0 0S90 $406.00 04 HEARING HELP PROVIDERS COLLEEN MORYL PHD BEVERLY HILLS N N 0 0 1 0 0 0S90 $90.00 04 FRIEDEL CUNNINGHAM MA TARZANA N N 0 0 1 0 0 0S90 $2,976.00 03 LAWRENCE STEIN MD WEST HILLS N N 0 0 1 0 0 0S90 $2,748.00 03 AUDIO RX HEARING SERVICE SUSAN FRUGONE MA LOS ANGELES N N 0 0 1 0 0 0S90 $543.00 03 ANDRES GODINEZ AUD SHERMAN OAKS N N 0 0 1 0 0 0S90 $436.00 03 AUDIOLOGIC ASSOCIATES IRA NADELL PHD SANTA BARBARA N N 0 0 1 0 0 0S90 $236.00 03 CV ENT SURGICAL GROUP VERA CECILIO MD ENCINO N N 0 0 1 0 0 0

Page 16 of 25

(b) (6)


JURIS DDS BRANCH









NON-KEY/VOLUME PROVIDERS VISITSV04 0 0 0 0 0

V04 $302,928.00 VV EWING DIAGNOSTICS & PSYCH SRVS STOCKTON Y Y 1 1 1 1 1 0V04 $145,774.10 VV PACIFIC HEALTH CLINIC ANTIOCH Y N 0 1 1 0 0 0V04 $134,636.00 VV AMBERSTONE MEDICAL GROUP STOCKTON Y N 0 1 1 0 0 0V04 $134,132.00 VV MDSI PHYSICIAN GROUP STOCKTON Y N 0 1 1 0 0 0V04 $125,422.00 VV NORTHSTATE CLINIC ANTIOCH Y N 0 1 1 0 0 0V04 $87,993.00 VV HEALTH ANALYSIS/PITTSBURG PITTSBURG Y N 0 1 1 0 0 0V04 $84,048.00 VV BAY VIEW HEALTH NET CONCORD Y N 0 1 1 0 0 0V04 $73,558.00 VV PRIORITY ANALYSIS CONCORD Y N 0 1 1 0 0 0V04 $69,302.00 VV MDSI PHYSICIAN GROUP VALLEJO Y N 0 1 1 0 0 0V04 $63,325.00 VV BAY VIEW HEALTH NET STOCKTON Y N 0 1 1 0 0 0V04 $60,052.00 VV AVATAR MEDICAL EXCELLENT NATRL UKIAH Y N 0 1 1 0 0 0V04 $56,798.00 VV SHAHID AND RUBY ALI MDS STOCKTON Y N 0 1 1 0 0 0V04 $55,596.00 VV EWING DIAGNOSTICS & PSYCH SRVS FAIRFIELD Y N 0 1 1 0 0 0V04 $47,092.00 VV BAY VIEW MEDICAL CLINIC VALLEJO Y N 0 1 1 0 0 0V04 $37,743.00 VV MDSI PHYSICIAN GROUP NAPA Y N 0 1 1 0 0 0V04 $37,446.00 VV MDSI PHYSICIAN GROUP CONCORD Y N 0 1 1 0 0 0V04 $36,301.00 VV MDSI PHYSICIAN GROUP VACAVILLE Y N 0 1 1 0 0 0V04 $30,507.00 VV MDSI PHYSICIAN GROUP FAIRFIELD Y N 0 1 1 0 0 0V04 $16,465.00 VV HEALTH ANALYSIS/TRACY TRACY Y N 0 1 1 0 0 0V04 $11,221.00 VV PRIORITY ANALYSIS PETALUMA Y N 0 1 1 0 0 0V04 $4,591.00 VV DIAGNOSTIC EVALUATION SERVICES STOCKTON Y N 0 1 1 0 0 0V04 $3,026.00 VV MSLA-CONCORD CONCORD Y N 0 1 1 0 0 0V04 $89,691.00 DL AVATAR MEDICAL EXCELLENT NATRL LAKEPORT N N 0 0 1 0 0 0V04 $38,068.00 DL EWING DIAGNOSTICS & PSYCH SRVS FAIRFIELD N N 0 0 1 0 0 0V04 $22,636.00 DL PRIORITY ANALYSIS PETALUMA N N 0 0 1 0 0 0V04 $10,887.00 DL EWING DIAGNOSTICS & PSYCH SRVS FAIRFIELD N N 0 0 1 0 0 0V04 $9,986.00 DL EWING DIAGNOSTICS & PSYCH SRVS FAIRFIELD N N 0 0 1 0 0 0V04 $9,041.00 DL CASSANDRA MAJESTIC PSYD DAVIS N N 0 0 1 0 0 0V04 $8,396.00 DL HEALTH ANALYSIS/ANTIOCH ANTIOCH N N 0 0 1 0 0 0V04 $8,044.00 DL EWING DIAGNOSTICS & PSYCH SRVS FAIRFIELD N N 0 0 1 0 0 0V04 $4,894.00 DL SOKLEY KHOI PHD CONCORD N N 0 0 1 0 0 0V04 $4,844.00 DL EDUCATIONAL PSYCHOLOGY AND ROBERT MATTESICH LEP STOCKTON N N 0 0 1 0 0 0V04 $3,616.00 DL MDSI PHYSICIAN GROUP UKIAH N N 0 0 1 0 0 0V04 $3,445.00 DL EWING DIAGNOSTICS & PSYCH SRVS FAIRFIELD N N 0 0 1 0 0 0V04 $2,715.00 DL EDUCATIONAL PSYCHOLOGY AND ROBERT MATTESICH LEP STOCKTON N N 0 0 1 0 0 0V04 $1,621.00 DL PHILIP CUSHMAN PHD UKIAH N N 0 0 1 0 0 0V04 $1,105.00 DL CASSANDRA MAJESTIC PSYD DAVIS N N 0 0 1 0 0 0V04 $977.00 DL SOKLEY KHOI PHD CONCORD N N 0 0 1 0 0 0V04 $862.00 DL STOCKTON HEARING AND SPEECH STOCKTON N N 0 0 1 0 0 0V04 $576.00 DL LANGUAGE WORLD SERVICES STOCKTON N N 0 0 1 0 0 0V04 $459.00 DL HARINDER AULUCK MD VALLEJO N N 0 0 1 0 0 0V04 $266.00 DL JOHN ALCHEMY MD UKIAH N N 0 0 1 0 0 0V04 $256.00 DL GILLERMO HERRERA PHD STOCKTON N N 0 0 1 0 0 0V04 $216.00 DL LANGUAGE WORLD SERVICES FAIRFIELD N N 0 0 1 0 0 0V04 $196.00 DL JACK MASON MD UKIAH N N 0 0 1 0 0 0V04 $157.00 DL PHILIP CUSHMAN PHD UKIAH N N 0 0 1 0 0 0V04 $144.00 DL TERESA FERNANDEZ STOCKTON N N 0 0 1 0 0 0V04 $138.00 DL JACK MASON MD UKIAH N N 0 0 1 0 0 0V04 $72.00 DL LANGUAGE WORLD SERVICES DAVIS N N 0 0 1 0 0 0V04 $65.00 DL PHILIP CUSHMAN PHD UKIAH N N 0 0 1 0 0 0V04 $40.00 DL DANIEL MANDELBAUM MD UKIAH N N 0 0 1 0 0 0V04 $65.00 BP NORTHERN CALIFORNIA IMAGING NAPA N N 0 0 1 0 0 0V04 $24.00 BP DELTA RADIOLOGY MEDICAL GROUP LODI N N 0 0 1 0 0 0V04 $130.00 80 ST JOSEPHS MEDICAL CENTER STOCKTON N N 0 0 1 0 0 0V04 $852.00 79 ST JOSEPHS MEDICAL CENTER STOCKTON N N 0 0 1 0 0 0V04 $90.00 79 QUEEN OF THE VALLEY HOSPITAL NAPA N N 0 0 1 0 0 0V04 $465.00 75 HEART AND HEALTH CENTER DANIEL ANDREWS MD NAPA N N 0 0 1 0 0 0V04 $115.00 73 ST JOSEPHS MEDICAL CENTER STOCKTON N N 0 0 1 0 0 0V04 $2,941.00 72 DANIEL ANDREWS MD NAPA N N 0 0 1 0 0 0V04 $40.00 63 SUTTER SOLANO MEDICAL CENTER VALLEJO N N 0 0 1 0 0 0V04 $35.00 63 PETALUMA VALLEY HOSPITAL PETALUMA N N 0 0 1 0 0 0V04 $28.00 63 SUTTER TRACY COMMUNITY HOSP TRACY N N 0 0 1 0 0 0V04 $23,302.00 55 COMMUNICATION DISORDERS LTD LAWRENCE FRIEDMAN STOCKTON N N 0 0 1 0 0 0

Page 17 of 25

(b) (6)


JURIS DDS BRANCH









NON-KEY/VOLUME PROVIDERS VISITSV04 $22,868.00 55 ANBERRY PHYSICAL REHAB CENTER ATWATER N N 0 0 1 0 0 0

V04 $690.00 51 STOCKTON DIAGNOSTIC IMAGING STOCKTON N N 0 0 1 0 0 0V04 $525.00 51 PETALUMA VALLEY HOSPITAL PETALUMA N N 0 0 1 0 0 0V04 $411.00 51 SUTTER LAKESIDE COMMUNITY HOSP LAKEPORT N N 0 0 1 0 0 0V04 $162.00 51 SUTTER TRACY COMMUNITY HOSP TRACY N N 0 0 1 0 0 0V04 $160.00 51 SUTTER SOLANO MEDICAL CENTER VALLEJO N N 0 0 1 0 0 0V04 $43.00 51 UKIAH VALLEY MEDICAL CENTER UKIAH N N 0 0 1 0 0 0V04 $38.00 51 ST JOSEPHS MEDICAL CENTER STOCKTON N N 0 0 1 0 0 0V04 $63,304.00 47 ALLIANCE ASSESSMENTS APARNA DIXIT PHD STOCKTON N N 0 0 1 0 0 0V04 $57,455.00 47 WENDY MCCRAY PHD ELK GROVE N N 0 0 1 0 0 0V04 $42,773.00 47 PHILIP CUSHMAN PHD VALLEJO N N 0 0 1 0 0 0V04 $37,805.00 47 WENDY MCCRAY PHD FAIRFIELD N N 0 0 1 0 0 0V04 $32,658.00 47 GILLERMO HERRERA PHD STOCKTON N N 0 0 1 0 0 0V04 $29,808.00 47 APRIL YOUNG PHD FAIRFIELD N N 0 0 1 0 0 0V04 $27,937.00 47 EWING DIAGNOSTICS & PSYCH SRVS WOODLAND N N 0 0 1 0 0 0V04 $24,096.00 47 APRIL YOUNG PHD PITTSBURG N N 0 0 1 0 0 0V04 $22,152.00 47 PHILIP CUSHMAN PHD UKIAH N N 0 0 1 0 0 0V04 $17,578.00 47 EDUCATIONAL PSYCHOLOGY COUNSLG JAMES WAKEFIELD PHD STOCKTON N N 0 0 1 0 0 0V04 $14,078.00 47 PETER BRADLEE PHD VACAVILLE N N 0 0 1 0 0 0V04 $12,977.00 47 ALLIANCE ASSESSMENTS APARNA DIXIT PHD NAPA N N 0 0 1 0 0 0V04 $3,770.00 47 LUMEN HEALTH & PSYCH SERVICES FAIRFIELD N N 0 0 1 0 0 0V04 $3,496.00 47 JANET CAIN PHD NAPA N N 0 0 1 0 0 0V04 $3,195.00 47 EDUCATIONAL PSYCHOLOGY & COUNS NANCY GOAD LEP STOCKTON N N 0 0 1 0 0 0V04 $2,311.00 47 JOHN CHELLSEN PHD STOCKTON N N 0 0 1 0 0 0V04 $82,437.20 45 LES KALMAN MD STOCKTON N N 0 0 1 0 0 0V04 $4,188.00 45 PHILIP CUSHMAN PHD VALLEJO N N 0 0 1 0 0 0V04 $4,056.00 45 TERRALYN RENFRO PSYD VACAVILLE N N 0 0 1 0 0 0V04 $4,017.00 45 PHILIP CUSHMAN PHD UKIAH N N 0 0 1 0 0 0V04 $1,753.40 45 LES KALMAN MD BENICIA N N 0 0 1 0 0 0V04 $196.20 45 LES KALMAN MD NAPA N N 0 0 1 0 0 0V04 $30,891.00 36 ALLIANCE ASSESSMENTS APARNA DIXIT PHD STOCKTON N N 0 0 1 0 0 0V04 $13,769.00 36 GILLERMO HERRERA PHD STOCKTON N N 0 0 1 0 0 0V04 $11,736.00 36 WENDY MCCRAY PHD ELK GROVE N N 0 0 1 0 0 0V04 $5,338.00 36 EDUCATIONAL PSYCHOLOGY COUNSLG JAMES WAKEFIELD PHD STOCKTON N N 0 0 1 0 0 0V04 $5,290.00 36 EWING DIAGNOSTICS & PSYCH SRVS WOODLAND N N 0 0 1 0 0 0V04 $4,217.00 36 PHILIP CUSHMAN PHD VALLEJO N N 0 0 1 0 0 0V04 $2,873.00 36 WENDY MCCRAY PHD FAIRFIELD N N 0 0 1 0 0 0V04 $2,520.00 36 APRIL YOUNG PHD PITTSBURG N N 0 0 1 0 0 0V04 $2,042.00 36 PETER BRADLEE PHD VACAVILLE N N 0 0 1 0 0 0V04 $1,392.00 36 ALLIANCE ASSESSMENTS APARNA DIXIT PHD NAPA N N 0 0 1 0 0 0V04 $1,249.00 36 APRIL YOUNG PHD FAIRFIELD N N 0 0 1 0 0 0V04 $709.00 36 PHILIP CUSHMAN PHD UKIAH N N 0 0 1 0 0 0V04 $553.00 36 LUMEN HEALTH & PSYCH SERVICES FAIRFIELD N N 0 0 1 0 0 0V04 $547.00 36 EDUCATIONAL PSYCHOLOGY & COUNS NANCY GOAD LEP STOCKTON N N 0 0 1 0 0 0V04 $291.00 36 ANDREW FISHER PHD VALLEJO N N 0 0 1 0 0 0V04 $271.00 36 JANET CAIN PHD NAPA N N 0 0 1 0 0 0V04 $1,481.00 30 CENTER FOR SIGHT MANTECA N N 0 0 1 0 0 0V04 $724.00 30 CENTER FOR SIGHT TRACY N N 0 0 1 0 0 0V04 $533.00 30 CENTER FOR SIGHT STOCKTON N N 0 0 1 0 0 0V04 $342.00 30 HERITAGE EYE ASSOCIATES KENNETH MISELIS MD STOCKTON N N 0 0 1 0 0 0V04 $9,344.00 29 REDWOOD EYE CENTER ROGER CARLSON MD VALLEJO N N 0 0 1 0 0 0V04 $8,215.00 29 CENTER FOR SIGHT STOCKTON N N 0 0 1 0 0 0V04 $7,885.00 29 CENTER FOR SIGHT MANTECA N N 0 0 1 0 0 0V04 $7,849.00 29 HERITAGE EYE ASSOCIATES KENNETH MISELIS MD STOCKTON N N 0 0 1 0 0 0V04 $2,926.00 29 CENTER FOR SIGHT TRACY N N 0 0 1 0 0 0V04 $2,147.00 29 CENTER FOR SIGHT STOCKTON N N 0 0 1 0 0 0V04 $968.00 28 CENTER FOR SIGHT STOCKTON N N 0 0 1 0 0 0V04 $797.00 28 CENTER FOR SIGHT MANTECA N N 0 0 1 0 0 0V04 $3,213.00 19 NORTHLAKE INTERNAL MEDICINE JOHN SCHWEIFLER MD LAKEPORT N N 0 0 1 0 0 0V04 $1,729.00 19 SAM SUNDAR MD CONCORD N N 0 0 1 0 0 0V04 $1,430.00 19 C & A MEDICAL GROUP MEHDI AZADI MD VACAVILLE N N 0 0 1 0 0 0V04 $1,237.00 19 GERIATRIC LONG TERM CARE MED BAO NGUYEN MD STOCKTON N N 0 0 1 0 0 0V04 $3,678.00 05 C & A MEDICAL GROUP MEHDI AZADI MD VACAVILLE N N 0 0 1 0 0 0V04 $3,640.00 05 DANIEL ANDREWS MD NAPA N N 0 0 1 0 0 0

Page 18 of 25

(b) (6)


JURIS DDS BRANCH









NON-KEY/VOLUME PROVIDERS VISITSV04 $274.00 04 UKIAH HEARING CARE GARY ANDRUS UKIAH N N 0 0 1 0 0 0

V04 $2,492.00 03 STOCKTON HEARING AND SPEECH STOCKTON N N 0 0 1 0 0 0V04 $80.00 03 UKIAH HEARING CARE GARY ANDRUS UKIAH N N 0 0 1 0 0 0

Page 19 of 25

(b) (6)


JURIS DDS BRANCH










V06 $313,525.00 VV S & L MEDICAL GROUP VICTORVILLE Y Y 1 1 1 1 1 0V06 $277,597.00 VV MEDPRO SERVICES RCH CUCAMONGA Y Y 1 1 1 1 1 0V06 $259,679.00 VV MSLA-LANCASTER LANCASTER Y Y 1 1 1 1 1 0V06 $211,610.00 VV DYNASTY MEDICAL GROUP LANCASTER Y Y 1 1 1 1 1 0V06 $89,543.00 VV MDSI PHYSICIAN GROUP LANCASTER Y N 0 1 1 0 0 0V06 $51,904.00 VV CALIFORNIA CARE MEDICAL GROUP ONTARIO Y N 0 1 1 0 0 0V06 $20,914.00 VV MSLA-CORONA CORONA Y N 0 1 1 0 0 0V06 $12,075.00 VV CALIFORNIA CARE MEDICAL GROUP DIAMOND BAR Y N 0 1 1 0 0 0

V06 $160,048.00 DL MILLENNIUM MULTISPECIALTY MED LANCASTER Y N removed

1 1 1 0 0 0V06 $69,453.00 DL MDSI PHYSICIAN GROUP LANCASTER N N 0 0 1 0 0 0

V06 $33,788.00 DL MILLENNIUM MULTISPECIALTY MED- CORONA N N removed 0 0 1 0 0 0

V06 $28,400.00 DL MILLENNIUM MULTISPECIALTY MED VICTORVILLE N N removed 0 0 1 0 0 0V06 $26,930.00 DL MORTON ISRAEL MD CORONA N N 0 0 1 0 0 0V06 $23,487.88 DL EASTHILLS SPEECH-LANGUAGE SRVC MAXINE RODRIGUEZ SLP PALMDALE N N 0 0 1 0 0 0V06 $218.00 DL S & L MEDICAL GROUP RCH CUCAMONGA N N 0 0 1 0 0 0V06 $32,044.00 55 TRANSITIONS SPEECH & LANGUAGE LANCASTER N N 0 0 1 0 0 0V06 $23,726.00 55 JANET CAMPBELL MA CLAREMONT N N 0 0 1 0 0 0V06 $3,501.79 55 EASTHILLS SPEECH-LANGUAGE SRVC MAXINE RODRIGUEZ SLP PALMDALE N N 0 0 1 0 0 0V06 $2,378.00 53 ARTHRITIS MEDICAL CLINIC CORONA N N 0 0 1 0 0 0V06 $60,641.00 47 STERLING HEALTH CARE LANCASTER N N 0 0 1 0 0 0V06 $29,028.00 47 SARA HOUGH PSYD LANCASTER N N 0 0 1 0 0 0V06 $2,605.00 47 ADVANCE COUNSELING CENTER LAWRENCE COATES PHD LANCASTER N N 0 0 1 0 0 0V06 $631.00 47 FAMILY GROWTH CLINIC ISADORE WENDEL PHD LANCASTER N N 0 0 1 0 0 0V06 $78.00 47 STEVEN GARMAN PSYD CLAREMONT N N 0 0 1 0 0 0V06 $17,756.00 45 SARA HOUGH PSYD LANCASTER N N 0 0 1 0 0 0V06 $9,887.00 45 FAMILY GROWTH CLINIC ISADORE WENDEL PHD LANCASTER N N 0 0 1 0 0 0V06 $8,347.00 45 TED GREENZANG MD SANTA ANA N N 0 0 1 0 0 0V06 $2,660.00 45 TANYA SCURRY MD ONTARIO N N 0 0 1 0 0 0V06 $725.00 38 TED GREENZANG MD SANTA ANA N N 0 0 1 0 0 0V06 $273.00 38 SARA HOUGH PSYD LANCASTER N N 0 0 1 0 0 0V06 $16,007.00 37 EFREN VALENZUELA MD VICTORVILLE N N 0 0 1 0 0 0V06 $1,596.00 37 MOHAN KUMARATNE MD HUNTINGTON BCH N N 0 0 1 0 0 0V06 $12,758.00 36 STERLING HEALTH CARE LANCASTER N N 0 0 1 0 0 0V06 $3,024.00 36 SARA HOUGH PSYD LANCASTER N N 0 0 1 0 0 0V06 $14,447.00 29 SHELIA WRIGHT-SCOTT MD PALMDALE N N 0 0 1 0 0 0V06 $3,764.00 19 MICHAEL MUMFORD MD SANTA ANA N N 0 0 1 0 0 0V06 $2,060.00 19 MARWAN EDRIS MD LAGUNA HILLS N N 0 0 1 0 0 0V06 $1,064.00 19 FOUNTAIN VALLEY CARDIOLOGY SHANKARLINGA SAINATH MD FOUNTAIN VALLEY N N 0 0 1 0 0 0V06 $399.00 19 ALLERGY & ASTHMA CENTER HENRY LIN MD CHINO N N 0 0 1 0 0 0V06 $2,434.00 05 MICHAEL MUMFORD MD SANTA ANA N N 0 0 1 0 0 0V06 $316.00 05 FOUNTAIN VALLEY CARDIOLOGY SHANKARLINGA SAINATH MD FOUNTAIN VALLEY N N 0 0 1 0 0 0

Page 20 of 25

(b) (6)

(b) (6)

(b) (6)


JURIS DDS BRANCH










V59 $608,654.00 VV MEDPRO SERVICES RIVERSIDE Y Y 1 1 1 1 1 0V59 $412,904.00 VV DIAMOND MEDICAL GROUP RIVERSIDE Y Y 1 1 1 1 1 0V59 $351,276.00 VV SEAGATE MEDICAL GROUP SAN DIEGO Y Y 1 1 1 1 1 0V59 $254,976.00 VV QTC MEDICAL GROUP PALM SPRINGS Y Y 1 1 1 1 1 0V59 $214,107.00 VV QTC MEDICAL GROUP CHULA VISTA Y Y 1 1 1 1 1 0V59 $213,239.00 VV MSLA-PALM SPRINGS PALM SPRINGS Y Y 1 1 1 1 1 0V59 $163,743.00 VV QTC MEDICAL GROUP TEMECULA Y Y 1 1 1 1 1 0V59 $120,839.00 VV CALIFORNIA CARE MEDICAL GROUP MURRIETA Y N 0 1 1 0 0 0V59 $75,854.00 VV MSLA-RIVERSIDE RIVERSIDE Y N 0 1 1 0 0 0V59 $45,641.00 VV MDSI PHYSICIAN GROUP PALM SPRINGS Y N 0 1 1 0 0 0V59 $11,218.00 VV AMCE PHSYICIANS GROUP SAN DIEGO Y N 0 1 1 0 0 0V59 $3,184.00 VV CONSULTATIVE EXAMINATION SVCS RIALTO Y N 0 1 1 0 0 0

V59 $27,665.00 DL MILLENNIUM MULTISPECIALTY MED RIVERSIDE N N removed 0 0 1 0 0 0V59 $9,837.00 DL H ENGELHORN MD SAN DIEGO N N 0 0 1 0 0 0V59 $2,565.00 DL S & L MEDICAL GROUP CHULA VISTA N N 0 0 1 0 0 0V59 $1,769.00 DL WILLIAM CHAPMAN MD NATIONAL CITY N N 0 0 1 0 0 0V59 $1,449.00 DL MARIA HANSEN DSRT HOT SPGS N N 0 0 1 0 0 0V59 $532.00 DL H ENGELHORN MD SAN DIEGO N N 0 0 1 0 0 0V59 $279.00 DL MSLA-PALM SPRINGS PALM SPRINGS N N 0 0 1 0 0 0V59 $246.00 DL WILLIAM JONES PHD PALM DESERT N N 0 0 1 0 0 0V59 $160.00 DL DOWNTOWN HEARING AID CENTER JANET BROWN RIVERSIDE N N 0 0 1 0 0 0V59 $140.00 DL NETWORK INTERPRETING SERVICE SAN DIEGO N N 0 0 1 0 0 0V59 $20.00 DL BAHAA GIRGIS MD RIVERSIDE N N 0 0 1 0 0 0V59 $69.00 81 PARKVIEW COMMUNITY HOSPITAL RIVERSIDE N N 0 0 1 0 0 0V59 $719.00 79 PARKVIEW COMMUNITY HOSPITAL RIVERSIDE N N 0 0 1 0 0 0V59 $56,048.00 55 KARA DODDS AND ASSOCIATES SAN DIEGO N N 0 0 1 0 0 0V59 $33,102.00 55 KELLY BROWN LLC RIVERSIDE N N 0 0 1 0 0 0V59 $16,235.00 55 ASSOCIATED SPEECH PATHOLOGISTS SAN MARCOS N N 0 0 1 0 0 0V59 $11,522.00 55 SENSABILITIES SPEECH-LANGUAGE RIVERSIDE N N 0 0 1 0 0 0V59 $2,618.80 55 CONSTANCE SIEGEL MURRIETA N N 0 0 1 0 0 0V59 $1,608.00 53 ARTHRITIS MEDICAL CLINIC RIVERSIDE N N 0 0 1 0 0 0V59 $52,740.00 47 APPLIED PSYCHOLOGY SERVICES DAN WHITEHEAD PHD SAN DIEGO N N 0 0 1 0 0 0V59 $16,429.00 47 MARCIE GOLDMAN PHD CHULA VISTA N N 0 0 1 0 0 0V59 $13,567.00 47 KIM GOLDMAN PSYD RIVERSIDE N N 0 0 1 0 0 0V59 $1,355.00 47 THE PSYCHOLOGICAL GROUP CHRISTOPHER COOPER PHD RIVERSIDE N N 0 0 1 0 0 0V59 $9,217.00 37 THOMAS SCHWELLER MD SAN DIEGO N N 0 0 1 0 0 0V59 $3,059.00 37 THOMAS SCHWELLER MD SAN MARCOS N N 0 0 1 0 0 0V59 $1,995.00 37 ADVANCED PEDIATRIC MEDICAL JAY SADRIEH MD SAN DIEGO N N 0 0 1 0 0 0V59 $1,749.00 37 TOURAJ SHAFAI MD RIVERSIDE N N 0 0 1 0 0 0V59 $4,063.00 36 KIM GOLDMAN PSYD RIVERSIDE N N 0 0 1 0 0 0V59 $2,002.00 36 MARCIE GOLDMAN PHD CHULA VISTA N N 0 0 1 0 0 0V59 $582.00 36 THE PSYCHOLOGICAL GROUP CHRISTOPHER COOPER PHD RIVERSIDE N N 0 0 1 0 0 0V59 $20,292.00 35 WILLIAM GORAL MD SAN BERNARDINO N N 0 0 1 0 0 0V59 $18,086.00 35 PIERRE RIVET MD SAN DIEGO N N 0 0 1 0 0 0V59 $7,219.00 35 PAUL GOODMAN MD SAN DIEGO N N 0 0 1 0 0 0V59 $662.00 35 PHILIP AZER MD SAN DIEGO N N 0 0 1 0 0 0V59 $14,082.00 29 WALLACE GOLDBAN MD PALM SPRINGS N N 0 0 1 0 0 0V59 $12,241.00 29 PRECISION EYE CARE GORDON MONTGOMERY MD NATIONAL CITY N N 0 0 1 0 0 0V59 $31,249.00 23 THOMAS SCHWELLER MD SAN DIEGO N N 0 0 1 0 0 0V59 $19,864.00 23 THOMAS SCHWELLER MD SAN MARCOS N N 0 0 1 0 0 0V59 $532.00 22 THOMAS SCHWELLER MD SAN DIEGO N N 0 0 1 0 0 0V59 $399.00 22 THOMAS SCHWELLER MD SAN MARCOS N N 0 0 1 0 0 0V59 $1,656.00 19 SENIOR CLINIC OF RIVERSIDE ROBERT NGUYEN MD RIVERSIDE N N 0 0 1 0 0 0V59 $1,395.00 19 PARS SURGERY HOSSAIN SAHLOLBAI MD BLYTHE N N 0 0 1 0 0 0V59 $399.00 19 INTERNAL MEDICINE ASSOCIATES RICHARD FRIEDMAN MD SAN DIEGO N N 0 0 1 0 0 0V59 $2,117.00 05 INTERNAL MEDICINE ASSOCIATES RICHARD FRIEDMAN MD SAN DIEGO N N 0 0 1 0 0 0V59 $160.00 03 MARJORIE HOUSTON ESCONDIDO N N 0 0 1 0 0 0V59 $20.00 03 JOHN HAUPT CCCA CHULA VISTA N N 0 0 1 0 0 0

Page 21 of 25

(b) (6)

(b) (6)


JURIS DDS BRANCH










V61 $538,107.00 VV MDSI PHYSICIAN GROUP BAKERSFIELD Y Y 1 1 1 1 1 0V61 $137,364.00 VV MDSI PHYSICIAN GROUP MERCED Y Y 0 1 1 0 1 0V61 $131,639.00 VV MDSI PHYSICIAN GROUP SALINAS Y Y 0 1 1 0 1 0V61 $99,458.00 VV IZZI MEDICAL ASSOCIATES SANTA MARIA Y N 0 1 1 0 0 0V61 $91,933.00 VV MSLA-BAKERSFIELD BAKERSFIELD Y Y 0 1 1 0 1 0V61 $90,336.00 VV BAY VIEW MEDICAL CLINIC SALINAS Y Y 0 1 1 0 1 0V61 $77,902.00 VV MDSI PHYSICIAN GROUP SANTA MARIA Y N 0 1 1 0 0 0V61 $63,569.00 VV MDSI PHYSICIAN GROUP SAN LUIS OBISPO Y N 0 1 1 0 0 0V61 $50,703.00 VV PRIORITY ANALYSIS SAN LUIS OBISPO Y N 0 1 1 0 0 0V61 $30,523.00 VV HEALTH ANALYSIS/MARINA MARINA Y N 0 1 1 0 0 0V61 $24,978.00 VV PRIORITY ANALYSIS PRUNEDALE Y N 0 1 1 0 0 0V61 $14,124.00 VV MSLA-MERCED MERCED Y N 0 1 1 0 0 0V61 $1,809.00 VV MSLA-SANTA MARIA SANTA MARIA Y N 0 1 1 0 0 0V61 $95,796.00 DL MDSI PHYSICIAN GROUP MERCED N N 0 0 1 0 0 0V61 $52,257.67 DL EASTHILLS SPEECH-LANGUAGE SRVC MAXINE RODRIGUEZ SLP BAKERSFIELD N N 0 0 1 0 0 0

V61 $38,238.00 DL MILLENNIUM MULTISPECIALTY MED BAKERSFIELD N N removed 0 0 1 0 0 0V61 $11,325.00 DL GARY BARTELL MD SAN LUIS OBISPO N N 0 0 1 0 0 0V61 $7,321.00 DL JOHN ZHANG PSYD BAKERSFIELD N N 0 0 1 0 0 0V61 $7,266.00 DL CHUCK-KWAN LEE MD BAKERSFIELD N N 0 0 1 0 0 0V61 $6,532.00 DL JOHN ZHANG PSYD BAKERSFIELD N N 0 0 1 0 0 0V61 $6,461.00 DL SOCIETY FOR DISABLED CHILDREN SANDI POOLE SLP BAKERSFIELD N N 0 0 1 0 0 0V61 $4,506.00 DL JOHN ZHANG PSYD BAKERSFIELD N N 0 0 1 0 0 0V61 $3,565.00 DL HAILSTON PSYCHOLOGICAL SERVICE LINDSEY HAILSTON PSYD ATASCADERO N N 0 0 1 0 0 0V61 $2,782.00 DL EASTHILLS SPEECH LANGUAGE SRVC CARYN GOVER SLP BAKERSFIELD N N 0 0 1 0 0 0V61 $2,565.00 DL HAILSTON PSYCHOLOGICAL SERVICE KARESA MEEK PSYD ATASCADERO N N 0 0 1 0 0 0V61 $2,474.00 DL FLORENCIO PANGILINAN MD BAKERSFIELD N N 0 0 1 0 0 0V61 $2,424.00 DL CROSS SPEECH & LANGUAGE CTR LOMPOC N N 0 0 1 0 0 0V61 $2,160.00 DL EASTHILLS SPEECH-LANGUAGE SRVC SANDRA MANZO SLP BAKERSFIELD N N 0 0 1 0 0 0V61 $1,277.00 DL NATIONAL PSYCHOLOGICAL EVAL KARESA MEEK PSYD ATASCADERO N N 0 0 1 0 0 0V61 $1,117.00 DL NATIONAL PSYCHOLOGICAL EVAL LINDSEY HAILSTON PSYD ATASCADERO N N 0 0 1 0 0 0V61 $1,029.00 DL PROFESSIONAL INTERPRETING SRVS LIBRADA VELA SANTA MARIA N N 0 0 1 0 0 0V61 $586.00 DL HAILSTON PSYCHOLOGICAL SERVICE LINDSEY HAILSTON PSYD ATASCADERO N N 0 0 1 0 0 0V61 $538.00 DL NATIONAL PSYCHOLOGICAL EVAL LINDSEY HAILSTON PSYD ATASCADERO N N 0 0 1 0 0 0V61 $360.00 DL MARIAN REGIONAL MEDICAL CENTER SANTA MARIA N N 0 0 1 0 0 0V61 $271.00 DL HAILSTON PSYCHOLOGICAL SERVICE KARESA MEEK PSYD ATASCADERO N N 0 0 1 0 0 0V61 $188.00 DL NATIONAL PSYCHOLOGICAL EVAL KARESA MEEK PSYD ATASCADERO N N 0 0 1 0 0 0V61 $182.83 DL COMPREHENSIVE PULMONARY AND ALPHA ANDERS MD BAKERSFIELD N N 0 0 1 0 0 0V61 $40.00 81 MARIAN REGIONAL MEDICAL CENTER SANTA MARIA N N 0 0 1 0 0 0V61 $260.00 80 MERCY THERAPY SERVICES MERCED N N 0 0 1 0 0 0V61 $1,290.00 79 MERCY THERAPY SERVICES MERCED N N 0 0 1 0 0 0V61 $1,232.00 79 NATIVIDAD MEDICAL CENTER SALINAS N N 0 0 1 0 0 0V61 $160.00 79 ANDERSON CLINIC PAUL ANDERSON MD CASTROVILLE N N 0 0 1 0 0 0V61 $185.00 73 NATIVIDAD MEDICAL CENTER SALINAS N N 0 0 1 0 0 0V61 $160.00 73 ST LOUISE REGIONAL HOSPITAL GILROY N N 0 0 1 0 0 0V61 $2,384.00 72 MERCY MEDICAL PAVILION MERCED N N 0 0 1 0 0 0V61 $800.00 72 NATIVIDAD MEDICAL CENTER SALINAS N N 0 0 1 0 0 0V61 $640.00 72 ADVANCED CARDIOLOGY MEDICAL YADVINDER NARANG MD BAKERSFIELD N N 0 0 1 0 0 0V61 $212.00 69 ANDERSON CLINIC PAUL ANDERSON MD CASTROVILLE N N 0 0 1 0 0 0V61 $215.60 63 MARIAN REGIONAL MEDICAL CENTER SANTA MARIA N N 0 0 1 0 0 0V61 $38.00 63 MERCY MEDICAL PAVILION MERCED N N 0 0 1 0 0 0V61 $28.00 63 SIERRA VISTA REGIONAL CENTER SAN LUIS OBISPO N N 0 0 1 0 0 0V61 $27,200.00 55 CENTRAL COAST LANGUAGE LEARNG JENNIFER DATTILIO MSCC MONTEREY N N 0 0 1 0 0 0V61 $7,998.00 55 CROSS SPEECH AND LANGUAGE CTR LOMPOC N N 0 0 1 0 0 0V61 $7,995.37 55 TED ISAACSON SLP BAKERSFIELD N N 0 0 1 0 0 0V61 $3,464.00 55 BUELLTON MEDICAL CENTER TED ISAACSON SLP BUELLTON N N 0 0 1 0 0 0V61 $3,424.00 55 EASTHILLS SPEECH-LANGUAGE SRVC MAXINE RODRIGUEZ SLP LAMONT N N 0 0 1 0 0 0V61 $3,036.00 55 SOCIETY FOR DISABLED CHILDREN TRACY BATTISTONI SLP BAKERSFIELD N N 0 0 1 0 0 0V61 $428.00 55 SOCIETY FOR DISABLED CHILDREN ANDREA YAKO SLP BAKERSFIELD N N 0 0 1 0 0 0V61 $214.00 55 EASTHILLS SPEECH-LANGUAGE SRVC CARYN GOVER SLP LAMONT N N 0 0 1 0 0 0

Page 22 of 25

(b) (6)

(b) (6)


JURIS DDS BRANCH









NON-KEY/VOLUME PROVIDERS VISITSV61 $1,550.00 51 TRUXTUN RADIOLOGY MEDICAL GRP BAKERSFIELD N N 0 0 1 0 0 0

V61 $1,474.00 51 TEMPLETON IMAGING MEDICAL TEMPLETON N N 0 0 1 0 0 0V61 $931.00 51 MERCED MRI MEDICAL GROUP MERCED N N 0 0 1 0 0 0V61 $818.00 51 DIGITAL MEDICAL IMAGING SANTA MARIA N N 0 0 1 0 0 0V61 $817.00 51 KERN RADIOLOGY MEDICAL GROUP BAKERSFIELD N N 0 0 1 0 0 0V61 $338.00 51 NATIVIDAD MEDICAL CENTER SALINAS N N 0 0 1 0 0 0V61 $291.00 51 SALINAS VALLEY RADIOLOGISTS SALINAS N N 0 0 1 0 0 0V61 $142.00 51 MERCY MEDICAL PAVILION MERCED N N 0 0 1 0 0 0V61 $65.00 51 HAZEL HAWKINS MEMORIAL HOSP HOLLISTER N N 0 0 1 0 0 0V61 $43.00 51 KERN RADIOLOGY MEDICAL GROUP BAKERSFIELD N N 0 0 1 0 0 0V61 $73,727.00 47 MARILYN MARTINEZ PHD BAKERSFIELD N N 0 0 1 0 0 0V61 $57,078.00 47 STEVEN SWANSON PHD MERCED N N 0 0 1 0 0 0V61 $39,718.60 47 KERN PSYCHOLOGICAL SERVICES MICHAEL MUSACCO PHD BAKERSFIELD N N 0 0 1 0 0 0V61 $20,862.00 47 KIM GOLDMAN PSYD CASTROVILLE N N 0 0 1 0 0 0V61 $10,965.00 47 AKIRA SUZUKI PHD BAKERSFIELD N N 0 0 1 0 0 0V61 $9,638.00 47 SEQUOIA PSYCHOTHERAPY CENTER MARK POPPER PHD FRESNO N N 0 0 1 0 0 0V61 $8,962.00 47 MARY VALENTI PHD BAKERSFIELD N N 0 0 1 0 0 0V61 $8,377.00 47 PEGGY JACKSON-SALCEDO PHD ARROYO GRANDE N N 0 0 1 0 0 0V61 $5,324.00 47 ROBERT OROPEZA PHD BAKERSFIELD N N 0 0 1 0 0 0V61 $5,265.00 47 KIM GOLDMAN PSYD GILROY N N 0 0 1 0 0 0V61 $4,694.00 47 JOHN ZHANG PSYD BAKERSFIELD N N 0 0 1 0 0 0V61 $1,230.00 47 PETER RUSSELL PHD ATASCADERO N N 0 0 1 0 0 0V61 $364.00 47 ANDERSON CLINIC CHARLES BILBREY PHD CASTROVILLE N N 0 0 1 0 0 0V61 $318.00 47 LORIN LINDNER PHD FRAZIER PARK N N 0 0 1 0 0 0V61 $258.00 47 THOMAS WYLIE PHD SANTA MARIA N N 0 0 1 0 0 0V61 $258.00 47 NATIONAL PSYCHOLOGICAL EVAL ATASCADERO N N 0 0 1 0 0 0V61 $3,534.00 45 KIM GOLDMAN PSYD GILROY N N 0 0 1 0 0 0V61 $20.00 38 LES KALMAN MD MERCED N N 0 0 1 0 0 0V61 $4,130.00 37 RIVERWALK PEDIATRIC CLINIC HASMUKH AMIN MD BAKERSFIELD N N 0 0 1 0 0 0V61 $61,063.00 36 MARILYN MARTINEZ PHD BAKERSFIELD N N 0 0 1 0 0 0V61 $28,836.00 36 STEVEN SWANSON PHD MERCED N N 0 0 1 0 0 0V61 $17,483.00 36 KERN PSYCHOLOGICAL SERVICES MICHAEL MUSACCO PHD BAKERSFIELD N N 0 0 1 0 0 0V61 $9,739.00 36 MARY VALENTI PHD BAKERSFIELD N N 0 0 1 0 0 0V61 $6,355.00 36 KIM GOLDMAN PSYD CASTROVILLE N N 0 0 1 0 0 0V61 $4,171.00 36 JOHN ZHANG PSYD BAKERSFIELD N N 0 0 1 0 0 0V61 $2,028.00 36 KIM GOLDMAN PSYD GILROY N N 0 0 1 0 0 0V61 $1,771.00 36 PEGGY JACKSON-SALCEDO PHD ARROYO GRANDE N N 0 0 1 0 0 0V61 $355.00 36 LORIN LINDNER PHD FRAZIER PARK N N 0 0 1 0 0 0V61 $291.00 36 NATIONAL PSYCHOLOGICAL EVAL ATASCADERO N N 0 0 1 0 0 0V61 $158.00 36 THOMAS WYLIE PHD SANTA MARIA N N 0 0 1 0 0 0V61 $4,790.00 35 CENTRAL COAST OTOLARYNGOLOGY RICHARD WIKHOLM MD SANTA MARIA N N 0 0 1 0 0 0V61 $8,400.00 31 STEVE RATTY OD BAKERSFIELD N N 0 0 1 0 0 0V61 $1,219.00 30 GRAHAM EYE CLINIC GARY GRAHAM MD MERCED N N 0 0 1 0 0 0V61 $367.00 30 THOMAS WEED MD MERCED N N 0 0 1 0 0 0V61 $7,449.00 29 GRAHAM EYE CLINIC GARY GRAHAM MD MERCED N N 0 0 1 0 0 0V61 $5,143.00 29 ELITE EYECARE MEDICAL GROUP SANTA MARIA N N 0 0 1 0 0 0V61 $3,210.00 29 JOHN CROWDER MD FREEDOM N N 0 0 1 0 0 0V61 $1,310.00 29 HAROLD SCHICK MD MERCED N N 0 0 1 0 0 0V61 $1,191.00 29 JOHN CROWDER MD HOLLISTER N N 0 0 1 0 0 0V61 $759.00 29 THOMAS WEED MD MERCED N N 0 0 1 0 0 0V61 $756.00 29 NATURAL VISION DAVID KAYE MD MADERA N N 0 0 1 0 0 0V61 $756.00 29 NATURAL VISION LOAN NGUYEN MD MADERA N N 0 0 1 0 0 0V61 $3,099.00 23 MONTEREY SPINE AND JOINT GERALD WAHL MD SALINAS N N 0 0 1 0 0 0V61 $7,575.00 19 SHAHRAM EHTESHAMI MD DELANO N N 0 0 1 0 0 0V61 $6,544.00 19 LAWRENCE RIEMER MD LOMPOC N N 0 0 1 0 0 0V61 $4,144.00 19 ANDERSON CLINIC PAUL ANDERSON MD CASTROVILLE N N 0 0 1 0 0 0V61 $6,004.00 05 ADVANCED CARDIOLOGY MEDICAL YADVINDER NARANG MD BAKERSFIELD N N 0 0 1 0 0 0V61 $266.00 05 ANDERSON CLINIC PAUL ANDERSON MD CASTROVILLE N N 0 0 1 0 0 0V61 $1,940.00 03 ANDERSEN HEARING SERVICES BAKERSFIELD N N 0 0 1 0 0 0V61 $124.00 03 HEARING CONSULTANTS OF CALIF JEFFREY DANHAUER PHD LOMPOC N N 0 0 1 0 0 0

Page 23 of 25

(b) (6)


JURIS DDS BRANCH










V63 $225.00 DL LYNN LARSON PHD LAS VEGAS N N 0 0 1 0 0 0V90 0 0 0 0 0V90 $1,092,207.00 VV MEDPRO SERVICES LOS ANGELES Y Y 1 1 1 1 1 0V90 $549,304.00 VV MEDPRO SERVICES LONG BEACH Y Y 1 1 1 1 1 0V90 $318,990.60 VV S & L MEDICAL GROUP LOS ANGELES Y Y 1 1 1 1 1 0V90 $303,204.00 VV MEDPRO SERVICES LOS ANGELES Y Y 1 1 1 1 1 0V90 $274,642.00 VV CHERRY MEDICAL CLINIC LONG BEACH Y Y 1 1 1 1 1 0V90 $270,483.00 VV S & L MEDICAL GROUP LONG BEACH Y Y 1 1 1 1 1 0V90 $267,102.00 VV CENTURY ASSESSMENT MANAGEMENT INGLEWOOD Y Y 1 1 1 1 1 0V90 $238,632.00 VV PELICAN MEDICAL GROUP CULVER CITY Y Y 1 1 1 1 1 0V90 $221,399.00 VV AVATAR MEDICAL EXCELLENT NATRL LYNWOOD Y Y 1 1 1 1 1 0V90 $216,810.58 VV S & L MEDICAL GROUP LOS ANGELES Y Y 1 1 1 1 1 0V90 $200,395.40 VV S & L MEDICAL GROUP LOS ANGELES Y Y 1 1 1 1 1 0V90 $157,791.00 VV GARDENA EVALUATION CENTER GARDENA Y Y 1 1 1 1 1 0V90 $130,181.00 VV MSLA-INGLEWOOD INGLEWOOD Y Y 0 1 1 0 1 0V90 $102,627.00 VV S & L MEDICAL GROUP LYNWOOD Y Y 0 1 1 0 1 0V90 $76,784.00 VV IZZI MEDICAL ASSOCIATES TORRANCE Y N 0 1 1 0 0 0V90 $64,114.00 VV AVATAR MEDICAL EXCELLENT NATRL LOS ANGELES Y Y 0 1 1 0 1 0V90 $61,572.00 VV MSLA-NORTH HOLLYWOOD NORTH HOLLYWOOD Y N 0 1 1 0 0 0V90 $26,990.00 VV RENEW MEDICAL CLINIC LONG BEACH Y Y 0 1 1 0 1 0V90 $4,096.49 VV RENEW MEDICAL CLINIC RIDGECREST Y Y 0 1 1 0 1 0V90 $156,472.00 DL ALPINE MEDICAL GROUP LOS ANGELES Y N 1 1 1 0 0 0V90 $147,360.00 DL EAST WEST FAMILY MEDICAL GROUP LYNWOOD N 0 0 1 0 0 0

V90 $122,152.00 DL MILLENNIUM MULTISPECIALTY MED LOS ANGELES N Y removed 0 0 1 0 0 1

V90 $86,405.00 DL MILLENNIUM MULTISPECIALTY MED INGLEWOOD N Y removed 0 0 1 0 0 1

V90 $70,529.00 DL MILLENNIUM MULTISPECIALTY MED LYNWOOD N Y removed 0 0 1 0 0 1

V90 $57,673.00 DL MILLENNIUM MULTISPECIALTY MED LONG BEACH N Y removed 0 0 1 0 0 1V90 $47,466.00 DL CARMEL MEDICAL GROUP BURBANK N N 0 0 1 0 0 0V90 $3,017.00 DL EAST-WEST EYE INSTITUTE ALBERT DAVIS MD TORRANCE N N 0 0 1 0 0 0V90 $1,617.00 DL RICHARD GLUCKMAN MD SAN PEDRO N N 0 0 1 0 0 0V90 $271.00 DL PRISM PSYCHOLOGY GROUP KIMBERLY SPITZ-MARES PHD SAN FERNANDO N N 0 0 1 0 0 0V90 $511.00 83 CALIFORNIA NEUROMEDICAL SRVCS ROSABEL YOUNG MD INGLEWOOD N N 0 0 1 0 0 0V90 $3,222.00 72 STEWART LONKY MD LOS ANGELES N N 0 0 1 0 0 0V90 $47,024.00 55 TRANSITIONS SPEECH & LANGUAGE INGLEWOOD N N 0 0 1 0 0 0V90 $19,348.00 55 BRIGHT BEGINNINGS SPEECH PATH LOS ANGELES N N 0 0 1 0 0 0V90 $13,268.00 55 CLARION SPEECH AND LANGUAGE LETHE WARD SLP COMPTON N N 0 0 1 0 0 0V90 $5,866.00 55 HILLSTOP SPEECH AND LANGUAGE JANET LYNN MA LONG BEACH N N 0 0 1 0 0 0V90 $18,617.00 47 JOHN STEPHENSON PHD TORRANCE N N 0 0 1 0 0 0V90 $1,377.00 47 SPECTRUM PSYCHOLOGY NETWORK KIMBERLY SPITZ-MARES PHD SAN FERNANDO N N 0 0 1 0 0 0V90 $895.00 47 WALTER BROWN PHD CULVER CITY N N 0 0 1 0 0 0V90 $4,075.00 45 ADVANCE COUNSELING CENTER LAWRENCE COATES PHD RIDGECREST N N 0 0 1 0 0 0V90 $12,010.00 37 EFREN VALENZUELA MD LOS ANGELES N N 0 0 1 0 0 0V90 $6,251.00 37 EFREN VALENZUELA MD HAWTHORNE N N 0 0 1 0 0 0V90 $2,715.00 36 JOHN STEPHENSON PHD TORRANCE N N 0 0 1 0 0 0V90 $236.00 36 WALTER BROWN PHD CULVER CITY N N 0 0 1 0 0 0V90 $35,945.00 35 FLAXIE FLETCHER MD LYNWOOD N N 0 0 1 0 0 0V90 $28,879.00 35 JESUS TAN MD LONG BEACH N N 0 0 1 0 0 0

Page 24 of 25

(b) (6)

(b) (6)


JURIS DDS BRANCH









NON-KEY/VOLUME PROVIDERS VISITSV90 $27,161.00 29 HENRY ULLMAN MD INGLEWOOD N N 0 0 1 0 0 0

V90 $12,232.00 29 ARTHUR EDELSTEIN MD LYNWOOD N N 0 0 1 0 0 0V90 $6,871.00 29 PATRICK YEH MD TORRANCE N N 0 0 1 0 0 0V90 $736.00 28 FAMILY EYE MEDICAL GROUP TERESA ROSALES MD LONG BEACH N N 0 0 1 0 0 0V90 $4,389.00 23 HARRIET COKELY MD SANTA MONICA N N 0 0 1 0 0 0V90 $2,048.00 23 THOMAS DIJULIO MD LONG BEACH N N 0 0 1 0 0 0V90 $399.00 19 JOSELYN BAILEY MD TORRANCE N N 0 0 1 0 0 0V90 $747.00 04 THE HEARING DOCTOR SOL MARGHZAR AUD CULVER CITY N N 0 0 1 0 0 0V90 $8,506.00 03 FLAXIE FLETCHER MD LYNWOOD N N 0 0 1 0 0 0V90 $788.00 03 THE HEARING DOCTOR SOL MARGHZAR AUD CULVER CITY N N 0 0 1 0 0 0

69 194 1105 68 101 15

TOTAL OVERSIGHTS COMPLETED: 116KEY PROVIDER OVERSIGHTS COMPLETED: 68

Page 25 of 25

(b) (6)

CE GROUP NAME CE PROVIDER KEY/VOLUME SITE VISIT INACTIVE REASON FOR INACTIVATIONAllied Assessments Jill Anderson TOP 5Allied Assessments Meredith Campbell TOP 5Allied Assessments Donald DeGroot TOP 5Allied Assessments Alicia Gauthier TOP 5Allied Assessments April Goggans IAllied Assessments Greta Hunter IAllied Assessments Robert Kirchner TOP 5Allied Assessments William Lewis TOP 5Allied Assessments Frederick Malmstrom TOP 5Allied Assessments Margaret McKinney IAllied Assessments Matthew Meija TOP 5 SVAllied Assessments Laura Moran IAllied Assessments Ryan Parsons TOP 5Allied Assessments Paula Pook TOP 5Allied Assessments David Solly TOP 5 SVColumbine Physicians Richard Carson TOP 5 SVColumbine Physicians Stephen Creer TOP 5 SVColumbine Physicians Sam Rubinson TOP 5 SVColumbine Physicians David Wallack TOP 5 SVConsulting Psychology Mary Ellen Fontenot PRIMARY CE WORK SVConsulting Psychology Frederick Leidal PRIMARY CE WORK SVDisability Exam Services Alicia Adams IDisability Exam Services Dustin Anderson TOP 5 SVDisability Exam Services Edwin Baca IDisability Exam Services Lauren Bergstrand IDisability Exam Services Samiran Bhattacharya TOP 5 SVDisability Exam Services Ashley Bloom IDisability Exam Services Charlene Borja TOP 5 SVDisability Exam Services Catherine Cooper TOP 5 SVDisability Exam Services Emily Corcoran TOP 5 SVDisability Exam Services Stephanie Cowherd TOP 5 SVDisability Exam Services Michael Dewey TOP 5 SVDisability Exam Services Alex Diaz TOP 5 SVDisability Exam Services Catherine Dunne TOP 5 SVDisability Exam Services Carolynn Francavilla-Brown IDisability Exam Services Hollie Gaeto IDisability Exam Services Emily Gutgsell IDisability Exam Services Aliea Herbert IDisability Exam Services Ryan Jackman TOP 5 SVDisability Exam Services Ronald Jendry IDisability Exam Services Kerry Kamer TOP 5 SVDisability Exam Services Michael Lersten TOP 5 SVDisability Exam Services DES LH IDisability Exam Services Hayley Marcus IDisability Exam Services Michael Matergia IDisability Exam Services Justin Neisler TOP 5 SVDisability Exam Services Anna Plunkett TOP 5 SVDisability Exam Services William Qutub TOP 5 SVDisability Exam Services Scott Rebich TOP 5 SVDisability Exam Services Thomas E. Reynolds TOP 5 SVDisability Exam Services Sarah Robbins TOP 5 SVDisability Exam Services Surieta Scheef TOP 5 SV

Colorado FY 2017

Disability Exam Services David Valencia TOP 5 SVDisability Exam Services Winay Virkud TOP 5 SVDisability Exam Services Carmen Wong IJohnsen Health Provider Services Travis Anderson IJohnsen Health Provider Services Alexis Carrington IJohnsen Health Provider Services Andrew Cleveland IJohnsen Health Provider Services Kimberly Johnson IJohnsen Health Provider Services Colleen Little IJohnsen Health Provider Services Christopher Meinzen IJohnsen Health Provider Services Matthew Nelson IJohnsen Health Provider Services Brittney Spivak IJohnsen Health Provider Services John Thomas IJohnsen Health Provider Services Tonya Wren IMDSI Lisa Butler TOP 5 SVMDSI Courtney Crance IMDSI Stanley Ginsburg TOP 5 SVMDSI Richard Harrison-Atlas TOP 5 SVMDSI Margaret MacDonald TOP 5 SVMDSI Michael McGuinn TOP 5 SVMDSI Victor Nwanguma IMDSI Lawrence Scibilia TOP 5 SVMDSI John Thomas TOP 5 SVMDSI Kenneth Washburn IQTC Venugopal Damerla IQTC Steven DeCoud IQTC Rosemary Greenslade TOP 5 SVQTC Gilbert Milburn-Westfall TOP 5 SVQTC Dana Monroe IQTC Sohini Parikh TOP 5 SVQTC Judith Ray TOP 5 SVQTC Joseph Sever TOP 5 SVQTC Jane Wells I

Jeanne "Lyn" Allen IKarma AnsbacherRoger AshmoreLaurence AylesworthLarry Barnett IJames BaroffioNeiel BaronbergDavid Benson PRIMARY CE WORK SVJohn BermudezAndras BodiniHelen BowdenDale BowenJoyce BoyerMac BradleyMolly BradyDavid BrownMonica BuettelMerlyn CaywoodNicholas CharitonCerola Charles IErnest Chavez

(b) (6)

Timothy Clark INatosha ClatterbaughVictor CorderoAmy CrockettScott CzarneckiLinda DaguerreBryan DavisLeAnna DeAngeloTimothy DoengesAnthony DoingMinette DossThomas Downes IDavid DruckerLara DunnJames EickelmanSandra EisemannHolly Estabrook-Doyle IVadim Fayngersh IPhaedra FegleyWinifred FlanaganRichard FlaniganRobert FoersterDavid FohrmanMarlene FrankelEdgar Galloway IIILynne GillickDavid GoodWilliam GrahamC. Patrick GreenMark GriffinLinda GryskiNolan HathawayKristin HelvigAimee HenleySteven HolleyKrista IannuzziRomeo IcasianoRoseanne IversenEdward JohnsonTerry JonesKatrina Katen IGina KimHeather KimBarton KnoxMajd KobitaryAmy Marie KunstleStuart KutzDenise LaGrandDennis Larson IEllen LewisStephen Lindendaum IJonathan Lipson IGary Luckasen

Stephen MackerrowRichard Madsen PRIMARY CE WORK SVRichard MadsenShanley MangeotJohn MarsBrad MartenMorgan McConnaughhayMark McDonaldBernadette MillsMichael MillsapYvonne MorriseyWilliam Morton PRIMARY CE WORK SVTimothy Moser PRIMARY CE WORK SVAngela MuriMary NelVictor NeufeldAndrew NorrisBarbara NovotnyMelinda O'RourkeRobert PelcNicolette PicernoJerry PostLynne Pred IJ. Christopher PruittJ.W. RagsdaleMichael RicafortT. Kevin RiceRoberta RichardsonJ. Lewis RomettKent RosengrenRandy RottmanBrian Scherzer, PhDJeffrey SchwartzRebecca Shtulman IScott SmetanaRebecca SmithCory SmithElizabeth StrakaCheryl Straus-WittyJustin StroteJanet Suarez IGregory SuchonKenneth SuslakRandall SwaimRussell ThyeBrandon TibbittsStephen TreatMichael TrowbridgeSarah VanWinkleMaria VasishtMarc VoelkelSteven VolmanNeil Wainwright I

Jill WaynePeter WeingartenImmaculate WesleyTodd WhitsittPhilip WileyStephen WittyMartin WongMartha Young IKori Ziegler I

CE Provider Name CityABIGAIL K HANNA MD - RedLink West HartfordADEBAMIRO ADEDOTUN MD New HavenADRIAN KLUFAS MD Bridgeport

ADVANCED RADIOLOGY CONSULTANTS Fairfield, Selden, Stamford, Stratford, Trumbull, Orange Color Key:ALOK BHARGAVA MD Waterbury Orange Volume ProvidersAMANDA HERNANDEZ-RIVERA PSYD Bridgeport, Waterbury Yellow: Key ProvidersAMANDA M. RAY, SLP Milford, West Hartford Purple: Onsite VisitsANDREW PLESHKEVICH PHD HartfordAMERICAN SCHOOL FOR THE DEAF West Hartford Red: Removed from panelANGELICA VALENTIN COLON PSYD Wethersfield Blue: New ProvidersANNA K KLOSINSKA-SALAZAR SLP West HartfordANNE MARIA ENGLISH LCSW WethersfieldANNEMARIE MURPHY PHD BridgeportANTHONY F CAMPAGNA PHD HamdenANTHONY ROSELLI MD West HartfordAPRIL MCLEAN PSYD ManchesterBALAZS SOMOGYI MD Cheshire, SouthingtonBINA ROGINSKY PSYD WoodbridgeBRIDGEPORT HOSPITAL BridgeportBRETT S RAYFORD PHD BRIDGEPORTBROOKE R CARSON PSYD WethersfieldBRUCE FREEDMAN PHD BloomfieldCHARLES A VASSILOPULOS PHD RockvilleCHARLOTTE HUNGERFORD HOSPITAL TorringtonCHERYL ELLIS PSYD WaterburyCRISTINA L CIOCCA PSYD HartfordCHRISTINA G FOREMAN PHD CCC SLP HartfordCLAUDIA GUEVARA KRASNICKI PSYD GlastonburyCLINICAL LABORATORY PARTNERS LLC Cheshire, Meriden, North Haven, WallingfordCONNECTICUT VALLEY RADIOLOGY PC Bloomfield, HartfordCRAIG W CZARSTY MD - HEALTH ONE OF CONNECTICUT PC OakvilleCYNTHIA L NYE PHD - AMCE RockyhillDAN A OREN MD - REDLINK New HavenDANA MARTINEZ PSYD Bridgeport, NewtownDANBURY HOSPITAL DanburyDANBURY RADIOLOGICAL ASSOCIATES PC DanburyDANIEL BELIN MD MiddletownDANIEL R BROCKETT PHD LLC SouthburyDAVID F ZITA PHD Old LymeDAVID K EMMEL MD WethersfieldDAY KIMBALL HOSPITAL PutnamDEBORA A KUSTRON PSYD - AMCE RockyhillDENISE K STONE PSYD GlastonburyDEREK T NOEL MD - MED PLUS MansfieldDIANA BADILLO MARTINEZ PHD WaterburyDIANE REESE LCSW WethersfieldDUANE F AUSTIN MD West HartfordELIANA ECHEVERRY SLP - REDLINK West Hartford, MilfordEMILY CASEY PSYD ColchesterEMILY B LITTMAN PHD WaterburyERIC FRAZER PSYD New HavenERICA PRESTON PSYD DanburyERIN LASHER JACOBSTEIN PSYD DanburyESTHER L ALFISI EDD MilfordEVANGELOS XISTRIS MD StamfordF SCOTT WINSTANLEY PHD New HavenFELIPE HERNANDEZ LCSW WethersfieldFRANCISCO A LOPEZ PHD New HavenFRANK J MONGILLO MD New Haven

GIL FREITAS MD East Lyme, Mansfield, South Windsor, Waterbury (2)

HARDIK P AMIN MD Derby

HERBERT REIHER, MD - MED PLUS & IMA East Lyme, Mansfield, South Windsor, Bridgeport, Waterbury (2)

HOSPITAL OF ST RAPHAEL New HavenHOWARD M KRIEGER PHD WaterburyIVETTE COSME SLP BridgeportJAIMIE BURNS PSYD West HartfordJAN J AKUS MD NorwichJAY M CUDRIN PHD West HartfordJEAN D IRISH PHD - AMCE Bridgeport

JEFFERSON X RAY GROUP INC Avon, Bloomfield, Enfield, Farmington, Glastonbury, Granby, Hartford, West Hartford, Wethersfield, Windsor

JEFFREY R SANDLER MD BridgeportJEFFREY S COHEN PHD StamfordJENNIFER SELDEN PHD GrotonJERILYN S ALLEN MD - EASTERN CONNECTICUT ENT PC Colchester, Norwich, Willimantic

CT FY 2017

JESUS A LAGO MD Bridgeport, Hamden, Hartford, Rye BrookJIE LIU MD Mansfield, South Windsor, Waterbury (2)JOANNE GAYESKI LCSW WethersfieldJOE LEE MD - REDLINK MILFORDJONATHAN WOODHOUSE PSYD DanburyJOSEPH B GUARNACCIA MD LLC DerbyJUDITH M MASCOLO MD West HartfordJUDITH ROSENFIELD MA CCC SLP AvonJULIE A KEEN PSYD Bridgeport, GrotonKAITLIN M CASTIGLIONE SLP - REDLINK West Hartford, MilfordKAITY R HUTCHINSON PSYD New Haven, OxfordKALMAN LEWIS WATSKY MD New HavenKAREN B GOLDFINGER PHD EssexKATHERINE RODRIGUEZ MD South Windsor, WaterburyKATHLEEN J MURPHY PHD DayvilleKENNETH S BLATT MD West HartfordKIMBERLY D HENDERSON-KJELLEN PSYD WethersfieldKristin A. Dilaj MD - NEW ENGLAND CENTER FOR HEARING REHABILITATION HamptonLALITHA PIERI PSYD WethersfieldLANCE HART PHD BranfordLASHANDA B HARVEY PSYD HartfordLAWRENCE AND MEMORIAL HOSPITAL New LondonLIESE FRANKLIN ZITZKAT PSYD LLC New HavenLISA HOLME PSYD GuilfordMABEL L TOLEDO SLP HartfordMALLICK Q ALAM MD New HavenMANCHESTER MEMORIAL HOSPITAL ManchesterMARC HILLBRAND PHD Cheshire, MiddletownMARGARITA HERNANDEZ PHD WethersfieldMARK E KAPLAN, PHD - AMCE Waterbury, BridgeportMark I Weinberger PSYD - IMA BridgeportMARTIN P HASENFELD MD New HavenMAYSA AKBAR PHD New Haven, OxfordMICHAEL A SHTERNFELD MD - MANCHESTER HEARING CENTER South WindsorMICHAEL F REGAN PHD WaterburyMICHAEL JOHNSON PHD DanburyMICHELE KRYNSKI PHD BloomfieldMIDDLESEX HOSPITAL Essex, Marlborough, MiddletownMIGDALIA S RIVERA ARZOLA PHD WethersfieldMOHAMED ZANBRAKJI MD South WindsorNAUGATUCK VALLEY RADIO COMPUTERIZED IMAG WaterburyNELSON RIVERA PHD WethersfieldNORWALK HOSPITAL ASSOCIATION NorwalkOCEAN RADIOLOGY ASSOCIATES LLC New LondonPATRICIA A GARRETT APRN DerbyPATRICK CARROLL MD East Lyme, MansfieldPATRICK F ALBERGO MD West HartfordPATRICK J RUSSOLILLO PHD MiddletownPENELOPE G COSENTINO PSYD NorwichPETER DONSHIK MD BloomfieldPHILIP S CARDAMONE PSYD WindsorSTEVEN POWELL MD - PULMONARY PHYSICIANS OF NORWICH PC NorwichQUEST DIAGNOSTICS INC Bethel, Branford, Bridgeport, Bridgeport, Bristol, Danbury,

East Hartford Enfield Essex Farifield Hartford HartfordRADIOLOGIC ASSOCIATES OF MIDDLETOWN Guilford, Middletown, West HavenRADIOLOGY ASSOCIATES INC Cheshire, HartfordRADIOLOGY ASSOCIATES OF HARTFORD PC HartfordRADIOLOGY ASSOCIATES OF WATERBURY WaterburyRADIOLOGY GROUP PC Branford, HamdenRADIOLOGY LLC EssexRAFAEL MORA DE JESUS PHD HartfordRAHIM SHAMSI MD SouthburyREBEKAH A JACKSON PSYD New HavenRICHARD M SLUTSKY MD StamfordRITA M DOHERTY EDD HamdenROBERT J BUNDY MD LLC WillimanticROBERT M DODENHOFF MD HartfordROBERT RUSSO MD Bridgeport, FairfieldROCIO CHANG ANGULO PSYD HartfordRUTH M GRANT PHD NorwalkSANDOR NAGY MD - HOSPITAL OF CENTRAL CT OCCUPATIONAL HEALTH NETWORK PlainvilleSARAH MULUKULTA MD DerbySEAN T HART PSYD SouthingtonSEKHAR C CHIRUNOMULA MD MonroeSHELDON B GREENBERG MD NorwalkSIDNEY S HOROWITZ PHD WaterburyST FRANCIS HOSPITAL HartfordST MARYS HOSPITAL WaterburySTEPHANIE LYNAM PSYD DanburySTEPHEN ROUSE MD - EASTERN CONNECTICUT ENT PC Colchester, Norwich, WillimanticSTEVEN E KARASHIK PSYD Ridgefield

STEVEN GREEN MD - EASTERN CONNECTICUT ENT PC Colchester, Norwich, WillimanticSTEVEN KAHN MD MeridenSUJATA KALE MD - REDLINK New HavenTHOMAS S KOCIENDA PSYD NewtownTORRINGTON RADIOLOGISTS PC TorringtonTURGUT YETIL MD NewingtonVISUAL PERCEPTIONS VernonWENDY A UNDERHILL PHD Hartford, TorringtonWILLIAM BACKUS HOSPITAL NorwichWILLIAM HIGGINS EDD BethelWILLIAM T CULVINER MD - EASTERN CONNECTICUT ENT PC Colchester, Norwich, WillimanticWINDHAM COMMUNITY MEMORIAL HOSPITAL WillimanticYACOV KOGAN MD Hartford, WaterburyZAID FADUL MD Rockyhill, Shelton, Stamford, Stratford, Trumbull

Volume Providers NoneKey Providers Company: Disability Associates of Connecticut LLC Doctors: YACOV KOGAN, MD

Company: Julie A. Keen LLC Doctors: JULIE A. KEEN, PSYDCompany: Med Plus Disability Evaluations INC Doctors: PATRICK CARROLL MDHERBERT REIHERDEREK T NOEL MDGIL FREITAS MDKATHERINE RODRIGUEZ MDJIE LIU MDCompany: Hartford Psychological Services LLC Doctors: RAFAEL MORA DE JESUS, PHDANDREW PLESHKEVICH, PHDLASHANDA B. HARVEY, PSYDCompany: AMCE Physicians Group Doctors: CHERYL ELLIS, PSYDZAID FADUL, MDDEBORA A KUSTRON, PDYDMARK E. KAPLAN, PHDAMANDA HERNANDEZ-RIVERA, PSYDJEAN D. IRISH, PHDCYNTHIA L. NYE, PHD

CE Providers Removed From Active List Company: AMCE Physicians Group Doctor: RICHARD I. STERNBERG PHD - AMCE Reason:AMCE Physicians Group REGINA P. WILSON, PHD - AMCE Reason:

Onsite Reviews Company: Rahim Shamsi, MD Doctor: RAHIM SHAMSI, MDCompany: Disability Associates of Connecticu,t LLC Doctor: YAKOV KOGAN, MD

Company: CTAME, LLC Doctor: ROBERT M DODENHOFF MDCompany: HARTFORD PSYCHOLOGICAL SERVICES Doctors: RAFAEL MORA DE JESUS, PHDANDREW PLESHKEVICH, PHDLASHANDA B HARVEY, PSYDCompany: Jan J. Akus, MD Doctor: JAN AKUS, MDCompany: COMPREHENSIVE PSYCHOLOGICAL Doctors: ANGELICA VALENTIN COLON PSYD & ASSESSMENT LILLIAM MARTINEZ LPCLALITHA PIERI PSYDCompany: Vision Associates of Prospect LAWRENCE KLINE, OD

CATHERINE GELINAS, OD

Company: Claudia Guevara Krasnicki, PsyD CLAUDIA GUEVARA KRASNICKI, PSYDNew CE Providers Added Doctor: ADVANCED RADIOLOGY CONSULTANTS - ORANGE, CT

AMERICAN SCHOOL FOR THE DEAF - WEST HARTFORD, CTCARLITA ELIAS, PSYDCATHERINE GELINAS, ODCYNTHIA L. NYE, PHDDAN A. OREN, MDELANOR HIRTREITER, PHDJASON A. GOCKEL, PSYDJEAN D. IRISH, PHDKATHIE H. MOFFITT, PHDLAWRENCE KLINE, ODLESLIE A. BURTON, PHDSTEPHANIE LYNAM, PSYDSUJATA KALE, MDZIARA M. KURYS, PSYD

Color Key:Orange Volume ProvidersYellow: Key ProvidersPurple: Onsite Visits

Red: Removed from panelBlue: New Providers

CT FY 2017

(b) (6)

PROVIDERS BY LOCATION AND SPECIALTY

Medical Providers License Number Expiration Date LOCATION

Dr. Gomez, Marisela 12/31/2018 IMA Office

Dr. Nolte, Elizabeth 12/31/2018 IMA Office

Dr. Miknowski, Eugene 12/31/2018 1145 19th St. NW, Suite 504, WDC 20036

Dr. Magurno, Justine 12/31/2018 IMA Office

Dr. Miller, Gary 12/31/2018 2440 M St NW #810, Washington, DC 20037

Dr. Pulver, David 12/31/2018 IMA Office

Dr. Taubin, Joel 12/31/2018 1145 19th St. NW, Suite 504, WDC 20036

Psych Providers License Number Expiration Date LOCATION

Dr. Arnold, James 12/31/2017 IMA Office

Dr. Campfield, Tracey 12/31/2017 IMA Office

Dr. Chaudhry-Jewani, Rukhsana 12/31/2017 IMA Office

Dr. Christman, Jennifer 12/31/2017 IMA Office

Dr. Clyburn, Sonya 12/31/2017 IMA Office

Dr. Coleman-King, Maia 12/31/2017 IMA Office

Dr. Crumpton, Howard 12/31/2017 IMA Office

Dr. Dubro, Alan 12/31/2017 IMA Office

Dr. Johnson, Stephanie 12/31/2017 IMA Office

Dr. Kalhor, Mona 12/31/2017 IMA Office

Dr. Maramark -Thomas, Sheilah 12/31/2017 IMA Office

Dr. Price, Gregory 12/31/2017 IMA Office

Dr. Siddique, Hoorie 12/31/2017 , SILVER SPRING, MD 2091

Dr. Weinberger, Mark 12/31/2017 IMA Office

Audio License Number Expiration Date LOCATION

Dr. Randolph, Patricia 12/31/2018 11120 New Hampshire Ave, Ste 504, Silver Spring, MD 20904. (301)593-3200

1145 19th St. NW, Suite 506, Washington, DC 20036WASHINGTON, D.C.

Updated 8/04/14 DH

(b) (6)

(b) (6)

(b) (6)

(b) (6)

PROVIDERS BY LOCATION AND SPECIALTY

ENT License Number Expiration Date LOCATION

Dr. Myers, Ernest 12/31/2018 11120 New Hampshire Ave, Ste 504, Silver Spring, MD 20904. (301)593-3200

Eye License Number Expiration Date LOCATION

Dr. Nasrallah, Fadi 12/31/2018 1145 19th St. NW, Ste 500, WDC 20036. (202)833-1668

Dr. Heffez, Jordan 12/31/2018 1145 19th St. NW, Ste 500, WDC 20036. (202)833-1668

Speech License Number Expiration Date LOCATION

Ms. Jacobs, Tiffany 12/31/2018 IMA OfficeMs. Luks, Jillian 12/31/2018 IMA OfficeMs. Jatene, Gabriela 12/31/2018 IMA Office

Updated 8/04/14 DH

(b) (6)

(b) (6)(b) (6)

(b) (6)

DDS Provider List* DDD only vendor * Top Five * Onsite Reviews Inactive CE Vendor Reason

A PLUS ASSOCIATED THERAPY PROSameh Elamir , MD

A SPEECH, HEARING & STRESS CLINIC

John Dawson, MD

A.T. RADIOLOGY P.A.

DFS Walk-In Clinic

AARON LIEBMAN AUDSamuel Rand, MD

ABBEY EYE CLINIC

Richard Reines, MD

ABBY CIOSICI SLP

Jonas Trinidad, PhD

ABBY CIOSICI, SLP*ABDUL BARI MDACADEMY EYE CARE**ACCESS BEHAVIORAL CARE ASSOCIATES*ACG THERAPY CENTER INCADA RAMIREZ PHDADAM GREENFIELD, DOAddys Prieto,Psy.D.Adele Besner, Psy.D.ADVANCED IMAGING CENTER INCAfzal Khan MDAGGARWAL MEDICAL ASSOC PAAIMEE JENNINGS, M.S. CCC-SLPAlan Kohn MDALAN LANE MDALAN MARCUS,D.O.ALEJANDRO J. ARIAS,PSY.D.*ALEXANDER NEIMAN, MDALISA TALKINGTON, PSYDALISON GROSSMAN, PH.D.ALL ACCESS THERAPY AND REHABALLISON TARBOX, PSYDALPHA AUDIOLOGY*ALVAN BARBER MD-ORMOND BEACH**ALVAN W BARBER MDALVAREZ AUDIOLOGY AND HEARING**AMCE: ERE

AMERICAN PSYC. CONSULTANTS AND MULTICULTURAL SERV.ANDREA CHAPMAN SLPANDRES NAZARIO, JR., PH.D.ANEESA AHMAD MDANELE DIAZANGEL MARTINEZ PHD-EREANGELA C. BRINSON, PH.D.*ANGELA HENDERSON, PHDANILKUMAR PATEL MDANITA PATEL MDANN L JACOBS PHDANOOP K REDDY, MDANTONIO PRADO, MD, PAARC GATEWAY INCARCHBOLD MEMORIAL HOSPITALASHOK MITTAL, MDASMA SYED, MD**ASSESSMENT & TREATMENT CENTERS, INC.ASSOCIATES FOR EVALUATION & THERAPY

Florida FY 2017

(b) (6)

AUDIOLOGY CONSULTANTS OF PANAMA CITY*AUTUMN MURPHY SLP - TALLAHASSEEAVP ASSESSMENT SERVICESAYMAN ABOULELA MDAZZAM ADHAL MD*Badri N. Mehrotra, M.D.BARBARA M PAULILLO, PSYD PABAY AREA HEART CENTERBAY MEDICAL CENTER - RESPIRATORY LAB*BAY PC PRIME MEDICALBAY RADIOLOGY ASSOCIATES PABAYFRONT HEALTH BROOKSVILLEBAYFRONT HEALTH PORT CHARLOTTEBEATRIZ AMADOR, PSY.D., P.A.BEE RIDGE VISION CENTERBEHAVIORAL HEALTH OF NORTH FLORIDABelinda Slater SLPBELL PSYCHOLOGICAL SERVICES INCBELTRAN BEHAVIORAL HEALTH LLCBENEFICIAL HEARING AID CENTERBENJAMIN N COHEN PHD**BETH INGRAM & ASSOCIATES*BHUPENDRA GUPTA MDBI-COUNTY SPEECH LANGUAGE PATHOLOGY, INC.BILINGUAL SPEECH LANGUAGE PATHOLOGY CENTER, INC.BILINGUAL THERAPY SERVICES LLC**BILLIE JO HATTON PHDBIRD EYE INSTITUTEBIRDS OF PARADISE PSYCHOLOGICAL SERVICESBRADLEY J BRADFORD MDBREVARD EAR NOSE & THROAT**BRIGHTSIDE HEALTH LLCBROADWATER HEARING CAREBROOKSVILLE EYE CENTERBROWARD THERAPY ASSOCIATESBRUCE R HOFFEN MD PABRUCE WHITING PH.D.*CAIRO EYE CARECAPITAL RESEARCH INSTITUTE, INC.CARDIAC CLINIC OF SUNIL KAKKARCARDIOLOGY AND INTERNAL MEDICINE GROUP - QUINCYCARDIOVASCULAR CONSULTANTSCarl Spirazza,D.O.CARLA HOLLOMAN DOCARLOS DANGERCARLOS M. MARTINEZ, M.D.Carmen Cornide,Psy.D.CARMEN TOZZO JULIAN PHDCAROL GRANT MD LLCCarol Walter Kaufman,Psy.D.CARRINGTON EVALUATION & BEHAVIOR SERVCARTER PSYCHOLOGY CENTERCAYLEIGH BENNY HARPERCECILIA YOCUM PHDCELEBRATION EYE CARE*CENTER FOR BEHAVIORAL HEALTH CARE P.A.CENTER FOR SPEECH & LANGCENTRAL FLA SPEECH & HEARINGCENTRAL FLORIDA PREMIERE EYE ASSOCIATESCENTRAL FLORIDA THERAPY INCCENTURY CLINICAL FAMILY MEDICINE*CHAD HAGANS, PHDCHARLENE WESTMAN

CHARLES MAITLAND MDCHRIS CATT, PSY.DCHRIS OKONKWO MDCHRISTIAN BERRIOS, PSYDCHRISTINE BECK-PALATKA*Ciceron V Lazo, M.D.CITRUS OPEN MRI CENTER*CLEAR SOUND AUDIOLOGY*CLEMENTS & ASSOCIATES PACLEMENTS & ASSOCIATES, P.A.*Clifford Share, M.D.*COLLEEN CHARACTER, PH.D.COLUMBIA EYE ASSOCIATES - LIVE OAKCOLUMBIA LAWNWOOD REGIONAL MEDICAL CTCOMPLETE MEDICAL CARE ASSOCIATES, INCCOMPLETE REHABILITATION FT WALTON BEACH: ERECONSULTING PSYCHOLOGISTS OF S.FLORIDA, INC.COPELY EYE CLINICCORNELIUS HALVEY MD**CORNERSTONE NEUROPSYCHOLOGY--ERECORNERSTONE PEDIATRICSCRESCENT THERAPY AND ASSESSMENTCRISTIAN DEL RIO, PSY.D.*CROSS CREEK MEDICAL PA - TALLAHASSEECYNTHIA HEISED. P. Raju, M.D.DALE K JOHNS MDDANIEL L. WARD,PH.D.Daniel Pope MDDARBY L GODWIN, PHDDAVID A. YUDELL, PSY.D.,P.A.DAVID B RAWLINGS PH D P ADAVID BRODNER M.D.David Echavarria, Ph.D.DAVID J. FLEISCHMANN, PH.D.**DAVID KARPF PHDDAVID M KLEIN M D OPHTHALMOLOGIST PADAVIS FAMILY HEARINGDAVIS OPTOMETRY GROUPDEBORAH F SHULTZ MD*DENISE VERONES PHDDennis D Dewey, M.D.

DEVELOPMENTAL BEHAVIORAL PEDIATRICS OF CENTRAL FLDFS WALK-IN CLINIC**DIANA BENTON PSYD - GAINESVILLEDIANE THEODORE M.Ed.**DISABILITY CONSULTANTS PC*DISABILITY CONSULTANTS PCDOCTORS IMAGING GROUP OF GAINESVILLEDOCTORS MEDICAL CENTER OF WALTON COUNTY PADOCTORS MEMORIAL HOSPITALDONALD A. STEWART, PSY.D.DONALD B KNAPP II MDDONALD J TINDALL MDDorothy Lekarczyk Ph.D.DR LYNN R BERNSTEIN & ASSOC PADR NANCY MACKAYE JACOB MDE MED URGENT AND PRIMARY CARE, PAEAR NOSE THROAT ASSOCIATES OF LAKE COUNTY PAEAR-TRONICS INCEAR-TRONICS INC

Eduardo Sanchez M.D.*EFTIM ADHAMI MDELIAS BANUELOS MD: EREELITE IMAGING GROUPELLEN D SILKES MD PAELLEN SUAREZ-PINZAS PSYD PAEMAD EISAEMERALD COAST AUDIOLOGYEMERALD COAST NECK AND BACK CLINIC***EMERALD COAST PSYCHOLOGY SANTA ROSA BEACH

EMERALD COAST SPORTS MEDICINE AND ORTHOPAEDICS PAEMERGENCY MEDICAL CENTEREMPOWER PREVENTIVE MEDICINE PA - JACKSONVILLEENID GILDAR MA CCCENIOLA OWI MDENT ASSOCIATES OF SOUTHWEST GEORGIAErnst Nicolitz M.D.*ESHAN M KIBRIA DOEugene Eisner MDEUGENE J. HERRMANN, PH.D.EVA GOYETTE, D.O.EXCEL PEDIATRICSEXODUS REHABILITATION INCEYE ASSOCIATES OF PINELLASEYE CENTER SOUTH, PANAMA CITYEYE-I-DEALS*F DONALD KELLY PHDFAMILY MEDICAL CARE OF THE PALM BEACHFELICE CENTER FOR PEDIATRIC REHABFELIX J SUBERVI III PHD*FIRST COAST HEARING CLINIC, INC.-PALM COASTFIRST COAST HEART & VASCULAR CENTERFlagler HospitalFLORIDA EYE ASSOCIATES INCFLORIDA EYE CLINICFLORIDA HOSPITAL AUDIOLOGYFLORIDA HOSPITAL HEARTLANDFLORIDA HOSPITAL MEMORIAL DIVISIONFLORIDA HOSPITAL SOUTHFLORIDA NEUROPSYCHOLOGYFLORIDA REHAB PROFESSIONALS GROUP, INC.*FLORIDA REHAB. PROFESSIONALS CENTRE, INC.Focus Imaging Group,Inc.FORT PIERCE FAMILY CARE INCFORT PIERCE VISION CAREFORT WALTON BEACH MEDICAL CENTERFRANK A BROWN PHDFRED L ALBERTS JR PHD*FUNDAMENTAL THERAPY SOLUTIONS (SPANISH EXAMS)GABRIEL YBARRA, PHDGARDNER AUDIOLOGYGARDNER AUDIOLOGY INVERNESSGARY HONICKMAN, PH.D.GENE TERREZZA OD**GEORGE SLADE MDGEORGE ZAKY PSYDGEORGE ZAKY, PSYDGHIATH KASHLAN MDGILLIOM AUDIOLOGY PAGLN SPEECH PATHOLOGY SVCS INC***GNC THERAPIES INC**GNC THERAPIES PENSACOLA: ERE

GNC THERAPIES, INC.GNC THERAPIES, INC.GOROVOY M.D. EYE SPECIALISTSGRADY GENERAL HOSPITALGREGORY C MARONE PHDGREGORY C. LANDRUM, Psy.D.GROWING WELL FAMILY BEHAVIORAL SERVICESGUILLERMO SUAREZ MDGULF COAST VISION CENTERGULF MEDICAL CLINICHarlan Chiron MDHarold Christopher Ward, D.O.Harold Friend MDHEALING EYE CAREHEALTH & WELLNESS PLACE INCHEALTH FIRST OCCUPATIONAL MEDICINEHEALTHPLEX FITNESS AND REHAB*HEALTHPSYCH ASSOCIATES, INCHEALTHPSYCH ASSOCIATES, INC.HEAR 4 KIDZ, INC.HEARING ASSOC OF CENTRAL FLHEARING ASSOCIATES OF PENSACOLAHEARING PARTNERS OF SOUTH FLORIDAHEARING SOLUTIONS INC - LAKE CITYHEATHER LASHER SLP-ORANGE CITY***Hector Meruelo, M.D.HENRY A TENENBAUM PHDHIGHLANDS BREAST & IMAGING CENTERHilda Besner, Ph.D.Hilda T Tejero MDHOMESTEAD HOSP PHYSICAL AND SPEECH THERAPY CTR.HOMI S COOPER MD**HOPE COUNSELING CENTERS*HOPE COUNSELING CENTERS-ERE**HOPE COUNSELING-ST AUGUSTINEHOPE, PANAMA CITY***IMA EVALUATIONS, INC.IMA EVALUATIONS,INC.**INDEPENDENT EXAMINERS PENSACOLA**INDUSTRIAL MEDICINE ASSOCIATES PCINPSYCH CONSULTANTS,P.A.INTEGRATED THERAPY ALLIANCE, INCISSAM AL-BANNA MDIVAN F. DANGER, PH.D.J OLIVER SPEECH PATHOLOGY*J. JEFF OATLEY, PH.DJack R. Weitz, Ph.D.JACKSON COUNTY HOSPITALJACKSONVILLE EYE CENTERJacquelin Alexis,Ph.D.JAIME SUMNER MSCCC SLP**JAMES HENDERSON MDJAMES R BOONE PHD**JAMES R. SHOEMAKER, D.O.JAMES W. HOLBROOK, ED.D.Jamie H Barron Psy DJANE A. O'BRIEN, AUD.,CCC,F-AAA**JANET HUMPHREYS PHD - GAINESVILLEJAS MEDICAL MGT.,LLCJAY ROSENFELD, OD PA*JEAN FELERT CADET MDJEFFREY A HIRSCHFIELD MDJENNIFER AUTENRIETH SLP

JENNIFER GOETTEJENNIFER MENDOZA PHDJEREMY N HARRIS MD*JET MEDICAL CENTER-SAMER CHOKSI, MDJMB SPEECH LANGUAGE PATHOLOGY SERVICES*JOHN DAWSON MDJohn E. Oshodi,Ph.D.JOHN J. CATANO,M.D.JOHN SWIFT MDJohn T Super PhDJONATHAN COHEN PHDJose A. Bengochea,M.D.JOSE NADINE GARCON, PSY.D.JOSE PEREZ-ARCE MDJOSEPH HOLZMACHER PSYDJoseph Singer, M.D.Josette Jourdan.M.D.Juan Sanchez MDJUNE H BLAUSTEIN MSKAREN F. KUHNS, M.D.KAREN HAGEROTTKAREN KOZY-LANDRESS*KARL R WILLERS PHD*KATINA SHINE, PHD**KENNETH LONG PHD - TALLAHASSEE*KENNETH LONG, MARIANNAKENNETH VISSER PHDKERNAGHAN & MOORE SPEECH & LANGUAGE THERAPYKEVIN M. KINDELAN, PHDKHALIL A WALLIZADA MDKIDS FIRST THERAPY CENTERKID'S THERAPY UNLIMITED INC-EREKIMBERLY WOOLDRIDGE, PSYD***KLM MEDICAL SERVICES LLCKRZYSZTOF LEWANDOWSKI MDL. Earl Wingo, M.D.LAB CORP - TALLAHASSEELABCORPLABCORPLABCORP - OCALALABCORP - PENSACOLALABORATORY CORP OF AMERICALABORATORY CORPORATION OF AMERICALABORATORY CORPORATION OF AMERICALAKE CITY MEDICAL CENTERLAKELAND REGIONAL HEALTH*LANCE CHODOSH MDLAROCCA SPEECH THERAPY, INC.Laura A. Cohen,Ph.D.Laura M. Artiles,Ph.D.*LAUREN E. LUCAS, PH.D.Lawrence Goldberg MD*LAWRENCE N PASMAN PHDLEBOWITZ MEDICAL GROUP PALEE MEMORIAL HEALTH SYSTEMSLESLIE ANN FRASER MS CCC SLPLETS TALKLIFE SOLUTIONS PSYCHOLOGICAL SERVICES, P.A.LINDA ABELES PHD**LINDA APPENFELDT PHDLINDA DELUCCALINDA S BOJARSKI PSYDLISA M WININGS PSYD

LORI BEN-EZRA, PH.D.LORI CHANG PHDLourdes E. Pola,Ph.D.LUIS ANEZ, MDLUIS ZALDIVAR, PH.D.MABEL LOPEZ PHDMAHFOUZ EL SHAHAWY MDMAITLAND INTERNAL MEDICINEMAITLAND PRIMARY CAREMAJID A. SHAMS,PH.D.,P.A.Manuel Alvarez Ph.DMANUEL MELENDEZ, M.D., P.AMARGARET R. MORTENSEN, PH.D.MARIA ELENA RODRIGUEZMARIA M. MENA, M.D.MARIA VAN SANT CCC SLPMARIBEL MERA PSYDMARIE BOURISQUOT, PSY.D.MARIE HUME GUILFORD PHD (TESTING)MARK REEVES PHDMARLA NADEL, SLPMARSHALL GLADNICK MDMARTIN D. SEGEL, PH.D.& ASSOCIATES,P.A.MARY CATHERINE SEGOTA PSYDMARY J.KING, D.O.MASINO--EREMATTHEW J. JALAZO, PSY.D.MAUREEN OHARRA PHDMAURO, REYNOLDS, AND ASSOC. IN COUNSELLING, P.A.MAXINE A. SADHAI, PSY.D.MAXINE RUDDOCK PHDMAYLO COMPREHENSIVE PSYCHOLOGICAL SERVICESMAYRA M. MIRO, PSY.D.MCCARTHY PREVENTIVE SERVICESMCCOY INSTITUTE OF HEARING AND BALANCE**MDSI PHYSICIAN'S GROUP, INC.MED EYE ASSOCIATES**MED PLUS - ST. AUGUSTINE**MED PLUS DISABILITY EVALUATIONSMED PLUS FL**MED PLUS PENSACOLAMEDICAL BILLING SERVICESMEDICAL EYE ASSOCIATESMEDICAL SPECIALISTS OF THE PALM BEACHES, INC.MELBOURNE URGENT CARE LLCMELBOURNE VASCULAR CENTERMELITA DUFFY SLPMICHAEL BREGLIA, MDMICHAEL DRUCKER MDMICHAEL P INMAN, PHDMICHAEL RAILEY PHD - TALLAHASSEEMICHAEL S. GREENBERG PH.D.MICHAEL SIMPSON,PH.D.MIGUEL FLORES,M.D.MILAURA B SPELMAN CCC-SLPMirentxu Leiva,Psy.D.MIRTHA E. CUEVAS, M.D., INC.MOHAMMAD YUNUS**MOONLIGHT EXAMS (XRAY)Morton S. Corin,M.D.MOSAIC PSYCH-ST AUGUSTINEMP DIAGNOSTIC LTDMULTI LINGUAL SPEECH GROUP INC

MULTILINGUAL PSYCHOLOGICAL SERVICES LLCMUNROE REGIONAL MEDICAL CENTER*MURALI KRISHNA MADDIPATI: EREMY EYE DR OPTOMETRY OF FLORIDA LLCMY EYE DR OPTOMETRY OF FLORIDA LLCN FLA REGIONAL MEDICAL CENTER*N KIRMANI MD-DELANDNAPLES COMMUNITY HOSPITALNATURES PLACE THERAPY SERVICESNEKESHIA HAMMOND PSYD PANEUROLOGIC CARE CENTER PANEUROPSYCHIATRIC INSTITUTENEUROPSYCHOLOGICAL & COUNSELING SERV.NEURO-REHAB PSYCHOLOGY GROUP OF TAMPANEUROSCIENCE CONSULTANTSNEW PATH PSYC-SANDRIK*NEWSOME MEDICAL LLCNICOLE HITE*NINA M BARNES PHDNLSA M MARBAN PSY.DNORTH ARMENIA MEDICAL CENTERNORTH BROWARD NEUROLOGYNORTH FLORIDA HEARING AND BALANCE - LAKE CITYNORTH FLORIDA PSYCHOLOGICAL SERVICES*NORTH FLORIDA THERAPY ASSOCIATES, LLCNORTH OKALOOSA MEDICAL CENTERNORTHSIDE MEDICAL CENTERNW FL COMMUNITY HOSPITAL**NYDIA CONRAD PSYD-EREOCALA EAR NOSE AND THROAT SPECIALISTSOccupational Medical CenterOCEAN OPTICALOMNI MEDICAL CLINICORANGE PARK AUDIOLOGYORTHO CENTER OF OKEECHOBEEOSAMA ELSHAZLY MDPALM BEACH PSYCHOLOGY GROUP LLCPAMELA ROWE MA CCC SLP LLCPAMELA ROWE SLP-OCALAPAMELA ROWE, MA, CCC-SLPPARAGON PSYCHOLOGICAL SERVICES CORPPASCAL BORDY MDPASCO EYE INSTITUTE**PATRICIA HARRISON MS CCCPATRICIA SHELLY LOHMANPATRICK KANE, MDPATRICK M. GONZALEZ, M.D.Paul J. Goldberg, M. D.PAUL TRITSOS: EREPEDIATRIC THERAPY/KIDS TALK - PENSACOLAPEDIATRICS PLUSPEREZ EYE CENTER PLPETER BURSTEN PH.D.***PETER KNOX,PSYD-DOWNTOWNPETER MILLHEISER, M.D,PETER S LARKIN*PHILIP JAMES DUBOSE JR PSYDPHYSIATRIC PAIN & MEDICAL REHAB CLINICPHYSICAL MEDICINE & REHAB CENTERPHYSICIAN'S CHOICE HEARING & DIZZINESS CENTERPHYSICIANS STAT LAB INCPIERRE-RICHARD EDOUARD, M.D.POMPANO BEACH PSYCHOLOGICAL SERVICES

PREFERRED PSYCH SERVICES*PREMIER MEDICAL CLINICPRESTIGE CARDIOLOGYPRIMARY CARE CENTERPRN SPEECH PATHOLOGISTSPRN SPEECH PATHOLOGISTSPSYCH ASSOCIATES**PSYCH INC - LAKE CITY*PSYCH INC-PALATKAPSYCHOLOGICAL & NEUROBEHAVIORAL ASSOCPSYCHOLOGICAL SERVICES-DR MILNE*PULLEN EYE CARE*PUTNAM FAMILY CARE INCPUTNAM RADIOLOGYQUALITY MEDICAL PERSONNEL,INC.QUINN EYE CENTER**R CRAIG NIELSEN MDR THAD GOODWIN MDRADIOLOGY & IMAGING SPECIALISTSRADIOLOGY ASSOC OF VENICERADIOLOGY ASSOCIATES OF TALLAHASSEE PARADIOLOGY REGIONAL CENTERRAHEEL AHMED MDRAJAN SAREEN MDRANDI MOST PHDRandy Levine,Ph.D.RATHINAM KRISHNA MOORTHY, MDRAUL ZELAYA MDRAYMOND F BARNES MDRAYMOND MCKNIGHT, M.D.*REBECCA WAMBOLT - TALLAHASSEE*REGIONAL THERAPY SERVICES INC - VALDOSTAREHABILITATION PHYSICIANSRene Rocha,Ph.D.RG THERAPY SERVICES INCRICHARD GLOSSER M.D.RICHARD L BELSHAM PHDRichard Reines, M.D.RICHARD S. KALSKI, M.D.Richard Sandrow, M.D.RICHARD SASSATELLI, PH.D.ROBERT E. SEIFER,PH.D.,P.A.*ROBERT GREENBERG MD***ROBERT KLINE PSYD - TALLAHASSEE (MSE ONLY)ROBERT M JAEGER DOROBERT M. MANDELKORN, MDRobert Martinez MDROBERT MOERING PSYDROBIN HUGHES MD*ROBIN JOHNSON, PSYDRODERICK SANTA MARIA D.O.ROGER L. BASH, PH.D.ROGER N ARUMUGAM MDROJEANNE JEAN, PH.D.ROLAND D. KAPLAN,D.O.RONALD SEIFER,PH.D.,P.A.ROSE RADIOLOGY CENTERS, INC.ROYCE N. JALAZO, PSY.D.SACRED HEART CARDIOLOGYSACRED HEART HEALTH SYSTEMSSAM BANNER MDSAM RANGANATHAN, M.D.SAMEH M. ELAMIR, MD

SANTA ROSA MEDICAL CENTERSARASOTA CHILDREN'S CLINICSarasota Memorial HospitalSAY IT PLEASE, INC.SCOTT L GELLER MDSCOTT M KAPLAN PSYDSCOTT WELSHSEIDMAN ASSOCIATES IN BEHAVIORAL COUNSELINGSeth D.Leventhal,Ph.D.Shahab Kidwai MD**SHANLIS INCSHARAD VYAS MDSHERYL FERGUSON, PSY.D.SHORELINE PSYCHOLOGICAL SERVICES, LLC**SILVER STAR FAMILY MEDICINE*SIMPLY SPEAKING, LLCSMALL STEPS PEDICATRIC THERAPY INC*SMALL TALK-ST AUGUSTINESOCRATES PEREZ-RODRIGUEZ MD, PASOUTH FLORIDA ENTSOUTH FLORIDA ENT ASSOCIATESSouth Miami Audiology Consultants*SOUTHEASTERN THERAPY SERVICES LLCSOUTHSHORE BILINGUAL SLP SERVICESSOUTHWEST FL CENTER FOR HEARING AND BALANCESPEAK EASY SOLUTIONS LLCSPECIALIZED SPEECH CENTER,INC.SPEECH & NEUROREHAB CENTER INCSPEECH AND LANGUAGE CENTER*SPEECH WORKS-PALM COASTSPEECHBUILDERS LLCST LUCIE EYE ASSOCIATES*ST VINCENTS FIRST CARE-ROOSEVELTST VINCENTS LUNG SLEEP & CRITIAL CARE SPECSt Vincents Medical CenterSTACY B. MELTZER, M.S.,CCC-SLPSTANFORD ANTHONY WILLIAMSON/P D E SSTEP BY STEP THERAPY*STEP N STONES SPEECH THERAPYSTEPHANIE CASTIGLIA PSY DSTEPHEN I HIRSCHORN PHDSTEPHEN TONER MDSTEVE KANAKIS PSYD**STEVE ODEH MD - FT WALTON BEACH**STEVE ODEH MD - THOMASVILLESTEVEN E. O'NEALSTEVEN L. KANNER, D.O.STEVEN MINTER, PSYDSTEVEN WU PHDSTUART BERNSTEINSUMA WELLNESS CENTERSUNCOAST THERAPYSUNRISE MEDICAL GROUPSUSAN DANAHY PHDSUSAN SHONBRUN, SLPSUSAN SULLIVAN PHD*SUSANA BARSKY PHDSUSANA LOZADA-MURRAY, PSY D, LLCSYED GILANI MDSYLVESTER AJUFO MDTALLAHASSEE ENT HEAD AND NECK SURGERYTALLAHASSEE MEMORIAL - VISUAL EVOKED POTENTIALTAMPA BAY ENT AND COSMETIC SURGERY PA

TAMPA BAY PULMONARYMEDICINE, PATampa Eye Clinic*TARGET TESTINGTED B. CUNLIFFE PH.D. LLCTHE CENTER FOR HEARING AND COMMUNICATIONTHE FOCAL POINTETHE HEARING CENTERTHE LUNG CLINIC*THERAPEUTIC ENDEAVORSTHERAPY ASSOCIATES OF GEORGIATHERAPY ASSOCIATES OF SOUTH FLA., INC.THERAPY ESSENTIALS INCTHOMAS A DIGERONIMO MD PATHOMAS F BEAMAN DOTHOMAS F GUIDERA PHDTHOMAS G TRIMMER PH D INCORPORATEDTIMOTHY FOSTER PHD LLCTOMOKA MEDICAL LAB INCTOPS REHABTOUCHSTONE IMAGING OF PENSACOLATOULA MCGINLEY, INCTOWNSEND&ASSOC-PALATKATraci Seidman,Ph.D.TRI-CITY WALK-IN CLINICTRINITY BEHAVIORAL HEALTHCARETURNING POINT CENTER FOR PSYCH & FAMILY GROWTH*U.S. HEALTHWORKS MEDICAL GROUP - OCALAUMESH MHATRE MD***UNIVERSITY MEDICAL HEALTH CENTERUNIVERSITY PEDIATRIC CENTER,INC.URGENT CARE USA*US HEALTHWORKS MEDICAL GROUPUS HEALTHWORKS MEDICAL GROUP-ORANGEUSE YOUR WORDS PEDIATRIC SPEECH THERAPY, INC.V SAMANTHA LINDMEIER PSYVAIDY V NATHAN MDVERO ENT ASSOCIATESVERO RADIOLOGYVICTORIA TE MDVINCENT IVERS MD*VIRGINIA DIXON-WOOD SLP (GAINESVILLE-B)Vivian Gonzalez-Diaz,Ph.D.**VIVIAN ROY PHD*W. Nicholson Ainsworth, IV, M.D.*WAKULLA URGENT CAREWELCH & MCLOY THERAPY SERVICESWEST BOYNTON BEACH OPEN IMAGING CENTER,LLCWEST COAST MUSCULOSKELETAL INSTITUTEWEST COAST MUSCULOSKELETAL-HOMASASSA*WEST FLORIDA MEDICAL GROUPWEST HERNANDO DIAGNOSTIC CTRWEST PALM BEACH NEUROLOGY PAWHITE WILSON MEDICAL CENTERWHITING PEDIATRIC THERAPY*WILLIAM BEATY PHDWilliam Beecham,Ph.D.*WILLIAM BENET PHD PSYDWILLIAM ERHARD EYRING III PSYDWILLIAM HULLEY DOWilliam J. Oktavec M.D.William V. Choisser, M.D.WINTER HAVEN HOSPITALYOUNT PSYCHOLOGICAL SERVICES PLLC

Last Name First Nm Credential Office Name

Onsite visits

completed Key/Reason Removal from panelAdams-Pelham Kristin PSYAgarwal Mukesh MD Satilla Family Medicine PCAgarwal Nishi MD Satilla Family Medicine PCAjayi Julius MD First Foundation Medical Clinic PCAkinsola Adebayo MD Baybol Pediatrics LLCAl-Amin Jessie Louise Muse MD volume $150KAlbritton Mary Kennedy SLP Greater Atlanta Speech & Language Clinic IncAlford Kimberly Brown SLP Communication PartnersAllen Belinda PT Regional Therapy Services IncAllen Steve PT Regional Therapy Services IncAllen Dawn M PhD key primary CEAllen Robert S AUD Hearing Doctors of GeorgiaAllen Ana Maria SLP AmeritherapyAllen, Jr Robert S AUD Hearing Doctors of GeorgiaAllsopp Ralph N PhD United Psychology CenterAnderson Larry DO Northside Primary Care Professional ServicesAndrews John S MDAnsine Sarah SLP Kidspeech IncArkin Lawrence Michael MDArrington Gertrude MD Kids Avenue Pediatrics LLCAshby Stacy Aileen AUD ENT Associates of Columbus PCAshraf Khuram RP Med Plus Disability Evaluations Inc volume $150KAtkins Jennifer MD Atkins ConsultingAtkinson Tameshia SLP Words & Beyond Speech Therapy Services LLCAyeni Oluropo Alfred MD Wellspring Medical Center key primary CEAyers Ashley Anthony SLP The Therapy SpotBailey David S PhDBaker Melody U SLP Regional Therapy Services IncBall Kelly J SLP Therapy Solution of Georgia IncBaloch Faryal MD East Metro Rheumatology LLCBank Richard PhD Bank PsychologyBanner Sammy MDBari Abdul MDBarnhill Magan Thomas SLP The Speech Clinic LLCBarrell Kelly Amanda SLP Palmetto Speech & LanguageBaskett Laura Colleen AUD Hearing Doctors of GeorgiaBattey Amanda Stephens AUDBayyapureddy Priya Vamsi MD Northside Primary Care Porofessional Services key primary CEBeasley Ellen Collier SLP ABC Pediatrics Therapy Partners IncBeldick Gary A MDBell Canady Christina Dawn SLP More Than WordsBenedict Alan MD Georgia Eye Specialists

Georgia FY 2017

(b) (6)

(b) (6)

Benefiled Kimberly B SLP Kidspeech IncBennett-Johnson Dianne MD Appointed Physicians IncBennett-Sims Melanie Ann MD Carlin VisionBerger Steven PhD Berger Psychological Services PC volume $150KBerry Garland Keith MD Carrollton Eye Clinic PCBerryhill Nancy Gunn SLP The Voice Box LLCBerry-Sawyer Kim PhD Med & PSY Associates IncBesses Valerie PhD Intown Psychological Associates volume $150KBeverly James OPTBingham Janelle E SLP Lets Talk TherapyBlakeman Rebecca S PhD Adolescent Child Specialty ServicesBluver Meredith Eden SLP Greater Atlanta Speech & Language Clinic IncBohannon Edgar Robin AUD Augusta Hearing & BalanceBonas Katherine Claire SLP Kidspeech IncBorn Ashley SLP Kidspeech IncBoswell Andrea Nestor SLPBouy Renee L SLP Kidspeech IncBowman Caroline Ursrey SLP The Therapy SpotBowman Carolin Ursrey SLP The Therapy SpotBoyd Stephanie PhD Family Forward LLCBrikman Alexander PhD volume $150K

Brown Regina S PhD Transitions Psychological & Consultative Services LLCBrown Reginald MD key primary CEBrown Adam MD Med Plus Disability Evaluations Inc volume $150KBrown Crystal Lynn Singlet MD Brown Family Practice LLCBrown Katherine D SLP Greater Atlanta Speech & Language Clinic IncBrowne Gloria MD Roman Medical GroupBruckner Howard L MD Academy of Cataract & Laser Surgery PCBryan Tammara G PhDBryant Leah SLP Kidspeech IncBuddington Roger PhD Buddington Psychology Clinic PCBurger Richard MD Southern Medical GroupBurnham Trisha Marie SLP Looper Speech & Hearing CebterButler Chandra Elis SLP Divine Speech Language Service IncButryn Matt PhD Athens Neuropsychological & CounselingByrd Tameka OD Med Plus Disability Evaluations Inc volume $150KCain Alicia MDCanady Leigh Blackburn SLP Leigh Blackburn Communication StationCannon Sterling Lane MD West Georgia Eye Care CenterCanup Marina Bilbao SLP ABC Pediatrics Therapy Partners IncCarden Nick PhD The Renaissance Centre key primary CECarey Danielle E SLP The Therapy SpotCarter Kricket Nicole SLP The Language Learning CenterCarter Stefani SLP Communicative Solutions Group Inc

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

Carter-Richardson Tamara J SLP Communications Solutions Group IncCastleberry Leigh SLP Kidspeech IncCaye David MSCerjan Diane PhD Journey Counseling & PsychologicalChadwick Brian Stephen MD Alta Medical Consulting Services LLC volume $150KChalam (Arunachalam) Krishnan MDChaplin Ursula AUD Chattanooga Hamilton Co Speech & Hearing CenterChapman Rees PhDChappell Nondi C SLP Clear Speech LLCCharest Tamara SLP Communication Partners IncChopra Hersh MD Georgia Eye SpecialistsClancy Priscilla Wilson PhD Leading Edge Consulting GroupClark (Coleman-Clark) Lilee (Carroll) PhD Georgia Developmental CenterCleary Kelly DO Prchal & Prchal PCCleveland Langston MD Worksmart Occupational HealthColegrove Eric William OPT Habersham Eye ClinicColeman Angela Horne MD Tri-State Occupational Medicine volume $150KCollins Kimberly Jill SLP Growing Communication IncCone Linsey Marie SLP Regional Therapy Services IncConnell Robert PhDCooper Adrienne Jenne SLP Looper Speech & HearingCooper Scott David MD Medical Associates Professional Services LLCCopes Kristen SLP The Speech Key IncCorey William F PhDCourtenay Clifford OPT Eye Associates of South GeorgiaCourtney Audrey PhDCrocker Bobby Anderson MD Goodlife Family Practice PCCrosby Lisa G SLP Greater Atlanta Speech & Language Clinic IncCrumbley Christian SLP Regional Therapy ServicesCrymes Brent Michael MD Athens Eye Dr & SurgeonsCulmer Ashley SLP Lets Talk TherapyCurry Alicia Joneka SLP Clear Speech LLCDavis Adrienne PhDDavis Nicholas Jerome OPT Braun Eyecare (Bruce L Johnson Inc)Davis Gavin MD Augusta EyeDavis Jennifer Diane AUD Hearing Associates PCDavis Matthew Edwin MDDavis Carly Marie SLP PediaSpeech ServicesDeen K Murray MD Upson Eye ClinicDegroot James F PhD United Psychology CenterDelancy Dara Ann PhD Family Forward LLCDellenbarger Leslie Ann PhD Flint River Therapy Associates IncDeLoach Ralph, III SLP Therapy Solution of Georgia IncDenes Gabriel PhD Counseling Psychology Associates LLCDesai Saurabh D MD Douglas Medical Group

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

Dinges David Lee MD Dalton ENT Associates PCDismuke Tinika Danyelle SLP Step N Stones Speech Language ServicesDixon Terri Chiquita SLP Speech Therapy Unlimited ServicesDixon-Martin Kelly Ann MD St Marys Industrial MedicineDoman Alexander MD S Atlanta Orthopaedics & Sports Medicine PCDoster Lenore PhD Barnesville / Newnan ServicesDubose Jr Philip Janes PhD Psychological Center volume $150KDuncan Scott PhD key primary CEDyer Divina N MD DG Medical Consultant LLCEady Lisa J SLP Communication Partners IncEanes Mark MD Southern Eye Center PCEaton Marc W PhD key primary CEEbron Marian MDEchols Melanie PhD Lifespan Psychological ServicesEdwards Kathleen Ann Lane SLP Looper Speech & Hearing CenterEggert Ann Elizabeth MD Peachtree Pediatrics PCElkan Mindy SLP Greater Atlanta Speech & Language Clinic IncEltarawy Islam MD Piedmont Physicians Group at East EllijayFainberg Jolie Carin AUD Atl Speech SchoolFarr Chastity Nicole PhD Newnan Psychological Services IncFayne Ashia Nicole SLP Lets Talk TherapyFeit Madyson Anne SLP Therapy Solution of Georgia IncFerguson Margaret SLP AmeritherapyFernando Marylou MDFesler Kellie Morgan SLP Regional Therapy ServicesFinley Katherine Jan PhD Athens Concussion & Neuropsychological CenterFischer Suzanne PhD Psychological Associates of NW Georgia IncFleitas Donna PhD My PSY LLCFomukong Mah-Fri Akere MD Med Plus Disability Evaluations Inc volume $150KFord Ashley Nicole SLP Communicative Solutions Group IncForrest John Wendell MD Forrest Eye CenterFoster Prima MD Capri Medical GroupFoster III Robert A PhDFraser Fred D PhDFrazer Anesha SLP Atlanta Speech TherapyFrederickson Edward Dent MD Mountain Medical Specialties IncFried Jeffrey MDFutral Heather PhDGadlin Scotty MD Athens Eye AssociatesGamble Nacondus OD South Eastern Eye CenterGanas Jennifer SLP Rehab Services of TiftonGandy-Walker Paris PhD New Day Psychological Services LLCGardner Beau MD Eye Physicians & Surgeons of Augusta PCGayer Harvey PhD Positive Outcome Psychological Services PCGentry Lisa Lovern SLP Kidspeech Inc

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

Gibbs Nakita SLP Communicate to Connect TherapyGiffen Devorah PhD Academy Psychological Services IncGoble Jennifer JE SLP Greater Atlanta Speech & Language Clinic IncGoddard John MD Carrollton Eye Clinic PCGoetzinger Robert MDGomez Robert F MDGonzalez Karen SLP Braun Eyecare (Bruce L Johnson Inc)Gordon Daniel Harry MD Live Well Medical Consultants key primary CEGordon Jenny L SLP Communication Partners IncGottlieb Dvora Posner SLP Savannah Speecy & HearingGrace John PhD Grace Psychotherapy key primary CEGraham Jannie Gail SLP Communication DynamicsGraham Robert MD Med Plus Disability Evaluations Inc volume $150KGrant Bruce Nicholas PhD Discovery Counseling Assessment Center LLCGrant Cathryn B AUD Harbin Clinic LLCGreen Roland MD Alta Medical Consulting Services LLC volume $150KGreene Mathew OPT Regional Eye CenterGreene Alton MD Med Plus Disability Evaluations Inc volume $150KGregg Stephanie A SLP Therapy Solution of Georgia IncGriner Nancy MD ENT SnellvilleGross-Barlow Lucinda SLP The Language Learning Center IncGuerin Chelsea Rebecca SLP Kidspeech IncGustafson Leland Mark MD Carrollton ENT PCHall Kristin Rowsey SLP Kidspeech IncHaluka Lance OPT Southern Eye CenterHamby Charles Stephen PhD volume $150KHankla James Waide AUD Hearcare AudiologyHannon Rachel Lea SLP Kidspeech IncHarper William OPT Prchal & Prchal PCHarper Ginger Archer SLP Communication PartnersHarper Hogan Cathy Lorraine MDHarrington Rosiland MD Decatur Medical Weight Loss LLCHarris Charles MD Southern Retina LLCHarris Duane PhDHarris Jacqueline MD Med Plus Disability Evaluations Inc volume $150KHarris-Davis Vonnia Lynett SLP Communications Solutions Group IncHarry Lois MD Med Plus Disability Evaluations Inc volume $150KHart-Moreland Santrell OPT East Lake Eye CareHartzell Arthur PhD Arthur W Hartzell PhD PCHaynes Andrea MD Tri-State Occupational Medicine volume $150KHerrin Allison Callaway SLP The Speech Clinic LLCHicks Melissa M PhD Communication Partners IncHicks Michele Harrison SLP Communication Partners IncHighbaugh Battle Angela MD Hazlehurst Pediatrics PCHinkley Ingrid Dawn SLP

(b) (6)

(b) (6)

(b) (6)

(b) (6)

Hobdy Lindsey Shiver SLP AmeritherapyHodges Edith McElheney SLP AmeritherapyHoffman Margaret N SLP Greater Atlanta Speech & Language Clinic IncHoghart Jiovanne AUD Hearing Doctors of GeorgiaHolme Robert J MD Tifton OphihalmologyHoloyda Basil MD Neurology Associates LLPHolsten Amy Welch PhD Family Forward LLCHope Donna SLPHosterman Pamela Sue SLP Chattanooga Hamilton Co Speech & Hearing CenterHoward Jamie Marie AUD St Francis ENTHowell Sarah PhDHuddleston Heather Alise SLP Regional Therapy Services IncHudson Mary Ann SLP Phenix Speech Language Services IncHughart Jiovanne AUD Hearing Doctors of GeorgiaHumayun Naseer MD Pulmonary & Sleep MedicieHunter Candace PhD Atlanta Veuro Center LLCHuthwaite Justin PhD Justin S Huthwaite PsyD PC volume $150KIrons Daniel Anthony MDJackson Demetria Larell SLPJacobs Ann PhD SE Psychological & Counseling Services LLCJames Robysina Louise MD Orthopedic IME Specialists LLCJanit Adrian PhD volume $150KJeannot Michael MD Walton Pulmonary & Sleep Medicine PCJelks Kim Willard MD Palmetto Health Council IncJohnson Katherine F OPT Vidalia Eye AssociatesJohnson Eric MD Athens Eye Dr & SurgeonsJohnson Bruce Lee OPT Braun Eyecare (Bruce L Johnson Inc)Johnson Kenia PhD Sweetwater Psychological Associates LLCJohnson John MD West Atlanta Internal MedicalJoiner Bret PT Therapy SouthJones Jennifer Lynn SLP Therapeutic Interventions of GeorgiaJones Jonathan PT Regional Therapy Services IncJones Mandisa PT Jones PT Physical Therapy & Physical TrainingJones Cristina SLP Lets Talk TherapyJones Angela M SLP Linguistic Impressions Therapeutic ServicesJones Sarah Elisabeth SLP Kidspeech IncJovovic Lauren Hudson SLP AmeritherapyJune Patricia MDKachra Dilshad SLP Lets Talk TherapyKanchrala Ashok Kumar MD Reddy Medical GroupKang Young MDKaplan Holly S AUD UGA School Psychology ClinicKaraseivich George PhD Hamilton Medical CenterKarikaran Nilanee MD Headache & Neurological Care CenterKatz Michael MD Med Ability Inc

(b) (6)

(b) (6)

(b) (6)

(b) (6)

Keller Deborah Beth SLP Communication PartnersKenney Nicole Elizabeth SLP The Therapy SpotKent Donald C PhDKent Joan H PhDKetisch Tanja PSY Mind Balance Psychology Center, LLCKhade John MD Med Plus Disability Evaluations Inc volume $150KKias Thomas Nelson MDKidwai Asim MD Piedmont Physicians Group at E EllijayKieran Rachel A PhDKim Dooho MD Professional Eye Associates IncKimbrell Bart Wade MD Southern Medical GroupKington Ginny PhD

Kini Ganesh MD Rockdale Physician Prac LLC - Primier Healthcare AllianceKirkpatrick Sarah Lindsey SLP Clear Speech LLCKitchens Wentzelle MD Washington County Internal Medicine PCKolanu Raghuram MD Neurology SouthKorey Alesya PhDKothari Ajay MDKozinn Mark MD Atlanta Neuroscience Associates LLCKrichever-Federowicz Maria MD Live Well Medical Consultants key primary CEKriete Kara SLP GNC Therapies IncKrone Howard Barry MDKruse Roberta J SLP Therapeutic Interventions of GeorgiaKulkarni Vasudev Venkatrao MD East Dublin Urgent Care CenterKurl Ravinder Kumar MD Henry Internal Medicine

Kuttappan Muthu MD Rockdale Physician Prac LLC - Primier Healthcare AllianceLabossiere- Hughley Tania SLP Communicative Solutions Group IncLaCayo Juan MD Alcovy Neurology PCLacount LaShonya Shamice SLP Precious Minds Academy LLCLaFerriere Lorraine Louise PhDLagunas Maribel SLP The Speech & Hearing CenterLambert Julie G AUD Albany ENT & Allergy ClinicLanghorne Sheredia D SLP Communicative Solutions Group IncLanier Amy Rogers SLP Communication PartnersLanier Lea Batten SLP The Therapy SpotLatham Carrie Smith SLP Kidspeech IncLeak Emily SLP Communication PartnersLebow Lori Charlotte OP Gainesville Eye Associates LLCLee Norman PhD North Atlanta Neuropsychology LLCLee Tiffany Charisse MD Priority Health LLCLeonard Julia Ashley SLP Kidspeech IncLewis Debra M PhD volume $150KLieberman Lewis PhD

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

Livingston Rita MD Live-Well Medical Consultants LLC key primary CELobel Steven MD Etowah Regional Medical Services PCLockhart Ricky MD Middle Georgia ENT Center PCLogan James Robert MD Candler ENT Practice LLCLopez Wandamarie PhD Better Mood Clinic PCLoverde Stacy Elise SLP Kidspeech IncLynes Michelle Lindsey SLP Savannah Speech & Hearing CenterMaddox Samuel PhD A Healig Paradigm LLCMahmood Khawaja MDMaierhofer Richard A PhD Maierhofer & Associates PCMaley Michael MDMalia Van Lee MDMaloy Jodi Nicole SLP Speech & Swallowing ClinicMancil Twyla Lucinda PhD Psych IncMann Christopher Jay OD Athens ENT & Allergy ClinicMannel Robert K MD Southern Medical GroupMarti Michael PhD Thrive Works LLCMassie Sean PhDMawhinney Katherine Holt AUD Ear Nose & Throat Associates PCMaya Sakib MD Alta Medical Consulting Services LLC volume $150KMcAdams Valerie PhD McAdams Psychological & Consulting ServiceMcCloud Mark Allen SLP Total Communication ServicesMcClure Floyd Dale R SLP The Speech Key IncMcCullough Jennifer Lee SLP Pedia Speech ServicesMcDonald Daniel PhDMcDonald Melvenia SLPMcElroy Teresa Lynn SLP Speech & Swallowing ClinicMcGlamry Macey DeAnne SLP Regional Therapy Services IncMcintosh Elizabeth Fogarty SLP Savannah Speecy & Hearing CenterMcManus Kari Huffstatler SLP GNC Therapies IncMcQueenery David PhD Monarch Behavioral Health IncMeck Donald PhDMehta Vinod C MDMercer Cassie Itaska SLPMerchan Joy Caroline SLPMillen James L. MD GA Internal MedMiller Mesa Sashea SLP Communication DynamicsMixson John OPT Regional Eye CenterMoates Kenneth OPT Regional Eye CenterMoates Valerie OPT Regional Eye CenterMobley Michael MD Psychiatric Medicine PCMoeller Jessica Lee SLP Lets Talk TherapyMoody Julie E SLP Therapy Solution of Georgia IncMoogerfeld Maria MDMoore Anne B PhD United Psychology Center

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

Moore Chelse M SLP Divine Speech Language Service IncMoorman Larry R MD Tifton OphihalmologyMorgan Jr Sidney MD Optim Health CareMoriarty Dawn M SLPMorin Hannah E SLP Communication Partners IncMorris Carly Rae SLP PediaSpeech ServicesMottwala Shabbir MDMoynihan-Greenberg Rita Michelle SLP Kidspeech IncMullady Thomas MD Chattanooga Diagnostic Associates LLCMuller John S PhD Evaluation Systems Inc volume $150KMurray Darrell Lee MD NW Georgia Psychological Associates LLCNagy Karen W SLP Sunshine Speech Therapy ServicesNariani Sanjay MD Jay Medical & Rehab Works PCNeal Kenneth David PhD Riverstone MD PCNeedle Michelle Elyse SLP Greater Atlanta Speech & Language Clinic IncNelson Catherine Ann SLP Savannah Speech & HearingNelson Keanna M SLP Speech Assessment Center IncNewman Phillip MD Center for SightNgu Julius N. MD Tri-State Occupational Medicine volume $150KNgumba-Gatabaki Eunice Wanjiru PhD ORI ALAAFIA Coaching & Psychotherapy LLCNix Cynthia MD West Georgia Eye Care CenterNorwood Melvina PhD Just A Journey Counseling & Psychological ServicesO'Boyle Timothy MD Professional Eye Associates IncOdeh Steve MD Heritage Health Care Services LLC volume $150KOdunbaku Amudalat A SLP Lets Talk TherapyO'Halloran Carolyn M SLP Kidspeech IncOjelade Ifetayo I PhD A Healing Paradigm LLC volume $150K

Okoro Casimir Chukwumeka MD Southside Internal Medicine PCOkoro Obioha Louis MD Central Georgia Pediatric IncOlson David MD DeKalb Neurology Group LLCOnyeabor Onyekachi MD Tri-State Occupational Medicine volume $150KOwensby Amber Pryor SLP Communication Partners

Pack David K MD Metro Rehabilitatio Medicie & Acupuncture Clinic PCPainter Jill Challenger SLP Therapeutic Interventions of GeorgiaPappoas Stephen MD Neuro Spinal & Headache CenterParikh Chirag MD Eye Care of Georgia LLCParker Kenneth C AUD Audiology Services of Chattanooga IncParker Trina MD Roman Medical GroupParks William PhDPatel Ami MD Alta Medical Consulting Services LLC volume $150KPatel Ateeqahmed MD Med Plus Disability Evaluations Inc volume $150KPatel Natvarlal MDPatel Nipun MD Premier Family Clinic

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

Patel Arvind Rambhai MDPatterson Emory MD Athens Eye Dr & SurgeonsPaulk Whitney Lauren SLP AmeritherapyPeacock Lamar Bonner MD GA Internal MedPerez Tracy Alexander SLP Therapy Solution of Georgia IncPeterson Laurie SLP Communication Partners IncPezold John Christopher MD Carrollton ENT PCPharis Donna Marie SLP Kidspeech IncPiquette Ashley S SLP Communication PartnersPiros Judith M. MD Georgia Eye Institute of The SoutheastPitts Robert Brian MD Carrollton ENT PCPompey Michael O MD Tri-State Occupational Medicine volume $150KPope Myra MD JC Lewis Primary Health Care CenterPrchal Gerald OPT Prchal & Prchal PCPrchal Joseph OPT Prchal & Prchal PCPritchett Joy W AUD Hearing Associates PCPruitt Helki C SLP Kidspeech IncRangaraj Ragesh Ramalingam OPT Kura LLLRao Kalpana PhD Horizons Behavioral Health SolutionsRapillard Sarah Waters SLP The Therapy SpotRay James MD Ray Clinic PCRector Rebecca Ellen SLP ABC Pediatrics Therapy Partners IncReddy Ram MD Reddy Medical GroupReddy Chelukala MDReeves Joseph MD Georgia Eye Institute of SavannahReticker Aleyda D SLP Comm. Solutions GroupRich Michele SLP Childrens Therapy Group IncRichardson Sheana A AUD Savannah Speech & Hearing CenterRiney Charles Timothy PhD Newnan ServicesRinow Michael Edward MD Pulmonary Diagnostic TestingRittenhouse Lance OPT Stay Focused EyecareRobbins-Brinson Larmia PhDRoman Charles Paul DO Roman Medical GroupRose Michael PhD volume $150KRoth Kristiansson PhD volume $150KRoy Deanna Lynne MD Med Plus Disability Evaluations Inc volume $150K

Ruble Paul Spencer DOMed Plus Disability Evaluations Inc volume $150K

Russell James PhDRyals Stephen MD Dalton ENT Associates PC Saintange Judith Jay-Simone AUD St Francis ENTSampson Dawn F SLP Regional Therapy Services IncSams IV Walter Augustus MD Athens Eye Dr & SurgeonsSanderlin Tia Smith MD

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

Sanderson Alice M SLP UGASanford Ken E MD 3KB Consultanta IncScandrett Tiffany Marie SLPSchacher Stephen MD Athens Occupational Medicine LLC volume $150KSchnapper Robert A MD Atlanta Neurological Associates PCSchoenrock Raymond PhDSchorn-Bellows Marilyn T AUD Gainesville Hearing Services IncSchuessler Suzanne MD Lagrange PediatricsSchwartz Sher E PhDScott Charles MD Wellness & Prevention IncSedgwick Charlalee PhDSellers Ansley Stroud SLP Speech Clinic of The Coastal Empire LLCSellers Ashely Delois SLP Speech Language & Beyond LLCSethi Ranjit MDShaffer Scott PhDShahid Salles Mohamad MD Sales & Lakhanpal PCShapiro Molly SLP Pedia Speech ServicesSharma Anish MD Barnesville Medical Services IncShelby Tracy L PhD Psychological Center for Growth & DevelopmentSherrill Rosalind D SLP Communicative Solutions Group IncShih John Y MD Suwanee Family Physicians key primary CEShin Eric MD Southern Medical GroupShiver Jeremy Dade PhDSidhpura Jagdish MDSikod Anna MD Med Plus Disability Evaluations Inc volume $150KSingh Rekha MD Total Medical Care IncSinlah Nmamah SLP Kidspeech IncSiwy James PhDSlaughter Christopher PhD Monarch Behavioral Health IncSlay Versie Lee MD Med Plus Disability Evaluations Inc volume $150KSmall Karen Suzzette SLP Communicative Solutions Group IncSmalley Glendon William MD Dublin Eye Associates PCSmith Todd PhD South Georgia Neuropsychological Associates PCSmith Ryan MD Eye Physicians & Surgeons of Augusta PCSnook Steven PhD volume $150KSpaniol Joseph Robert MD Med Plus Disability Evaluations Inc volume $150KSparks Susan Wilkes SLP Speech Hearing & RehabilitationSperr Edwin PhDSperr Shelby PhDStanley Morgan Dull SLP Looper Speech & Hearing CenterStephens Rebecca PhDStewart Scott Jay PhD Southeastern Psychological ConsultantsStewart James Alfred OPT Georgia Eye PartnersStewart Zachary MD Med Plus Disability Evaluations Inc volume $150KStillman Mark A PhD MA Stillman PhD & Associates Inc

(b) (6)

(b) (6)(b) (6)

(b) (6)

Stokes Desire' Searcy SLP Step N Stones Speech Language ServicesStorms Robert PhDStreiff Irwin G. MD Med Plus Disability Evaluations Inc volume $150KStutts William PhDSubrahmanian Kavita Joshi PhD Berger Psychological Services PCSuit James Ivory MD Eye Physicians Professional AssociationSumner Anita Marie SLP The Language Learning CenterSuper Eileen Nikko MD Med Plus Disability Evaluations Inc volume $150KSwain Susan M AUD Hearing Plus IncSyed Saima MD AIM MedicalSzwarc Brian James MD ENT Associates of SW Georgia LLCTaormina Michael MD The Neurological Center of East GA PCTaylor Jennifer Daughtrey SLP Therapy Solution of Georgia IncThangavelu Arasi MD South Georgia Medical LLCThompson Monica L PSY Lyn Psychology & Associates LLCTodd Brook Cox SLP Childrens Therapy Group IncTrimble Arcella Jean Keys PhD A Healing Paradigm LLC volume $150KTu (Turk) Althea Lorraine MD Regional Eye CenterTung William MDTurk Chanh MD Regional Eye CenterTurknett Joshua MD DeKalb Neurology Group LLCTurner Miriam OPT Midtowne Vision CenterTurner M Kevin PhD Transitions of AugustaTurner Joyce Marie SLPUssery Donna Renee PhD

Valentine Christopher St Patrick MD Canduceus Occupational Medicine LLC Vaught Samuel F AUD Auditology Center of SnellvilleVega Manuel Arnaldo MD Cardiology Associates of DublinVessel-McGee Alethea Faye SLP Better Speech & Language IncWachtel Daniel J PhD Pioneer Psychological AssociatesWagenhorst Bret Bouton MD Tifton OphihalmologyWalker Paul MD Pointmed Inc key primary CEWalker Larry Dean PhDWalsh Robin PhD The Journey CounselingWashington Andrea MDWatson Byron Maurice MD Med Plus Disability Evaluations Inc volume $150KWeitzman-Swain Ann PhD Eating Disorders Recovery Center of AthensWelch Lisa MD CTA Healthcare LLCWest Becky PT West Rehab ServicesWhitcomb David MDWhite Milton MD Atlanta Better Health PCWhitley, III John C PhD volume $150KWiener Alice PhDWiggs Shaddai N SLP Clear Speech LLC

(b) (6)

(b) (6)

Wiksell Carla Maria SLP Chattanooga Hamilton Co Speech & Hearing CenterWildstein Albert MD Metro Vascular PCWilliams Marie PhD Talk Works IncWilliams Joanne MD Alta Medical Consulting Services LLC volume $150KWilliams Rhonda MD Internal Medicine Associates of Waycross PCWilliamson Stanford Anthony DO Physician Disability Examination Services Inc volume $150KWilson Erica Renee SLP Clear Speech LLCWinstead Timothy Gene AUD Hearing Doctors of GeorgiaWise Larry Andrew AUD St Francis ENTWong Rosalinda SLP Kidspeech IncWood Jimmy PT Horizon Physical Therapy & Rehabilitation IncWood Frank MDWood, Jr Robert Warner MDWright Carmen H AUD Hearing Associates PCWu Xiaowen MD Alpoharetta Family Medical ClinicWyatt Massi PhDYarborough Alicia Joy SLP Kidspeech IncZafrani Shayan Greg MD Alta Medical Consulting Services LLC volume $150KZdonczyk Daniel MDZuck Caroline E H AUD Savannah Speech & Hearing

(b) (6)

Vendor list

2017 Specialty 1st CE appt 2017 top 5 Key vendors 2017 Onsite visits Reason for onsite visit

1 Belcher, Daniel, MD IM 12/28/1992 9/22/2017

onsite visit2 Bratton, Joseph, PhD Psychology 5/24/1997 1 9/22/2017 Volume/Key vendor3 Cazin, Antoine, MD IM 6/22/2006 5 9/19/2017 Volume/Key vendor4 Coschignano, Deanna, Phd Psychology 12/3/2011 2 5/25/2017 Volume/Key vendor5 Donovan, Dennis, Phd Psychology 5/5/2007 3 9/12/2017 Volume/Key vendor6 Drs. Lui, Lai & Assoc. Optometry 5/13/20097 Hashimoto, Don, Psy.D Psychology 8/5/20048 I Ola Lahui, Inc. Psychology 5/10/2011 8/14/20179 Luke, Stanley, Phd Psychology 7/28/2000

10 Marchetto-Ryan, Matthew, Psyd Psychology 7/28/201511 McDermott, Heather, Psyd Psychology 1/2/201412 McNamara, Kathleen, Phd Psychology 8/26/199813 McNichols, Brandon, Psyd Psychology 5/6/2017 5/6/201714 MSLA IM 11/17/201115 Murakami, Wilson, MD IM 4/4/199416 Pang, Edith, MD IM 6/18/201617 Park, Gregory, MD Psychiatric 11/21/200618 Rabara, Michael, Psyd Psychology 1/24/201719 Robb Shibayama, OD, IN Optometry 9/19/201220 Ruth, Marylee Audiology 4/6/201121 Sunamoto, Kenneth, MD Orthopedic/IM 7/15/200222 Taketa, Steven, Psyd Psychology 2/14/2015 4 5/6/2017 Volume/Key vendor23 Triolo, Santo, Phd Psychology 4/6/201524 Zafrani, Michael, MD Psychiatric 4/21/2005

LOSSES: SpecialtyDate of First

Exam Reason for leaving Last ExamFulsand, Elise, MD, JD IM 10/27/2016 1/17/2017Lind, Dennis, MD Psychiatry 12/19/1995 12/20/2016Ohana Psychology Psychology 9/23/2011 4/25/2017

No panelist removed due to inactive license, sanction, or other causes.

Indicates NEW CEPs

Hawaii FY 2017

(b) (6)

(b) (6)

(b) (6)

Vendor list

2016 Specialty Date of First Exam 2016 top 5 Key vendors 2016 Onsite visits1 Belcher, Daniel, MD IM 12/28/19922 Bratton, Joseph, PhD Psychology 5/24/1997 TOP 5 key and volume X3 Cazin, Antoine, MD IM 6/22/20064 Coschignano, Deanna PhD Psychology 12/3/2011 TOP 5 key and volume X5 Donovan, Dennis, PhD Psychology 5/5/2007 TOP 5 key and volume6 Drs. Lui, lai & Assoc. (optometrist) Optometry 5/13/20097 Hashimoto, Don, Psy.D Psychology 8/5/20048 I Ola Lahui (Psychologist) Psychology 5/10/20119 Lind, Dennis, MD Psychiatry 12/19/1995

10 Luke, Stanley, Phd Psychology 7/28/200011 Marchetto-Ryan, Matthew, Psyd Psychology 7/28/2015 X12 McDermott, Heather, Psyd Psychology 1/2/201413 McNamara, Kathleen, Phd Psychology 8/26/199814 MSLA IM 11/17/2011 TOP 5 key and volume15 Murakami, Wilson, MD IM 4/4/199416 Ohana Psychological Svcs LL Psychology 9/24/2011 TOP 5 key and volume X17 Park, Gregory, MD Psychiatric 11/21/200618 Robb Shibayama, OD, IN Optometry 9/19/201219 Ruth, Marylee Audiology 4/6/201120 Sunamoto, Kenneth, MD Orthopedic/IM 7/15/200221 Taketa, Steven, Psyd Psychology 2/14/201522 Triolo, Santo, Phd Psychology 4/6/201523 Zafrani, Michael, MD Psychiatric 4/21/200524 Edith Pang, MD IM 6/18/201625 Elise Fulsang, MD IM 10/27/2016

LOSSES: Specialty Date of First Exam Reason for leaving Last ExamKimberly Kudaishi, MS, CCC SLP 2/2/2008 12/12/2015Jeremy Lam, MD Pediatric 6/23/2005 4/14/2016

Na Pu uwai NHHCS Psychology 3/23/2015 8/26/2015Wingert, John, Phd Psychology 4/25/2005 8/29/2016


Indicates NEW

(b) (6)

Vendor list

2015 Specialty 1st CE appt 2015 top 5 Key vendors 2015 Onsite visits1 Belcher, Daniel, MD IM 12/28/19922 Bratton, Joseph, PhD Psychology 5/24/1997 2 3 Cazin, Antoine, MD IM 6/22/20064 Coschignano, Deanna, Phd Psychology 12/3/2011 1 X5 Donovan, Dennis, Phd Psychology 5/5/2007 3 6 Drs. Lui, Lai & Assoc. Optometry 5/13/20097 Hashimoto, Don, Psy.D Psychology 8/5/20048 I Ola Lahui, Inc. Psychology 5/10/2011 X9 Kudaishi, Kimberly, MS, CCC SLP 2/2/2008

10 Lam, Jeremy, MD Pediatric 6/23/200511 Lind, Dennis, MD Psychiatry 12/19/199512 Luke, Stanley, Phd Psychology 7/28/200013 Marchetto-Ryan, Matthew, Psyd Psychology 7/28/2015 14 McDermott, Heather, Psyd Psychology 1/2/201415 McNamara, Kathleen, Phd Psychology 8/26/199816 MSLA IM 11/17/2011 5 X17 Murakami, Wilson, MD IM 4/4/199418 Na Pu uwai NHHCS Psychology 3/23/201519 Ohana Psychological Svcs LL Psychology 9/24/2011 4 X20 Park, Gregory, MD Psychiatric 11/21/200621 Robb Shibayama, OD, IN Optometry 9/19/201222 Ruth, Marylee Audiology 4/6/201123 Sunamoto, Kenneth, MD Orthopedic/IM 7/15/200224 Taketa, Steven, Psyd Psychology 2/14/2015 X25 Triolo, Santo, Phd Psychology 4/6/201526 Wingert, John, Phd Psychology 4/25/2005 27 Zafrani, Michael, MD Psychiatric 4/21/2005

LOSSES: SpecialtyDate of First

Exam Reason for leaving Last ExamGilstein, Kenneth, Phd PsychologyKamaka, Joseph, MD IM 6/23/2014 3/24/2015


Indicates NEW

VENDORNBR VENDNAME ADDR1 ADDR2 CITY STATE ZIP Total Paid CountMARIE PARKMAN PSYD I ADEPT BUSINESS SERVI 8065 WEST MAIN RATHDRUM ID 83858 $21,576.50 126BONNER GENERAL HOSPI ATTN: CARDIO PULMON 520 NORTH THIRD AVE SANDPOINT ID 83864 $583.80 6EASTERN ID RMC (PULM 3100 CHANNING WAY IDAHO FALLS ID 83404 $389.20 4GERALD GARDNER PHD COEUR D ALENE ID 83814 $96,822.00 569WEST VALLEY MEDICAL 1717 ARLINGTON CALDWELL ID 83605 $939.70 19ST JOSEPHS RMC (PFT) 415 6TH STREET LEWISTON ID 83501 $1,362.20 14VALOR HEALTH ATTN: RADIOLOGY DEPT 1202 EAST LOCUST STR EMMETT ID 83617 $182.80 4ST LUKES RMC C/P 190 E BANNOCK BOISE ID 83712 $2,393.50 24BINGHAM MEMORIAL HOS ATTENTION: RADIOLOGY 98 POPLAR STREET BLACKFOOT ID 83221 $8,504.00 157PORTNEUF MEDICAL CTR 777 HOSPITAL WAY POCATELLO ID 83201 $137.63 4ST LUKES MAGIC VALLE 775 POLE LINE RD W TWIN FALLS ID 83301 $8,552.00 169PATRICK J PARDEN MD COEUR D ALENE ID 83814 $757.00 5ST ALPHONSUS MEDICAL 351 SW 9TH ST ONTARIO OR 97914 $1,079.30 12GRITMAN MEDICAL CENT ATTN: RADIOLOGY 700 S MAIN STREET MOSCOW ID 83843 $204.00 4KRAIG C MCGEE MD 333 N 18TH AVE STE B POCATELLO ID 83201 $863.58 7DAVID N SIM MD BOISE ID 83704 $6,813.40 38ST LUKES RMC RADIOLO ATTN: RADIOLOGY 190 E BANNOCK BOISE ID 83712 $895.00 17TETON CARDIOVASCULAR 2001 S WOODRUFF STE IDAHO FALLS ID 83404 $1,468.50 16CHRISTINE PICKFORD P 1655 FAIRVIEW SUITE MAIN STREET PLAZA BOISE ID 83702 $19,623.00 117TETON RADIOLOGY OF I 2001 S WOODRUFF STE IDAHO FALLS ID 83404 $5,046.70 100ST LUKES MAGIC VALLE 775 POLE LINE RD W S TWIN FALLS ID 83301 $1,556.80 16PORTNEUF MEDICAL CEN 777 HOSPITAL WAY POCATELLO ID 83201 $1,362.20 14EASTERN ID RMC (RADI 3100 CHANNING WAY IDAHO FALLS ID 83404 $180.00 4ST ALPHONSUS MEDICAL 351 SW 9TH ST ONTARIO OR 97914 $3,597.50 70KOOTENAI MED CTR (PF 2003 KOOTENAI HEALTH COEUR D ALENE ID 83814 $2,830.70 30ST JOSEPHS RMC RADIO 307 ST JOHNS WAY LEWISTON ID 83501 $11,597.70 225ST ALS MED CTR RADIO 1512 12TH AVE RD NAMPA ID 83651 $116.90 2GREGORY KENT MD CALD CALDWELL ID 83605 $1,798.00 12BONNER GENERAL HOSPI 520 NORTH THIRD AVE SANDPOINT ID 83864 $1,835.00 32GREGORY KENT MD MERI MERIDIAN ID 83642 $2,772.00 20JERRY DOKE PHD 10448 GARVERDALE CT SUITE 612 BOISE ID 83704 $45,269.50 256CLEARWATER VALLEY HO 301 CEDAR OROFINO ID 83544 $174.00 4ISU SPEECH, HEARING 650 MEMORIAL DRIVE # POCATELLO ID 83209 $77.29 1CDA KOOTENAI OUTPATI 700 IRONWOOD STE 175 COEUR D ALENE ID 83814 $677.00 14SCOTT ALLAN MD 526 H SHOUP AVE W TWIN FALLS ID 83301 $384.00 3ST LUKES RMC RAD MER 520 S EAGLE RD MERIDIAN ID 83642 $14,193.00 240ST LUKES MAGIC VALLE 775 POLE LINE RD W TWIN FALLS ID 83301 $34.63 2PF KOOTENAI OP IMAGI 1300 E MULLAN POST FALLS ID 83854 $577.00 10REBECCA ALEXANDER PH LEWISTON ID 83501 $42,734.50 244ST LUKES MERIDIAN RM ATTN: PULMONARY FUNC 520 S EAGLE RD MERIDIAN ID 83642 $2,492.00 24RICHARD T SONNENBERG BOISE ID 83702 $55,571.50 321CHERYL TURNER MS NAMPA ID 83651 $1,329.00 9J CRAIG STEVENS MD P PONDERAY ID 83852 $4,124.00 31JAMES BATES MD MERIDIAN ID 83642 $50,430.00 463REBECCA ALEXANDER PH MOSCOW ID 83843 $19,384.00 113WILLIAM JACKLINE EDD SPOKANE WA 99224 $11,563.00 65ST LUKES MERIDIAN RM ATTN: LABORATORY 520 S EAGLE RD MERIDIAN ID 83642 $62.29 3ST LUKES ID ELKS HEA 172 SECOND ST SOUTH NAMPA ID 83651 $70.00 1JERRY DOKE PHD TF 834 FALLS AVE STE 20 TWIN FALLS ID 83301 $37,093.00 211

Idaho FY 2017

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)(b) (6)(b) (6)(b) (6)(b) (6)

INTERMOUNTAIN MEDICA 2929 EAST MAGIC VIEW MERIDIAN ID 83642 $10,974.00 147RYAN MCKINNON MD CALDWELL ID 83605 $3,264.00 25MARK CAPENER MD 2065 E 17TH ST STE B IDAHO FALLS ID 83401 $302.00 2MICHAEL SANT MD ONTARIO OR 97914 $11,644.00 93KOOTENAI HEART CENTE 2003 KOOTENAI HEALTH COEUR D ALENE ID 83814 $199.50 1JOHN L CHRISTENSEN P POCATELLO ID 83201 $23,522.00 132MICHAEL SANT MD (BOI 600 N ROBBINS RD STE BOISE ID 83701 $7,179.00 48MICHAEL SANT MD (MER MERIDIAN ID 83642 $8,931.00 59ALAN L ZOHNER PHD IDAHO FALLS ID 83401 $35,284.00 194JOHN B CASPER MD INV THE OSPREY BUILDING 4700 N CLOVERDALE RD BOISE ID 83713 $12,587.40 106BRAD W LEVITT PSYD PAYETTE ID 83661 $27,139.50 150ZACK HALE MS 3345 MERLIN DR STE 2 IDAHO FALLS ID 83404 $309.16 4RYAN MCKINNON MD NAM SALTZER MEDICAL GROU 215 E HAWAII AVE NAMPA ID 83686 $4,705.00 33CHARLES BOGE MD AMMON MEDICAL & URGE 3456 E 17TH ST STE 1 AMMON ID 83406 $18,456.00 166MICHAEL P EMERY PHD SAFARI INN DOWNTOWN 1070 GROVE ST BOISE ID 83702 $27,045.00 154JASON HALVERSON MD(T TWIN FALLS ID 83301 $164.00 1DONALD M WHITLEY PHD IDAHO PHYSICIANS CLI 98 POPLAR BLACKFOOT ID 83221 $14,069.00 81REX E HEAD MD REXBUR REXBURG ID 83440 $23,709.00 177ST LUKES ID ELKS HEA 520 S EAGLE ROAD #12 MERIDIAN ID 83642 $70.00 1JASON GAGE PHD BOISE ID 83704 $14,687.00 80DONALD M WHITLEY PHD PHYSICIAN AND SURGEO 1151 HOSPITAL WAY BL POCATELLO ID 83201 $58,146.00 333MICHAEL SANT MD(TF) URGENT CARE OF TWIN 2392 ADDISON AVE EAS TWIN FALLS ID 83301 $17,371.00 138JACOB W KAMMER MD BOISE ID 83704-8767 $499.00 6NAYA ANTINK MD BOISE ID 83704 $1,632.00 8RYAN VAN DE GRAAFF M SOUTHWEST IDAHO ENT 900 N LIBERTY STE 40 BOISE ID 83706 $1,102.50 7SPENCER CHESHIRE AUD SOUTHWEST IDAHO EAR 900 N LIBERTY STE 40 BOISE ID 83706 $77.29 1KOOTENAI EAR NOSE TH INTERLAKE MEDICAL BU 700 W IRONWOOD DR ST COEUR D'ALENE ID 83814 $164.00 1PORTNEUF MEDICAL CTR 777 HOSPITAL WAY POCATELLO ID 83201 $10,713.00 206ST LUKES MCCALL HOSP 1000 STATE ST MCCALL ID 83638 $194.60 2LAWRENCE E GREEN MD 16060 IDAHO CENTER B NAMPA ID 83687 $10,879.00 65MARK YAMA PHD ST JOSEPH'S OUTPATIE 428 6TH AVE LEWISTON ID 83501 $15,257.00 82INTERPATH LABORATORY 496 SHOUP AVE WEST S TWIN FALLS ID 83301 $26.08 2CHAD MCCORMICK MD KOOTENAI EAR NOSE TH 700 IRONWOOD STE 278 COEUR D'ALENE ID 83814 $492.00 3CHAD BOUTERSE DO EYE CARE SPECIALISTS 500 PORT DRIVE CLARKSTON WA 99403 $1,369.82 8KEVIN HILL MD INV 777 HOSPITAL WAY SMO POCATELLO ID 83201 $329.00 3NELS M SATHER PHD IDAHO STATE HOSPITAL 700 EAST ALICE BLACKFOOT ID 83221 $24,597.00 132KOOTENAI AUDIOLOGY L 700 IRONWOOD #278 COEUR D'ALENE ID 83814 $309.16 4NORTHWEST SPECIALTY 1593 E POLSTON AVE POST FALLS ID 83854 $3,175.00 50NELS SATHER PHD FR TWIN FALLS MENTAL HE 823 HARRISON STREET TWIN FALLS ID 83301 $9,425.00 55RYAN HULBERT PHD MER OFFICE OF SCOTT P HO 2273 E GALA STE 100 MERIDIAN ID 83642 $22,164.00 115JOANN HAMMOND SLP 1820 E 17TH SUITE 27 IDAHO FALLS ID 83404 $2,588.00 16RANDALL H HUTCHINGS NAMPA ID 83686 $11,462.20 97NATASHA MILLER MD 315 E ELM STE 100 CALDWELL ID 83605 $204.00 1ST ALS HEALTH PLAZA 4400 E FLAMINGO NAMPA ID 83687 $692.20 13THEODORE W GARDNER P JUSTAMERE INN 401 GOODING ST N STE TWIN FALLS ID 83301 $20,283.50 116NATHAN WELCH MD 526 SHOUP AVE W STE TWIN FALLS ID 83301 $972.00 7RIAN CHATTERTON MS C BOISE ID 83713 $2,244.00 11RALPH D HECKARD MD B ADVANTAGE WALK-IN CH 2013 E HOSPITALITY L BOISE ID 83716 $54,413.00 508RALPH D HECKARD MD I IDAHO WORK CARE/WEIG 203 N HOLMES AVE IDAHO FALLS ID 83401 $29,081.00 274RALPH D HECKARD MD T JOSHUA B OLSEN DC BL 497 EASTLAND DR TWIN FALLS ID 83301 $33,431.50 326

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

RALPH D HECKARD MD P ALL AMERICAN CHIROPR THE OFFICE OF DR JES POCATELLO ID 83201 $41,616.20 342SHALISE ADAMS AUD SOUTHWEST IDAHO EAR 900 N LIBERTY STE 40 BOISE ID 83706 $231.87 3MICHAEL SPACKMAN MD ACHIEVE PHYSICAL THE 4776 N FIVE MILE ROA BOISE ID 83713 $49,415.40 415COMMUNITY CARE REXBU 72 EAST MAIN REXBURG ID 83440 $4,579.00 70JEFFREY ELDER PHD CN CENTERPOINT COUNSELI 393 EAST SECOND NORT REXBURG ID 83440 $27,313.00 158PAUL A GERLACH MD IDAHO FALLS ID 83404 $1,539.60 9KYLAN PETERSON DO ST LUKES CLINIC PHYS 730 N COLLEGE RD STE TWIN FALLS ID 83301 $1,425.67 12ARTHUR C JONES MD NA 4424 E FLAMINGO STE NAMPA ID 83687 $1,874.00 13SHALISE ADAMS AUD NA 4424 E FLAMINGO STE NAMPA ID 83687 $456.45 7GRANT GILBERT PHD ROCK POINT III BUILD 1330 N WASHINGTON #2 SPOKANE WA 99201 $2,724.76 9SPENCER CHESHIRE AUD 4424 E FLAMINGO STE NAMPA ID 83687 $386.45 5JAMES WHITAKER DO IN IDAHO JOINT AND SPIN 9510 WEST FAIRVIEW A BOISE ID 83704 $7,714.00 85MONTY SMICK OD VISION ART EYECARE C 205 WEST INDIANA AVE SPOKANE WA 99205 $2,591.00 20REX E HEAD MD MOUNTAIN VIEW CHIROP 1624 EAST SELTICE WA POST FALLS ID 83854 $8,068.00 68REX E HEAD MD LEW LEWISTON FAMILY CHIR 3510 12TH STREET SUI LEWISTON ID 83501 $7,212.00 51MICHAEL P GIBSON MD ST ALS MEDICAL GRP O 315 E ELM SUITE 100 CALDWELL ID 83605 $16,327.00 177MICHAEL J CARRAHER M HERITAGE HEALTH 925 E POLSTON POST FALLS ID 83854 $2,958.50 24MATTHEW TRAYNOR MD PREMIER EYE CARE OF 2100 PROVIDENCE WAY IDAHO FALLS ID 83404 $9,440.00 57CORY D WORKMAN AUD SOUTHWEST IDAHO EAR 900 N LIBERTY STE 40 BOISE ID 83706 $77.29 1RYAN HULBERT PHD CAL AMBITIONS OF IDAHO 524 E CLEVELAND BLVD CALDWELL ID 83605 $9,779.00 52STACEY HYDE SLP CAREY ID 83320 $612.00 3EVAN ALLAN MD TWIN FALLS ID 83301 $534.00 4SENNETT A PIERCE SR LEWISTON ID 83501 $482.58 4MARTIN SEIDENFELD PH BOISE ID 83704 $51,515.00 315KEVIN J CHICOINE MD LEWISTON ID 83501 $16,886.00 149JACOB W KAMMER MD ST ALS MEDICAL GRP O 315 E ELM SUITE 100 CALDWELL ID 83605 $7,839.00 92GEORGE MASON GARCIA IDAHO FALLS ID 83404 $2,381.30 13PAULA M NORDSTROM PH NAMPA ID 83651 $15,970.50 91JAMES BRUCE PHD BOISE ID 83706 $10,730.50 61DEBRA DAVIS-JOHNSON PO BOX 21 BOISE ID 83704 $10,921.00 61REX E HEAD MD BLACKF ELLIS CHIROPRACTIC 512 W JUDICIAL ST BLACKFOOT ID 83221 $30,557.00 234REX E HEAD MD TF WILLIAMS CHIROPRACTI 1015 WASHINGTON ST N TWIN FALLS ID 83301 $22,949.00 177EVAN ALLAN MD BURLEY ID 83318 $375.00 3BENJAMIN KARTCHNER M MOUNTAIN VIEW CHIROP 1624 E SELTICE WAY POST FALLS ID 83854 $78,710.00 824BENJAMIN KARTCHNER M SANDPOINT CHIROPRACT 400 SCHWEITZER PLAZA PONDERAY ID 83852 $25,784.00 287BENJAMIN KARTCHNER M LEWISTON FAMILY CHIR 3510 12TH STREET SUI LEWISTON ID 83501 $1,141.00 9NELS SATHER PHD TH HEALTH AND WELFARE 803 HARRISON STREET TWIN FALLS ID 83301 $6,215.50 34RYAN HULBERT PHD NAM AMBITIONS OF IDAHO 1002 W SANETTA STREE NAMPA ID 83651 $13,680.00 75STERLING D. ANDELIN 2539 CHANNING WAY SU IDAHO FALLS ID 83404 $16,042.00 85DEBRA K MCKINNON DO LEWISTON FAMILY CHIR 3510 12TH STREET STE LEWISTON ID 83501 $15,719.00 123DAVID R STARR PHD 1815 SOUTH 10TH AVE CALDWELL ID 83605 $143,933.00 850CORY D WORKMAN AUD 4424 E FLAMINGO STE NAMPA ID 83687 $77.29 1KAREN TOROSIAN AUD AUDIOLOGY RESEARCH 700 W IRONWOOD #220 COEUR D ALENE ID 83814 $154.58 2MICHAEL KOENIG MD IN GARDEN VALLEY FAMILY 856 BANKS LOWMAN RD GARDEN VALLEY ID 83622 $239.00 2DAVID BECKSTEAD MD I PRESTON MEDICAL CLIN 41 N 100 E PRESTON ID 83263 $4.80 1AARON AFFLECK MD INV IDAHO FALLS ID 83404 $164.00 1DUSTIN JONES OD INV SALMON RIVER VISION 1301 MAIN ST STE 10 SALMON ID 83467 $201.00 2MDSI PHYSICIANS GROU MEDICAL DENTAL STAFF THE LLOYD 1201 BULID PORTLAND OR 97232 $235.45 1EUNICE GARDNER PHD POCATELLO ID 83201-4374 $2,769.00 14JOHN B CASPER MD MEDICAL CONSULTING S 3023 EAST COPPER POI MERIDIAN ID 83642 $6,011.00 49

(b) (6)

(b) (6)

(b) (6)(b) (6)(b) (6)(b) (6)(b) (6)

(b) (6)(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

CIARA C CHRISTENSEN JOSHUA B OLSEN DC BL 497 EASTLAND DRIVE TWIN FALLS ID 83301 $16,979.50 102ST AL'S MEDICAL GRP 3041 E COPPER POINT MERIDIAN ID 83642 $1,188.00 27BOYD K SOUTHWICK DO IDAHO FALLS ID 83404 $185.00 1DAVID WATERMAN MD LOGAN UT 84341 $248.00 2JEFFREY ELDER PHD PINGEL LAW OFFICE 2194 CHANNING WAY IDAHO FALLS ID 83404 $9,552.00 53CIARA C CHRISTENSEN ADVANCED CHIROPRACTI 725 JENSEN GROVE DRI BLACKFOOT ID 83221 $2,614.00 14MARIE PARKMAN PSYD WESTWOOD PLAZA 13785 HIGHWAY 53 UNI RATHDRUM ID 83858 $8,603.50 53HOWARD SHOEMAKER MD ST ALS MEDICAL GRP O 315 E ELM SUITE 100 CALDWELL ID 83605 $2,085.00 26JENNIFER HENDERSON P INNOVATIVE HEALTH CA 115 EAST 16TH STREET IDAHO FALLS ID 83404 $902.00 6ADAM REYES AUD SOUTHWEST IDAHO ENT 900 N LIBERTY STE 40 BOISE ID 83706 $77.29 1DAVID G SANFORD PHD BOISE ID 83709 $264.00 2

(b) (6)(b) (6)(b) (6)

(b) (6)

All CE Providers for FY 2017VENDNAME ADDR1 ADDR2 CITY STATE ZIP Total Paid CountAARON AFFLECK MD INV IDAHO FALLS ID 83404 $164.00 1ADAM REYES AUD SOUTHWEST IDAHO ENT 900 N LIBERTY STE 40 BOISE ID 83706 $77.29 1ALAN L ZOHNER PHD IDAHO FALLS ID 83401 $35,284.00 194ARTHUR C JONES MD NA NAMPA ID 83687 $1,874.00 13BENJAMIN KARTCHNER M MOUNTAIN VIEW CHIROP 1624 E SELTICE WAY POST FALLS ID 83854 $78,710.00 824BENJAMIN KARTCHNER M SANDPOINT CHIROPRACT 400 SCHWEITZER PLAZA PONDERAY ID 83852 $25,784.00 287BENJAMIN KARTCHNER M LEWISTON FAMILY CHIR 3510 12TH STREET SUI LEWISTON ID 83501 $1,141.00 9BINGHAM MEMORIAL HOS ATTENTION: RADIOLOGY 98 POPLAR STREET BLACKFOOT ID 83221 $8,504.00 157BONNER GENERAL HOSPI ATTN: CARDIO PULMON 520 NORTH THIRD AVE SANDPOINT ID 83864 $583.80 6BONNER GENERAL HOSPI 520 NORTH THIRD AVE SANDPOINT ID 83864 $1,835.00 32BOYD K SOUTHWICK DO IDAHO FALLS ID 83404 $185.00 1BRAD W LEVITT PSYD PAYETTE ID 83661 $27,139.50 150CDA KOOTENAI OUTPATI 700 IRONWOOD STE 175 COEUR D ALENE ID 83814 $677.00 14CHAD BOUTERSE DO EYE CARE SPECIALISTS 500 PORT DRIVE CLARKSTON WA 99403 $1,369.82 8CHAD MCCORMICK MD KOOTENAI EAR NOSE TH 700 IRONWOOD STE 278 COEUR D'ALENE ID 83814 $492.00 3CHARLES BOGE MD AMMON MEDICAL & URGE 3456 E 17TH ST STE 1 AMMON ID 83406 $18,456.00 166CHERYL TURNER MS NAMPA ID 83651 $1,329.00 9CHRISTINE PICKFORD P 1655 FAIRVIEW SUITE MAIN STREET PLAZA BOISE ID 83702 $19,623.00 117CIARA C CHRISTENSEN JOSHUA B OLSEN DC BL 497 EASTLAND DRIVE TWIN FALLS ID 83301 $16,979.50 102CIARA C CHRISTENSEN ADVANCED CHIROPRACTI 725 JENSEN GROVE DRI BLACKFOOT ID 83221 $2,614.00 14CLEARWATER VALLEY HO 301 CEDAR OROFINO ID 83544 $174.00 4COMMUNITY CARE REXBU 72 EAST MAIN REXBURG ID 83440 $4,579.00 70CORY D WORKMAN AUD SOUTHWEST IDAHO EAR 900 N LIBERTY STE 40 BOISE ID 83706 $77.29 1CORY D WORKMAN AUD 4424 E FLAMINGO STE NAMPA ID 83687 $77.29 1DAVID BECKSTEAD MD I PRESTON MEDICAL CLIN 41 N 100 E PRESTON ID 83263 $4.80 1DAVID G SANFORD PHD BOISE ID 83709 $264.00 2DAVID N SIM MD BOISE ID 83704 $6,813.40 38DAVID R STARR PHD CALDWELL ID 83605 $143,933.00 850DAVID WATERMAN MD LOGAN UT 84341 $248.00 2DEBRA DAVIS-JOHNSON PO BOX 21 BOISE ID 83704 $10,921.00 61DEBRA K MCKINNON DO LEWISTON FAMILY CHIR 3510 12TH STREET STE LEWISTON ID 83501 $15,719.00 123DONALD M WHITLEY PHD IDAHO PHYSICIANS CLI 98 POPLAR BLACKFOOT ID 83221 $14,069.00 81DONALD M WHITLEY PHD PHYSICIAN AND SURGEO 1151 HOSPITAL WAY BL POCATELLO ID 83201 $58,146.00 333DUSTIN JONES OD INV SALMON RIVER VISION 1301 MAIN ST STE 10 SALMON ID 83467 $201.00 2EASTERN ID RMC (PULM 3100 CHANNING WAY IDAHO FALLS ID 83404 $389.20 4EASTERN ID RMC (RADI 3100 CHANNING WAY IDAHO FALLS ID 83404 $180.00 4EUNICE GARDNER PHD POCATELLO ID 83201-4374 $2,769.00 14EVAN ALLAN MD TWIN FALLS ID 83301 $534.00 4EVAN ALLAN MD BURLEY ID 83318 $375.00 3GEORGE MASON GARCIA IDAHO FALLS ID 83404 $2,381.30 13GERALD GARDNER PHD COEUR D ALENE ID 83814 $96,822.00 569GRANT GILBERT PHD ROCK POINT III BUILD 1330 N WASHINGTON #2 SPOKANE WA 99201 $2,724.76 9GREGORY KENT MD CALD CALDWELL ID 83605 $1,798.00 12

Idaho FY 2017 Continued

(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)(b) (6)(b) (6)(b) (6)

(b) (6)(b) (6)(b) (6)(b) (6)(b) (6)

(b) (6)

GREGORY KENT MD MERI MERIDIAN ID 83642 $2,772.00 20GRITMAN MEDICAL CENT ATTN: RADIOLOGY 700 S MAIN STREET MOSCOW ID 83843 $204.00 4HOWARD SHOEMAKER MD ST ALS MEDICAL GRP O 315 E ELM SUITE 100 CALDWELL ID 83605 $2,085.00 26INTERMOUNTAIN MEDICA 2929 EAST MAGIC VIEW MERIDIAN ID 83642 $10,974.00 147INTERPATH LABORATORY 496 SHOUP AVE WEST S TWIN FALLS ID 83301 $26.08 2ISU SPEECH, HEARING 650 MEMORIAL DRIVE # POCATELLO ID 83209 $77.29 1J CRAIG STEVENS MD P PONDERAY ID 83852 $4,124.00 31JACOB W KAMMER MD BOISE ID 83704-8767 $499.00 6JACOB W KAMMER MD ST ALS MEDICAL GRP O 315 E ELM SUITE 100 CALDWELL ID 83605 $7,839.00 92JAMES BATES MD MERIDIAN ID 83642 $50,430.00 463JAMES BRUCE PHD BOISE ID 83706 $10,730.50 61JAMES WHITAKER DO IN IDAHO JOINT AND SPIN 9510 WEST FAIRVIEW A BOISE ID 83704 $7,714.00 85JASON GAGE PHD BOISE ID 83704 $14,687.00 80JASON HALVERSON MD(T TWIN FALLS ID 83301 $164.00 1JEFFREY ELDER PHD PINGEL LAW OFFICE 2194 CHANNING WAY IDAHO FALLS ID 83404 $9,552.00 53JEFFREY ELDER PHD CN CENTERPOINT COUNSELI 393 EAST SECOND NORT REXBURG ID 83440 $27,313.00 158JENNIFER HENDERSON P INNOVATIVE HEALTH CA 115 EAST 16TH STREET IDAHO FALLS ID 83404 $902.00 6JERRY DOKE PHD 10448 GARVERDALE CT SUITE 612 BOISE ID 83704 $45,269.50 256JERRY DOKE PHD TF 834 FALLS AVE STE 20 TWIN FALLS ID 83301 $37,093.00 211JOANN HAMMOND SLP 1820 E 17TH SUITE 27 IDAHO FALLS ID 83404 $2,588.00 16JOHN B CASPER MD MEDICAL CONSULTING S 3023 EAST COPPER POI MERIDIAN ID 83642 $6,011.00 49JOHN B CASPER MD INV THE OSPREY BUILDING 4700 N CLOVERDALE RD BOISE ID 83713 $12,587.40 106JOHN L CHRISTENSEN P POCATELLO ID 83201 $23,522.00 132KAREN TOROSIAN AUD AUDIOLOGY RESEARCH 700 W IRONWOOD #220 COEUR D ALENE ID 83814 $154.58 2KEVIN HILL MD INV 777 HOSPITAL WAY SMO POCATELLO ID 83201 $329.00 3KEVIN J CHICOINE MD LEWISTON ID 83501 $16,886.00 149KOOTENAI AUDIOLOGY L 700 IRONWOOD #278 COEUR D'ALENE ID 83814 $309.16 4KOOTENAI EAR NOSE TH INTERLAKE MEDICAL BU 700 W IRONWOOD DR ST COEUR D'ALENE ID 83814 $164.00 1KOOTENAI HEART CENTE 2003 KOOTENAI HEALTH COEUR D ALENE ID 83814 $199.50 1KOOTENAI MED CTR (PF 2003 KOOTENAI HEALTH COEUR D ALENE ID 83814 $2,830.70 30KRAIG C MCGEE MD 333 N 18TH AVE STE B POCATELLO ID 83201 $863.58 7KYLAN PETERSON DO ST LUKES CLINIC PHYS 730 N COLLEGE RD STE TWIN FALLS ID 83301 $1,425.67 12LAWRENCE E GREEN MD 16060 IDAHO CENTER B NAMPA ID 83687 $10,879.00 65MARIE PARKMAN PSYD WESTWOOD PLAZA 13785 HIGHWAY 53 UNI RATHDRUM ID 83858 $8,603.50 53MARIE PARKMAN PSYD I ADEPT BUSINESS SERVI 8065 WEST MAIN RATHDRUM ID 83858 $21,576.50 126MARK CAPENER MD 2065 E 17TH ST STE B IDAHO FALLS ID 83401 $302.00 2MARK YAMA PHD ST JOSEPH'S OUTPATIE 428 6TH AVE LEWISTON ID 83501 $15,257.00 82MARTIN SEIDENFELD PH BOISE ID 83704 $51,515.00 315MATTHEW TRAYNOR MD PREMIER EYE CARE OF 2100 PROVIDENCE WAY IDAHO FALLS ID 83404 $9,440.00 57MDSI PHYSICIANS GROU MEDICAL DENTAL STAFF THE LLOYD 1201 BULID PORTLAND OR 97232 $235.45 1MICHAEL J CARRAHER M HERITAGE HEALTH 925 E POLSTON POST FALLS ID 83854 $2,958.50 24MICHAEL KOENIG MD IN GARDEN VALLEY FAMILY 856 BANKS LOWMAN RD GARDEN VALLEY ID 83622 $239.00 2MICHAEL P EMERY PHD SAFARI INN DOWNTOWN 1070 GROVE ST BOISE ID 83702 $27,045.00 154MICHAEL P GIBSON MD ST ALS MEDICAL GRP O 315 E ELM SUITE 100 CALDWELL ID 83605 $16,327.00 177MICHAEL SANT MD ONTARIO OR 97914 $11,644.00 93

(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

MICHAEL SANT MD (BOI BOISE ID 83701 $7,179.00 48MICHAEL SANT MD (MER MERIDIAN ID 83642 $8,931.00 59MICHAEL SANT MD(TF) URGENT CARE OF TWIN 2392 ADDISON AVE EAS TWIN FALLS ID 83301 $17,371.00 138MICHAEL SPACKMAN MD ACHIEVE PHYSICAL THE 4776 N FIVE MILE ROA BOISE ID 83713 $49,415.40 415MONTY SMICK OD VISION ART EYECARE C 205 WEST INDIANA AVE SPOKANE WA 99205 $2,591.00 20NATASHA MILLER MD 315 E ELM STE 100 CALDWELL ID 83605 $204.00 1NATHAN WELCH MD TWIN FALLS ID 83301 $972.00 7NAYA ANTINK MD BOISE ID 83704 $1,632.00 8NELS M SATHER PHD IDAHO STATE HOSPITAL 700 EAST ALICE BLACKFOOT ID 83221 $24,597.00 132NELS SATHER PHD FR TWIN FALLS MENTAL HE 823 HARRISON STREET TWIN FALLS ID 83301 $9,425.00 55NELS SATHER PHD TH HEALTH AND WELFARE 803 HARRISON STREET TWIN FALLS ID 83301 $6,215.50 34NORTHWEST SPECIALTY 1593 E POLSTON AVE POST FALLS ID 83854 $3,175.00 50PATRICK J PARDEN MD COEUR D ALENE ID 83814 $757.00 5PAUL A GERLACH MD IDAHO FALLS ID 83404 $1,539.60 9PAULA M NORDSTROM PH NAMPA ID 83651 $15,970.50 91PF KOOTENAI OP IMAGI 1300 E MULLAN POST FALLS ID 83854 $577.00 10PORTNEUF MEDICAL CEN 777 HOSPITAL WAY POCATELLO ID 83201 $1,362.20 14PORTNEUF MEDICAL CTR 777 HOSPITAL WAY POCATELLO ID 83201 $137.63 4PORTNEUF MEDICAL CTR 777 HOSPITAL WAY POCATELLO ID 83201 $10,713.00 206RALPH D HECKARD MD B ADVANTAGE WALK-IN CH 2013 E HOSPITALITY L BOISE ID 83716 $54,413.00 508RALPH D HECKARD MD I IDAHO WORK CARE/WEIG 203 N HOLMES AVE IDAHO FALLS ID 83401 $29,081.00 274RALPH D HECKARD MD P ALL AMERICAN CHIROPR THE OFFICE OF DR JES POCATELLO ID 83201 $41,616.20 342RALPH D HECKARD MD T JOSHUA B OLSEN DC BL 497 EASTLAND DR TWIN FALLS ID 83301 $33,431.50 326RANDALL H HUTCHINGS NAMPA ID 83686 $11,462.20 97REBECCA ALEXANDER PH LEWISTON ID 83501 $42,734.50 244REBECCA ALEXANDER PH MOSCOW ID 83843 $19,384.00 113REX E HEAD MD MOUNTAIN VIEW CHIROP 1624 EAST SELTICE WA POST FALLS ID 83854 $8,068.00 68REX E HEAD MD BLACKF ELLIS CHIROPRACTIC 512 W JUDICIAL ST BLACKFOOT ID 83221 $30,557.00 234REX E HEAD MD LEW LEWISTON FAMILY CHIR 3510 12TH STREET SUI LEWISTON ID 83501 $7,212.00 51REX E HEAD MD REXBUR REXBURG ID 83440 $23,709.00 177REX E HEAD MD TF WILLIAMS CHIROPRACTI 1015 WASHINGTON ST N TWIN FALLS ID 83301 $22,949.00 177RIAN CHATTERTON MS C BOISE ID 83713 $2,244.00 11RICHARD T SONNENBERG BOISE ID 83702 $55,571.50 321RYAN HULBERT PHD CAL AMBITIONS OF IDAHO 524 E CLEVELAND BLVD CALDWELL ID 83605 $9,779.00 52RYAN HULBERT PHD MER OFFICE OF SCOTT P HO 2273 E GALA STE 100 MERIDIAN ID 83642 $22,164.00 115RYAN HULBERT PHD NAM AMBITIONS OF IDAHO 1002 W SANETTA STREE NAMPA ID 83651 $13,680.00 75RYAN MCKINNON MD CALDWELL ID 83605 $3,264.00 25RYAN MCKINNON MD NAM SALTZER MEDICAL GROU 215 E HAWAII AVE NAMPA ID 83686 $4,705.00 33RYAN VAN DE GRAAFF M SOUTHWEST IDAHO ENT 900 N LIBERTY STE 40 BOISE ID 83706 $1,102.50 7SCOTT ALLAN MD TWIN FALLS ID 83301 $384.00 3SENNETT A PIERCE SR LEWISTON ID 83501 $482.58 4SHALISE ADAMS AUD SOUTHWEST IDAHO EAR 900 N LIBERTY STE 40 BOISE ID 83706 $231.87 3SHALISE ADAMS AUD NA 4424 E FLAMINGO STE NAMPA ID 83687 $456.45 7SPENCER CHESHIRE AUD SOUTHWEST IDAHO EAR 900 N LIBERTY STE 40 BOISE ID 83706 $77.29 1SPENCER CHESHIRE AUD 4424 E FLAMINGO STE NAMPA ID 83687 $386.45 5

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)(b) (6)

(b) (6)(b) (6)(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)(b) (6)

ST ALPHONSUS MEDICAL 351 SW 9TH ST ONTARIO OR 97914 $1,079.30 12ST ALPHONSUS MEDICAL 351 SW 9TH ST ONTARIO OR 97914 $3,597.50 70ST ALS HEALTH PLAZA 4400 E FLAMINGO NAMPA ID 83687 $692.20 13ST ALS MED CTR RADIO 1512 12TH AVE RD NAMPA ID 83651 $116.90 2ST AL'S MEDICAL GRP 3041 E COPPER POINT MERIDIAN ID 83642 $1,188.00 27ST JOSEPHS RMC (PFT) 415 6TH STREET LEWISTON ID 83501 $1,362.20 14ST JOSEPHS RMC RADIO 307 ST JOHNS WAY LEWISTON ID 83501 $11,597.70 225ST LUKES ID ELKS HEA 172 SECOND ST SOUTH NAMPA ID 83651 $70.00 1ST LUKES ID ELKS HEA 520 S EAGLE ROAD #12 MERIDIAN ID 83642 $70.00 1ST LUKES MAGIC VALLE 775 POLE LINE RD W TWIN FALLS ID 83301 $8,552.00 169ST LUKES MAGIC VALLE 775 POLE LINE RD W S TWIN FALLS ID 83301 $1,556.80 16ST LUKES MAGIC VALLE 775 POLE LINE RD W TWIN FALLS ID 83301 $34.63 2ST LUKES MCCALL HOSP 1000 STATE ST MCCALL ID 83638 $194.60 2ST LUKES MERIDIAN RM ATTN: PULMONARY FUNC 520 S EAGLE RD MERIDIAN ID 83642 $2,492.00 24ST LUKES MERIDIAN RM ATTN: LABORATORY 520 S EAGLE RD MERIDIAN ID 83642 $62.29 3ST LUKES RMC C/P 190 E BANNOCK BOISE ID 83712 $2,393.50 24ST LUKES RMC RAD MER 520 S EAGLE RD MERIDIAN ID 83642 $14,193.00 240ST LUKES RMC RADIOLO ATTN: RADIOLOGY 190 E BANNOCK BOISE ID 83712 $895.00 17STACEY HYDE SLP CAREY ID 83320 $612.00 3STERLING D. ANDELIN IDAHO FALLS ID 83404 $16,042.00 85TETON CARDIOVASCULAR 2001 S WOODRUFF STE IDAHO FALLS ID 83404 $1,468.50 16TETON RADIOLOGY OF I 2001 S WOODRUFF STE IDAHO FALLS ID 83404 $5,046.70 100THEODORE W GARDNER P JUSTAMERE INN 401 GOODING ST N STE TWIN FALLS ID 83301 $20,283.50 116VALOR HEALTH ATTN: RADIOLOGY DEPT 1202 EAST LOCUST STR EMMETT ID 83617 $182.80 4WEST VALLEY MEDICAL 1717 ARLINGTON CALDWELL ID 83605 $939.70 19WILLIAM JACKLINE EDD SPOKANE WA 99224 $11,563.00 65ZACK HALE MS 3345 MERLIN DR STE 2 IDAHO FALLS ID 83404 $309.16 4

$1,790,875.71 13528

(b) (6)(b) (6)

(b) (6)

Volume and Key ProvidersVENDNAME ADDR1 ADDR2 CITY STATE ZIP Total Paid CountBENJAMIN KARTCHNER M MOUNTAIN VIEW CHIROP 1624 E SELTICE WAY POST FALLS ID 83854 $78,710.00 824BENJAMIN KARTCHNER M SANDPOINT CHIROPRACT 400 SCHWEITZER PLAZA PONDERAY ID 83852 $25,784.00 287BENJAMIN KARTCHNER M LEWISTON FAMILY CHIR 3510 12TH STREET SUI LEWISTON ID 83501 $1,141.00 9DAVID R STARR PHD CALDWELL ID 83605 $143,933.00 850GERALD GARDNER PHD COEUR D ALENE ID 83814 $96,822.00 569JERRY DOKE PHD 10448 GARVERDALE CT SUITE 612 BOISE ID 83704 $45,269.50 256JERRY DOKE PHD TF 834 FALLS AVE STE 20 TWIN FALLS ID 83301 $37,093.00 211RALPH D HECKARD MD B ADVANTAGE WALK-IN CH 2013 E HOSPITALITY L BOISE ID 83716 $54,413.00 508RALPH D HECKARD MD I IDAHO WORK CARE/WEIG 203 N HOLMES AVE IDAHO FALLS ID 83401 $29,081.00 274RALPH D HECKARD MD P ALL AMERICAN CHIROPR THE OFFICE OF DR JES POCATELLO ID 83201 $41,616.20 342RALPH D HECKARD MD T JOSHUA B OLSEN DC BL 497 EASTLAND DR TWIN FALLS ID 83301 $33,431.50 326REX E HEAD MD MOUNTAIN VIEW CHIROP 1624 EAST SELTICE WA POST FALLS ID 83854 $8,068.00 68REX E HEAD MD BLACKF ELLIS CHIROPRACTIC 512 W JUDICIAL ST BLACKFOOT ID 83221 $30,557.00 234REX E HEAD MD LEW LEWISTON FAMILY CHIR 3510 12TH STREET SUI LEWISTON ID 83501 $7,212.00 51REX E HEAD MD REXBUR REXBURG ID 83440 $23,709.00 177REX E HEAD MD TF WILLIAMS CHIROPRACTI 1015 WASHINGTON ST N TWIN FALLS ID 83301 $22,949.00 177

$679,789.20 5163

(b) (6)(b) (6)

(b) (6)

CE Providers RemovedNone

CE Provider Onsight CompletedVENDNAME ADDR1 ADDR2 CITY STATE ZIP Total Paid CountCHARLES BOGE MD AMMON MEDICAL & URGE 3456 E 17TH ST STE 1 AMMON ID 83406 $18,456.00 166CHRISTINE PICKFORD P 1655 FAIRVIEW SUITE MAIN STREET PLAZA BOISE ID 83702 $19,623.00 117CIARA C CHRISTENSEN JOSHUA B OLSEN DC BL 497 EASTLAND DRIVE TWIN FALLS ID 83301 $16,979.50 102DAVID R STARR PHD CALDWELL ID 83605 $143,933.00 850DONALD M WHITLEY PHD PHYSICIAN AND SURGEO 1151 HOSPITAL WAY BL POCATELLO ID 83201 $58,146.00 333EASTERN ID RMC (PULM 3100 CHANNING WAY IDAHO FALLS ID 83404 $389.20 4EUNICE GARDNER PHD POCATELLO ID 83201-4374 $2,769.00 14GERALD GARDNER PHD COEUR D ALENE ID 83814 $96,822.00 569JEFFREY ELDER PHD CN CENTERPOINT COUNSELI 393 EAST SECOND NORT REXBURG ID 83440 $27,313.00 158JENNIFER HENDERSON P INNOVATIVE HEALTH CA 115 EAST 16TH STREET IDAHO FALLS ID 83404 $902.00 6JERRY DOKE PHD 10448 GARVERDALE CT SUITE 612 BOISE ID 83704 $45,269.50 256JOANN HAMMOND SLP 1820 E 17TH SUITE 27 IDAHO FALLS ID 83404 $2,588.00 16JOHN L CHRISTENSEN P POCATELLO ID 83201 $23,522.00 132KEVIN J CHICOINE MD LEWISTON ID 83501 $16,886.00 149MARIE PARKMAN PSYD WESTWOOD PLAZA 13785 HIGHWAY 53 UNI RATHDRUM ID 83858 $8,603.50 53MICHAEL SANT MD (BOI BOISE ID 83701 $7,179.00 48NELS SATHER PHD FR TWIN FALLS MENTAL HE 823 HARRISON STREET TWIN FALLS ID 83301 $9,425.00 55PORTNEUF MEDICAL CEN 777 HOSPITAL WAY POCATELLO ID 83201 $1,362.20 14RALPH D HECKARD MD B ADVANTAGE WALK-IN CH 2013 E HOSPITALITY L BOISE ID 83716 $54,413.00 508REBECCA ALEXANDER PH LEWISTON ID 83501 $42,734.50 244REX E HEAD MD LEW LEWISTON FAMILY CHIR 3510 12TH STREET SUI LEWISTON ID 83501 $7,212.00 51RYAN MCKINNON MD CALDWELL ID 83605 $3,264.00 25ST LUKES MAGIC VALLE 775 POLE LINE RD W TWIN FALLS ID 83301 $8,552.00 169STERLING D. ANDELIN IDAHO FALLS ID 83404 $16,042.00 85ZACK HALE MS 3345 MERLIN DR STE 2 IDAHO FALLS ID 83404 $309.16 4

$632,694.56 4128

(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

ILLINOIS ABC PEDIATRIC AHMED, AZIZ MD AKTAR, RIAZ MD Onsite review comleted AMDUR, MARK MD ANUKWU, LINUS MD ANYANWU, JOVITA MD

ARTHRITIS & INT MED SPEC Multiple sites Key/High Volume provider meets threshhold

Onsite review completed-Chicago, Elgin, Skokie

AUDIOLOGY CONSULT Multiple sites BELTRAN, NORA MD BILAS, KRISTIN SLP BONSKY, LAURA PSYDBOYD, JERRY PHD Multiple sites BRAUER, JOHN PSYD Multiple sites BUCH, PIYUSH MD BYERS-SPRAETZ, JEANNE SLP CGH MEDICAL CENTER

CHAPA, VITTAL MD Multiple sites Key/High Volume provider meets threshhold

Onsite review completed-East Peoria

CHEAK, ERIN SLP

CHICAGO CONSULTING PHYS Key/High Volume provider meets threshhold Onsite review completed

CHICAGO GLAUCOMA CONSULTCHILD & FAMILY PSYCH CTRCHO, SUNG JIN PSYD CILINO-FOLKS (formerly Aurand) JENNIFER PSYD COLLINSWORTH, LINDA PHD COX, BEVERLY PHD CUNNINGHAM, JEAN PHD DAILEY, JOHN MD DAVENPORT, TERESA PHD Multiple sites DAY, JOHN & ASSOC

DEPPE, HARRY PHD Multiple sites Key/High Volume provider meets threshhold

Onsite review completed-Centralia

DOYLE, SHANNON PHDDYSON, VIDA PHD EAST WEST INT MED Multiple sites ELMUDESI, FRANK J PSYD

PROVIDERS-OVERSIGHT FFY 2017

FEINERMAN, ADRIAN MD Multiple sites Key/High Volume provider meets threshhold

Onsite review completed-Centralia

FROMAN, FRANK EDDGARCIA, PHILIP MD Multiple sites GARG, RAKESH MD GO, DENNIS MD GOEBEL, J B PHD GOOD SAMARITAN REG HLTH CTR

GOZI MEDICAL & OCC HLTH Multiple sites Key/High Volume provider meets threshhold

Onsite review completed-Hazel Crest

GREEN, OLGA PSYD GROESCH, DAVID SLP Multiple sites GUPTA, SANDEEP MD HARDY, STEPHEN PHDHARRIS, BRENDA SLPHASSON, ALBERT MD HAUSER-ROSS EYE INSTHEINRICHS, KENNETH PSYD HERNANDEZ, NIKKI PHD HILGER, SANDRA SLP Multiple sites HOOVER & ASSOC HOUSE, ALVIN PHDJACOBS, ALAN PHDJAIN, DINESH MD JAIN, MUKESH MD JESWANI, SEEMA MD JFJ EYECARE JOHNSTON, CHRISTY SLP Multiple sites JOYNER THERAPY Multiple sites KAHLON, SURINDERPAL MDKANAGARAJU, BALA MD

KARR, JEFFREY PHDKey/High Volume provider meets threshhold Onsite review completed

KETTERING, RANDY PHDKIMBEL, PATRICIA PSYDKING, JASON PSYD KLUG, FRED, PHD Multiple sites KNOPF, NORTON PHD KOGAN, ALAN MD KOGAN, JULIA MD KOHEN, WILLIAM PSYD

KRUCEK, MICHELLE PSYD LAGOUROS, EVAN MD

LAKE SHORE MEDICAL CLINIC Key/High Volume provider meets threshhold Onsite review completed

LAKESIDE EYE GROUP

LANGGUT, MARK PHD Multiple sites Key/High Volume provider meets threshhold

Onsite review completed-Ottawa

LATHAM, ALISON SLP LEE, KAREN PSYD LEVITAN, KENNETH MD LOUCK DAVIS, AMY PSYD LUCIETTO-SIERADZKI, THERESE MD LUDWIG, GARY PHD L & Y GROUP MARKS-FREY, MARILYN PHD MCELHENNEY, RISE SLP

MEDICAL EVALUATION CTRKey/High Volume provider meets threshhold Onsite review completed

MIDDLETON, KIMBERLY MD MIDTOWN PHYSICIANS Multiple sites

MUNOZ, GILBERTO MD Multiple sites Key/High Volume provider meets threshhold Onsite review completed

MUZAFFAR, ZAHIDA MD NADKARNI, U P MD NAGPAL-ARORA ASSOC NORTHWEST EYE OGBEVOEN, JUSTIN MD OKOLI, UZOMA MD OLAUGHLIN, CHARLES MD OMONDI, PRICE DO OSAFO HEALTHCARE OSF REHAB SVCSOSTROWSKI, MICHAEL EDD PATIL, M S MD PETERSON, JAMES PHD Multiple sites

PHYS MGT NORTH, SYSTEM, WEST Multiple sites Key/High Volume provider meets threshhold

Onsite review completed-Lake Zurich, Chicago, Hillside

PIMENTEL, DANTE MD POWELL, DAVID AUD PRAIRIE EYE PRAIRIE WIND Multiple sites

PROFESSIONAL EYE PROGRESSIVE EYE PSYCHCARE ASSOC

PSYCHOLOGY CONSULT Multiple sites Key/High Volume provider meets threshhold

Onsite review completed-Rockford

QUANTUM VISION Multiple sites QUINN, MIRJAM PHD RAFIQ, MUHAMMAD MD Multiple sites RAHMAN, AZIZ MD

RAMCHANDANI, K P MD Key/High Volume provider meets threshhold Onsite review completed

RUSSELL, JOHN OD SCHIER, LESLIE MD Multiple sites SCHULTZ, LYNETTE PSYD SEBASTIAN, FELICITAS PHD SHAH, PRANJAL MD SHAH, SYED MD SHEVLYAGIN, SERGEI MD SHUKHMAN, MARK MD SICHER, STEVEN MD

SIGNATURE CONSULT Multiple sites Key/High Volume provider meets threshhold

Onsite review completed-Sycamore

SINGH, PARAMJEET MD SO IL INST BEHAVIOR HLTHSPEECH & LANG REHAB STAHNKE, ROBERTA PSYD STELLING, FRED MA STERZIK, TIMOTHY PSYD Onsite review completed STILES, WILLIAM MD ST MARYS ADULT & GERIATRIC SWANSON, ERICKA PSYD

TAIWO, AFIZ MD Multiple sites Key/High Volume provider meets threshhold

Onsite review completed-Princeton, Peoria

TAMRAGOURI, RAVIKIRAN MD THERAPY CARE THOMAS-STAGG, JONATHAN PHD Multiple sites TRELLO, DOLORES PSYD Multiple sites TRIEGER, MICHAEL PSYD VETTER, MARIE AUD Multiple sites

VINCENT, STEPHEN PHD Multiple sites Key/High Volume provider meets threshhold Onsite review completed-Alton

VOSS, VALERIE MD Multiple sites VYAS, KETAN MD WANG, PAUL MD WARSHAUER, DAVID PHD WASHINGTON COUNTY HOSP & RURAL HLTH CLINICWEGIEREK, ANNA PSYD

WEST PARK MEDICAL Multiple sites Key/High Volume provider meets threshhold Onsite review completed-Alton

WISE, JOAN PSYD WITHERSPOON, KIRK PHD WRIGHT, SARAH PSYD WURGLITZ, GLEN PSYD YALAMANCHILI, SARAT MD YORK-ANDERSON, DOLLEAN PHD

IOWA ANDERREGG, THOMAS PHD

MISSOURI FOREST PARK MEDICAL

**There were no CE Panelists removed because of inactive license, sanction, or due cause.

INDIANA DDS FY 2017 CE PROVIDER LISTVendCd Off Type Name PS nbr PRO Tmp? Inact sDt

C IU HEALTH BEDFORD HOSPITAL N 0C IU HEALTH BEDFORD HOSPITAL N 0C IU HEALTH BEDFORD HOSPITAL N 0C IU HEALTH ARNETT CARDIOLOGY (ECHO) N 0C IU HEALTH ARNETT CARDIOLOGY (TET) N 0C INDIANA UNIVERSITY HEALTH ARNETT (XRAY) N 0C INDIANA UNIVERSITY HEALTH ARNETT (PULM) N 0C THE SOUTH BEND CLINIC (ENT) N 0C SOUTH BEND CLINIC (PFS) N 0C SOUTH BEND CLINIC(LABS X RAYS) N 0C SOUTH BEND CLINIC (OPT) N 0C IU HEALTH BALL MEMORIAL HOSPITAL N 0C IU HEALTH BALL MEMORIAL HOSPITAL N 0C IU HEALTH BALL MEMORIAL HOSPITAL N 0C IU HEALTH BALL MEMORIAL HOSPITAL N 0C MARION GENERAL HOSPITAL N 0C MARION GENERAL HOSPITAL (PFS ONLY) N 0C MARION GENERAL HOSPITAL N 0C ST CATHERINE HOSPITAL (LABS/XR) N 0C ST CATHERINE HOSPITAL (PULM) N 0C ST CATHERINE HOSPITAL (SLP) N 0C ST. JOSEPH HOSPITAL N 0C ST. JOSEPH HOSPITAL N 0C ST. JOSEPH HOSPITAL(LABS & XRAYS) N 0C ST. JOSEPH HOSPITAL N 0C ST. JOSEPH HOSPITAL N 0C MD IMAGING N 0C MD IMAGING (X-RAYS) N 0C ST. JOSEPH HOSPITAL(PFS/EKGS/PULSE OX) N 0C ST. JOSEPH HOSPITAL (ECHOS) N 0C ST. JOSEPH HOSPITAL( DOPP) N 0C ST JOSEPH REGIONAL MEDICAL CENTER N 0C ST. JOSEPH REGIONAL MEDICAL CENTER N 0C ST. JOSEPH REGIONAL MEDICAL CENTER N 0C ST JOSEPH REGIONAL MEDICAL CENTER N 0C IU HEALTH METHODIST HOSPITAL (PUL) N 0C IU HEALTH METHODIST HOSPITAL (LAB) N 0C UNION HOSPITAL WEST N 0C UNION HOSPITAL AT CLINTON N 0C UNION HOSPITAL WEST(SLP) N 0C UNION HOSPITAL (X-RAYS) N 0C UNION HOSPITAL CLINTON (XR) N 0C ST VINCENT ANDERSON REGIONAL HOSPITAL, INC. N 0C ST VINCENT ANDERSON REGIONAL HOSPITAL, INC. N 0C ST VINCENT ANDERSON REGIONAL HOSPITAL, INC. N 0C ST VINCENT ANDERSON REGIONAL HOSPITAL, INC. N 0C ST VINCENT ANDERSON REGIONAL HOSPITAL, INC. N 0C ST VINCENT ANDERSON REGIONAL HOSPITAL, INC. N 0C ENT ASSOCIATES OF SOUTHERN IN N 0C REID MEMORIAL HOSPITAL N 0C REID MEMORIAL HOSPITAL (LABS & XRAY) N 0C REID HOSPITAL AND HEALTH CARE SERVICES N 0C KINGS DAUGHTERS HEALTH N 0C KINGS DAUGHTERS HEALTH N 0C KINGS DAUGHTERS HEALTH N 0C KINGS DAUGHTERS HEALTH N 0C KINGS DAUGHTERS HEALTH N 0C ST FRANCIS HOSPITAL CENTER N 0C ST ELIZABETH EAST N 0C ST ELIZABETH CENTRAL N 0C ST ELIZABETH EAST N 0C ST ELIZABETH EAST (CARDIO) N 0

(b) (6) (b) (6)

C ST ELIZABETH EAST (LABS) N 0C IU HEALTH BLOOMINGTON HOSPITAL (RESP) N 0C IU HEALTH BLOOMINGTON HOSPITAL (VASC) N 0C IU HEALTH BLOOMINGTON HOSPITAL N 0C SCOTT MEMORIAL HOSPITAL N 0C SCOTT MEMORIAL HOSPITAL N 0C SCOTT MEMORIAL HOSPITAL N 0C SCOTT MEMORIAL HOSPITAL (PFS/DLCO) N 0C COMMUNITY HOWARD REGIONAL HEALTH INC. N 0C COMMUNITY HOWARD REGIONAL HEALTH INC. N 0C COLUMBUS REGIONAL HOSP (LABS X RAYS) N 0C COLUMBUS REGIONAL HOSP (ECHOS) N 0C COLUMBUS REGIONAL HOSP (PFTS,ABG) N 0C PUTNAM COUNTY HOSPITAL N 0C PUTNAM COUNTY HOSPITAL(LABS) N 0C PUTNAM COUNTY HOSPITAL(X RAYS) N 0C IU HEALTH STARKE HOSPITAL N 0C IU HEALTH STARKE HOSPITAL N 0C IU HEALTH STARKE HOSPITAL N 0C IU HEALTH STARKE HOSPITAL N 0C IU HEALTH STARKE HOSPITAL N 0C STARKE HOSPITAL N 0C STARKE HOSPITAL N 0C STARKE HOSPITAL N 0C STARKE HOSPITAL N 0C STARKE HOSPITAL N 0C EVANSVILLE SURGICAL ASSOCIATES N 0C AP HOLD N 0C MSD HOLD N 0C PRD HOLD N 0C ODAR HOLD N 0C MIDWEST EAR INSTITUTE N 0C THE CONSULTING CENTER (KEPES) N 0C THE CONSULTING CENTER - LESLIE PREDINA N 0C WAYNE VON BARGEN, PH.D. N 0C TERRE HAUTE REGIONAL HOSPITAL N 0C TERRE HAUTE REGIONAL HOSPITAL( ABG/PULSE OX) N 0C TERRE HAUTE REGIONAL HOSPITAL N 0C TERRE HAUTE REGIONAL HOSPITAL N 0C TERRE HAUTE REGIONAL HOSPITAL N 0C TERRE HAUTE REGIONAL HOSPITAL( PFT/DLCO) N 0C M HILLIARD ROSEFF MD N 0C DION J. DULAY, M.D. N 0C TERRE HAUTE HEART CENTER N 0C MAX A HENRY MD (C) N 0C MAX A HENRY MD (G) N 0C MICHELE KOSELKE, PSY.D. (LEBANON) N 0C MICHELE KOSELKE, PSY.D. (LAF) N 0C RALPH INABNIT, D.O. (SB) N 0C RALPH INABNIT, D.O. (SB PFS) N 0C DONALD M. PEREZ, M.D. N 0C JULIE PELLETIER,PHD N 0C GOOD SAMARITAN HOSPITAL N 0C GOOD SAMARITAN HOSPITAL N 0C GOOD SAMARITAN HOSPITAL N 0C GOOD SAMARITAN HOSPITAL N 0C RILEY HOSPITAL N 0C DEARBORN COUNTY HOSPITAL N 0C DEARBORN COUNTY HOSPITAL N 0C DEARBORN COUNTY HOSPITAL N 0C DEARBORN COUNTY HOSPITAL N 0C DEARBORN COUNTY HOSPITAL N 0C DEARBORN COUNTY HOSPITAL N 0C BAPTIST HEALTH (FLOYD) PFS/DLCO N 0

(b) (6)(b) (6)

C BAPTIST HEALTH (FLOYD) TET N 0C BAPTIST HEALTH (FLOYD) LAB N 0C BAPTIST HEALTH (FLOYD) ABG N 0C BAPTIST HEALTH (FLOYD) SLP N 0C BAPTIST HEALTH (FLOYD) DOPPLERS N 0C BAPTIST HEALTH (FLOYD) TET-JEFF N 0C UNIVERSITY OF CHICAGO HOSPITAL N 0C DOCTORS EYE INSTITUTE N 0C DOCTORS EYE INSTITUTE (OPT) N 0C GLENN STEWART DAVIDSON, JR., PH.D. N 0C JEFFREY W. GRAY, PH.D. (E) N 0C THOMAS A SMITH PHD N 0C HOWARD WOODEN, PH.D. (T) N 0C HOWARD WOODEN, PH.D. (I) N 0C PATRICK UTZ, PH.D. (SB) N 0C JOHN NIETERS MD N 0C SUZANNE LEIPHART PHD N 0C CHICAGO CONSULTING PHYSICIANS N 0C CHICAGO CONSULTING PHYSICIANS N 0C PAUL J ROBERTS PHD HSPP N 0C JEFFREY T. KARR, PH.D N 0C CATARACT & LASER INSTITUTE N 0C SOUTHLAKE SPEECH & HEARING CENTER, INC. N 0C HEARING & SPEECH ASSOCIATES N 0C IRENA M WALTERS PSYD N 0C DAVID W. ZAUEL, M.D. N 0C DAVID W. ZAUEL, M.D. N 0C LOGANSPORT MEMORIAL HOSPITAL N 0C LOGANSPORT MEMORIAL HOSPITAL(PFS/DLCO) N 0C PERU MEDICAL CENTER N 0C PERU MEDICAL CENTER (ANC) N 0C JOYCE SCULLY, PSY.D (GARY) N 0C RUSH MEMORIAL HOSPITAL (DOPPLER) N 0C RUSH MEMORIAL HOSPITAL (LABS ONLY) N 0C RUSH MEMORIAL HOSPITAL (PFS/DLCO) N 0C RUSH MEMORIAL HOSPITAL (ECHO) N 0C RUSH MEMORIAL HOSPITAL- TET N 0C RUSH MEMORIAL HOSPITAL- STRESS ECHO N 0C J. MARK DOBBS, PSY.D. N 0C PHILLIP L VANDIVIER ED D N 0C HUGH VAN AUKEN, SR., PH.D. N 0C ANCHOR BEHAVIORAL (NC) N 0C ANCHOR BEHAVIORAL (F) N 0C ANCHOR BEHAVIORAL (ANDERSON) N 0C MIDWEST CLINIC N 0C HAMILTON CENTER- DR. SCHNEIDER (PL) N 0C HAMILTON CENTER - DR LEAH POWELL (BRAZIL) N 0C HAMILTON CENTER - ADULT (TH) N 0C ERIC LEVINE, MD (GREENWOOD) N 0C IU HEALTH GOSHEN HOSPITAL N 0C IU HEALTH GOSHEN HOSPITAL (AJ) N 0C IU HEALTH GOSHEN HOSPITAL (CC) N 0C IU HEALTH GOSHEN HOSPITAL (AB) N 0C ROBERT J. KURZHALS, PH.D. (L) N 0C ROBERT J. KURZHALS, PH.D. (S) N 0C ALAN H. WAX, PH.D. (M) N 0C ALAN H. WAX, PH.D. (P) N 0C ALAN H. WAX, PH.D. (E) N 0C D MARK BICKERS MD N 0C DOUGLAS STREICH PH.D. N 0C FLOYD ROBISON PH.D. N 0C FLOYD ROBISON PH.D. (BLOOMINGTON) N 0C ROBERT BLAKE, PH.D. N 0C INDIANAPOLIS MEDICAL EVALUATION N 0

(b) (6)(b) (6)

C UNITED HEALTH SERVICES N 0C MEDSTAT URGENT CARE (PFS) N 0C MEDSTAT URGENT CARE (XRAY AND LABS) N 0C MEDSTAT URGENT CARE WARSAW N 0C MEDSTAT URGENT CARE (SYRACUSE-ANC) N 0C MEDSTAT URGENT CARE (SYRACUSE) N 0C MEDSTAT URGENT CARE NAPPANEE N 0C MEDSTAT URGENT CARE (XRAY & LABS) NAPPANEE N 0C MEDSTAT URGENT CARE (PFS-NAPPANEE) N 0C RUDY YUNG MD N 0C MID-AMERICA PSYCH COUNSELING SERVICES(M) N 0C MID-AMERICA PSYCH COUNSELING SERV (G-SINGH) N 0C MID-AMERICA PSYCH COUNSELING SERV (G-GOPAL) N 0C MID-AMERICA PSYCH COUNSELING SERV (O'DANOVICH) N 0C MID-AMERICA PSYCH COUNSELING SERVICES(MUNSTER) N 0C MICHAEL R WILD MD (K) N 0C GARY M. DURAK, PH.D. (V) N 0C LARRY F. FREUDENBERGER, PSY.D. N 0C CEOLA BERRY PHD (NC) N 0C CEOLA BERRY PHD (MA) N 0C BETTYE L. PATE, PSY.D. N 0C CHRISTOPHER H. SCRUTON, PH.D. N 0C CRAIG NORDSTROM, PSY.D. (P) N 0C CRAIG NORDSTROM, PSY.D. (E) N 0C METHODIST PHYSICIAN GROUP CARDIOVASCULAR CLINIC N 0C VICTOR P. RINI, PSY.D. (VALPO) N 0C VICTOR P. RINI, PSY.D. (HIGHLAND) N 0C MICHAEL OBRIEN PSYD (I) N 0C MICHAEL OBRIEN PSYD (K) N 0C DAVID A. CAMPBELL, M.D. N 0C LUZIO & ASSOCIATES-DR. JONES N 0C ST VINCENT DUNN HOSPITAL N 0C A & J REHABILITATION SERVICES N 0C KOSCIUSKO COMMUNITY HOSPITAL(ECHOS) N 0C KOSCIUSKO COMMUNITY HOSPITAL(PFS/DLCO) N 0C KOSCIUSKO COMMUNITY HOSPITAL(ABG) N 0C RUSS RASMUSSEN, PSY.D. N 0C CANDACE MARTIN PSYD N 0C GREENWOOD PEDIATRICS & INTERNAL MEDICINE N 0C PAULA GARDNER PSYD N 0C COMPREHENSIVE PSYCH SERV (CH) N 0C COMPREHENSIVE PSYCH SERV (G) N 0C C KENNETH FISCHER MD N 0C ACACIA CENTER FOR HUMAN GROWTH & DEVELOPMENT N 0C JOHNSON MEMORIAL HOSPITAL (LAB) N 0C JOHNSON MEMORIAL HOSPITAL (X RAYS) N 0C JOHNSON MEMORIAL HOSPITAL (PULM) N 0C JOHNSON MEMORIAL HOSPITAL (ECHO) N 0C ALLISON RUGANI, MA, CCC-SLP N 0C JILL A MILLER PSYD N 0C MUNSTER EYE CARE ASSOCIATES, P.C. N 0C ROSALIND SCHMUTTE PSYD N 0C IU HEALTH ENT DEPARTMENT (WANGSTROM & BANCROFT) N 0C IU HEALTH ENT DEPARTMENT (WANGSTROM & BANCROFT) N 0C BLUFFTON REGIONAL MEDICAL CENTER N 0C GRETCHEN HADAR CCC,SLP (I) N 0C JACQUELINE BROOKS, M.ED., CCC-SLP N 0C KARL W. EVANS, PSYD, HSPP N 0C KATHRYN NAGDEMAN, MA-CCC N 0C PAUL DEARDORFF PHD N 0C NICOLE LEISGANG PSYD (INDY) N 0C PAUL DEARDORFF PH.D. (INDY) N 0C NICOLE LEISGANG PSYD (RICHMD) N 0C PAUL DEARDORFF PH.D. (RICHMD) N 0

(b) (6) (b) (6)

C REGINA MCKINNEY PSYD (RICHMD) N 0C REGINA MCKINNEY PSYD(INDY) N 0C LONDON PSYCHOLOGICAL SERVICES N 0C GARY MARYMAN PSYD N 0C GARY MARYMAN PSYD(BL) N 0C GARY MARYMAN PSYD(MADISON) N 0C MAJOR HOSPITAL (LAB) N 0C MAJOR HOSPITAL (X RAY) N 0C MAJOR HOSPITAL (PFS) N 0C MAJOR HOSPITAL N 0C MAJOR HOSPITAL N 0C ARSHAD MALIK, M.D. N 0C ARSHAD MALIK, M.D. (TET) N 0C SACKS CLINICAL CONSULTING,PC N 0C JEFFREY SAMELSON, PH.D. (SACKS) N 0C SHARON SACKS, PHD( SOUTH BEND) N 0C JOHN T HEROLDT EDD (LA) N 0C JOHN T HEROLDT EDD (MC) N 0C JOHN T HEROLDT EDD (M) N 0C JOHN T HEROLDT EDD (LO) N 0C SOUTHERN INDIANA EYE ASSC LLC N 0C CENTRAL IN INTERPRETING SERVICE N 0C ADVOCATE ILLINOIS MASONIC MEDICAL CENTER N 0C FLORENCE REZNIK CCC-SLP (CARMEL) N 0C FLORENCE REZNIK CCC-SLP (ANDERSON) N 0C CARYN BROWN PSYD (M) N 0C CARYN BROWN PSYD (L) N 0C HEUSER HEARING INSTITUTE N 0C COURTER COMMUNICATIONS, LLC (C) N 0C COURTER COMMUNICATIONS, LLC N 0C COURTER COMMUNICATIONS, LLC (K) N 0C RUSSELL G COULTER-KERN PHD (NMAN) N 0C RUSSELL G COULTER-KERN PHD (M) N 0C SOUTHERN INDIANA REHAB HOSPITAL N 0C PSYCHOLOGICAL & SOCIAL SERVICES N 0C TODD A SNYDER PSYD (ELKHART) N 0C JAMES ASCOUGH, PHD, HSPP N 0C DEBORAH A. ZERA, PSY.D. N 0C SIMPLY SPEAKING N 0C MONROE HOSPITAL N 0C MONROE HOSPITAL N 0C MONROE HOSPITAL N 0C MONROE HOSPITAL N 0C SPEECH AND LANGUAGE PRIORITIES LLC N 0C SPEECH AND LANGUAGE PRIORITIES (C) N 0C JULIE WEAVER CCC-SLP N 0C CONNECTIONS INC N 0C CONNECTIONS INC (TESTING ONLY) N 0C ADVANCED OPHTHALMOLOGY ASSOCIATES N 0C KIMBERLY MORAN PSYD N 0C GROSSNICKLE EYE CTR (M) N 0C GROSSNICKLE EYE CTR (E) N 0C GROSSNICKLE EYE CTR (M)(OPT) N 0C GROSSNICKLE EYE CTR (E)(OPT) N 0C BLACKBIRD CLINICAL SERVICES(PFTS-ANC) N 0C IU HEALTH NEUROPHYSIOLOGY N 0C RILEY HOSPITAL FOR CHILDREN(HINT) N 0C CTR FOR PSYCH DEV - DALE N 0C TRINA VIAN, CCC-SLP N 0C AAA SPEECH THERAPY SERVICES, LLC. N 0C WORKING WELL (MC) N 0C WORKING WELL (MC) LABS/XRAYS N 0C STEVEN B ASHTON DO N 0C STEFANIE WADE PSYD N 0

(b) (6) (b) (6)

C NWI PATIENT CARE (G) N 0C NWI PATIENT CARE (GARY-A) N 0C NWI PATIENT CARE (ECHOS) N 0C NWI PATIENT CARE (M) N 0C NWI PATIENT CARE (ECHOS-M) N 0C NWI PATIENT CARE (ANCILLARIES-M) N 0C NWI PATIENT CARE (DOPPLER-G) N 0C NWI PATIENT CARE (DOPPLER-M) N 0C NWI PATIENT CARE (ELK) N 0C NWI PATIENT CARE (ELK-ANC) N 0C NWI PATIENT CARE (ECHOS-ELK) N 0C LUTHERAN MEDICAL GROUP N 0C BRIDGET ROBERTS-PITTMAN, PH.D. N 0C DAWN CASTNER-RECTOR, PH.D. N 0C INDY BEHAVIORAL HEALTH LLC (I) N 0C INDY BEHAVIORAL HEALTH LLC (A) N 0C INDY BEHAVIORAL HEALTH LLC (R) N 0C DAN BOEN PHD N 0C ERICKA STEIN, CCC-SLP N 0C GERALD GRUEN PHD N 0C TULIP TREE FAMILY HEALTH CENTER N 0C KALEIDOSCOPE LLC N 0C JEFFERY HUTTINGER PSYD. N 0C THE CONSULTING CENTER- DR KAY ROY N 0C MICHAEL SCHERBINSKI PHD N 0C ABRAMS EYE CARE ASSOCIATES (C) N 0C ABRAMS EYE CARE ASSOCIATES (DT) N 0C ABRAMS EYE CARE ASSOCIATES (I-WEST) N 0C MATTHEW GRANT, PSYD N 0C COMMUNITY HOSPITAL OF BREMEN N 0C NORTHEAST INTERNAL MEDICINE (LAGRANGE) N 0C NORTHEAST INTERNAL MEDICINE(KENDALLVILLE) N 0C NORTHEAST INTERNAL MEDICINE (TET-L) N 0C NORTHEAST INTERNAL MEDICINE (TET-K) N 0C NORTHEAST INTERNAL MEDICINE (PFT LAGRANGE) N 0C NORTHEAST INTERNAL MEDICINE (XRAYS L) N 0C NORTHEAST INTERNAL MEDICINE (L-DOPP) N 0C NORTHEAST INTERNAL MEDICINE(K-DOPP) N 0C AMANDA MAYLE PHD N 0C DAVIESS COMMUNITY HOSPITAL N 0C E. ANN MILLER PH. D. HSPP N 0C IRA YOUNGER MD (BATESVILLE) N 0C IRA YOUNGER MD (LAWRENCEBURG) N 0C PRIMARY CARE CENTER N 0C PRIMARY CARE CENTER (LABS ONLY) N 0C PRIMARY CARE CENTER(ECHOS/PFS/DLCO) N 0C HEALTHPLEX (LABS/XRAYS ONLY) N 0C KRISTIN MCGOVERN PHD N 0C AMBER WHITED, PH.D. N 0C YUICHUNG CHAN, PHD N 0C DEBORAH J. MILLER, PHD N 0C SHRIDHAR VENTRAPRAGADA MD N 0C DR GEISSLERS HEARING CENTER N 0C MEMORIAL HOSPITAL(LABS & PFS) N 0C MEMORIAL HOSPITAL - AUDIOLOGY DEPT N 0C MEMORIAL HOSPITAL (CARDIAC) N 0C MERIDIAN DIAGNOSTIC (PFS/DLCO) N 0C MERIDIAN DIAGNOSTIC (ECHOS) N 0C MERIDIAN DIAGNOSTIC (DOPPLERS) N 0C MERIDIAN DIAGNOSTIC (IME-1) N 0C MERIDIAN DIAGNOSTIC (X RAYS) N 0C MERIDIAN DIAGNOSTIC (INDY-LABS & LIMITED) N 0C MERIDIAN DIAGNOSTIC (NEW ALBANY) N 0C MERIDIAN DIAGNOSTIC (PFS-NEW ALBANY) N 0

(b) (6) (b) (6)

C MERIDIAN DIAGNOSTIC (X RAYS NA) N 0C IMAGING CENTER (XRAYS) N 0C WORKMED OCCUPATIONAL HEALTH N 0C WORKMED OCCUPATIONAL HEALTH (PFS) N 0C RIVERVIEW HOSPITAL (ECHOS) N 0C HANCOCK REGIONAL HOSPITAL N 0C HANCOCK REGIONAL HOSPITAL N 0C PARKWAY MEDICAL CENTER N 0C BEDFORD OUTPATIENT THERAPY N 0C JEFFREY NICHOLS MD N 0C DDJ MEDICAL INC N 0C DDJ MEDICAL INC (LABS/LIMITEDS) N 0C MICHELE THORNE PHD (AUSTIN) N 0C MICHELE THORNE PHD (INDY) N 0C THUY "AVA" LE (TESTING ONLY) N 0C FORT WAYNE NEUROLOGICAL CTR (ADULTS) N 0C THE JEAN CLINIC,LLC N 0C THE JEAN CLINIC,LLC (ANDERSON) N 0C THE JEAN CLINIC,LLC (A-LIMITED) N 0C THE JEAN CLINIC,LLC INDY -PFS N 0C THE JEAN CLINIC,LLC PFS -A N 0C THE JEAN CLINIC, LLC (FORT WAYNE) N 0C THE JEAN CLINIC, LLC (FW-LIMITED) N 0C THE JEAN CLINIC, LLC PFS-FW N 0C MELISSA UMALI, PSY.D.(E) N 0C THOMAS E. HOLSWORTH, PH.D., HSPP N 0C WITHAM HEALTH SERVICES (ECHOS) N 0C WITHAM HEALTH SERVICES (LABS) N 0C WITHAM HEALTH SERVICES (XRAYS) N 0C WITHAM HEALTH SERVICES (PFS/DLCO) N 0C ADVANCED CARDIOVASCULAR INSTITUTE (ECHO/TET) N 0C ADVANCED CARDIOVASCULAR INSTITUTE (DOPPLERS) N 0C SOUND HEARING SOLUTIONS N 0C BURGETT EYE CARE N 0C DOCTORS HEARING CARE N 0C THE HEARING CLINIC N 0C BALL STATE UNIVERSITY AUDIOLOGY CLINIC N 0C EVANSVILLE HEART CENTER (ECHOS) N 0C BHARAT PITHADIA M.D. N 0C ST JOSEPH REGIONAL - PLYMOUTH (PFS) N 0C ST JOSEPH REGIONAL - PLYMOUTH (XR) N 0C ST JOSEPH REGIONAL - PLYMOUTH (MUGA) N 0C ST JOSEPH REGIONAL - PLYMOUTH (LABS/EKG) N 0C JARED OUTCALT, PH.D. N 0C KATHRYN HULS, PSY.D. N 0C HEATH FERVIDA PSYD (WARSAW) N 0C ANN CAROL SINGLER, PH.D. N 0C PAUL KEVIN BOLINSKEY, PH.D., HSPP N 0C DUNCAN PSYCHOLOGICAL SERVICES (WASH) N 0C DUNCAN PSYCHOLOGICAL SERVICES (VIN) N 0C PROVIDENCE MEDICAL GROUP (ECHOS) N 0C ST MARY MEDICAL CENTER (XRAY) N 0C ST MARY MEDICAL CENTER (PULM) N 0C VALPARAISO HEALTH CENTER OF ST MARY MEDICAL CTR N 0C VALPARAISO HEALTH CENTER OF ST MARY MEDICAL CTR N 0C ERIN KENNEDY, PH.D. N 0C INDIANA EAR(SB) N 0C INDIANA EAR (FW) N 0C ANDREW MILLER, PSY.D. (FW) N 0C KURT JACOBS, D.O. N 0C KURT JACOBS, D.O. (PFS & LIMITED) N 0C KURT JACOBS, D.O.(MADISON) N 0C KURT JACOBS, D.O. MADISON (PFS & LIMITED) N 0C ERIC GUDAN, PSY.D. N 0

(b) (6) (b) (6)

C PAUL LYSAKER, PH.D. N 0C STEVEN L MARLOW, PH.D. N 0C UNION ASSOCIATED PHYSICIANS CLINIC LLC N 0C CARMEL NEUROPSYCHOLOGY SERVICES N 0C AMY MEYER, PSY.D.(CON) N 0C AMY MEYER, PSY.D.(GR) N 0C RESOLUTIONS PSYCHOLOGICAL SERVICES N 0C JOHN CADWALLADER, PSY.D. N 0C CARA PRATT, MA (TX ONLY) N 0C DLH COUNSELING AND CONSULTING LLC N 0C NORTH CENTRAL CARDIOVASCULAR SPECIALISTS N 0C OPHTHALMOLOGY CONSULTANTS OF FT WAYNE N 0C OPHTHALMOLOGY CONSULTANTS OF FT WAYNE (OPT) N 0C SIRA IMAGING CENTER LLC N 0C BUSINESS HEALTH PLUS N 0C BUSINESS HEALTH PLUS (PFS/XRAY) N 0C RACHEL SCHALLER, CCC-SLP N 0C RACHEL SCHALLER, CCC-SLP (MARION) N 0C WELLCARE (INDY) N 0C WELLCARE (INDY-/PFS-LIMITED) N 0C WELLCARE (LAF) N 0C WELLCARE (LAF-PFS/X-RAYS, LIMITED) N 0C WELLCARE (EVANSVILLE) N 0C WELLCARE (E-PFS/X-RAY-LIMITED) N 0C DECATUR CO MEM HOSPITAL (PUL) N 0C INDEPENDENT DISABILITY EXAMINERS & ASSOCIATES (MU) N 0C INDEPENDENT DISABILITY EXAMINERS & ASSOC(MU-PFS) N 0C IDEA (MARION) N 0C IDEA (MARION-PFS) N 0C IDEA (FT WAYNE) N 0C IDEA (FW-PFS) N 0C BRENDA F. HARRIS, SLP N 0C MACHA FAMILY EYE CARE, PC N 0C FOUNTAIN SQUARE EYE CARE N 0C MATTHEW HARKIN OD N 0C EYEWORKS N 0C GREGORY L. WILSON, O.D. N 0C HARMONY EYECARE N 0C GAILMARD EYE CENTER N 0C DAN R HOST, O.D. N 0C LONGE VISION CENTER N 0C MIDWEST EYE CONSULTANTS (K) N 0C ABOITE FAMILY EYECARE CENTER N 0C CHARLES H. RUTAN OD N 0C CHARLES H. RUTAN OD (TERRE HAUTE) N 0C THE EYE PLACE, INC. N 0C MOSES EYECARE CENTERS (G) N 0C MOSES EYECARE CENTERS (M) N 0C YOUR FAMILY & HEART CARE CENTER N 0C YOUR FAMILY & HEART CARE CENTER N 0C FOCUS AUDIOLOGY & HEARING SVCES N 0C GREGORY M. FRENCH, M.D. N 0C GREGORY M. FRENCH, M.D. N 0C ROBBI CRAIN, PSY.D., HSPP N 0C JESSICA NEUKAM-HELMS PSY.D N 0C OWENS OPTOMETRY, INC. N 0C DR SORAJ ARORA N 0C DR SORAJ ARORA (PFS/ANCILLARIES) N 0C DR SORAJ ARORA (ECHOS) N 0C SHELEY THERAPY SERVICES N 0C CRAIG FENIMORE, O.D. N 0C MICHAEL D. PISANO, PH.D. (I-DT) N 0C ST MARYS MEDICAL CENTER (E-XRAY/LABS) N 0C ST MARYS MEDICAL CENTER (E-PUL) N 0

(b) (6) (b) (6)

C ST MARYS MEDICAL CENTER (E-ABG) N 0C PURDUE UNIVERSITY AUDIOLOGY CLINIC N 0C EASTER SEALS REHABILITATION CENTER N 0C DAVID FINGERHUT, PH.D. (AUSTIN) N 0C DAVID FINGERHUT, PH.D. (INDY) N 0C CRAIG S. CABEZAS, PH.D. N 0C CRAIG S. CABEZAS, PH.D. N 0C ELIZABETH S. RAYL, PH.D. N 0C DR ARTHUR KUPERSMITH N 0C JESSICA HUETT, PSY.D. N 0C JENNIFER M HATFIELD, SLP (VALPO) N 0C JENNIFER M HATFIELD, SLP (M) N 0C JENNIFER M HATFIELD, SLP (E) N 0C JOHN A CONSTANTINE PHD HSPP N 0C LYNETTE SCHULTZ, PSY.D. (GARY) N 0C COMMUNICATION AND READING EXCELLENCE, PC N 0C ERICKA SWANSON, PSY.D. N 0C 180 MEDICAL IMAGING, LLC N 0C FOCUS EYE CARE CENTER N 0C MELISSA SPRINKLE, PSY.D. N 0C CHAD EDWARDS, PH.D., HSPP N 0C TRI-STATE OCCUPATIONAL (SCOTTSBURG) N 0C TRI-STATE OCCUPATIONAL (SCOTTSBURG-PFS) N 0C PRO MEDICAL MIDWEST (BLOOMINGTON) N 0C PRO MEDICAL MIDWEST (LAWRENCEBURG) N 0C PRO MEDICAL MIDWEST (TH) N 0C DR. ALAN STAGE N 0C KIMBERLY M MARTIN PSYD N 0C REVATHI BINGI PHD N 0C RUTH REEVES, PSY.D. N 0C INTERACTIVE SCHOOL THERAPY LLC N 0C ASSC PHYSICIANS OF IN (C) N 0C ASSOC. PHYSICIANS OF IN (C-PFS/XRAY) N 0C ASSOC. PHYSICIANS OF IN (G) N 0C ASSOC. PHYSICIANS OF IN (G-XRAY) N 0C NEIL WATKINS M.D. N 0C JAMILA PERRY RICHMOND, MA, CCC-SLP N 0C JODEE GRAHAM SLP-CCC-M.S N 0C PROFESSIONAL INTERPRETERS FOR THE DEAF N 0C DEAF COMMUNITY SERVICES N 0C DEAF SERVICES, INC. N 0C LUNA LANGUAGE SERVICES N 0

(b) (6) (b) (6)

CARDIOLOGISTSNAME ADDR1 CITY ST ZIP AREA EX NUMBGENESIS HEALTH GROUP 1520 W 53RD ST STE 1 DAVENPORT IA 52806 563 421 4900DIAGNOSTIC SERVICES 1200 PLEASANT ST E 318 DES MOINES IA 50309 515 241 6111MERCY MEDICAL CENTER - NORTH IOWA 1000 4TH ST SW MASON CITY IA 50401 641 428 7000CARDIOVASCULAR ASSOCIATES 2720 STONE PARK BLVD STE 110 SIOUX CITY IA 51104 712 239 4702

GENERAL PRACTITIONEERSNAME ADDR1 CITY ST ZIP AREA EX NUMBBURLINGTON NEUROLOGY & SLEEP CLINIC 6580 165ST ALBIA IA 52531 319 754 4400KOSSUTH REGIONAL HEALTH CENTER/CLINIC 1515 S PHILLIPS ST ALGONA IA 50511 515 295 7714ALAN SCHER MD ALGONA IA 50511 515 295 3761ANKENY WALK IN CLINIC 225 SE ORALABOR RD STE 3 ANKENY IA 50023 515 964 1340MEDIX OCCUPATIONAL HEALTH 1824 SW WHITE BIRCH CIR ANKENY IA 50023 515 964 9003ANTHON MERCY MEDICAL CLINIC 307 E MAIN ST ANTHON IA 51004 712 373 5711MEDIX OCCUPATIONAL HEALTH 886 TANGLEFOOT LN BETTENDORF IA 52722 515 964 9903BROOKLYN MEDICAL CLINIC 128 JACKSON ST BROOKLYN IA 52211 641 522 7221BRIAN ALLEN DO CEDAR FALLS IA 50613 507 450 995MERCY CARE MEDICAL DISTRICT 600 7TH ST SE STE 100 CEDAR RAPIDS IA 52401 319 363 2929MEDIX OCCUPATIONAL HEALTH 1520 MIDLAND CT NE STE 200 CEDAR RAPIDS IA 52402 515 964 9003VAL O LYONS MD CHARLES CITY IA 50616 641 257 4309LEE MERRITT MD CHARLES CITY IA 50616 641 257 4309CHARLES CITY FAMILY HEALTH CENTER 1501 S MAIN STE 1 CHARLES CITY IA 50616 641 228 5151MILLER ORTHOPAEDIC AFFILIATES ONE EDMUNDSON PLACE STE 500 COUNCIL BLUFFS IA 51503 712 323 5333QUAD CITY OCCUPTATIONAL HEALTH 1820 W 3RD ST DAVENPORT IA 52802 563 322 2103GENESIS HEALTH GROUP 1520 W 53RD ST STE 1 DAVENPORT IA 52806 563 421 4900GUNDERSEN CLINIC LTD 1830 STATE HWY 9 DECORAH IA 52101 563 382 3140CRAWFORD COUNTY CLINIC 1820 HIGHWAY 30 E DENISON IA 51442 712 263 6116DENISON FAMILY HEALTH 2540 N AVE DENISON IA 51442 712 263 3033BROADLAWNS GERIATRIC MEDICINE AND MEMORY CENTER 1801 HICKMAN RD DES MOINES IA 50314 515 282 5700IOWA ARTHRITIS CENTER 8421 PLUM DR DES MOINES IA 50322 515 270 7222FINLEY OCCUPATIONAL HEALTH 1665 EMBASSY WEST DR STE 200 DUBUQUE IA 52002 563 585 1290BURLINGTON NEUROLOGY & SLEEP CLINIC 2000 S MAIN FAIRFIELD IA 52556 319 754 4400MERCY FAMILY CLINIC - FOREST CITY 635 E US HIGHWAY 9 FOREST CITY IA 50436 641 585 2904BURLINGTON NEUROLOGY & SLEEP CLINIC 5409 AVE O STE 108 FORT MADISON IA 52627 319 754 4400BRET HEILESON MD HARLAN IA 51537 712 755 5130IDA GROVE FAMILY HEALTH CENTER 101 E 2ND ST IDA GROVE IA 51445 712 364 2300BURLINGTON NEUROLOGY & SLEEP CLINIC 1425 MORGAN ST KEOKUK IA 52632 319 754 4400BRIAN ALLEN DO LANCASTER WI 53813 507 450 995MAQUOKETA FAMILY CLINIC 206 N ARCADE MAQUOKETA IA 52060 563 652 6711MARSHALLTOWN ORTHOPEDICS 312 E MAIN ST STE 2400 MARSHALLTOWN IA 50158 641 752 7191BRIAN ALLEN DO 423 4TH ST SW STE A MASON CITY IA 50401 641 450 995MERCYCARE MONTICELLO 619 S MAIN ST MONTICELLO IA 52310 319 465 5937BURLINGTON NEUROLOGY & SLEEP CLINIC 407 S WHITE ST MOUNT PLEASANT IA 52641 319 754 4400UNITYPOINT OCCUPATIONAL MEDICINE 1616 CEDAR ST UPPER LEVEL MUSCATINE IA 52761 563 262 4120MIDTOWN MEDICAL GROUP 115 S 8TH ST NEBRASKA CITY NE 68410 402 558 1440MCFARLAND CLINIC - NEVADA 230 6TH ST NEVADA IA 50201 515 382 5471NEWTON CLINIC 300 N 4TH AVE E STE 200 NEWTON IA 50208 641 792 2112UI HEALTHWORKS 3 LIONS DR NORTH LIBERTY IA 52317 319 356 3335SAMUEL MOESSNER MD 1941 S 42ND ST STE 404 OMAHA NE 68105 402 206 5820MIDTOWN MEDICAL GROUP 101 N 38TH AVE OMAHA NE 68131 402 558 1440MAHASKA HEALTH PARTNERSHIP 410 N 12TH ST OSKALOOSA IA 52577 641 672 2090BURLINGTON NEUROLOGY & SLEEP CLINIC 1207 N JEFFERSON ST OTTUMWA IA 52501 319 754 4400JACK BRINDLEY MD 15260 TRUMAN ST STE 4 OTTUMWA IA 52501 641 680 660PELLA REGIONAL HEALTH CLINIC 920 N QUINCY ST OTTUMWA IA 52501 641 455 5206PAULLINA FAMILY MEDICINE CLINIC 108 E GROESBECK ST PAULLINA IA 51046 712 448 2126COUNTRYSIDE MEDICAL CLINIC LLC 1959 200TH ST RED OAK IA 51566 712 629 40DOUGLAS MARTIN MD SIOUX CITY IA 51109 712 224 4300CENTER FOR FAMILY MEDICINE 1115 E 20TH ST SIOUX FALLS SD 57105 605 575 1633MIDTOWN MEDICAL GROUP 3900 DAKOTA AVE STE 5 SOUTH SIOUX CITY NE 68776 402 558 1440BRIAN ALLEN DO SPIRIT LAKE IA 51301 507 450 995UNITYPOINT BUENA VISTA CLINIC 620 NORTHWESTERN DR STORM LAKE IA 50588 712 732 5030SUTHERLAND MERCY MEDICAL CLINIC 108 W 2ND ST SUTHERLAND IA 51058 712 446 2567VILLISCA FAMILY HEALTH CENTER 309 S 5TH AVE VILLISCA IA 50864 712 826 3003NORTHEAST IOWA FAMILY PRACTICE CENTER 2055 KIMBALL AVE WATERLOO IA 50702 319 272 2112JOSEPH LATELLA DO WEBSTER CITY IA 50595 515 832 2911BURLINGTON NEUROLOGY & SLEEP CLINIC 1225 S GEAR AVE STE 153 WEST BURLINGTON IA 52655 319 754 4400BARAZANJI FAMILY MEDICAL CLINIC 1701 22ND ST WEST DES MOINES IA 50266 515 440 6622BASIL HASSAN MD 230 S 68TH ST STE 1203 WEST DES MOINES IA 50266 515 471 1800MERCY OCCUPATIONAL HEALTH 1055 JORDAN CREEK PKWY STE 100 WEST DES MOINES IA 50266 515 358 5950MADISON COUNTY MEDICAL ASSOCIATES 60 E COURT AVE WINTERSET IA 50273 515 462 1162

LABNAME ADDR1 CITY ST ZIP AREA EX NUMBBURLINGTON NEUROLOGY & SLEEP CLINIC 6580 165ST ALBIA IA 52531 319 754 4400KOSSUTH REGIONAL HEALTH CENTER/CLINIC 1515 S PHILLIPS ST ALGONA IA 50511 515 295 7714MEDIX OCCUPATIONAL HEALTH 1824 SW WHITE BIRCH CIR ANKENY IA 50023 515 964 9003ANTHON MERCY MEDICAL CLINIC 307 E MAIN ST ANTHON IA 51004 712 373 5711MEDIX OCCUPATIONAL HEALTH 886 TANGLEFOOT LN BETTENDORF IA 52722 515 964 9903ST ANTHONY REGIONAL HOSPITAL 311 S CLARK ST CARROLL IA 51401 712 792 3581SARTORI MEMORIAL HOSPITAL 515 COLLEGE ST CEDAR FALLS IA 50613 319 268 3000

State of Iowa DDS - 2017 Consultative Examination Providers

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

MERCY CARE SECOND AVENUE 1444 2ND AVE SE CEDAR RAPIDS IA 52403 319 363 2929WELAND CLINICAL LABORATORIES 1911 1ST AVE SE CEDAR RAPIDS IA 52406 319 366 1503ST LUKES HOSPITAL 1026 A AVE NE CEDAR RAPIDS IA 52406 319 369 7211ST LUKES HOSPITAL 1026 A AVE NE CEDAR RAPIDS IA 52406 319 369 8129MEDIX OCCUPATIONAL HEALTH 1520 MIDLAND CT NE STE 200 CEDAR RAPIDS IA 52402 515 964 9003MERCY MEDICAL CENTER 1 SAINT JOSEPH DR CENTERVILLE IA 52544 641 437 4111MERCY MEDICAL CENTER 19876 SAINT JOSEPH DR CENTERVILLE IA 52544 641 856 8684CHEROKEE REGIONAL MEDICAL CENTER 300 SIOUX VALLEY DR CHEROKEE IA 51012 712 225 5101CLARINDA REGIONAL HEALTH CENTER 17TH & WELLS ST CLARINDA IA 51632 712 542 2176ALEGENT HEALTH MERCY HOSPITAL 603 ROSARY DR CORNING IA 50841 641 322 3121WAYNE COUNTY HOSPITAL 417 S EAST ST CORYDON IA 50060 641 872 2260JENNIE EDMUNDSON MEMORIAL HOSPITAL 933 E PIERCE ST COUNCIL BLUFFS IA 51503 712 396 7600MERCY HOSPITAL - VASCULAR LAB 800 MERCY DR COUNCIL BLUFFS IA 51502 712 328 5000GENESIS HEALTH GROUP 1520 W 53RD ST STE 1 DAVENPORT IA 52806 563 421 4900GENESIS MEDICAL CENTER 1401 W CENTRAL PARK AVE DAVENPORT IA 52804 563 421 3200GUNDERSEN CLINIC LTD 1830 STATE HWY 9 DECORAH IA 52101 563 382 3140CRAWFORD COUNTY MEMORIAL HOSPITAL 100 MEDICAL PKWY DENISON IA 51442 712 265 2667CRAWFORD COUNTY CLINIC 1820 HIGHWAY 30 E DENISON IA 51442 712 263 6116MERCY PEDIATRIC CLINIC 330 LAUREL ST STE 2100 DES MOINES IA 50306 515 643 8611DIAGNOSTIC SERVICES 1200 PLEASANT ST E 318 DES MOINES IA 50309 515 241 6111FINLEY HOSPITAL (RESPIRATORY) 350 N GRANDVIEW AVE DUBUQUE IA 52001 563 557 2787CENTRAL COMMUNITY HOSPITAL 901 DAVIDSON ST NW ELKADER IA 52043 563 245 7000BURLINGTON NEUROLOGY & SLEEP CLINIC 2000 S MAIN FAIRFIELD IA 52556 319 754 4400MERCY FAMILY CLINIC - FOREST CITY 635 E US HIGHWAY 9 FOREST CITY IA 50436 641 585 2904GUTHRIE COUNTY HOSPITAL 710 N 12TH ST GUTHRIE CENTER IA 50115 641 332 2201MYRTUE MEMORIAL HOSPITAL 1213 GARFIELD AVE HARLAN IA 51537 712 755 5161IDA GROVE FAMILY HEALTH CENTER 101 E 2ND ST IDA GROVE IA 51445 712 364 2300ENT MEDICAL SERVICES 2615 NORTHGATE DR IOWA CITY IA 52245 319 351 5680MERCY HOSPITAL - IOWA CITY 500 E MARKET ST IOWA CITY IA 52245 319 339 300KNOXVILLE AREA COMMUNITY HOSPITAL 1002 S LINCOLN KNOXVILLE IA 50138 641 842 2151FLOYD VALLEY HOSPITAL 714 LINCOLN ST NE LEMARS IA 51031 712 546 3394MAQUOKETA FAMILY CLINIC 206 N ARCADE MAQUOKETA IA 52060 563 652 6711MARSHALLTOWN MEDICAL & SURGICAL CENTER 3 S 4TH AVE MARSHALLTOWN IA 50158 641 754 5056MERCY MEDICAL CENTER - NORTH IOWA 1000 4TH ST SW MASON CITY IA 50401 641 428 7000MERCYCARE MONTICELLO 619 S MAIN ST MONTICELLO IA 52310 319 465 5937BURLINGTON NEUROLOGY & SLEEP CLINIC 407 S WHITE ST MOUNT PLEASANT IA 52641 319 754 4400HENRY COUNTY HEALTH CENTER 407 S WHITE ST MOUNT PLEASANT IA 52641 319 385 3141UNITYPOINT TRINITY HOSPITAL - MUSCATINE 1518 MULBERRY AVE MUSCATINE IA 52761 563 264 9100MCFARLAND CLINIC - NEVADA 230 6TH ST NEVADA IA 50201 515 382 5471SKIFF MEDICAL CENTER 204 N 4TH AVE E NEWTON IA 50208 641 791 4310MERCY HOSPITAL OF FRANCISCAN SISTERS 201 8TH AVE SE OELWEIN IA 50662 319 283 6000MIDTOWN MEDICAL GROUP 101 N 38TH AVE OMAHA NE 68131 402 558 1440BURGESS HEALTH CENTER 1600 DIAMOND ST ONAWA IA 51040 712 423 2311MAHASKA HEALTH PARTNERSHIP 410 N 12TH ST OSKALOOSA IA 52577 641 672 2090MAHASKA COUNTY HOSPITAL 1229 C AVE E OSKALOOSA IA 52577 641 673 3431BURLINGTON NEUROLOGY & SLEEP CLINIC 1207 N JEFFERSON ST OTTUMWA IA 52501 319 754 4400PELLA REGIONAL HEALTH CLINIC 920 N QUINCY ST OTTUMWA IA 52501 641 455 5206PAULLINA FAMILY MEDICINE CLINIC 108 E GROESBECK ST PAULLINA IA 51046 712 448 2126PELLA REGIONAL HEALTH CENTER 404 JEFFERSON ST PELLA IA 50219 641 628 3150HEGG MEMORIAL HEALTH CENTER 1202 21ST AVE ROCK VALLEY IA 51247 712 476 8000SHENANDOAH MEDICAL CENTER 300 PERSHING AVE SHENANDOAH IA 51601 712 246 7211SIOUX CENTER COMMUNITY HOSPITAL 1101 9TH ST SE SIOUX CENTER IA 51250 712 722 1271ST LUKES REGIONAL MEDICAL CENTER 2720 STONE PARK BLVD SIOUX CITY IA 51104 712 279 7979MERCY MEDICAL CENTER 801 5TH ST SIOUX CITY IA 51101 800 284 7231CARDIOVASCULAR ASSOCIATES 2720 STONE PARK BLVD STE 110 SIOUX CITY IA 51104 712 239 4702DOUGLAS MARTIN MD SIOUX CITY IA 51109 712 224 4300PRAIRIE PEDIATRIC & ADOLESCENT CLINIC 1125 PIERCE ST SIOUX CITY IA 51105 712 255 8901CENTER FOR FAMILY MEDICINE 1115 E 20TH ST SIOUX FALLS SD 57105 605 575 1633BUENA VISTA REGIONAL MEDICAL CENTER 1525 W 5TH ST STORM LAKE IA 50588 712 732 4030UNITYPOINT BUENA VISTA CLINIC 620 NORTHWESTERN DR STORM LAKE IA 50588 712 732 5030SUTHERLAND MERCY MEDICAL CLINIC 108 W 2ND ST SUTHERLAND IA 51058 712 446 2567VILLISCA FAMILY HEALTH CENTER 309 S 5TH AVE VILLISCA IA 50864 712 826 3003COVENANT MEDICAL CENTER 3421 W 9TH ST WATERLOO IA 50702 319 272 8000ALLEN MEMORIAL HOSPITAL 1825 LOGAN AVE WATERLOO IA 50702 319 235 5100NORTHEAST IOWA FAMILY PRACTICE CENTER 2055 KIMBALL AVE WATERLOO IA 50702 319 272 2112JOSEPH LATELLA DO WEBSTER CITY IA 50595 515 832 2911GREAT RIVER MED CENTER 1221 S GEAR AVE WEST BURLINGTON IA 52655 319 768 3590BARAZANJI FAMILY MEDICAL CLINIC 1701 22ND ST WEST DES MOINES IA 50266 515 440 6622BASIL HASSAN MD 230 S 68TH ST STE 1203 WEST DES MOINES IA 50266 515 471 1800MADISON COUNTY MEDICAL ASSOCIATES 60 E COURT AVE WINTERSET IA 50273 515 462 1162

NEUROLOGISTSNAME ADDR1 CITY ST ZIP AREA EX NUMBBURLINGTON NEUROLOGY & SLEEP CLINIC 6580 165ST ALBIA IA 52531 319 754 4400RUAN NEUROLOGY - EAST TOWER 1111 6TH AVE E TOWER STE A100 DES MOINES IA 50314 515 358 11BURLINGTON NEUROLOGY & SLEEP CLINIC 2000 S MAIN FAIRFIELD IA 52556 319 754 4400BURLINGTON NEUROLOGY & SLEEP CLINIC 5409 AVE O STE 108 FORT MADISON IA 52627 319 754 4400BURLINGTON NEUROLOGY & SLEEP CLINIC 1425 MORGAN ST KEOKUK IA 52632 319 754 4400BURLINGTON NEUROLOGY & SLEEP CLINIC 407 S WHITE ST MOUNT PLEASANT IA 52641 319 754 4400GOLDNER COOPER COTTON SUNDELL FRANEL 8901 W DODGE RD STE 210 OMAHA NE 68114 402 354 2000BURLINGTON NEUROLOGY & SLEEP CLINIC 1207 N JEFFERSON ST OTTUMWA IA 52501 319 754 4400BURLINGTON NEUROLOGY & SLEEP CLINIC 1225 S GEAR AVE STE 153 WEST BURLINGTON IA 52655 319 754 4400

ORTHOPEDISTSNAME ADDR1 CITY ST ZIP AREA EX NUMB

(b) (6)

(b) (6)

MILLER ORTHOPAEDIC AFFILIATES ONE EDMUNDSON PLACE STE 500 COUNCIL BLUFFS IA 51503 712 323 5333MARSHALLTOWN ORTHOPEDICS 312 E MAIN ST STE 2400 MARSHALLTOWN IA 50158 641 752 7191

OTOLARYNGOLOGISTSNAME ADDR1 CITY ST ZIP AREA EX NUMBAUDIOLOGICAL SERVICES INC 712 SIMON AVE STE A CARROLL IA 51401 712 792 5933WELLENDORF ENT PC 405 S CLARK ST STE 215 CARROLL IA 51401 712 792 4368PHYSICIANS CLINIC OF IOWA - ENT 202 10TH ST SE CEDAR RAPIDS IA 52401 319 399 2022AUDIOLOGICAL SERVICES INC 1200 N 7TH ST CHARITON IA 50049 712 623 4802AUDIOLOGICAL SERVICES INC 319 W ADAMS CRESTON IA 50801 641 782 2494EAR NOSE & THROAT CONSULTANTS 101 TOWER RD STE 120 DAKOTA DUNES SD 57049 605 217 4320QUAD CITIES AUDIOLOGY CONSULTANTS 2215 E 52ND ST STE 2 DAVENPORT IA 52807 563 355 7712IOWA HEAD & NECK ASSOCIATES 3901 INGERSOLL AVE DES MOINES IA 50312 515 274 9136IOWA EAR CENTER 12499 UNIVERSITY AVE STE 200 DES MOINES IA 50325 515 418 9960DUBUQUE ENT 310 N GRANDVIEW AVE DUBUQUE IA 52001 563 588 506LEOPOLDO DELUCCA MD 804 S KENYON RD STE 200 FORT DODGE IA 50501 515 576 5000ENT MEDICAL SERVICES 2615 NORTHGATE DR IOWA CITY IA 52245 319 351 5680UIH DEPARTMENT OF OTOLARYNGOLOGY 200 HAWKINS RD IOWA CITY IA 52242 319 384 8092CHILDSERVE CENTER 5406 MERLE HAY RD JOHNSTON IA 50131 515 727 1561WOLFE CLINIC - AUDIOLOGY 309 E CHURCH ST MARSHALLTOWN IA 50158 866 642 8142MASON CITY CLINIC - ENT 250 S CRESCENT DR MASON CITY IA 50401 641 494 5380AUDIOLOGY CONSULTANTS 3426 N PORT DR STE 500 MUSCATINE IA 52761 563 264 9406BOYSTOWN NATIONAL HOSPITAL 555 N 30TH ST OMAHA NE 68131 402 452 5059FAMILY EAR NOSE & THROAT CLINIC 6751 N 72ND ST STE 207 OMAHA NE 68122 402 572 3165VISION CARE CLINIC 721 10TH ST ONAWA IA 51040 712 423 2737MOORE HEARING CLINIC 1317 N COURT ST OTTUMWA IA 52501 641 683 3277NORTHWEST IOWA EAR NOSE & THROAT 920 N GRAND AVE SPENCER IA 51301 712 262 8120ANN SPRINGER SPEECH THERAPIST WATERLOO IA 50702 319 235 5100BLACK HAWK HEARING AID CENTER 3138 KIMBALL AVE WATERLOO IA 50702 319 234 4360COVENANT CLINIC - ENT CENTER 2710 ST FRANCIS DR STE 411 WATERLOO IA 50702 319 272 5805GREAT RIVER MED CT SCHEDULING 1221 S GEAR AVE WEST BURLINGTON IA 52655 319 768 3590IOWA CLINIC ENT 5950 UNIVERSITY AVE STE 265 WEST DES MOINES IA 50266 515 875 9456

PEDIATRICIANSNAME ADDR1 CITY ST ZIP AREA EX NUMBMERCY PEDIATRIC CLINIC 330 LAUREL ST STE 2100 DES MOINES IA 50306 515 643 8611RIVER HILLS PEDIATRICS 931 PENNSYLVANIA AVE OTTUMWA IA 52501 641 684 3000PRAIRIE PEDIATRIC & ADOLESCENT CLINIC 1125 PIERCE ST SIOUX CITY IA 51105 712 255 8901JOSEPH LATELLA DO WEBSTER CITY IA 50595 515 832 2911

PHYSICAL THERAPISTS21ST CENTURY REHAB 612 8TH ST SW ALTOONA IA 50009 515 967 4124MARY GREELEY REHAB & WELLNESS 1015 DUFF AVE AMES IA 50010 515 239 6770MARY GREELEY REHAB & WELLNESS 1111 DUFF AVE AMES IA 50010 515 239 6770WAPSI PHYSICAL THERAPY 315 E MAIN ST ANAMOSA IA 52205 319 462 6882ATHLETICO PHYSICAL THERAPY 2525 N ANKENY BLVD STE 101 ANKENY IA 50021 515 965 4594EXCEL PHYSICAL THERAPY 309 N ANKENY BLVD STE 2 ANKENY IA 50021 515 964 2559MERCY NORTH PHYSICAL THERAPY 800 E 1ST ST STE W270 ANKENY IA 50021 515 643 7555AUDUBON COUNTY MEMORIAL HOSPITAL 515 PACIFIC AVE AUDUBON IA 50025 712 563 2611ATHLETICO PHYSICAL THERAPY 509 13TH ST STE B BELLE PLAINE IA 52208 319 434 6150GENESIS OUTPATIENT REHABILITATION 4710 DEVILS GLEN RD STE 100 BETTENDORF IA 52722 563 421 3460CAMANCHE PHYSICAL THERAPY 1427 S WASHINGTON BLVD CAMANCHE IA 52730 563 259 444021ST CENTURY REHAB 125 N 1ST ST CARLISLE IA 50047 515 989 100ST ANTHONY REGIONAL HOSPITAL 311 S CLARK ST CARROLL IA 51401 712 792 3581ATHLETICO PHYSICAL THERAPY 1710 W 1ST ST STE D CEDAR FALLS IA 50613 319 273 8988SARTORI MEMORIAL HOSPITAL 515 COLLEGE ST CEDAR FALLS IA 50613 319 272 2260ATHLETICO PHYSICAL THERAPY 3720 QUEEN CT SW STE 1 CEDAR RAPIDS IA 52404 319 364 300LINN COUNTY PHYSICAL THERAPY 1825 29TH ST NE STE C CEDAR RAPIDS IA 52402 319 362 6994MERCY PHYSICAL REHABILITATION 5264 COUNCIL ST NE CEDAR RAPIDS IA 52402 319 861 7778MERCY PHYSICAL REHABILITATION 701 10TH ST SE 4TH FLOOR CEDAR RAPIDS IA 52403 319 861 7778MERCY MEDICAL CENTER 1 SAINT JOSEPH DR CENTERVILLE IA 52544 641 437 4111TRESEMER PHYSICAL THERAPY 612 E FRANKLIN ST CENTERVILLE IA 52544 641 856 2515CHEROKEE REGIONAL MEDICAL CENTER 300 SIOUX VALLEY DR CHEROKEE IA 51012 712 225 5101SPORTS REHAB & PROFESSIONAL THERAPY ASSOC 1101 N 2ND ST STE 1 CHEROKEE IA 51012 712 225 3344ATHLETICO PHYSICAL THERAPY 7 S 8TH ST STE C CLEAR LAKE IA 50428 641 357 1003ADVANCED PHYSICAL THERAPY 404 S 1ST ST CLINTON IA 52732 563 243 4301MIDWEST PHYSICAL THERAPY 1647 LINCOLN WAY CLINTON IA 52732 563 242 2900ROCK VALLEY PHYSICAL THERAPY 2635 LINCOLN WAY STE C CLINTON IA 52372 563 243 8324HOPP PHYSICAL THERAPY 201 W BROADWAY COUNCIL BLUFFS IA 51503 712 329 9419GREATER REGIONAL MEDICAL CENTER 1700 W TOWNLINE ST CRESTON IA 50801 641 782 7091PHYSICAL THERAPY CENTER 1747 E 54TH ST DAVENPORT IA 52806 563 355 3867QUAD CITY PHYSICAL THERAPY & SPINE 5254 UTICA RIDGE RD DAVENPORT IA 52807 563 359 3799ROCK VALLEY PHYSICAL THERAPY 1700 DIVISION ST STE 200 DAVENPORT IA 52804 563 324 2263WINNESHIEK MEDICAL CENTER 901 MONTGOMERY ST DECORAH IA 52101 563 382 2911INTEGRATED PT & SPORTS MEDICINE 1515 LINDEN ST STE 101 DES MOINES IA 50309 515 288 569KINETIC EDGE PHYSICAL THERAPY 516 3RD ST STE 100 DES MOINES IA 50309 515 309 4706DUBUQUE PHYSICAL THERAPY 2300 JOHN F KENNEDY RD DUBUQUE IA 52002 563 588 3891PHYSICAL THERAPY SOLUTIONS 1129 11TH ST SE STE A DYERSVILLE IA 52040 563 875 8615SALVO PHYSICAL THERAPY 1158 EDGINGTON AVE ELDORA IA 50627 641 939 7311PALO ALTO COUNTY HOSPITAL 3201 W 1ST ST EMMETSBURG IA 50536 712 852 5500TRINITY REGIONAL MEDICAL CENTER 802 KENYON RD FORT DODGE IA 50501 515 574 690021ST CENTURY REHAB 270 SW 1ST ST STE H GRIMES IA 50111 515 986 9667ATHLETICO PHYSICAL THERAPY 1451 GATEWAY CIR STE 500 GRIMES IA 50111 515 986 5190MYRTUE MEMORIAL HOSPITAL 1213 GARFIELD AVE HARLAN IA 51537 712 755 5161

(b) (6)

(b) (6)

COMMUNITY HOSPITAL 1111 11TH ST HAWARDEN IA 51023 712 551 3100HUXLEY PHYSICAL THERAPY 408 CAMPUS DR STE B HUXLEY IA 50124 515 597 3726INDIANOLA PHYSICAL THERAPY 1507 N 1ST ST INDIANOLA IA 50125 515 961 7435PHYSIOTHERAPY ASSOCIATES 1555 S 1ST AVE IOWA CITY IA 52240 319 248 6800PROGRESSIVE REHABILITATION ASSOCIATES 540 E JEFFERSON ST STE 302 IOWA CITY IA 52245 319 339 3611HANSEN FAMILY HOSPITAL 920 S OAK ST IOWA FALLS IA 50126 641 648 7055GREENE COUNTY MEDICAL CENTER 1000 W LINCOLNWAY JEFFERSON IA 50129 515 386 2114VAN BUREN COUNTY HOSPITAL 304 FRANKLIN ST KEOSAUQUA IA 52565 319 293 3171KNOXVILLE AREA COMMUNITY HOSPITAL 1002 S LINCOLN KNOXVILLE IA 50138 641 842 2151LAKE MILLS PHYSICAL THERAPY 115 N MILL ST LAKE MILLS IA 50450 641 592 3500FLOYD VALLEY HOSPITAL 720 LINCOLN ST NE LEMARS IA 51031 712 546 7871LEMARS PHYSICAL THERAPY 789 HOLTON DR LEMARS IA 51031 712 546 1718DECATUR COUNTY HOSPITAL 1405 NW CHURCH ST LEON IA 50144 641 446 487121ST CENTURY REHAB 209 W 2ND ST MADRID IA 50156 515 795 2427MARION PHYSICAL THERAPY 999 44TH ST STE 10000 MARION IA 52302 319 373 7311SPORTSPLUS 32 E MAIN ST MARSHALLTOWN IA 50158 641 753 6636IOWA PHYSICAL THERAPY 820 W 1ST ST MONTICELLO IA 52310 319 465 4057INTEGRATED THERAPY SPECIALISTS PC 2109 CEDARWOOD DR STE 100 MUSCATINE IA 52761 563 288 6787ROCK VALLEY PHYSICAL THERAPY 3605 UNIVERSITY DR STE 2 MUSCATINE IA 52761 563 263 2639NASHUA CLINIC 80 AMHEARST BLVD STE 400 NASHUA IA 50658 641 435 4133TWENTY FIRST CENTURY REHAB 640 S 19TH ST NEVADA IA 50201 515 382 7008KINETIC EDGE PHYSICAL THERAPY 321 E 3RD ST N STE 200 NEWTON IA 50208 641 791 9675SKIFF MEDICAL CENTER 204 N 4TH AVE E NEWTON IA 50208 641 792 1273ATHLETICO PHYSICAL THERAPY 800 COLONIAL CIR STE 100 NORWALK IA 50211 515 953 1310MERCY HOSPITAL OF FRANCISCAN SISTERS 201 EIGHTH AVE SE OELWEIN IA 50662 319 283 6100ORANGE CITY PHYSICAL THERAPY 101 3RD ST NW ORANGE CITY IA 51041 712 707 5050CLARKE COUNTY HOSPITAL 800 S FILLMORE ST OSCEOLA IA 50213 641 342 2184PROFESSIONAL PHYSICAL THERAPY SERVICES 123 E JEFFERSON OSCEOLA IA 50213 641 341 1470KINETIC EDGE PHYSICAL THERAPY 1412 A AVE W STE A OSKALOOSA IA 52577 641 676 3535MAHASKA COUNTY HOSPITAL 1229 C AVE E OSKALOOSA IA 52577 641 672 3100OTTUMWA REGIONAL HEALTH CENTER 1001 PENNSYLVANIA AVE OTTUMWA IA 52501 641 684 3125SOUTHEAST IOWA PHYSICAL THERAPY SERVICES 115 S WASHINGTON ST OTTUMWA IA 52501 641 682 8171KINETIC EDGE PHYSICAL THERAPY 604 LIBERTY ST STE 227 PELLA IA 50219 641 621 230MONTGOMERY COUNTY MEMORIAL HOSPITAL 2301 EASTERN AVE RED OAK IA 51566 712 623 7000HEGG MEMORIAL HEALTH CENTER 1202 21ST AVE ROCK VALLEY IA 51247 712 476 8000DISEASE PREVENTION AND WELLNESS CENTER TWO JACK FOSTER DR SHENANDOAH IA 51601 712 246 1230SIOUX CITY PHYSICAL THERAPY 2802 CASTLES GATE DR SIOUX CITY IA 51106 712 266 707ST LUKES REHAB - RIVERSIDE CLINIC 4230 WAR EAGLE DR SIOUX CITY IA 51109 712 224 4330SPENCER MUNICIPAL HOSPITAL 1200 1ST AVE E SPENCER IA 51301 712 264 6189THOMAS PHYSICAL THERAPY PROFESSIONALS LLC 20 W 6TH ST STE 101 SPENCER IA 51301 712 580 5008OKOBOJI PHYSICAL THERAPY 1380 LAKE ST SPIRIT LAKE IA 51360 712 336 8404SPORTS REHAB & PHYSICAL THERAPY 315 W 5TH ST STORM LAKE IA 50588 712 732 7724MARY GREELEY REHAB & WELLNESS 812 ELM AVE STORY CITY IA 50248 515 733 5129PROGRESSIVE REHABILITATION ASSOCIATES 120 E 5TH ST TIPTON IA 52772 563 886 3421VIRGINIA GAY HOSPITAL 502 N 9TH AVE VINTON IA 52349 319 472 6372ALLEN MEMORIAL HOSPITAL 1825 LOGAN AVE WATERLOO IA 50703 319 235 5294COVENANT MEDICAL CENTER EDI 3421 W 9TH ST WATERLOO IA 50702 319 272 2260ROCK VALLEY PT 815 TOWER PARK DR WATERLOO IA 50701 319 233 6995TAYLOR PHYSICAL THERAPY 312 9TH ST SW WAVERLY IA 50677 319 352 5644VAN DIEST MEDICAL CENTER PO BOX 430 WEBSTER CITY IA 50595 515 832 7735CENTER FOR REHAB SERVICES 1401 W AGENCY RD WEST BURLINGTON IA 52655 319 768 4100ATHLETICO PHYSICAL THERAPY 800 S 50TH ST STE 103 WEST DES MOINES IA 50266 515 226 1616CORE PHYSICAL THERAPY 2001 WESTOWN PKWY STE 107 WEST DES MOINES IA 50265 515 440 3439PROGRESSIVE REHABILITATION ASSOCIATES 518 ELM ST WILLIAMSBURG IA 52361 319 668 9399

PSYCHIATRISTSNAME ADDR1 CITY ST ZIP AREA EX NUMBSOUTHWEST IOWA MENTAL HEALTH CENTER 1500 E 10TH ST ATLANTIC IA 50022 712 243 2606ALI SAFDAR MD CEDAR RAPIDS IA 52405 319 398 3562

PSYCHOLOGISTSNAME ADDR1 CITY ST ZIP AREA EX NUMBPLAINS AREA MENTAL HEALTH CENTER 109 W STATE ST ALGONA IA 50511 712 546 4624RAYMOND TIBE PSYD ALTOONA IA 50009 515 279 3266ARTHUR KONAR PHD PLC 511 DUFF AVE STE 100 AMES IA 50010 515 292 2703CENTRAL IOWA PSYCHOLOGICAL SERVICES 223 S WALNUT AVE AMES IA 50010 515 233 1122SOUTHWEST IOWA MENTAL HEALTH CENTER 1500 E 10TH ST ATLANTIC IA 50022 712 243 2606SARAH HERZBERG PHD 1500 E 10TH ST ATLANTIC IA 50022 712 250 8023REBECKA THOMPKINS PHD 1500 E 10TH ST ATLANTIC IA 50022 712 250 8023JOHN BIGELOW JR PSYD 1500 E 10TH ST ATLANTIC IA 50022 712 250 8023FAMILY COUNSELING & PSYCHOLOGY CENTER 2485 TECH DR BETTENDORF IA 52722 563 355 1611COLLIN LODICO PHD 2485 TECH DR BETTENDORF IA 52722 563 355 1611SUSAN WOOD EDD 2485 TECH DR BETTENDORF IA 52722 563 355 1611WILLIAM MARTIN JR PHD BOONE IA 50036 515 433 343PSYCHOLOGICAL CONSULTING & ASSESSMENT 1000 N ROOSEVELT AVE STE 7 BURLINGTON IA 52601 641 629 240TIMOTHY WAHL PHD 1000 N ROOSEVELT AVE BURLINGTON IA 52601 641 891 8970PLAINS AREA MENTAL HEALTH CENTER 318 S MAPLE ST STE 1 CARROLL IA 51401 712 546 4624CONDITT PSYCHOLOGICAL SERVICES 2412 WATERLOO RD CEDAR FALLS IA 50613 319 277 1020GREGORY HOTSENPILLER MD PHD 1730 1ST AVE NE CEDAR RAPIDS IA 52402 319 365 3993PAUL SUNDELL PHD 1730 1ST AVE NE CEDAR RAPIDS IA 52402 319 365 3993CARROLL ROLAND PHD 450 5TH AVE SE 2ND FLOOR CEDAR RAPIDS IA 52401 319 234 7481ROGER MRAZ PHD 4403 1ST AVE SE ROOM L15 CEDAR RAPIDS IA 52402 319 728 2419STEPHANIE ANTHONY PHD 373 COLLINS RD NE STE 203 CEDAR RAPIDS IA 52402 319 210 2820MICHELE MCNEAL 708 J AVE NE STE 205 CEDAR RAPIDS IA 52402 319 551 1556RANDALL WATKINS 708 J AVE NE STE 205 CEDAR RAPIDS IA 52402 319 430 7466

(b) (6)

(b) (6)

(b) (6)

ROBERT METZGER PSYD CEDAR RAPIDS IA 52402 319 297 3520MICHAEL MARCH PHD PLLC 700 16TH ST NE STE 201 CEDAR RAPIDS IA 52402 319 364 170NANNETT ROACH PHD CENTERVILLE IA 52544 641 676 3999LORNE JOHNSON PSYD CHARLES CITY IA 50616 641 228 6830PLAINS AREA MENTAL HEALTH CENTER 1231 WEST CEDAR LOOP CHEROKEE IA 51012 712 546 4624STEPHEN HOLBROOK PSYD 518 S 8TH ST STE 207 CLEAR LAKE IA 50428 641 357 272JOHN KERAUS PHD CLINTON IA 52732 563 243 5633JANET DREW PHD 215 6TH AVE S STE 25 CLINTON IA 52732 563 242 9210ROGER MRAZ PHD 205 E ACCESS RD STE D COLUMBUS JUNCTION IA 52738 319 728 2419ROSANNA JONES-THURMAN PHD 300 W BROADWAY STE 3 COUNCIL BLUFFS IA 51503 402 715 4321NICOLE BLAZEK PHD COUNCIL BLUFFS IA 51503 402 208 6315RUSSELL MOULTON MS CRESTON IA 50801 712 527 2845PATRICIA BLAKE PHD CRESTON IA 50801 402 769 2121PSYCHOLOGY ASSOCIATES LTD 4455 E 56TH ST DAVENPORT IA 52807 563 355 2577ROGER MRAZ PHD DAVENPORT IA 52804 319 728 2419PSYCHOLOGY HEALTH GROUP 2102 E 38TH ST DAVENPORT IA 52807 563 359 4049JOSEPH BREITENSTEIN PHD DECORAH IA 52101 563 419 4340JERALD CATRON PHD 3850 MERLE HAY RD STE 300 DES MOINES IA 50312 515 254 9009ROBERT STRAIGHT PHD 1000 73RD ST STE 5 DES MOINES IA 50324 515 222 1175PHILIP ASCHEMAN PHD 7177 HICKMAN RD STE 12 DES MOINES IA 50322 515 253 566PAUL ASCHEMAN PHD 7177 HICKMAN RD STE 12 DES MOINES IA 50322 515 253 566TIMOTHY WAHL PHD DES MOINES IA 50319 641 891 8970MARION HUETTNER PHD 1000 LANGWORTHY DUBUQUE IA 52001 563 584 3441MARTHA GOULD PHD 1000 LANGWORTHY DUBUQUE IA 52001 563 584 3441CARROLL ROLAND PHD DUBUQUE IA 52001 319 234 7481THOMAS ANDEREGG PHD 200 MERCY DR STE 200 DUBUQUE IA 52001 563 582 145MEDICAL ASSOCIATES CLINIC/PSYCH 200 MERCY DR STE 201 DUBUQUE IA 52001 563 584 3500DON JOHNSON PSY.D ESTHERVILLE IA 51334 712 362 4093PSYCHOLOGICAL CONSULTING & ASSESSMENT 112 S COURT FAIRFIELD IA 52556 641 629 240PLAINS AREA MENTAL HEALTH CENTER 723 1ST AVE S FORT DODGE IA 50501 712 546 4624DAN L ROGERS PHD 809 CENTRAL AVE STE 300 FORT DODGE IA 50501 515 955 8172MELANIE PORTER PSYD FORT DODGE IA 50501 515 955 7171TIMI JORDISON PHD 1728 CENTRAL AVE STE 14 FORT DODGE IA 50501 515 573 3628JAMES CHESNUTT PSYD 809 CENTRAL AVE STE 300 FORT DODGE IA 50501 515 955 3029RUSSELL MOULTON MS GLENWOOD IA 51534 712 527 2845BRIAN STEINER PHD 821 5TH AVE STE 403 GRINNELL IA 50112 641 844 1200DAVIS PSYCHOLOGICAL SERVICES 1104 5TH AVE GRINNELL IA 50112 641 236 632ROSANNA JONES-THURMAN PHD HARLAN IA 51537 402 715 4321PLAINS AREA MENTAL HEALTH CENTER 700 E 2ND ST STE 2 IDA GROVE IA 50588 712 546 4624COUNSELING & ASSESSMENT SERVICE 515 2ND ST NE INDEPENDENCE IA 50644 319 334 6820GEORGE HARPER PHD 515 2ND ST NE INDEPENDENCE IA 50644 319 334 6820SETH BROWN PHD 515 2ND ST NE INDEPENDENCE IA 50644 319 334 6820SEASHORE PSYCHOLOGY CLINIC 328 IOWA AVE IOWA CITY IA 52242 319 335 2467DAVID JOHNSON PHD IOWA CITY IA 52245 319 337 6998RANDALL WATKINS IOWA CITY IA 52240 319 430 7466MARVIN DENBURG PHD 3030 NORTHGATE DR STE E IOWA CITY IA 52245 319 337 6483KATHLEEN KIKENDALL PHD 220 LAFAYETTE ST STE 128 IOWA CITY IA 52240 319 354 8057DENNIS HARPER PHD IOWA CITY IA 52245 319 351 7542PATRICK EWING MS KEOKUK IA 52632 319 524 510TIMOTHY WAHL PHD KNOXVILLE IA 50138 641 891 8970PLAINS AREA MENTAL HEALTH CENTER 180 10TH ST SE STE 201 LEMARS IA 51031 712 546 4624PLAINS AREA MENTAL HEALTH CENTER 180 10TH ST SE STE 201 LEMARS IA 51031 712 546 4624MENTAL HEALTH ASSOCIATES 650 J ST STE 403 LINCOLN NE 68508 402 435 1313CENTER ASSOCIATES 9 N 4TH AVE MARSHALLTOWN IA 50158 641 752 1585BRIAN STEINER PHD 16 E MAIN ST STE 200 MARSHALLTOWN IA 50158 641 844 1200CARROLL ROLAND PHD 103 E STATE ST RM 406 FL 4 MASON CITY IA 50401 319 234 7481JACKIE JIANG COUNSELING AND EVALUATION 3816 27TH ST MOLINE IL 61256 309 944 7833TIMOTHY WAHL PHD MUSCATINE COMMUNITY COLLEGE MUSCATINE IA 52761 319 728 2419MIDTOWN MEDICAL GROUP 115 S 8TH ST NEBRASKA CITY NE 68410 402 558 1440BRIAN STEINER PHD NEVADA IA 50201 641 844 1200TIMOTHY WAHL PHD DMACC 600 N 2ND AVE W NEWTON IA 50208 641 629 240KEVIN KRUMVIEDA PHD NORTH LIBERTY IA 52317 319 665 2137PSYCHOLOGICAL SERVICES 10506 BURT CIR OMAHA NE 68114 402 493 4444JOHN ENGLER PHD 10506 BURT CIR OMAHA NE 68114 402 493 4444EUGENE EGNOSKI PHD 10506 BURT CIR OMAHA NE 68114 402 493 4444MARY ANN STRIDER PHD 10506 BURT CIR OMAHA NE 68114 402 493 4444A JAMES FIX PHD 1941 S 42ND ST STE 404 OMAHA NE 68105 402 206 5820ROSANNA JONES-THURMAN PHD 6818 GROVER ST STE 305 OMAHA NE 68106 402 715 4321MIDTOWN MEDICAL GROUP 101 N 38TH AVE OMAHA NE 68131 402 558 1440AMY COREY PHD 440 REGENCY PKWY DR STE 230 OMAHA NE 68114 402 769 2121PATRICIA BLAKE PHD 440 REGENCY PKWY DR STE 230 OMAHA NE 68114 402 769 2121JAMES MATHISEN PSYD PC OMAHA NE 68137 402 590 2947TIMOTHY WAHL PHD OSCEOLA IA 50213 641 629 240PSYCHOLOGICAL CONSULTING & ASSESSMENT 1710 N MARKET ST OSKALOOSA IA 52577 641 629 240TIMOTHY WAHL PHD OSKALOOSA IA 52577 641 891 8970NANNETT ROACH PHD OSKALOOSA IA 52577 641 676 3999PSYCHOLOGICAL CONSULTING & ASSESSMENT 15260 TRUMAN ST STE 4 OTTUMWA IA 52501 641 629 240TIMOTHY WAHL PHD 15260 TRUMAN ST STE 4 OTTUMWA IA 52501 641 891 8970NANNETT ROACH PHD 15260 TRUMAN ST STE 4 OTTUMWA IA 52501 641 676 3999PSYCHOLOGICAL CONSULTING & ASSESSMENT 603 MAIN ST PELLA IA 50219 641 629 240RUSSELL MOULTON MS RED OAK IA 51566 712 527 2845LORI O'DELL MCCOLLUM PHD 2100 18TH AVE STE 6 ROCK ISLAND IL 61201 309 788 730DEREK GRIMMELL PHD 2100 18TH AVE STE 6 ROCK ISLAND IL 61201 309 788 730CREATIVE LIVING CENTER 1905 10TH ST ROCK VALLEY IA 51247 712 476 5245PLAINS AREA MENTAL HEALTH CENTER 105 N 18TH AVE SHELDON IA 51201 712 546 4624RUSSELL MOULTON MS SHENANDOAH IA 51601 712 527 2845MENTAL HEALTH ASSOCIATES 2212 PIERCE ST STE 100 SIOUX CITY IA 51104 712 255 8323

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

ASSOCIATES FOR PSYCH AND THERAPY SERVICES 1551 INDIAN HILLS DR STE 221 SIOUX CITY IA 51104 712 252 1473SUZANNE KEIZER PSYD 4301 SERGEANT RD STE 210 SIOUX CITY IA 51106 712 276 3296CROSSROADS PSYCHOLOGY CENTER 102 E MAIN ST SOLON IA 52333 319 359 6137MIDTOWN MEDICAL GROUP 3900 DAKOTA AVE STE 8 SOUTH SIOUX CITY NE 68776 402 558 1440CARROLL ROLAND PHD SPENCER IA 51301 319 234 7481PLAINS AREA MENTAL HEALTH CENTER 728 ERIE ST STORM LAKE IA 50588 712 546 4624CAL J SEDA PC URBANDALE IA 50322 515 270 1344EVA CHRISTIANSEN PHD URBANDALE IA 50322 515 274 4006CHARLENE BELL EDD 7177 HICKMAN RD STE 12 URBANDALE IA 50322 515 253 566ROGER MRAZ PHD WASHINGTON IA 52353 319 728 2419CARROLL ROLAND PHD WATERLOO IA 50701 319 234 7481JOHN WILLIAMS PHD WATERLOO IA 50701 319 232 2086CHRISTINE GUEVARA PHD 1425 W 5TH ST STE 1 WATERLOO IA 50702 319 883 9811CENTRAL IOWA PSYCHOLOGICAL SERVICES 3737 WOODLAND AVE STE 415 WEST DES MOINES IA 50266 515 222 1999RANDAL DAVID REYNOLDS PHD 4401 WESTOWN PKWY STE 309 WEST DES MOINES IA 50266 515 440 3804CATALINA D'ACHIARDI-RESSLER PHD 1045 76TH ST STE 3030 WEST DES MOINES IA 50266 515 777 3388

PULMONARY FUNCTION STUDIESCASS COUNTY MEMORIAL HOSPITAL 1501 E 10TH ST ATLANTIC IA 50022 712 243 7590MERCY MEDICAL CENTER 701 10TH ST SE CEDAR RAPIDS IA 52403 319 398 6011ST LUKES HOSPITAL 1026 A AVE NE CEDAR RAPIDS IA 52406 319 369 7211MERCY MEDICAL CENTER 1 SAINT JOSEPH DR CENTERVILLE IA 52544 641 437 4111MERCY MEDICAL CENTER - NORTH CAMPUS 1410 N 4TH ST CLINTON IA 52732 563 244 5722CHEST INFECTIOUS DISEASE & CRITICAL CARE ASSOC 1601 NW 114TH ST STE 347 CLIVE IA 50325 515 224 1777JENNIE EDMUNDSON MEMORIAL HOSPITAL 933 E PIERCE ST COUNCIL BLUFFS IA 51503 712 396 7600GREATER REGIONAL MEDICAL CENTER 1700 W TOWNLINE ST CRESTON IA 50801 641 782 3611GENESIS MEDICAL CENTER 1401 W CENTRAL PARK AVE DAVENPORT IA 52804 563 421 3200WINNESHIEK MEDICAL CENTER 901 MONTGOMERY ST DECORAH IA 52101 563 387 3035CRAWFORD COUNTY MEMORIAL HOSPITAL 100 MEDICAL PKWY DENISON IA 51442 712 265 2667FINLEY HOSPITAL (RESPIRATORY) 350 N GRANDVIEW AVE DUBUQUE IA 52001 563 557 2787UNITYPOINT TRINITY REGIONAL HOSPITAL 802 KENYON RD FORT DODGE IA 50501 515 574 6772COMMUNITY HOSPITAL 1111 11TH ST HAWARDEN IA 51023 712 551 3100MERCY HOSPITAL - IOWA CITY 500 E MARKET ST IOWA CITY IA 52245 319 339 300GREENE COUNTY MEDICAL CENTER 1000 W LINCOLNWAY JEFFERSON IA 50129 515 386 2114KEOKUK AREA HOSPITAL 1600 MORGAN ST KEOKUK IA 52632 319 526 8769MARSHALLTOWN MEDICAL & SURGICAL CENTER 3 S 4TH AVE MARSHALLTOWN IA 50158 641 754 5056MERCY MEDICAL CENTER - NORTH IOWA 1000 4TH ST SW MASON CITY IA 50401 641 428 7000UNITYPOINT TRINITY HOSPITAL - MUSCATINE 1518 MULBERRY AVE MUSCATINE IA 52761 563 264 9100SKIFF MEDICAL CENTER 204 N 4TH AVE E NEWTON IA 50208 641 787 3070MIDTOWN MEDICAL GROUP 101 N 38TH AVE OMAHA NE 68131 402 558 1440BURGESS HEALTH CENTER 1600 DIAMOND ST ONAWA IA 51040 712 423 2311MAHASKA COUNTY HOSPITAL 1229 C AVE E OSKALOOSA IA 52577 641 673 3431OTTUMWA REGIONAL HEALTH CENTER 1001 PENNSYLVANIA AVE OTTUMWA IA 52501 641 684 2348SHENANDOAH MEDICAL CENTER 300 PERSHING AVE SHENANDOAH IA 51601 712 246 7211ST LUKES REGIONAL MEDICAL CENTER 2720 STONE PARK BLVD SIOUX CITY IA 51104 712 279 7979MERCY MEDICAL CENTER - SCHEDULING 801 5TH ST SIOUX CITY IA 51101 800 284 7231LAKES REGIONAL HEALTH CARE 2301 HIGHWAY 71 SPIRIT LAKE IA 51360 712 336 8659BUENA VISTA REGIONAL MEDICAL CENTER 1525 W 5TH ST STORM LAKE IA 50588 712 732 4030ALLEN MEMORIAL HOSPITAL 1825 LOGAN AVE WATERLOO IA 50703 319 235 5100GREAT RIVER MED CT SCHEDULING 1221 S GEAR AVE WEST BURLINGTON IA 52655 319 768 3590

SPEECH LANGUAGE NAME ADDR1 CITY ST ZIP AREA EX NUMBCHILDSERVE CENTER 1915 PHILADELPHIA ST AMES IA 50010 515 232 7220BRAATEN HEALTH LLC 3740 UTICA RIDGE RD STE 4 BETTENDORF IA 52722 563 326 1400GENESIS MEDICAL CENTER - PEDATRIC 2535 MAPLECREST RD STE 23 BETTENDORF IA 52722 563 421 3497BOONE COUNTY HOSPITAL SPEECH DEPT 1015 UNION ST BOONE IA 50036 515 433 8625BEVERLY SHERBONDY SLP 828 PARKWAY DR BURLINGTON IA 52601 319 752 2255UNITYPOINT PRAIRIE PARKWAY 5100 PRAIRIE PARKWAY CEDAR FALLS IA 50613 319 222 2901MERCY PHYSICAL REHABILITATION 5264 COUNCIL ST NE CEDAR RAPIDS IA 52402 319 861 7778WITWER CHILDRENS THERAPY CENTER 3245 WILLIAMS PKWY SW CEDAR RAPIDS IA 52404 319 369 8407ST LUKES HOSPITAL 1026 A AVE NE CEDAR RAPIDS IA 52406 319 369 7211ST LUKES HOSPITAL 1026 A AVE NE CEDAR RAPIDS IA 52406 319 369 7211LINDSEY BRANDHORST MA CCC SLP CEDAR RAPIDS IA 52404 319 350 5468LORI HUFFMAN SLP CLIVE IA 50325 515 643 9830GREATER REGIONAL MEDICAL CENTER 1700 W TOWNLINE ST CRESTON IA 50801 641 782 7091WINNESHIEK MEDICAL CENTER 901 MONTGOMERY ST DECORAH IA 52101 563 387 3031FINLEY WESTMARK CLINIC 1665 EMBASSY WEST DR DUBUQUE IA 52001 563 557 9955UNIFIED THERAPY SERVICES INC 4121 PENNSYLVANIA AVE DUBUQUE IA 52002 563 583 4003MYRTUE MEMORIAL HOSPITAL 1213 GARFIELD AVE HARLAN IA 51537 712 755 4342WITWER CHILDRENS THERAPY 1079 N CENTER POINT RD HIAWATHA IA 52233 319 369 8001CHILDSERVE CENTER 5406 MERLE HAY RD JOHNSTON IA 50131 515 727 1561MERCY MEDICAL CENTER SPEECH THERAPY 1501 4TH ST SW MASON CITY IA 50401 641 428 7498LAB OF SPEECH LANGUAGE DISORDERS 4239 FARNAM ST STE 509 OMAHA NE 68131 402 551 7338PAMA BENNETT SLP SIOUX CITY IA 51104 712 490 3206TREVA GRAVES SLP SPENCER IA 51301 712 363 678BUENA VISTA REGIONAL MEDICAL CENTER 1525 W 5TH ST STORM LAKE IA 50588 712 732 4030ANN SPRINGER SPEECH THERAPIST WATERLOO IA 50702 319 235 5100NORTHERN IOWA THERAPY 1810 4TH ST SW STE 103 WAVERLY IA 50677 319 352 1234CENTER FOR REHAB SERVICES 1401 W AGENCY RD WEST BURLINGTON IA 52655 319 768 4100CENTRAL REHABILITATION LTD 950 OFFICE PARK RD STE 100 WEST DES MOINES IA 50265 515 224 979

TREADMILL STRESS TESTNAME ADDR1 CITY ST ZIP AREA EX NUMB

(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)

ST ANTHONY REGIONAL HOSPITAL 311 S CLARK ST CARROLL IA 51401 712 792 3581ST LUKES HOSPITAL 1026 A AVE NE CEDAR RAPIDS IA 52406 319 369 7211MERCY MEDICAL CENTER 1 SAINT JOSEPH DR CENTERVILLE IA 52544 641 437 4111CLARINDA REGIONAL HEALTH CENTER 17TH & WELLS ST CLARINDA IA 51632 712 542 2176JENNIE EDMUNDSON MEMORIAL HOSPITAL 933 E PIERCE ST COUNCIL BLUFFS IA 51503 712 396 7600MERCY HOSPITAL - VASCULAR LAB 800 MERCY DR COUNCIL BLUFFS IA 51502 712 328 5000GREATER REGIONAL MEDICAL CENTER 1700 W TOWNLINE ST CRESTON IA 50801 641 782 3611GENESIS MEDICAL CENTER 1401 W CENTRAL PARK AVE DAVENPORT IA 52804 563 421 3200MYRTUE MEMORIAL HOSPITAL 1213 GARFIELD AVE HARLAN IA 51537 712 755 5161MERCY HOSPITAL - IOWA CITY 500 E MARKET ST IOWA CITY IA 52245 319 339 300MARSHALLTOWN MEDICAL & SURGICAL CENTER 3 S 4TH AVE MARSHALLTOWN IA 50158 641 754 5056MERCY MEDICAL CENTER - NORTH IOWA 1000 4TH ST SW MASON CITY IA 50401 641 428 7000SHENANDOAH MEDICAL CENTER 300 PERSHING AVE SHENANDOAH IA 51601 712 246 7211CARDIOVASCULAR ASSOCIATES 2720 STONE PARK BLVD STE 110 SIOUX CITY IA 51104 712 239 4702BUENA VISTA REGIONAL MEDICAL CENTER 1525 W 5TH ST STORM LAKE IA 50588 712 732 4030GREAT RIVER MED CT SCHEDULING 1221 S GEAR AVE WEST BURLINGTON IA 52655 319 768 3590

VISION EXAMSNAME ADDR1 CITY ST ZIP AREA EX NUMBMCFARLAND EYE CENTER 1128 DUFF AVE AMES IA 50010 515 239 4460WOLFE CLINIC 2020 PHILADELPHIA ST AMES IA 50010 515 232 2450EYE SURGEONS ASSOCIATES 777 TANGLEFOOT LN BETTENDORF IA 52722 563 323 2020BOONE VISION CENTER 621 STORY ST BOONE IA 50036 515 432 2973FAMILY EYE CARE 90 MAIN AVE N BRITT IA 50423 641 843 3841SLIWINSKI FAMILY EYECARE PC 3031 FLINT HILLS DR BURLINGTON IA 52601 319 754 5518CARROLL EYE CARE ASSOCIATES 805 N MAIN CARROLL IA 51401 712 792 9687WOLFE CLINIC 516 S DIVISION ST CEDAR FALLS IA 50613 800 542 7956IOWA EYE CENTER 1650 1ST AVE NE CEDAR RAPIDS IA 52402 319 362 3937CHILDRENS EYE CENTER 4207 GLASS RD NE CEDAR RAPIDS IA 52402 319 366 4455WENDELL STOELTING OD PC CHEROKEE IA 51012 712 225 3822MIDWEST VISION CLINIC 425 S 2ND ST CLINTON IA 52732 563 242 223MID-WEST EYE CARE INC 715 HARMONY 3RD FL COUNCIL BLUFFS IA 51503 712 388 2600FAMILY VISION CENTER 807 N SUMNER CRESTON IA 50801 641 782 2111BRUENING EYE SPECIALISTS 101 TOWER RD STE 300 DAKOTA DUNES SD 57049 605 217 4500VIRDI EYE CLINIC 4624 PROGRESS DR STE C DAVENPORT IA 52807 563 359 3357MEEHAN AND SCHWARTZ OD PLC DECORAH IA 52101 563 382 4279MEDICAL ASSOCIATES CLINIC - WEST 1500 ASSOCIATES DR DUBUQUE IA 52002 563 584 3207DUBUQUE FAMILY EYE CARE PC 3343 CENTER GROVE DR STE D DUBUQUE IA 52003 563 588 2093WOLFE CLINIC 804 S KENYON RD STE 100 FORT DODGE IA 50501 515 576 7777RIVER CITIES OPHTHALMOLOGY 5409 AVE O STE 118 FORT MADISON IA 52627 319 372 9292FAMILY EYE CARE 45 STATE ST GARNER IA 50438 641 923 3737HARLAN VISION CLINIC 2306 12TH ST HARLAN IA 51537 712 755 3893WOLFE CLINIC 1195 BOYSON RD HIAWATHA IA 52222 319 362 8032MARK ZIMMER OD INDEPENDENCE IA 50644 319 334 3631EYE PHYSICIANS AND SURGEONS 2629 NORTHGATE DR IOWA CITY IA 52245 319 338 3623UIH OPHTHALMOLOGY DEPARTMENT 200 HAWKINS RD IOWA CITY IA 52242 319 356 1616AMERICAN EYECARE CENTER 2025 MAIN ST KEOKUK IA 52632 319 524 2020LEMARS OPTOMETRIC CLINIC 120 1ST ST NW LEMARS IA 51031 712 546 4183EYECARE ASSOCIATES 501 E MAIN ST MARSHALLTOWN IA 50158 641 752 1511WOLFE CLINIC - MARSHALLTOWN 309 E CHURCH ST MARSHALLTOWN IA 50158 800 542 7956NORTH IOWA EYE CLINIC 3121 4TH ST SW MASON CITY IA 50402 641 423 8861VISION CENTER 1700 PARK AVE MUSCATINE IA 52761 563 263 2020MARK ZIMMER OD OELWEIN IA 50662 319 283 3155MIDWEST EYE CARE 4353 DODGE ST OMAHA NE 68131 402 552 2020FIRST EYE ASSOCIATES 8111 DODGE ST STE 143 OMAHA NE 68114 402 354 8111VISION CARE CLINIC 721 10TH ST ONAWA IA 51040 712 423 2737WOLFE EYE CLINIC - OTTUMWA 1005 PENNSYLVANIA AVE STE 110 OTTUMWA IA 52501 641 682 8571MICHAEL PORTZ OD RED OAK IA 51566 712 623 5551SPRONK VANDER GRIEND & RADKE 928 3RD AVE SHELDON IA 51201 712 324 2552JAMES CLOEPFIL OD SHENANDOAH IA 51601 712 246 5098WADZINSKI EYE CLINIC 5855 SUNNYBROOK DR SIOUX CITY IA 51104 712 226 3937DR KINCAID FETT AND THARP 1000 W 29TH ST STE 302 SOUTH SIOUX CITY NE 68776 402 494 5533EYECARE CENTRE 2312 23RD ST SPIRIT LAKE IA 51360 712 336 1960VISION CARE ASSOCIATES 600 ONTARIO ST STORM LAKE IA 50588 712 732 3233ADVANCED EYE CARE ASSOCIATES 1113 W 3RD ST VINTON IA 52349 319 472 3848CEDAR VALLEY EYE CARE 909 E SAN MARNAN DR WATERLOO IA 50702 319 234 2616MAUER EYE CENTER 2515 CYCLONE DR WATERLOO IA 50701 319 433 3000WOLFE CLINIC 999 HOME PLZ WATERLOO IA 50701 319 287 5890RIVER CITIES OPHTHALMOLOGY 1223 S GEAR AVE STE 307 WEST BURLINGTON IA 52655 319 752 2020DES MOINES EYE SURGEONS 5901 WESTOWN PKWY STE 200 WEST DES MOINES IA 50266 515 225 3546PHYSICIANS EYE CLINIC 2101 WESTOWN PKWY WEST DES MOINES IA 50265 515 225 2566WOLFE CLINIC 6200 WESTOWN PKWY WEST DES MOINES IA 50266 515 223 8685

X-RAYSNAME ADDR1 CITY ST ZIP AREA EX NUMBMONROE COUNTY HOSPITAL 6580 165TH ST ALBIA IA 52531 641 932 2134KOSSUTH REGIONAL HEALTH CENTER/CLINIC 1515 S PHILLIPS ST ALGONA IA 50511 515 295 7714CASS COUNTY MEMORIAL HOSPITAL 1501 E 10TH ST ATLANTIC IA 50022 712 243 7590AUDUBON COUNTY MEMORIAL HOSPITAL 515 PACIFIC AVE AUDUBON IA 50025 712 563 2611DAVIS COUNTY HOSPITAL - X-RAY 509 N MADISON ST BLOOMFIELD IA 52537 641 664 2145BROOKLYN MEDICAL CLINIC 128 JACKSON ST BROOKLYN IA 52211 641 522 7221ST ANTHONY REGIONAL HOSPITAL 311 S CLARK ST CARROLL IA 51401 712 792 3581SARTORI MEMORIAL HOSPITAL 515 COLLEGE ST CEDAR FALLS IA 50613 319 268 3000RADIOLOGY CONSULTANTS OF IOWA 1948 1ST AVE NE CEDAR RAPIDS IA 52402 319 832 1742MERCY MEDICAL CTR - RADIOLOGY 701 10TH ST SE CEDAR RAPIDS IA 52403 319 861 7778

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

RADIOLOGY CONSULTANTS OF IOWA 1948 1ST AVE NE CEDAR RAPIDS IA 52402 319 364 121ST LUKES HOSPITAL 1026 A AVE NE CEDAR RAPIDS IA 52406 319 369 7211MERCY MEDICAL CENTER 1 SAINT JOSEPH DR CENTERVILLE IA 52544 641 437 4111LUCAS COUNTY HEALTH CENTER 1200 N 7TH ST CHARITON IA 50049 641 774 3000VAL O LYONS MD CHARLES CITY IA 50616 641 257 4309FLOYD COUNTY MEMORIAL HOSPITAL 800 11TH ST CHARLES CITY IA 50616 641 257 4301CHEROKEE REGIONAL MEDICAL CENTER 300 SIOUX VALLEY DR CHEROKEE IA 51012 712 225 5101CLARINDA REGIONAL HEALTH CENTER 17TH & WELLS ST CLARINDA IA 51632 712 542 2176MERCY MEDICAL CENTER - NORTH CAMPUS 1410 N 4TH ST CLINTON IA 52732 563 244 5642CHEST INFECTIOUS DISEASE & CRITICAL CARE ASSOC 1601 NW 114TH ST STE 347 CLIVE IA 50325 515 224 1777CORRIDOR RADIOLOGY 2769 HEARTLAND DR STE 105 CORALVILLE IA 52241 319 545 7300ALEGENT HEALTH MERCY HOSPITAL 603 ROSARY DR CORNING IA 50841 641 322 3121WAYNE COUNTY HOSPITAL 417 S EAST ST CORYDON IA 50060 641 872 2260JENNIE EDMUNDSON MEMORIAL HOSPITAL 933 E PIERCE ST COUNCIL BLUFFS IA 51503 712 396 7600MILLER ORTHOPAEDIC AFFILIATES ONE EDMUNDSON PLACE STE 500 COUNCIL BLUFFS IA 51503 712 323 5333CONSULTANTS IN DISABILITY 427 E KANESVILLE STE 407 COUNCIL BLUFFS IA 51503 402 317 2480REGIONAL HEALTH SYSTEM 235 8TH AVE W CRESCO IA 52136 563 547 2101GENESIS HEALTH GROUP 1520 W 53RD STE 1 DAVENPORT IA 52806 563 421 4900GENESIS MEDICAL CENTER 1401 W CENTRAL PARK AVE DAVENPORT IA 52804 563 421 3200WINNESHIEK MEDICAL CENTER 901 MONTGOMERY ST DECORAH IA 52101 563 382 2911GUNDERSEN CLINIC LTD 1830 STATE HWY 9 DECORAH IA 52101 563 382 3140CRAWFORD COUNTY MEMORIAL HOSPITAL 100 MEDICAL PKWY DENISON IA 51442 712 265 2651THE IOWA CLINIC RADIOLOGY 1221 PLEASANT ST DES MOINES IA 50309 515 244 5109MERCY MEDICAL CENTER - RADIOLOGY DEPT 1111 6TH AVE DES MOINES IA 50314 515 247 3130FINLEY HOSPITAL (RADIOLOGY) 350 N GRANDVIEW AVE DUBUQUE IA 52001 563 557 2787CENTRAL COMMUNITY HOSPITAL 901 DAVIDSON ST NW ELKADER IA 52043 563 245 7000PALO ALTO COUNTY HOSPITAL 3201 1ST ST EMMETSBURG IA 50536 712 852 5500THE FAIRFIELD CLINIC 2000C S MAIN ST FAIRFIELD IA 52556 641 472 4141MERCY FAMILY CLINIC - FOREST CITY 635 E US HIGHWAY 9 FOREST CITY IA 50436 641 585 2904UNITYPOINT TRINITY REGIONAL MEDICAL CENTER 802 KENYON RD FORT DODGE IA 50501 515 574 6528FORT MADISON COMMUNITY HOSPITAL 5445 AVE O FORT MADISON IA 52627 319 372 6530GUTHRIE COUNTY HOSPITAL 710 N 12TH ST GUTHRIE CENTER IA 50115 641 332 2201MYRTUE MEMORIAL HOSPITAL 1213 GARFIELD AVE HARLAN IA 51537 712 755 5161COMMUNITY HOSPITAL 1111 11TH ST HAWARDEN IA 51023 712 551 3100MERCY CARE BLAIRS FERRY 1790 BLAIRS FERRY RD HIAWATHA IA 52233 319 294 5080HORN MEMORIAL HOSPITAL 701 E 2ND ST IDA GROVE IA 51445 712 364 3311MERCY HOSPITAL - IOWA CITY 500 E MARKET ST IOWA CITY IA 52245 319 339 300HANSON FAMILY HOSPITAL 920 S OAK ST IOWA FALLS IA 50126 641 648 7025GREENE COUNTY MEDICAL CENTER 1000 W LINCOLNWAY JEFFERSON IA 50129 515 386 2114KEOKUK AREA HOSPITAL 1600 MORGAN ST KEOKUK IA 52632 319 526 8700KNOXVILLE AREA COMMUNITY HOSPITAL 1002 S LINCOLN KNOXVILLE IA 50138 641 842 2151STEWART MEMORIAL COMMUNITY HOSPITAL 1301 W MAIN ST LAKE CITY IA 51449 712 464 3171FLOYD VALLEY HOSPITAL 714 LINCOLN ST NE LEMARS IA 51031 712 546 3394DECATUR COUNTY HOSPITAL 1405 NW CHURCH ST LEON IA 50144 641 446 4871REGIONAL MEDICAL CENTER 709 W MAIN ST MANCHESTER IA 52057 563 927 7338BURGESS FAMILY CLINIC- MAPLE VALLEY 111 S 5TH ST MAPLETON IA 51034 712 882 2234JACKSON COUNTY PUBLIC HOSPITAL 700 W GROVE ST MAQUOKETA IA 52060 563 652 2474MARSHALLTOWN MEDICAL & SURGICAL CENTER 3 S 4TH AVE MARSHALLTOWN IA 50158 641 754 5076MARSHALLTOWN ORTHOPEDICS 312 E MAIN ST STE 2400 MARSHALLTOWN IA 50158 641 752 7191RADIOLOGISTS OF NORTH IOWA 1010 4TH ST SW STE 100 MASON CITY IA 50401 641 428 5155MERCY MEDICAL CENTER - NORTH IOWA 1000 4TH ST SW MASON CITY IA 50401 641 428 7000MERCYCARE MONTICELLO 619 S MAIN ST MONTICELLO IA 52310 319 465 5937RINGGOLD COUNTY HOSPITAL 504 N CLEVELAND ST MOUNT AYR IA 50854 641 464 3226HENRY COUNTY HEALTH CENTER 407 S WHITE ST MOUNT PLEASANT IA 52641 319 385 3141UNITYPOINT TRINITY HOSPITAL MUSCATINE 1518 MULBERRY AVE MUSCATINE IA 52761 563 264 9100MCFARLAND CLINIC - NEVADA 230 6TH ST NEVADA IA 50201 515 382 5471SKIFF MEDICAL CENTER 204 N 4TH AVE E NEWTON IA 50208 641 791 4310MERCY HOSPITAL OF FRANCISCAN SISTERS 201 8TH AVE SE OELWEIN IA 50662 319 283 6000MIDTOWN MEDICAL GROUP 101 N 38TH AVE OMAHA NE 68131 402 558 1440BURGESS HEALTH CENTER 1600 DIAMOND ST ONAWA IA 51040 712 423 2311CLARKE COUNTY HOSPITAL 800 S FILLMORE ST OSCEOLA IA 50213 641 342 2184MAHASKA HEALTH PARTNERSHIP 410 N 12TH ST OSKALOOSA IA 52577 641 672 2090MAHASKA COUNTY HOSPITAL 1229 C AVE E OSKALOOSA IA 52577 641 673 3431RADIOLOGY ASSOCIATES OF OTTUMWA 1005 PENNSYLVANIA AVE STE 103 OTTUMWA IA 52501 641 682 5453PELLA REGIONAL HEALTH CENTER 404 JEFFERSON ST PELLA IA 50219 641 628 3150HEGG MEMORIAL HEALTH CENTER 1202 21ST AVE ROCK VALLEY IA 51247 712 476 8000LORING HOSPITAL 211 HIGHLAND AVE SAC CITY IA 50583 712 662 7105SHENANDOAH MEDICAL CENTER 300 PERSHING AVE SHENANDOAH IA 51601 712 246 1230SIOUX CENTER COMMUNITY HOSPITAL 1101 9TH ST SE SIOUX CENTER IA 51250 712 722 1271ST LUKES REGIONAL MEDICAL CENTER 2720 STONE PARK BLVD SIOUX CITY IA 51104 712 279 7979MERCY MEDICAL CENTER - SCHEDULING 801 5TH ST SIOUX CITY IA 51101 800 284 7231CARDIOVASCULAR ASSOCIATES 2720 STONE PARK BLVD STE 110 SIOUX CITY IA 51104 712 239 4702DOUGLAS MARTIN MD SIOUX CITY IA 51109 712 224 4300PRAIRIE PEDIATRIC & ADOLESCENT CLINIC 1125 PIERCE ST SIOUX CITY IA 51105 712 255 8901CENTER FOR FAMILY MEDICINE 1115 E 20TH ST SIOUX FALLS SD 57105 605 575 1633MIDTOWN MEDICAL GROUP 3900 DAKOTA AVE STE 5 SOUTH SIOUX CITY NE 68776 402 558 1440AVERA SPENCER FAMILY CLINIC 116 E 11TH ST STE 101 SPENCER IA 51301 712 264 3530SPENCER MUNICIPAL HOSPITAL 1200 1ST AVE E SPENCER IA 51301 712 264 6181LAKES REGIONAL HEALTH CARE 2301 HIGHWAY 71 SPIRIT LAKE IA 51360 712 336 1230BUENA VISTA REGIONAL MEDICAL CENTER 1525 W 5TH ST STORM LAKE IA 50588 712 732 4030UNITYPOINT BUENA VISTA CLINIC 620 NORTHWESTERN DR STORM LAKE IA 50588 712 732 5030VIRGINIA GAY HOSPITAL 502 N 9TH AVE VINTON IA 52349 319 472 6200COVENANT MEDICAL CENTER 3421 W 9TH ST WATERLOO IA 50702 319 272 8000ALLEN MEMORIAL HOSPITAL 1825 LOGAN AVE WATERLOO IA 50702 319 235 5100NORTHEAST IOWA FAMILY PRACTICE CENTER 2055 KIMBALL AVE WATERLOO IA 50702 319 272 2112VETERANS MEMORIAL HOSPITAL 40 1ST ST SE WAUKON IA 52172 563 568 3411VAN DIEST MEDICAL CENTER 2350 HOSPITAL DR WEBSTER CITY IA 50595 515 832 7739

(b) (6)

(b) (6)

GREAT RIVER MED CTR SCHEDULING 1221 S GEAR AVE WEST BURLINGTON IA 52655 319 768 3590BARAZANJI FAMILY MEDICAL CLINIC 1701 22ND ST WEST DES MOINES IA 50266 515 440 6622BASIL HASSAN MD 230 S 68TH ST STE 1203 WEST DES MOINES IA 50266 515 471 1800MADISON COUNTY MEDICAL ASSOCIATES 60 E COURT AVE WINTERSET IA 50273 515 462 1162

KEY VOLUME VENDORS IN IOWA – May 2016 - MAY 2017 Rank for Name Amount Paid 1 Carroll Roland, PHD $ 248,209 2 Wahl Psychological Services $ 129,600 3 Rich Martin, PHD $ 122,500 4 Roger Mraz, PHD $ 116,472 5 Medix Occupational Medicine $ 79,750 6 Rosanna Jones Thurman PHD $ 70,750 7 Midtown Medical $ 68,352 8 Psychology Health Group $ 60,100 9 Plains Area MHC $ 56,225 10 Basil Hassan MD $ 52,246 Total paid out this period $ 1,004,424 Total paid out last period $ 940,026

The following vendors were not reviewed this year: Carroll Roland PHD, Roger Mraz, PHD and Psychology Health Group as they were all reviewed in 2016. Tim Wahl PHD, Rich Martin PHD, and John Kuhnlein DO, as they were all reviewed in 2015. The following vendors received an onsite visit this year; Rosanna Jones Thurman, PHD, Midtown Medical Group, Plains Area MHC and Basil Hassan MD are all in the top ten and have not been reviewed in several years. Russell Moulton also received an onsite visit, as he has consistently ranked in the top 20, but has never received a review.

KEY OR VOLUMEKEY/VOLUME PROVIDER-PrimaryKEY/VOLUME PROVIDER-PrimaryKEY PROVIDER-PrimaryKEY PROVIDER-PrimaryKEY PROVIDER-PrimaryKEY PROVIDER-PrimaryKEY PROVIDER-PrimaryKEY PROVIDER-PrimaryKEY PROVIDER-Primary

KEY PROVIDER-Primary

KEY PROVIDER-Primary

NEW - ADDED NEW - ADDED

NEW - ADDED

REMOVED REMOVED

NEW - ADDED

NEW - ADDED

REMOVED

NEW - ADDED

11/03/2017 KANSAS TOP CE VENDORS10/1/2016 THRU 9/30/2017

VENDNAME AMT PAIDSTANLEY I MINTZ PH D $203,597.64CENTRAL MEDICAL CONSULTANTS $164,877.02MICHAEL H SCHWARTZ PHD $135,893.70SOUTHERN MEDICAL GROUP INC $97,465.12STEVEN WALTERS LCP $76,046.62JASON E. NEUFELD, PH.D. $74,313.00JARROD S STEFFAN PH D $74,263.00MIDWEST CES $69,838.39MELVIN R BERG PH D $59,639.00JAN SNIDER KENT PHD $45,430.71KOENEMAN PSYCHOLOGICAL SERVICES LLC $44,955.00REDLINK $35,061.96GARY R HACKNEY PHD $33,480.00THOMAS S BARTLETT PSYD $30,010.00EVE MEDICAL SERVICES LLC $22,710.82JOI MCNELEY-PHELPS, PH.D. $20,570.94TODD A SCHEMMEL PH D $18,880.00DAVID PULCHER PHD $18,830.00TAMMY E SHEEHAN PSYD $18,351.95KAREN M JORDAN PH D $17,704.94RICK THOMAS PHD $13,714.34PRISCILLA WALLINGFORD PH D $13,459.00GEORGETTE YETTER PHD $12,568.00CAROLYN KARR PHD $11,857.39JASON R WELLS PSY D $11,635.00MELINDA SHAVER PSY D $11,619.00T A MOELLER PH D $11,279.00EMILY RUNYAN LCP $10,940.00COMMUNITY HEALTH CTR OF SE KANSAS $10,822.00BRUCE W BEAN PHD $10,454.00MARC QUILLEN PHD $10,132.00CYNTHIA WILSON PSYD $10,040.00ST JOSEPH MEDICAL CENTER $9,222.66SAAD M. AL-SHATHIR, M.D. $8,914.14DENNIS HEMMENDINGER PHD $8,142.00DOMINICK SCALISE PHD LLC $7,271.00JACKIE TENNEY MD $6,507.20DIVINA VERNER MD $6,284.52SERENITY PSYCHOLOGICAL SERVICES $5,975.00PROVIDENCE MEDICAL CENTER $5,922.70UNIVERSITY OF KANSAS HOSPITAL $5,662.33ERICA SMITH SLP $5,239.20STORMONT-VAIL HEALTHCARE $4,588.72HUTCHINSON REGIONAL MEDICAL CENTER $4,423.37WICHITA FAMILY VISION CLINIC $4,384.31RENEW EATING DISORDER RECOVERY $4,080.00SAM N COHLMIA MD $3,749.41MANISH DIXIT, M.D. $3,688.74KANSAS IMAGING CONSULTANTS PA $3,655.12RANDALL J KRESIE MD $3,623.76TERRY B ROTHSTEIN MD $3,604.34ALY A GADALLA MD $3,197.26SITHA U MILLER MD $3,005.64JENNIFER A MADER CCC-SLP $2,841.60HEATHER R ESTRADA SLP $2,841.60LABETTE HEALTH $2,798.06UNITED IMAGING CONSULTANTS $2,743.65VIA CHRISTI HOSPITAL PITTSBURG INC $2,724.90OLATHE MEDICAL CENTER $2,721.84LAWRENCE MEMORIAL HOSPITAL $2,677.34BILINGUAL SPEECH THERAPY OF KANSAS $2,663.20CINDY E. PENZLER, MD $2,564.21ERIC FRY, MD $2,464.47RANDALL A POHLENZ OD $2,256.28

(b) (6)

(b) (6)


REMOVED

REMOVED

NEW - ADDED

ONE TIME PCP EXAM

NEW - ADDED

COFFEYVILLE REGIONAL MEDICAL CENTER $2,170.59RADIOLOGY & NUCLEAR MEDICINE $2,146.80EYECARE ASSOCIATES OF OSAWATOMIE $2,085.79VIA CHRISTI HOSPITAL MANHATTAN $2,032.82WESTERN PLAINS MEDICAL COMPLEX $2,029.87ST ROSE HEALTH CARE $1,954.70SOUTHWEST MEDICAL CENTER $1,833.09SHEILA WOOD CCC-SLP $1,776.00GEARY COMMUNITY HOSPITAL $1,711.31SHELLY BREDIN-OJA, SPEECH THERAPIST $1,598.40HAYS AREA CHILDREN'S CENTER $1,598.40MEMORIAL HOSPITAL, INC. $1,583.59RANSOM MEMORIAL HOSPITAL $1,562.09HAYS MEDICAL CENTER-ST ANTHONY CAMPUS $1,510.31JOYCE A WOODFORD PHD $1,440.00PRATT REGIONAL MEDICAL CENTER $1,422.12HOLLY MCCARTER MA CCC-SLP-L $1,420.80SUSAN B ALLEN MEMORIAL HOSPITAL $1,406.35AUDIOLOGY & HEARING AID SERVICES INC $1,363.10ST CATHERINE HOSPITAL $1,293.90AVNER STERN PHD $1,270.00PRAIRIE WIND EYECARE $1,238.31LYLE SMITH MD $1,229.58NEOSHO MEMORIAL HOSPITAL $1,162.80FREEMAN WEST HOSPITAL $1,119.06MOLLY E. CHASE SLP $1,065.60RADIOLOGY PROF OF HUTCHINSON LLC $927.96WAYNE L ANLIKER MD $905.23JOHN J SAND MD $865.48DONALD L JAMES MD $819.72ALLEN COUNTY HOSPITAL $808.00NEWMAN MEMORIAL COUNTY HOSPITAL $737.79UNITED RADIOLOGY BILLING LLC $730.80MERCY HOSPITAL $719.85GREAT PLAINS RADIOLOGY SERVICES $717.00NEWTON MEDICAL CENTER $714.21MICHAEL J JOHNSON MD $683.10ATCHISON HOSPITAL $673.46COMMUNITY MEMORIAL HOSPITAL $666.02WILLIAM NEWTON MEMORIAL HOSPITAL $627.63RADIOLOGY ASSOCIATES OF HAYS PA $619.19MANHATTAN RADIOLOGY $589.15RADIOLOGY IMAGING ASSOCIATES PC $565.01PROFESSIONAL HEARING AID ASSOCIATES $532.24LINDA SCHULTZ MS $510.92KU MEDWEST $472.09AREA HEARING & SPEECH CLINIC $460.17STEVE C MITCHELL SR OD $457.51MEREDITH POORE HAROLD PHD CCC-SLP $444.00MEMORIAL HOSPITAL $430.85FREEMAN PHYSICIAN GROUP $425.61RADIOLOGIC PROFESSIONAL SERVICES PA $418.92SUMNER REGIONAL MEDICAL CENTER $414.88MIAMI COUNTY MEDICAL CENTER, INC. $405.52DONALD C WHITE MD PA $398.87KIM HENDRICKS M A CCC-A $397.70CLOUD COUNTY HEALTH CENTER $394.15PHILLIPS COUNTY HOSPITAL $361.04ST JOHN HOSPITAL $344.30ROBERT CHARLES GIBBS MD $318.17CHANUTE RADIOLOGY, P.A. $312.01DAVID LINSENMEYER $310.00SELECT SPECIALTY HOSPITAL WICHITA $287.40CITIZENS MEDICAL CENTER $287.30SOUTH CENTRAL REGIONAL MEDICAL CENTER $273.69

(b) (6)

(b) (6)


NEW - ADDED

NEW - ADDED

ONE TIME PCP EXAMONE TIME PCP EXAMNEW - ADDED

KINGMAN COMMUNITY HOSPITAL $256.55VIA CHRISTI CLINICS CENTRALIZED $217.44GOODLAND REGIONAL MEDICAL CENTER $200.21HIAWATHA COMMUNITY HOSPITAL $199.92RADIOLOGY SPECIALISTS OF ST. JO $192.32MORTON COUNTY HOSPITAL $177.15MARSTON HEARING CENTER $168.33PRECISION RADIOLOGY LLC $163.58ELLSWORTH COUNTY MEDICAL CENTER $155.40A ZAINALI MD $147.96MELISSA M. MALONE, M.D. $140.40R J KUEKER MD $137.19MAHESH MOHAN MD $136.62BARBARA A BROWN-APPLEGATE DO $125.00STEVENS COUNTY HOSPITAL $114.05HORTON COMMUNITY HOSPITAL $112.97HOXIE MEDICAL CLINIC $102.00KEVIN L HAMM DO $100.27KEVIN S HUGHES DO $99.19KRISHNA M KOTECHA MD $95.56WICHITA RADIOLOGICAL GROUP PA $83.54ROBERT LACKAMP MD PC $40.50

COMMUNITY HOSPITAL $16.39E CLOUD RADIOLOGY LLC $8.16

FORT HAYS STATE UNIVERSITY $39.77DIVERSIFIED RADIOLOGY OF COLORADO $37.12RADIOLOGY SERVICES PC $21.00

KENTUCKY DDS FY 2017 CE PROVIDERS LISTPaid Amount PAYTAXID PAYVENDCD PAYNAME

$8,190.00 ELIZABETH I CARLETON-SCHEPER SLP$205.00 MALINDA ISAACS PHD

$8,810.00 LESLIE JENKINS PHD$11,115.00 KEN EPPERSON MS-LPP$4,800.00 GAIL WALSH MS CCC SLP

$47,060.00 RUTH BEWLEY, PHD$5,370.00 MEDICAL VISION INSTITUTE

$100,810.00 LISA KING PSYD$6,910.00 WILLIAM M. PARELL, MD.,PSC.$2,229.00 JAN J. WEISBERG, MD.$3,490.00 EYE CARE FOR KENTUCKY$4,514.00 BOURBON PHYSICIAN PRACTICE

$28,575.00 LITTLE PSYCHOLOGICAL SERVICES$40,930.00 ROBERT GENTHNER PHD$35,995.00 ROBERT W ADAMS PSYD$11,575.00 MARC PLAVIN PHD

$680.00 COMMONWEALTH SPECIALISTS OF KY$3,600.00 MARK S PARZYCH MA-LPP

$20,422.00 STEVEN J SIMON PHD$7,175.00 RAFAEL VEROSLAVSKY PSYD$1,560.00 JASON MCCLOUD OD$440.00 CENTRAL KENTUCKY INTERPRETER REFERRAL INC

$23,160.00 GERALDO DA COSTA LIMA PHD$69,702.00 RIVER CITY HEALTH SERVICES

$190.00 ENT SPECIALISTS OF NASHVILLE$750.00 JARVIS VISION CENTER, PLLC

$9,320.00 ELLEN YASS-REED MA PLLC$22,700.00 BARBARA M BAKER & ASSOCIATES LLC$47,145.00 BRENDAN RYAN MS-LPP$30,870.00 M MAUDE O'NEILL PHD LLC

$126,650.00 DANIEL A MILLER PHD$125,400.00 TIMOTHY L BAGGS PSYD

$9,411.00 ADVANCED EAR NOSE THROAT & ALLERGY PLLC$84,630.00 MEGAN L GREEN PSYD$21,785.00 COMPREHENSIVE NEUROPSYCHOLOGICAL ASSESSMENT$43,470.00 GARY STEWART PHD PSC$2,250.00 DENNIS J BUCHHOLZ PHD

$23,520.00 RICHARD L KLEM PHD$66,035.00 JENNIFER L FISHKOFF PSYD

$210.20 HEARING SPEECH AND DEAF CENTER$870.00 TRI-STATE CENTERS FOR SIGHT

$3,705.00 EYE CARE ASSOCIATES OF GREATER CINCINNATI$17,335.00 PSYCHOLOGICAL CONSULTS

$220.00 MARVA P JOHNSON$20,605.00 JEFFREY W GRAY PHD$2,910.00 ASSOCIATES IN EYE CARE$4,125.00 TIM J CONRAD MD

$412,807.00 LIBERTY MEDICAL ASSESSMENT LLC

(b) (6)

$4,695.00 BENJAMIN MACKEY MD$71,140.00 WILLIAM R RIGBY PHD$22,060.00 BARRY ADKINS MS$57,030.00 SOMERSET SPEECH/LANGUAGE PATHOLOGY$6,100.00 BRITTANY ONKST SLP

$16,745.00 MARY ALLEN GENTHNER MS$1,002.00 EDITH DOT STALLARD

$38,140.00 MARK KROGER MS$16,305.00 WAYNE HERNER PSYD$17,760.00 R COURTNEY SPEAR MA$1,680.00 DAVID ATCHER MD

$76,235.00 CRISTI HUNDLEY PHD$4,500.00 CHARLENE C SHEEHAN SLP

$347,787.75 WELLCARE INC$135,940.00 GREGORY LYNCH PHD

$3,205.00 PAUL A. OWEN$55,530.00 J LORILEA CONYER MA, LPP

$150.00 MY LE K. NGUYEN$50,825.00 GEOFF SCHWERZLER PSYD

$121,230.00 FORD MENTAL HEALTH SERVICES$11,190.00 JULIE JOSEPH-FOX$37,735.00 MICHAEL E. WHITTEN PHD

$297,706.00 SKAGGS CONSULTING, PLLC$77,815.00 BRIAN E. MCLEAN MS-LPP$91,300.00 AAFREEL, LLC$7,800.00 WIGHT SPEECH AND LANGUAGE SERVICES LLC

$102,170.00 SHAW PSYCHOLOGICAL SERVICES LLC$34,075.00 JODI BAUER, LLC$4,530.00 DR EDD EASTON-HOGG PSYD LLC

$25,740.00 SOUND PATH LLC$60,075.00 THE SCOTT GROUP, PLLC$36,580.00 CAPSTONE PSYCHOLOGICAL SERVICES PLLC

$275.00 INTERPRETING SERVICE OF THE COMMONWEALTH, LLC$71,031.00 WALPERT PSYCHOLOGICAL & CONSULTING SERVICES PLLC$25,050.00 LIME KILN CONSULTING LLC$19,595.00 KERRICK PSYCHOLOGICAL SERVICES$39,515.00 SOUTHLAND COUNSELING AND ASSESSMENT CENTER$1,156.50 RICHARD E PURNELL

$27,955.00 JONES PSYCHOLOGICAL SERVICE LLC$1,700.00 DAVID L WINSCH PHD

$80.00 MIDDLESBORO ARH$6,381.00 JOSEPH TOUMA M.D.

$225,535.62 TRI-STATE OCCUP MED INC$19,850.00 MIDLANDS BEHAVIORAL MEDICINE INC$19,025.00 HORN AND ASSOCIATES IN REHABILITATION

$916.30 HARRISON MEMORIAL HOSPITAL$1,444.60 CALDWELL MEDICAL CENTER$517.60 COALMINER RESPIRATORY CLINIC

$3,069.00 PIKEVILLE MEDICAL CENTER$1,415.20 ROCKCASTLE HOSPITAL INC

(b) (6)

$8,536.65 BAPTIST HEALTH MADISONVILLE$90.00 KENTUCKY HEART & VASCULAR PHYSICIANS

$7,025.00 NORTHKEY COMMUNITY CARE$875.65 GRAVES GILBERT CLINIC$966.95 NORTON HEALTHCARE

$2,565.00 THE OPHTHALMOLOGY GROUP LLP$1,635.00 KOBY & KARP PSC$3,315.00 ENT AND ALLERGY SPECIALISTS$450.00 ASHLAND PEDIATRIC ASSOCIATES P$667.00 ROBERT WOODS II MD

$477,900.50 STORY CONSULTING SERVICES INC$1,965.00 MAURICE J OAKLEY MD$270.00 WEST KENTUCKY REFUGEE MUTUAL A

$2,480.00 PIKEVILLE RADIOLOGY$8,300.00 S H K REDDY MD

$30,135.25 JAMES C OWEN MD$6,435.00 THEODORE WANDZILAK MD$3,940.90 AABDUL DAHHAN MD PSC

$53,655.00 DENNIS B SPRAGUE PHD PSC$1,890.00 EYE INSTITUTE OF CENTRAL KENTU$2,085.00 ANTHONY MAYO OD$7,060.00 JAMES W MATTHEWS MD PSC

$75.00 JOSEPH R BRIGHTWELL MD$3,045.00 EDMUND WILKINS MD$2,295.00 CATHOLIC CHARITIES INC$338.00 EYECARE SPECIALISTS

$16,335.00 MICHELE AMBURGEY MA$123,575.00 DENNIS PSYCHOLOGICAL SERVICES

$1,365.00 MCPEAK VISION PARTNERS$55,915.00 ONSITE MEDICAL SERVICES$29,335.00 EAST KY THERAPY CLINIC

$830.00 MEDICAL CENTER CARDIOLOGISTS$21,540.00 DISABILITY CONSULTANTS OF KENTUCKY LLC$1,900.00 EMILY G LAIRD CCC,SLP MA$3,600.00 PEDIATRIC HEALTH GROUP$947.40 W LAWRENCE LONG MD PLLC

$38,536.00 SAHNER & ASSOCIATES INC$5,106.00 LAKE CUMBERLAND MEDICAL ASSOCIATES

$129,208.00 SOUTHERN MEDICAL GROUP INC$9,565.00 REYNOLDS-BLACKBURN PSYCHOLOGICAL SERVICE

$31,020.00 G STEPHEN PERRY EDD$11,455.00 DENNIS BUCHHOLZ, PH.D.$16,415.00 LESLIE JENKINS PHD$9,150.00 KATHY SEIGLER, SEIGLER PSYCHOLOGICAL SERVICES$770.00 KERI BARLOW MS CCC SLP$200.00 NU CARE

$5,177.00 ACCIPIO LANGUAGES SERVICES

(b) (6)

VENDCD VENDOFF VENDNAME ADDR1 ADDR2 ADDR3 CITY STATE ZIP

J PAUL SWEARINGEN MD 7607 YOUREE DR PIERREMONT EYE INSTITUTE SHREVEPORT LA 71105

ROBERT T CASANOVA JR MD 1110 DR AC TERRENCE BLVD SUITE 1 OPELOUSAS LA 70570

LYNDE ULMER LCSW 7737 OLD HAMMOND HWY #A3 BATON ROUGE LA 70809

EMMETT B CHAPITAL JR M D NEW ORLEANS LA 70119

THOMAS E STAATS PH D 2924 KNIGHT ST BLDG 3, SUITE 357 SHREVEPORT LA 71105

NEW ORLEANS SPEECH AND HEARING CENTER 1636 TOLEDANO NEW ORLEANS LA 70115

NEW ORLEANS SPEECH AND HEARING EAST 5646 READ BLVD SUITE 320 NEW ORLEANS LA 70127

FAYE C THRASHER ALEXANDRIA LA 71301

MED PLUS LA OPELOUSAS 204 N. UNION ST. ORTEGO CHIROPRACTIC CLINIC OPELOUSAS LA 70570

MED PLUS NEW IBERIA 800 WEST MAIN ST BRYANT WELLNESS CLINIC NEW IBERIA LA 70560

MED PLUS LA ALEXANDRIA 2595 NORTH MACARTHUR DRIVE ALEXANDRIA LA 71303

MED PLUS LA BOSSIER CITY 3018 OLD MINDEN RD SUITE 203 BOSSIER CITY LA 71112-2427

MED PLUS LA AMITE STE D MED PLUS AMITE - D. W. RAY, M.D. 309 WALNUT AMITE LA 70422

MED PLUS LAKE CHARLES 1210 EAST MCNEESE ST LAKE CHARLES LA 70607

MED PLUS LA LAF 2201 KALISTE SALOOM SUITE 202 LAFAYETTE LA 70508

MED PLUS LA MONROE CHS-CHIROPRACTIC HEALTH SERVICES, LLC 610 CYPRESS STREET WEST MONROE LA 71291

COVINGTON SPEECH AND LANGUAGE CENTER 424 SOUTH TYLER COVINGTON LA 70433

HUSSEIN ALAMMAR MD LEESVILLE LA 71446

ACADIANA MEDICINE CLINIC SUITE 4 1200 HOSPITAL DRIVE OPELOUSAS LA 70570

SPEECH CONCEPTS LLC SUITE 210 8870 YOUREE DRIVE SHREVEPORT LA 71115

KIM A JOHNSON-LCSW ALEXANDRIA LA 71301

A A FRANCIS MD OPTIMAL HEALTH OUTPATIENT CLIN 7240 RENOIR AVENUE BATON ROUGE LA 70806

D L MOORE PH D 805 STUBBS AVE SUITE B MONROE LA 71201

MICHAEL D MANUEL MD ALEXANDRIA LA 71301

PEDIATRIC GROUP OF ACADIANA SUITE 100 MEDICAL RECORDS 401 YOUNGSVILLE HIGHWAY LAFAYETTE LA 70508

DR. SAI CHENNAMSETTY 401 YOUNGSVILLE HWY STE 200 B LAFAYETTE LA 70508

ACI HEARING AND BALANCE CENTER 103 ST. THOMAS ST. LAFAYETTE LA 70506

PAUL M FRIEDBERG PH D SUITE 304 2020 W. PINHOOK RD. LAFAYETTE LA 70508

NAOMI FRIEDBERG PHD SUITE 304 2020 WEST PINHOOK RD LAFAYETTE LA 70508

VICTOR M OLIVER MD BATON ROUGE LA 70806

GIRISHKUMAR SHAH MD 409 MARINERS PLAZA SUITE A MANDEVILLE LA 70448

SPEECH PATHOLOGY OF LOUISIANA SUITE 401 8676 GOODWOOD BLVD BATON ROUGE LA 70806

DONNELL C ASHFORD 8676 GOODWOOD BOULEVARD SUITE 202 BATON ROUGE LA 70806

AUDIOLOGY ASSOCIATES (DUCOMBS) MEDICAL RECORDS 15706 PROFESSIONAL PLAZA HAMMOND LA 70403

CHRISTINE B POWANDA PHD TERRYTOWN 1799 STUMPF BLVD BLDG 7 SUITE 1A TERRYTOWN LA 70056

CHRISTINE B POWANDA PHD CO NORTHSHORE SOUTHSHORE COUNSELING 201 HOLIDAY BLVD SUITE 120 COVINGTON LA 70433

NICOLE F LANCLOS HOPE MEDICAL SERVICES 5615-D JACKSON ST EXTENSION 2ND BUILDING COURTYARD ALEXANDRIA LA 71303

NICHOLE F. LANCLOS PHD 2020 WEST PINHOOK RD. SUITE 504 LAFAYETTE LA 70508

Louisiana FY 2017

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

POINT OF CARE HEALTH HOUMA 210 NEW ORLEANS BLVD HOUMA LA 70364

POINT OF CARE BATON ROUGE 7354 ALBERTA ST SUITE A BATON ROUGE LA 70808

SUNRISE PEDIATRIC ASSOCIATES 3116 SIXTH STREET SUITE 101 METAIRIE LA 70002

ASHLEY W SIPES M D SHREVEPORT LA 71105

CAROLYN FLEMING MONROE LA 71201

JAMES QUILLIN PHD ALEXANDRIA LA 71303

PREMIER HEAR & BAL HAMMOND 16038 DOCTORS BLVD HAMMOND LA 70403

PREMIER HEAR & BAL MANDEVILLE 3545 HIGHWAY 190 MANDEVILLE LA 70471

R ASHTON HOLLOWAY MD BATON ROUGE LA 70806

SOUTHERN MEDICAL GR SHREVEPORT 2924 KNIGHT ST, BLDG 4, SUITE 440 SHREVEPORT LA 71105

SOUTHERN MEDICAL GR PINEVILLE 1319 DONAHUE-FERRY PINEVILLE LA 71360

SOUTHERN MEDICAL GRP MONROE 1212 STUBBS AVE. MONROE LA 71201

SOUTHERN MEDICAL GRP LAKE CHARLES 4100 LOUISIANA AVENUE LAKE CHARLES LA 70607

SOUTHERN MEDICAL GR LAFAYETTE 345 DOUCET RD SUITE 104B LAFAYETTE LA 70503

SOUTHERN MEDICAL GROUP NATCHITOCHES 366 SOUTH DRIVE NATCHITOCHES LA 71457

JOHN H. FAIRBANKS JR. FAIRBANKS ORTHOPEDIC CENTER 107 FRONT ST. STE 2134 VIDALIA LA 71373

JOSEPH A GUILLORY PHD OPELOUSAS LA 70570

INTERNAL MEDICINE ASSOCIATES NEW ORLEANS FIRST FLOOR 618 N CARROLLTON AVE NEW ORLEANS LA 70119

INTERNAL MEDICINE ASSOCIATES KENNER 2001 42ND ST SUITE A KENNER LA 70065

INTERNAL MEDICINE ASSOCIATES TERRYTOWN 1799 STUMPF BLVD. BLDG 5 SUITE 2 TERRYTOWN LA 70056

C SCOTT ECKHOLDT PHD LAFAYETTE LA 70508

SAMUEL WEBB SENTELL PH D SHREVEPORT LA 71106

DR SETH KUNEN 2435 DRUSILLA LANE STE. M BATON ROUGE LA 70809

LA HEART CENTER COVINGTON 39 STARBRUSH CIRCLE COVINGTON LA 70433

LA HEART CENTER HAMMOND 42078 VETERANS AVE SUITE C AND D HAMMOND LA 70403

LA HEART CENTER CHALMETTE 8050 WEST JUDGE PEREZ SUITE 2500 CHALMETTE LA 70043

LA HEART CENTER SLIDELL 2ND FLOOR 901 GAUSE BLVD SLIDELL LA 70458

PERRY HILL, PHD 7330 FERN AVE STE 602 BLDG 6 SHREVEPORT LA 71105

DONALD R PEAVY M D BATON ROUGE LA 70806

THOMAS C STUCKEY III 7777 HENNESSEY BLVD SUITE 3001 BATON ROUGE LA 70808

DANIEL J TRAHANT M D 3901 HOUMA BLVD SUITE 305 METAIRIE LA 70006

TULANE UNIVERSITY HOSPITAL AND CLINIC PULMONARY CLINIC 7TH FLOOR 1415 TULANE AVENUE NEW ORLEANS LA 70112

JACK MILLER JR OD EUNICE LA 70535

GERALD GERDES JR OD OAKDALE LA 71463

DR R V CHRISTIAN OPELOUSAS LA 70570

WILLIAMSON ALLEMOND REGIONAL EYE CENTER 2421 CHURCH ST. ZACHARY LA 70791

CLINICAL PATHOLOGY LABORATORIES 2535 BERT KOUNS INDUSTRIAL LOOP SUITE 219 SHREVEPORT LA 71118

CLINICAL PATHOLOGY LABORATORIES METAIRIE 3901 HOUMA BLVD SUITE 100 METAIRIE LA 70006

CLINICAL PATHOLOGY LABORATORIES- BATON ROUGE 8130 SUMMA AVENUE BATON ROUGE LA 70809

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

CLINICAL PATHOLOGY LABORATORIES LAKE CHARLES 2800 1ST AVENUE SUITE E LAKE CHARLES LA 70601

CLINICAL PATHOLOGY LABORATORIES ALEXANDRIA 5615-C JACKSON STREET EXTENSION ALEXANDRIA LA 71301

CPL NATCHITOCHES 99 SOUTH DRIVE SUITE A NATCHITOCHES LA 71457

CLINICAL PATHOLOGY LABORATORIES MONROE 221 MCMILLIAN RD SUITE A WEST MONROE LA 71291-5321

CLINICAL PATHOLOGY LABORATORIES NEW ORLEANS 3525 PRYTANIA ST. SUITE 319 NEW ORLEANS LA 70115

CLINICAL PATHOLOGY LABORATORIES HARAHAN 520 ELMWOOD PARK BLVD. SUITE 130 JEFFERSON LA 70123

CLINICAL PATHOLOGY LABORATORIES MARRERO 4520 WICHERS DR. SUITE 102 MARRERO LA 70072

CLINICAL PATHOLOGY LABS- FERN AVE, SHREVEPORT 7607 FERN AVE, SUITE 501 SHREVEPORT LA 71105

CLINICAL PATHOLOGY LABORATORIES HOUMA 900 BELANGER ST. HOUMA LA 70360

CLINICAL PATHOLOGY LABORATORIES HAMMOND 16026 DOCTOR'S BLVD. HAMMOND LA 70403

CLINICAL PATHOLOGY LABORATORIES-COVINGTON 204 HIGHLAND PARK PLAZA COVINGTON LA 70433

CLINICAL PATHOLOGY LABS- BOSSIER CITY 2250 HOSPITAL DRIVE SUITE 112 BOSSIER CITY LA 71111

MICHAEL N KLEAMENAKIS O D NEW ORLEANS LA 70122

MENARD EYE CENTER 4315 LAKE ST SUITE 2 LAKE CHARLES LA 70605

WARREN P MCKENNA JR MD NEW ORLEANS LA 70114

DONNA M MANCUSO MD 1301 ANTONINE STREET SUITE 500 NEW ORLEANS LA 70115

ELENITA P SANTOS-MATA MD 4851 W. PARK SUITE A ZACHARY LA 70791

ANDREW THRASHER PHD 2500 MAPLEWOOD DR SUITE 1 SULPHUR LA 70663

MANUEL DE LA RUA, O.D. 3701 WILLIAMS BLVD SUITE 204 KENNER LA 70065

BRYAN S. JEANFREAU OD 231 WINDERMERE BLVD ALEXANDRIA LA 71303

PATRICK REDMOND MD 231 WINDERMERE BLVD ALEXANDRIA LA 71303

BRYAN S. JEANFREAU OD LOUISIANA EYE LASER CENTER 201 FRITZ STREET JONESVILLE LA 71343

JILL COOK 8762 QUARTERS LAKE BUILDING 12 BATON ROUGE LA 70809

JILL COOK NEW ORLEANS LA 70119

DR STEPHANIE HENSON 1801 FAIRFIELD AVE SUITE 201 SHREVEPORT LA 71101

NATCHITOCHES FAMILY EYE CARE 946 KEYSER AVE NATCHITOCHES LA 71457

DESOTO FAMILY EYE CARE 405 POLK ST MANSFIELD LA 71052

SABINE FAMILY EYE CARE 220B HIGHLAND DR MANY LA 71449

ROBERT L. KRENEK, JR., PHD 3018 OLD. MINDEN RD, SUITE 1100 BOSSIER CITY LA 71112

LINDSAY YORK MD 1111 MEDICAL CENTER BOULEVARD NORTH TOWER ROOM 803 MARRERO LA 70072

ACL HEARING & BALANCE INC 7952 GOODWOOD BLVD BATON ROUGE LA 70806

THE GUIDANCE CENTER - ORLEANS 330 N. JEFFERSON DAVIS PKWY NEW ORLEANS LA 70119

THE GUIDANCE CENTER - CHALMETTE 2626 CHARLES DR SUITE 211 CHALMETTE LA 70043

ELIZABETH B WHITE MD MEDICAL RECORDS SUITE 205 205 HIGHLAND PARK PLAZA COVINGTON LA 70433

JAMES A. VAN HOOK III, PHD 1200 S ACADIAN THRUWAY SUITE 110B BATON ROUGE LA 70806

AMCE PHYSICIANS GROUP-BR 8772 QUARTERS LAKE RD BLDG 13 STE 18 BATON ROUGE LA 70809

AMCE PHYSICIANS GROUP-NEW ORLEANS 1100 POYDRAS STREET, SUITE 2900 NEW ORLEANS LA 70163

AMCE PHYSICIANS GROUP- SLIDELL 1 436 OLD SPANISH TRAIL SLIDELL LA 70458-3904

AMCE PHYSICIANS GROUP-SLIDELL 2 PULMONARY HEALTH ASSOCIATES BLDG. 2240 GAUZE BLVD. EAST SLIDELL LA 70461

(b) (6)

(b) (6)

(b) (6)

(b) (6)

ALFRED E BUXTON PH D 155 HOSPITAL DR SUITE 200. LAFAYETTE LA 70503

GERALD B. BROUSSARD MD BROUSSARD CATARACT & EYE INSTITUTE 1250 PECANLAND ROAD MONROE LA 71203

W DONNER MIZELLE 225 N COLLEGE RD ACADIAN VISION ASSOCIATES LAFAYETTE LA 70506

LACOMBE EYE CENTER LLC 4400 D AMBASSADOR CAFFERY LAFAYETTE LA 70508

LAHAYE CENTER FOR ADVANCED EYE CARE 4313 I-49 S SERVICE RD OPELOUSAS LA 70570

AUDIOLOGY CONSULTANTS OF LA 1408 METRO DRIVE ALEXANDRIA LA 71301

CATHERINE PIERCE-AUDIOLOGIST 1408 METRO DRIVE ALEXANDRIA LA 71301

JOY TERRELL PHD 5618 SUPERIOR DR SUITE F BATON ROUGE LA 70816

WEST JEFFERSON MEDICAL CENTER 1101 MEDICAL CENTER BLVD RESPIRATORY DEPARTMENT 2ND FLOOR MARRERO LA 70072

BARBARA MOOREHEAD PSYD BRAIN MATTERS 1419 MAIN ST. ALEXANDRIA LA 71301

MARK D FRUGE PH D 923 NAPOLEON AVENUE P O BOX 734 SUNSET LA 70584

AMY CAVANAUGH PHD LAFAYETTE LA 70508

ANDRE LONG OD PINEVILLE LA 71360

GARY GLEN FUTCH PHD ALEXANDRIA LA 71301

CARLOS KRONBERGER PH D 3520 GENERAL DEGAULLE DR SUITE 3024 3RD FLOOR NEW ORLEANS LA 70131

KEVIN ROGERS, O. D. ROGERS REGIONAL EYE CENTER 18901 GREENWELL SPRINGS ROAD GREENWELL SPRINGS LA 70739

JAMES L. ZUMBRUNNEN, MD 7925 YOUREE DR., SUITE 200 SHREVEPORT LA 71105

JOSEPH A LAMANNA ED D ALEXANDRIA LA 71301

ANDREW COMEAUX, LCSW 2625 LINE AVE SUITE 106 SHREVEPORT LA 71104

BATON ROUGE CLINIC 7373 PERKINS RD BATON ROUGE LA 70808

KEVIN TRIPEAUX LCSW ONE AMERICAN PLACE 301 MAIN ST. STE. 2200 BATON ROUGE LA 70802

WENDI RICHARDSON-SPEECH LANGUAGE PATHOLOGIST WEST MONROE LA 71291

LESTER C CULVER PH D - BOGALUSA BOGALUSA LA 70427

LESTER C CULVER PHD - NEW ORLEANS 2930 CANAL ST 3RD FLOOR NEW ORLEANS LA 70119

LESTER C CULVER PH D - MARRERO MARRERO LA 70072

LESTER C CULVER PH D - METAIRIE 3017 HARVARD ST FLOOR 1 METAIRIE LA 70006

LESTER CULVER PH D - COVINGTON COVINGTON LA 70433

M.B. THERAPY, INC. 1440 PETERMAN DRIVE SUITE A ALEXANDRIA LA 71303

HAMMOND HEART CLINIC 16033 DOCTORS BLVD HAMMOND LA 70403

CHARLES C. UGOKWE MD ALEXANDRIA LA 71301

JULANA D. MONTI, MD- MINDEN MINDEN LA 71055

JULANA D. MONTI, MD- LAFAYETTE LAFAYETTE LA 70508

JULANA MONTI, MD-BOSSIER CITY 3018 OLD MINDEN RD SUITE 1203 BOSSIER CITY LA 71112

DR. JOHN H WISE CROWLEY LA 70526

DR. JOHN H WISE RAYNE LA 70578

DR. JEFFREY C. FITTER 1234 DAVID DR. SUITE 103 MORGAN CITY LA 70380

SURGICAL EYE ASSOCIATES-COVI 1120 N US HWY 190 COVINGTON LA 70433

SURGICAL EYE ASSOCIATES FRANKLINTON 803 RIVERSIDE DR FRANKLINTON LA 70438

DARREL B. TURNER PH D BRAIN MATTERS 1419 MAIN ST. ALEXANDRIA LA 71301

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

DARREL B. TURNER, PHD LAKE CHARLES LA 70601

KICHEA S. BURT, LCSW BACS 2372 ST. CLAUDE AVE. SUITE 220 NEW ORLEANS LA 70117

TERRY O. THOMAS, PH.D. MONROE LA 71201

TAIRA WOODROFFE M.D. 4242 HWY 19, BLDG 3 SUITE A ZACHARY LA 70791

ALEXANDRIA EYE LASER 1008 SOUTH 6TH ST LEESVILLE LA 71446

OLYMPUS HEALTH SERVICES ALEXANDRIA 11 HEYMAN LANE ALEXANDRIA LA 71303

OLYMPUS HEALTH DERIDDER 311 S. PINE ST. DERIDDER LA 70634

ANDRIETTE FITCH MD 4336 NORTH BLVD SUITE 103 BATON ROUGE LA 70806

RAFAEL F. OTERO, PH.D TEXARKANA TX 75503

BEAU J. BAGLEY, MD 1331 OCHSNER BLVD. SUITE 100 COVINGTON LA 70433

CAROLA OKOGBAA MD 7855 HOWELL BLVD SUITE 130-A BATON ROUGE LA 70807

DAVID LANDRY PH.D 203 W. MAIN ST. SUITE 105 NEW IBERIA LA 70560

SHANNAE HARNESS, PHD- LAPL 232 BELLE TERRE BLVD. SUITE B LAPLACE LA 70068

SHANNAE HARNESS, PHD- HOU HOUMA LA 70360

SHANNAE HARNESS, PHD- RAC RACELAND LA 70394

SUSAN C. TUCKER, PHD 2040 LINE AVE SUITE 101 SHREVEPORT LA 71104

KTN MEDICAL, LLC 1718 N. MARTIN LUTHER KING HWY LAKE CHARLES LA 70601

CLAUDE FALLIS OD ABBEVILLE LA 70510

ANTHONY J PALAZZO M D BOGALUSA LA 70427-0370

GLENWOOD REGIONAL MEDICAL CENTER 503 MCMILLAN RD. WEST MONROE LA 71291

ST. CHARLES VISION (UPTOWN) 8040 ST. CHARLES AVE. NEW ORLEANS LA 70118

CAROL REDILLAS, MD CHALMETTE LA 70043

MARK A. SKELLIE, PSYD (N.O.) 137 N. CLARK ST. SUITE 4 NEW ORLEANS LA 70119

GNC THERAPIES INC-BATON ROUGE 301 NORTH MAIN ST, SUITE 2200 BATON ROUGE LA 70802

GNC THERAPIES, INC (N.O) 1615 POYDRAS STREET SUITE 900 NEW ORLEANS LA 70112

GNC THERAPIES, INC (MET) ONE GALLERIA BLVD SUITE 1900 METAIRIE LA 70002-1726

WEST JEFFERSON MEDICAL CENTER 1101 MEDICAL CENTER BLVD MARRERO LA 70072

SHERRY RUMBY, LPC MINDEN LA 71055

STEPHEN T. JONES, MD URGENT CARE ELEVEN 3218 ST. CLAUDE AVE. NEW ORLEANS LA 70117

JIMMY EATON O.D. 911 TECH DRIVE RUSTON LA 71270

GARY AVALLONE O.D. 911 TECH DRIVE RUSTON LA 71270

KRISTI GRAVES HUBBARD S&LP 1799 STUMPF BLVD. BLDG 5 SUITE 2 TERRYTOWN LA 70056

LISA FLEMING BANNISTER-SLP MONROE LA 71201

DERRICK STEVENSON, LCSW 8924 JEWELLA AVE ROOM 22W SHREVEPORT LA 71118

DORIS A. SMALL, LCSW 1760 TEXAS ST NATCHITOCHES LA 71457

SHARON BEARD, LPC 1760 TEXAS ST NATCHITOCHES LA 71457

KIMBERLY CARTER - SLP RAYVILLE LA 71269

MARTIN AUDIFFRED LAFAYETTE LA 70506

MICHAEL D. MCGILL, MCD, CCC-SLP 8730 YOUREE DRIVE, SUITE B SHREVEPORT LA 71115

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

NOLA HEARING 1700 VETERANS BLVD STE 200 METAIRIE LA 70005

DEBRA D. LAING, M.C.D., CCC-SLP SHREVEPORT LA 71105

ALETHA NELSON-LPC 908 NORTH 3RD ST. MONROE LA 71201

CAROLYN BRUCE-LPC 908 NORTH 3RD ST. MONROE LA 71201

ANTHEA JOSEPH-LPC 908 NORTH 3RD ST. MONROE LA 71201

DR JOHN F. LOUPE 2223 QUAIL RUN DR. STE G1 BATON ROUGE LA 70808

MAGNOLIA MEDICAL SERVICES SHREVEPORT 2121 FAIRFIELD AVE, SUITE 110 SHREVEPORT LA 71104

MAGNOLIA MEDICAL SERVICES MONROE 3001 ARMAND ST.SUITE C MONROE LA 71201

MAGNOLIA MEDICAL SERVICES - CROWLEY 207 EAST 5TH ST. CROWLEY LA 70526

MAGNOLIA MEDICAL- MORGAN CITY 2403 6TH ST. MORGAN CITY LA 70460

MAGNOLIA MEDICAL SERVICES- LEESVILLE ST. MICHAEL'S CENTER 105 WEST SOUTH ST. LEESVILLE LA 71446

MAGNOLIA MEDICAL- HOUMA FLYNN MANCEAUX ETC. - CHIROPRACTORS 6902 W MAIN ST HOUMA LA 70360

APRIL GILCHRIST, LPC-S, NCC 4859 SHED ROAD SUITE 500 BOSSIER CITY LA 71111

KIMBERLY HUTCHINSON LAKE CHARLES LA 70601

JOSEPH WARNER, LPC LAPLACE LA 70068

GEORGE W. HEBERT, PHD 411 SOUTH PRIEUR ST. SUITE 307 NEW ORLEANS LA 70112

BUDI SUGENG MD LAFAYETTE LA 70506

JAMES LEE HOOVER, ED.D. TEXARKANA TX 75503

GERALD NISSLEY, JR., PSY.D. 505 EAST TRAVIS ST, SUITE 208 MARSHALL TX 75670

DR. JENNINGS, PSY.D.SHREVEPORT 920 PIERREMONT RD, SUITE 205 SHREVEPORT LA 71106

GAIL G LEGER CCC SLP ST. CHRISTOPHER COLLEGE BUILDING 3419 NORTHWEST EVANGELINE THRUWAY SUITE A-5 CARENCRO LA 70520

DEBORAH A. MAYEUX-SLP 3654 GOVERNMENT STREET SUITE 10 ALEXANDRIA LA 71302

KERRY HYMEL-NESBIT MA LPC 501 RUE DE SANTE SUITE 4 LAPLACE LA 70068

SCHERELL SIMONET 606 COLONIAL DR SUITE B FLIP MY FROWN COUNSELING SERVICES BATON ROUGE LA 70815

DR. ALBERTO PALMIANO 2312 E MAIN ST. STE. B NEW IBERIA LA 70560

SARAH B. HUGHES, LPC-S NEW ORLEANS LA 70119

LANA JOSEPH AU.D CCC-A, MSHCM HIGH LEVEL HEARING TECHNOLOGY 5640 JEFFERSON HIGHWAY HARAHAN LA 70123

TODAY'S EYECARE LLC MALL OF ACADIANA/LENSCRAFTERS 5725 JOHNSTON ST., SUITE 2314 LAFAYETTE LA 70503

LYNN DAIGLE, LPC HOUMA HOUMA LA 70360

KENDRA MICHAEL MD TOTAL FAMILY HEALTHCARE 4336 NORTH BLVD. STE 103 BATON ROUGE LA 70806

MICHAEL W. PARKER PHD STRONG AR 71765

DR. MARVIN D. CLIFTON 10319 OLD HAMMOND HWY STE. B2 BATON ROUGE LA 70816

DR. HAROLD J. HEBERT JR. 501 JEFFERSON TER SUITE A 501 JEFFERSON TERRACE BLVD NEW IBERIA NEW IBERIA LA 70560

MONICA G. BAGLEY, MCD, CCC-SLP 1331 OCHSNER BLVD. SUITE 100 COVINGTON LA 70433

STEPHANY HILLMAN, PHD 1244 BARROW STREET SUITE 107 HOUMA LA 70360

MARC L ZIMMERMANN PH D 2798 O'NEAL LANE BLDG. D BATON ROUGE LA 70816

MONICA STEVENS, PHD 131 SOUTH ROBERTSON ST. 14TH FLOOR (MURPHY BUILDING) NEW ORLEANS LA 70112

SORRELLS AUDIOLOGY LLC 555 DR. MICHAEL DEBAKEY DR. STE 104 LAKE CHARLES LA 70601

AMANDA GALLAGHER, PH.D. 1440 CANAL ST SUITE 1000 NEW ORLEANS LA 70112

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

FERNANDO PASTRANA, PHD 310 HUEY P. LONG AVE. SUITE 107 GRETNA LA 70053

TRENISE HARRIS LPC-S HOPE AND HEALING COUNSELING CENTER 3349 RIDGELAKE DR SUITE 104 METAIRIE LA 70001

JILL GAUDET 2533 BERT KOUNS IND. LOOP, SUITE 104 SHREVEPORT LA 71118

CYNTHIA R. LINDSEY, PSY.D. 733 KEYSER AVE, SUITE 100 NATCHITOCHES LA 71457

ST. CHARLES VISION-BOUTTE 13322 HWY. 90 BOUTTE LA 70039

MICHAEL B. GALLAGHER, PSY.D. ALEXANDRIA LA 71301

MARY MUNGER, PHD METAIRIE LA 70005

JOSEPH KATZ LCSW MAYERS MENTAL HEALTH LLC 216 SAINT LANDRY STREET LAFAYETTE LA 70506

MAISA E. SHELMIRE, LCSW 7855 HOWELL BLVD SUITE 120 BATON ROUGE LA 70807

DR. ANDREW J. THRASHER III 2500 MAPLEWOOD DR. SUITE 1 SULPHUR LA 70663

PATSY HERNANDEZ, LCSW ST. CHRISTOPHER COLLEGE BUILDING 3419 NORTHWEST EVANGELINE THRUWAY CARENCRO LA 70520

HILLARY COOPER, M.A., CCC-SLP- RUSTON FYZICAL THERAPY BALANCE CENTERS 730 CELEBRITY DRIVE RUSTON LA 71270

HILLARY COOPER, M.A., CCC-SLP- JONESBORO FYZICAL THERAPY BALANCE CENTERS 900 PERSHING HWY. JONESBORO LA 71251

MAURA C. MIZE HOPE THERAPY CENTER 1727 IMPERIAL BLVD BUILDING 3 LAKE CHARLES LA 70605

JENNIFER BAUM-LPC VOLUNTEERS OF AMERICA 3704 COLISEUM BLVD ALEXANDRIA LA 71303

BLAKE A. BOOTH MD BATON ROUGE EYE PHYSICIANS 4848 NORTH BLVD BATON ROUGE LA 70806

DIANNA DUCOTE MS CCC SLP 401 NORTH ST CHARLES BLDG B 401 NORTH ST CHARLES ABBEVILLE LA 70510

CHRISTOPHER CENAC SR MD HOUMA LA 70361

JOSEPH L PALOTTA MD UNIVERSAL PLAZA 5211 ESSEN LANE STE 8A BATON ROUGE LA 70809

DOCTOR FAUST, MD MEDICAL RECORDS STE 600 2633 NAPOLEON AVE NEW ORLEANS LA 70115

TERRY L ROBERTS M A ROBERTS HEARING CLINIC 4007 PARLIMENT DRIVE ALEXANDRIA LA 71303

TERRY L. ROBERTS, M.A. ROBERTS HEARING CLINIC 1503 GOODWIN RD. SUITE 205 RUSTON LA 71270

WILLIS KNIGHTON MEDICAL CENTER ATTN: RESPIRATORY THERAPY 2600 GREENWOOD RD SHREVEPORT LA 71103

CARLOS B REINOSO PHD MEDICAL RECORDS 4517 LORINO STREET METAIRIE LA 70006

S F FONTENELLE III PHD-METAIRIE METAIRIE LA 70001

S F FONTENELLE III PHD-NEW ORLEANS N O SPEECH AND HEARING BLDG 1636 TOLEDANO ST NEW ORLEANS LA 70115

JANE V MCDOW OD WAL-MART VISION CENTER STORE 542 1901 TCHOUPITOULAS ST NEW ORLEANS LA 70130

JOHN P. SANDIFER, MD MID STATE ORTHOPAEDICS 134 E. 5TH ST. NATCHITOCHES LA 71457

MARK BOWEN OD JENA LA 71342

BARRY TILLMAN MD RIVERPARK MEDICAL CENTER 107 FRONT ST. VIDALIA LA 71373

TIMOTHY BARRY OD MEDICAL RECORDS 418 N. MAIN STREET JENNINGS LA 70546

RODERICK E ADAMS PH D PINEVILLE LA 71360

PSYCHOLOGICAL ASSESSMENT TREATMENT 1502 STUBBS AVENUE MONROE LA 71201

PSYCHOLOGICAL ASSESSMENT & TREATMENT 1502 STUBBS AVE. MONROE LA 71201

RIAZ M CHAUDHRY MD JENA LA 71342

LINDA C STEWART M D 604 CHEVELLE DRIVE SUITE C BATON ROUGE LA 70806

DAVID D CLARK ED D 4565 LASALLE ST. SUITE 302 MANDEVILLE LA 70471

MOLLIE WEBB SPEECH HEARING C SHREVEPORT LA 71103-4601

ROGELIO A CASAMA M D 537 KENTUCKY AVE SUITE A BOGALUSA LA 70427

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

GEORGE J HAAG PH D ALEXANDRIA LA 71301

GEORGE J HAAG PH D 805 STUBBS AVE. SUITE C MONROE LA 71201

SATYARTHI GUPTA M D HIGHLAND PARK PLAZA COMPLEX 1 STE 108 COVINGTON LA 70433

HAROLD R YORK M D 4937 HEARST SUITE 2A METAIRIE LA 70001

LABCORP OF AMERICA 11441 INDUSTRIPLEX BLVD STE 140 BATON ROUGE LA 70809

DR. MIA SINGLETON BEN ALL KIDS PEDIATRICS 920 N. MAIN ST. OPELOUSAS LA 70570

JARRETT JOHNSON OD PRIMARY EYE CARE 1530 N BROAD ST NEW ORLEANS LA 70119

WK PIERREMONT CARDIOLOGY 1811 E BERT KOUNS INDUSTRIAL LOOP STE 210 SHREVEPORT LA 71105

BETTER HEARING SYSTEMS 1000 CHINABERRY DR SUITE 103 BOSSIER CITY LA 71111

MEDICAL CENTER DIAGNOSTICS 67250 INDUSTRY LANE COVINGTON LA 70433

WILLIAM E FOWLER PHD MET 3351 SEVERN AVE STE 301 METAIRIE LA 70002

WILLIAM E FOWLER PHD HOUMA HOUMA LA 70360-6301

THE THERAPY GROUP 7843 PARK AVENUE SUITE A HOUMA LA 70364

ST FRANCES CABRINI HOSPITAL 3330 MASONIC DRIVE ALEXANDRIA LA 71301

ST FRANCES CABRINI OP LAB 2108 TEXAS AVENUE SUITE 1060 ALEXANDRIA LA 71301

SANDRA B DURDIN PHD BR 8676 GOODWOOD BOULEVARD SUITE 404 BATON ROUGE LA 70806

SANDRA B DURDIN PH D LAFAYETTE 2032 NE EVANGELINE TRWY RAMADA INN LAFAYETTE LA 70501

SANDRA DURDIN PH D HAMMOND 15706 PROFESSIONAL PLAZA AUDIOLOGY ASSOCIATES BUILDING HAMMOND LA 70403

LAUREN ARBOUR 8762 QUARTERS LAKE RD BLDG 12 BATON ROUGE LA 70809

LAUREN ARBOUR NEW ORLEANS LA 70119

(b) (6)

(b) (6)

(b) (6)

(b) (6)

MAINE DDS CE PROVIDER LIST FY 2017JOHN AGEE PHDDAVID AXELMAN MDNADIR BEHREM PSYDRONALD BLUM MDJUSTIN CLARK DOFREEMAN COREY LCSWCOUNTY PT - PAUL MARQUIS PT

RYAN CORMIER PTSHERMAN-CLARK-LETOURNEAU PT

KERRY DRACH PSYDJONATHAN FREEDMAN PHDREHABILITATION ASSOCIATES-FRED FRIDMAN DODONNA GATES PHDROGER GINN PHDANNE PRATT GIROUX AUDJOHN HALE EDDNELSON HAAS MDDWAYNE HOGAN LCSWKAREN HOVER MDPETER IPPOLITI PHD ROBERT KAHL PHDPATRICIA KOLOSOWSKI PHDMAINE CENTER FOR INTEGRATED REHABELISE MAGNUSON PSYDRENATO MEDRANO MDJAMES MORAN EDDMARGARET MORRISON PHDCHRISTOPHER MUNCIE PSYDLARRY NEWMAN MDRICHARD PARKER PHDROBERT PHELPS MDEDWARD QUINN PHDGARY RASMUSSEN PHDNICHOLAS REHAGAN PHDARTHUR SCOTT MDSELECT PTBEVERLY SHERWIN PHDCOREY SMITH PSYDJAMES SMITH DOSUSAN STIEFEL PHDIRA STOCKWELL MDRICHARD STOCKWELL DO

LEYA LAVERRIERE NPNATACHA SOVETSKY-CHABOT NP

TRENTON HPATRICIA RILEY APRN-CNPALBERT MARIAN PATINA GRIFFINKATHY KOTAS MD

PAMELA WANSKER DOJAMES WERRBACH PHDJAMES WHELAN PSYDJOSEPH WOJCIK PHDMICHAEL MCLAUGHLIN PHDBRUCE SAUNDERS PHDWORKMED

JERRY LEBEL PAERICA LANGLOIS LCSW

SPECIALTIESMIDCOAST MEDICAL GROUP ENTNORTHERN MAINE SPEECHMAINELY KIDZ PTSANDCASTLE CLINICAL AND EDUCATIONAL SERVICESASSOCIATED EYE CAREATLEE GLEATON EYE CAREMAINE EYE CENTERDOWNEAST EYE

MIDCOAST EYE ASSOCIATES - BATH AND BRUNSWICKVISION CARE OF MAINE 5 LOCATIONS (BANGOR, PRESQUE ISLE, DOVER FOXCROFT, HOULTON, HALLOWELLEMMC AUDIOLOGYEMMC OTOLARYNGOLOGYMAINE GENERAL MEDICAL CENTER FOOT HILL CENTER -AUDIO/SPEECHMAINE GENERAL MEDICAL CENTER REHAB AND AUDIOLOGICAL DEPTMAINE GENERAL MEDICAL CENTER EDMUND ERVIN PEDIATRIC CENTERKENNEBEC EYE CAREEYE CARE MEDICAL GROUPMARK HAMMOND ENT ASSOCIATESRIVERSIDE EYE CARE 2 LOCATIONSMERCY ENTEYE CARE MAINE

SITE VISIT RANDOM SELECTION SITE VISITS/TOP 5TOP 5 & Primary CE work

MD DDS CE Provider List FY16

First Name Last Name Credentials Group Volume/Key Provider Onsite Review Removal for Cause

Mohammed Abuzahara MDAndres Aceituno MDSrinivas Addala MDYasmin Ahmed MD AMCE PhysiciansRuth Agwuna MDMohammed Ahmed MDAdebowale Ajayi MDDamanhuri Alkaitis MDChristeen Allen PsyDPatrick Allen EdDShivangi Amin MD Med PlusApril Anderson SLP National Speech LanguageJanet Anderson PhDEva Anderson PhD

Justin Anderson PsyD Psych Inc. Key Provider - Volume for FY17

Onsite Visit FY17

Gail Anderson MDMouhamad Annous MDEdward Ansel PhDMerrill Ansher MDSamina Anwar MDMichael April MDSajid Arain MD Redlink

Daniel Arnheim PhDOnsite Visit FY17

Riffat Ashai MDChalita Attalah MD RedlinkRida Azer MDDeepa Balasubramaniam MDN'Dama Bamba MD Med PlusMemunatu Bangura MDDarpan Bansal MDPaul Barbera MDTracy Bartlett SLP Therapy SourceWilliam Barrish MDAmit Bhargava MDPraveen Bolarum MD Med PlusKelly Bonnette SLPRenee Bovelle MDLevi Breuer PsyDGlenwood Brooks PhDJacinth Brooks PsyDRebekah Brown MD Med PlusStanley Brull MDIlana Burgh PsyDKenneth Burlingame PhD

Tyler Calabrese PsyD

Onsite Visit FY17 - Psych Inc (Justin Anderson)

Tracey Calvo Clarke SLPKimberly Campbell PhD AMCE PhysiciansWilliam Canter PhD AMCE PhysiciansRenee Carr PsyD

Nicola Cascella MDKey Provider - Volume for FY17

Onsite Visit FY17

Matthew Celozzi PhDDonna Chambers MDRenu Chandra MDMahesh Chandra MDTanu Chandra MD CE Provider ServicesJanis Chester MD

Dennis Chodnicki MDAshok Chopra MDMatthew Christian MD CE Provider ServicesShawn Clausen MD AMCE PhysiciansRaymond Clifford MDHoward Cohen MDDoriscine Colley MDJoseph Cudjoe MD Med PlusScott Daly MDEphrem Daniel MDAjit Das MD Saluja Medical AssociatesRene Desmarais MDRobert Dewberry PhD

Shakuntala Dhir MDOnsite Visit FY17

Miles Diller PhDGloria Domingo MDMary Donnelly PhDMichael Draughon SLPJohn Driscoll PhDJonathan Dubin MDErica Edelman PhDMichael Elman MDClifford Essman PhDMichelle Estis PhDJonathan Etter MDVictoria Eyler PsyDCamellus Ezeugwu MDRebekah Farrar SLP National Speech Language

Jeremy Fenlon Owner Redlink Key Provider - CE Only for FY17

Onsite Visit FY17

Dana Fensterman SLP National Speech LanguageHarvey Fernbach PhDEvelyn Fielding PhDFrancis Fishburne PhDGawin Flynn MDRobert Foster PhD

Carolyn Fox Owner Med PlusKey Provider - CE Only for FY17

Onsite Visit FY17

Claude Fox MD Med PlusKey Provider - CE Only for FY17

Onsite Visit FY17

Ashley Fralen Owner EBSShleia Freeman MDLinda Freilich MDJodi French PsyDA. Jerry Friedman MDWilfredo Gamez MD CE Provider ServicesRobert Ganter PhDBridget Garrison AuDAllen genut MDClarnece Ghris MDDenise Gooch MD AMCE PhysiciansChristopher Goodrich MDVictor Gong MDRamana Gopalan MDLenita Gorrell PsyDCatherine Graham PhD CCC-SLPTwhanna Green PhDLouis Grenzer MDAmy Gross SLP EBSDavid Gross MDAmanda Guenther SLP National Speech LanguageNishi Gulati MDSuresh Gupta MDGeorge Hajjar Jr MDMary Hanisee MD Med Plus

Jethalal Harkhani MDDeborah Harris PhDShoaib Hashmi MDIrafan Hassen MDShalena Heard PhDJordan Heffez MD

Lawrence Honick MDKey Provider - Volume for FY17

Onsite Visit FY17

Linda Hoopes OwnerKey Provider - Volume for FY17

Onsite Visit FY17

John Hornbaker MDDavid Hoyt MDSaw Htun MDRichard Hunt Jr MDCarl Hurwitz PhDNabeen Hussain MDDonna Ignelzi-Ferraro PhDJames Isaacs MDJulian Jakobovits MDMariflor Jamora MDSukhpal Jassi MDAllan Jensen MDChristian Jensen MDCarola Jobe PsyDRaynell Johnson PhDSavinder Julka MDChidinma Kabba MD CE Provider ServicesZalman Kahn MD

Michael Kaiser PhDKey Provider - Volume for FY17

Neha Kalaria MD Saluja Medical AssociatesMohammad Kamsheh MDVijay Kannan MDHassan Kassamali MDTahoora Kawaja MDMichael Kelleher MDRashid Khan MDShafaat Khan MDSuresh Khetan MDMichael Kennedy MDBrian Kim DOSuman King PhDGary Klein MD

Leigh Knotts PsyDKey Provider - Top 5 for FY17

Onsite Visit FY17

John Konikkara MD RedlinkAnuja Kurichh MDAjit Kurup MD

Alan Langlieb MDKey Provider - Volume for FY17

Onsite Visit FY17

Gerald Lee MDJames Lee MDBrooke Leiman SLP National Speech LanguageSteven Lerner MDTamara Levin PsyDWeerasak Lima MDRobert Lisk MDCheryl Lowman PhD AMCE PhysiciansDavid Lumsden MDSuhas Madhiraju MD AMCE PhysiciansMonica Maines CCC-SLPMatthew Malta MDEric Marcalus MDGladys Marcum SLPBrett Martin MD Med PlusNalin Mathur MD

Deborah Matthews PhDKey Provider - Top 5 for FY17

Sally Mays PhDSally McBride PhD

Nancy McDonald PhDKey Provider - Volume for FY17

Onsite Visit FY17

Philip McGann MDHarriet Meier MDBrandon Metcalf MDMartha Merrion PhDSarah Michel SLP National Speech LanguageShama Mittal MDBenhur Mohammed MD CE Provider ServicesLanning Moldauer PhDC. Bernard Mond MDJorge Mondino MDJ. Renee Moneyhun MDMelanie Montemayor MD CE Provider ServicesCatherine Moore SLP EBSAkintunde Morakinyo PhDTavia Morgan PsyD AMCE PhysiciansAnwar Mumtaz MDFarid Murshed MDErnest Myers MDFadi Nasrallah MDAngela Nduaguba-Ezumba DOBruce Neckritz MDAshley Nimmo SLP EBSDeborah O'Donnell PhDLorraine Ofori-Awuah MDSanjin Oh MDMarjorie Okum PhDIkechi Okwara MDAdaku Onukogu MDKelly Ooi SLP National Speech LanguageSisom Osia MDDavid Ospital MDTheodore Osuala SLPPatricia Ourand PhDFrederick Parente PhDMark Paris MDDavid Parver MDPranav Patel SLPJacqueline Paterson SLPDonna Paul MDStephan Pavlos MDMichael Peimer MD/PhDJane Peng PsyDAmber Penuel MDRafael Perez-Mera MDKatherine Perry MDAnnette Pham MD

Sara Phillips PhDKey Provider - Volume for FY17

Onsite Visit FY17

Vaul Phillips MDMelissa Phillips Jordan PhDArturo Pidlaoan MDDavid Plotkin MDStacey Pollack PhDShauna Pollard PhDKenneth Pompilio MDRegina Presley AUD/CCC-ASohail Qarni MD

Ebenezer Quainoo MDKey Provider - Top 5 for FY17

Onsite Visit FY17

Bruce Rabin MD/PhD

Joseph Raffetto MDPatricia Randolph PhD CCC-AVani Rao MDHarvey Rapp PhDAnuradha Reddy MD

Vijayalakshmi Reddy MDDenise Revel MS, CCC-SLPPedro Rivera-Velazquez MDFrances Rodriguez MDA. Miguel Rodriquez PhDAda Rodriguez MD AMCE PhysiciansPaul Rogers PsyD

Gregory Ross MD CEIKey Provider - Top 5 for FY17

Onsite Visit FY17

William Russell MDBernard Rubin MDRichard Ruth PhDBenjamin Rutt PhDJessica Safer SLP National Speech LanguageDaliah Salahuddin MDDaljeet Saluja MD Saluja Medical AssociatesDarshan Saluja MD Saluja Medical AssociatesKimberly Sanschagrin JD/PhDDaljit Sawhney EdD/CCC-SLPRobert Scherr PhDLinda Schuerholz EDD Faith Schwartz MDMichael Sellman MDMohammad Shafiei MDVijay Sharma MDArlyne Sher PhD, PA

Paul Short PhD AMCE PhysiciansGerald Shugoll MD

Will Shumway Owner CE Provider ServicesKey Provider - Volume for FY17

Onsite Visit FY17

Hoorie Siddique PhDDaljeet Sidhu MDSamaranayake Silverine MDWanda Simmons-Clemmons MD CE Provider ServicesIqbal Singh MDJames Smith PhD AMCE PhysiciansAjay Soodan MDJillyan St. Laurent SLP EBS

Melinda Stein PhDKey Provider - Top 5 for FY17

Robert Stephens MDNicole Stern MDJohn Stokes MD Saluja Medical AssociatesSamuel Stoleru MDBina Taibi MD Saluja Medical AssociatesAlla Taller MDInna Taller MD

Mikhael Taller MDKey Provider - Volume for FY17

Onsite Visit FY17

James Tansinda MDLaura Tanyi-Remarck MD CE Provider ServicesMary Taylor-Ennis PhDDuane Thomas PhDTeresa Trabue PsyDNjideka Udochi MDPerfecto Valarao MDLucy Van Voorhees MDJudy Versola-Russo PsyDBarry Walters MD

(b) (6)

Tracie Warnick CCC-SLPCraig Watkins MD Saluja Medical Associates

Sheldon Weinstock PhDKey Provider - CE Only for FY17

Onsite Visit FY17

Charles Weng MDJeffrey Wexler MDAlexander Whelan SLP National Speech LanguageSarah White MDJeffrey Wieland MDMark Williams MD

Nellie Whitaker MD CE Provider Services

Marcia Wolf MDDouglas Wright MDLing Wu PsyDAnita Wyatt CCC-SLPKendel Wylie-Pugh PsyD AMCE PhysiciansJames Yan MDMark Young MDWillie Yu MDDavid Zahm PhD AMCE PhysiciansMohammad Zamani MDJohn Zampella MD CE Provider ServicesCharles Zeitler PsyDBritney Ziskind PhD AMCE PhysiciansAmy Zimmerman MD

(b) (6)

MD DDS CE Facility List FY16

Facility Name

Advanced RadiologyAnne Arundel Medical CenterBaltimore Heart AssociatesBaltimore Pulmonary Critical Care PABon Secours HospitalCalvert Memorial HospitalChester River HospitalCommunity Radiology Associates, Inc.Diagnostic Imaging ServicesDorchester General HospitalFranklin Square Hospital CenterFrederick Memorial HospitalHarford Memorial HospitalLifebridge Community Pulmonology LLCMaryland Healthcare ClinicsMemorial Hospital of EastonMeritus Medical Center

Meritus Medical Laboratory (Hagerstown Medical Lab)

Northwest Hospital CenterPeninsula Regional Medical CenterPrince George's Hospital CenterPulmonary Consults of HagerstownShady Grove RadiologistsSonus Hearing CenterSt. Mary's HospitalSuburban HospitalTri State Occupational Medicine Inc.Union Hospital of Cecil CountyUniversity of Maryland Med Ctr Midtown CampusWashington Adventist HospitalWestern Maryland Regional Medical CenterWMHS Bradock Hospital Corp

Massachusetts

Doctor's Name Lic Type Status (Top/Key Provider) Onsite Visits

Alfred, Pierre (Greenfield Eye Care Assoc.) M.D.Aliotta, Armand M.D.

Anscombe, Roderick M.D.Bakow, Harry Ph.D Yes

Bekken, Kaaren Ph.D YesBerkowitz, Albert Ed.D

Bevis, Judith Ph.D Top provider based on dollar volume YesBhembe, Xenia Johnson M.D. Yes

Blackmon, Kahni Ph.D YesBohnert, Michael M.D.Broder, Steven N. Ph.D Top provider based on dollar volume YesBrooks, Mark L. Ph.DBucklin, Janet Psy.D YesCahan, David M.D.

Carbone, Victor Ph.DCarnes, Maureen Ph.D

Caron, Mark Ph.D YesCarruthers, Wendelyn SLP

Cattanach, Lynn Ph.DChannell, Shawn Ph.DCohen, Geoffrey Ph.DColburn, Marnee Ph.D

Colcher, Susan Ph.D Top provider based on dollar volume YesCopersino, Marc Ph.DCordero, Astrid SLP

Covington, Elizabeth (CHC) SLPCox, Adam Ph.D

Cusher, Alan (Med Plus) Ph.DDiaz-Torres, Bonnie (CHC) SLP

Dudley, Desreen Psy.DDunne, Barbara Ed.D Top provider based on dollar volume Yes

Dunn-Riordan, Christine (CHC) SLPFahey, John Ph.D

Farizan, Morey M.D.Forteith, Doris (part of Vorpahl) Ph.D

Gendlerman, Josef M.D.Gershberg, Rick Ph.D

Glieberman, Oscar M.D.Glikstein, Violetta SLPGoldberg, Ronald M.D.

Greiner, Jack D.O. YesGuenther, Teena Ph.D

Haas, Scott Ph.DHastings, Lisa (CHC) SLPHemani, Sadruddin M.D.

Henderson-Kjellen, Kimberly Psy.D Key Provider- Top 5 provider based on dollar volumeHennessy, John P. Ph.D

Hentoff, Steven Ph.DHernandez, Ananda Psy.D YesHernandez, Frank Ph.D Yes

Hernandez, Margarita Ph.DHoekstra, Renee Psy.D Top provider based on dollar volume YesHolloway, Robert Ed.D Top provider based on dollar volume YesHorton, Timothy Ph.D Top provider based on dollar volume Yes

Howland, Charles C. Ph.DI.M.A. M.D./Ph.D

Ingle, David Psy.D YesIscan, Sureyya Ph.D Yes

Jacques-Twichell, Kathy (CHC) SLPJagelman Hunter, Jane Ph.D Top provider based on dollar volume Yes

Jones, Wendell M.D.Kacprzak, Krzysztof M.D.

Kay, Howard (Brockton Pediatrics) M.D.Keat, Jane Psy.D Yes

Kent, David Psy.DKissin, Miriam Psy.D Key Provider - Top 5 provider based on dollar volume Yes

Kogan, Jacob Yacov M.D. Key Provider - Top 5 provider based on dollar volume YesKomer, R. Roger M.D. YesKovalcik, Rimma Psy.D Key Provider - Top 5 provider based on dollar volume Yes

Krueger, William P. Ph.D Top provider based on dollar volume YesKurlander, Karen Ph.D Yes

Massachusetts


Lawson, Jasper Ph.D YesLeibowitz, Janet Psy.D Yes

LeJacq-Smith, Timothy Ph.DLenhart, Sharyn M.D.LeSueur, L. Lynn Ph.D Yes

Levy, Dean Ph.DLosada-Zarate, Gloria Psy.D YesMacDonald, Marian Ph.D

Markey, Sean Ph.D Top provider based on dollar volume YesMarkosian, Nahid Ph.D Top provider based on dollar volume Yes

Marks LeConey, R. Cindy (lic # 7980) Ph.DMayers, Felix M.D.

Mondale, Jason M.D. YesMora De Jesus, Rafael (Hartford Psychological Svcs) Ph.D

Morgenstern, Doris (CHC) SLPMorocco, Daniel Ed.DMurray, Shannon Psy.D

Natapov, Irina M.D.Norris, Ronald M.D.

Nowell, David D. Ph.D Top provider based on dollar volume YesOber, Richard Ph.D Yes

O'Connor, William E. M.d.Ojutalayo, Ayobami M.D. YesOladipo, Olarewaju M.D. Yes

Osofsky, Robert M.D.Parsons, John Ph.D

Peifer, Darcy (part of Vorpahl) Ph.DPittenger, Sol Ph.D Top provider based on dollar volume Yes

Powell (Harvey), Lashanda (Hartford Psychological Svcs) Psy.DPowers, Edward Ph.D Top provider based on dollar volume Yes

Quamina, Benjamin Andre M.D.Quinn, Sarah A. Ph.D

Rahman, M. Anis M.D.Riad, Mamdouh M.D.

Roache, Caitlin (part of Vorpahl) Ph.DRobertson, Leah Ph.DRobison, James M.D. YesRoselli, Anthony M.D. Yes

Rosenblum, Debra M.D.Rosenthal, James M.D.Rothfarb, Herbert Ph.DRusnak, Stanley Ed.DSalusti, Donna Psy.D YesSaris, Stephen M.D.Saxena, Asha M.D.

Schuetz, Richard Ph.DSchultz, Kristin Psy.DSlavit, Michael Ph.D YesSmith, David A. Ph.DSmith, Michael SLP

Sokol, Mark Ed.D Top provider based on dollar volume & Key Provider primary does CE's YesSteinmark, Andrew Psy.D Yes

Stephenson, Margaret Ph.DStillson, Richard Ph.D

Strominger, Mitchell M.D.

Stronach, Theodore Ph.D Top provider based on dollar volume & Key Provider primary does CE's YesSutcliffe, Ernest M.D.Taylor, Milton Ph.D Key Provider primary does CE'sTodd, James M.D.

Toledo, Mabel (Hartford Psychological Svcs) SLP Key Provider - Top 5 provider based on dollar volumeVallery, Sandra Ph.D

Vorpahl, Jacqueline Ph.DWahlund, Thomas Psy.D Key Provider primary does CE's

Warren, John (Franklin Eye Care Assoc.) M.D.Waters, Richard Psy.D

Weene, Lawrence M.D.Weida, Alexandria Ed.DWhipple, Donna Psy.D YesWhitworth, Don Ph.D

Massachusetts


Williams, Douglas N. Psy.DWoodacre (O'Brien), Emily (CHC) SLP

Yufit, Vladimir (Southcoast Physician Svcs) M.D. YesZarnoch, Chester M.D.

No longer contracting but performed CE's during the year:

Albin, John M.D.Basta, Nabil M.D.Bowie, Mark M.D.

Brown, Peter A. Ph.D YesCarlson, Katrin Ph.D

Christian-Bratwaite, Nicole M.D.Ciri, Molly Psy.D

Davies, Jeffrey M.D.Endriga, Raul M.D.Faherty, Ellen Psy.DGrillo, George M.D.

Gutowski, Stanley Ph.DHager, Joanne Ph.D

Hulseberg, Kevin M.D.

Husson, David Psy.D Top provider based on dollar volume & Key Provider primary does CE's YesKahn, Michael M.D.

Kouperschmidt, Larisa M.D. YesLaFlamme, Elise (Med Plus) M.D.

Leeds, Svetlana Ph.DMatos, Greg Psy.D

Matthews, Rebecca Ph.DMorin, Gregory Ph.D

O'Brien, Paul Ed.DOlden, Lindsay (Wright) Ph.DOropeza-Diaz, Yashira Psy.D

Perry, Catherine Ph.D YesPerry, David Ph.D Yes

Piascik, Tiffany Ph.DShea, Leo Ph.D

Tenenbaum, Simon M.D.Thomson, Donald J. M.D.

York, Richard Ph.DZina-Duarte, Jessica M.D. Yes

(b) (6)

Michigan DDS - AudiologistsCalhoun, MonseilleDalecki, Renee AEllis, SonyaLarsen, Margaret

Michigan DDS - Facilities7C LingoAAA Evaluations *Ace Psychological ConsultantsAkasha Medical Consultants PC* KEYAllegiance ENTAMCE Physicians GroupAssociates in Humanistic Psychology* (Terry Rudolph) *onsite visit completed FY 17Battle Creek Counseling *Bright Horizons Psychological CenterBurman and Zuckerbrod OphthmologyComprehensive Psychological ServicesDearborn ENTDiagnostic Evaluation Services *Disability Consultants, P.C.Ear, Nose, Throat and Plastic Surgery Assoc.*ENT ConsultantsEye Associates MarquetteGreat Lakes Eye CareGreat Lakes Eye Institute*Great Lakes Medical Evaluations *Hackley Workplace HealthHolt Eye Care PLLCHour TransportationHuman Capabilities Corporation *Human Resource AssociatesJohn R. Medical ClinicKalamazoo Psychological LLCLakeshore Ear, Nose and Throat Center, PCLansing OphthalmologyLifetime EyecareLung Associates, P.C.Medical Care Plus *Medical Rehabilitation GroupMichigan Medical Consultants *Michigan Medical EvaluationMid-Michigan Ear, Nose and ThroatMonarch Evaluation Services *Munson Community Health CenterNovi Health Center, PCOld Town Psychological Services Port Huron Ophthalmology Psycho-Educational Consutant ServicePsychological Resource & Testing ConsultantsResolute InterpretingRonan Psychological Associates *

Key Provider (Top 5)Key Provider (Primary CE work)

Rontal Akervall ClinicSaginaw Psychological Services *Seasons Counseling Center *Sermic Psychological *Sierra Medical Group *South Michigan OphthamologySouthern Michigan ENT, PCSuperior Ear, Nose and Throat SpecialistTri-State Occupational Medicine, Inc. *Vision Eyecare Vision Institute of MichiganVPS of MI PLLCWeber and Devers Psychological ServicesWilkinson Eye ClinicWorkplace HealthWyandotte Eye Clinic

Michigan DDS - MDs and DosBatah FouadBest Todd T KEYBlum George MDBorovik Harry RBuchman Clifford M *onsite visit completed FY 17Campbell Vern JCarlson Waldo MDCho Sung-RanDawis Elvira Dragoo Bruce DFawcett RobertFriedman Neil AGoebel EricHillelson June DLerchin Cheryl DLopatin Fred LQureshi Tanvir IRocco JamesSayyid Samiullah H MDTinney Roderic MDWahl Larry H DOWaitzman Ariel MD


Michigan DDS - OptometristsMiller Bernard OD

Scarbrough Family Eye Care Wyandotte Eye

Michigan DDS - PsychologistsAbramsky Atara Ajayi-Nabors MargaretBechard Joseph ABonanno Shelly KEYBrooks LoisBrown BonnieBrown CraigBush Allison *onsite visit completed FY 17Camp William LCaputo Janette SCashbaugh * David LLPCroce Michelle LCullen-Ott MaryDecker PatriciaEmerson Lynne EFindley James Gardner* NancyGensterblum AnthonyGoergen Marianne TGriffith Robert LGventer Dawn BHackworth BruceHayes Michael PHaynes Jack PHorner* Thomas MInman MichaelJacobson* Bruce NJames RichardJeter* John DKantor Anne GKilpela Gary SKinzie Wayne BKirzner Gerald SKitchen Paul SKoenig-Forbis NancyKroemer HenrikeLehmann Carol JLozer James VMacleod EricMajerczyk Brian DaleMakie ErikMarkowicz Jocelyn A PhDMcAndrews Lynn PhD

Key Provider (Top 5)

Key Provider (Primary CE work)

McCulloch Leonard JMurphy PatrickOliver-Brannon GaylePekrul* KathrynPestrue George EPeterson Glen*Potts David Reilly Neil JReppuhn Steven DRidella-Mehlos Sharon JRosenbaum Thomas SRosenweig MelissaSlamika Staci PhDSommerschield Harold SVan Horn Firoza BVander Woude Kenneth WWalberer Daniel LWheeler Samantha FLPZaroff MarkZimostrad Scott

Michigan DDS - SLPBabcock Ann MBloom RichardChampagne ArthurChapman ColeenChevillet SharonCohen-Babcock JodiDahlman SusanDenis Rachel Edwards PatriciaEllis StacyEurich KathleenGlonek SarahGoletz Aira Gould Carol LHandren ShelleyHarper MelanieHartley Julie SLPJaynes BeverlyKilmer CynthiaLang JasonMaisel Teresa SLPMartin-Kobessi KathiMellen PennyMosier Nancy SLPMurphy Rachel LO'Leksy GailPollich KristenPopma JamesRobertson PhyllisRobbins Amy R KEYSaidi Samah M SLPScow Cecilia HShier ConnieSmith Michele E *onsite visit completed FY 17Spencer SusanToth KathleenVanorman Amy SLPVermeulen Linda SLPWeeden Annette Winegar Rebecca

Carl's Speech and LanguageCertified Speech Therapy ServicesSpeech Pathology Assoc.Superior Rehabiitation and Prof Serv


MI DDS FY 2017 - Testing

Greater Flint Imaging dba Lindent RdMid Michigan Radiology Assoc.OMH Speciality and Diagnostic Clinic Otsego Memorial HospitalRegional Medical TestingSt, Marys of MichiganWest Branch Regional Medical Center

VENDOR_NO NAME EXAMS Top 10 Provider Onsite VisitA TO Z WORLD LANGUAGES INC 13ABBAS, CAITLIN 1ABDULWAHAM, ADEEM 1ABRAHAM, DENNIS MD 1ALBERIO, KATHLEEN 2ALLEN, BRIAN DO 77ANDERSEN, DENNIS MA 146ALTRU CLINIC GRAND FORKS 1ANDERSEN, SALLY SLP 19ANDERSON, ANNIKA E OD 3ANDERSON, CASSIE SLP 4ANDERSON, CHRISTOPHER MD 1ANDERSON, MARK 55ANDERSON, STEVEN MD 2ANGLE, REBECCA PHD 39ANHORN, JENNIFER SLP 2ARCH LANGUAGE NETWORK 9BACHMAN, ANNA 8BACHMEIER, ERIK 25BACKLAS, TYLER 2BALDUS, JAMES PHD 46BARNES, MADALINE PHD 10BARRON, DR CRAIG 1059 Yes 7/28/2015BARRON, ROBERT C PHD 266 Yes 9/3/2015BARSTAD, TRENT PHD 7BARTH, TARA OD 28BAUER, MATTHEW OD 38BECKEN, ERIC THOMAS MD 6BOETTCHER, BRITTANY OD 21BONTE, BRIAN MD 87BOOTH, JILL SLP 6BOURDEAUX, MONIQUE PHD 988 9/8/2015BOWMAN, SARAH 54BREITENBUCHER, MARY PHD 5BRIDGE WORLD LANGUAGE CENTE 103BROCKMAN, HEATHER 11BUBOLTZ, MARK OD 34BUTSON, STEPHANIE 1CABRERA SVENDSEN, MATTHEW 3CABRERA, SHANNON 2CARLIN, SUSAN M SLP 20CARLSON, BETHANY 1CARLSON, DANIEL L 60CARLSON, SHERIE LP 70CARROLL, PATRICK J MS 179CASPERS, DIANE LP 14CAVEN, ELIZABETH J PSYD 31CHESLOCK, GERMAINE 2CHRISTIANSEN, TIMOTHY N 10CLARITY INTERPRETING SERVIC 5CLOUTIER-GILL, NOUMIA OD 15COCKER, RICHARD MS 29COMMUNICATION SERVICE FOR D 25COX, JOSEPH PSYD 101COX, VICTOR STUART 25CRAGLE, STEPHEN MD 8CROSS CULTURAL MEDICAL INTE 19CURTIS, STEVEN B 48DARVEAUX, DION LP 33DAUER, EILEEN MD 8

Minnesota FY 2017

(b) (6)

DEARKING, AMY C MD 8DESMONDE, MARCUS PSYD 87DICKSON, WILLIAM J PHD 109DOEDEN, GINA OD 19DULUTH CLINIC VIRGINIA 1DVORAK, JOHN A 11EDELSON, DOROTHY PSYD 44EGLI, ANDREA PHD 10EICHLER, MICHAEL MD 2ESSENTIA HEALTH ST MARYS HO 22FAUL, KIRI ANN PHD 1FERRY, LOUISE PHD 27FISCHLER, GARY PHD 7FLOHR, JAMIE MD 42FLORES, JANIE 2FREDRICKSON, SARA OD 9GAUTHAM, SHANTA MD 2GENDRON, KRISTIN MD 28GERHARDT, JENNIFER 44 GLYNN, CHRISTINE 1GOMAN, KRISTEN 10GRAHAM, JOHN A MS 34GRAND ITASCA CLINIC & HOSPI 4GRANITE FALLS MUN HOSPITAL 6GREEN, LARRY LP 73GUNDERSON, LAURA 1HAINES, KAYLA 1HAMILTON, PAMELA 6HAMLIN, FALICIA 1HANSON, RONALD MD 4HEALY, ANNE 2HILBRAND, ASHLEY MD 3HINZE, TRAVIS PHD 20 HOBBS, JOHNNA 3HOFFMAN, KRISTINA SLP 2HORECKA, RICHARD MD 43HOWK, LUPY 1HUBER, JAMES PHD 426 Yes HUNTER, PATRICIA PHD 18IMMANUEL ST JOSEPHS HOSPITA 13ITASCA INTERPRETING SERVICES 201IVERSON-HILL, SONJA OD 1JANKUS, WARD R 1022 Yes 8/27/2015JOHNSON, A NEIL MD 2573 Yes 9/18/2015JOHNSON, ANNIE MA 6JOHNSON, BRENT D 1JOHNSON, NENA 16JOHNSON, SUSAN MD 216 8/18/2015JOHNSTAD, MARIE SLP 31JOPLIN, ANDREA 7JOSEPH, THRESIAMMA 4KAHLER, RONALD LP 36KARAYUSUF, ALFORD 2752 Yes 8/10/2015KARLEN, RICHARD MD 2KARPYAK, TATYANA PSYD 94KEARNEY, MICHAEL M 45KELLY, BRANDON OD 13KEYSTONE INTERP SOLUTIONS I 64KIRCHNER, JOEL PSYD 185KRAMLINGER, MARY 1KOENIG, MIKAELA MD 1

(b) (6)

KRENIK, SARAH SLP 6KRUEGER, NICOLE 4KULLA, KAREN 36LAKE REGION HOSPITAL 5LANE, STEPHEN S MD 1LANG, JACOB R OD 3LARSON, ROBERT MD 1LAVALLIE, SEAN OD 9LEAVECK, APRIL S PSYD 27LEE, ANNIE MD 1LEINONEN, CAROL L PSYD 46 LIEF, JENNY 1LOPNO, ROBERT L II 163LYNCH, JEFFERY MD 1LYSNE, MARK PHD 139MAGNUSON, TODD 8MANGIAMELE, SEBASTIAN MD 239MARQUARDT, JAMES 5MARION, MITCHELL MD 8MARSHALL, LINDA PHD 32MARTENS, KENNETH L MS 142MARTIN, MARK D0 40MAYO CLINIC HEALTH SYSTEM A 7MCCABE, WENDY 10MCNELIS SAVRE, LORI SLP 8MELANDER, MCKENZIE 15MERCY HOSPITAL 31MEYER, KRISTINE M MA 108MIDWEST EAR NOSE & THROAT S 1MIDWEST INTERP/TRANSLATION 992MILLER, SARAH 8MISKAVIGE, LINDSEY SLP 5MODAHL, ED LP 36MONTEALEGRE, KATE OD 7MONTELIBANO, SHELLY 7MOONEY, RENE PSYD 3MORAN, DEBRA LP 114MORIN, MATANA 8NORENBERG, KAYLA MD 4MURPHY, JESSICA L OD 3OKNER, THOMAS MD 3OLSEN, ROGER A PSYD 87OLSON, SPENCER ANTON PSYD LP 124 8/8/2017OREGAN, JOHN T 297 OWATONNA HOSPITAL 45PAPENFUSS, JANET 3PHILLIPPI, JAY 50 8/2/2017PIEH, TIMOTHY 14PROJECT FINE 30RADEMACHER, MARY MS 4RAMTHUN, STACIE 18RESSLER, SCOTT LP 34 8/2/2017REYNOLDS, ABIGAIL MD 3RICE MEMORIAL HOSPITAL 2RICE REHABILITATION CENTER 25RIDGEVIEW MED CENTER 2RIES, ADAM LP 5RIGGS, SHAINA MD 1RIVERVIEW HOSPITAL 12RONDLA, SUCHITRA 3ROWAN, LESLIE PHD LP 71

(b) (6)

SABIR, DAVID 9SANFORD BEMIDJI MED CENTER 151SANT, SAMUEL 6SARFF, PHILIP PHD 205 SAUNDERS, MARY 5SCHAFER, RYAN LP 132 8/10/2017SCHULER, MARK PHD 156 SCORE, KATHRYN MD 1SCURRY, WILLIAM PHD 93SHELHAMER, LEONARD E 1SKOPHAMMER, HEIDI SLP 19SMITH, ROBERT MD 24SPANIER, DIANE 2SPEECH LANGUAGE PATHOLOGY D 269ST CLOUD HOSPITAL 12ST CLOUD MED GROUP 93ST GABRIELS HOSPITAL 2ST LUKES HOSPITAL 2ST PAUL PULMONARY DIAGNOSTI 70STEVENS, MARY LOUISE 18STICH, SHERREY 9STREITMAN, SANDRA LP 100STROM, JANELLE OD 24STUBENVOLL, ROBERT 7SWITRAS, JOSEPH E PHD 47THIBODEAU, ALYSSE 10YHOMALLA, ANTHONY 6THOMPSON, SEAN 15TOREN, ALISON PHD 3TRUITT, THEODORE MD 5TRULSEN, MARLIN O PHD 1037 Yes 8/11/2017UNIV MED CENTER MESABI 4VAN NOORD, CHERYL SYBESMA L 127VAN NOORD, ROBERT G PHD 172WAGNER, LYLE III LP 115 9/20/2017WAGNER, LYLE W PHD 325 Yes 9/20/2017WALLACE-REED, RITA MD 142WARNER, DUSTIN J PSYD 704 Yes 7/27/2017WATSON MILLER, REBECCA J PH 25WERNER, HEIDI MD 2WICKERSHAM, JENNA OD 4WIGER, DONALD PHD 1762 Yes 8/8/2017WINONA HEALTH SERVICES 8WINTER, MELISSA PSYD 21WINTERS, PATRICIA M OD 1WOLNER, BRAD 7WU, CHARLIE MD 20YERKA, ED PHD 138YOHE, MARK MD 166YOSHIDA, GLEN Y 4

(b) (6)

Vendor ID Organization Name First Name Last Name City StateAQEEB AHMAD BRIDGETON MOFRANCES ANDERSON SPRINGFIELD MOMICHAEL ARMOUR CLAYTON MOSUSAN BARNGROVER LEES SUMMIT MOANNA BELLATIN KANSAS CITY MOJOE BENNETT SEDALIA MOJENNIFER BIERE MOBERLY MOJENNIFER BIERE SALISBURY MOC WILLIAM BRECKENRIDGE KANSAS CITY MOLAURA BRENNER COLUMBIA MORONALD BUENING SEYMOUR MOLAWRENCE COHEN KANSAS CITY MOJERRY CUNNINGHAM POPLAR BLUFF MOJERRY CUNNINGHAM FENTON MOKALA DANUSHKODI N KANSAS CITY MOMANISH DIXIT PARSONS KSNINA EPPERSON LIBERTY MOROBERT FORSYTH SPRINGFIELD MOD FRISBIE JOPLIN MOCHAD GERHART JOPLIN MOBRYCE GRAY HANNIBAL MOBRYCE GRAY NEVADA MOBRYCE GRAY COLUMBIA MOBRYCE GRAY SEDALIA MOKELLEY GRAY CRYSTAL CITY MOALISE GRAY COLUMBIA MOGARY HACKNEY WICHITA KSKAREN HAMPTON ST LOUIS MOJEFFREY HARDEN KIRKSVILLE MOWILLIAM HUGHES JOPLIN MOYUNG HWANG CARTHAGE MOYUNG HWANG SPRINGFIELD MOALAN ISRAEL KANSAS CITY MOKAREN JORDAN OVERLAND PARK KSCAROLYN KARR NEVADA MOLOUIS KRENN JR WILLARD MOV NANDA KUMAR ST JOSEPH MOROBERT LACKAMP SEDALIA MOTIMOTHY LEONBERGER ST LOUIS MOROBERT LEWIS ST LOUIS MOLYNN LIEBERMAN KANSAS CITY MODAVID LINSENMEYER DODGE CITY KSJOHN LUCIO JEFFERSON CITY MOCHRISTOPHER MAGLIO KIRKSVILLE MOJOSEPH MCCORMACK JEFFERSON CITY MOJOI MCNELEY-PHELPS LENEXA KSSTANLEY MINTZ LEAVENWORTH KSSTANLEY MINTZ LAWRENCE KSRUTHIE MOCCIA COLUMBIA MOJASON NEUFELD OVERLAND PARK KSALLEN PARMET KANSAS CITY MODAVID PEACO WENTZVILLE MORANDALL POHLENZ TOPEKA KSJAMIE PRESTAGE KANSAS CITY MODAVID PULCHER OVERLAND PARK KSPAUL REXROAT ST LOUIS MOJONATHAN ROSENBOOM CHILLICOTHE MOMARTIN ROSSO FLORISSANT MOKEN RUBENACKER SIKESTON MOJANE RUEDI BLUE SPRINGS MODOMINICK SCALISE OLATHE KSTODD SCHEMMEL OLATHE KSMARK SCHMITZ COLUMBIA MOWALTER SCHROEDER JR CAPE GIRARDEAU MOLINDA SCHULTZ MOBERLY MOLINDA SCHULTZ BOONVILLE MOMICHAEL SCHWARTZ KANSAS CITY MOMICHAEL SCHWARTZ ST JOSEPH MOMICHAEL SCHWARTZ SALINA KSMICHAEL SCHWARTZ OVERLAND PARK KSRAMESH SHAH JOPLIN MOTHOMAS SPENCER JEFFERSON CITY MOCRAIG SPIEGEL BRIDGETON MORUTH STOECKER ROLLA MOS SUBRAMANIAN CARTHAGE MORICK THOMAS BELTON MORICK THOMAS LIBERTY MORICK THOMAS LIBERTY MO

Missouri FY 2017

(b) (6)

RICK THOMAS KANSAS CITY MOJAMES TICHENOR KIRKSVILLE MOLAURA TISHEY CLAYTON MOPRISCILLA WALLINGFORD LEAWOOD KSSTEVEN WALTERS GREAT BEND KSCHRIS WEBER BRANSON MOBROOKE WHISENHUNT SPRINGFIELD MO

247 PC CHICAGO ILA RASHID QURESHI MD INC A RASHID QURESHI ST LOUIS MOACADEMIC MEDICINE INC KIRKSVILLE MOADELMAN & ASSOCIATES STEVEN ADELMAN VERSAILLES MOADVANCED NATURAL HEALTHCARE JOHN BRANDT WEST PLAINS MOADVANCED NATURAL HEALTHCARE RICHARD FREDERICK WEST PLAINS MOADVANCED PHYSICAL THERAPY JOSHUA HOCKETT BLUE SPRINGS MOADVANCED PHYSICAL THERAPY TIMOTHY ROBERTS BLUE SPRINGS MOADVANCED PHYSICAL THERAPY TRAVIS RUMP BLUE SPRINGS MOADVANCED RADIOLOGY LLC OSAGE BEACH MOADVANCES IN THERAPY AMY FLESHMAN KIRKSVILLE MOAFFINIA HEALTHCARE-BIDDLE ST LOUIS MOAFFINIA HEALTHCARE-LEMP ST LOUIS MOALLIANCE RADIOLOGY KANSAS CITY MOAPEXNETWORK PHYSICAL THERAPY JOHN TOCCI SPRINGFIELD MOAPPLIED PSYCHOLOGICAL CENTER DAVID VAN PELT CAPE GIRARDEAU MOAREA HEARING & SPEECH CLINIC JOPLIN MOASSESSMENT CONSULTANTS LLC AMY FISCH KANSAS CITY MOASSOC BEHAVIORAL CONSULTANTS THOMAS SPENCER ROLLA MOASSOC BEHAVIORAL CONSULTANTS THOMAS SPENCER WASHINGTON MOASSOC BEHAVIORAL CONSULTANTS THOMAS SPENCER ST CHARLES MOASSOCIATED BEHAVIORAL CONSULT NINA EPPERSON ST JOSEPH MOASSOCIATED BEHAVIORAL CONSULTA THOMAS SPENCER PEVELY MOASSOCIATED BEHAVIORAL HEALTH THOMAS SPENCER HANNIBAL MOASSOCIATED BEHAVORIAL CONSULT THOMAS SPENCER CRYSTAL CITY MOAT STILL UNIV-GUTENSOHN CLINIC STEPHEN BERGMAN KIRKSVILLE MOATCHISON HOSPITAL ASSOCIATION ATCHISON KSAUDIOLOGY & HEARING AID SERV WICHITA KSAUDIOLOGY & HEARING CENTER KELLEY GRAY FARMINGTON MOAUDIOLOGY CENTER CAPE GIRARDEAU MOBATEK FAMILY EYE CARE SHARON BATEK FULTON MOBLUFF RADIOLOGY GROUP POPLAR BLUFF MOBODENHAMER EYE CONSULTANTS BRET BODENHAMER JEFFERSON CITY MOBOLIVAR PHYSICAL THERAPY BOLIVAR MOBOONE HOSPITAL CENTER COLUMBIA MOBOONE HOSPITAL CENTER COLUMBIA MOBOONE HOSPITAL CENTER COLUMBIA MOBOONE HOSPITAL CTR COLUMBIA MOBOOTHEEL EYE CARE JUSTIN SCHROEDER CARUTHERSVILLE MOBOTHWELL REGIONAL HEALTH CTR SEDALIA MOBOTHWELL REGIONAL HEALTH CTR SEDALIA MOBROOKSIDE COUNSELING RICK THOMAS KANSAS CITY MOBURRELL KINGSLEY CLINIC CHRISTINA PIETZ SPRINGFIELD MOBURTON CREEK RURAL CLINIC BRUCE PRESTON WEST PLAINS MOBUTLER-DAVIDSON COUNSELING SER LINDA DAVIDSON NEVADA MOCAMERON REGIONAL MED CENTER CAMERON MOCAMERON REGIONAL MED CENTER CAMERON MOCAPE GIRARDEAU PUBLIC LIBRARY JENNIFER STEELMAN CAPE GIRARDEAU MOCAPE MEDICAL WEIGHT LOSS & FP DEBBIE EVANS CAPE GIRARDEAU MOCAPE RADIOLOGY GROUP INC CAPE GIRARDEAU MOCAPITAL REG MED CTR-HEALTHPLEX GWEN MOE JEFFERSON CITY MOCAPITAL REGION MED CENTER JEFFERSON CITY MOCAPITAL REGION MED CTR JEFFERSON CITY MOCAPITAL REGION MED CTR JEFFERSON CITY MOCAPITAL REGION MED CTR-STILL JEFFERSON CITY MOCARDIOVASCULAR CONSULTANTS CAPE GIRARDEAU MOCASSVILLE BRANCH LIBRARY JAMES CARPENTER CASSVILLE MOCENTER OF ORTHO EXCELLENCE GREGGORY KUHLMANN JEFFERSON CITY MOCENTRAL MEDICAL CONSULTANTS WICHITA KSCENTRAL MEDICAL CONSULTANTS TOPEKA KSCENTRAL MEDICAL CONSULTANTS SHAWNEE MISSION KSCENTRAL MO ENT & SINUS PC ROBERT MCDONALD JEFFERSON CITY MOCHAFFEE HIGH SCHOOL LANA ATKINS CHAFFEE MOCHRISTIAN HOSPITAL NE ST LOUIS MOCHRISTIAN PSYCH SERVICES OF KC DON BRADY BLUE SPRINGS MOCitizen's Bank building 2nd fl LYNN LIEBERMAN KANSAS CITY MOCITIZENS MEDICAL CENTER COLBY KSCITIZENS MEMORIAL HOSPITAL BOLIVAR MOCITY SPEECH INC CLAYTON MOCLINICAL ASSMNT PSYCHOLOG SVCS JOHN WOOD POPLAR BLUFF MOCLINICAL RADIOLOGY CONS INC SEDALIA MOCOLBY DCF OFFICE MICHAEL SCHWARTZ COLBY KS

(b) (6)

COLLEGE SKYLINE CENTER AMY COLE JOPLIN MOCOLLEGE SKYLINE CENTER CHARLES DOYLE JOPLIN MOCOLUMBIA RADIOLOGY LTD COLUMBIA MOCOMPREHENSIVE CONSULTING/COUNS ROBERT FORSYTH WEST PLAINS MOCOMPREHENSIVE EYE CARE LTD MICHAEL KORENFELD WASHINGTON MOCOMPREHENSIVE PAIN SOLUTIONS DINA VERNER ABILENE KSCOMTREA KELLEY GRAY ARNOLD MOCONCORDIA DCF OFFICE MICHAEL SCHWARTZ CONCORDIA KSCOX HEALTH MEDICAL PLAZA ROBERT FORSYTH HOLLISTER MOCOX MEDICAL CENTER BRANSON BRANSON MOCPC-CENTER FOR PROF COUNSELING DAVID LUTZ SPRINGFIELD MOCRANSTON CLINIC SAAD AL-SHATHIR PITTSBURG KSCRG LLC CAPE GIRARDEAU MOCRYSTAL CITY PUBLIC LIBRARY JERRY CUNNINGHAM CRYSTAL CITY MODADE COUNTY HEALTH DEPARTMENT JAMES CARPENTER GREENFIELD MODCF OFFICE MICHAEL SCHWARTZ HAYS KSDCFS STANLEY MINTZ WINFIELD KSDEBORAH A KING MA & ASSOC INC KEITH GRAHL KANSAS CITY MODEBORAH A KING MA & ASSOCIATES LIBBY STARR LIBERTY MODEBORAH KING MA & ASSOC DASCHIA CARPENTER LIBERTY MODEBORAH KING MA & ASSOCIATES JENNIFER BOYD KANSAS CITY MODEBORAH KING MA & ASSOCIATES LIBBY STARR KANSAS CITY MODEPARTMENT OF OTOLARYNGOLOGY ST LOUIS MODEPT CHILDREN & FAMILY SERVICE STANLEY MINTZ EMPORIA KSDEPT CHILDREN & FAMILY SERVICE JASON NEUFELD LAWRENCE KSDEPT CHLD & FAMILY SVCS STANLEY MINTZ S HUTCHINSON KSDIAGNOSTIC IMAGING CENTER INDEPENDENCE MODIAGNOSTIC IMAGING CENTERS PA KANSAS CITY MODIAGNOSTIC IMAGING CENTERS PA KANSAS CITY MODIAGNOSTIC IMAGING CENTERS PA LEES SUMMIT MODISCOVER VISION CENTERS JOHN TAYLOR INDEPENDENCE MODISCOVER VISION CENTERS JOHN TAYLOR LEE'S SUMMIT MODO NOT USE PAUL REXROAT UNION MOE L JORDAN JR DO PC E JORDAN JR JOPLIN MOEAR NOSE & THROAT SURGICAL GRP DONALD JAMES WICHITA KSEVE MEDICAL SERVICES BARTLESVILLE OKEXAM PRO JOPLIN MOEXAM PRO LLC SPRINGFIELD MOEXAM PRO LLC KANSAS CITY MOEXECUTIVE COURT BLDG JARROD STEFFAN WICHITA KSEXECUTIVE PSYCH RESCOURES AMYKAY COLE JOPLIN MOEYE HEALTH CARE DANIEL OBERMARK SIKESTON MOEYE HEALTH CARE DANIEL OBERMARK POPLAR BLUFF MOEYE SURGEONS OF SPRINGFIELD C FAULKNER SPRINGFIELD MOEYE SURGEONS OF SPRINGFIELD JUDD MCNAUGHTON SPRINGFIELD MOEYECARE ASSOC OF OSAWATOMIE OSAWATOMIE KSFAMILY MEDICAL GROUP DAVID LIPSITZ ST PETERS MOFAMILY WALK-IN CLINIC MTN GRV CHRISTY BRAMWELL MOUNTAIN GROVE MOFARMINGTON PUBLIC LIBRARY JERRY CUNNINGHAM FARMINGTON MOFERGUSON MEDICAL GROUP JAMES CRITCHLOW SIKESTON MOFERGUSON MEDICAL GROUP JAMES CRITCHLOW DEXTER MOFERGUSON MEDICAL GROUP DAVID DAHLBECK SIKESTON MOFERGUSON MEDICAL GROUP DAVID DAHLBECK EAST PRAIRIE MOFERGUSON MEDICAL GROUP DAVID DAHLBECK DEXTER MOFERGUSON MEDICAL GROUP DAVID DAHLBECK KENNETT MOFERGUSON MEDICAL GROUP MARGARET DICUS CHARLESTON MOFERGUSON MEDICAL GROUP LAUREN HARDY SIKESTON MOFERGUSON MEDICAL GROUP DAVID LAWRENCE CHARLESTON MOFERGUSON MEDICAL GROUP CINDY NAZARIO-MATOS SIKESTON MOFERGUSON MEDICAL GROUP DANA REEDER FARMINGTON MOFERGUSON MEDICAL GROUP DANA REEDER DEXTER MOFERGUSON MEDICAL GROUP AMY SHELTON SIKESTON MOFERGUSON MEDICAL GROUP MIRANDA THURMAN EAST PRAIRIE MOFERRELL DUNCAN AUDIOLOGY SPRINGFIELD MOFERRELL DUNCAN ENT ANTHONY BENTLEY SPRINGFIELD MOFERRELL DUNCAN ENT DAN CROZIER SPRINGFIELD MOFERRELL DUNCAN ENT DAVID RANDALL SPRINGFIELD MOFERRELL DUNCAN ENT JACOB SMITH SPRINGFIELD MOFHSU HERNDON CLINIC HAYS KSFIRST CHOICE PHYSICAL THERAPY BRYAN ALBRIGHT HANNIBAL MOFITZGIBBON HOSPITAL MARSHALL MOFITZGIBBON HOSPITAL RAVINDER ARORA MARSHALL MOFORT HAYS STATE UNIV STEVEN WALTERS HAYS KSFOSTER FAMILY MEDICINE & ASSOC RANDY FOSTER MOBERLY MOFREEMAN HEALTH SYSTEM NEOSHO NEOSHO MOFREEMAN HEARING CENTER DAVID ANTHONY JOPLIN MOFREEMAN HOSPITAL & HLTH SYSTEM JOPLIN MOFREEMAN HOSPITAL-PULMONARY JOPLIN MOFREEMAN OAK HILL HLTH SYSTEM JOPLIN MO

(b) (6)

FULTON MEDICAL CENTER FULTON MOGARDEN CITY DCF OFFICE MICHAEL SCHWARTZ GARDEN CITY KSGOLDEN VALLEY MEDICAL CLINTON CLINTON MOGOLDEN VALLEY MEMORIAL HOSP CLINTON MOGOLDEN VALLEY MEMORIAL HOSP CLINTON MOGOOD SAMARITAN REG HEALTH CARE MT VERNON ILGOODLAND REGIONAL MED CENTER GOODLAND KSHAMPTON INN BRYCE GRAY CLINTON MOHANNIBAL CLINIC RESPIRATORY HANNIBAL MOHANNIBAL CLINIC ULTRASOUND HANNIBAL MOHANNIBAL REGIONAL HOSPITAL HANNIBAL MOHANNIBAL REGIONAL HOSPITAL HANNIBAL MOHANNIBAL REGIONAL HOSPITAL HANNIBAL MOHANNIBAL REGIONAL MED GROUP LINDA CARLETON HANNIBAL MOHANNIBAL REGIONAL MED GROUP GREGORY HENRY HANNIBAL MOHARRISON COUNTY COMMUNITY HOSP BETHANY MOHAYS MEDICAL CENTER HAYS KSHAYS MEDICAL CENTER HAYS KSHEALTHPOINT MATTHEW KARSHNER CAPE GIRARDEAU MOHEAR USA (TIMBRE) COLUMBIA MOHEARTLAND CLINICAL CONSULTANTS STANLEY MINTZ TOPEKA KSHEARTLAND CTR FOR PROF COUNSEL DEBRA RAU SIKESTON MOHEDRICK MEDICAL CENTER CHILLICOTHE MOHEDRICK MEDICAL CENTER CHILLICOTHE MOHERITAGE MENTAL HEALTH CLINIC MELVIN BERG TOPEKA KSHERNDON A SNIDER & ASSOCIATES JAN KENT JOPLIN MOHOMETOWN MEDICAL BRANDON FORESTER PIERCE CITY MOINDEPENDENT IMAGING LLC JEFFREY SHORE JOPLIN MOINTERNATIONAL EYE CARE TERRENCE HAWKINS KIRKSVILLE MOIRVING ELEMENTARY LUANN BUDDING JOPLIN MOJARED NEUROSCIENCE CENTER TED LENNARD SPRINGFIELD MOJARED NEUROSCIENCE CENTER JEFFREY WOODWARD SPRINGFIELD MOJCMG STEVE LINSENBARDT JEFFERSON CITY MOJEFFERSON CITY MEDICAL GROUP THOMAS SCHNEIDER JEFFERSON CITY MOJENNINGS MEDICAL CENTER INC AQEEB AHMAD JENNINGS MOJONES EYE CENTER ROBERT JONES WEST PLAINS MOJOURNEY COUNSELING CENTER JOHN BRANDT LEBANON MOJOURNEY COUNSELING CENTER RICHARD FREDERICK LEBANON MOKANSAS IMAGING CONSULTANTS WICHITA KSKANSAS MEDICAL ASSOCIATES SITHA MILLER WICHITA KSKANSAS MEDICAL ASSOCIATES SITHA MILLER ANDOVER KSKANSAS UNIV MED CENTER ENT KANSAS CITY KSKANSAS UNIVERSITY MEDICAL CTR KANSAS CITY KSKANSAS UNIVERSITY MEDICAL CTR KANSAS CITY KSKELSEY NORMAN ELEMENTARY BETHANY BANDY JOPLIN MOKEOUGH & ASSOCIATES JOHN KEOUGH CHILLICOTHE MOKEOUGH & ASSOCIATES PSYCH JOHN KEOUGH SEDALIA MOKEOUGH & ASSOCIATES PSYCH JOHN KEOUGH KANSAS CITY MOKIRKSVILLE ALLERGY & ASTHMA KIRKSVILLE MOKNEIBERT CLINIC PFT LAB POPLAR BLUFF MOKOENEMAN PSYCHOLOGICAL SERVICE SCOTT KOENEMAN OLATHE KSKRESIE & PENZLER MDS PA RANDALL KRESIE TOPEKA KSKRESIE & PENZLER MDS PA CINDY PENZLER MD TOPEKA KSLABETTE COUNTY MEDICAL CENTER PARSONS KSLAKE OZARK RADIOLOGY INC OSAGE BEACH MOLAKE OZARKS CHIROPRACTIC CNTR ROBERT MILEY CAMDENTON MOLAKE REGIONAL HEALTH SYSTEM OSAGE BEACH MOLAKES REGION IMAGING OKLAHOMA CITY OKLAMONDA CLINIC GARY LAMONDA COLUMBIA MOLASSEN VISION CENTER RAY LASSEN DONIPHAN MOLAWRENCE MEMORIAL HOSPITAL LAWRENCE KSLAWRENCE MEMORIAL HOSPITAL LAWRENCE KSLEET EYECARE CAPE GIRARDEAU MOLIBERAL DCF OFFICE MICHAEL SCHWARTZ LIBERAL KSLIBERTY COUNSELING SERVICES JOSEPH BLEIER LIBERTY MOLIBERTY HOSPITAL LIBERTY MOLIBERTY OFFICE PARK JERRY CUNNINGHAM FARMINGTON MOLIBERTY OFFICE PARK LAURA TISHEY FARMINGTON MOLIBERTY OFFICE PARK LAURETTA WALKER FARMINGTON MOLIFESONG FOR GROWTH & WELLNESS RICHARD LILLARD JEFFERSON CITY MOLITTLE BEAR RADIOLOGY COLUMBIA MOLOWRY & ASSOCIATES DAVID BREMER MONETT MOLOWRY & ASSOCIATES LLC BRYCE GRAY MONETT MOM D ELECTRODIAGNOSIS INC JOHN SAND KANSAS CITY MOMAGNOLIA MEDICAL SERVICES SPRINGFIELD MOMAGNOLIA MEDICAL SERVICES NEVADA MOMAGNOLIA MEDICAL SERVICES LINN CREEK MOMARSHFIELD REHAB MARSHFIELD MOMARSTON HEARING CENTER LAWRENCE KS

(b) (6)

MATTAX NEU PRATER EYE CENTER MICHAEL ENGLEMAN SPRINGFIELD MOMATTAX NEU PRATER EYE CENTER MATTHEW SMITH SPRINGFIELD MOMATTAX NEU PRATER EYE CENTER MATTHEW SMITH MONETT MOMATTAX NEU PRATER EYE CTR INC KENNETH NEU SPRINGFIELD MOMATTAX NUE PRATER EYE CENTER MARLA SMITH LEBANON MOMCINTIRE EAR NOSE & THROAT CTR LARRY MCINTIRE JOPLIN MOMCS INCORPORATED OF MISSOURI ANTHONY MORRISON CHILLICOTHE MOMED EXAM PLUS LLC ROBERT MILEY SEDALIA MOMEDEX ST LOUIS MOMEDICAL IMAGING ASSO OF MEXICO MEXICO MOMEDPLUS BRANSON MOMEDPLUS WARRENSBURG MOMEDPLUS JOPLIN MOMEDPLUS MONETT MOMEDPLUS KIRKSVILLE MOMEDPLUS SPRINGFIELD MOMEFFORD, VAUGNIAUX, & ASSOC TOM MEFFORD SEDALIA MOMEFFORD, VUAGNIAUX & ASSOC PC TIM VUAGNIAUX LAURIE MOMEFFORD, VUAGNIAUX & ASSOC PC TIM VUAGNIAUX SEDALIA MOMEMORIAL HOSPITAL ABILENE KSMEMORIAL HOSPITAL ABILENE KSMENTAL WELLNESS LLC KAREN MACDONALD OSAGE BEACH MOMENTAL WELLNESS LLC JENNIFER STEVENS OSAGE BEACH MOMERCY CLINIC SPRINGFIELD MOMERCY CLINIC AUDIOLOGY/ENT SPRINGFIELD MOMERCY CLINIC CARDIOLOGY SPRINGFIELD MOMERCY CLINIC ORTHOPEDIC SANDRA TATE ST LOUIS MOMERCY FAMILY PRACTICE SANDRA DEMPSEY ST JAMES MOMERCY HOSPITAL AURORA AURORA MOMERCY HOSPITAL JEFFERSON FESTUS MOMERCY HOSPITAL LEBANON LEBANON MOMERCY HOSPITAL SPRINGFIELD SPRINGFIELD MOMERCY HOSPITAL WASHINGTON WASHINGTON MOMERCY HOSPITAL WASHINGTON WASHINGTON MOMERCY HOSPITAL WASHINGTON WASHINGTON MOMERCY HOSPITAL-CASSVILLE CASSVILLE MOMERCY MCCUNE-BROOKS HOSPITAL CARTHAGE MOMERCY ST FRANCIS HOSPITAL MOUNTAIN VIEW MOMERCY ST FRANCIS HOSPITAL MOUNTAIN VIEW MOMIAMI COUNTY MED CTR-RADIOLOGY PAOLA KSMID AMERICA RADIOLOGY SC ST LOUIS MOMIDWEST ASSESS & PSYCHOTHERAPY TROY MOMIDWEST ASSESS & PSYCHOTHERAPY NIXA MOMIDWEST ASSESS & PSYCHOTHERAPY BRANSON MOMIDWEST ASSESS & PSYCHOTHERAPY SPRINGFIELD MOMIDWEST ASSESS & PSYCHOTHERAPY SPRINGFIELD MOMIDWEST ASSESS & PSYCHOTHERAPY MONETT MOMIDWEST BONE & JOINT PC NOLA MOORE MACON MOMIDWEST CES N KANSAS CITY MOMIDWEST CES KANSAS CITY MOMIDWEST CES ST JOSEPH MOMIDWEST CES ROLLA MOMIDWEST CES WEST PLAINS MOMIDWEST CES CAPE GIRARDEAU MOMIDWEST CES COLUMBIA MOMIDWEST CES SEDALIA MOMIDWEST CES BOLIVAR MOMIDWEST CES CHILLICOTHE MOMIDWEST CES JEFFERSON CITY MOMIDWEST CES MACON MOMIDWEST CES ST LOUIS MOMIDWEST CES HANNIBAL MOMIDWEST CES JOPLIN MOMIDWEST CES CHANUTE KSMIDWEST CES KANSAS CITY MOMIDWEST CES TROY MOMIDWEST CHEST CONSULTANTS THOMAS SILER ST CHARLES MOMIDWEST RADIOLOGICAL ASSOC ST LOUIS MOMIDWEST REHABILITATION PA JAY JANI TOPEKA KSMISSOURI EAR NOSE & THROAT CTR COLUMBIA MOMISSOURI OCCUPATIONAL INJURY KEVIN KOMES COLUMBIA MOMISSOURI OCCUPATIONAL MEDICINE BOBBY ENKVETCHAKUL WASHINGTON MOMISSOURI VALLEY PHYSICIANS JACK UHRIG MARSHALL MOMO DELTA MEDICAL CENTER SIKESTON MOMOBERLY REGIONAL MEDICAL CTR MOBERLY MOMORE THAN THERAPY LETISHAE DAVIS ST LOUIS MOMOSAIC LIFE CARE AT ST JOSEPH ST JOSEPH MOMOSAIC LIFE CARE BURLINGTON KANSAS CITY MOMOSAIC LIFE CARE COUNSELING TOM BEIN ST JOSEPH MO

(b) (6)

MOSAIC LIFE CARE COUNSELING TOM BEIN ST JOSEPH MOMOSAIC LIFE CARE COUNSELING RICHARD TAYLOR ST JOSEPH MOMOSAIC LIFE CARE COUNSELING RICHARD TAYLOR ST JOSEPH MOMOSAIC LIFE CARE OF ST JOSEPH ST JOSEPH MOMOSAIC LIFE CARE PULM & CRIT ST JOSEPH MOMOSAIC LIFE CARE SHOAL CREEK KANSAS CITY MOMURPHY WATSON BURR EYE CENTER WILLIAM BURR ST JOSEPH MOMURPHY WATSON BURR EYE CENTER SCOTT MURPHY ST JOSEPH MOMURPHY WATSON BURR EYE CENTER SCOTT MURPHY CHILLICOTHE MOMURPHY WATSON BURR EYE CENTER R WATSON ST JOSEPH MONASM DANIEL KAN SPRINGFIELD MONEUROLOGIC ASSOCIATES OF CAPE ROBERT GARDNER JR CAPE GIRARDEAU MONEUROPSYCHOLOGICAL ASSOC SW MO MOUNTAIN GROVE MONEVADA REGIONAL MEDICAL CENTER NEVADA MONORTHEAST MO IMAGING ASSOC HANNIBAL MONORTHEAST REGIONAL MEDICAL CTR KIRKSVILLE MONU CARE POPLAR BLUFF MONU CARE KENNETT MONU CARE FARMINGTON MOOACAC BRYCE GRAY BOLIVAR MOOCCUPATIONAL MEDICINE CLINIC J PAULINE ABBOTT OSAGE BEACH MOOLATHE MEDICAL CENTER OLATHE KSONSITE REHABILITATION PC GEOFFREY CARSON OSAGE BEACH MOORTHO ONE INC BLUE SPRINGS MOORTHOPAEDIC SPORTS HEALTH MICHAEL JOHNSON SALINA KSOSAGE BEACH LIBRARY BRYCE GRAY OSAGE BEACH MOOZARK OB/GYN AMBER RICHARDSON POPLAR BLUFF MOOZARK PHYSICAL THERAPY POPLAR BLUFF MOOZARK PSYCHOLOGICAL ASSOCIATES SARA HOLLIS SPRINGFIELD MOOZARKS FAMILY VISION CENTRE STEPHEN PIERSON BRANSON MOOZARKS MEDICAL CENTER WEST PLAINS MOPARKLAND HEALTH CENTER FARMINGTON MOPARTNERS IN REHAB MEDICINE STEVEN HENDLER KANSAS CITY MOPATHWAYS MICHAELA BEEZLEY ROLLA MOPATHWAYS MICHAELA BEEZLEY SULLIVAN MOPATHWAYS CATHY GRIGG LEBANON MOPATHWAYS TOSHA LARSON RAYMORE MOPATHWAYS JONATHAN ROSENBOOM WARRENSBURG MOPATHWAYS JONATHAN ROSENBOOM SEDALIA MOPATHWAYS SARA WILSON LEBANON MOPATHWAYS COMM BEHAV HLTHCARE ASHLEY PARKS CLINTON MOPATHWAYS-HARBOR VILLAGE JONATHAN ROSENBOOM WARSAW MOPCRMC-BOND CLINIC LARRY MAZZEO ROLLA MOPEAK SPORT & SPINE GREGGORY KUHLMANN OSAGE BEACH MOPEAK SPORT & SPINE GREGGORY KUHLMANN SEDALIA MOPEAK SPORT & SPINE GREGGORY KUHLMANN MOBERLY MOPEAK SPORT AND SPINE PT JESSICA CHANEY OSAGE BEACH MOPEDIATRIC THERAPY SERVICES HANNIBAL MOPHELPS CO REGIONAL MEDICAL CTR ROLLA MOPHELPS CO REGIONAL MEDICAL CTR ROLLA MOPHYSICAL THERAPY SPECIALIST BRYCE GRAY MOUNTAIN GROVE MOPHYSICAL THERAPY SPECIALISTS ALISE GRAY MOUNTAIN GROVE MOPHYSICIANS PARK PRIMARY CARE POPLAR BLUFF MOPIKE CO MEMORIAL HOSPITAL LOUISIANA MOPLAINS RADIOLOGY SERVICES KEARNEY NEPOLLOCK PSYCHOLOGICAL SERVICES ANN POLLOCK JEFFERSON CITY MOPOPLAR BLUFF NEUROLOGY CTR PC SHAHID CHOUDHARY POPLAR BLUFF MOPOTOSI RURAL HEALTH PATTY ALLEN POTOSI MOPRATT DCF OFFICE MICHAEL SCHWARTZ PRATT KSPRECISION EYE CARE JOHN FITZ FARMINGTON MOPREMIER HEALTH CENTER YASUO ISHIDA SULLIVAN MOPRO OF KENNETT REHAB SERVICES KEN RUBENACKER KENNETT MOPROVIDENCE MEDICAL CENTER KANSAS CITY KSPROVIDENCE MEDICAL CENTER KANSAS CITY KSPSYCHOLOGICAL ASSOCIATES THEODORE MOELLER WICHITA KSPSYCHOLOGISTS & EDUCATORS INC ALAN POLITTE ST LOUIS MOPSYCHOLOGY ASSOCIATES INC FRANK FROMAN QUINCY ILPUTNAM COUNTY MEMORIAL HOSP UNIONVILLE MOQMB RADIOLOGY LLC SPRINGFIELD MORADIOLOGIC IMAGING CONSULTANTS ST CHARLES MORADIOLOGIC PROFESSIONAL SERV LAWRENCE KSRADIOLOGY & NUCLEAR MEDICINE TOPEKA KSRADIOLOGY ASSOCIATES OF HAYS KANSAS CITY MORADIOLOGY CONSULTANTS COLUMBIA MORADIOLOGY IMAGING ASSOCIATES ENGLEWOOD CORADIOLOGY SPEC OF ST JOSEPH PC ST JOSEPH MORAMULA SAMUDRALA MD RAMULU SAMUDRALA ST LOUIS MORAMULU SAMUDRALA MD PC RAMULU SAMUDRALA ST LOUIS MORANSOM MEMORIAL HOSPITAL OTTAWA KS

(b) (6)

RAPID RADIOLOGY INC LAKEWAY TXRDI BUILDING JOAN BENDER SPRINGFIELD MOREAM OPTOMETRY ANNE REAM WEST PLAINS MOREDLINK FESTUS MOREDLINK INC HAYS KSREDLINK INC MCCOOK NEREYNOLDS & ANLIKER MANHATTAN KSRHEUMATOLOGY SPECIALISTS OF KC CAMERON JONES KANSAS CITY MORIVER CITY HEALTH CLINIC WANDA HORN CAPE GIRARDEAU MORIVER PARK PSYCH CONSULTANTS MICHAEL SCHWARTZ WICHITA KSROCKHILL PLAZA BUILDING KAT BOWIE KANSAS CITY MOROGERSVILLE PHYSICAL THERAPY ROGERSVILLE MORUNDE OCCUPATIONA ERV & PHY EDDIE RUNDE MEXICO MORUNDE OCCUPATIONAL ERV & PHY EDDIE RUNDE COLUMBIA MOSAGO & STREET EYECARE LLC JASON STREET FARMINGTON MOSALEM MEMORIAL DISTRICT HOSP JOHN DEMORLIS SALEM MOSALEM MEMORIAL HOSPITAL SALEM MOSALEM MEMORIAL HOSPITAL SALEM MOSALINA REG MED ARTS IMAGING SALINA KSSALINA REGIONAL HEALTH CENTER SALINA KSSALINA REGIONAL MEDICAL ARTS SALINA KSSALVATION ARMY PAUL REXROAT CAPE GIRARDEAU MOSAMARITAN MEMORIAL HOSPITAL MACON MOSBS MEDICAL SERVICES INC STEPHEN SMITH ST LOUIS MOSCHULTZ PSYCHOLOGICAL SERVICES LINDA SCHULTZ JEFFERSON CITY MOSCOTLAND COUNTY MEMORIAL HOSP MEMPHIS MOSCOTT COUNTY CENTRAL ELEM SCHL LANA ATKINS SIKESTON MOSCOTT RADIOLOGY GROUP ST LOUIS MOSEE REMARKS DAVID SIMCKES ST PETERS MOSEMO COMMUNITY SERVICES JERRY CUNNINGHAM KENNETT MOSEMO HEALTH NETWORK DAVID DAHLBECK KENNETT MOSHADOW WOOD CLINICAL ASSOCIATE THOMAS BARTLETT TOPEKA KSSHEEHAN PSYCHOLOGICAL SERVICES TAMMY SHEEHAN KANSAS CITY MOSHOP #1 STANLEY MINTZ CHANUTE KSSMITH IMAGING INC PEORIA ILSMITH STREET CLINIC ADONIS BERNARDO SIKESTON MOSOMERS EYE CENTER MICHAEL SOMERS KANSAS CITY MOSOUTH CENTRAL KS REG MED CTR ARKANSAS CITY KSSOUTH CITY HEARING & AUDIOLOGY NANCY RICHMAN ST LOUIS MOSOUTHEAST HEALTH MALDEN CLINIC KIMBERLY ESSNER MALDEN MOSOUTHEAST HEALTH STODDARD CTY DEXTER MOSOUTHEAST HLTH CTR-RIPLEY CTY DONIPHAN MOSOUTHERN MEDICAL GROUP WICHITA KSSOUTHERN MEDICAL GROUP TOPEKA KSSOUTHERN MEDICAL GROUP SALINA KSSOUTHERN MEDICAL GROUP KANSAS CITY KSSOUTHERN MEDICAL GROUP DODGE CITY KSSOUTHERN MEDICAL GROUP LAWRENCE KSSOUTHSIDE CENTER SAAD AL-SHATHIR JOPLIN MOSOUTHWEST MEDICAL CENTER LIBERAL KSSOUTHWEST MISSOURI EXAMS JOPLIN MOSOUTHWEST PLAZA OFFICE BLDG JASON NEUFELD TOPEKA KSSOUTHWEST REHABILITATION BRANSON WEST MOSPECIALISTS IN INTERNAL MED MELVIN BUTLER CLAYTON MOSPEECH LANGUAGE SERVICES ROBIN RICKMAN DEXTER MOSSM HLTH-ST JOSEPH WENTZVILLE WENTZVILLE MOST ALEXIUS HOSPITAL ST LOUIS MOST FRANCIS FAMILY HEALTH CARE KANTI HAVALDAR MARYVILLE MOST FRANCIS HEALTHCARE TOPEKA KSST FRANCIS HEALTHCARE TOPEKA KSST FRANCIS HEALTHCARE TOPEKA KSST FRANCIS HOSPITAL MARYVILLE MOST FRANCIS MED CTR/HEALING ART LORELEI LEIBLE CAPE GIRARDEAU MOST FRANCIS MEDICAL CENTER CAPE GIRARDEAU MOST FRANCIS MEDICAL CENTER STEPHEN JORDAN CAPE GIRARDEAU MOST LOUIS PSYCH SERVICES CLAYTON MOST LUKES MIDWEST PULMONARY CON KANSAS CITY MOST LUKES REGION LAB KANSAS CITY MOST MARYS HOSPITAL-AUDRAIN MEXICO MOST ROSE HEALTH CENTER GREAT BEND KSSTONEY CREEK HOTEL & CONF CTR BRYCE GRAY ST JOSEPH MOSTONEY CREEK HOTEL & CONF CTR ALISE GRAY ST JOSEPH MOSTORMONT-VAIL HEALTHCARE TOPEKA KSSTORMONT-VAIL HEALTHCARE TOPEKA KST.P. CHILDREN & TEENS CARE TASANAPORN PITIYANUVATH KANSAS CITY MOTENNEY PEDIATRIC & ADOLESCENT DIONNE COZIER ROSS KANSAS CITY MOTENNEY PEDIATRIC & ADOLESCENT PAOLA LUNA KANSAS CITY MOTENNEY PEDIATRIC & ADOLESCENT JACKIE TENNEY KANSAS CITY MOTEXAS COUNTY MEMORIAL HOSPITAL HOUSTON MO

(b) (6)

THE HEADACHE & PAIN CENTER PA BERNARD ABRAMS LEAWOOD KSTHE LUNG CENTER ST LOUIS MOTHERACARE OUTPATIENT SERVICES MELANIE STINNETT SPRINGFIELD MOTHERAPY ASSOCIATES OF OZARKS LEBANON MOTHERAPY ASSOCS OF THE OZARKS SPRINGFIELD MOTHERAPY ASSOCS OF THE OZARKS DEBRA LEWIS SPRINGFIELD MOTLC PEDIATRICS PC ASSAD SHAFFIEY SEDALIA MOTO YOUR HEALTH FAM MED CLINIC CAROLLE SILNEY COLUMBIA MOTRI STATE OCCUPATIONAL MED BARRY BURCHETT FARMINGTON MOTRI STATE OCCUPATIONAL MED BARRY BURCHETT SIKESTON MOTRI STATE OCCUPATIONAL MED BARRY BURCHETT KENNETT MOTRI STATE OCCUPATIONAL MED RAYMOND LEUNG WASHINGTON MOTRI-STATE OCCUPATIONAL MEDICIN BARRY BURCHETT PEVELY MOTWIN RIVERS REGIONAL MEDICAL KENNETT MOUNITED IMAGING CONSULTANTS LLC MISSION KSUNITED METHODIST CHURCH KENNETH SHERRY HUMANSVILLE MOUNITED RADIOLOGY BILLING SALINA KSUS HEALTHCARE SHOAL CREEK KANSAS CITY MOUS HEALTHWORKS ST JOSEPH MOUS HEALTHWORKS KANSAS CITY MOUS HEALTHWORKS MED GROUP OF KC DARYL THOMAS KANSAS CITY MOUSA RADIOLOGY MANAGEMENT ST LOUIS MOVIA CHRISTI HOSPITAL PITTSBURG PITTSBURG KSVIA CHRISTI ST FRANCIS HOSP WICHITA KSVICTORY MINISTRY ROBERT MCDERMID JOPLIN MOVICTORY MINISTRY GYM KEVIN WHISMAN JOPLIN MOVILLAGE PLAZA JASON WELLS ATCHISON KSVISION CLINIC BRANSON BRANSON MOWARREN CO SCENIC REG LIBRARY BRYCE GRAY WARRENTON MOWARRENSBURG INTERNAL MEDICINE JAYENDRA ASTIK WARRENSBURG MOWASHINGTON UNIV VASCULAR LAB BRIAN RUBIN ST LOUIS MOWEBER SPEECH CLINIC REBECCA WEBER ST JOSEPH MOWEST COUNTY RADIOLOGICAL GROUP ST LOUIS MOWEST PARK MEDICAL CLINIC RAYMOND LEUNG QUINCY ILWEST PARK MEDICAL CLINIC RAYMOND LEUNG ALTON ILWESTERN MISSOURI INTERNAL MED SYED HASAN WARRENSBURG MOWESTERN MO MEDICAL CENTER WARRENSBURG MOWESTWOOD MEDICAL CLINIC INC CHUL KIM POPLAR BLUFF MOWICHITA OPTHALMOLOGY SAM COHLMIA WICHITA KSWICHITA RADIOLOGICAL GROUP PA OKLAHOMA CITY OKWINDSOR MEDICAL GROUP CALEB MASTERSON NIXA MOWSU SPEECH LANGUAGE HEARING WICHITA KSZAINALI A MD RADIOLOGY PA WICHITA KS

(b) (6)

PAID AMOUNT VENDOR/REMIT VENDOR VENDOR REMIT CITY

$249,996.84 TRI-STATE OCCUPATIONAL Total BARRY BURCHETT, MD HUNTINGTON S83$104,407.94 CUNNINGHAM, JERRY Total MALDEN S83

$95,254.27 FERGUSON MEDICAL GROUP RURAL & LP Total (DAVID DAHLBECK, PHD) SIKESTON S83$84,145.14 WESTWOOD MEDICAL CLINIC INC Total CHUL KIM, MD POPLAR BLUFF S83$36,196.81 SOUTHEAST MISSOURI HOSPITAL Total MATTHEW KARSHNER, MD CAPE GIRARDEAU S83$32,506.63 WALKER, LAURETTA V Total IRONTON S83$10,021.34 GRAY, KELLEY Total FARMINGTON S83

$160,233.37 ASSOCIATED BEHAVIORAL Total TOM SPENCER, PHD FULTON S80$71,213.64 COMPASS HEALTH INC Total PATHWAYS CLINTON S80$40,269.10 SCHMITZ, MARK W Total COLUMBIA S80$30,366.63 SCHULTZ, LINDA L Total COLUMBIA S80$20,584.48 POLLOCK PSYCIOLOGICAL SERVICES Total ANN POLLOCK, PSYD JEFFERSON CITY S80

$742,361.48 MIDWEST CES Total NORTH SALT LAKE S82$95,492.33 ISRAEL, ALAN R Total SHAWNEE MISSION S82$84,404.53 KEOUGH, JOHN A Total BUTLER S82$73,207.72 RICK D THOMAS PHD LLC Total BELTON S82$60,230.13 MICHAEL H SCHWARTZ PHD PC Total OVERLAND PARK S82$35,306.90 LIEBERMAN, LYNN I Total WESTWOOD HILLS S82$22,102.54 ASSESSMENT CONSULTANTS LLC Total AMY M FISCH, PHD SPRINGFIELD S82

$179,756.38 GRAY PSYCHOLOGICAL SERVICES Total ALICE GRAY, PSYD & BRYCE GRAY, PSYD NIXA S84$139,493.25 EXAM PRO LLC Total SPRINGFIELD S84$104,192.81 MEDPLUS DISABILITY EDUCATIONS Total FRANKLIN, TN S84

$77,657.26 MIDWEST ASSESSMENT AND PSYCHOTHERAPY (MAPS) Total SPRINGFIELD S84$71,574.11 FORSYTH, ROBERT Total SPRINGFIELD S84$35,324.80 KAN, DANIEL Total AURORA S84

$8,591.28 ANDERSON, FRANCES J Total TURNERS S84

$922,991.73 FOREST PARK MEDICAL CLINIC INC Total MEDEX ST LOUIS S81$111,481.06 PAUL W REXROAT PHD PC Total PACIFIC S81$106,498.83 ST LOUIS PYSCHOLOGICAL SERVICE Total ALISON BURNER, PHD WILDWOOD S81

$81,726.10 LAURA R TISHEY PSY D LLC Total CLAYTON S81$69,550.07 MICHAEL T ARMOUR PHD LLC Total CLAYTON S81$67,108.41 LEONBERGER, F TIMOTHY Total ST LOUIS S81

D

ONSITE Key Provider Top 5, $150,000+ or Primarily CE Work

Cape Girardeau Yes Yes Top 5 and $150,000+Cape Girardeau YesCape Girardeau YesCape Girardeau YesCape Girardeau YesCape Girardeau Yes Yes Primarily CE WorkCape Girardeau Yes Yes Primarily CE Work

Jefferson City Yes Yes Top 5 and $150,000+Jefferson City YesJefferson City Yes Yes Primarily CE WorkJefferson City Yes Yes Primarily CE WorkJefferson City Yes

Kansas City Yes Yes Top 5 and $150,000+Kansas City Yes Yes Primarily CE WorkKansas City Yes Yes Primarily CE WorkKansas City Yes Yes Primarily CE WorkKansas City Yes Yes Primarily CE WorkKansas City Yes Yes Primarily CE WorkKansas City Yes Yes Primarily CE Work

Springfield Yes Yes Top 5 and $150,000+Springfield Yes Yes Primarily CE WorkSpringfield Yes Yes Primarily CE WorkSpringfield Yes Yes Primarily CE WorkSpringfield YesSpringfield Yes Yes Primarily CE WorkSpringfield Yes Yes Primarily CE Work

St Louis Yes Yes Top 5 and $150,000+St Louis Yes Yes Primarily CE WorkSt Louis Yes Yes Primarily CE WorkSt Louis Yes Yes Primarily CE WorkSt Louis Yes Yes Primarily CE WorkSt Louis Yes Yes Primarily CE Work

DDS OFFICE

CE providers removed due to inactive license, sanction or removal for cause with reason noted:

Not applicable

CE COST SORTED BY TOTALS report

10/19/17 15:58:46 CE TOTALS 10/01/16 - 09/30/17 PAGE 1

Total Cost Key Name Vendor No.

526,952.00 C. E. PROVIDER SERVICES

303,008.14 MDSI PHYSICIAN GROUP INC

247,537.00 WHELAN, WILLIAM MICHAEL

227,241.00 ALEXANDER, J MORRIS

221,171.00 BOGGS, JAN

204,880.00 ZAKARAS, PATSY H

184,265.00 LOTT, W. CRISS

170,900.64 RIDGELAND DIAGNOSTIC CENTER

124,972.00 PROFESSIONAL ASSESSMENT CTR

121,978.00 RC SSD LLC

114,649.00 MIDWAY FAMILY CARE

98,168.00 ADAMS, JAMES GRAY

87,983.00 DRUMHELLER PSYCHOLOGICAL SR

86,412.00 MED PLUS DISABILITY EVALUAT

78,581.00 BLAYLOCK MED CL

77,586.00 GAMMEL COMPANIES

74,959.00 ZAKARAS, MICHAEL E.

74,430.00 COLUMBIA PSYCHOLOGIVAL SERV

67,452.38 SIEGEL, BARRY ROSS

62,469.00 SAVELL, HAROLD E.

61,803.00 MASUR, LOUIS III

59,635.00 LANE, JAMES R. III

53,534.00 THOMAS, WILLIAM BRIAN

52,354.00 REG 1 MENTAL HEALTH CENT

51,248.00 SMITH, GEORGE

50,282.47 RANDOLPH, BRUCE W MD

47,574.00 TRI STATE OCCUPATIONAL MED

39,555.00 SISON, GUSTAVE F JR

38,881.00 BARRILLEAUX, GERALD STEVE

38,530.13 ENVISION EYE CARE INC

38,358.00 YAZDANI, LISA B PHD

36,321.25 TUNICA CO HEALTHCARE AUTHOR

33,806.46 SINGING RIVER HOSPITAL

33,583.00 MYERS, BARBARA P

33,246.87 JEFF ANDERSON REG MED CTR

32,766.66 EXPRESS CARE WEST

27,529.00 SOUTHERN MEDICAL GROUP INC

26,686.00 JENKINS, GEORGINA F MS

26,040.00 LEONARD, PAUL S

25,871.00 HETRICK, ETHEL W PHD

23,681.82 GOLDEN TRIANGLE REG MED CTR

23,557.00 MATHERNE, J DONALD

23,330.00 BETTER COMMUNICATION CLINIC

23,150.24 MERIT HEALTH -CENTRAL

23,021.93 SOUTH CENTRAL REG MEDICAL C

22,803.00 LINDSEY, MICHAEL SLP

22,068.58 FORREST GENERAL HOSPITAL

CECOSTTOT CECOSTTOTR/JGMLIB

Mississippi FY 2017

(b) (6)

10/19/17 15:58:46 CE TOTALS 10/01/16 - 09/30/17 PAGE 2


21,819.67 DELTA REGIONAL MEDICAL CENT

20,957.00 TATUM, ROBERT E

20,772.00 MOYE, JEFF INC

19,912.00 DRS CRAIN AND MORRIS

19,678.00 MARION COUNSELING SERVICES

19,333.89 SW MS REGIONAL MEDICAL CENT

17,950.00 TRICOUNTY PULMONARY & SLEEP

17,860.29 GREEN EYE INSTITUTE, PA

17,691.58 UMMC GRENADA

17,589.50 MEMORIAL HOSP AT GULFPORT

16,958.25 MAGNOLIA REGIONAL HEALTH CT

16,938.00 EICKE, FRANCIS J.

16,827.94 EYE CLINIC

16,249.00 RABY, JOANN P

15,876.00 CLARKSDALE SPEECH JENNIE

15,756.02 GREENWOOD LEFLORE HOSPITAL

15,676.00 JACKSON, HELEN PSYD

15,568.00 POWERS, DAVID D

15,037.69 CARDIOLOGY ASSOC OF N MS PA

14,934.00 STOUDENMIRE, JOHN JR

14,822.00 SPEECH PATHOLOGY ASSOC INC

14,295.00 PROFESSINAL PSYCHOLOGY SERV

14,218.62 MERIT HEALTH-NATCHEZ

13,987.00 JACKSON CARDIOLOGY ASSOC

13,655.00 ENT & FACIAL PLASTIC SURGER

13,478.34 OSBORNE, YVONNE H

13,378.21 SINGING RIVER RADIOLOGY GRO

12,980.00 EAR NOSE & THROAT PHY OF N

12,411.75 DRS COOPER AND PANG

11,417.57 ORTHOPAEDIC CLINICS OF SW M

11,364.50 BRASWELL, T KEVIN

11,078.73 MERIT HEALTH NW REG MED CTR

10,371.49 JACKSON RADIOLOGY ASSOCIATE

10,075.00 WASHINGTON, LINDA M PHD

9,158.62 GREENVILLE CLINIC

9,094.00 NEVELS, ROBERT MOUNGER

8,787.00 BURKE, RANDY S

8,671.29 MERIDIAN IMAGING PA

8,485.72 GOLDEN TRIANGLE RADIOLOGY P

8,402.47 ASSAF, MOHAMMAD

8,072.00 BROWN, JAMES S III

7,885.33 BARNES CROSSING VISION CENT

7,869.00 REMEDIAL SPECIALIST INC

7,804.09 KING'S DAUGHTERS MEDICAL CT

7,468.00 AUSTIN, JAMES B.

7,280.12 EYE CLINIC OF MERIDIAN

7,044.87 NESHOBA CO GENERAL HOSPITAL


(b) (6)

10/19/17 15:58:46 CE TOTALS 10/01/16 - 09/30/17 PAGE 3


6,707.18 RADIOLOGY ASSOC-LAUREL

6,572.00 HAAG, GEORGE J PSYD

6,297.00 MINDFUL ACCEPTANCE THERAPIE

6,292.55 LAKELAND RADIOLOGISTS

5,587.08 ALLIANCE HEALTHCARE SYSTEM

5,565.00 PARKER, JEFFERSON D PHD

5,393.00 FLEETWOOD, BARBARA

5,385.00 GULF COAST CHILDRENS CLINIC

5,382.87 BAPTIST MEM HOSP-NORTH MS

5,066.31 IMA OF TUPELO

4,897.00 MEDICAL FOUNDATION OF CENT

4,864.00 HAYS, TONYA F PHD

4,850.75 DESOTO

4,664.46 COPIAH COUNTY MEDICAL CTR

4,580.53 RADIOLOGY ASSOC OF OXFORD

4,568.34 COMPREHENSIVE RADIOLOGY SRV

4,404.63 MERIT HEALTH-BILOXI

4,387.04 JAGWANI, SUNDER MD

4,359.69 BOLIVAR MEDICAL CENTER

4,338.34 MAGNOLIA IMAGING ASSOCIATES

4,230.00 INTERNAL MEDICINE CLINIC

4,134.46 BRANDON

3,881.31 MERIT HEALTH

3,818.10 MERIT HEALTH RIVER REGION

3,701.00 PATTERSON, KATHLEEN SUE PHD

3,535.00 SW MS ENT CLINIC

3,486.26 SEARK RADIOLOGY PA

3,455.11 OXFORD EYE CLINCI

3,451.35 MARION GENERAL HOSPITAL

3,399.13 ST DOM JACKSON MEM HOSPITAL

3,248.00 PSYCHOLOGY ASSOCIATES

3,236.66 MERIT HEALTH

2,912.28 NELSON, HUNTER B MD

2,886.04 WINSTON MEDICAL CLINIC LLC

2,840.36 COOK, JEFFREY N

2,774.53 PREMIER RADIOLOGY PA

2,688.00 HALL, DONALD S JR

2,605.50 TUPELO EYE CLINIC

2,300.00 MISSISSIPPI BEHAVIORAL HEAL

2,270.78 RADIOLOGY ASSOC OF NATCHEZ,

2,035.23 MERIT HEALTH BATESVILLE

1,920.00 YOUNG, LASHUN PH.D

1,898.09 SMB RADIOLOGY PA

1,786.10 MS BAPTIST MEDICAL-ATTALA

1,752.88 SIMPSON GENERAL HOSPITAL

1,743.34 TRACE REGIONAL HOSPITAL

1,741.24 TYLER HOLMES MEMORIAL HOSPI


(b) (6)

10/19/17 15:58:46 CE TOTALS 10/01/16 - 09/30/17 PAGE 4


1,658.60 MERIDIAN PEDIATRICS PLLC

1,610.86 HOGAN EYE CLINIC PA

1,609.82 MID-SOUTH IMAGING/THERAPEUT

1,607.75 MISSISSIPPI BAPTIST MED CTR

1,597.18 KING'S DAUGHTERS HOSPITAL

1,586.14 NEW COAST CARDIOLOGY PLLC

1,585.94 RADIOLOGICAL GROUP PA

1,520.52 BROOKHAVEN RADIOLOGY PLLC

1,461.01 HANCOCK MEDICAL CENTER

1,260.80 CASTILLO, JULIO DEL

1,131.31 ASSOCIATED RADIOLOGISTS, PA

1,117.98 PRIOR RADIOLOGY SERVICES PA

1,095.62 CROSSROADS EYE CENTER LLC

733.55 SINGING RIVER HOSPITAL

539.34 DIAGNOSTIC ULTRASOUND CONSU

536.65 FORREST GENERAL HOSPITAL

498.29 TILLMAN MEDICAL GROUP

491.89 RADIOLOGY PHYSICIANS OF NEW

455.00 HATTIESBURG CLINIC PA

436.08 RIGDON, EDWARD E

431.72 COGNITIVE BRIDGES, INC

294.00 SINGING RIVER HEALTH SYS

275.30 BADVE, SEEMA A

265.00 STARKVILLE PEDIATRIC CLINIC

252.22 ACCESS RADIOLOGY

226.50 JACKSON EYE ASSOCIATES PLLC

211.45 AMORY HMA INC/GILMORE

210.00 MERIDIAN MEDICAL ASSOCIATES

200.00 HEAD & NECK SURGICAL GROUP

170.00 GULF COAST AUDIOLOGY INC

168.25 COLEMAN EYE CENTER

156.00 EYE ASSOCIATES OF THE SOUTH

129.02 OKTIBBEHA COUNTY HOSPITAL

120.45 YALOBUSHA GENERAL HOSPITAL

120.00 SEMINARY FAMILY HEALTH CTR

105.00 DULAM, VIKRAMADITYA

101.00 BPSOS

85.00 TURNER CARE

70.00 NATCHEZ MEDICAL FOUNDATION

58.25 HALL, JAMES E MD

43.71 VIRTUAL RADIOLOGIC PROFESSI

35.00 FG

29.29 BAPTIST MEM HOSP - BOONEVIL

19.74 RPG MEDICAL OF N MS LLC

19.23 CENTRAL MS RADIOLOGY

5.00 MEDICAL FOUNDATION OF CENT

.00 MEDICAL IMAGING LLC

.00 THE NEUROLOGY GROUP PC

* * * E N D O F R E P O R T * * *

(b) (6)

Onsite Visits Provider List ALL

KEY VENDORS SUMMARY

KEY PROVIDER TOTALS

X MARK MOZER PHD-MISSOULA VIDEO 305 REDLINK 1269X REDLINK-BILLINGS 295 MOZER 943

REDLINK-MISSOULA 278 SOPHIA 254MARK MOZER PHD-GF VIDEO CE 250 PETERSON 194

X TRISTAN SOPHIA PSYD-BILLINGS 242 MAHONEY 163REDLINK-GREAT FALLS 237 GREGG 152MARK MOZER PHD-BUTTE 217 DONALDSON 137DEAN GREGG PHD 152 REED 101

X F TOM PETERSON EDD-BILLINGS 133 NASH 96REDLINK-BUTTE 133 MARIAS 88REDLINK-WHITEFISH 130

X DAVID J MAHONEY PHD-WHITEFISH 102 Top5 Key ProvidersX THERESA M REED PHD-MISSOULA 101

REDLINK-HELENA 94MARIAS HEALTHCARE CENTER 88PAUL DONALDSON MD-BOZEMAN 84

X ALAN BAUER EDD- BILLINGS 76DONNA M ZOOK PHD 63

X MARK MOZER PHD-HELENA 63X DAVID J MAHONEY PHD-LIBBY 61

F TOM PETERSON EDD-MILES CITY 61X SUSAN K DAY PHD MISSOULA 61

REDLINK-GLASGOW 54PAUL DONALDSON MD-HELENA 53

X PROVIDENCE ST JOSEPH-IRWIN MD 49MARK MOZER PHD-GREAT FALLS 48MICHAEL NASH PHD-BOZEMAN 48MARK MOZER PHD-GLASGOW VIDEO C 47

X OCCUPATIONAL HEALTH & WELLNESS 45BIGHORN VALLEY HEALTH CENTER 44

X LIBBY CLINIC 43REDLINK-HAVRE 42GABERT CLINIC 40JIM MURPHEY PHD 40

X SWEETGRASS PSYCH SVCS-WHITEFIS 40CORY D HESSEL PHD 37ROSEBUD HEALTHCARE CTR CLINIC 36WALKER ASHCRAFT MD 30LIVINGSTON HEALTHCARE-CLINIC 27

X CLANCY CONE MD 26MICHAEL NASH PHD-LIVINGSTON 25

X ED TRONTEL PHD 20CAPITAL CITY CONSULTANTS 18

X MONTANA EYE CARE- MISSOULA 18X ROBERT KAUTZ OD 18X TRACY ROGERS PAC 15

MARK MOZER PHD-DEER LODGE PRIS 13

No providers removed d/t license, sanction, or other removal

Montana FY 2017

NORTHERN MT FAMILY MED CTR 12TRISTAN SOPHIA PSYD-LIVINGSTON 12BAIR MEMORIAL CLINIC 11MICHAEL NASH PHD-BILLINGS 11MICHAEL NASH PHD-CUT BANK 11PLENTYWOOD CLINIC 11

X VICTOR DAVIS MD 10JENNIFER LEIGHT PHD 9WILLIAM FERNANDEZ MD-GLASGOW 7RUBY VALLEY RURAL HEALTH CLINI 6MARY KAY BOGUMILL PHD-BUTTE 0PATRICK MCGREE MD 5TWIN BRIDGES RURAL HEALTH CLIN 5FALLON MEDICAL CLINIC 4REDLINK-SANDPOINT 4

X SWEETGRASS PSYCHOLOGICAL SVCS 4X BIGFORK MEDICAL CLINIC- DR JEN 3

GREG VOLK PSYD 3SUSAN TAYLOR SLP- HELENA 3BILLINGS CLINIC CARDIOLOGY 2

X CHILDRENS CLINIC 2GABERT CLINIC- WIBAUX 2GREAT FALLS CLINIC-PEDIATRICS 2NORTHERN MT BEHAVIORAL HEALTH 2PEDIATRIC THERAPY CLINIC 2REDLINK-POST FALLS 2VIBRANT HEARING-MISSOULA 2ALLISON FAILING SLP 1CLINICAL PSYCH CENTER 1CURT WHICKER MS-GLENDIVE 1CURT WHICKER MS-MILES CITY 1FRANCES MAHON DEAC HOSP-MALTA 1

X GLACIER EYE CLINIC 1MARTA KING MD 1MICHAEL NASH PHD-SHELBY 1MONTANA EYECARE- HELENA 1NORTHERN MT VISION CENTER 1REHDER HEARING CLINIC 1SIDNEY HEALTH CENTER- AUDIO 1ST PETERS HOSP-DIAGNOSTIC IMAG 1ST PETERS MEDICAL GROUP-AUDIOL 1ST VINCENT HOSPITAL-CARDIOPULM 1

Total 4264

PRIMARY SECONDARY INSTITUTION DOCTOR ADDRESS_1 ACITY STATKEY PROVIDER

ONSITE VISIT

ADDITIONAL NOTES

C748 ST CLAIRE, LYNN PO BOX 2344 BELCOURT ND NO NOC175 COAL COUNTRY COMM HEALTH CTR JACKSON, ORLAN 1312 HWY 49 NW BEULAH ND NO NOC2 01 SANFORD MEDICAL CENTER ENT ARNESON-THILMONY, DEB 225 N 7TH ST BISMARCK ND NO NOC154 DAKOTA EYE INSTITUTE BALLIET, PAUL 200 S 5TH ST BISMARCK ND NO YESC154 DAKOTA EYE INSTITUTE BEATTIE, SHARON 200 S 5TH ST BISMARCK ND NO YES

C15 08 BISMARCK RADIOLOGY ASSOCIATES BISMARCK RADIOLOGY ASSOCIAT BISMARCK RADIOLOGY ASSOC BISMARCK ND NO NOC2 01 SANFORD MEDICAL CENTER ENT BOUTILIER, AMANDA 225 N 7TH ST BISMARCK ND NO NOC18 01 CENTER FOR FAMILY MEDICINE CENTER FOR FAMILY MEDICINE PULMONARY DEPT BISMARCK ND NO NO

C18 02 CENTER FOR FAMILY MEDICINE CENTER FOR FAMILY MEDICINE 701 E ROSSER AVE BISMARCK ND YES YES KEY PROVIDERC18 CENTER FOR FAMILY MEDICINE CLAUSON, RYAN 701 E ROSSER AVE BISMARCK ND NO NOC18 CENTER FOR FAMILY MEDICINE DAVIS, ABBY 701 E ROSSER AVE BISMARCK ND NO NOC168 THE EYE CLINIC OF ND HANSTED, TOM 620 N 9TH ST BISMARCK ND NO NOC18 CENTER FOR FAMILY MEDICINE HENDRICKSON, MEGHAN 701 E ROSSER AVE BISMARCK ND NO NOC2 20 SANFORD HEALTH SPEECH THERAPY ISAACSON, DEB 300 N 7TH ST BISMARCK ND NO NOC239 CHAMBERS & BLOHM JOHNSON, ROBERT PSYCHOLOGICAL SVCS BISMARCK ND NO NO

C40 KEHRWALD, EDWARD 721 MEMORIAL HIGHWAY BISMARCK ND YES NOONSITE VISIT IN 2016

C41 KUCHLER, CHRISTINE J 721 MEMORIAL HIGHWAY BISMARCK ND NO NOC722 LINK PSYCHOLOGICAL SERVICES PC LINK, JAMES P 1424 W CENTURY AVE STE 207 BISMARCK ND NO YESC2 20 SANFORD HEALTH SPEECH THERAPY LOCKREM, TRACEY 300 N 7TH ST BISMARCK ND NO NOC18 CENTER FOR FAMILY MEDICINE MARQUARDT, JARED 701 E ROSSER AVE BISMARCK ND NO NOC18 CENTER FOR FAMILY MEDICINE MICKELSON, SCOT 701 E ROSSER AVE BISMARCK ND NO NOC18 CENTER FOR FAMILY MEDICINE MUGHAL, AYESHA 701 E ROSSER AVE BISMARCK ND NO NOC2 01 SANFORD MEDICAL CENTER ENT NELSON, JEFFREY 225 N 7TH ST BISMARCK ND NO NOC18 CENTER FOR FAMILY MEDICINE OSTGARD, ESTELLE 701 E ROSSER AVE BISMARCK ND NO NOC154 04 DAKOTA EYE INSTITUTE RANUM, MICHAEL 3119 N 14TH ST BISMARCK ND NO NOC18 CENTER FOR FAMILY MEDICINE SAHAI, PRIYA 701 E ROSSER AVE BISMARCK ND NO NO

C2 10 SANFORD HEALTH RADIOLOGY DEPT SANFORD HEALTH RADIOLOGY DE PO BOX 5525 BISMARCK ND NO NOC18 CENTER FOR FAMILY MEDICINE SAUTER, SHANNON 701 E ROSSER AVE BISMARCK ND NO NOC18 CENTER FOR FAMILY MEDICINE SNUSTAD, BRITTANY 701 E ROSSER AVE BISMARCK ND NO NOC18 CENTER FOR FAMILY MEDICINE SOMERS, TYREL 701 E ROSSER AVE BISMARCK ND NO NOC18 CENTER FOR FAMILY MEDICINE THUEN, BOBBI RAE 701 E ROSSER AVE BISMARCK ND NO NOC18 CENTER FOR FAMILY MEDICINE TINCHER, AMBER 701 E ROSSER AVE BISMARCK ND NO NOC168 THE EYE CLINIC OF ND TOWLE, STEVEN 620 N 9TH ST BISMARCK ND NO NOC18 CENTER FOR FAMILY MEDICINE WANZEK, RACHEL 701 E ROSSER AVE BISMARCK ND NO NO

C239 CHAMBERS & BLOHM WEISZ, SHANNON PSYCHOLOGICAL SVCS BISMARCK ND YES YES KEY PROVIDERC18 CENTER FOR FAMILY MEDICINE WHITE, CHRISTINE 701 E ROSSER AVE BISMARCK ND NO NOC18 CENTER FOR FAMILY MEDICINE YOUSUF, SADAF 701 E ROSSER AVE BISMARCK ND NO NOC95 01 FAMILY VISION CENTER DUNDERLAND, PAUL 522 MAIN ST BOTTINEAU ND NO NOC185 01 SOUTHWEST MEDICAL CLINIC LANCHBURY, FORREST 12 6TH AVE SW BOWMAN ND NO NOC185 01 SOUTHWEST MEDICAL CLINIC TOMBOULIAN, SHERRYL J 12 6TH AVE SW BOWMAN ND NO NOC55 02 CARRINGTON HEALTH CTR-LAB CARRINGTON HEALTH CTR-LAB 800 4TH ST N CARRINGTON ND NO NOC54 01 FOSTER COUNTY MED CENTER HOFF, BRAD 820 5TH ST N CARRINGTON ND NO NOC59 02 ST LUKE'S HOSPITAL ST LUKE'S HOSPITAL PO BOX 10 CROSBY ND NO NOC58 01 CROSBY CLINIC WARREN, GINGER 702 1ST ST SW CROSBY ND NO NO

North Dakota FY 2017

C99 01 NORTHEAST EYE CENTER PC DICKEN, ROBERT 404 HIGHWAY 2 EAST DEVILS LAKE ND NO NOC128 01 ALTRU CLINIC LAKE REGION FLEISSNER, PAUL 1001 7TH ST NE DEVILS LAKE ND NO NOC66 05 ALTRU CLINIC LAKE REGION GREEN, MANDY 1001 7TH ST DEVILS LAKE ND NO NO

C704 01 BLOOMING PRAIRIE ASSESS CENTER HOFFARTH, JENNIFER 211 4TH STREET NE STE 4 DEVILS LAKE ND YES NO

Onsite visit performed FY2015

C66 05 ALTRU CLINIC LAKE REGION LAPP, GREG 1001 7TH ST DEVILS LAKE ND NO NOC103 MEDICAL IMAGING ASSOCIATES MEDICAL IMAGING ASSOCIATES PO BOX 801 DEVILS LAKE ND NO NOC102 01 MERCY HOSP RESP THERAPY DEPT MERCY HOSP RESP THERAPY DEP 1031 7TH ST E DEVILS LAKE ND NO NO

C704 01 BLOOMING PRAIRIE ASSESS CENTER SODERSTROM, JOCELYN 211 4TH STREET NE STE 4 DEVILS LAKE ND YES NO

Onsite visit performed FY 2015

C170 REHAB VISIONS ABEL, AMBER 683 STATE AVE STE B DICKINSON ND NO NOC170 REHAB VISIONS ANDRADE, BRIANNA 683 STATE AVE STE B DICKINSON ND NO NOC222 DICKINSON FAMILY COUNSELING BAER, ROBERT 11 2ND AVE E STE B DICKINSON ND NO NOC44 WESTWIND CONSULTING CENTER FEHR, ALAN 135 W VILLARD ST DICKINSON ND NO NOC26 GREAT PLAINS CLINIC GOLD, MARY ANN 33 9TH ST W DICKINSON ND NO NOC44 WESTWIND CONSULTING CENTER HALL, SHELLY 135 W VILLARD ST DICKINSON ND NO NOC236 KELLER, JESSICA EYEWEAR CONCEPTS DICKINSON ND NO NOC26 GREAT PLAINS CLINIC RATHGEBER, CORY 33 9TH ST W DICKINSON ND NO NOC236 SHILMAN, NATE EYEWEAR CONCEPTS DICKINSON ND NO NOC10 02 ST JOSEPHS HOSP RESP THER DEPT ST JOSEPHS HOSP RTU 2500 FAIRWAY STREET DICKINSON ND NO NO

C14 O1 ELGIN COMMUNITY CLINIC GOYAL, DEEPAK C/O JACOBSON MEMORIAL HOSPITAL ELGIN ND NO NO

C14 O1 ELGIN COMMUNITY CLINIC RIVINIUS, CAREY C/O JACOBSON MEMORIAL HOSPITAL ELGIN ND NO NOC237 CATALYST MEDICAL CENTER BELLIS, MORRIS 1800 21ST AVE S FARGO ND NO NOC7 03 ESSENTIA HLTH SPEECH PATHOLOGY BOOTH, JILL 1702 S UNIVERSITY DR FARGO ND NO NOC237 CATALYST MEDICAL CENTER BRAKKE, ROSE 1800 21ST AVE S FARGO ND NO NOC123 DARVEAUX, DION X 1308 23RD ST S LL STE G FARGO ND NO NOC20 FAMILY HEALTHCARE CENTER ESPEJO, NAPOLEON 301 NP AVE N FARGO ND NO NO

C21 INDEPENDENT RADIOLOGY SERVICES INDEPENDENT RADIOLOGY SERVI PO BOX 2746 FARGO ND NO NOC199 02 INTERNAL MEDICINE ASSOCIATES INTERNAL MEDICINE ASSOCIATE 1707 GOLD DR S STE 101 FARGO ND NO NOC162 07 SANFORD EYE DEPARTMENT JORDAN, ANDREW 1717 S UNIVERSITY DR FARGO ND NO NOC162 07 SANFORD EYE DEPARTMENT KELLY, BRENDAN 1717 S UNIVERSITY DR FARGO ND NO NOC237 CATALYST MEDICAL CENTER MATHISON, SUSAN M 1800 21ST AVE S FARGO ND NO NOC7 11 INNOVIS HEALTH EYE CLINIC METZGER, TODD 1702 S UNIVERSITY DR FARGO ND NO NOC162 04 SANFORD EAR NOSE & THROAT MOY, JUSTIN 737 BROADWAY FARGO ND NO NOC162 04 SANFORD EAR NOSE & THROAT OLSON, ARDELL 737 BROADWAY FARGO ND NO NOC764 PPI CONSULTING PHILLIPPI, JAY 1330 PAGE DR STE 202A FARGO ND NO NOC768 SEVEN DAY CLINIC NORTH RATAJCZAK, AMY 1100 19TH AVE NORTH FARGO ND NO NOC162 12 SANFORD HEALTH CENTER SANFORD HEALTH CENTER 737 BROADWAY AVE N FARGO ND NO NOC162 19 SOUTHWEST CHILDRENS CLINIC SETTY, ARVEITY R 2701 13TH AVE S FARGO ND NO NOC778 THOM, STEVEN B THOM EYE AND LASER CLINIC FARGO ND NO NOC199 INTERNAL MEDICINE ASSOCIATES YOHE, MARK 1707 GOLD DR S STE 101 FARGO ND YES NOC150 01 HOCHHALTER, SUSAN EARLY CHILDHOOD TRACKING FORT YATES ND NO NOC97 01 HEARTLAND EYE CARE PC HELGESON, MARK 415 HILL AVE GRAFTON ND NO NOC97 01 HEARTLAND EYE CARE PC HOENKE, JAMIE 415 HILL AVE GRAFTON ND NO NOC61 GRAFTON FAMILY CLINIC OMOTUNDE, JOSHUA O MD 155 14TH ST W GRAFTON ND NO NOC63 01 UNITY MEDICAL CNTR RT DEPT UNITY MEDICAL CNTR RT DEPT 164 W 13TH ST GRAFTON ND NO NO

C772 01 QUOTABLE KIDS SPEECH & LANG ZIEGELMANN, KRISTIN 819 HILL AVE GRAFTON ND NO NO

C66 01 ALTRU CLINIC ADJEKUM, GLORIA 1000 S COLUMBIA RD GRAND FORKS ND NO NO

C66 08 ALTRU CLINIC ALTRU CLINIC VASCULAR ULTRA SOUND DEPT GRAND FORKS ND NO NO

C66 09 ALTRU CLINIC ALTRU CLINIC RADIOLOGY DEPT GRAND FORKS ND NO NO

C66 11 ALTRU CLINIC-RADIOLOGY ALTRU CLINIC-RADIOLOGY PO BOX 6003 GRAND FORKS ND NO NO

C104 02 ALTRU HOSP RADIOLOGY DEPT ALTRU HOSP RADIOLOGY DEPT 1200 S COLUMBIA RD GRAND FORKS ND NO NO

C104 01 ALTRU HOSPITAL ALTRU HOSPITAL PULMONARY FUNCTION LAB GRAND FORKS ND NO NO

C112 01 ALTRU REHABILITATION CENTER ANDERSON, CASSIE 1300 S COLUMBIA RD GRAND FORKS ND NO NO

C66 04 ALTRU CLINIC BANSAL, ASHOK K PSYCHIATRY CENTER GRAND FORKS ND NO NO

C66 01 ALTRU CLINIC BECK, GWENDOLYN 1000 S COLUMBIA RD GRAND FORKS ND NO NO

C66 01 ALTRU CLINIC BRANDT, MACKENSIE 1000 S COLUMBIA RD GRAND FORKS ND NO NO

C66 01 ALTRU CLINIC DOUVOYIANNIS, MILTIADIS 1000 S COLUMBIA RD GRAND FORKS ND NO NO

C96 NORTH DAKOTA EYE CLINIC DUNHAM, TOM 3035 DEMERS AVENUE GRAND FORKS ND NO NO

C66 01 ALTRU CLINIC GAUTHAM, SHANTA 1000 S COLUMBIA RD GRAND FORKS ND YES NO

ONSITE VISIT PERFORMED IN 2016

C772 QUOTABLE KIDS SPEECH & LANG KJONO, CHELSEY 2600 DEMERS AVE STE 106 GRAND FORKS ND NO NO

C112 01 ALTRU REHABILITATION CENTER MISKAVIGE, LINDSEY 1300 S COLUMBIA RD GRAND FORKS ND NO NO

C241 FAMILY INSTITUTE ROWAN, LESLIE 2100 S COLUMBIA RD STE 202 GRAND FORKS ND YES NO


C772 QUOTABLE KIDS SPEECH & LANG VOLK, ANDREA 2600 DEMERS AVE STE 106 GRAND FORKS ND NO NOC67 CENTRAL DAKOTA CLINIC NYHUS, CHARLES 922 LINCOLN AVE HARVEY ND NO NOC781 ST ALOISIUS MEDICAL CENTER ST ALOISIUS MEDICAL CENTER 325 BREWSTER ST EAST HARVEY ND NO NOC7 08 ESSENTIA HEALTH JAMESTOWN BUSCH, TANIA 2430 20TH ST SW JAMESTOWN ND NO NOC153 PROFESSIONAL EYECARE CENTERS FROHLICH, DOUGLAS 210 10TH ST SE JAMESTOWN ND NO NOC153 PROFESSIONAL EYECARE CENTERS FRONK, KENT 210 10TH ST SE JAMESTOWN ND NO NOC46 01 JAMESTOWN HOSPITAL JAMESTOWN HOSPITAL RESPIRATORY CARE DEPT JAMESTOWN ND NO NOC157 LARSEN, RAYMOND JAMESTOWN ND NO NOC177 T&K SPEECH & LANGUAGE SERVICES LORENZ, KRISTY JAMESTOWN BUSINESS CENTER JAMESTOWN ND NO NO

C767 01 MILLER, ADAM D HORACE MANN INSURANCE BUILDING JAMESTOWN ND NO NOC7 08 ESSENTIA HEALTH JAMESTOWN TORRANCE, JAMES 2430 20TH ST SW JAMESTOWN ND NO NOC32 02 KULM COMMUNITY CLINIC HAUFF, ROSEMARY PO BOX B KULM ND NO NOC71 01 LANGDON CLINIC NOYES, RANDAL H 901 2ND ST LANGDON ND NO NOC31 LISBON AREA HEALTH SERVICES LISBON AREA HEALTH SERVICES PO BOX 353 LISBON ND NO NO

(b) (6)

C30 01 FAMILY MEDICAL CLINIC SHEETS-OLSON, BARBARA 10 9TH AVE E LISBON ND NO NOC79 01 MINOT CENTER FOR FAMILY MED ALI, NOOR A 1201 11TH AVE SW MINOT ND NO NOC79 01 MINOT CENTER FOR FAMILY MED BAAJ, MOHAMAD KARAM 1201 11TH AVE SW MINOT ND NO NOC79 01 MINOT CENTER FOR FAMILY MED BAHAL, PAUL 1201 11TH AVE SW MINOT ND NO NOC83 06 MEDICAL ARTS CLINIC BOGGARAPU, SHALINI 400 BURDICK EXPRESSWAY EAST MINOT ND NO NOC79 01 MINOT CENTER FOR FAMILY MED CHHIBBER, VISHAL 1201 11TH AVE SW MINOT ND NO NOC79 01 MINOT CENTER FOR FAMILY MED CHOI, TAE HO 1201 11TH AVE SW MINOT ND NO NO

C122 EATON, TIMOTHY MINOT ND YES NO


C184 01 FICEK, KOLETTA M MINOT STATE UNIVERSITY MINOT ND NO NOC79 01 MINOT CENTER FOR FAMILY MED GREWAL, SHUBNEET 1201 11TH AVE SW MINOT ND NO NOC79 01 MINOT CENTER FOR FAMILY MED GUPTA, KARANVIR 1201 11TH AVE SW MINOT ND NO NOC81 04 TRINITY HOSP SPEECH PATHOLOGY HAALAND, CHELSIE 407 3RD ST SE MINOT ND NO NOC79 01 MINOT CENTER FOR FAMILY MED IDANGODAGE, HASITHA 1201 11TH AVE SW MINOT ND NO NOC79 01 MINOT CENTER FOR FAMILY MED JOSHI, PURWA 1201 11TH AVE SW MINOT ND NO NOC79 01 MINOT CENTER FOR FAMILY MED MAHATO, SANJU 1201 11TH AVE SW MINOT ND NO NOC79 01 MINOT CENTER FOR FAMILY MED MANGAT, SUNEET 1201 11TH AVE SW MINOT ND NO NOC83 11 MINOT ENT CLINIC MAXSON, JERRICA TRINITY HEALTH CENTER WEST MINOT ND NO NO

C85 MEHTA, RAJNIKANT 315 MAIN ST STE 102 MINOT ND YES NO


C79 01 MINOT CENTER FOR FAMILY MED MONI, MONIKA 1201 11TH AVE SW MINOT ND NO NOC79 01 MINOT CENTER FOR FAMILY MED MOROLIA, PRASHANT 1201 11TH AVE SW MINOT ND NO NOC83 11 MINOT ENT CLINIC NECHODOM, TRICIA TRINITY HEALTH CENTER WEST MINOT ND NO NOC83 11 MINOT ENT CLINIC NOEL, MARK TRINITY HEALTH CENTER WEST MINOT ND NO NOC79 01 MINOT CENTER FOR FAMILY MED PANNU, PRINCE 1201 11TH AVE SW MINOT ND NO NOC79 01 MINOT CENTER FOR FAMILY MED PANT, SHRADHA 1201 11TH AVE SW MINOT ND NO NOC79 01 MINOT CENTER FOR FAMILY MED SANDRONI, PETER 1201 11TH AVE SW MINOT ND NO NOC79 01 MINOT CENTER FOR FAMILY MED SUBRAMANIYAN, GOWRI 1201 11TH AVE SW MINOT ND NO NOC79 01 MINOT CENTER FOR FAMILY MED TAUFIK, MIREILLE 1201 11TH AVE SW MINOT ND NO NO

C81 03 TRINITY HOSP CARDIO-PULMONARY TRINITY HOSP CARDIO-PULMONA 3 BURDICK EXPRESSWAY W MINOT ND NO NOC81 01 TRINITY MED CTR RADIOLOGY TRINITY MED CTR RADIOLOGY 1 BURDICK EXPRESSWAY W MINOT ND NO NOC202 TRINITY MEDICAL GROUP TRINITY MEDICAL GROUP PO BOX 5010 MINOT ND NO NOC81 04 TRINITY HOSP SPEECH PATHOLOGY WALSH, GEORGINE 407 3RD ST SE MINOT ND NO NOC93 PROFESSIONAL HEARING SERVICES WELLS, JESSICA 1400 37TH AVE SW MINOT ND NO NOC83 09 TRINITY REGIONAL EYE CARE WILLIAMS, DARRELL 2815 16TH ST SW STE 102 MINOT ND NO NOC83 09 TRINITY REGIONAL EYE CARE WOLSKY, CHAD 2815 16TH ST SW STE 102 MINOT ND NO NO

C39 01 ODDEN, RON HEARTLAND PROFESSIONAL BLDG MOORHEAD MN YES NO


C19 03 SANFORD HEALTH OAKES CLINIC NAGALA, VANI 420 S 7TH ST OAKES ND NO NOC779 RATH PC, GEOFFREY PO BOX 491 OAKES ND NO NOC19 04 SANFORD HEALTH OAKES CLINIC SANFORD HEALTH OAKES CLINIC 420 S 7TH ST OAKES ND NO NOC105 02 PRESENTATION MED CTR RTU PRESENTATION MED CTR RTU RESPIRATORY THERAPY DEPT ROLLA ND NO NOC118 01 THORMAN, JOSEPH ROLLA EYE CLINIC ROLLA ND NO NOC124 03 ROLLA OUTREACH OFFICE VOLK, GREG 113 MAIN AVE EAST ROLLA ND NO NOC106 01 HEART OF AMERICA MED CTR RTU HEART OF AMERICA MED CTR RT 800 S MAIN RUGBY ND NO NO

C106 02 HEART OF AMERICA MEDCTR RADIOL HEART OF AMERICA MEDCTR RAD 800 S MAIN RUGBY ND NO NO

(b) (6)

C759 01 MOUNTRAIL CTY MEDICAL CENTER MOUNTRAIL CTY MEDICAL CENTE PO BOX 399 STANLEY ND NO NOC162 16 SANFORD CLINIC VALLEY CITY BUHR, JAMES 520 CHAUTAUQUA BLVD VALLEY CITY ND NO NOC162 17 SANFORD CLINIC WAHPETON BRAUN, LISA PA 332 2ND AVE N WAHPETON ND NO NOC162 17 SANFORD CLINIC WAHPETON GETZ, ARIANE M 332 2ND AVE N WAHPETON ND NO NOC162 17 SANFORD CLINIC WAHPETON MYRON, SARAH 332 2ND AVE N WAHPETON ND NO NOC93 04 PROFESSIONAL HEARING SERVICES KILTHAU, KELCI 104 MAIN ST S WILLISTON ND NO NO

C78 03 MERCY MEDICAL CENTER RT DEPT MERCY MEDICAL CENTER RT DEP RESPIRATORY THERAPY DEPARTMENT WILLISTON ND NO NOC83 10 TRINITY REG EYECARE WESTERN DK ROLES, CYNTHIA 1321 W DAKOTA PARKWAY WILLISTON ND NO NOC780 CW WIEBE MEDICAL CENTRE BLIGNAUT, JOHANN 385 MAIN ST WINKLER MB NO NOC206 SLUSKY, ALAN 136 MARKET AVE STE 350 WINNIPEG MB NO NOC32 01 WISHEK COMMUNITY CLINIC THIRUMALAREDDY, JOSEPH 1007 4TH AVE S WISHEK ND NO NOC239 1 CHAMBERS & BLOHM 309 N MANDAN STREET BISMARCK ND YES YESC787 1 RESSLER, SCOTT FARGO ND NO NO

C793 HASE, HAROLD BISMARCK ND NO NO

PERFORMS VIDEO CE's ONLY NO OFFICE

(b) (6)

(b) (6)

Provider Name/Group SpecialityVolume & Key

ProviderOnsite Review

Midtown Medical Group Barb Eckert PS X X Holly Filcheck PS X X Jennifer Linder PS X X Elizabeth Morell PS X X Joshua Needelman PS X X David Barton IN X X Nathan Bertoldo IN X X William Poulson IN X X Meryl Severson IN X X James Wax IN X X James Bisanti IN X X Antionette Tribulato IN X XElizabeth Dayton IN X XBradley Hall IN X XKimberly Joynt IN X XAmanda Millemon IN X XGene Pershwitz IN X XJason Talmadge IN X X

Community Action Partnership (CAPWN) INAbdel Kader IN X XGage Stermensky IN X XElizabeth Walton IN X XChristopher Wiles IN X XJohn Carrington IN X XCaroly Herman IN X X

AUDIOLOGISTNora Fuch AULori Dailey AUGraig Foss AUKimberly Andresen AURoy Christensen AU

OTOLARYNGOLOGISTPaul Sherrered ENNila Novotny ENThomas Kenny ENSarah Powell ENThomas Nabity ENV Richard Bowen EN

Nebraska CE Oversight October 1, 2016 - September 31, 2017

Active CE Provider List

Nebraska2016-17 FY CE Oversight

Mark Keller ENRichard Bowen ENKate Rosenberger ENChristopher Cederberg ENBenton Nelson ENRoyce Mueller ENTerry Olson ENBrian Gartrell ENDana Wolfe ENH Russell Semm ENBritt Thedinger EN

INTERNIST (MDs, DO, PA, APRN)James Massey Jr INJeffrey Meade INJohn Gill INMichael Zaruba INMark Jobman INDonald Weldon INBrett Studley INJuvet Che INJames Nelson INLinda Mazour INWilliam Sandy INSteven Saathoff INRuby Northrup INShiuvaun Jaeger INBrenda Korth-Wurdinger INLarry Birch IN XDavid Lindley INVijay Agarwal INMark Pilley INSamuel Moessner INShailendra Saxena INAdam Wineinger INCarl Cornelius Jr INDouglas Martin INMark McCorkindale INMelvin Campbell INDana Farris INMakayla Wiese INWilliam Blair INRuby Houck INJerry McLain INThomas Smith INBrett Wergin INAlyssa Finck INAdam Rensch IN


Kathryn Thelen INKimberly Butts INThomas Fischer INBenjamin Egger INKelli Garwood INMarehan Nakhnoukh INStephen Smith INCharles Burkett INAshley Powell INAdam Strehle INJustin Morar IN

NEUROLOGISTDaniel Stevens NEC Robert Adam NEJohn Aita NEJohn Goldner NERobert Sundell NEJoel Cotton NEJohn Hannam NEManjula Tella NE

OPTHALOMOLOGIST/OPTOMETRISTDavid Franco ODMatthew Willis ODRoger Filips ODJerry Damme ODRobert Stamm ODDirk Gray ODGregory Kouri ODAnn Feidler-Klein ODJeffrey Klein ODTeri Geist ODKrystal Wells ODScott Greder ODMatthew Willis ODJ Todd Mahoney ODPaul Colburn ODNatasha Jenkins Long ODTerry Adams ODPenelope Haeker ODJanet Fett ODDaniel Kincaid ODPeter Diedrichsen OPSteven Samuelson OPGregory Haskins OPJan Jensen OPLinda Blakely OP


Frederick Mausolf OPVincent Sutton OPMario Mota OPThomas Graul OPLee Thurber OPRichard Maw OPMichael Feilmeier OPJane Bailey OPDavid Ingvoldstad OPCortney Hellman OPMartin Mizener OPMichael Goldstein OPJeffery Hottman OPJohn Peters OPMark Emig OPMatthew Appenzeller OPPeter Whitted OPD Francis Arkfeld OPMichael Halsted OPCamilla Parson OPJill Grennan OPDaniel Sharp OPMonte Dirks OPMichael Wadzinski OP

PEDIATRICIANEyad Najdawi PESusan Caldwell PENitya Brenner PERex Rundquist PE

PSYCHIATRIST/PSYCHOLOGISTKay Shilling PSRobert Arias PSJustin Anderson PSJames Mathisen PSPaul Adams PSLeland Zlomke PSRebecca Schroeder PSAllen Meyer PSBrad Bigelow PS Linda Hunter PSMichael Renner PSDavid Duke PSJohn Meidlinger PSKevin Menefee PSRyan Ernst PSLisa Logsden PSJames Carmer PS


Daniel Ullman PSThomas Tiegs PSKimberly Kilgore PSGail Ihle PSEugene Egnoski PSJohn Curran PSMark Nelson PSMark Hannappel PSAmy T. Corey PSA James Fix PS XGary Van Ert PS X XMatthew Hutt PSCaroline Sedlacek PSSarah Schaffer PSLloyd Lee Kimzey PSJoseph Rizzo PSJoseph Stankus PSLindsey Hauser PSRosanna Jones-Thurman PSPatricia Blake PSKelly Fairbanks PSJohn Hunziker PSAmanda Holmgreen PSMark Hald PSSuzanne Keizer PSMichael Baker PSDenise Marandola PSDena Olwan PSJoel Merkwan PSLinda Schmechel PSJack Kramer PSNicholas Stevens PS

PHYSICAL THERAPISTJonathon Brezenski PTRandy Peraul PTJay James Pelan PTSue Jeffrey PTSherril Kilpatrick PTTiffany Beiermann PTEric Bjorkman PTKate Robb PTBrett Woslager PTBruce Bednar PTBecky Pearson PTBonnie Mevis PT

SPEECH LAGUAGE PATHOLOGISTMartha Douglas SLP


Tracie Heckenlively SLPRuth Anderson SLPDeb Fisher SLPPam Peters SLPShana Merrihew SLPAshley Meyer SLPJessica Ferfuson SLPJennifer Arndt SLPShannon Klimas-Bernitt SLPElizabeth Weber SLPNoelle Lindauer SLPMindy Uden-Roberts SLPJessica Thoene SLP

Provider Name/Group SpecialityVolume & Key

ProviderOnsite Review

Jessica Reuter SLPAlissa Brady SLPConnie Hanson SLPDeb O'Connor SLPMelissa Harmon SLPCarly Thomas SLPKara McKeone SLPPaige Gurciullo SLPMary K Miklas SLPLinda Lawlis SLP


Provider Name/Group Speciality Reason Derrick Eichele IN Herman Hernandez IN Brian Hollis IN Jerry Authier PS Gary Gard PS Jeffrey Klug IN Joseph Kent PS Silas Williams IN Andrew Smith PS Cynthia Topf PS Keegan Harkin IN Natalie Ommen IN Patrick Anderel INChris Rathburn PSHelen Kuehlman INWilliam Packard PSDavid Johnson INChristopher Costa INElaine Christiansen INMelissa Kudlacek INMatthias Okoye INAdam Rusmussen INAnna Darymple INMackenzie Hemje INDouglas Bauer INRulin Wang INElizabeth Wooster INMansoor Ahmad INEli Burks INKunal Gandhi INBradley Irvin INGuy Domm INAngela McLaughlin INShibu Oommen INJanae Dudgeon INJawad Ahmad INMohammad esmadi INEdward Schima NEColby Fletcher OPAnn Rehan PE

Nebraska CE Oversight October 1, 2016 - September 31, 2017

CE Terminated List


(b) (6)

John Engler PSLisa Stinson PSKari Perez PSMary Ann Strider PSKim Marlatt PTLori Ford SLPLynn Grubb SLP


(b) (6)

2017 CE Providers- Nevada DDS

Vendor Name Vendor Address Rate Key/ VolumActive/ InactivActive/ Inactive Reason OnSite Inspections Completed

Medical Support Los Angeles 2110 E Flamingo Rd #216 Las Vegas, NV 89119 $289,922.00 Key/ VolumActive 6/20/2017

Desert Psychological 9183 W Flamingo Rd #100 Las Vegas, NV 89147 $189,205.00 Key/ VolumINACTIVE

Intergrated Psych Solutions 2780 S. Jones Blvd #108 Las Vegas NV 89146 $188,350.00 Key/ VolumActive 6/8/2017

Innovative Medical LLC 1489 W Warm Springs Rd #110 Henderson, NV 89014 $158,898.00 Key/Volum Active 5/31/2017Marc Zucker PsyD 4955 S Durango Dr. #221 Las Vegas, NV 89113 $134,905.00 Key Active Not completedNorthern Nevada Psychology 309 E John St #1 Carson City, NV 89706 $105,691.00 Key Active 6/22/2017Lisa M Foerster PsyD 9163 W Flamingo Rd #120 Las Vegas, NV 89147 $103,250.00 Key Active Not completedAMCE Physicians Group 5365 Mae Anne Ave #B-2 Reno, NV 89523 $99,135.00 Key Active LV-5/22/17 Reno-6/21/17Myra Thompson Psyd LLC 6069 S Fort Apache Rd #100 Las Vegas, NV 89148 $96,510.00 Key Active 8/23/2017Kathleen S Mayers PhD 4550 W. Oakey Blvd. # 111, Las Vegas, NV 89102 $89,445.00 Key Active Not completed

Verna Fabella Hicks PhD 2881 Business Park Courte #150 , Las Vegas NV 89128 $76,420.00 Key Active 8/15/2017Richard A Cestkowski DO 6655 W Sahara Ave #D100 Las Vegas, NV 89146 $74,691.50 Key Active Not completedMichael Glick, DO St Reno , NV 89511 $74,513.00 Key Active 6/21/2017Rager Diagnostics and Behavior 1050 Indigo Dr. #112, Las, Vegas, NV 89145 $63,590.00 Key Active Not completed

Gary Lenkeit PhD 1820 E Warm Springs Rd #115 Las Vegas, NV 89119 $54,885.00 Key Active Not completedSFS Therapies/ SYD Nukleo 1333 N. Buffalo Drive, #260, Las Vegas, NV 89128 $49,520.00 Key Active 10/19/2017R Kirby Reed LTD Las Vegas, NV 89120 $44,380.00 Key Active Not completedShrinkwrapt Las Vegas LLC 2580 Anthem Village Dr Henderson, NV 89052 $41,270.00 Key Active 5/31/2017RBM Clinic 2675 S. Jones Blvd, #112, Las Vegas, NV 89146 $39,842.00 INACTIVE InactiveElizabeth James PhD 4955 S Durango Dr. #221 Las Vegas, NV 89113 $37,449.00 Key Active Not completedL.D Larson PhD Las Vegas, NV 89146 $35,935.00 Key Active Not completedPsych Inc 200 S Virginia St 8th Floor Reno, NV 89501 $33,870.00 Key Active 10/12/2017SDMI Limited Partnership 7301 Peak Dr #200 Las Vegas, NV 89128 $29,754.50 Non Key Active Not completedDaniel Malatesta EdD Las Vegas, NV 89129 $29,150.00 Key Active Not completedSpencer Quinton OD 305 N Pecos Rd #A Henderson, NV 89074 $26,165.00 Non Key Active 5/31/2017

Radiology Consultants/Reno Diagnostics 590 Eureka Ave, Reno, NV 89512 $22,639.00 Non Key Active 9/13/2017Julius M Rogina PhD 427 Ridge St #A Reno, NV 89501 $22,225.00 Key Active 6/22/2017Wendy Riback Las Vegas, NV 89117 $18,485.00 Key Active Not completedMaria Doncaster PhD 3450 E Russell Rd #103 Las Vegas, NV 89120 $17,795.00 Key Active 6/1/2017Nevada Heart Consultants 3017 W Charleston Blvd #80 Las Vegas, NV 89102 $12,510.00 Key Active 8/17/2017

RD Prabhu Lata K Shete MDS 5701 W Charleston Blvd #100 Las Vegas, NV 89146 $12,217.00 Non Key Active Not completedNevada Education & Therapy 500 Ryland St #150 Reno, NV 89502 $11,005.00 Non Key Active Not completed

Valley Pediatric & Specialty 3100 W Charleston Ave #210 Las Vegas, NV 89102 $10,720.00 Non Key Active Not completedOlympus Health Nevada LLC 700 N. Carr Road, Plainsfield, IN 46168 $10,523.50 Key Active Not completed

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

Tyson F Kales OD Reno, NV 89502 $8,865.00 Key Active 8/30/2017Lubritz & Nasri LLP 3201 S Maryland Pkwy #300 Las Vegas, NV 89109 $5,516.00 Non Key Active Not completedConcentra Medical Center 255 Glendale Ave #12 Reno, NV 89431 $4,854.00 Non Key Active 10/12/2017Martha Mahaffey PhD Reno, NV 89502 $4,710.00 INACTIVE InactiveReflections Therapy 2620 Regatta Dr. #202, Las Vegas, NV 89128 $4,250.00 Key Active 8/8/2017Anderson Audiology 3120 S Rainbow Blvd #202 Las Vegas, NV 89146 $3,366.00 Non Key Active 5/23/2017Complete Family Care Ltd 255 W Peckham Ln #2 Reno, NV 89509 $2,410.00 Non Key Active 9/14/2017John R Shepherd MD LTD Las Vegas, NV 89121 $2,345.00 INACTIVE InactiveNeurology Center Of Las Vegas 2480 Professional Ct Las Vegas NV 89128 $2,050.00 Non Key Active Not completedZucker, Irene 4955 S Durango Dr. #221 Las Vegas, NV 89113 $1,550.00 Non Key Active Not completed

Odyssey Wellness-Dr. Ahmad 9183 W. Flamingo Rd, Las Vegas, NV 89147 $1,350.00 Non Key ActiveNot completed- Using one of Dr. Hollands offices

David L Mathis MD Reno, NV 89523 $1,012.00 Key INACTIVE InactiveSilver State Hearing & Balance 501 Hammill Ln Reno, NV 89511 $770.00 Non Key Active 9/13/2017Estella O Racoma LLC 2675 S Jones Blvd #112 Las Vegas, NV 89146 $770.00 Non Key INACTIVE InactiveKenneth W Houchin MD Elko, NV 89801 $495.00 Non Key Active 9/12/2017Carson Tahoe Cardiology 1470 Medical Pkwy #160 Carson City, NV 89703 $312.00 INACTIVE InactiveSierra Speech and Language DBA Sierra Therapy Group 9520 Prototype Ct Reno, NV 89521 $170.00 Non Key Active Not completedPinion Road Clinic 1780 Browning Way Elko, NV 89801 $156.00 Non Key Active 9/12/2017Marietta Nelson 2800 N Tenaya #102 Las Vegas, NV 89128 $100.00 Non Key Active Not completedStacey Knobler MD Reno, NV 89509 $0.00 Non Key Active 9/13/2017Yesnick Vision Center 10198 W Flamingo Rd #100 Las Vegas, NV 89147 $0.00 Non Key Active Not completedWarner Wilson PHD 3376 S Eastern Blvd #120 Las Vegas, NV 89109 $0.00 Non Key Active Not completedValette Group/Jurani Clinic 4520 Paradise Rd Las Vegas, NV 89169 $0.00 Non Key Active Not completed

Dr. Lesile Westfield PhD , Henderson, NV 89074 $0.00 Key Active 9/27/2017Innovation Behavioral Health 6655 W. Sahara Ave. #B200, Las Vegas, NV 89146 $0.00 Key Active 9/5/2017

Dr. Bree Mullins PsyD 1820 E Warm Springs Rd #115 Las Vegas, NV 89119 $0.00 Key Active Not completedDr. Sunshine Collins PsyD 9163 W. Flamingo Rd. #120, Las Vegas, NV $0.00 Key Active Not completedDr. Jacquelyn Johnson PsyD Reno, NV 89509 $0.00 Key Active 10/13/2017Moonlight Examinations 4300 Anaconda Ct, Granberry, TX 76048 $0.00 Key Active 10/12/2017Marilyn Maschgan AuD 301 N. Pecos Rd, #G, Henderson, NV 89074 $0.00 Non Key Active 8/10/2017

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

Beginning FY17 = 137 136-6+11=141

Removed = 10

Added = 14 Includes 3 additional locations for FillmoreEnding FY17 = 141

VENDOR NAME / FACILITY NAME FACILITY PHYSICIAN NAMES NOTES Removed AddedLocation Date 150 10 14

ABQ HEALTH PARTNERS (DaVita)Nagaraju, SivakumarNazon, Daniel

Roswell 1/25/2017 ADAMS, CARL B PHDADVANCED MEDICAL CONSULTANTS (Dr. Newell -- contact)

Chavez, JulianaClark, RossEl-Emawy, Ahmed

Evans, Scott D.Dr. Newell stated Dr Evans moved out of state - not working here

Fitzgerald, JuddGarzon Lopez, Agustina C. (goes by Dr. Garzon)Maes, LeviMcKinney, MichaelRichter, Dustin

AGE TO AGE COUNSELINGAlbuquerque 12/16/2016 Spies, Shari

ALAMOGORDO INTERNAL MEDICINEAnireddy, Giridhar R. Hanumandla, Sarojana

ALBUQUERQUE HEARING ASSOCIATES(Mary Spilman, Financial Coordinator)Almquist, ElaineClifford, CarolMolloy-Sawyer, Patricia

Las Vegas 4/27/2017ALTA VISTA REGIONAL HOSPITAL - use Rural Radiology for XR AMCE

Albuquerque 12/16/2016 Black, Marian (LISW)LISW (LC, Hobbs, Roswell, Silver City) - Removed as of 7/13/17 per Linda

DeBernardi, AmyDraper, JohnMacy, Ruth (LISW) NO Longer works w/ AMCE; last appt 6/28/17

McCanna, CharlesNo longer works w/AMCE; inactivated 8/18/17 per email

Mead, Diane R. (LISW)added per email received 03/16/17, inactivated 7/6/17 per email request

Schaefer, Shayna (LISW) no longer on staff per email received 03/16/17Schweiger, Russell (LISW) no longer on staff per email received 03/16/17

Previously lumped together; adjusted to make consistent with other providers

COLOR KEY:INACTIVE - within FY17

SANCTIONSTOP 5 KEY/VOLUME PROVIDERS

Site Visit

New Mexico FY 2017

AMPLIFIED THERAPY

Bradberry, Shalako SLP-CCC

ANDERSON, N PHOENIXInactive as of 9/28/16 - but was not removed from 2016 X

ARIS TELERADIOLOGY (xray interpretation for Miner's Colfax MC)

Barnes, PatriciaBass, DavidCavin, LillianDier, GaryFisher, Timothy SebastianGalvez, MichelleGrebenc, MaryHatch, WendellHsu, JamesJacobson, LeslieLuyckx, BenoitMaung, TonyMinotti, AnthonyNorconk, JamesPatterson, RichardShah, AbhijitWohlwend, John

ARTESIA GENERAL HOSPITAL -- use Pinon Radiology for XR

Anwar, Khawaja 9/12/17 InactiveBatty, JohnFeroze, HamidSpar, Jon

Atkinson, Leah FPNP *New Provider as of 6/21/17 XAUDIO ACOUSTICS HEARING CTR INC

Corbin, KambraGonzalez Rodriguez, Angelica

Santa Fe 7/13/2017 BATEN, MICHAEL MDBEHAVIORAL MEDICINE ASSOC. INC *New Vendor as of 4/19/17 X

Whitlock, BrianJimenez, Julie MSWTrevizo, Karla MA

BELL, ROBERT M MD

Border Area Mental Health*New Vendor w/Locations in Silver City and Deming as of 6/21/17 X

Kathleen Hunt, LPCCSilvia Madrid, LPCC

Portales 9/28/2017 BROOKS, CHARLESCaplan & Associates Caplan, Marc PhD *New Vendor a s of 9/22/17 X

Guglielmina, AriaCARDIAC CARE CONSULTANTS OF NM P.C. ABQ/Los Lunas/Belen/Rio Rancho/Gallup/LV

Gurule, Michael

Ierides, Loutsios

Palmer, Elizabeth

Sandoval, AnthonyCARLSBAD MEDICAL CENTER

Ardakani, NavidBraude, DarrenCaverly, JeffreyConner, PatrickDara, BharatDavenport, JenniferDewan, RahulDubey, NeerajErvin, WilliamGallegos, EmmanuelGonzalez-Villaverde, AlbertoGurczak, PatriciaHolmes, GerardHopson, GabrieleKampe, DelmarKuehn, NicolausLimonte, LeonelLis, StevenLue, JasonMangat, JagjitMehta, NikhilMitchell, RichardMunoz, JulioNewell, PeterPatel, AtulPiampiano, PeterQureshi, HumaReed, PeilinReuter, RobertRippner, RobertRuzich, JefferySarno, RonaldSobredo, SergioVincent, AlixWayburn, LawrenceZwiener, John

Farmington 4/10/2017 CE PROVIDER SERVICESClawson, DianeColleran, Kathleen M.

Como, Jennifer

Glassheim, JeffreyMcBride, Sandra

CIBOLA GENERAL HOSPITAL - use XR Assoc for radiology & NMHI Cardiology CLAYTON, STARLIA MSCCC-SLPCUMMINGS, MICHAEL A PHD DAN C TRIGG MEMORIAL HOSPITAL (uses Radiology Assoc of ABQ) Derri Pender

Las Cruces 3/15/2017 DARAKJY, JENNIFER PHD

DELANEY, MARITA PHD Rio Rancho 5/19/2017 DHANENS, THOMAS

DINSMORE, ELIZABETH PHD Inactive as of 1/12/17 XEASTERN NEW MEXICO MEDICAL CENTER - use Online Rad. For XR

address licensing letters to Shill Breedyk Business OfficeAdajar, FundadorFeroze, HamidPearson, Clarence

EAST MOUNTAIN HEARING & BALANCE Pulsipher, LisaEMERY, MICHAELESPANOLA HOSPITAL -- Use RAA for XR EYE ASSOCIATES OF NEW MEXICO/ABQ-Eubank Michelle Butcher, Credentialing

Achilles, Amanda Dudeck, KirstenKoschmeder, JasonMcGraw, Matthew D.Roland, Nathaniel 10/31/16 Provider moved out of state

EYE ASSOCIATES OF NEW MEXICO/ABQ-Harper Achilles, Amanda Allen, RebekahArmentrout, MatthewBeebe, EllenBobick, LaurenBrinkley, JohnCano-Howes, Melinda A. Also at the Los Lunas officeCarlow, ThomasChan, VanLinChang, LanChiang, CharlesDimonaco, MichaelDurso, FrankGoecks, Tara M.Himmel, KennethLesher, MarkMares, FrankMarsh, BarbaraMcGraw, Matthew D.Monson, BryanMorris, CaraOgawa, GregoryPitcher, JohnRamaiya, Kamalesh

Ritsema, MollyRitz, NicholasRoybal, ChristopherSanchez, Philip JamesSong, Mi-KyoungVroman, CraigWatterberg, TinaWeinstein, Arthur

EYE ASSOCIATES OF NEW MEXICO/ABQ - MLKBeebe, EllenBobick, LaurenCano-Howes, Melinda A. Also at the Los Lunas officeChiu, MarkMcGraw, Matthew D.Reddy, AshokReidy, RobertWieland, WilliamWyant, Frank

EYE ASSOCIATES OF NEW MEXICO/EspanolaBratton, AngelaCoulter, JuliaRorebeck, Warren

Farmington 4/10/2017 EYE ASSOCIATES OF NEW MEXICO/FarmingtonKleva, JulieWiggins, Duane

Gallup 10/17/2016 EYE ASSOCIATES OF NEW MEXICO/GallupChiang, CharlesBobick, LaurenKim, MarissaMcGraw, Matthew D.Roybal, Christopher

EYE ASSOCIATES OF NEW MEXICO/Las Vegas

Vander Meer, Robert emailed contact 9/19/16 - License shows "retired" EYE ASSOCIATES OF NEW MEXICO/Los Alamos

Johnson, TimothyEYE ASSOCIATES OF NEW MEXICO/Los Lunas

Cano-Howes, Melinda A.EYE ASSOCIATES OF NEW MEXICO/Roswell

Fitch, Patricia Will begin seeing patients at Eye Assoicates on 5/2/16Hillam, Steven Roybal, Christopher

EYE ASSOCIATES OF NEW MEXICO/Rio RanchoAchilles, Amanda Bigelow, DarylGoecks, Tara M.Melendez, Robert FMcGraw, Matthew D.Roybal, Christopher

Strosnider, Jeff CEYE ASSOCIATES OF NEW MEXICO/Santa Fe

Achilles, Amanda Byrne, ErinCoulter, JuliaCyr, KellyFitch, PatriciaGoecks, Tara M.Himmel, KennethJavid, A.J.Levy, RennyReidy, KristinRoybal, ChristopherSoloway, Mahlon

EYE ASSOCIATES OF NEW MEXICO/Socorro Office closed 9/1/17 XBeebe, EllenCano-Howes, Melinda A.

EYE ASSOCIATES OF NEW MEXICO/Taos

Morrison, John Jr.contact emailed on 9/14/16; remains expired as of 11/1/16

Oneby, TerriRorebeck, Warren

Las Cruces 3/16/2017 EYES OF THE SOUTHWEST PC Apple, NealHernandez, Edward

Mohammed, AndrewPer letter dated 05/02/17, provider no longer active eff 05/01/17

Las Cruces 3/16/2017 FILLMORE EYE CLINIC INC - Las Cruces Multiple offices - Providers rotateAnderson, AaronFillmore, ParleyHall, JonHicks, BrandonMargolis, Michael

Alamogordo 3/30/2017 FILLMORE EYE CLINIC INC - Alamogordo providers listed above XDeming 5/25/2017 FILLMORE EYE CLINIC INC - Deming providers listed above X

FILLMORE EYE CLINIC INC - T or C providers listed above X

Clovis2/28/2017

9/27/17 FINK, RICHARD PHD FOSTER, ELAINE ORABONA PHDFOUR CORNERS RADIOLOGY (XR interpretatio for San Juan RMC)

Bliss, Lynne FBray, MaceyOrbelo, RobertWeaver, Robert RoyWebster, John Roger IIIWolske, Kristy Marie

Alamogordo 3/30/2017GERALD CHAMPION REGIONAL MEDICAL CENTER (2nd Xray Assoc)

Abood, Ferial

Alqassem, NasserAnireddy, Giridhar Fellers, NealHanumandla, Sarojana

Silver City 3/13/2017GILA REGIONAL MEDICAL CENTER - (use Rural Radiology for XR) GUADALUPE COUNTY HOSPITAL (Use High Plains Rad for XR)

Brown, RandalCalkins, DavidCambron, BradfordCisneros, RaquelMaes, Levi

Gutierrez, Rhonda LPCC *New Provider as of 9/12/17 XEspanola 2/9/2017 GZASKOW, MICHAEL F MD

HARRINGTON, JAMES PHD HEARING GROUP OF NM

Correa, JoseVigil, Diana Au.D.

HERLIHY, KERRI SPEECH PATHOLOGY HIGH PLAINS RADIOLOGY ASSOCIATION - (Union & Guadalupe Co)

Andrew, John L. MD, DABRAragon, Gary L. MD, DABRArcher, Branch T. MD, DABRArcher Jr., Richard K. MD, DABRBickers, Gayle H. MD, DABRBrooks, Charles MD, DABRClark, Crandon MD, DABRCook, Stanley MD, DABRCurrie, Tully Jenks MD, DABR 11/1/16 - not renewed Daniel, Michael MD, DABRElliott, Aaron MD, DABR

Haas, Stephan MD, DABR

Hall, Michael MD, DABRHashmi, Arouj MD, DABRKhu, Richard C. MD, DABRMehta, Rahul MD, DABRPan, Paul P. MD, DABRPinkston, Robert L. MD, DABR

Scalapino, Matthew C. MD, DABRShah, Rakesh R. MD, DABRUszynski, Martin MD, DABRWaugh, Kimberly A. MD, DABR 11/1/16 - not renewed

Zarian, Lawrence MD, DABR

HOLY CROSS HOSPITAL - use Rural Radiology for XR Constantin, Luis MDIsmail, Geilan MDKaufman, Michael H

Albuquerque 12/21/2016 HUGHSON, PAULA MD Albuquerque 6/1/2017 HUNT, MARY SPEECH PATHOLOGY *Provider will be moving out of state end of 2017

Hush, Rachael Speech Pathology *New Provider as of 8/18/17 XJOHNSON-JIMENEZ, ERIKA PHD

Ruidoso 3/29/2017 KENNEY, KENNETH C. KENNETH KENNEY, PhD

Torres, Rebecca M (NCSP)School Psychologist - license on NM Public Education Department

KING, EMILY PSYD *Inactive as of 9/6/17 - no location XFarmington 4/10/2017 KOEWLER, JOHN H III Santa Fe 2/9/2017 KRUEGER, ROBERT PHD Albuquerque 12/21/2016 LACOURT, DAVID PHD Espanola 2/9/2017 LANG, JOHN PHD

LAS CRUCES RADIOLOGY ASSOC Kathleen Parsons, CredentialingDevasthali, RamakrishnaGhei, Puneet

Hobbs 1/24/2017 LEA REGIONAL MEDICAL CENTER Kernan, John BMaddox, Truett Patel, Mukeshbhai

Pfaff, Charles Order to be released from board order dated 5/21/10Techeira, Aemon

Lesko, Paul MD *New Provider as of 8/18/17 XLIFESPAN THERAPY SERVICES Sandy Custer, Practice Manger *Inactive as of 9/28/16 but not removed in 2016 X

Castle, KathleenDavis, KindraHolifield, Julie C

Las Cruces 3/16/2017 LIFEWORKS UNLIMITEDCastellanos, Luisa

Carlsbad 8/24/2017 LIM, MICHAEL MD Ruidoso 3/28/2017 LINCOLN COUNTY MEDICAL CENTER

Robinson, Walter C

LINCOLN COUNTY RADIOLOGY (Reads for Lincoln Co MC)

Devasthali, Ramakrishna MDGhei, PuneetSmiley, HylasSpera, Thomas Techeira, AemonWolfel, Donald

LITTLEFIELD, JERALD J MD XAlbuquerque 12/21/2016 LOESCHER, MARY S PHD

Albuquerque 3/7/2017 LOVELACE SCIENTIFIC RESOURCES McGuire, Michael

Manole, Athanasios, MD *New Provider as of 8/15/17 XMAY-VALENCIA, BARBARA PHD MEDICAL DIAGNOSTICS IMAGING GROUP (interprets for Sierra Vista)

Carr, BarbaraChung, EugeneEelkema, JohnFenzl, GregoryFinkel, LawrenceFiske, ShirleyIngui, ChristianJalalzai, WaheedKazem, ImranLin, IreneMcCarver, RobertPatel, KalpeshPatel, RakeshRoy, AnjaliRuvo, VeronicaSadegi, BarryShah, AbhijitStair, DorisWeitz, DavidWilley, RichardWolsey, GilmanZernich, Brian

MEDICAL DIAGNOSTICS SERVICES (interprets for San Juan Regional)

Barry-Prather, Eleanore AnnGlover, Donald KSpence, James J

MED-PLUSTori Quimby-- Program Administrator

Albuquerque 12/21/2016 Alshurbaji, Ehab no longer with Med-Plus after 2/2017Hobbs 1/24/2017 Andrews, NathanRoswell 1/26/2017 Bagga, Arlene

Silver City 3/13/2017 Brisky, Martha (PHD)11/1/16 works with UNM/VA - Med Plus does not perform psych evals

Las Cruces 3/15/2017 Chen, YuefengFarmington 4/13/2017 Cheng, Terri

Clawson, DianeCrumbacher, James Decker, MichaelFishburn, StevenFleg, AnthonyGreenburg, DavidGreene, Heather

Greer, KyleGreig, Elizabeth (name change to Hopson) name change to HopsonGuerrero-Pezzano, TatyanaHaaland, Christina Hammons, LauraHindi, YousefHopson, ElizabethLarson, AndrewMaes, Levi Also works for Advanced MedicalNunez, WilliePastrana, Carlos

Ponce, Lianano longer w/ med-plus as of 3/2012; reactivated 8/9/17

Pou, Nelson

Rossini, Juan

Scott, Ariel JoySilverthorne, PatrickYoung-Rodriguez, Raul

Las Vegas 4/26/2017MILLER, FRANKLIN (PFS Interpretation for Alta Vista Hospital)

Deming 3/14/2017 MIMBRES MEMORIAL HOSPITAL Atkinson, George

Dubey, NeerajLahiri, SanjayPham, JustinSaurborn, DanielTan, Kenneth (Radiology 24/7)

Raton 4/25/2017 MINERS COLFAX MEDICAL CENTER (Use ARIS for XR) Henrietta Romero (licensing)Sood, Akshay

Albuquerque 5/20/2017 MOBILE CARE CONCEPTSClark, RossGreenbaum, AlissaLunkenheimer, JaredMcClain, MollyYoon, Moon

NADIG, CHARULATA *Inactive as of 9/6/17 XAlbuquerque 12/16/2016 NEW MEXICO HEART INSTITUTE/ABQ no longer in roswell

Bieniarz, MarkBujoi, MihaelaCastlemain, BrianCavanaugh, BrendanDowney, RossFrankis, MaryHenao, EstebanKim, CharlesKunz, Geoffrey

Mansfield, WilliamMazer, Sean

Orchard, Robert

Peralta, MelRamo, BarryRonan, AdamSopko, KarenStamm, R. BradWyndham, ChristopherZolnick, Mark

Farmington 4/10/2017 OLYMPUS HEALTHAlbuquerque 5/20/2017 Greene, HeatherLas Cruces 8/7/2017 Larson, Andrew

Manole, Athanasios now working separatelyMusgrave, ZacharyPuckett, Yana MD

Farmington 4/13/2017 ONIK INTEGRATIVE MEDICINE

Onik, CaseyONLINE RADIOLOGY MEDICAL GRP INC - reads for Eastern NMMC

Ardakani, Navid ArefiBraunstein, John BCaverly, Jeffrey ClarkDew, Linda LouiseGivens, LarryGonzales-Villaverde, AlbertoHarris, Gary Stuart 11/1/16 - license lapsedJun, Aaron HaoKuehn, Nicolaus JosephLis, Steven ThaddeusLue, JasonMcLellan, Garey LMitchell, Richard APatel, Atul JPiampiano, Peter PaulReed, Peilin ChenRippner, Robert StevenRoy, Dave ASalen, SamuelSarfraz, JamilWarren, James PWayburn, Lawrence GaryWedeen, Glenn P 11/1/16 - license lapsedWells, David LWolke, Ira Stephen

ONRAD ICI 24/7 (was RADIOLOGY 24/7)Hudkins, Matthew

Jain, Sanjay Tan, Kenneth

Albuquerque 3/7/2017 OWEN, JOHN P PHD Albuquerque 5/18/2017 PADILLA, ELIGIO R PHD

PATE, TONNA Inactive as of 6/2016 but not removed in 2016 XPITTS, MICHAEL PSYD inactive as of 9/28/16 but not removed in 2016 X

PLAINS REGIONAL MEDICAL CENTER

PO Box 911576, Denver, CO 80291-1576 & 2100 N Martin Luther King Jr., Clovis, NM 88101

Clovis2/28/2017

9/28/17 Poe, Chase M PhD

Consulting Psychological Services, PAdba Clovis Counseling Center

Albuquerque 6/30/2017 PREMIER HEARING CENTER/ALBUQUERQUE

Rachel Trujillo Patient Care Coordinator 505-933-6315 (Rio Rancho Office)

Ballachanda, BopannaThis was the owner, he has since retired and sold the business 6/12/17 removed from all locations

Cannon, MicheleSanta Fe 7/13/2017 PREMIER HEARING CENTER/SANTA FE

Ballachanda, BopannaJackson, Catherine

PREMIER HEARING CENTER/ LOS ALAMOS Ballachanda, BopannaJackson, Catherine

PREMIER HEARING CENTER/RIO RANCHO Ballachanda, BopannaJackson, Catherine

PREMIER HEARING CENTER /TAOS Ballachanda, BopannaJackson, Catherine

RADIOLOGY ASSOCIATES OF ALBUQUERQUE -reads for Dan Trigg, Socorro General, Plains Regional, Espanola Hospital

Reads for 200110A, 200225A, 201305A, 206001A, 221202C

Bauman, ChristopherButler-Lewis, ReneeCarroll, StephenCentenera, Luis VitalianoCollingwood, John ClairFuentes-Bernardo, Daniel A.Hootman, KentKing, JerryLill, DuncanLogan, JeremyLopez, KathleenMeek, DouglasMena, Juan CarlosMontesinos, JamesMullen, SeanNisenbaum, Josef

Patriquin, Lara Marie

Pfaff, CharlesPhung, DavidPluto, CharlesPotts, BrianRivera, Eugenio Jr.Rosenberg, RobertRowley, MichaelRyan, HillaryRyan, PatrickSchmit, BerndtSellers, RandallSoutham, Samuel L.

Las Vegas 4/27/2017 RAINBOW RD THERAPIES, INC Simpson, M. Adelaide

REED, RICHARD P PHD

Gallup 10/17/2016REHOBOTH-MCKINLEY CHRISTIAN HEALTHCARE SERVICESRODRIGUEZ, MICHAEL PHD Romero, Linda MD *New Provider as of 5/1/17 XRURAL RADIOLOGY ASSOCIATES LPPC -reads for Alta Vista, Gila Regional, and Holy Cross Hospitals

Burke, James B.Gordon, Robert E.Johnson, Paul E.LaMotte, Gary A.Moses, Samuel LeeOrzel, Joseph A.Selzer, Peter M.Thomas, Lovick Whitaker, John Bacon

RURAL RADIOLOGY (was Taos Mountain Radiology)

Farmington 4/13/2017SAN JUAN REGIONAL MEDICAL CENTER uses Four Corners for XR

Chavez, DeniseDel Carmen, VillaDevitre, DavidGabaldon, JudeHoffman, CharlesJacob, SodaranKumar, RahulKumar, RanjitLi, Ronald AlanMartin, Patrick 11/1/16 License lapsedObisike, UchePlagge, AmyRobinson, WilliamSandhu, Faraz

Sharma, VivekVela-Sandoval, CarlosWeathers, LutherWest, Michael B.Wilkins, CharlesWyndham, Christopher R.

Santa Fe 1/19/2017SANTA FE IMAGING LLC - reads for Christus St. Vincent's and Dr. Baten

Santa Fe 5/30/2017 Beagle, Andrew NBurdick, Thomas RGallegos, Margaret LGriste, John DKoolpe, Karen SLee, Kevin DLehman, Jonathan DPruett, Wesley CSaini, Monica HValencia, Regina A

SANTA FE RADIOLOGY read for St. Vincent's Hospital Beagle, Andrew NBurdick, Thomas RGallegos, Margaret LGriste, John DKoolpe, Karen SLee, Kevin DLehman, Jonathan DPruett, Wesley CSaini, Monica HValencia, Regina A

Silver CityLas Cruces

3/14/20178/7/17 SCHUTTE, JAMES PhD

SF PULMONARY & CRITICAL CARE (interp St. Vincent's PFS) PO Box 843802, Dallas, TX 75284-3802SIDD, RICHARD J MD 207 N Union, Ste. C, Roswell, NM 88201

TorC 5/22/2017 SIERRA VISTA HOSPITAL SIMPSON, MARK PSYD MAC LA DAC

Socorro 3/31/2017 SOCORRO GENERAL HOSPITAL SOISSON, ELLEN L. PsyD

Sorenson Communications, Inc *New Provider - (sign language interp) as of 9/13/17 XDawson, Lee AnnaMacFarlane, JamesMcCluskey, Paula Morris, EldoraRivera, Amelia (Aimee)Sower, Monica

Roswell 1/26/2017 SOUTHERN COUNSELING Southern, DouglasSOUTHWEST PEDIATRIC CARE

Roque, Florence DNP, CPNP

Las Cruces 3/16/2017 SOUTHWESTERN EYE CENTERVillalobos, Robert

Santa Fe 5/30/2017 STEINMAN, WARREN PHD

Silver City 3/14/2017 STINAR, DONALD MD (Interprets PFTs for Gila Regional) PO Box 2857, Silver City, NM 88062-2857

Santa Fe1/19/2017

2/9/17ST VINCENT'S HOSPITAL - uses Santa Fe Radiology for XR and SF Pulmonary for PFT

Las Cruces 3/15/2017 SUN VIEW IMAGING SERVICES Algeo, James H.

Carlsbad 1/25/2017 TADDY FAMILY CLINICAddy, Nii Tetteh

TRICORE REFERENCE LABORATORIES (all locations) ABQ-ANNA KASEMAN ABQ-ATRISCOABQ-CEDARABQ-COORSABQ-ENCINOABQ-HARPERABQ-ISLETAABQ-MONTGOMERYABQ-SAN MATEOBELENCARLSBADCLOVISESPANOLALAS CRUCESLAS VEGASLOS LUNASRIO RANCHORUIDOSOSANTA FESILVER CITY

TRUJILLO, MARTIN MD *Inactive as of 8/11/17 X

Clayton 4/24/2017UNION COUNTY GENERAL HOSPITAL - use High Plains Radiology for XR PO Box 489, Clayton, NM 88415

Andrew, JohnAragon, GaryArcher, BranchBentley, GailBickers, GayleBrooks, CharlesChao, StanClark, CrandonCook, StanleyCox, SammyCurrie, TullyDaniel, MichaelElliott, AaronFrance, Ratchnee

Goodell, Charles

Haas, StephanHall, MichaelHashmi, AroujKhanlian, RobertKhu, RichardMehta, RahulNunn, HowardPan, PaulPinkston, RobertRadunsky, Daniel

Rosebrock, Richard

Salem, TarekScalapino, MatthewShah, RakeshSpeaks, SusanUszynski, MartinWaugh, KimberlyZarian, Lawrence

Albuquerque 3/7/2017 VALLE, VALERIE PSYD Moved out of State - will be deactivated after all payments are processed.

Espanola 5/30/2017 WARD, E MD

Las Cruces 9/15/2017 WorkMed Occupational Health *New Provider as of 8/9/17 XGallardo, Benito MDPoncik, Wanda Jean CNP also licensed in Texas

Corrales 5/19/2017 WYNNE, LOUIS PHDX RAY ASSOCIATES OF NEW MEXICO

Albuquerque 6/1/2017 Bennett, ShelbyBrooks, Gregory NormanCampbell, Karien MDChaffey, Margaret MDCreel, Christopher Jeffrey MDCronk, Roger L. DODautenhahn, Lawrence W. MDDepper, Mark H. MDFillmore, David MDGerety, BrigidJellison, Brian MDLeung, Jimmy Ching Man MDLinver, Michael N. MDLoRusso, Alexander Patrick MDLowry, James L. MDMartin, Thomas P. MDMatyas, Michael Alan MDMeyer, Kathleen MDMiller, Anthony James MD

Miller, Kathryn MDNenoff, Richard S MDParker, Russell Kenneth MDParker, Timothy W. MDRedd, Bernadette A. MDRolle, Timothy Jon MDStewart, John Martin MDWinterkorn, Keith G. MD

THE TOP FIVE CE PROVIDERS, BY DOLLAR AMOUNT, ARE DENOTED IN GREEN. ONSITE REVIEWS WERE COMPLETED FOR EACH OF THEM. NO CE PANELISTS WERE REMOVED FROM THE PANEL DUE TO INACTIVE LICENSE, SANCTION, OR CAUSE.

VNDR_SURNAMEVNDR_1ST_N

AME

VNDR

_2ND_NAME VNDR_SURNAME

VNDR_PROF_QUA

L VNDR_LOC_ADDR_LINE_1VNDR_LOC_ADDR_LI

NE_2

VNDR_LOC_ADDR_

LINE_3VNDR_LOC_AD

DR_CITY

VNDR_LOC_ADDR_STAT

EVNDR_LOC_ADDR_Z

IP

AUG JANET AUG ODHITCHCOCK CLINIC OPHTHALMOLOGY

149 EMERALD STREET KEENE NH 03110-3611

BECOTTE DENNIS P BECOTTE PHD 142 MAIN ST STE 220 NASHUA NH 03060-2721

BILDNER CHERYL BILDNER PHD MT WASHINGTON VALLEY PSYCH SVC 81 WASHINGTON ST CONWAY NH 03818-6044

BLAKE TIMOTHY D BLAKE MD NASHUA EYE ASSOCIATES 5 COLISEUM AVE NASHUA NH 03063-3206

BROWN LAURA BROWN PSYD BERLIN NH 03570-4875

BURNETTE REXFORD F BURNETTE PHD 5 PLEASANT ST STE 1 BRISTOL NH 03222-3002

BURNS THOMAS F BURNS PHD DOVER NH 03820-0000

BYER JEFFREY B BYER MD ENT PHYSICIANS & SURGEONS PA 130 TARRYTOWN RD MANCHESTER NH 03103-2713

CARWELL MARK A CARWELL MD CONCORD OTOLARYNGOLOGY PA194 PLEASANT ST STE 2 CONCORD NH 03301-2952

COUTU RONALD B COUTU OD NASHUA EYE ASSOCIATES5 COLISEUM AVE STE 101 NASHUA NH 03063-3292

CRAIG MEGHAN A CRAIG PSYD MERRIMACK VALLEY COUNSELINGN. CREST EX OFFICE PARK 2A

39 SIMON ST NASHUA NH 03060-3046

DANIELL CHRISTOPHER H DANIELL MD CONCORD OTOLARYNGOLOGY PA194 PLEASANT ST STE 2 CONCORD NH 03301-2952

DARLING LAURA DARLING SLP KIDSPEAK LANGUAGE LE PO BOX 779 CONCORD NH 03302-0779

DESAI-BARTOLI SONALEE DESAI-BARTOLI OD NASHUA EYE ASSOCIATES5 COLISEUM AVE STE 101 NASHUA NH 03068-3292

FY 2017 NH DDS CE PROVIDERS

(b) (6)

(b) (6)

DINAN WILLIAM A DINAN PHD CONCORD NH 03301-4803DOWNEY PAUL DOWNEY PHD DURHAM NH 03824-0000

FRIEDRICH SHERIE L FRIEDRICH PSYD BROOKLINE NH 03033-0000

FUNG EVA FUNG OD MACKAY VISION CENTER207 MEETINGHOUSE RD BEDFORD NH 03110-6090

207 MEETINGHOUSE RD BEDFORD NH

03110-6090

GARBER BENJAMIN D GARBER PHD 400 AMHERST ST STE 407 HEALTHYPARENT.COM NASHUA NH 03063-4225

GARFINKLE ANDREW GARFINKLE MD LACONIA EYE ASSOCIATES 368 HOUNSELL AVE GILFORD NH 03249-6922

GLASSMAN STUART J GLASSMAN MD GRANITE PHYSIATRY60 COMMERCIAL ST, STE 303 CONCORD NH 03301-5096

GOLDBLATT WARREN S GOLDBLATT MDEYESIGHT OPHTHALMIC SERVICES PA

267 ROUTE 108 STE A

SOMERSWORTH NH 03878-6512

GOURVITZ ROSS GOURVITZ PHD CONCORD NH 03301-2000

GRAF FRANK A GRAF MD 152 COURT ST STE 2 PORTSMOUTH NH 03801-4453

GRIFFIN ERICA L GRIFFIN OD LITTLETON EYE CARE CTR 104 MEADOW ST LITTLETON NH 03561-4026

GRIFFIN STEFANIE GRIFFIN PHD NE EVALUATION SPECIALISTS 1 WASHINGTON ST STE 443 DOVER NH 03820-3831

GUSTAVSON DARLENE GUSTAVSON PSYD 814 ELM ST STE 90A MANCHESTER NH 03101-2130

HALL BRADFORD S HALL OD CONCORD EYE CARE PC248 PLEASANT ST STE 1600 CONCORD NH 03301-2588

HASKELL SUSAN HASKELL ODEYESIGHT OPHTHALMIC SERVICES PA

267 ROUTE 108 STE A


HESS ELIZABETH P HESS PHD BERLIN NH 03570-1017

HOLMES WILLIAM S HOLMES OD LITTLETON EYE CARE CTR 104 MEADOW ST LITTLETON NH 03561-4026

HUTTON ANNA HUTTON PSYD PO BOX 250 GRANTHAM NH 03786-0250

JACKSON TRINA JACKSON PSYD SHELBURNE NH 03581-3101

JAEGER LAWRENCE J JAEGER MDDARTMOUTH HITCHCOCK OPHTHAL


(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

JARZOMBEK MICHAEL JARZOMBEK PSYD WEARE NH 03281-0000KALPAKIAN BASILIO KALPAKIAN MD DARTMOUTH HITCHCOCK OPHTHAL 149 EMERALD STREET KEENE NH 03110-3611

KAMEN DAVID G KAMEN PHD 25 GREENVIEW DR APT 18 MANCHESTER NH 03102-8933

KANAGALINGAM SIVASHAKTHI KANAGALINHAM MDDARTMOUTH HITCHCOCK MEDCIAL CENTER

1 MEDICAL CENTER DR LEBANON NH 03756-0000

KAVANAGH MARSHA C KAVANAGH OD EYESIGHT OPHTHALMIC SERVICES PA

155 BORTHWICK AVE STE 200E PORTSMOUTH NH 03801-4184

KIRMES WILLIAM J KIRMES DO MANCHESTER NH 03104-6116

KORGESKI GREGORY KORGESKI PHD PO BOX 408 SAXON RIVER VT 05154-0408LEE BRIAN LEE DO CONCORD OTOLARYNGOLOGY PA 194 PLEASANT ST STE 2 CONCORD NH 03301-2952

LEE RICHARD H LEE MD ENT PHYSICIANS & SURGEONS PA 130 TARRYTOWN RD MANCHESTER NH 03103-2713

LOESER PETER LOESER MD CROSSROADS FAMILY MEDICINE194 PLEASANT ST STE 7 CONCORD NH 03301-2952

MACKAY DAVID MACKAY OD MACKAY VISION CENTER207 MEETINGHOUSE RD BEDFORD NH 03110-6090

MCLAUGHLIN LAUREN K MCLAUGHLIN OD EYESIGHT OPHTHALMIC SERVICES PA

267 ROUTE 108 STE A


MCLAUGHLIN MICHELLE L MCLAUGHLIN OD EYESIGHT OPHTHALMIC SERVICES PA 192 WATER ST EXETER NH 03833-2416

MEEHAN LAUREN K MEEHAN PSYD SALEM PSYCHOLOGICAL SERVICES 87 STILES RD STE 106SALEM NH

03079-0000

MOQUIN DENISE MOQUIN PHD MOQUIN PSYCHOLOGICAL SERVICES 753 CHESTNUT ST MANCHESTER NH 03104-4614

MOSCOLA RITAMARIE MOSCOLA MD MPH BEDFORD NH 00000-3110

MURRAY JAMES MURRAY MD ENT PHYSICIANS & SURGEONS PA 130 TARRYTOWN RD MANCHESTER NH 03103-0831

NEAL GEORGE B NEAL MD 18 CONSTITUTION DR UNIT 6 BEDFORD NH 03110-6076

PAC ADRIENNE PAC ODEYESIGHT OPHTHALMIC SERVICES PA

267 ROUTE 108 STE A


(b) (6)

(b) (6)

(b) (6)

PIASCIK TIFFANY PIASCIK PSYD SALEM PSYCHOLOGICAL SERVICES87 STILES ROAD STE 106 SALEM NH 03079-2899

POLLACK DALE POLLACK OD HITCHCOCK CLINIC OPHTHALMOLOGY


POWELL STEVEN W POWELL MDNEW ENGLAND MEDICINE COUNSELING ASSOC

120 ROUTE 10 SOUTH GRANTHAM NH 03753-00000

REDDY ASHOK N REDDY MD CONCORD OTOLARYNGOLOGY PA194 PLEASANT ST STE 2 CONCORD NH 03301-2952

REGAN MAURICE REGAN PHD THE CONCORD CENTER 10 FERRY ST CONCORD NH 03301-0000RIDDLE PATRICK J RIDDLE OD NASHUA NH 03063-3206

ROBBINS PHILLIP ROBBINS PHD 87 STILES RD STE 106 SALEM NH 03079-0000

ROOT RICHARD ROOT EDD RIDGEWOOD BLDG SPRINGFLD HOSP 20 RIDGEWOOD RD SPRINGFIELD VT 05156-2003

RUPPEL GEORGE RUPPEL PHD MERRIMACK VALLEY COUNSELING N CREST EX OFFICE PARK 2A

39 SIMON ST NASHUA NH 03060-3046

SAMSON JAMES SAMSON OTNORTHEAST EVALUATION SPECIALISTS

1 WASHINGTON ST STE 443 DOVER NH 03820-3831

SCOTT DOUGLAS SCOTT MD LACONIA EYE ASSOCIATES 368 HOUNSELL AVE GILFORD NH 03249-6922

SIRONICH-KALKAN SILVIA SIRONCH-KALKAN MD THE DOCTORS OFFICE865 S MAIN ST STE 103 MANCHESTER NH 03102-0000

SITKOWSKI SUZANNE SITKOWSKI PHD 511 ROUTE 132 NORWICH VT 05055-0000

SNEAD MAXWELL A SNEAD MD CONCORD EYE CARE PC248 PLEASANT ST STE 1600 CONCORD NH 03301-2586

SPINDEL GERALD P SPINDEL OD SPINDEL EYE ASSOCIATES6 TSIENNETO RD STE 101 DERRY NH 03038-1584

STERN JESSICA STERN PHD 169 PORTSMOUTH ST UNIT 192 CONCORD NH 03301-5844

STOCK MARJORIE STOCK MD ENT PHYSICIANS & SURGEONS PA 130 TARRYTOWN RD MANCHESTER NH 03103-2713

(b) (6)

STRATTON KEVIN M STRATTON OD LITTLETON EYE CARE CTR 104 MEADOW ST LITTLETON NH 03561-4026

SU PRESCOTT ROBERT SU PRESCOTT PHD 20 LADD ST FL 4 PORTSMOUTH NH 03801-4087

SULLIVAN MAURA D SULLIVAN PSYD 15 N MAIN ST # 9 WOLFEBORO NH 03894-4485

SUTHERLAND PHILIP L SUTHERLAND OD NASHUA EYE ASSOCIATES5 COLISEUM AVE STE 101 NASHUA NH 03063-3292

SWINBURNE WILLIAM SWINBURNE PHD KEENE NH 03431-3409

SZAL MARK A SZAL MD CONCORD EYE CARE PC248 PLEASANT ST STE 1600 CONCORD NH 03301-2586

SZYMD LUCIAN SZMYD JR OD EYESIGHT OPHTHALMIC SERVICES PA

155 BORTHWICK AVE STE 200E PORTSMOUTH NH 03801-4184

TRICE JAMES M TRICE MD 21 S FRUIT ST, STE 30 CONCORD NH 03301-2453

TRUDEL TINA TRUDEL PHDNORTHEAST EVALUATION SPECIALISTS

1 WASHINGTON ST STE 443 DOVER NH 03820-3831

TSENG WINNIE TSENG OD LITTLETON EYE CARE CTR 104 MEADOW ST LITTLETON MJ 03561-4026

TUITE JOEL TUITE OD LITTLETON EYE CARE CTR 104 MEADOW ST LITTLETON NH 03561-4026VALLERY SANDRA K VALLERY PHD EXETER NH 03833-2779

WASSERMAN PETER WASSERMAN MD CONCORD EYE CARE PC248 PLEASANT ST STE 1600 CONCORD NH 03301-2586

WEIL MICHAEL D WEIL PSYD PETERBOROUGH CLINICAL ASSOC20 GROVE ST STE 250

PETERBOROUGH NH 03458-1470

WHEELER MAYNARD B WHEELER MD CONCORD EYE CARE PC248 PLEASANT ST STE 1600 CONCORD NH 03301-2588

WILSON DONALD V WILSON MD HITCHCOCK CLINIC E.N.T. 580 COURT ST KEENE NH 03110-1718

WINDLER WILLIAM N WINDLER MD THE DOCTORS OFFICE765 S MAIN ST STE 103 MANCHESER NH 03102-0000

WINGATE CHARLES E WINGATE JR OD NASHUA EYE ASSOCIATES 5 COLISEUM AVE NASHUA NH 03063-3206

(b) (6)

(b) (6)

WOLF RALPH R WOLF III MD HEALTH STOP OF SO NASHUA228 DANIEL WEBSTER HWY NASHUA NH 03060-5537

WOODARD FREDERICK J WOODARD PHD MILFORD NH 03055-0000

YAGER ROBERT D YAGER MD HEALTH STOP OF SO NASHUA228 DANIEL WEBSTER HWY NASHUA NH 03060-5537

(b) (6)

Name Des Group Name OnsiteAbel SLP, Cristy G Speechworks Therapy ServicesAbinanti SLP, Annie M G Pediatric Development TherapyAbramowitz PhD, Robert H I Robert H Abramowitz PhDAdair MD, Brian C G Graystone Ophthalmology AssociatesAdam MD, Lindsay G Coastal Carolina Eye ClinicAdams SLP, Monica L G TheraPeas

Advanced Medical Consultants, GE Advanced Medical Consultants4/25/2017, 5/16/2017

Akpaka PhD, Ernest Kalu I Ernest Kalu Akpaka MA 7/25/2017Alamance Eye Center, GE Alamance Eye CenterAlamance Regional Medical Center, M Alamance Regional Medical CenterAlbert PhD, Jerome B I Jerome B Albert PhD 4/25/2017Aldinger MD, Kyle Anthony G Shelby Medical AssociatesAlesii PhD, LeKisha I Center for Health and Emotional WellnessAlleghany Memorial Hospital, M Alleghany Memorial HospitalAllen MD, Molly V G Coastal Carolina Eye ClinicAllen MD, Joseph G Graystone Ophthalmology AssociatesAllen SLP, Charlotte-Anne I Charlotte-Anne Allen SLPAllf MD, Bryan I Carolina Eye CareAnand MD, Dhanya G Med Plus NCAngel Medical Center, M Angel Medical CenterAnthony PhD, Cheri R I Cheri R Anthony PhDAppollo PhD, Joseph P I Joseph P Appollo PhDArrowood Jr MD, John Patterson G CarolinaEast Ear Nose & ThroatAshe Memorial Hosptial, M Ashe Memorial HosptialAsheville Eye Associates, GE Asheville Eye AssociatesAsheville Head, Neck & Ear Surgeons, GE Asheville Head, Neck & Ear SurgeonsAsheville Radiological Associates PA, M Asheville Radiological Associates PAAtienza MD, Romeo B I Romeo B Atienza MD 7/25/2017Atkinson PsyD, Audrey I Balanced Mind Psychological ServicesAtkinson SLP, Keisha G Lenoir Memorial Hospital

Bachara PhD, Gary H I Brentwood Psycho & Counseling10/13/2016, 4/25/2017

Baggett MD, Henry Clifford G UNC Ear Nose and ThroatBahia MD, Surinder S G Advanced Medical ConsultantsBall MD, Tracei I On Call Mobile Medical and WellnessBarnes MD, Tinka G Medical Support AssociatesBaron SLP, Nadege G Speech TacticsBeards SLP, Karen G Speechworks Therapy ServicesBeasley MD, Charles G Kinston Head & Neck Physicians & SurgeonsBelhumeur MA, Jacqueline G Sylva Clinical AssociatesBell MD, William L I FirstHealth Family Medicine Robbins 12/16/2016Berg MD, Mary I The Pisgah Institute for Psycho & EducationBerk MD, Carl G Pinehurst Surgical ClinicBevis MA, Jay G LifeworksBhatti MD, Muhammad A I Wayne Family Medical Center 8/31/2017Bing PhD, Richard Jefferson I Richard Jefferson Bing PhDBlack MD, Kristin S G Gaston Family Health ServicesBlack MD, Brendan G Olympus Health North CarolinaBlatz PA, Kristin G Pinehurst Surgical ClinicBloom MD, Mitchell G MDSI Physician GroupBlue Ridge Cardiology & Internal Medicine, M Blue Ridge Cardiology & Internal MedicineBlue Ridge ENT Allergy & Facial Plastic, GE Blue Ridge ENT Allergy & Facial PlasticBlue Ridge Radiology Associates, M Blue Ridge Radiology AssociatesBlue Ridge Regional Hospital, M Blue Ridge Regional HospitalBoan FNP, Ardelius G Merolina Medical ClinicBoice Willis Clinic, M Boice Willis Immediate Care ClinicBoliek SLP, Haden P G Pediatric Development Therapy

North Carolina FY 2017

Bolz MD, Everett G Tri State Occupational MedicineBones MD, Brian G Med Plus NCBones MD, Victoria G Olympus Health North CarolinaBonfield MD, Kenneth G Morganton Eye PhysiciansBoone SLP, Aliya I A to Z Speech TherapyBoutilier MD, Susan G ECU Physicians NeurologyBowers SLP, Bradley I Speech Pathology & Audiology Services of RobesonBowers SLP, Linda S G WCU Speech & HearingBoyce MD, Stephen E G Raleigh Capitol Ear, Nose, & ThroatBradford MD, Daniel William I Daniel William Bradford MDBrafford SLP, Kasten G Tidewater Therapy for ChildrenBrahmbhatt MD, Bharat G CE Provider Services, LLCBramble MA, J Michael I J Michael BrambleBranch MD, James D I James D Branch MDBranner MD, William G Charlotte Ophthalmology ClinicBrannon PhD, Julia M I Julia M Brannon PhDBrantley III PsyD, David I David Brantley III PsyDBrasington MD, Chadwick G Alamance Eye CenterBrechtelsbauer MD, Paul G Eastern Carolina ENT Head & Neck SurgeryBrewer MA, Lisa I Lisa Brewer MABriere DO, Misha G CE Provider Services, LLCBritt SLP, Wendy I Confident Solutions LLCBrna Jr. MD, Theodore George I Bailey Family Practice CenterBrodish MD, Brian G Eastern Carolina ENT Head & Neck SurgeryBroman-Fulks PhD, Joshua Jefferson I Joshua Jefferson Broman-Fulks PhD 10/21/2016Brown MD, Sandra G Cabarrus Eye CenterBrown MD, Jonisha R G Olympus Health North CarolinaBrown MD, Laura D G Raleigh Capitol Ear, Nose, & ThroatBrown SLP, Erin E G Therapy PlaygroundBuglisi MD, Joseph I Buglisi Eye CareBurgess Jr PsyD, Elwood Johnson G The Neuropsychology ConsultantsBurgess MD, Stephen B G Tri State Occupational MedicineBurnett PhD, Edmund C I Carriage House AssociatesCabarrus Eye Center, GE Cabarrus Eye CenterCaceres MD, Marco G CE Provider Services, LLCCain MD, Wilbert I Wilbert Cain MDCalderon MD, Boris G Med Plus NCCaldwell Memorial Hospital, M Caldwell Memorial HospitalCameron MD, Harold G Coastal Eye ClinicCamilleri SLP, Kathryn C G Complete Speech Therapy & WellnessCampbell PhD, Richard C I Richard C Campbell PhD 11/21/2016Cape Fear Eye Associates, GE Cape Fear Eye AssociatesCarbonell MD, Antonio G SXR Medical EvaluationsCardiology Associates of the Carolinas, GE Cardiology Associates of the CarolinasCarolina East Medical Center, M Carolina East Medical CenterCarolina Imaging Center, M Carolina Imaging of FayettevilleCarolina Psychology Group, GE Carolina Psychology GroupCarolina Radiology Consultants, M Carolina Radiology ConsultantsCarolina Surgery and Cancer Center PLLC, M Carolina Surgery and Cancer Center PLLCCarolina Vision Center, GE Carolina Vision CenterCarolina West Radiology PA, M Carolina West Radiology PACarolinaEast Diagnostic Center, M CarolinaEast Diagnostic CenterCarolinaEast Ear Nose & Throat, GE CarolinaEast Ear Nose & ThroatCarolinas HealthCare System Anson, M Carolinas Anson Healthcare IncCarolinas HealthCare System Cleveland, M Cleveland Regional Medical CenterCarolinas Medical Center Lincoln, M Carolinas Medical Center LincolnCarolinas Medical Center Union, M Carolinas Medical Center UnionCarraro MD, Stevie N G CE Provider Services, LLCCarter SLP, Jennifer L G Speechcenter

Carteret Clinic for Adolescents & Children, GE Carteret Clinic for Adolescents & ChildrenCarteret County General Hopsital, M Carteret County General HopsitalCasterlow MA, Ronnie D I Ronnie Dean Casterlow MACatawba Radiological Associates, M Catawba Radiological AssociatesCatawba Valley Medical Center, M Catawba Valley Medical CenterCatawba Valley Psychological Associates, GE Catawba Valley Psychological Associates 9/6/2017CE Provider Services, LLC, GE CE Provider Services, LLC 9/9/2017Central Carolina Hospital, M Central Carolina HospitalCeraulo MD, Anthony G Olympus Health North CarolinaChadbourn Family Practice Center, GE Chadbourn Family Practice CenterChae MD, Phillip G CE Provider Services, LLCChance MD, James Kenneth G Coastal Eye ClinicChang MD, Richard I G Graystone Ophthalmology AssociatesCharles A Cannon Jr Memorial Hospital, M Charles A Cannon Jr Memorial HospitalCharles MD, Cathy-Anne G CE Provider Services, LLCCharlotte EENT Associates PA, GE Charlotte EENT Associates PACharlotte Medical Clinic, GE Charlotte Medical ClinicCharlotte Ophthalmology Clinic, GE Charlotte Ophthalmology ClinicCharlotte Radiology, M Charlotte RadiologyChristianson MD, Dana J G Looking Glass Eye CenterCHS Blue Ridge Morganton, M CHS Blue Ridge MorgantonCHS Blue Ridge Valdese, M CHS Blue Ridge ValdeseCHS Northeast, M CHS NortheastClark MD, Lee I Medical Eye Associates PAClark MD, William G I Wake Forest Urgent Care 2/16/2017Clark SLP, Bridget G Speechworks Therapy ServicesClarkson MD, Mark W G Raleigh Capitol Ear, Nose, & ThroatClay Jr MD, Hank G Hank Clay Jr MDClay SLP, Rebekkah K I R Kelley ClayCleveland County Health Care System, M Cleveland County Health Care SystemClinton X-Ray Associates, M Clinton X-Ray AssociatesCoastal Carolina Eye Clinic, GE Coastal Carolina Eye ClinicCoastal Eye Center, GE Coastal Eye CenterCoastal Eye Clinic, GE Coastal Eye ClinicCoastal Internal Medicine, GE Coastal Internal Medicine 7/21/2017Coastal Radiology, M Coastal RadiologyCoastal Surgical Specialists, M Coastal Surgical SpecialistsCoffey PhD, Jerry G Sylva Clinical AssociatesColeman MA, David I David Coleman MACollier MD, John R G ENT CarolinaCollins MA, Clyde A G Southeastern Psychological ServicesColumbus Regional Healthcare System, M Columbus Regional Healthcare SystemComplete Speech Therapy & Wellness, GE Complete Speech Therapy & WellnessCone Health Medical Group Heartcare, M Cone Health Medical Group HeartcareConnect Center for Wellness, GE Connect Center for Wellness 7/27/2017Cornerstone Ear, Nose & Throat, GE Cornerstone Ear, Nose & ThroatCorrea SLP, Nancy J G SpeechcenterCorrie SLP, Sarah I Pediatric Speech SolutionsCoury DO, Jeffrey G I Coastal Carolina Ear, Nose & ThroatCox MD, Stanley G Pinehurst Surgical ClinicCox PhD, Keith I Keith Cox PhDCraig DO, Christopher G CE Provider Services, LLCCrandall MD, James D G Asheville Eye AssociatesCrane Ed.D, Edward I Edward Crane Ed.DCrane PsyD, Karen I Karen Crane PsyDCraven SLP, Caitlin A G SpeechcenterCrawford MD, Bronson G CE Provider Services, LLCCrawford MD, Michael D G UNC Ear Nose and ThroatCrichlow MD, Brian I Brian Crichlow MD

Currin MA, Heather I Heather Currin MADaniel MA, Rebecca G Sylva Clinical AssociatesDaniels-Davis SLP, Chanda S I KidSpeak IncDarji MD, Sunny G CE Provider Services, LLCDavant MD, Charles I Blowing Rock Medical ClinicDavidson Eye Associates, GE Davidson Eye AssociatesDavis MD, Teneisha C G Advanced Medical ConsultantsDavis MD, Andrew G Morganton Eye PhysiciansDavis PhD, Cheryl I Cheryl Davis PhD 8/2/2017Davis SLP, M. Patricia G WCU Speech & HearingDawson MD, Sean G Olympus Health North CarolinaDearinger DO, Michael R G Olympus Health North CarolinaDeem MD, Mark G SXR Medical EvaluationsDelaney Radiology Group, M Delaney Radiology GroupDempsey SLP, Hannah G SpeechcenterDenny PhD, Ellen I Triangle Behavioral HealthDeWilde MD, Kristen G CE Provider Services, LLCDimuzio Jr DO, James I Coastal Carolina Ear, Nose & ThroatDingeldein MD, Steven A G Alamance Eye CenterDinkins SLP, Brittany G Speechworks Therapy ServicesDorton MD, Leighanne G Charlotte EENT Associates PADowning PsyD, Lori J I Downing Psychological 5/4/2017Downs MD, Jairon G Olympus Health North CarolinaDoyle MD, Kevin M G Raleigh Capitol Ear, Nose, & ThroatDubiel MD, Barbara I Barbara Dubiel MDDuke Cardiology of Raleigh, M Private Diagnostic ClinicDuke Eye Center, M Duke Eye CenterDuke Radiology of Raleigh, M Duke Radiology of RaleighDuke Raleigh Hospital, M Duke Raleigh HospitalDuke Regional Hospital, M Duke Regional HospitalDunmire SLP, Sherry G Kommunikate PlusDunn SLP, Beverly I Beverly L Dunn SLPDunn SLP, Lucy C G SpeechcenterDurham Diagnostic Imaging LLC, M Durham Diagnostic ImagingDurham Radiology Associates Inc, M Durham Radiology Associates IncDurland Jr MD, William Frederick G Raleigh Capitol Ear, Nose, & ThroatDurrett MD, Samuel G CE Provider Services, LLCDuszlak MD, Carla G MDSI Physician GroupDye PhD, Shiahna G Connect Center for WellnessDziadziola Jr. MD, James Kenneth G Northeast ENT CenterEarwood SLP, Kendra L I Speech ConnectionsEason MD, Ernest B I Dr Ernest B Easton 3/21/2017East Carolina Neurology, GE ECU Physicians NeurologyEast Carolina University, M East Carolina UniversityEastern Carolina ENT Head & Neck Surgery, GE Eastern Carolina ENT Head & Neck SurgeryEastern Radiologists, M Eastern RadiologistsEastern Radiologists Inc, M Eastern Radiologists IncEdsell SLP, Janet G Speechworks Therapy ServicesEdwin MD, Micah G SXR Medical EvaluationsEichenbaum MD, Daniel M I Daniel M Eichenbaum MDEllebracht SLP, Susan G Tidewater Therapy for ChildrenEmekauwa MD, Chikanele G Med Plus NCENT Carolina, GE ENT CarolinaEpps Jr MD, Earl I Earl J Epps Jr MDEsame MD, Alice G Med Plus NCEskander MD, Essam S G Chadbourn Family Practice CenterEspiritu MD, Maria G Med Plus NCEvans III PhD, Frank Barton I Frank B Evans PhDFannin Regional Hospital, M Fannin Regional Hospital

Farhad DO, Bamdad G Advanced Medical ConsultantsFarhad MD, Bamdad G Med Plus NCFarmer PhD, C Craig I C Craig Farmer PhDFerguson MD, Steven W I Eastern Carolina Geriatric Assoc and Family Care CFerriss SLP, Beth I Speech UnlimitedFertil SLP, Cavin G Speechworks Therapy ServicesFields MD, Mark Lewis I Mark Lewis Fields MD 3/21/2017Finnegan MD, Lindsey G CE Provider Services, LLCFiore PhD, Michael Francis I Michael Fiore PhDFirsthealth Cardiology of Laurinburg, GE Firsthealth CardiologyFirsthealth Cardiology of Rockingham, GE Firsthealth CardiologyFirstHealth of the Carolinas, M FirstHealth of the CarolinasFishel OD PA, Jennifer R I Jennifer Fishel OD PAFitzgerald MA, Jeffrey R G LifeworksFitzpatrick SLP, Joy G Therapy PlaygroundFleming MD, Duard G ECU Physicians NeurologyFletcher Hospital Inc, M Fletcher Hospital IncFlinn SLP, Jamie G Speak AdvantageFlores MD, Agustin Gilbert R G MDSI Physician GroupFolds MD, William I Club Haven Family PracticeFootman SLP, Chantanna G Speechworks Therapy ServicesForero MD, Edward G SXR Medical EvaluationsFowler PsyD, Sean I Piedmont Counseling and Developmental GroupFox PsyD, Lisa G The Neuropsychology ConsultantsFox SLP, Elizabeth G TheraPeasFrank MD, Harrison I Frank Institute for Health and WellnessFranklin MD, Quentin G Coastal Eye CenterFranklin SLP, Montoya G Speech TacticsFrere MD, Robert Carroll G ECU Physicians NeurologyFriedland MD, Beth R G Park OphthamologyFriedman SLP, Tia G Tidewater Therapy for ChildrenFuller MD, Lance G Yelverton's Enrichment Services, IncGarner SLP, Laurie G Speechworks Therapy ServicesGartlan DO, William A G Med Plus NCGaslin MD, Michael G ENT CarolinaGaston Eye Associates, GE Gaston Eye AssociatesGaston Family Health Services, GE Gaston Family Health ServicesGaston Memorial Hosptial Inc, M Gaston Memorial Hosptial IncGaston Radiology PA, M Gaston Radiology PAGebrail MD, Ayman G Coastal Internal MedicineGencarella SLP, Laura E G Speech TacticsGerber MD, Matthew J G Raleigh Capitol Ear, Nose, & ThroatGibson MA, Barbara I Barbara Gibson MA 7/6/2017Gillespie MD, Richard R G Cornerstone Ear, Nose & ThroatGirmay MD, Aregai G Gaston Family Health ServicesGish MD, Larry Morgan I Rowan DiagnosticsGliga MD, Diana G CE Provider Services, LLCGloor DO, Richard I Richard Gloor DOGodfrey SLP, Natalie R G SpeechcenterGold MD, Steven R G Charlotte EENT Associates PAGoldberg MD, Eric I Tidewater NeurologistsGombas DO, Michelle M G CE Provider Services, LLCGoncharow DO, William G G CE Provider Services, LLCGoodwin-Baldwin PsyD, Tanya I Goodwin Psychological ServicesGrady MD, Richard Dwight G CarolinaEast Ear Nose & ThroatGrafenberg MD, Matthew G Pinehurst Surgical ClinicGranite Falls Primary Care, GE Cornerstone HealthcareGray PsyD, Samuel B G Carolina Psychology GroupGraystone Ophthalmology Associates, GE Graystone Ophthalmology Associates

Greene SLP, Michaela G SpeechcenterGreensboro Ophthalmology Associates, GE Greensboro Ophthalmology AssociatesGreensboro Radiology, M Greensboro Radiology PAGreensboro Radiology PA, M Greensboro Radiology PAGregson SLP, Cara G SpeechcenterGrewal MD, Harkiran G Med Plus NCGroat Eyecare Associates, GE Groat Eyecare AssociatesGroat MD, Richard S G Groat Eyecare AssociatesGroat MD, Christopher L G Groat Eyecare AssociatesGroat MD, Robert L G Groat Eyecare AssociatesGrover PsyD, Brianna G The Neuropsychology ConsultantsGuttler MD, Sanford G Cornerstone HealthcareHalford SLP, Amy G Speechworks Therapy ServicesHalifax Medical Specialists, M Halifax Medical SpecialistsHalifax Regional Medical Center Inc, M Halifax Regional Medical Center IncHall SLP, Brenda I Brenda Hall SLPHamm OD, Cara G Coastal Eye ClinicHammond Assessment Services, GE Hammond Assessment ServicesHammond PhD, Joseph K G Hammond Assessment ServicesHammond SLP, Ellie I Hammond Assessment ServicesHancock PhD, Russell C I Russell C Hancock PhDHank Clay Jr MD, GE Hank Clay Jr MDHannah MD, Frank G Morganton Eye PhysiciansHardy MD, John G ECU Physicians NeurologyHargrove MD, Roderick N G Graystone Ophthalmology AssociatesHarhara MD, Haleema G CE Provider Services, LLCHarnett Health System Inc, M Harnett Health System IncHarper MD, Nathan G CE Provider Services, LLCHarrelson MD, Bryan H G MDSI Physician GroupHarris Jr MD, James Woodrow G Graystone Ophthalmology AssociatesHarris MD, Gregory Stuart G Advanced Medical ConsultantsHarris Regional Hospital Inc, M Harris Regional Hospital IncHarris SLP, Stacy G Speechworks Therapy ServicesHarris SLP, Meka G Speechworks Therapy ServicesHatfield PhD, Phillip B I Phillip B Hatfield PhD 12/15/2016Hawkins MD, Thomas G Davidson Eye AssociatesHaywood Medical Imaging, M Haywood Medical ImagingHaywood Regional Medical Center, M Haywood Regional Medical CenterHefner SLP, Rachel Helms G Therapy PlaygroundHeim SLP, Lindsay M G WCU Speech & HearingHemphill MD, Irmaine G Olympus Health North CarolinaHenderson County Hospital Corp, M Henderson County Hospital CorpHendersonville Radiological Consultatns, M Hendersonville Radiological ConsultantsHendrix MD, Robert G UNC Ear Nose and ThroatHerek SLP, Kasha G Tidewater Therapy for ChildrenHester MA, Rebecca G Sylva Clinical AssociatesHeyder MD, Albrecht I Atlantic Pulmonary AssociatesHigh Point Regional Hospital, M High Point Regional HospitalHighsmith-Rainey Specialty Hospital, M Highsmith-Rainey Memorial HospitalHildreth MS, Jeffrey I Jeffrey Hildreth MS 11/9/2016Hill SLP, Tina G Pitt County Memorial HospitalHillman MD, Vincent Francis G Huntersville Family Practice 8/24/2017Hinson PhD, Renee C G Trinity CenterHollander MD, Edward G Greensboro Ophthalmology AssociatesHolmes SLP, Michelle A G Therapy PlaygroundHoneycutt SLP, Michelle E G Kommunikate PlusHoogerman PhD, Dennis I Dennis Hoogerman PhDHooker MD, Neema G Olympus Health North CarolinaHorizon Surgical Associates, M Horizon Surgical Associates

Horsley MA, Elizabeth I Ross Psychological ServicesHosea MD, Robert G Kinston Head & Neck Physicians & SurgeonsHowell MD, Tamieka G CE Provider Services, LLCHugh Chatham Memorial Hospital, M Hugh Chatham Memorial HospitalHughey MD, Rebekah G Med Plus NCHumphrey MD, Jordan C G CE Provider Services, LLCHuneycutt MD, Bouasy Ly G Olympus Health North CarolinaHunt PsyD, J Craig I J Craig Hunt PsyD 8/11/2017Huntersville Family Practice, GE Huntersville Family PracticeHutchens SLP, Patricia G Pediatric Development TherapyIgboekwe MD, Vincent G Advanced Medical ConsultantsIpock SLP, Crystal T G Lenoir Memorial HospitalIredell Memorial Hospital, M Iredell Memorial HospitalIredell Radiology Associates, M Iredell Radiology AssociatesIzquierdo DO, Manuel G CE Provider Services, LLCJ Arthur Dosher Memorial Hospital, M J Arthur Dosher Memorial HospitalJacksonville Diagnostic Imaging LLC, M Jacksonville Diagnostic Imaging LLCJames PsyD, Amy I Amy D James PsyDJames SLP, Deborah C I Southern Therapy ServicesJames-Nzambele MD, Shana D G Gaston Family Health ServicesJamison MD, Cornelius G MDSI Physician GroupJamison PsyD, Deanna Lynn G The Neuropsychology ConsultantsJarvis MD, Bennie G UNC Ear Nose and ThroatJean-Gracia MD, Jolene G MDSI Physician GroupJeffrey FNP, Benjamin G Yelverton's Enrichment Services, IncJerrell SLP, Kai G Speechworks Therapy ServicesJiang MD, Bo G Olympus Health North CarolinaJindal MD, Vinod I New Century Opthalmology GroupJohnson MA, David C I Pineview Psyc Services Inc 1/23/2017Johnson MD, Gregory James G Coastal Carolina Eye ClinicJohnson MD, James C I James C Johnson MDJohnson PhD, Amy Fowler I Amy Johnson PhD 8/2/2017Johnson PhD, Amy L I The Gathering SpaceJohnston DO, Timothy L I Timothy L Johnston DOJohnston Memorial Hospital, M Johnston Memorial HospitalJones MD, Karen G Olympus Health North CarolinaJones SLP, Jerry L I JCS Rehabilitation & Wellness 6/7/2017Jones SLP, Alina G Speechworks Therapy ServicesJones SLP, Holly G Speechworks Therapy ServicesJones SLP, Kerri G Tidewater Therapy for ChildrenJordan SLP, Sharon C G Speech TacticsJoslyn MD, Ann K G Graystone Ophthalmology AssociatesJudkins DO, Kyle G Med Plus NCJulich MD, Brian G CE Provider Services, LLCKantesaria MD, Atul N I Atul N Kanesaria MD 7/29/2017Kapoor MD, Sushma S G Med Plus NCKath MD, Philip D G Morganton Eye PhysiciansKauff MA, Elizabeth Ann I Cleveland Psychological Services 2/16/2017Kelleher SLP, Kate G WCU Speech & HearingKellermann FNP, Kendra G Coastal Internal MedicineKern SLP, Christie I Saltwater Speech TherapyKerr MD, Kirsten S G Cornerstone HealthcareKeshinro MD, Munirat G CE Provider Services, LLCKesler MD, James L G Coastal Carolina Eye ClinicKhurana MD, Neera I Neera Khurana MDKillian MD, Frank G Asheville Eye AssociatesKilpatrick MD, Jefferson G Pinehurst Surgical ClinicKincaid MS, Rebecca J I Rebecca J Kincaid MS 8/11/2017King MD, Bradley G Alamance Eye Center

King MD, Walter L I Dr Walter L KingKing PhD, Anne Ashley I Anne Ashley King PhD 3/21/2017King PsyD, Michele I King Neuropsychological Services 6/10/2017Kinston Head & Neck Physicians, GE Kinston Head & Neck Physicians & SurgeonsKirby Jr MA, Johnny G Catawba Valley Psychological AssociatesKiser SLP, Lawson G Lincoln Speech ServicesKnowles-Jonas MD, Lynde G CE Provider Services, LLCKohli MD, Asha K I Family Psychiatric ClinicKommunikate Plus, GE Kommunikate PlusKrause MD, Robert A I Robert A Krause MDKrauss SLP, Jeffrey G Speechworks Therapy ServicesKrych PhD, Raymond E G Sylva Clinical AssociatesKukreja MD, Neeta I South Charlotte Pediatrics PLLCKuranga MD, Abraham G Olympus Health North CarolinaKyerematen MD, Gabriel G Advanced Medical ConsultantsLaboratory Corportaion of America, M Laboratory Corportaion of AmericaLacroix, Christopher I Viva Med PLLCLacroix MD, Christopher G Advanced Medical ConsultantsLadson-Abrom SLP, Lakeeta G Complete Speech Therapy & WellnessLam OD, Duy G Cape Fear Eye AssociatesLandau MD, Steven G MDSI Physician GroupLangston MD, Dennis G CE Provider Services, LLCLanier PhD, Joseph G PsycLincLavoie PA, Bryan G Coastal Internal MedicineLawal MD, Olujide G Firsthealth CardiologyLe MD, Tin T I Med Stat CentreLenoir Memorial Hospital, M Lenoir Memorial HospitalLevitt MD, Stephen R I Stephen R Levitt MDLevy MD, Frederic G ENT CarolinaLewis MA, Mary Frances G Southeastern Psychological ServicesLexington Memorial Hospital Inc, M Lexington Memorial Hospital IncLifeworks, GE Lifeworks 6/19/2017Lincoln Speech Services, GE Lincoln Speech Services 6/19/2017Lindsay MD, Carlotta M G Advanced Medical ConsultantsLink PhD, William G Southeastern Psychological ServicesLocklear MD, Aaron G Advanced Medical ConsultantsLocklear SLP, Ursulla I Simply Speaking Speech TherapyLong PsyD, Lisa G MDSI Physician GroupLooking Glass Eye Center, GE Looking Glass Eye CenterLopez MS, Alexander I Alexander Lopez MS 12/15/2016Lorence MA, Jeffrey I Jeffrey Lorence MA 8/24/2017Love PsyD, Christopher G PsycLincLoveless MD, Howard W G CarolinaEast Ear Nose & ThroatLoVerde MD, Zachary J G MDSI Physician GroupLowery MD, John G Gaston Eye AssociatesLowry MD, Jadene I Jadene Lowry MD 1/23/2017Lowry MD, Jonathan G Morganton Eye PhysiciansLucas MA, Gayla R I Gayla R Lucas MALucas PhD, Bert I Lucas Psychological Services 6/6/2017Ludwigsen SLP, Kelly Rice G Therapy PlaygroundLukacs DO, Nicholas G Cornerstone Ear, Nose & ThroatLund MD, Michael G Gaston Eye AssociatesLutz MD, Cordula G Med Plus NCLyles MD, Graham W G Greensboro Ophthalmology AssociatesMadujibeya SLP, Belinda I BJM Speech Language Therapy & RehabilitationMaginn PhD, Vincent J I Vincent J Maginn PhDMann MD, David B G Blue Ridge ENT Allergy & Facial PlasticMansour MA, Donna A I Donna A Mansour MA 6/27/2017Marcellino MD, Amanda Jo G Olympus Health North Carolina

Marchese MD, Diana G Olympus Health North CarolinaMarcus PsyD, Karen R I Karen R Marcus PsyDMariah Parham Medical Center LLC, M Mariah Parham Hospital IncMark Beattie MD, M Hidden Valley Medical CenterMartinat SLP, Martha G Speechworks Therapy ServicesMasere MD, Constant G CE Provider Services, LLCMatt PhD, Allyson I Allyson Matt PhDMaxwell PhD, David I Ascent Psychological ServicesMcCarter SLP, Lara G Tidewater Therapy for ChildrenMcClelland MD, William Alfred G Cornerstone Ear, Nose & ThroatMcCullen MD, Bobby G Gaston Eye AssociatesMcDaniel PhD, William F I William F McDaniel PhDMcDowell FNP, Mary G Shelby Medical AssociatesMcFadden SLP, Marcella G TheraPeasMcGaffagan MA, Patricia G The Neuropsychology ConsultantsMcGilberry MS, Janice G Connect Center for WellnessMcGuirt MD, Wyman T G Pinehurst Surgical ClinicMcKinnon MD, Steve I McKinnon Eye Clinic PAMcKnight MD, Thomas Alexander G Med Plus NCMcKnight MD, Thomas A G Olympus Health North CarolinaMCM Pediatric and Adolescent Home Practice, GE MCM Pediatric and Adolescent Home PracticeMcNeil SLP, Cynthia G Speechworks Therapy ServicesMcNeill FPN, Charlotte G MCM Pediatric and Adolescent Home PracticeMcNulty PhD, Walter I Walter McNulty PhD

MDSI Physician Group, GE MDSI Physician Group7/1/2017, 8/12/2017

Mecklenburg X-Ray Associates PA, M Mecklenburg X-Ray Associates PAMed Plus NC, GE Med Plus NC 7/20/2017MedFirst Medical Center, GE MedFirst Medical Center 8/16/2017Medford PsyD, Jessica I Medford Psychological ServicesMedical Support Associates, GE Medical Support Associates 7/1/2017Meekins MD, Bettina G Coastal Eye ClinicMelson Mock MD, Michelle I Michelle Melson Mock MDMeltzer MD, Morton I Morton Meltzer MD 8/3/2017Melvin Kearney SLP, Amanda I Amanda Melvin SLP 8/7/2017Melvin MD, Frank G Asheville Head, Neck & Ear SurgeonsMerghani MD, Mohamed G MCM Pediatric and Adolescent Home PracticeMerolina Medical Clinic, GE Merolina Medical ClinicMeymandi MD, PhD DLFAPA, Assad I Assad Meymandi MD PhDMid-Carolina Radiological Associates PA, M Mid-Carolina Radiological Associates PAMiddleton SLP, Taylar G TheraPeasMidgley MD, John C I Dunn Internal Medicine 7/20/2017Mikac DO, Ryan G Med Plus NCMiller MA, Jerry L I Genesis CounselingMission Hospital Inc, M Mission Hospital IncMission Imaging Services, M Mission Imaging ServicesMonk SLP, Chareen R I Chareen R MonkMoody SLP, Tammie G Lincoln Speech ServicesMoore MD, Robert Brian G Asheville Head, Neck & Ear SurgeonsMoorehead MD, Katharine S G Carteret Clinic for Adolescents & ChildrenMorehead Memorial Hospital, M Morehead Memorial HospitalMorelli SLP, Karla G Speech TacticsMorganton Eye Physicians, GE Morganton Eye PhysiciansMorris MD, Peter G Advanced Medical ConsultantsMorris MD, Peter Delaney G MDSI Physician GroupMorrison SLP, Haywood J G Speechworks Therapy ServicesMorton PhD, Todd L I Todd L Morton PhDMorton SLP, Jeanine I TheraplayMoshay SLP, Beverly I Beverly R Moshay SLP

Moss MA, Tamela I Moss Psychological AssessmentsMount PsyD, David I David Mount PsyDMouser MD, Timothy I Southeastern Eye CareMozie MD, Benjamin I Shalom Medical 12/8/2016Mullins MD, Jessica G CE Provider Services, LLCMunn III MD, Alber R I Capital Eye CenterMunoz MD, Melchor Hernan G Olympus Health North CarolinaMurphy Medical Center Inc, M Murphy Medical Center IncMurphy SLP, Kathy O G Therapy PlaygroundMyers MD, Brian G Med Plus NCMyers SLP, Letishe G Complete Speech Therapy & WellnessNabors MD, Lawrence Howard I L Howard Nabors MDNash Hospital Inc, M Nash Hospital IncNash X-ray Associates PA, M Nash X-ray Associates PANational Radiology Consultants, M National Radiology ConsultantsNelson MD, James G Olympus Health North CarolinaNew Hanover Regional Medical Center, M Cleveland County Health Care SystemNewton PsyD, Rosalyn G PsycLincNgo MD, Corazon I Dr Corazon Ngo 12/8/2016Nguyen MD, Hao G Advanced Medical ConsultantsNguyen MD, Hien N G Olympus Health North CarolinaNortheast ENT Center, GE Northeast ENT CenterNorthern Hospital of Surry County, M Northern Hospital of Surry CountyNovant Health Brunswick Medical Center, M Brunswick Community Hospital LLCNovant Health Imaging Maplewood, M Novant Health Imaging MaplewoodNovant Health Imaging Museum, M Novant Health Imaging MuseumNovant Health Imaging Triad, M Novant Health Imaging TriadNovant Health Imaging University, M Novant Health Imaging UniversityOcloo MD, Shirley D G Gaston Family Health ServicesOcloo MD, Shirley G Medical Support AssociatesOdeke MD, Sylvester G CE Provider Services, LLCOgu MD, Dontus G Merolina Medical ClinicOkeiyi MD, Benson G Med Plus NCOlympus Health North Carolina, GE Olympus Health North Carolina 8/12/2017Onslow Memorial Hospital, M Onslow Memorial HospitalOrrison MD, William G Morganton Eye PhysiciansO'Shaughnessy SLP, Sallie L G SpeechcenterOsman MD, Ibrahim G Advanced Medical ConsultantsOuano MD, Dean G Coastal Eye ClinicOursler III MD, Ralph E G Graystone Ophthalmology AssociatesOwen MD, James C I James C Owen MDPabst SLP, Mary G Pitt County Memorial HospitalPacker SLP, Yalonda G Speak AdvantagePalanza MA, Michael A I Michael A Palanza MAPardoll PsyD, Mindy E I Mindy E Pardoll PsyDPark Ophthamology, GE Park OphthamologyPatel MD, Maharshi G Advanced Medical ConsultantsPatel MD, Mishal G Advanced Medical ConsultantsPatel PA, Khushboo G MedFirst Medical CenterPatterson MD, Dwayne G Tri State Occupational MedicinePatterson PhD, Nona Louise I Nona Louise Patterson PhDPaulson SLP, Leah G Tidewater Therapy for ChildrenPediatric Development Therapy, GE Pediatric Development TherapyPender Memorial Hospital Inc, M Pender Memorial Hospital IncPerson County Memorial Hospital Inc, M Person County Memorial Hospital IncPerson Health Cardiology, M Person Health Cardiology/Person Physicians PracticPettit FNP, Carrie G Yelverton's Enrichment Services, IncPhillips MD, Brandon G Carolina Vision CenterPhysicians East, M Physicians East

Pinehurst Neurology, GE Pinehurst NeurologyPinehurst Radiology Associates, M Pinehurst Radiology AssociatesPinehurst Surgical Clinic, GE Pinehurst Surgical ClinicPitt County Memorial Hospital, M Vidant Medical CenterPitt County Memorial Hospital - SLP, GE Pitt County Memorial HospitalPlemmons MA, Mitchell G Catawba Valley Psychological AssociatesPoole PhD, Teresa A. I Teresa A. Poole PhDPorfilio MD, William L G Alamance Eye CenterPowell MD, Eugene Neal I Carolina Orthopaedic Surgery AssociatesPowell SLP, Denise G Speechworks Therapy ServicesPresbyterian Hospital Inc, M Presbyterian Hospital IncPrice Jr, MD, Donald Lowell G ECU Physicians NeurologyPrice PhD, John Ryan I Carolina Child PsychologyProvidence Imaging Center Inc, M Providence Imaging CenterPsycLinc, GE PsycLincPuente PhD, Antonio E I Antonio E Puente PhDQuest Diagnostics Inc, M Quest Diagnostics IncQuinn MD, Robert Patel I Quinn Ear, Nose & ThroatQuinn PhD, Patrick C I Behavioral Health and Consulting Psychology 6/12/2017Qureshi MD, Ayyaz M I Dr Ayyaz M Qureshi 1/31/2017Radson MS, Robert D I Radson & Strayer Psychological Associates 2/16/2017Raleigh Capitol Ear, Nose, & Throat, GE Raleigh Capitol Ear, Nose, & ThroatRaleigh Radiology Cedarhurst, M Raleigh Radiology CedarhurstRaleigh Radiology LLC, M Raleigh Radiology LLCRandolph Hospital Inc, M Randolph Hospital IncRansak MD, Amy G Olympus Health North CarolinaRapchik MD, Joel I Joel Rapchik MDRaynor MD, Leighton G Morganton Eye PhysiciansReavis PhD, Mary Rachel Rebecca G PsycLinc 5/30/2017Reiber MD, Mark Edwin G ENT CarolinaReihl PhD, Kristina I Reihl Psychological Services PLLCRene MD, Marshel G Tri State Occupational MedicineRex Hospital Inc, M Rex Hospital IncRex Pulmonary Specialists, M Rex Pulmonary SpecialistsRex Surgical Specialists, M Rex Surgical SpecialistsReynolds II MD, Eugene G Gaston Family Health ServicesRheney Jr, MD, Theodore G Asheville Head, Neck & Ear SurgeonsRhoads MD, Edward J I Edward J Rhoads MDRicci PhD, Christopher M I Christopher M Ricci PhDRichardson FNP, David G Coastal Internal MedicineRichardson MA, Jan H G LifeworksRichardson MD, Kendra G Olympus Health North CarolinaRichman MD, Jonathan G Pinehurst NeurologyRicketson PsyD, Jake E I High Point Psyc Associates 4/6/2017Riddick MD, Gwendolyn L G CE Provider Services, LLCRitterspach PsyD, Chad Christopher I Valued LivingRoberti SLP, Graciela I Bilingual Therapy & Language Services 8/23/2017Rogers SLP, Sherry G Kommunikate PlusRogers SLP, Jean I Three Cs Speech Therapy Services PLLCRollinson EdD, Allison G RTC Psychological AssociatesRomine OD, Van S G Alamance Eye CenterRose SLP, Sonya F G Kommunikate PlusRose SLP, Amy J G WCU Speech & HearingRosenthal-Dibb SLP, Jennifer L G Therapy PlaygroundRothrock MA, Heather I Heather Rothrock MARowan Regional Medical Center, M Rowan Regional Medical CenterRowe MD, Loreli G Carteret Clinic for Adolescents & ChildrenRoy MD, Perry G Olympus Health North CarolinaRoyster SLP, Eden G TheraPeas

RTC Psychological Associates, GE RTC Psychological AssociatesSabiston MD, Walter G Kinston Head & Neck Physicians & SurgeonsSadoff PhD, Jennifer L I Lake Norman Psychological Services 8/7/2017Salisbury MD, James G Morganton Eye PhysiciansSamia MD, Mark A G MedFirst Medical CenterSampson Regional Medical Center, M Sampson Regional Medical CenterSanders MD, Stephen B I Dr Stephen B Sanders 4/6/2017Satterly MD, R Alan G Eastern Carolina ENT Head & Neck SurgeryScaglione MD, Jamie G Northeast ENT CenterScanlon SLP, Amanda W I Amanda W Scanlon SLPScheinder MD, Inaam I Schneider Medical Group, PA 7/19/2017Schell MD, Scott T I Scott T Schell MDSchneider MD, Lori I Harborview Plastic Surg/NeurologySchneidmiller PhD, Sara I Sara Schneidmiller PhD 7/19/2017Sciarra DO, Marc G Med Plus NCScotland Cardiology, M Scotland CardiologyScotland Memorial Hospital, M Scotland Memorial HospitalScott SLP, Pamela G Pitt County Memorial HospitalSeagle MD, Roger I Cardiology Associates of the Carolinas 5/30/2017Seales MD, David M I Northwest NeurologySentara Albemarle Medical Center, M Albemarle Hospital AuthoritySetty MD, Janaki Ram G Advanced Medical ConsultantsSewell MD, Kia G CE Provider Services, LLCShannon-Kirby MA, Roberta A G Catawba Valley Psychological AssociatesSharon Jr MD, Elliott G SXR Medical EvaluationsShaw PhD, Elizabeth I Elizabeth Shaw PhDSheffield SLP, Elizabeth G Tidewater Therapy for ChildrenShelby Radiological Associates PA, M Shelby Radiological Associates PAShelton PsyD, Robert Ray I Robert Ray Shelton PsyDSherrod SLP, Faith G Speechworks Therapy ServicesShukla MD, Vikram R I Dr Vikram R ShuklaShuping SLP, Rebekah G Complete Speech Therapy & WellnessShuping SLP, Rebekah Ann I Professional Speech ServicesSibille MD, Joshua A G Med Plus NCSilver PhD, Rueben J I Rueben J Silver PhDSilverstein MD, Michael G CE Provider Services, LLCSinclair PsyD, Andrea G Catawba Valley Psychological AssociatesSingh MD, Jasvinder P I Albemarle Pulmonary Med AssocSizemore MA, Nancy I All Care Psychological AssociatesSizemore SLP, Jessica G SpeechcenterSlawek MD, David F I David F Slawek MDSlutzky PsyD, Howard I Safe Harbor Psychological ServicesSlyman MD, James G Davidson Eye AssociatesSmeltz Zapata MA, Christine I Christine Smeltz-Zapata MASmith MD, John R I John R Smith MDSmith MD, Rondell A G MDSI Physician GroupSmith SLP, Jana G Lincoln Speech ServicesSnyder MD, Robert G Pinehurst NeurologySobanjo MD, Sybil O G Med Plus NCSolanki PsyD, Nina G MDSI Physician GroupSolomon MD, Bruce G Pinehurst NeurologySolstas Lab Partners, M Solstas Lab PartnersSolutions of Hickory, GE Solutions of HickorySong MD, Ronnie G Med Plus NCSouffrant MD, Edmire G Med Plus NCSoutheastern Psychological Services, GE Southeastern Psychological Services 1/23/2017Southeastern Radiology Associates, M Southeastern Radiology AssociatesSoutheastern Regional Medical Center, M Southeastern Regional Medical CenterSouthern Medical Group, GE Southern Medical Group 8/5/2017

Spaulding PhD, Christopher I Christopher Spaulding PhDSpeak Advantage, GE Speak AdvantageSpectrum Medical Group, M Spectrum Medical GroupSpeech Tactics, GE Speech TacticsSpeechcenter, GE SpeechcenterSpeechworks Therapy Services, GE Speechworks Therapy ServicesSpruill SLP, Nicole I Spruill's Speech and Language ServicesStahl MD, Jennifer G CE Provider Services, LLCStallings MD, Leonard G CE Provider Services, LLCStamp MD, Ian Patrick I Shelby Internal MedicineStanly County Imaging PLLC, M Stanly County Imaging PLLCStanly Regional Medical Center, M Stanly Regional Medical CenterStaten DO, Elaine Alice I Scotland Memorial HospitalStatesville HMA Inc, M Statesville HMA IncSteeb SLP, Amanda G Lincoln Speech ServicesSteinmuller MD, Warren J I Dr Warren J SteinmullerStella OD, David I David Stella ODStephenson MD, Shelby G Cape Fear Eye AssociatesStitt Jr MD, Van J G Medical Support AssociatesStone FNP, Amanda Jo G Coastal Internal MedicineSundar MD, Veerappan I Veerappan Sundar MDSutton PhD, Griffin I Griffin Sutton PhDSwaim SLP, Amy J G Swaim TherapiesSwaim Therapies, GE Swaim TherapiesSwaminathan MD, Viswanathan I East Coast Psychiatric ServicesSXR Medical Evaluations, GE SXR Medical Evaluations 7/21/2017Sylva Clinical Associates, GE Sylva Clinical AssociatesTabet MD, Munther I Munther Tabet MDTamba DO, Ismael G Advanced Medical ConsultantsTaylor MA, Rebecca Marie G RTC Psychological AssociatesTennessee Interventional and Imaging Associates, M Tennessee Interventional and Imaging AssociatesTeoh MD, Su Wooi I Su Wooi Teoh MDTessnear PhD, Eddie S I Coastal Psychological AssociatesThe McDowell Hospital, M McDowell HospitalThe Moses H Cone Memorial Hospital, M Annie Penn HospitalThe Neuropsychology Consultants, GE The Neuropsychology Consultants 12/8/2016The Outer Banks Hospital Inc, M The Outer Banks Hospital IncTheraPeas, GE TheraPeasTherapy Playground, GE Therapy PlaygroundThompson MD, Caroline G Advanced Medical ConsultantsThornton MA, Sally Jane I Magnolia Center for Counseling 9/6/2017Tidewater Therapy for Children, GE Tidewater Therapy for ChildrenTighe NP, Connie G Pinehurst Surgical ClinicTonn MS, Henry I Henry Tonn MS 11/21/2016Total Radiology Solutions, M Total Radiology SolutionsTransylvania Community Hospital, M Transylvania Community HospitalTri State Occupational Medicine, GE Tri State Occupational Medicine 7/19/2017Triad Radiology Associates, M Triad Radiology AssociatesTring DO, Vi Song G Med Plus NCTrinity Center, GE Trinity CenterTrivette SLP, Laura G WCU Speech & HearingTroxler PhD, Susie Ozetta I Susie Ozetta Troxler PhDTucker SLP, Cheryl G Speechworks Therapy ServicesTunau MD, Habiba G MDSI Physician GroupUddstrom SLP, Sarah E G Speech TacticsUmesi MD, Joseph G Advanced Medical ConsultantsUNC Ear Nose and Throat at Nash, GE UNC Ear Nose and Throat at NashUNC Ear Nose and Throat at Roanoke Rapids, GE UNC Ear Nose and Throat at Roanoke RapidsUNC Hospital Hearing and Voice Center, M UNC Hospital Hearing and Voice Center

Underwood MD, Gregory Alan G Charlotte Medical ClinicUnion General Hospital, M Union General HospitalValley Radiology, M Valley RadiologyValley Radiology Associates PA, M Valley Radiology Associates PAVan Der Vaart, Robert G Coastal Carolina Eye ClinicVaziri MD, Boyd G Charlotte Ophthalmology ClinicVecchio-Russell MS, Kathryn G The Neuropsychology ConsultantsVerdi MD, Vincent James G Coastal Eye CenterVerma SLP, Madhu G Tidewater Therapy for ChildrenVidant Bertie Hospital, M Vidant Bertie HospitalVidant Chowan Hospital, M Vidant Chowan HospitalVidant Duplin Hospital, M Vidant Duplin HospitalVidant Hospital, M Vidant Beaufort HospitalVidant Roanoke-Chowan Hospital, M Vidant Roanoke-Chowan HospitalVillacorte MD, Lizette G Med Plus NCVillanueva MD, David G Olympus Health North CarolinaVillarosa PhD, Gregory A I Gregory A Villarosa PhD 6/21/2017Vin-Parikh MD, Anita P G Alamance Eye CenterVockel SLP, Giovanna G Swaim TherapiesVolatile MD, Katherine G Looking Glass Eye CenterWake Forest Univ Health Sciences, M Baptist HospitalWake Radiology Consultants PA, M Wake Radiology Consultants PAWake Radiology Diagnostic Imaging, M Wake Radiology Diagnostic ImagingWake Radiology Diagnostic Imaging Inc, M Wake Radiology Diagnostic ImagingWalker PhD, Jessica A I Jessica Ann Walker PhDWall MD, Antoinette I Antoinette Wall MDWall MD, Stephen I Haywood Ped & Adolscence MedWarner MS, Terry I Terry Warner MSWarnken MS, John K I John K Warnken MS 8/7/2017Washington County Hospital, M Washington County HospitalWatauga Medical Center Inc, M Watauga Medical Center IncWatauga Radiological Services PA, M Watauga Radiological Services PAWatkins PA, Veronica G MedFirst Medical CenterWatson MD, Samantha G Coastal Carolina Eye ClinicWayne Memorial Hospital, M Wayne Memorial HospitalWayne Radiologists PA, M Wayne Radiologists PAWCU Speech & Hearing, GE WCU Speech & HearingWeatherford MA, Rita G PsycLincWebb SLP, Janet G Tidewater Therapy for ChildrenWeeks MA, Ashly T G The Neuropsychology ConsultantsWelborne MD, Barry M G Charlotte Medical ClinicWelcker PhD, Joy I JLF Services 4/6/2017Westfall MA, Alexandria I Alexandria Westfall MA 6/21/2017Whitaker MD, Albert I Gastonia Family PracticeWhitehead PhD, Courtney G MDSI Physician GroupWiggins Jr MD, Robert G Asheville Eye AssociatesWilkes Radiology PA, M Wilkes Radiology PAWilliams MD, Randal J G Graystone Ophthalmology AssociatesWilliams MD, Thomas R G Graystone Ophthalmology AssociatesWilliams SLP, Ebony G Speak AdvantageWillis MD, Larry F G Morganton Eye PhysiciansWillis SLP, Cynthia I Perfectly SpeakingWilmed Healthcare, M Wilmed HealthcareWilmington Health Associates Medical Clinic, M Wilmington Health Associates Medical ClinicWilson MA, Jana I NC Center for Counseling & Psychological ServicesWilson Mem Hospital Community Radiology, M Wilson Mem Hospital Community RadiologyWilson SLP, Stacy I Dogwood Developmental TherapyWims SLP, Wanda G Speechworks Therapy ServicesWinford MD, Tyler G Med Plus NC

Winston Salem Cardiology Associates, M Winston Salem Cardiology AssociatesWood MD, Frank I Frank Wood MDWRMC Hospital Operating Corp, M WRMC Hospital Operating CorpYadkin River Radiology PA, M Yadkin River Radiology PAYelverton's Enrichment Services, Inc, GE Yelverton's Enrichment Services, IncYork SLP, Faeben G Complete Speech Therapy & WellnessYoung MD, Leo K G MDSI Physician GroupZafar MD, Muhammad S G Southern Medical GroupZahner MA, Courtney G Trinity CenterZechman MD, James I Allergey & Asthma Clinic of New BernZelenak MD, Jozef I Zelenak Psychiatry PLLCZoda SLP, Stephanie G TheraPeasZorko MD, Bryan G CE Provider Services, LLC

Removed from panel in 2016 - Removal for Cause OnsiteMorris Britt PhD 6/12/2017

Kumar Internal Medicine (Kamlesh Kumar MD, Satish Kumar MD)

11/9/2016, 5/4/2017, 8/7/2017

Dean MD, Joan

Reason

(b) (6)

I - signifies indiviudal provider performing examinations on their ownG - significes individual provider performing examinations with a groupGE - indicates a groupM - Studies only provider (i.e. hosptials, labs, radiologists)

Volume and Key providers in blue (by group)Top 5 providers in Red (by group)

KEY CE_PROVIDER_NM CASE WHEN MA_ADDRLN_1 IS NULL THEN SA_ADDRLN_1 ELSE MA_ADDRLN_1 END MA_CITY MA_STATE

INDUSTRIAL MEDICINE ASSOCIATES 3250 WESTCHESTER AVE, STE 120 BRONX NYINDUSTRIAL MEDICINE ASSOCIATES 186 JORALEMON STREET 5TH FLOOR BROOKLYN NYINDUSTRIAL MEDICINE ASSOCS, PC 699 HERTEL AVE STE 355 BUFFALO NYINDUSTRIAL MEDICINE ASSOC PC 42 BROADWAY 19TH FLOOR NEW YORK NYINDUSTRIAL MEDICINE ASSOC, PC 214 ALEXANDER ST STE 200 ROCHESTER NYINDUSTRIAL MEDICINE ASSOC PC 1762 CENTRAL AVE ALBANY NYINDUSTRIAL MEDICINE ASSOC PC 518 JAMES STREET SYRACUSE NYINDUSTRIAL MEDICINE ASSOCIATES 80-02 KEW GARDENS RD KEW GARDENS NYINDUSTRIAL MEDICINE ASSOCIATES 1690 WASHINGTON AVE BOHEMIA NYINDUSTRIAL MEDICAL ASSOC PC 301 MANCHESTER MILL CENTER POUGHKEEPSIE NYINDUSTRIAL MEDICINE ASSOC PC 280 N. CENTRAL AVE, STE 115 HARTSDALE NYINDUSTRIAL MEDICINE ASSOC PC 679 MAIN STREET WESTOVER NYINDUSTRIAL MEDICINE ASSOCS, PC 430 COURT STREET UTICA NYINDUSTRIAL MEDICINE ASSOCIATES 250 FULTON AVE HEMPSTEAD NYBATH BEACH MEDICAL PC 2071 CLOVE ROAD STE A STATEN ISLAND NYINDUSTRIAL MEDICINE ASSOCS PC 31 SHERMAN ST STE 1300 JAMESTOWN NYBUFFALO HEARING & SPEECH CTR 6941 ELAINE DRIVE SUITE 4 NIAGARA FALLS NYGLENS FALLS HOSPITAL 102 PARK ST., SUITE B-2 GLENS FALLS NYOSIKA & SCARANO PSYCH SVC PC 5 PINE STREET GLENS FALLS NYLAUREANO CRISTINA M. BRONX NYFROMER, MARK D MDPC 550 PARK AVENUE NEW YORK NYFROMER, MARK D MDPC MED CORP 550 PARK AVENUE NEW YORK NYSCHIFFMAN, RICHARD G. MD BROOKLYN NYSTURM, JOSEPH MD Woodmere NYWEINBERG, JERRY C MD PENNSPORT MALL PHILADELPHIA PAEYES ON ROCHESTER 1157 FAIRPORT ROAD SUITE 201 FAIRPORT NYENT & ALLERGY ASSOCIATES 75 SOUTH BROADWAY, 3RD FLOOR WHITE PLAINS NYENT AND ALLERGY ASSOCIATES,LLP 1200 WATERS PLACE/STE 110 BRONX NYEYECARE OF CNY 2901 COURT STREET SYRACUSE NYEAST END EYE ASSOCIATES 251 EAST OAKLAND AVENUE PORT JEFFERSON NYBERNARD, PETER J. MD NEW YORK NYCAPITAL REG OTO HEAD & NECK GP 6 EXECUTIVE PARK DRIVE #C ALBANY NYCORTLAND ENT PC 64 POMEROY STREET CORTLAND NYHERSH, SHELDON MD FOREST HILLS NYKAKANI, RAJESH MD ADVANCED OTOLARYNGOLOGY PC GARDEN CITY NYRATHI, SEEMA MD YONKERS NY

CAYUGA COMP PSYCH SERVICES, PC TIOGA PLACE ON ITHACA COMMONS ITHACA NYTITONE, FRANK R. MD JACKSON HEIGHTS NYKUPERBERG, ABRAHAM PHD FAIR LAWN NJZOLTAN, ROBERT MD FOREST HILLS NYYELENA GLOBINA MD 50 COURT STREET SUITE 508A BROOKLYN NYGRIFFIN PHD, EUGENA PO BOX 80327 BROOKLYN NYCHENG, ANDREW MD NEW YORK NYREHABILITATION TODAY SERVICES 784 MAIN STREET OLEAN NYROBATEAU, LISA CCC-SLP 78 RYERSON ST, GROUND FLOOR BROOKLYN NYKATZ, SUSAN 240 EAST 82nd ST APT 4E NEW YORK CITY NYOMNI EYE SURGERY 406 15TH STREET BROOKLYN NYFROMER, MARK D MDPC 109-33 71ST ROAD STE 2C FOREST HILLS NYTHOMAS, KELLY PSYD 150 WEST 225TH STREET APT 29F BRONX NYKELLER, PETER MD BRONX NYHAHN, JUNG LEE MD STATEN ISLAND NYSHARON JOLLY & ASSOCIATES 101 STAGE ROAD MONROE NYMILESTONE PSYCHIATRIC SVCS PC 15 PLEASANT STREET HORNELL NYNO COUNTRY FAM PHYSICIANS PC 309 COUNTY RTE 47-STE 1 SARANAC LAKE NYRUBIN, CHARLES MD JOHNSON CITY NYBERNIER JR., JOSEPH PHD 5 PINE WEST PLAZA-SUITE 508 ALBANY NY

New York FY 2017

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

LIOTTA RICHARD PHD PO BOX 229 RAINBOW LAKE NYANTWINE-BOYD, NAFEESAH 453 MACON STREET APT A1 BROOKLYN NY

BRONX PSYCHOLOGY SERVICES,PLLC 27 Melrose Ave Mount Vernon NYBONANNO, PHILIP MD 70 GLEN STREET ROOM 380 GLEN COVE NYGURTOVY, MARK MD 2150 CENTER AVE STE 1-B FORT LEE NJTHOMAS BEHAVIORAL HEALTH INC 150 WEST 225TH STREET APT 29F BRONX NYBERNSTEIN SPEECH-LANGUAGE PLLC 61-21 215TH STREET BAYSIDE NYNORTH COUNTRY KIDS 22 New York Road PLATTSBURGH NY

BERNSTEIN, MARTIN MDYORKTOWN HEIGHTS NY

PICHE JACQUES MD PO BOX 1732 PLATTSBURGH NYHESS, DAVID MD CARDIO CONSULT OF LONG ISLAND NEW HYDE PARK NYGLENS FALLS HOSPITAL QUEENSBURY NYJAMESTOWN OPTOMETRIC GROUP DBA/SPECTRUM EYE CARE JAMESTOWN NYLEXINGTON HEARING & SPEECH CTR 25-26 75TH STREET JACKSON HEIGHTS NYOLAJIDE, BOLANLE ABIMBOLA MD BALDWIN NYLONG ISLAND E.N.T.ASSOCS PC 100 EAST SUNRISE HWY STE A LINDENHURST NYMORGAN,RITA M.S. POMONA NYMYERS, BONNIE CCC/SLP Plattsburgh NYGALETTE, FRITZ PHD STATEN ISLAND NYDURANTE, ANTHONY J. MD MINEOLA NYBRONX PARK SURGICAL OF SBH ATTN: BRONX NYYU PHD, WEIZHEN 76-58 174th STREET FRESH MEADOWS NYFREEDMAN, BLIMIE MS CCC SLP BROOKLYN NYTHOMAS MYERS PHD 25306 WEST END DR 2ND FL LITTLE NECK NYDR.MATTHEW D'ORTONA, PSY.D ELMIRA NYBUMATAY,JOSEPH MD FLUSHING NYPATHAK, KAMAL D. MD CORNING NYBENJAMIN, ANAT MD NEW HYDE PARK NYSHPITALNIK, VILOR MD 1723 E. 12TH ST.2ND FLR BROOKLYN NYTHOMAS PSYD, KELLY 150 WEST 225TH ST APT 29F BRONX NYSCHLEUDERER, CLAUDE PHD KINGSTON NYPEARL, ALDEN J. MD 34 PLAZA STREET EAST STE 106 BROOKLYN NYLAB CORP OF AMERICA PO BOX 12140 BURLINGTON NCSAFO MARGARET MD FAR ROCKAWAY NYJOLLY, SHARON 77 QUAKER AVE UNIT 202 CORNWALL NYLAUREANO, CHRISTINA M BRONX NYPHELPS, STEPHEN W. PHD LAURENS NYABRAMSON, VICTOR MD 532 NEPTUNE AVE ROOM 203 BROOKLYN NYTSUI, ELLEN C PHD 837 58th STREET 3rd FL BROOKLYN NYABRAMSON, ALLA MD BROOKLYN NYNEWMAN, STEVEN MD BROOKLYN NYHERSH, SHELDON MD WOODMERE NYSHAPIRO, ARNOLD L. MD 2448 ROUTE 54A PENN YAN NYRUBIN PSYCHOLOGICAL SVCS PC 320 ROBINSON AVE STE 201A NEWBURGH NYBERTI, MARTHA SLP PC NORTHPORT NYSHPITALNIK, VILOR MD 1723 E.12TH ST. 2ND FLR BROOKLYN NYBRENNAN, HOPE SLP SAUGERTIES NYADIRONDACK MEDICAL CENTER LAKE COLBY DRIVE SARANAC LAKE NYENG NANCY PHD. SP/L 9 MOTT STREET SUITE 200 NEW YORK NYWAKSLAK, HARRY PHD LONG BEACH NYBAKST, YAEL CCC/SLP FLUSHING NYRODRIGUEZ-HERMAN, LINDA PHD LRH SPEECH PATHOLOGY INC WANTAGH NYST JOHNS RIVERSIDE HOSPITAL 967 NORTH BROADWAY YONKERS NYKIM, DAMIAN MD FLUSHING NYBEDARD, JOEL MD HEMPSTEAD NYNEERUKONDA, SAMPATH MD HORNELL NYSMUGLIN, CLAUDIA MD REGO PARK NY

(b) (6)

(b) (6)

(b) (6)(b) (6)(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)(b) (6)(b) (6)

NEYSTAT, MARINA MD WEILL CORNELL MED COLL ALUMNI NEW YORK NYSPITZER, JEFFREY MD BROOKLYN NYSUNY/FREDONIA THOMPSON HALL/ROOM W123 FREDONIA NYLAGO, JESUS A. MD PURCHASE NYALBANY EYE PHYSICIAN & SURGEON 930 ALBANY SHAKER ROAD LATHAM NYDEMARCO, LAURA PHD HORNELL NYOSIKA & SCARANO PSYCH SVCS 8 Williams Street Elizabethtown NYLONG ISLAND E.N.T. ASSOC. PC 875 OLD COUNTRY ROAD SUITE 200 PLAINVIEW NYFEINER, LEONARD MD LAWRENCE NY

HIGHLAND OPHTHALMOLOGY ASSOC 140 EXECUTIVE DR NEW WINDSOR NYCULLINAN, THOMAS PHD 2190 BOSTON RD STE 1A BRONX NYDR ALLEN MARK HOCHBERG PHD VESTAL NYESHKENAZI, AZARIAH MD FOREST HILLS NYSTATEN ISLAND UNIVERSITY HOSP 475 SEAVIEW AVENUE STATEN ISLAND NYACM MEDICAL LABORATORIES INC 160 ELM GROVE PARK ROCHESTER NYGrand Total

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

MA_ZIP5 O/V Count Amount Certified for Payment

10461 27,726 $3,490,289.07 11201 19,211 $2,714,695.00 14207 15,376 $2,280,437.30 10004 15,137 $2,083,966.01 14607 13,711 $2,025,987.70 12205 11,900 $1,657,610.45 13203 12,141 $1,547,596.28 11415 10,788 $1,481,319.12 11716 9,592 $1,348,701.50 12603 8,397 $1,165,576.51 10530 6,704 $1,001,939.35 13790 7,403 $939,816.94 13502 5,353 $808,162.03 11550 5,343 $792,428.69 10304 3,776 $597,704.83 14701 2,488 $364,232.59 14304 952 $214,850.40 12801 807 $162,307.15 12801 776 $106,898.42 10465 289 $61,955.82 10021 298 $51,107.00 10065 263 $45,104.50 11235 173 $44,430.75 11598 232 $39,788.00 19148 170 $29,155.00 14450 141 $24,181.50 10601 88 $22,638.00 10465 88 $22,638.00 13208 125 $21,437.50 11777 119 $20,408.50 10128 76 $19,691.88 12203 76 $19,477.50 13045 68 $17,493.00 11375 66 $16,978.50 11530 65 $16,721.25 10701 92 $15,778.00

14850 109 $15,509.04 11372 89 $15,263.50 7410 94 $14,976.07 11375 85 $14,577.50 11201 112 $14,406.56 11208 101 $13,046.74 10013 47 $12,090.75 14760 73 $11,925.73 11205 56 $11,919.53 10028 55 $11,790.90 11215 66 $11,319.00 11375 65 $11,147.50 10463 83 $10,676.29 10461 34 $9,371.42 10305 70 $9,004.10 10950 39 $8,360.82 14843 48 $8,305.72 12983 57 $7,932.16 13790 46 $7,889.00 12205 34 $7,625.79

12976 57 $7,497.28 11233 56 $7,203.28

10552 31 $6,713.34 11542 36 $6,174.00 7024 46 $5,916.98 10463 44 $5,659.72 11364 25 $5,359.50 12903 25 $5,359.50

10598 30 $5,145.00 12901 20 $5,145.00 11040 13 $5,126.75 12804 21 $4,501.98 14701 26 $4,459.00 11370 16 $4,183.38 11510 32 $4,116.16 11757 16 $4,116.00 10970 19 $4,073.22 12901 18 $3,858.84 10305 24 $3,724.10 11501 15 $3,675.00 10457 21 $3,601.50 11366 27 $3,473.01 11210 16 $3,430.08 11362 22 $3,322.98 14901 22 $2,829.86 11366 10 $2,572.50 14830 10 $2,572.50 11040 13 $2,229.50 11229 17 $2,186.71 10463 17 $2,186.71 12401 16 $2,145.29 11238 8 $2,058.00 27216 120 $1,957.19 11691 15 $1,929.45 12518 9 $1,929.42 10465 9 $1,929.42 13796 12 $1,855.93 11224 14 $1,800.82 11220 11 $1,561.93 11224 12 $1,543.56 11209 12 $1,543.56 11598 6 $1,543.50 14527 9 $1,543.50 12550 8 $1,506.78 11768 7 $1,500.66 11229 11 $1,414.93 12477 6 $1,286.28 12983 8 $1,190.72 10013 5 $1,071.90 11561 7 $900.41 11367 4 $857.52 11793 4 $857.52 10701 3 $826.89 11354 6 $771.78 11550 5 $643.15 14843 5 $643.15 11374 5 $643.15

10065 4 $514.52 11215 3 $514.50 14063 2 $428.76 10577 3 $385.89 12110 2 $343.00 14843 2 $257.26 12932 2 $257.26 11803 1 $257.25 11559 1 $171.50

12553 1 $171.50 10462 1 $128.63 13850 1 $128.63 11375 1 $128.63 10305 2 $18.90 14624 1 $10.13

182,482 $25,672,228.31

Provider Name Street Address City StateBERNIER JR., JOSEPH PHD 5 PINE WEST PLAZA-SUITE 508 ALBANY NYCAPITAL REG OTO HEAD & NECK GP 6 EXECUTIVE PARK DRIVE #C ALBANY NYOLAJIDE, BOLANLE ABIMBOLA MD BALDWIN NYBERNSTEIN SPEECH-LANGUAGE PLLC BAYSIDE NYBRONX PARK SURGICAL OF SBH ATTN: BRONX NYCULLINAN, THOMAS PHD 2190 BOSTON RD STE 1A BRONX NYENT AND ALLERGY ASSOCIATES,LLP 1200 WATERS PLACE/STE 110 BRONX NYKELLER, PETER MD BRONX NYLAUREANO CRISTINA M. BRONX NYTHOMAS BEHAVIORAL HEALTH INC 150 WEST 225TH STREET APT 29F BRONX NYABRAMSON, ALLA MD 532 NEPTUNE AVE BROOKLYN NYABRAMSON, VICTOR MD 532 NEPTUNE AVE ROOM 203 BROOKLYN NYANTWINE-BOYD, NAFEESAH 453 MACON STREET APT A1 BROOKLYN NYFREEDMAN, BLIMIE MS CCC SLP 1285 EAST 34TH STREET BROOKLYN NYGRIFFIN PHD, EUGENA PO BOX 80327 BROOKLYN NYNEWMAN, STEVEN MD BROOKLYN NYOMNI EYE SURGERY 406 15TH STREET BROOKLYN NYPEARL, ALDEN J. MD 34 PLAZA STREET EAST STE 106 BROOKLYN NYROBATEAU, LISA CCC-SLP 78 RYERSON ST, GROUND FLOOR BROOKLYN NYSCHIFFMAN, RICHARD G. MD BROOKLYN NYSHPITALNIK, VILOR MD 1723 E. 12TH ST.2ND FLR BROOKLYN NYSPITZER, JEFFREY MD BROOKLYN NYTSUI, ELLEN C PHD 837 58th STREET 3rd FL BROOKLYN NYYELENA GLOBINA MD 50 COURT STREET SUITE 508A BROOKLYN NYPATHAK, KAMAL D. MD CORNING NYJOLLY, SHARON 77 QUAKER AVE UNIT 202 CORNWALL NYCORTLAND ENT PC 64 POMEROY STREET CORTLAND NYOSIKA & SCARANO PSYCH SVCS 8 Williams Street Elizabethtown NYCHANG, BENJAMIN MD LIBERTY PHYSICAL MED & REHAB ELMHURST NYDR.MATTHEW D'ORTONA, PSY.D ELMIRA NYKUPERBERG, ABRAHAM PHD FAIR LAWN NJEYES ON ROCHESTER 1157 FAIRPORT ROAD SUITE 201 FAIRPORT NYSAFO MARGARET MD FAR ROCKAWAY NYBAKST, YAEL CCC/SLP FLUSHING NYBUMATAY,JOSEPH MD FLUSHING NYKIM, DAMIAN MD FLUSHING NYESHKENAZI, AZARIAH MD FOREST HILLS NYFROMER, MARK D MDPC 109-33 71ST ROAD STE 2C FOREST HILLS NYZOLTAN, ROBERT MD FOREST HILLS NYGURTOVY, MARK MD 2150 CENTER AVE STE 1-B FORT LEE NJSUNY/FREDONIA THOMPSON HALL/ROOM W123 FREDONIA NYYU PHD, WEIZHEN FRESH MEADOWS NYKAKANI, RAJESH MD ADVANCED OTOLARYNGOLOGY PC GARDEN CITY NYBONANNO, PHILIP MD 70 GLEN STREET ROOM 380 GLEN COVE NYGLENS FALLS HOSPITAL 102 PARK ST., SUITE B-2 GLENS FALLS NYOSIKA & SCARANO PSYCH SVC PC 5 PINE STREET GLENS FALLS NYBEDARD, JOEL MD HEMPSTEAD NYDEMARCO, LAURA PHD HORNELL NYMILESTONE PSYCHIATRIC SVCS PC 15 PLEASANT STREET HORNELL NYNEERUKONDA, SAMPATH MD HORNELL NY

CAYUGA COMP PSYCH SERVICES, PC TIOGA PLACE ON ITHACA COMMONS ITHACA NYLEXINGTON HEARING & SPEECH CTR 25-26 75TH STREET JACKSON HEIGHTS NYTITONE, FRANK R. MD JACKSON HEIGHTS NYJAMESTOWN OPTOMETRIC GROUP DBA/SPECTRUM EYE CARE JAMESTOWN NYRUBIN, CHARLES MD JOHNSON CITY NYSCHLEUDERER, CLAUDE PHD KINGSTON NYALBANY EYE PHYSICIAN & SURGEON 930 ALBANY SHAKER ROAD LATHAM NY

New York FY 2017

(b) (6)(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)(b) (6)(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

PHELPS, STEPHEN W. PHD LAURENS NYFEINER, LEONARD MD LAWRENCE NYLONG ISLAND E.N.T.ASSOCS PC 100 EAST SUNRISE HWY STE A LINDENHURST NYTHOMAS MYERS PHD 25306 WEST END DR 2ND FL LITTLE NECK NYWAKSLAK, HARRY PHD LONG BEACH NYDURANTE, ANTHONY J. MD MINEOLA NYSHARON JOLLY & ASSOCIATES 101 STAGE ROAD MONROE NY

BRONX PSYCHOLOGY SERVICES,PLLC 27 Melrose Ave Mount Vernon NYBENJAMIN, ANAT MD NEW HYDE PARK NYHESS, DAVID MD CARDIO CONSULT OF LONG ISLAND NEW HYDE PARK NY

HIGHLAND OPHTHALMOLOGY ASSOC 140 EXECUTIVE DR NEW WINDSOR NYBERNARD, PETER J. MD NEW YORK NYCHENG, ANDREW MD NEW YORK NYENG NANCY PHD. SP/L 9 MOTT STREET SUITE 200 NEW YORK NYFROMER, MARK D MDPC NEW YORK NYNEYSTAT, MARINA MD WEILL CORNELL MED COLL ALUMNI NEW YORK NYKATZ, SUSAN 240 EAST 82nd ST APT 4E NEW YORK CITY NYRUBIN PSYCHOLOGICAL SVCS PC 320 ROBINSON AVE STE 201A NEWBURGH NYBUFFALO HEARING & SPEECH CTR 6941 ELAINE DRIVE SUITE 4 NIAGARA FALLS NYBERTI, MARTHA SLP PC NORTHPORT NYREHABILITATION TODAY SERVICES 784 MAIN STREET OLEAN NYSHAPIRO, ARNOLD L. MD PENN YAN NYWEINBERG, JERRY C MD PENNSPORT MALL PHILADELPHIA PALONG ISLAND E.N.T. ASSOC. PC 875 OLD COUNTRY ROAD SUITE 200 PLAINVIEW NYMYERS, BONNIE CCC/SLP Plattsburgh NYNORTH COUNTRY KIDS 22 New York Road PLATTSBURGH NYPICHE JACQUES MD PO BOX 1732 PLATTSBURGH NYMORGAN,RITA M.S. POMONA NYEAST END EYE ASSOCIATES 251 EAST OAKLAND AVENUE PORT JEFFERSON NYLAGO, JESUS A. MD PURCHASE NYGLENS FALLS HOSPITAL QUEENSBURY NYLIOTTA RICHARD PHD PO BOX 229 RAINBOW LAKE NYSMUGLIN, CLAUDIA MD REGO PARK NYACM MEDICAL LABORATORIES INC 160 ELM GROVE PARK ROCHESTER NYADIRONDACK MEDICAL CENTER LAKE COLBY DRIVE SARANAC LAKE NYNO COUNTRY FAM PHYSICIANS PC 309 COUNTY RTE 47-STE 1 SARANAC LAKE NYBRENNAN, HOPE SLP SAUGERTIES NYGALETTE, FRITZ PHD STATEN ISLAND NYHAHN, JUNG LEE MD STATEN ISLAND NYSTATEN ISLAND UNIVERSITY HOSP 475 SEAVIEW AVENUE STATEN ISLAND NYEYECARE OF CNY 2901 COURT STREET SYRACUSE NYENT & ALLERGY ASSOCIATES 75 SOUTH BROADWAY, 3RD FLOOR WHITE PLAINS NYSTURM, JOSEPH MD Woodmere NYRATHI, SEEMA MD YONKERS NYST JOHNS RIVERSIDE HOSPITAL 967 NORTH BROADWAY YONKERS NY

BERNSTEIN, MARTIN MDYORKTOWN HEIGHTS NY

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)

Zip12205122031151011364104571046210465104611046510463112241122411233112101120811209112151123811205112351122911215112201120114830125181304512932113731490174101445011691113671136611354113751137511375702414063113661153011542128011280111550148431484314843

14850113701137214701137901240112110

13796115591175711362115611150110950

105521104011040

1255310128100131001310021100651002812550143041176814760145271914811803129011290312901109701177710577128041297611374146241298312983124771030510305103051320810601115981070110701

10598

Thursday, October 26, 2017 Page 1 of 94

Alphabetical Vendor List

Vendor Name Vendor Number

Address Phone Speciality Email Scheduler / Pro

ACCESS 2 INTERPRETERS

492 S High St Ste 200

Columbus OH 43215

(614) 899-6666

f:(614) 464-3004

L-Interp

ADAMS COUNTY REGIONAL MEDICAL CENTER

230 MEDICAL CENTER DR

SEAMAN OH 45679

(937) 386-3441

f:(937) 386-3459

ANC

ADAMS COUNTY REGIONAL MEDICAL CENTER

230 MEDICAL CENTER DR

SEAMAN OH 45679

(937) 386-3441

f:(937) 386-3459

FAC

Ohio FY 2017

(b) (6)(b) (6)

(b) (6)

(b) (6)


ADVANTAGE IMAGING

6900 Ridge Rd

Parma OH 44129

(440) 843-9900

f:(440) 843-9901

ANC Scheduler


Address Phone Speciality Email

ADVANTAGE IMAGING

3733 PARK EAST DRIVE

BEACHWOOD OH 44122

(216) 292-9998

f:(216) 292-9799

ANC

AFFINITY MEDICAL CENTER

845 EIGHTH ST NE SUITE #3

MASSILLON OH 44646

330-832-8761

f:

ANC

AINA, OLAYINKA, M.D.

PEEBLES OH 45660

FAC

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)


AINA, OLAYINKA, M.D.

PEEBLES OH 45660

IM, CD, ANC Scheduler

Alice Wang PSY D

Jackson OH 45640

Psych



AMANAMBU, CHIMEZIE, M.D.

APEX MEDICAL EVALUATION SERVICES 1655 W. MARKET ST. STE L AKRON OH 44313

330-375-0000

f:(330) 375-0002

IM [email protected]

AMCE Physicians Group

1 COURTHOUSE LANE SUITE 2

MARIETTA OH 45750

(800) 440-3305

f:(877) 468-4543

IM

(b) (6)(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)


AMCE Physicians Group

1799 Akron-Peninsula Rd. Suite 305

Akron OH 44313

(800) 440-3305

f:(866) 369-4424

Psych

AMERIRAD

364 PATTERSOON DR PO BOX 297

MORGANTOWN W 26507 V

304-598-2291

f:

ANC-INTERP

ANA MARIA CARRILLO, PHD

THE DARWOOD BUILDING 23360 CHAGRIN BLVD SUITE 205

BEACHWOOD OH 44122

PSYCH



ANAT NURKO, SLP

12429 Cedar Rd Suite 18 2nd Floor Cleveland Hgts OH 44106

SLP

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)


ASIST MEDICAL INTERPRETING AND TRANSLATION INC

4891 SAWMILL RD STE 210

COLUMBUS OH 43235

(614) 451-2027

f:(614) 451-0442

L/SL-INTERP

AYESU-OFFEI, YAW, M.D.

COLUMBUS OH 43211

IM, ANC

BAILEY REHABILITATION SERVICES

3300 BAILEY ST NW SUITE #104

MASSILLON OH 44646

330-837-3823

f:330-837-8313

PM, ANC [email protected]

BARD, E.M., PHD

Cook Prof Bldg 1826 S Main Street

AKRON OH 44301

PSYCH



(b) (6)(b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)


BARTOW, KATHRYN, SLP

CLEVELAND OH 44131

SLP

BARTOW, KATHRYN, SLP

2221 9TH ST SW (TOTAL LIVING CENTER) CANTON OH 44706

f:

SLP

BASHIR, SHAHID, M.D.

CUYAHOGA FALLS OH 44223

f:

ANC-INTERP

BERG, NORMAN, PHD

Adams County Regional Med Center 230 Medical Center Drive

Seaman OH 45679

513-745-1040

f:513-745-4380

PSYCH

BERG, NORMAN, PHD

XAVIER HOUSE - SYCAMORE HOUSE 3818 WINDING WAY

CINCINNATI OH 45207

PSYCH

(b) (6)(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)




BILLMANN, STEPHEN PSY D

8150 Corporate Park Dr, Suite 170

Cincinnati OH 45242

Psych

BILLMANN, STEPHEN PSY D

8150 Corporate Park Dr, Suite 170

Cincinnati OH 45242

Psych

Black, Princess, PSY D

6100 Channingway Blvd. Suite 404

Columbus OH 43232

Psych

BOERGER, ALAN, PHD

TIPP CITY OH 45371

PSYCH

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)


BONDS, GIOVANNI, PHD

DAYTON OH 45405

PSYCH Scheduler



BOUSQUET, DAVID, MED

THE TOWERS BLDG 5TH FLOOR 500 MARKET ST STE 518 & 520

STEUBENVILLE OH 43952

PSYCH

BOUSQUET, DAVID, MED

CADIZ OH 43907

PSYCH

BOWLING GREEN STATE UNIV, SPEECH AND HEARING CLINIC

200 HEALTH CENTER BUILDING

BOWLING GREEN OH 43402

419-372-2516

f:419-372-8089

SLP

(b) (6)(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6)


BRADFORD, DOROTHY, M.D.

SEVERANCE MEDICAL BUILDING 5 SEVERANCE CIRCLE SUITE 815

CLEVELAND HEIGHTS OH 44118

IM, ANC Scheduler



BRIGHAM, MARK, D.O.

195 WADSWORTH RD SUITE 401

WADSWORTH OH 44281

ENT, AUDIO

Budzenksi, Carol A. PHD

Stryker OH 43557

Psych

CANNON, PATRICIA, M.D.

CHILD CARE CONSULTANTS INC. 111 INAH AVE

COLUMBUS OH 43228

614-878-6415

f:(614) 878-7946

PED cccimanager@cccipediatrics .com

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)


CANTON OPTHALMOLOGY ASSOCIATES

2600 W TUSCARAWAS SUITE 200

CANTON OH 44708

330-456-0047

f:330-456-9308

OPTH [email protected] Scheduler

CARDIOLOGY ASSOCIATES OF CINCINNATI

GSH PULMONARY SVC (ATTN: 375 DIXMYTH RD

CINCINNATI OH 45220

513-862-2412

f:513-862-2952

INTERP



CE PROVIDER SERVICES

5850 Ridge Rd #200

PARMA OH 44129

(877) 534-5153

f:(877) 258-2461

IM, PED, ANC ceproviderservices@yahoo. com


260 Niles Cortland RD NE

WARREN OH 44484

(877) 534-5153

f:(877) 258-2461

IM,Ped ceproviderservices@yahoo. com

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)



Edgerton Family Chiropractic 113 W Lynn St

Edgerton OH 43517

(877) 534-5153

f:(877) 258-2461

IM, PED ceproviderservices@yahoo. com

Scheduler


SIMPSON CHIROPRATIC 981 ASHLAND RD

Mansfield OH 44905

(877) 534-5153

f:(877) 258-2461

IM, PED


4190 HOLIDAY ST NEW, PRESTON CHIROPRACTIC CANTON OH 44718

(877) 534-5153

f:(877) 253-1198

IM, PE, ORTHO CEPROVIDERSERVICES@ HOTMAIL.COM



CHIARELLA, DAVID, PHD

1950 NILES-COURTLAND RD NE ST RT 46 STE 6

WARREN OH 44484

PSYCH

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)


CHIARELLA, DAVID, PHD

LIBERTY PLACE 3200 Belmont (2nd Floor)

YOUNGSTOWN OH 44505

PSYCH Scheduler

CHILD & FAMILY PSYCH ASSOCIATES

822 PORTAGE TRAIL


330-923-9344

f:(866) 248-1103

PSYCH

CHILD & FAMILY PSYCHOLOGICAL ASSOCIATES

822 PORTAGE TRAIL


(330) 923-9344

f:

PSYCH

CHUCK, JORETHIA PHD

Cleveland OH 44103

Psych



(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)


CIARRONE, JOHN, SLP

Wakeman Community Library 33 Pleasant Street

Wakeman OH 44889

SLP Scheduler

CIESLAK, BERNADETTE SLP

HAMILTON LANE LIBRARY - 300 N. THIRD STREET HAMILTON OH 45011

SLP

CLEVELAND CLINIC FOUNDATION

WESTLAKE MEDICAL CAMPUS, 850 COLUMBIA RD., SUITE 100 WESTLAKE OH 44145

(440) 250-5744

f:(440) 250-5755

ENT, AUDIO

CLINIC MEDICAL SERVICES CO

PO BOX 92237

CLEVELAND OH 44193 f:

ANC-INTERP

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)


COLUMBUS RADIOLGY

P O BOX 714150

CINCINNATI OH 45271-4150 f:

ANC-INTERP Scheduler



COMMUNITY SERVICES FOR THE DEAF

CLEVELAND HEARING & SPEECH CTR 11635 EUCLID AVE

CLEVELAND OH 44106

(216) 231-8787

f:(216) 795-2135

SL-INTERP

COMMUNITY SERVICES FOR THE DEAF

212 E EXCHANGE ST

AKRON OH 44304

(330) 376-9494

f:

SL-INTERP

COMMUNITY SPEECH SERVICES

4700 MASSILLON RD.

GREEN OH 44232

330-896-9119

f:330-896-1185

SLP [email protected]

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)


CONSULTING PSYCHOLOGY INC

3250 W MARKET ST STE 106

FAIRLAWN OH 44333

330-873-9516

f:(330) 864-8678

PSYCH [email protected] Scheduler

Cooper, Marsha D. MD

Sandusky OH 44870

IM, CD



COOPERRIDER, JON

Mansfield OH 44906

OPTH

CORBUS JOHNSON CONSULTING LLC

580 S HIGH ST STE 250

COLUMBUS OH 43215

(614) 349-8014

f:(614) 221-8912

PSYCH

(b) (6)(b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6)


DALLARA, ROBERT, PHD

550 E ROBINSON AVE SUITE #8 BARBERTON OH 44203

PSYCH Scheduler

DAVIS, RICHARD, M.A.

14805 DETROIT RD STE #450

LAKEWOOD OH 44107

PSYCH

DEAF SERVICES CENTER INC

5830 NORTH HIGH STREET

WORTHINGTON OH 43085

(614) 841-1991

f:(614) 841-4909

SL-INTERP



Deaf Services CenterPortsmouth

1835 OAKLAND AVE (PIXLEY BLDG)

PORTSMOUTH

OH 45662

(740) 356-7200

f:(740) 356-6110

SL-INTERP

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)


DEARDORFF, PAUL PHD (FORPSYCH)

FINDLAY OH 45840

(800) 239-8886

f:(513) 569-5933



GALLIPOLIS OH 45631

(800) 239-8886

f:(513) 871-7281

Psych [email protected]


Peebles OH 45660

(800) 239-8886

f:(513) 871-7281



NEW PHILADELPHIA OH 44633

(800) 239-8886

f:(513) 871-7281

PSYCH [email protected]



(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


DEARDORFF, PAUL, PHD (FORPSYCH)

SIDNEY

OH 45365

(800) 239-8886

f:(513) 871-7281

PSYCH

Scheduler


15711 MADISON AVE STE 102

LAKEWOOD OH 44107 f:(513) 871-7281

PSYCH


200 PUTNAM ST STE 522

MARIETTA OH 45750

800-239-8886

f:(513) 871-7281

PSYCH


PORTSMOUTH OH 45662

(800) 239-8886

f:(513) 871-7281

PSYCH

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)



VANDALIA OH 45377

f:(513) 871-7281





LIMA OH 45805

(800) 239-8886

f:(513) 871-7281

PSYCH


731 E MAIN ST UNIT 16

JACKSON OH 45640

(800) 239-8886

f:(513) 871-7281



COSHOCTON COUNTY JOB AND FAMILY SERVICES

COSCHOCTON OH 43812

(800) 239-8886

f:(513) 871-7285

PSYCH

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)



THE WESTGATE BUILDING, 3450 W. CENTRAL AVE., STE 334

TOLEDO OH 43606

(800) 239-8886

f:(513) 871-7281

Psych Scheduler


MILFORD

OH 45150

PSYCH




CINCINNATI OH 45208

f:513-871-7281

PSYCH

DEARDORFF, PAUL, PHD, (FORPSYCH)

PAULDING OH 45879

(800) 239-8886

f:513-871-7281

PSYCH

(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)


DEARDORFF, PAUL, PSYD (FORPSYCH)

1159 LYONS RD BLG E

CENTERVILLE OH 45459

f:

PSYCH Scheduler

DeCola, Louis PHD

355 West Prospect Rd. Suite 116C

Ashtabula OH 44004

Psych

Doyle, Andria PH.D.

Findlay OH 45840

Psych



DR PEDERZOLLI & BRINE MDS

.

SALEM OH 44460

330-332-9991

f:330-332-2188

OPTH

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)


DRANKWALTER, TIMOTHY, D.O.

GAHANNA OH 43230

ENT, ANC

DUBEY, SUDHIR, PSYD

COLUMBUS OH 43220

f:

PSYCH

DUBEY, SUDHIR, PSYD

MARION OH 43302

PSYCH

DUNN, RYAN, PHD

DOVER OH 44622

PSYCH newlifecounseling@roadrun

ner.com



(b) (6)(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)


EAST OHIO REGIONAL HOSPITAL

90 N FOURTH ST

MARTINS FERRY OH 43935

(740) 633-4444

f:(740) 633-4124

ANC Scheduler


VASCULAR LAB 90 N FOURTH ST


740-633-4444

f:

ANC


RADIOLOGY DEPT 90 N FOURTH ST


740-633-4444

f:

ANC, FAC

EASTER SEALS

3930 FULTON DR NW SUITE 107

CANTON OH 44718

330-494-3642

f:330-494-4538

SLP

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)


EASTER SEALS OF NORTHEAST OHIO

3085 W MARKET ST SUITE 124

AKRON OH 44333

330-836-9741

f:(330) 836-4967

SLP Scheduler




1929 A EAST ROYALTON RD

BROADVIEW HGTS OH 44147

440-838-0990

f:440-838-8440

SLP


14701 DETROIT AVE SUITE #470

LAKEWOOD OH 44107

216-228-5170

f:216-228-1018

SLP

EASTER SEALS OF NORTHERN OHIO

4841 Monroe St Ste 201

TOLEDO OH 43623

(419) 535-5750

f:(419) 535-5780

SLP

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)



101 S STONE ST

FREMONT OH 43420

419-332-3016

f:419-332-3048

SLP Scheduler


2173 N. RIDGE RD SUITE G

LORAIN OH 44055

440-324-6600

f:440-324-6602

SLP



EDWARDS, KEVIN, PHD

Thornville OH 43076

f:

psych

ELTINA DAVIS SLP

2000 AUBURN DR ONE CHAGRIN HIGHLANDS SUITE 200

BEACHWOOD OH 44122

f:

SLP

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)


ELTINA DAVIS SLP

ST. CLAIRSVILLE OH 43950

f:

SLP

ELTINA DAVIS SLP

ATHENS

OH 45701

f:

SLP

ENT PHYSICIANS, INC

3829 WOODLEY RD BLDG B

TOLEDO OH 43606

419-474-9324

f:419-474-9345

ENT, ANC



EVANS, MICHELE, PHD

4937 WEST BROAD STREET STE 205

COLUMBUS OH 43228

f:

PSYCH

(b) (6)(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)


EVANS, THOMAS, PHD

MILAN OH 44846

PSYCH Scheduler

EYE CARE ASSOCIATES

1075 WEST WESTERN RESERVE RD POLAND OH 44514

330-746-7691

f:330-743-8322

OPTH

EYE SITE OF LIMA

1034 W MARKET ST

LIMA OH 45805

(419) 228-8116 f:(419) 228-1160

OPTH

FAMILY SERVICES ASSOCIATION

2211 Arbor Blvd

DAYTON OH 45439

(937) 640-8032

f:(937) 640-8036

SL-INTERP



(b) (6)(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


FARRELL, MICHAEL, PHD

375 GLENSPRINGS DR SUITE #300

CINCINNATI OH 45246

PSYCH

Scheduler

FAUST PSYCHOLOGICAL SERVICES

MICHAEL FAUST, PHD LUTHERAN HOSPITAL 1730 W. 25TH ST CLEVELAND OH 44113

216-363-2386

f:(216) 696-7488

PSYCH

FILE, MARY, M.D.

ST THOMAS PROF CTR 444 N MAIN ST STE 423

AKRON OH 44310

OPTH

FIRELANDS REGIONAL MEDICAL CENTER

1111 HAYES AVE

SANDUSKY OH 44870

800-342-1177

f:419-557-7039

ANC

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


Flexman-Myers Clinic

WEST PAVILLION 1ST FLOOR SUITE C 1 ELIZABETH PLACE DAYTON OH 45301

937-256-5300

f:937-258-4162

PSYCH [email protected] m

Scheduler



FORENSIC PSYCH CENTER

70 W ERIE ST

PAINESVILLE OH 44077

(440) 721-4994

f:(888) 752-8808

PSYCH

FORENSIC PSYCH CENTER

4822 MARKET STREET

BOARDMAN OH 44512

(330) 259-8822

f:(888) 752-8808

PSYCH

FORPSYCH

953 S SOUTH STREET WILMINGTON OH 45177

800-239-8886 f:513-871-7281

PSYCH

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


Forpsych

30 Custer Rd

Heath OH 43056

(800) 239-8886 f:(513) 871-7281


FORPSYCH

2882 WHIPPLE AVE NW

CANTON OH 44708

(800) 239-8886 f:(513) 871-7281




FORT HAMILTON HOSPITAL

630 EATON AVE

HAMILTON OH 45013

(513) 867-2263

f:

ANC

FORT HAMILTON HOSPITAL

X-RAY DEPT 630 EATON AVE

HAMILTON OH 45013

(513) 867-2263

f:(513) 867-2414

ANC

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)


GENESIS HEALTHCARE

GOVT BILLER PATIENT ACCTS. RADIOLOGY 2951 N MAPLE AVE

ZANESVILLE OH 43701

740-454-4301

f:(740) 454-4326

ANC Scheduler

GENESIS HEALTHCARE, (BETHESDA)

PHYSICIANS PAVILION 945 BETHESDA DR

ZANESVILLE OH 43701

(740) 454-4242

f:(740) 454-4326

ANC

GENESIS HEALTHCARE, (BETHESDA)

PHYSICIANS PAVILION RESPIRATORY DEPT. 945 BETHESEDA DRIVE

ZANESVILLE OH 43701

740-454-4242

f:(740) 454-4326

ANC



(b) (6)(b) (6)

(b) (6)

(b) (6)


GERMAINE LANGUAGE CENTER INC

4300 OLD SALEM RD

ENGLEWOOD OH 45322

(937) 836-8451

f:(937) 832-4567

L-INTERP Scheduler

GLENWAY TRIHEALTH / GOOD SAMARITAN HOSPITAL

TRI HEALTH MEDICAL CENTER 6350 GLENWAY AVE STE #101

CINCINNATI OH 45211

513-862-2412

f:513-862-2952

ANC

GOOD SAMARITAN HOSPITAL

375 DIXMYTH RD

CINCINNATI OH 45220

513-862-2412

f:513-862-2952

IM, CD, ANC

GOOD-SISSON, TRACI, SLP

CHILLICOTHE OH 45601

SLP

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)


GRODNER, HERBERT M.D.

WESTERVILLE OH 43081

IM, CD, ANC Scheduler



GRODNER, HERBERT M.D.


ANC

GRONECK, TAYLOR, PSYD

WILIMINGTON OH 45177

PSYCH

GRUENFELD, KENNETH, PSYD

5500 MARKET STREET STE #90

YOUNGSTOWN OH 44512

PSYCH

(b) (6)(b) (6)

(b) (6) (b) (6)(b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)


HAAGA, JENNIFER, PSYD

106 E MARKET STREET SUITE 605

WARREN OH 44481

Psych Scheduler

Halmi, Stephen, PSY D

1303 Lyons Rd. Building H

Dayton OH 45458

Psych



HARRIS, GORDON, PHD

DAYTON OH 45415

PSYCH

HEALTHLINK OCCUPATIONAL HLTH SVCS

710 CLEVELAND AVE

Fremont OH 43420

(419) 333-6411

f:(419) 333-6438

IM/PM/ORTHO

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6)


HEARING / SPEECH & DEAF CENTER OF CINCINNATI

2825 BURNET AVE Suite 304

CINCINNATI OH 45219

(513) 221-1703

f:513-221-5505

SL-Interp Scheduler

HESS, ROBERT, M.D.


-0566 f:614-895-7123

NE, ORTHO

HOLZER MEDICAL CENTER

TRACI GOOD, SLP 100 JACKSON PIKE

GALLIPOLIS OH 45631

740-446-5121

f:(740) 441-3335

SLP



HUNT, AILEEN, SLP

The Westgate Bldg 3450 W Central Ave Ste 334

TOLEDO OH 43606

SLP

(b) (6)(b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)


ICKES, CURTIS, PHD

1060 CLAREMONT AVE #6 ASHLAND OH 44805

f:

PSYCH

IEMMA, JOSEPH, M.D.

ATTN: DR. DUNCAN 96 GRAHAM RD SUITE B


IM, CD, ANC

IMA, PC

DEACONESS PROFESSIONAL BUILDING 4269 PEARL RD. SUITE 102

CLEVELAND OH 44109

(216) 661-1687

f:

IM, PED, PM, ANC

IMA, PC

26 Nesbitt Rd. Suite 154 New Castle PA 16105

(724) 698-7310 f:

PSYCH



(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


IMA, PC

4269 Pearl Rd. Ste 102

Cleveland OH 44109

f: PSYCH

INTERNATIONAL INSTITUTE

207 E TALLMADGE AVE

AKRON OH 44310

330-376-5106

f:

L-INTERP

INTERNATIONAL LANGUAGE BANK

PO BOX 19323

CONNEAUT OH 44030

440-599-9999

f:440-599-9777

L-INTERP

IOMI PATTEN SLP

MARYSVILLE OH 43040

f:

SLP

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)


IRONTON PSYCHOLOGICAL SERVICES

M & G TRIPLETT LLC 401 CENTER ST STE B

IRONTON

OH 45638

(513) 404-7202

f:

FAC

Scheduler



JAMES, LARRY PHD

70 BIRCH ALLEY SUITE 240

BEAVERCREEK OH 45440

PSYCH

Janco-Gidley, PhD

1701 Mentor Ave., Ste. 10

Painesville OH 44077

f:

Psych

Jennifer Ujcich SLP

Columbus Metropolitan Library Shepard Branch 850 N. Nelson Rd.

Columbus OH 43219

SLP

(b) (6)(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)


JOHNSON CORBUS CONSULTING LLC


COLUMBUS OH 43215

(614) 349-8014

f:(614) 221-8912

PSYCH

Scheduler

JONES, MARY, PHD

4134 LINDEN AVE. STE. 200

DAYTON OH 45432

PSYCH



JOSELL, PAUL, PSYD

5564 WILSON MILLS RD SUITE #201

HIGHLAND HGTS OH 44143

PSYCH

KELLY, JAMES BRUCE, M.ED

134 WEST SOUTH BOUNDARY STE R PERRYSBURG OH 43551

PSYCH

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)


KENFORD, SUSAN, PHD

XAVIER UNIV. SYCAMORE HOUSE 3818 WINDING WAY

CINCINNATI OH 45207

PSYCH Scheduler

KENNINGTON, ROHN TYSEN, M.D.

2100 EMMANUEL WAY SUITE A

SPRINGFIELD OH 45502

IM, OR, PM, NEURO

KESSLER, WILLIAM, M.D.

2600 FAR HILLS AVE SUITE #15

DAYTON OH 45419

OPTH



KETTERING NETWORK RADIOLOGISTS

7901 SCHATZ

DAYTON OH 45459

(937) 439-0390

f:(937) 439-4082

ANC-INTERP

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)


KIRSTEIN & ASSOC, INC

Grande Central Station, 4600 Smith Rd C-10

Norwood OH 45212

(513) 631-8889

f:(513) 631-8891

Opth Scheduler

KONIECZNY, J. JOSEPH, PHD

8166 MARKET STREET SUITE M

BOARDMAN OH 44512

f:

PSYCH

KONIECZNY, JOESPH, PHD

23811 CHAGRIN BLVD CHAGRIN PLAZA E STE LL70

BEACHWOOD OH 44122

f:

PSYCH

KONIECZNY, JOESPH, PHD

605 S TRIMBLE RD STE D

MANSFIELD OH 44906

f:

PSYCH



(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)


Kopey, Stephanie A.

Warren OH 44484

IM, PM

Scheduler

KORICKE, DEBORAH, PHD

21403 CHAGRIN BLVD. STE. 104 BEACHWOOD OH 44122

PSYCH

KORICKE, DEBORAH, PHD

20800 WESTGATE MALL STE 200

FAIRVIEW PARK OH 44126

PSYCH

KOSE, ROBERT, M.D.

MAUMEE OH 43537

ANC-INTERP

KRASNYANSKY, MD, INNA

24755 CHAGRIN BLVD SUITE #320

BEACHWOOD OH 44122

CD, IM, ANC

(b) (6)(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)




KRUPADEV, H.L. M.D.

MARIETTA OH 45750

IM, CD, ANC

KRUSZEWSKI, LYNN, SLP

3450 W Central Ave. Ste 334

TOLEDO OH 43606

SLP

KURZHALS, ROBERT PHD

23986 STATE LINE RD SUITE 102

BRIGHT IN 47025

PSYCH

LAKHANI, PRABHUDAS, M.D.

1255 BOARDMAN-CANFIELD RD SUITE 100

YOUNGSTOWN OH 44512

IM, ANC

(b) (6)(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)


LANGUAGE BANK

3740 Glenway Ave.

CINCINNATI OH 45205

513-354-5702 f:513-345-8559

L-INTERP Scheduler



LE, CHUC P., M.D.

BETHESDA CARE NORWOOD 4592 MONTGOMERY RD

NORWOOD OH 45212

513-731-3399

f:(513) 852-3116

ORTHO, PM, ANC

LEE HOWARD, INC

580 S HIGH ST STE 100 COLUMBUS OH 43215

(614) 444-0961 f:(614) 444-0962

PSYCH

LEE HOWARD, INC


COLUMBUS OH 43215

(614) 444-0961 f:(614) 444-0962

PSYCH

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


LEE HOWARD, INC

601 UNDERWOOD STREET ZANESVILLE OH 43701

(614) 444-0961 f:(614) 444-0962

PSYCH

LEE HOWARD, INC


COLUMBUS OH 43215

(614) 444-0961 f:(614) 444-0962

PSYCH



LESTER, GEORGE, PSYD

800 COMPTON RD SUITE #1

CINCINNATI OH 45231

PSYCH

LIANG, JAMES, M.D.

5500 RIDGE RD SUITE #220 PARMA OH 44129

PED, ANC

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


LIBERTY MEDICAL ASSESSMENTS

CHIROPRACTIC CONCEPTS 5395 N ABBE RD

ELYRIA OH 44035

(502) 451-6085

f:(877) 551-4548

IM, PM, ANC Scheduler

LIBERTY MEDICAL ASSESSMENTS

GALLIPOLIS CHIROPRACTIC CENTER 990 SECOND AVE

GALLIPOLIS OH 45631

(502) 451-6085

f:(877) 551-4548

IM, PM, ANC

LIBERTY MEDICAL ASSOCIATES (LMA)

168 WEST MAIN ST

WILMINGTON OH 45177

(502) 451-6085

f:(877) 551-4548

IM, PM, ANC



LIMA RADIOLOGICAL ASSOCIATES

P O BOX 5128

LIMA OH 45802

(866) 876-5561

f:

ANC-INTERP

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


Malcolm, Bruce E. Psy D

Dover OH 44622

Psych

Scheduler

MARIETTA MEMORIAL HOSPITAL

401 MATTHEW ST

MARIETTA OH 45750

740-568-5397

f:

ANC

MARIETTA MEMORIAL HOSPITAL

401 MATTHEW ST

MARIETTA OH 45750

740-374-1434

f:(740) 374-1480

ANC



MARION ANCILLARY SERVICES

LLC 1040 DELAWARE AVE PO BOX 1827

MARION OH 43301

f:

ANC

(b) (6)(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)


MARION ANCILLARY SERVICES

LLC 1040 DELAWARE AVE

MARION OH 43301

(740) 383-7092

f:(740) 383-7942

ANC Scheduler

MCCABE, PAULA,

HUBBARD OH 44425

f:

FAC

MCCABE, PAULA,

GIRARD OH 44420

SLP

MCINTIRE, DONALD, PHD

125 EXECUTIVE DR, SUITE 201

MARION OH 43302

PSYCH



(b) (6)(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)


MED & OCCUPATIONAL HEALTH

1010 SUMMIT DRIVE

MIDDLETOWN OH 45042

513-727-0827

f:513-621-1060

IM, CD, ORTHO, ANC

Scheduler


2825 BURNET AVE, SUITE 304

CINCINNATI OH 45219

513-621-4202

f:513-621-1060

IM, CD, ANC


FOLKE BLOCK BLDG 4TH FLOOR 14 S PAINT ST


740-774-3640

f:513-621-1060

IM, CD, ORTHO, ANC


806 SIXTH STREET

PORTSMOUTH OH 45662

740-354-6928

f:513-621-1060

IM, CD, ORTHO, ANC

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)





Ackerman Medical Bldg 3080 Ackerman Blvd Ste 310

Kettering OH 45429

(513) 405-9180

f:(513) 621-1060

IM, ORTHO, CARDIO,

ANCILLARY

Scheduler

MEDICAL EVALUATION SERVICES

3400 N HIGH STREET, 3RD FLOOR, SUITE 340

COLUMBUS OH 43202

614-261-9723

f:614-261-7243

NE


83 N MILLER RD

AKRON OH 44333

330-836-0258

f:330-836-2025

IM, CD, ANC


83 N MILLER RD

AKRON OH 44333

(330) 836-0258

f:(330) 836-2025

Ortho, PM, ANC

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)





3400 N. HIGH ST 3RD FLOOR

COLUMBUS OH 43202

(614) 261-9723

f:(614) 261-7243

PEDS, ANC Scheduler


3400 N. HIGH STREET 3RD FLOOR

COLUMBUS OH 43202

f:

Ortho, ANC


3400 N HIGH ST 3RD FLOOR

COLUMBUS OH 43202

(614) 261-9723

f:(614) 261-7243

IM, ANC

MEDICAL X-RAY INC

375 DIXMYTH AVE CINCINNATI OH 45220

513-965-8041 f:

INTERP

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


MELISSA K LANZA PHD

400 E STATE STREET ST H

ATHENS OH 45701

Psych Scheduler



Mercy Physical Medicine and Rehabilitation

5800 MONROE ST Building A

SYLVANIA OH 43560

419-885-8449

f:419-882-7621

PM, ANC

METRO HEALTH MEDICAL CENTER

2500 METRO HEALTH DR 2ND FLOOR REHABILITATION PAVILLION STE 2201

CLEVELAND OH 44109

(216) 778-4414

f:(216) 778-7767

PM, ANC

MIDWEST EXAMS INC

420 CAROLINE RD

YOUNGSTOWN OH 44501

440-333-5000

f:440-333-1856

SLP

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


MIDWEST EXAMS INC

1932 Niles Courtland Rd NE

WARREN OH 44484

440-333-5000

f:440-333-1856

SLP Scheduler

MILLER, MARC, PHD

NEWARK OH 43055

PSYCH



MILLER, MARC, PHD

LANCASTER OH 43130

PSYCH

MILLER, NANCY, PHD, SLP

MONTGOMERY SPEECH CLINIC, 10768 MONTGOMERY ROAD

CINCINNATI OH 45242

513-469-0971

f:513-469-1254

SLP montgomeryspeechclinic@f use.net

(b) (6)(b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)


MORELLI-NEDDY, AIMEE, SLP

Tri-County Rehabilitation 567 E Main St.

Canfield OH 44406

(330) 533-1080

f:

SLP Scheduler

MORSE, WAYNE, PHD

1604 E PERKINS AVE. SUITE 201

SANDUSKY OH 44870

PSYCH

MYERS, KATHERINE, PSYD

1502 UNIVERSITY BLVD, SUITE D

HAMILTON OH 45011

PSYCH




1502 UNIVERSITY BLVD.,SUITE D HAMILTON OH 45011

f:

PSYCH

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)



1502 UNIVERSITY BLVD., SUITE D HAMILTON OH 45011

PSYCH

Scheduler


1502 UNIVERSITY BLVD, SUITE D

HAMILTON

OH 45011

f:

PSYCH


1502 UNIVERSITY BLVD. SUITE D

HAMILTON OH 45011

PSYCH

Nadkarni, Radha B. PH.D.

2529 Oakstone Dr. Suite B

Columbus OH 43231

Psych integratedchildcenter@gma il.com



(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)


NELSON MA, KATHLEEN

3450 W CENTRAL AVE THE WESTGATE BLDG

TOLEDO OH 463606

SLP Scheduler

NELSON, MICHAEL, PHD

XAVIER UNIV-SYCAMORE HOUSE, 3818 WINDING WAY CINCINNATI OH 45207

PSYCH

NORTH COAST FAMILY FOUNDATION

6929 W. 130TH ST, SUITE #500

PARMA HEIGHTS OH 44130

PSYCH

NORTHWEST EYE SURGEONS

NORTHWEST EYE SURGEONS INC, 2250 NORTH BANK DRIVE

COLUMBUS OH 43220

614-451-7550

f:614-451-8642

OPTH

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)


OAKLEY, MAURICE, M.D. PSC

ASHLAND KY 41101

OPTH Scheduler



OCCHA

3660 SHIRELY RD YOUNGSTOWN OH 44502

(330) 781-1808 f:(330) 781-0885

L-INTERP

O'Connell, Haley PSY D

1303 Lyons Rd. Building H

Beavercreek OH 45458

Psych

OHIO MYOFASCIAL SPECIALISTS INC

840 BETHESDA DR BLDG #3 B

ZANESVILLE OH 43701

800-917-9085

f:(888) 269-4948

IM, CD, ANC

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)


OHIO MYOFASCIAL SPECIALISTS INC

716 WEST MARKET ST

TIFFIN OH 44883

800-917-9085

f:

IM, CD, ANC

Scheduler

OLYMPUS HEALTH

5810 Pearl Rd.

Parma OH 44130

(800) 860-3144 f:(800) 860-3144

IM PM ORTHO



OLYMPUS HEALTH

743 S. Byrne Rd

Toledo OH 43609

(419) 704-0061

f:

IM, OR, PM

OLYMPUS HEALTH

1036 Mt. Vernon Ave.

Marion OH 43302

(740) 389-5151

f:

IM, OR, PM

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


OLYMPUS HEALTH

773 South Broadway

Geneva OH 44041

(800) 860-3144 f:(800) 860-3144

IM, OR, PM

Scheduler

ONAMUSI, BABATUNDE

FREEDOM CHIROPRACTIC 420 W RUSSELL RD

SIDNEY OH 45365

(419) 222-9410

f:(419) 222-6175

IM, PED, CD [email protected]

Onamusi, Babatunde

Lima OH 45805

(419) 222-9410

f:(419) 222-6175

IM, CD, Ortho, PED

[email protected]



ONAMUSI, BABATUNDE MD

Teeters Chiropractic 1353 Woodman Dr.

Dayton OH 45432

(419) 222-9410

f:(419) 222-6175

IM, CARDIO, ORTHO, PEDS.

PHYS MED

[email protected]

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


ONAMUSI, BABTUNDE, M.D.

DEFIANCE OH 43512

(419) 785-4274

f:(419) 222-6175

CD, IM, ORTHO, PED, ANC

[email protected] Scheduler

OSU East

181 Taylor Ave

Columbus OH 43203

(614) 257-2138

f:(614) 366-9595

Anc

OSU Internal Medicine LLC

700 Ackerman Rd Suite 270

Columbus OH 43202

(614) 685-2772

f:(614) 685-5789

INTERP

OZA & OZA

1100 S MAIN ST. SUITE 203

DAYTON OH 45409

937-222-3544 f:937-222-7122

IM, ANC [email protected]



(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


PAWLOSKI, BRITHANY, PSYD

4930 N HOLLAND SYLVANIA RD STE B

SYLVANIA OH 43560

Psych Scheduler

PEDIATRIC OPTHAMOLOGY ASSOCIATES

555 S. 18th St; Suite 4C

Columbus OH 43205

(614) 241-5992

f:(614) 241-5232

OPTH

PEMA, ROBERT, D.O.

TOTAL CARE ENT 4488 W. BROAD ST.

COLUMBUS OH 43228

(614) 853-1950

f:(614) 853-1951

ENT [email protected]

PERRY, JOSEPH, PHD

COOK PROF BLDG 1826 S MAIN ST

AKRON OH 44301

PSYCH

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)


PICKHOLTZ, HERSCHEL, ED.D

24100 CHAGRIN BLVD. SUITE 120 BEACHWOOD OH 44122

PSYCH Scheduler



PLONA, RANDY DO

Orrville OH 44667

IM, PM, ANC

POWERS, JAMES, M.D.

340 E. TOWN ST. STE 700 (8TH FLOOR)

COLUMBUS OH 43215

PM, ANC

PRECISION RADIOLOGY

PO BOX 74289

CLEVELAND OH 44194

866-439-9184

f:

INTERP

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)


PRO MEDICAL MIDWEST, LLC

8401 CLAUDE THOMAS RD #27 FRANKLIN OH 45005

(419) 297-6766

f:(937) 806-3079

ENT-Danielle Gorsky

Scheduler


120 Sturges Ave. Suite # 5

Mansfield OH 44907

(419) 297-6766

f:(937) 806-3079

IM




68 W. Church St. Suite 104

Newark OH 43055

(419) 297-6766

f:(937) 640-1452

IM

PROFESSIONAL RADIOLOGY INC

FORT HAMILTON HOSPITAL 1010 CEREAL AVE #311

HAMILTON OH 45011

(614) 513-8724

f:(513) 867-2840

INTERP

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


PROVAZNIK, DAVID, D.O.

WHEELERSBURG OH 45694

IM, PED, CD, ANC

Scheduler

PULMONARY PHYSICIANS

2600 W TUSCARAWAS RD STE 100

CANTON OH 44708

330-452-8844

f:330-452-7012

ANC [email protected] om

QUEST DIAGNOSTICS

7451 W RIDGEWOOD DR

PARMA OH 44129

440-842-8122

f:440-842-4789

ANC



QUINN, RUTH, SLP

10133 SPRINGFIELD PIKE STE D CINCINNATI OH 45215

SLP

(b) (6)(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)


RADIOLOGY ASSOCIATES OF SEO

P O BOX 250

ZANESVILLE OH 43702

(740) 452-9087

f:


RAINBOW COUNSELING

414 E FIFTH ST

E LIVERPOOL OH 43920

330-386-3844

f:330-386-4129

PSYCH info@rainbowcounselingce nter.com

Rainbow Counseling Ctr Inc

380 Summit Ave. Suite 202

Steubenville OH 43952

(330) 386-3844

f:(330) 386-4129

Psych info@rainbowcounselingce nter.com

RAITER, KRISTIN, SLP

MARYSVILLE OH 43040

SLP



(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)


RAMACHANDRAN, VIDHYA MD

CANTON OH 44720

PED canton.pediatrics@hotmail. com

Scheduler

RAY, GARY, M.D.

FORT HAMILTON HOSPITAL 1010 CEREAL AVE #311

HAMILTON OH 45013

513-867-2730

f:513-867-2840

PM, ANC

REECE, JOHN, PSYD

1110 MORSE RD STE 218

COLUMBUS OH 43229

PSYCH

REECE, JOHN, PSYD

NEWARK OH 43055

PSYCH

REECE, JOHN, PSYD

LANCASTER OH 43130

PSYCH

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)




RESOLUTE INTERPRETING, LLC

PO BOX 532

TOLEDO OH 43697

(419) 244-8377

f:(419) 534-9828

SL-INTERP, L- INTERP

RINDSBERG, JEFF, PSYD

25200 CHAGRIN BLVD SUITE 105

BEACHWOOD OH 44122

PSYCH

RIVERSIDE RADIOLOGY & INTERVENTIONAL ASSOCS

3525 Olentangy River Rd.

Columbus OH 43214

(614) 340-7747

f:(614) 340-7742

ANC-INTERP

Robert Pema, DO

OSUP OTALARYNOLOGY CAREPOINT EAST 543 Taylor Ave.; 2nd Floor

Columbus OH 43203

(614) 853-1950

f:(614) 853-1951

ENT

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


ROBIE, KAREN PHD

4930 N HOLLAND-SYLVANIA RD STE B

SYLVANIA OH 43560

PSYCH

Scheduler



ROSENTHAL, JAMES PSY D

WILDWOOD OFFICE PARK 1006 N UNIVERSITY BLVD

MIDDLETOWN OH 45042

PSYCH

SAGHAFI, DARIUSH, M.D.

6681 RIDGE RD SUITE 300

PARMA OH 44129

IM, NEURO,

SARVER, GARY, PHD

ATHENS OH 45701

PSYCH

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)


SCHMIDTGOESSLIN G, NANCY, PHD

CINCINNATI OH 45238

PSYCH Scheduler

SCHULZ, GEORGE, PHD

2100 East High St. Suite 110 (Governor's Manor)


PSYCH



SCIOTO CAMPUS

PORTSMOUTH OH 45662

f:

ANC

SCIOTO CAMPUS

PORTSMOUTH OH 45662

ANC

(b) (6)(b) (6)

(b) (6) (b) (6)(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)


SCIOTO CAMPUS

PORTSMOUTH OH 45662

f:

ANC

SCIOTO CAMPUS

PORTSMOUTH OH 45662

ANC

SCIOTO PAINT VALLY MHC

4449 SR 159 PO BOX 6179


FAC



SED, CHAD PHD

Portsmouth OH 45662

PSYCH OR

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)


Sed, Chad, PhD

Chillicothe OH 45601

Psych

Scheduler

SELLA, GABRIEL, M.D.

92 N FOURTH ST STE 12


IM, CD, ANC

SEXTON, RICHARD PH D

CINCINNATI

OH 45208

f:

Psych

SEXTON, RICHARD PH D

1159 LYONS RD BLDG E

CENTERVILLE OH 45458

f:

Psych



(b) (6)(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)


SEXTON, RICHARD PHD

401 CENTER ST STE B

401 CENTER ST STE B

IRONTON OH 45638

f:

PSYCH

Scheduler

SIOSON, EULOGIO, M.D.

4200 WARRENSVILLE CTR RD, OHIO UNIVERSITY-MEDICAL BLDG STE 320

WARRENSVILLE HGTS OH 44122

IM, CD, ANC

SIPPS, GARY, PHD

71 WEST AVE STE 3

TALLMADGE OH 44278

PSYCH

SMITH, MARGARET, PHD

6100 CHANNINGWAY BLVD STE 506

COLUMBUS OH 43232

PSYCH

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)


SMITH, RONALD, PHD

5321 MEADOW LN CT #5

ELYRIA OH 44035

PSYCH Scheduler



SOURS, FLOYD, M.A.

ZANESVILLE OH 43701

PSYCH

SOUTH POINTE HOSPITAL

DR SIOSON, S. POINTE BLDG A #320, 4200 WARRENSVILLE CTR RD

WARRENSVILLE HGTS OH 44112

f:

ANC

SOUTH POINTE HOSPITAL

4180 WARRENSVILLE CENTER RD

WARRENSVILLE HGTS OH 44122 f:

ANC

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6)


SOUTHERN OHIO RADIOLOGIST

PO BOX 643933

COLUMBUS OH 45624

(740) 356-7547

f:(740) 356-6170


Spader, Michelle PSY D

6260 S. Sunbury Rd. Suite 5

Westerville OH 43081

Psych contact@spaderpsychology. com



SPANISH AMERICAN COMMITTEE

4407 LORAIN AVE

CLEVELAND OH 44113

216-961-2100

f:216-961-3305

L-Interp

Sparks Psychological Services

3951 W. Franklin St. #4

Bellbrook OH 45305

(513) 297-3455

f:(513) 297-7594

Psych sparksofficemanager@gmail .com

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


SPARKS PSYCHOLOGICAL SERVICES, LLC

8118 Corporate Way Suite 121

Mason OH 45040

(513) 297-3455

f:(513) 297-7495

Psych sparksofficemanager@gmail com

Scheduler

Sparks Psychological Services, LLC

8118 Corporate Way, Suite 121

Mason OH 45040

(513) 297-3455

f:(513) 297-7594

Psych

SPINDLER, JAMES, M.S.

CAMBRIDGE OH 43725

FAC




LORAIN OH 44052

PSYCH

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)



927 WHEELING AVE STE 104

CAMBRIDGE OH 43725

PSYCH Scheduler

SPRINGFIELD REGIONAL MED CTR

100 Medical Center Dr.

Springfield OH 45504

(937) 523-1651

f:(937) 523-1080

ANC

SPRINGFIELD REGIONAL MEDICAL CENTER

100 Medical Center Dr.

Springfield OH 45504

(937) 523-1080

f:(937) 523-1959

ANC

ST LUKES HOSPITAL

PATIENT REGISTRATION 5901 MONCLOVA RD

MAUMEE OH 43537

(419) 893-5927

f:(419) 897-8444

ANC



(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)


ST RITA'S MEDICAL CENTER

730 W MARKET ST

LIMA OH 45801

(419) 226-9132

f:419-226-9657

ANC Scheduler

ST RITA'S MEDICAL CENTER

730 W MARKET ST

LIMA OH 45801

(419) 226-9132

f:

ANC

ST. LUKES HOSPITAL

5901 MONOCLOVA RD

MAUMEE OH 43537

419-893-5927 f:419-891-8018

ANC

STEINHOFF, WILLIAM, M.A.

POINT PLEASANT W 45631 V

PSYCH

STINSON, BOB, PSYD

20 S. THIRD STREET SUITE 210 COLUMBUS OH 43215

PSYCH

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6)




SUDHIR DUBEY PSY D

CENTER FOR INTEGRATED HEALTH 484 S MILLER RD STE 201

FAIRLAWN OH 44333

(614) 568-7101

f:(614) 568-7103

PSYCH Scheduler

SUDHIR DUBEY PSY D

Ontario OH 449069

Psych

SUDHIR DUBEY PSY D

2040 Brice Rd, Ste 160

Reynoldsburg OH 43068

Psych

Swearingen, T Rodney, PH D

605 S. Trimble Rd. Suite D

Mansfield OH 44906

Psych

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)


Swearingen, T Rodney, PH D

Zanesville OH 43701

Psych

Scheduler



SWEARINGEN, T RODNEY, PHD

6877 N HIGH ST STE 305

COLUMBUS OH 43085

FAC


6877 N HIGH ST STE 305

Worthington OH 43085

PSYCH


125 EXECUTIVE DR STE 201

MARION OH 43302

PSYCH

(b) (6)(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)


Swearingen, T. Rodney Ph.D.

Chillicothe OH 45601

Psych

Scheduler

Swearingen, T. Rodney, PH D

Mt. Vernon OH 43050

PSYCH



SWIFT, ADRIENNE, PHD

8080 BECKETT CTR DR STE 313

WEST CHESTER OH 45069

PSYCH

T C HOBBS & ASSOCIATES

4937 WEST BROAD ST, SUITE 302 COLUMBUS OH 43228

614-544-2301

f:

INTERP

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)


TANLEY, JAMES PHD

4041 N HIGH ST 300P COLUMBUS OH 43214

PSYCH

TANLEY, JAMES PHD


PSYCH

TANLEY, JAMES PHD

DELAWARE OH 43015

PSYCH



THE SPEECH AND LANGUAGE PATH

1120 N MEMORIAL DR

LANCASTER OH 43130

(740) 277-7882

f:(614) 522-6750

SLP thespeechlanguagepath@ya hoo.com

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)



1440 ROCKSIDE RD SUTIE 320

PARMA OH 44134

(614) 505-7330

f:(614) 522-6750


Scheduler


43 N THIRD ST

MANSFIELD OH 44902

(614) 505-7330

f:(614) 522-6750

SLP


103 LUCASVILLE-MINFORD RD

LUCASVILLE OH 45648

(614) 505-7330

f:(614) 522-6750



70 BIRCH ALLEY SUITE 240 BUILDING B

BEAVERCREEK OH 45440

(614) 556-3366

f:(614) 522-6750

SLP



(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)



7100 N. HIGH ST. SUITE 203

COLUMBUS OH 43085

(614) 505-7330

f:(614) 522-6750

FAC thespeechlanguagepath@ya hoo.com

Scheduler


650 W MARKET ST

LIMA OH 45801

(614) 505-7330

f:(614) 522-6750


THOMAS EYECARE, LTD

3619 PARK EAST DR SUITE 306

BEACHWOOD OH 44122

(216) 292-9150

f:(216) 292-9159

OPTH DRTHOMAS@THOMASE YECARE.ORG

THOMAS M EVANS, PHD

THE CENTER FOR CLINICAL PSYCHOLOGY 31674 Center Ridge Rd Ste 103

NORTH RIDGEVILLE OH 44039

(440) 263-0266

f:(440) 348-2362

PSYCH

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


THORTON, LISA, PHD

4041 N HIGH ST STE 300 I

COLUMBUS OH 43214

PSYCH Scheduler



TOGLIATTI- TRICKETT, KIMBERLY, M.D.

PARMA OH 44129

PM, ORTHO, ANC

TRI - STATE OCCUPATIONAL MEDICINE

1649 BRICE RD STE B

REYNOLDSBURG OH 43068

(800) 929-8766

f:(304) 525-0664

IM, PEDS, ANC


5510 PEARL ROAD SUITE 205

CLEVELAND OH 44129

(800) 929-8766

f:(304) 525-0664

IM, PED, ANC

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)



400 E STATE ST

ATHENS OH 45701

800-929-8766

f:304-525-0664

IM, PED, ANC Scheduler




3 ROSEMAR CIRCLE SUITE C

PARKERSBURG W 26104 V

800-929-8766

f:304-525-4231

IM, CD, NE, ORTHO, ANC


4417 N HOLLAND-SYLVANIA RD SUITE C

TOLEDO OH 43623

(800) 929-8766

f:(304) 525-4231

IM, PED, ANC

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)



FAMILY HEALTH CARE 2057 S LIMESTONE E


800-929-8766

f:304-525-0664

IM, CD, PED, ANC

Scheduler


CCMH DOCTOR'S CLINIC 1523 WALNUT STREET

COSHOCTON OH 43812

800-929-8766

f:740-623-4145

IM, PED, ANC




46141 National Rd. - Bisbocci Chiropractic

ST CLAIRSVILLE OH 43950

800-929-8766

f:304-525-0664

IM, CD, ORTHO, ANC, PEDS

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)



702 6TH AVE

HUNTINGTON

W 25701 V

(800) 929-8766

f:(304) 525-0664

IM/ORTHO

Scheduler

TRI STATE OCCUPATIONAL MEDICINE

1069 DELAWARE AVENUE (DELEX ONE BUILDING)

MARION OH 43302

(800) 929-8766

f:(304) 525-0664

IM, PEDS, PE, ANC

TRI STATE OCCUPATIONAL MEDICINE

872 OHIO PIKE

CINCINNATI OH 45245

(800) 929-8766

f:(304) 525-0664

IM, PM, ORTHO, PEDS



(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


TRI-STATE OCCUPATIONAL

51 STATE STREET

STRUTHERS OH 44471

(800) 929-8766

f:(304) 525-0664

IM, PM, ANC Scheduler

TWEHUES, JESSICA

1487 N. High St., Suite 500 HILLSBORO OH 45133

PSYCH

TWEHUES, JESSICA, PSYD

CINCINNATI OH 45255

PSYCH

TWEHUES, JESSICA, PSYD

311 NILLES RD STE A

FAIRFIELD OH 45014

PSYCH

UHC VASCULAR

GSH PULMONARY SVC (ATTN: 375 DIXMYTH RD

CINCINNATI OH 45220

513-569-5027

f:

INTERP

(b) (6)(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)(b) (6)




UJCICH, JENNIFER SLP

MARION PUBLIC LIBRARY 2ND FLOOR CONFERENCE ROOM 445 EAST CHURCH STREET

MARION OH 43302

f:

SLP Scheduler

US COMMITTEE FOR REFUGEES AND IMMIGRANTS

815 SUPERIOR AVE E STE 100

CLEVELAND OH 44114

(216) 781-4560

f:(216) 781-4565

L-INTERP

US TOGETHER

2021 E DUBLIN GRANVILLE RD., SUITE 190

COLUMBUS OH 43229

614-581-4357

f:614-737-3487

L-INTERP

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)


VALLEY RADIOLOGISTS

P O BOX 6825

WHEELING W 26003 V

(304) 233-9314

f:




VANESTENBERG, ANDREA PHD

5815 MARKET ST Suite #5

BOARDMAN OH 44512

PSYCH

VITOLS, AIVARS, D.O.

ORTHOPEDIC ASSOCS OF SW OHIO 4160 LITTLE YORK RD STE 10

DAYTON

OH 45414

(937) 415-9117

f:(937) 439-0362

ORTHO, ANC

VOCALINK

405 W 1st St Dayton OH 45402

(937) 401-1460 f:(866) 264-1163

L-INTERP

(b) (6)(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


WARREN OPHTHALMOLOGY ASSOCIATES

3921 MARKET ST

WARREN OH 44484

(330) 856-3300

f:(330) 856-4539

OPTH Scheduler

WARREN OTOLOGICAL, INC

3893 E MARKET ST

WARREN OH 44484

330-856-4000

f:330-609-9910

ENT



WATKINS, DANIEL, PHD

3450 W CENTRAL AVE STE 350

TOLEDO OH 43606

PSYCH

WAX, MITCHELL, PHD

LAKEWOOD OH 44107

PSYCH

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6) (b) (6)


Welden Medical LLC

Eastside Urgent Care 872 Ohio Pike

Cincinnati OH 45245

(513) 947-9115

f:(513) 752-6695

IM, ANC, Ortho Scheduler

Wellcare

241 N. Superior St. Ste. 301

Toledo OH 43604

(419) 214-3220 f:(859) 987-0839

IM, PM, ST

WHEELING HOSPITAL

SPEECH PATHOLOGY DEPT 1021 MT. DECHANTAL RD. #2 WHEELING W 26003 V

304-243-370

f:304-243-3901

SLP



Whitlow PhD, Natalie

HUMANISTIC COUNSELING CENTER 26250 EUCLID AVE STE 527

Euclid OH 44132

(573) 525-6060

f:(216) 671-7543

Psych

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


WIERWILLE, JENA L

Van Wert Med Arts Bldg, 140 Fox Rd., Ste. 301

Van Wert OH 45891

f:

PSYCH Scheduler

Wierwille, Jena L.

Van Wert OH 45891

f:

PSYCH

WILSON MEMORIAL HOSPITAL

315 W MICHIGAN ST

SIDNEY OH 45365

(937) 492-7296

f:(937) 498-5544

ANC

WUEBKER, MICHAEL, PHD

2444 CABLE CT STE H

LIMA OH 45805

PSYCH



(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)


WUEBKER, MICHAEL, PHD

334 GODFREY AVE STE A

CELINA OH 45822

PSYCH Scheduler

YOUNGSTOWN HEARING / SPEECH CENTER

6614 SOUTHERN BLVD

YOUNGSTOWN OH 44512

330-726-8855

f:330-726-9182

SL-INTERP

Z A/P Screen In

f:

ZAKE, JEROME, PHD

3454 OAK ALLEY CT STE 305 TOLEDO OH 43606

PSYCH

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)

ID NUMBER VENDOR NAME TOTAL PAID PSYCHOLOGICAL MEDICAL COMMENTS.FORPSYCH CORPORATION $1,556,573.00 $1,556,573.00MEDICAL & OCCUPATIONAL HEALTH $758,357.00 $758,357.00 MARTIN FRITZHAND MDTRI-STATE OCCUPATIONAL MED INC $588,259.00 $588,259.00IMA EVALUATIONS OF OHIO INC $450,090.00 $120,391.00 $329,699.00MEDICAL EVALUATION SERV INC $368,702.25 $368,702.25 X REF REC INCJ JOSEPH KONIECZNY, PHD $314,303.00 $314,303.00CONSULTING PSYCHOLOGY INC $299,644.00 $299,644.00 DRS LEIDAL & MAGLEBYFARRELL NELSON SERVICES INC $283,302.00 $283,302.00 LEE HOWARD OFFICEJOHN S REECE $258,841.00 $258,841.00JAMES C TANLEY, PHD $255,753.00 $255,753.00T RODNEY SWEARINGEN PHD $255,469.00 $255,469.00REC INC $243,430.00 $243,430.00 X REF MED EVAL SVCSRICHARD SEXTON, PHD $227,978.00 $227,978.00NANCY SCHMIDTGOESSLING, PHD $227,614.00 $227,614.00ADVANCED INJURY MANAGEMENT SC $225,643.00 $225,643.00 SUDHIR DUBEY PSYDFORENSIC PSYCHOLOGICAL CENTER $203,611.00 $203,611.00HEMISPHERIC PSYCHOLOGICAL $195,433.00 $195,433.00 MARK HAMMERLY PHDMICHAEL W FAUST $193,304.00 $193,304.00DOROTHY A BRADFORD, MD $184,191.50 $184,191.50NORMAN L BERG, PHD $175,605.00 $175,605.00THE SPEECH LANGUAGE PATH LLC $173,037.50 $173,037.50JOPPA CAPITAL VENTURES INC $171,545.00 $171,545.00CENTER FOR CLINICAL PSYCHOLOGY $171,318.00 $171,318.00WELLCARE DISABILITY LLC $161,258.00 $161,258.00BABATUNDE ONAMUSI, MD $160,157.00 $160,157.00JESSICA TWEHUES PSYD $160,148.00 $160,148.00MARC E MILLER $158,584.00 $158,584.00LIBERTY MEDICAL ASSESSMENT LLC $156,479.00 $156,479.00

TOTAL $8,578,629.25 $5,283,514.00 $3,295,115.25

Ohio FY 2017 Key Providers

(b) (6)

Vendor ID letter Providers name Clinic name City state Specialty

ABDOLKARIM KHORASANCHIAN MD ABDOLKARIM KHORASANCHIAN MD McAlester OK Cardio

Abhilash Davlapur MD Sooner Medical Services OKC OK InternistABLETALK THERAPIES - Croley ABLETALK THERAPIES INC Tulsa OK SpeechABLETALK THERAPIES - Croley ABLETALK THERAPIES INC Tulsa OK SpeechADEL MALATI MD ADEL MALATI MD Okmulgee OK InternistADEL MALATI MD ADEL MALATI MD Okemah OK InternistAkram Abraham MD Abraham Medical Clinic Hollis OK InternistAlan Miner DO Midwest CES Ada OK InternistAlan Miner DO Midwest CES Ardmore OK InternistAlan Miner DO Midwest CES McAlester OK InternistAlan Miner DO Midwest CES Muskogee OK Internist

ALDEN CLINICAL EVALUATION SVCS ALDEN CLINICAL EVALUATION SVCS El Reno OK PsychologyAlison Hansen-Pitts OD The Eye Institute Inc Tulsa OK OptometryAllison Craig SLP Discovery Pediatric Therapy Poteau OK SpeechAlyssa Rippy PhD Advanced Pain Specialist Tulsa OK PsychologyAmy Ashcraft ARNP Abraham Medical Clinic Hollis OK InternistAndrea Jones MD Sooner Medical Services OKC OK InternistAndrea Miller MD Eve Medical Services Enid OK InternistAndrea Miller MD Eve Medical Services Weatherford OK InternistAndrea Miller MD Eve Medical Services Bartlesville OK InternistAndrea Miller MD Eve Medical Services Miami OK InternistAndrew White MD Sooner Medical Services OKC OK InternistAneri Gupta-Lim Sooner Medical Services OKC OK InternistANIL PATEL MD Dean McGee Eye Institute OKC OK OptometryAnna M Homen PhD Moore Counseling Center Moore OK PsychologyAnna M Homen PhD Moore Counseling Center Moore OK PsychologyArjun Ghodasara MD Midtown Medical Associates LLC Tulsa OK Internist

Arkansas Occupational Health Arkansas Occupational Health Clinic Springdale AR Lab/Xray/PFS

Arkansas Occupational Health Arkansas Occupational Health Clinic Van Buren AR Lab/Xray/PFS

ASHOK KACHE MD ASHOK KACHE MD Tulsa OK EMGASHOK KACHE MD ASHOK KACHE MD Tulsa OK InternistAUDIOLOGY OF TULSA - Lang, Nitzel, Russ, Worth, Alred AUDIOLOGY OF TULSA Tulsa OK AudiologyBAILEY RUNKLES DO Midtown Medical Associates LLC Tulsa OK InternistBALA KRISHNA V ARABOLU MD BALA KRISHNA V ARABOLU MD Durant OK PediatricsBENJAMIN ROBERTS DO Midtown Medical Associates LLC Tulsa OK InternistBETTY J FEIR PHD PC BETTY J FEIR PHD PC Texarkana TX PsychologyBeverly Cooper ARNP Abraham Medical Clinic Hollis OK InternistBlake Carlisle OD Blake Carlisle OD Fairview OK OptometryBRAD LISTON DO Liston LLC Ponca City OK InternistBRADLEY K FARRIS MD - Neuro Opthamologist Dean McGee Eye Institute OKC OK OptometryBrandi Duncan SLP Discovery Pediatric Therapy Poteau Ok SLPBRANDI WOFFORD SLP Wofford Speech Therapy Tulsa OK SpeechBRIAN BIRDWELL MD (LAWTON) BRIAN BIRDWELL MD (LAWTON) Lawton OK InternistBrian Snider PhD Psychological Services of Tulsa Tulsa OK PsychologyBronwyn Howard ARNP Main Street Family Clinic Stroud OK InternistBryan Peck MD Eve Medical Enid OK InternistBryan Peck MD Eve Medical Weatherford OK Internist

Mariana Navas Bryant SLPBILINGUAL COMMUNICATION POTENTIAL OKC OK Speech

Cameron Smith DO H&H Exams LLC Tulsa OK InternistCatherine Fusilier MD Sooner Medical Services OKC OK InternistCE Provider Services CE Provider Services Amarillo TX InternistCharles B Fullenwider MD Midwest CES Ada OK InternistCharles B Fullenwider MD Midwest CES Ardmore OK InternistCharles B Fullenwider MD Midwest CES McAlester OK InternistCharles B Fullenwider MD Midwest CES Muskogee OK InternistCHARLES D TAYLOR MD (OKC) CHARLES D TAYLOR MD (OKC) OKC OK Internist

Charles R Vest MDCentral Oklahoma Family Medical Center Ada OK Internist

Chelsea Berges DO Janza LLC Tulsa OK InternistChristine Beeson DO Janza LLC Tulsa OK Internist

CHRISTOPHER CAMPBELL PHD (LAWTON) CHRISTOPHER CAMPBELL PHD (LAWTON) Lawton OK Psychology

CHRISTOPHER CAMPBELL PHD (LAWTON) CHRISTOPHER CAMPBELL PHD (LAWTON) Pauls Valley OK Psychology

Christopher Thompson DO H & H Exams Tulsa OK InternistCHRISTOPHER L SUDDUTH MD (ADA) Midwest CES Ada OK InternistChristopher L Sudduth MD (Ardmore) Midwest CES Ardmore OK InternistCHRISTOPHER L SUDDUTH MD (MCALESTER) Midwest CES McAlester OK InternistCHRISTOPHER L SUDDUTH MD (MUSKOGEE) Midwest CES Muskogee OK Internist

CINDY L ROBERTS MS CCCA (ENID) CINDY L ROBERTS MS CCCA (ENID) Enid OK AudiologyCorey Babb DO Midtown Medical Associates LLC Tulsa OK Internist

Oklahoma FY 2017

(b) (6)

Corey Matthews DO H & H Exams Tulsa OK InternistCRYSTEN CHEATWOOD DO (TULSA) Midtown Medical Associates LLC Tulsa OK InternistDANA FOLEY PHD (ARDMORE) DANA FOLEY PHD (ARDMORE) Ardmore OK Psychology

DANA GUDGEL MA CCC SLP (TULSA) DANA GUDGEL MA CCC SLP (TULSA) Tulsa OK PsychologyDARIO M ESPINA MD (FT SMITH) Arkansas Heart Center Ft Smith AR Cardio

DARRELL L LYNCH PHD (LAWTON) DARRELL L LYNCH PHD (LAWTON) Lawton OK PsychologyDave Kerby PhD Moore Counseling Center Moore OK PsychologyDavid Bishop MD Sooner Medical Services OKC OK InternistDAVID BRINKER MD (OKC) Northwest Eye Physicians OKC OK OptometryDAVID J KING DO (OKC) Quality Medical Clinic OKC OK InternistDAVID WIEGMAN MD (BARTLESVILLE) Eve Medical Bartlesville OK InternistDAVID WIEGMAN MD (MIAMI) Eve Medical Miami OK Internist

DEANN M GATTIS PHD (NORMAN) DEANN M GATTIS Psychological Services Norman OK Psychology

DEANNA SEVERSON CCC SLP DEANNA SEVERSON CCC SLP Bartlesville OK Speech

DENISE LAGRAND PSY D (TAHLEQUAH) DENISE LAGRAND PSY D (TAHLEQUAH) Tahlequah OK Psychology

Dennis Morris OD Vision Source Sapulpa OK OptometryDennis Whitehouse DO Pauls Valley Medical Center Pauls Valley OK InternistDERRISE L GARNER PSY D (MIAMI) Herndon Snider & Associates PC Miami OK PsychologyDivya Byragani MD Midtown Medical Associates LLC Tulsa OK Internist

DLO (ADA) - Sooner Medical Diagnostic Laboratory of Oklahoma Ada OK Lab

DLO (ARDMORE) - Sooner Medical Diagnostic Laboratory of Oklahoma Ardmore OK Lab

DLO (CLINTON) - Sooner Medical Diagnostic Laboratory of Oklahoma Clinton OK Lab

DLO (DURANT) - Sooner Medical Diagnostic Laboratory of Oklahoma Durant OK Lab

DLO (EDMOND) - Sooner Medical Diagnostic Laboratory of Oklahoma Edmond OK Lab

DLO (ELK CITY) - Sooner Medical Diagnostic Laboratory of Oklahoma Elk City OK Lab

DLO (ENID) - Sooner Medical Diagnostic Laboratory of Oklahoma Enid OK Lab

DLO (GROVE) - Sooner Medical Diagnostic Laboratory of Oklahoma Grove OK Lab

DLO (Idabel) - Sooner Medical Diagnostic Laboratory of Oklahoma Idabel OK Lab

DLO (LAWTON) - Sooner Medical Diagnostic Laboratory of Oklahoma Lawton OK Lab

DLO (MCALESTER) - Sooner Medical Diagnostic Laboratory of Oklahoma McAlester OK Lab

DLO (MIAMI) - Sooner Medical Diagnostic Laboratory of Oklahoma Miami OK Lab

DLO (MUSKOGEE) - Sooner Medical Diagnostic Laboratory of Oklahoma Muskogee OK Lab

DLO (OKC) - Sooner Medical Diagnostic Laboratory of Oklahoma OKC OK Lab

DLO (SHAWNEE) - Sooner Medical Diagnostic Laboratory of Oklahoma Shawnee OK Lab

DLO (STILLWATER) - Sooner Medical Diagnostic Laboratory of Oklahoma Stillwater OK Lab

DLO (TULSA) - Sooner Medical Diagnostic Laboratory of Oklahoma Tulsa OK LabDragos Vesbianu MD Midtown Medical Associates LLC Tulsa OK InternistDUSTIN GANT WARD PHD (MOORE) Moore Counseling Center Moore OK PsychologyDUSTIN GANT WARD PHD (MOORE)(IQ) Moore Counseling Center Moore OK PsychologyE L JORDAN JR DO PC (JOPLIN) E L JORDAN JR DO PC (JOPLIN) Joplin MO Optometry

Eddie Scott PhD ALDEN CLINICAL EVALUATION SVCS El Reno OK PsychologyEmily Sullivan SLP Moore Counseling Center Moore OK SpeechERIN RAMSEY SLP Ramsey Speech Pathology PLLC Muskogee OK SpeechEVE MEDICAL SERVICES (ENID) EVE MEDICAL SERVICES (ENID) Enid OK PFSEVE MEDICAL SERVICES (MIAMI) EVE MEDICAL SERVICES (MIAMI) Miami OK PFS

EVE MEDICAL SERVICES (WEATHERFORD) EVE MEDICAL SERVICES (WEATHERFORD) Weatherford OK PFS

Family Vision Clinic (Robert Head, Kyle Head, Kristina Flint) FAMILY VISION CLINIC (LAWTON) Lawton OK Optometry

GAIL POYNER PHD (CHOCTAW)(IQ) GAIL POYNER PHD (CHOCTAW)(IQ) Choctaw OK Psychology

GAIL POYNER PHD (CHOCTAW)(MSE) GAIL POYNER PHD (CHOCTAW)(MSE) Choctaw OK Psychology

GARY DENSLOW MD (Muskogee) Pediatric Opthalmology Inc Muskogee OK OptometryGARY DENSLOW MD (TULSA) Pediatric Opthalmology Inc Tulsa OK Optometry

GEORGE S CHRYSANT MD (ALTUS) Integris Cardiovascular Physicians LLC Altus OK Cardio

(b) (6)

GEORGE S CHRYSANT MD (CHICKASHA) Integris Cardiovascular Physicians LLC Chickasha OK Cardio

GEORGE S CHRYSANT MD (ADA)Integris Cardiovascular Physicians LLC Ada OK Cardio

GEORGE S CHRYSANT MD (CLINTON) Integris Cardiovascular Physicians LLC Clinton OK Cardio

GEORGE S CHRYSANT MD (OKC) Integris Cardiovascular Physicians LLC OKC OK Cardio

GREAT PLAINS REG MEDICAL CENTER-ELK CITY GREAT PLAINS REG MEDICAL CENTER-ELK CITY Elk City OK Lab

Guila Hall MD Sooner Medical Services OKC OK InternistGWEN FUENTES MD (ARDMORE) GWEN FUENTES MD (ARDMORE) Ardmore OK InternistHAROLD ZANE DELAUGHTER DO (TULSA) Janza LLC Tulsa OK InternistHealthcare Stat (Corbert Bercier) Healthcare Stat Chickasha OK InternistHealthcare Stat (Dustin Wade) Healthcare Stat Chickasha OK InternistHealthcare Stat (Heather Worden) Healthcare Stat Chickasha OK InternistHealthcare Stat (Lindsey Leehan) Healthcare Stat Chickasha OK InternistHealthcare Stat (Martin Christensen) Healthcare Stat Chickasha OK InternistHealthcare Stat (Shawn Bonilla) Healthcare Stat Chickasha OK InternistHealthcare Stat (Tonya Jones) Healthcare Stat Chickasha OK InternistHEARTS FOR HEARING - (Wolfe, Neumann) HEARTS FOR HEARING OKC OK AudiologyHEATHER RANGER PHD (TULSA) HEATHER RANGER PHD (TULSA) Tulsa OK PsychologyHope Burkett DO H&H Exams LLC Tulsa OK InternistIlse Carrizales PhD Moore Counseling Center Moore OK PsychologyINNOVATIVE EXPRESSIONS INNOVATIVE EXPRESSIONS Edmond Ok SpeechJACOB AZURDIA MD (Sooner Medical OKC) Sooner Medical Services OKC OK InternistJACOB AZURDIA MD(ENID) Eve Medical Enid OK InternistJACOB AZURDIA MD(WEATHERFORD) Eve Medical Weatherford OK InternistJAMES CHAPMAN MD (GROVE) Oklahoma Heart Institute Grove Ok CardioJAMES CRUTCHER MD (BARTLESVILLE) Eve Medical Bartlesville Ok InternistJAMES CRUTCHER MD (MIAMI) Eve Medical Miami Ok InternistJAMES H GENTRY DO (ADA) Midwest CES Ada Ok InternistJAMES H GENTRY DO (ARDMORE) Midwest CES Ardmore Ok InternistJAMES H GENTRY DO (MCALESTER) Midwest CES McAlester Ok InternistJAMES H GENTRY DO (MUSKOGEE) Midwest CES Muskogee OK InternistJAMES L BURKE DO (OKC) Quality Medical Clinic OKC OK Internist

JAMES SCOTT PSY D (SHAWNEE) (MSE) Ok Assessment & Therapy Services Shawnee OK Psychology

JAMES SCOTT PSY D (SHAWNEE)(IQ) Ok Assessment & Therapy Services Shawnee OK PsychologyJAN S KENT PHD (MIAMI) Herndon Snider & Associates PC Joplin MO PsychologyJANA B KLUCK MA CCC SLP (OKC) JANA B KLUCK MA CCC SLP (OKC) OKC OK SpeechJANET KATES PHD (OKC) JANET KATES PHD (OKC) OKC OK PsychologyJason Pickard OD Cornerstone Eye Care OKC OK OptometryJennifer Davis SLP Ramsey Speech Pathology PLLC Muskogee OK SpeechJENNIFER LANCASTER PHD (NORMAN)(IQ) Lancaster Psychological Services Norman OK PsychologyJENNIFER LANCASTER PHD (NORMAN)(MSE) Lancaster Psychological Services Norman OK PsychologyJENNY BENDURE PhD Serinity Mental Health Norman OK Psychology

JEROME M DILLING JR MD (ENID) JEROME M DILLING JR MD (ENID) Enid OK AudiologyJERRY CHILDS JR DO (OKC) Quality Medical Clinic OKC OK InternistJERRY D FIRST MD (TULSA) JERRY D FIRST MD (TULSA) Tulsa OK InternistJERRY D WHITE PHD (OKC) JERRY D WHITE PHD (OKC) OKC OK PsychologyJOHN B BARRINGER OD (ARDMORE) Vision Source Ardmore OK OptometryJOHN FARAG DO (Eve Medical) Eve Medical Weatherford OK InternistJOHN FARAG DO (Sooner Medical) Sooner Medical OKC OK InternistJOHN J ALPAR MD (AMARILLO) JOHN J ALPAR MD (AMARILLO) Amarillo TX OptometryJOHN RICE DO (CHECOTAH) Payne & Rice Clinic Checotah OK Internist

JOHNA KAY SMASAL PHD (TULSA) JOHNA KAY SMASAL PHD (TULSA) Tulsa OK Psychology

JOHNA KAY SMASAL PHD (TULSA) JOHNA KAY SMASAL PHD (TULSA) Tulsa OK PsychologyJohnnie Brasuell APRN Johnnie Brasuell APRN Catoosa OK InternistJOHNSON GOURD MD (MIAMI) Eve Medical Miami OK Internist

JOSE A ALEMPARTE MD (FT SMITH) JOSE A ALEMPARTE MD (FT SMITH) Ft Smith AR CardioJOSEPH JAMES PSY D (TULSA) (TEST) Christian Family Institute Tulsa OK PsychologyJOSEPH JAMES PSY D (TULSA)(MSE) Christian Family Institute Tulsa OK Psychology

JUAN MALDONADO MD (ANADARKO) JUAN MALDONADO MD (ANADARKO) Anadarko OK Internist

JUAN RANGO MD (ADA) Midwest CES Ada OK InternistJUAN RANGO MD (ARDMORE) Midwest CES Ardmore OK InternistJUAN RANGO MD (MCALESTER) Midwest CES McAlester OK InternistJUAN RANGO MD (MUSKOGEE) Midwest CES Muskogee OK InternistJUSTIN ANDERSON MD (OKC) Quality Medical Clinic OKC Ok InternistJustin Funk OD Premier Eyecare of Enid Enid OK Optometry

KARA RODGERS PSY D (OKC) Brookwood Psychological Services OKC Ok Psychology

KATHLEEN A WARD PHD (MCALESTER) KATHLEEN A WARD PHD (MCALESTER) McAlester Ok Psychology

(b) (6)

KEITH GREEN PHD (OKC) R KEITH GREEN PHD (OKC) OKC Ok Psychology

KENNY A PARIS PHD (TAHLEQUAH) KENNY A PARIS PHD (TAHLEQUAH) Tahlequah Ok PsychologyKent Abernathy DO Midtown Medical Associates LLC Tulsa OK Internist

KEVIN M WHISMAN PSY D (JOPLIN) KEVIN M WHISMAN PSY D (JOPLIN) Joplin MO PsychologyKimi Carson PhD Moore Counseling Center Moore OK Psychology

Konstantin Berestnev MDArkansas Occupational Health Clinic Springdale AR Internist

Konstantin Berestnev MDArkansas Occupational Health Clinic Van Buren AR Internist

KRISTI L BRATKOVICH PHD (LAWTON) KRISTI L BRATKOVICH PHD (LAWTON) Lawton OK Psychology

Lacy Crissup OD Claremore Eye Associates Claremore OK OptometryLARRY VAUGHT PHD (TULSA) LARRY VAUGHT PHD (TULSA) Tulsa OK PsychologyLeah Upton DO Jenks Health Team Jenks Ok InternistLeomar Bautista DO H & H Exams Tulsa OK InternistLesley Flores SLP Lesley Flores SLP Tulsa OK SpeechLevi Armstrong PhD Paris Counseling Center Paris TX Psychology

LINDA K CAMERON MA CCC (EDMOND) LINDA K CAMERON MA CCC (EDMOND) Edmond OK Speech

M. Said Sadeghi DO Pediatric Opthalmology Inc Tulsa OK Optometry

MARK ENGLANDER PHD (MSE) (NORMAN) MARK ENGLANDER PHD (MSE) (NORMAN) Norman OK Psychology


MARK WOOD MD (OKC) Otologic Medical Clinic OKC OK AudiologyMARTIN D BAUTISTA MD (GUYMON) Specialty Clinics Of St Anne PLLC Guymon OK InternistMARY MARGUERITE LANGILLE-HOPPE PSY D (SHAWNEE) Ok Assessment & Therapy Services Shawnee OK PsychologyMatthew Heisey APRN Pauls Valley Medical Center Pauls Valley OK InternistMATTHEW PHILIP FEIST MD (ADA) Midwest CES Ada OK InternistMATTHEW PHILIP FEIST MD (ARDMORE) Midwest CES Ardmore OK InternistMATTHEW PHILIP FEIST MD (MCALESTER) Midwest CES McAlester OK InternistMatthew Philip Feist MD (Muskogee) Midwest CES Muskogee OK InternistMatthew Smith DO H & H Exams Tulsa OK InternistMAX CARLISLE OD (FAIRVIEW) MAX CARLISLE OD (FAIRVIEW) Fairview OK OptometryMaxwell Sencherey DO H & H Exams Tulsa OK Internist

MCCURTAIN MEMORIAL HOSPITAL-PFS MCCURTAIN MEMORIAL HOSPITAL-PFS Idabel OK PFS

MELINDA SHAVER PSY D (BARTLESVILLE) (MSE) MELINDA SHAVER PSY D (BARTLESVILLE) (MSE) Bartlesville OK Psychology

MICHAEL KARATHANOS MD (TULSA) MICHAEL KARATHANOS MD (TULSA) Tulsa OK Neurology

MICHAEL MCGEE MD (OKC) Otologic Medical Clinic OKC OK Audiology

MICHAEL SCHIFF MD (PONCA CITY) Integris Cardiovascular Physicians LLC Ponca City OK Cardio

MICHELINE CHRISMAN PSYD (NORMAN) MICHELINE CHRISMAN PSYD (NORMAN) Norman OK Psychology

MINOR GORDON PHD (CLAREMORE) MINOR GORDON PHD (CLAREMORE) Claremore OK Psychology

MIRACLE GOETZ PSY D (MOORE)(IQ) Moore Counseling Center Moore OK PsychologyMIRACLE GOETZ PSY D (MOORE)(MSE) Moore Counseling Center Moore OK Psychology

NANCY FAYE BARTON PHD (TULSA) NANCY FAYE BARTON PHD (TULSA) Tulsa OK PsychologyNICK LEE CARROLL DO (TULSA) Midtown Medical Associates LLC Tulsa OK InternistOKEY NWOKOLO MD (OKC) Okey Nwololo MD & Associates OKC OK PediatricsPAUL J SCHWARTZ PHD (TULSA) PAUL J SCHWARTZ PHD (TULSA) Tulsa OK Psychology

PAUL J SCHWARTZ PHD (TULSA) (TEST) PAUL J SCHWARTZ PHD (TULSA) (TEST) Tulsa OK Psychology

PAUL S THOMAS MD (MCALESTER) Warren Clinic McAlester OK PsychologyPauls Valley Medical Center Pauls Valley Medical Center Pauls Valley OK X-rays/labsPeggy Gardner ARNP Main Street Family Clinic Stroud OK InternistPETER CIALI PHD (TULSA) Advanced Pain Specialist Tulsa OK PsychologyPeter Holm PhD Peter Holm PhD Sherman TX Psychology

PULMONARY PHYSICIANS OF OKC PULMONARY PHYSICIANS OF OKC OKC OK PFS

QTC MEDICAL GROUP INC (LAWTON) QTC MEDICAL GROUP INC (LAWTON) Lawton Ok X-ray/labs

QTC MEDICAL GROUP INC (OKC) QTC MEDICAL GROUP INC (OKC) OKC Ok X-ray/labs

QUALITY MEDICAL CLINIC (OKC)-PFS/LAB QUALITY MEDICAL CLINIC (OKC)-PFS/LAB OKC Ok PFS/Labs

RACHEL SMILEY PHD (IQ) (MOORE) Moore Counseling Center Moore Ok PsychologyRACHEL SMILEY PHD (MOORE)(MSE) Moore Counseling Center Moore Ok Psychology

RAFAEL F OTERO PHD (TEXARKANA) RAFAEL F OTERO PHD (TEXARKANA) Texarkana TX Psychology

RAY HAND PHD (OKC) RAY HAND PHD (OKC) OKC OK PsychologyRaymond Azadgoli MD Quality Medical Clinic OKC Ok Internist

RED RIVER VALLEY RAD & PATHOLGY (PARIS) RED RIVER VALLEY RAD & PATHOLGY (PARIS) Paris TX X-ray

(b) (6)


REDA RASCO PSY D (WICHITA FALLS, TX) Madden Counseling Witchita Falls TX PsychologyREDA RASCO PSY D (WICHITA FALLS,TX) Madden Counseling Witchita Falls TX PsychologyRENETTA REEVES MD (ADA) Midwest CES Ada OK InternistRENETTA REEVES MD (MCALESTER) Midwest CES McAlester OK InternistRENETTA REEVES MD (MUSKOGEE) Midwest CES Muskogee OK Internist

RICHARD KAHOE PHD (WATONGA) RICHARD KAHOE PHD (WATONGA) Watonga OK Psychology

RICHARD KAHOE PHD (WOODWARD) RICHARD KAHOE PHD (WOODWARD) Woodward OK Psychology

RIVER SMITH PHD (TULSA) Advanced Pain Specialist Tulsa OK PsychologyROBERT C BALOGH MD (LAWTON) Allied Labs of Lawton Lawton OK Internist

Robert Danaher PhD ALDEN CLINICAL EVALUATION SVCS El Reno OK Psychology

ROBERT L SPRAY JR PHD PA (FT SMITH) ROBERT L SPRAY JR PHD PA (FT SMITH) Ft Smith AR Psychology

ROBERT R WALLER PHD (OKC) ROBERT R WALLER PHD (OKC) OKC OK PsychologyROBIN HALL MD (OKC) Quality Medical Clinic OKC OK Internist

Russell Pella PhDComprehensive Comm Rehab Services Tulsa OK Psychology

S A CHAUDHRY MD (OKC) S A CHAUDHRY MD (OKC) OKC OK Internist

S KRISHNAMURTHI MD (SAPULPA) S KRISHNAMURTHI MD (SAPULPA) Sapulpa OK CardioSARAH CLAY OD (ARDMORE) Clay Optometry Ardmore OK OptometrySARAH MILLER COATS PHD (ENID) SARAH K Miller PhD Enid OK Psychology

SEAN P SATTERFIELD MED CCC SLP (PONCA CITY) SEAN P SATTERFIELD MED CCC SLP (PONCA CITY) Ponca City OK Speech

Sharon Bowen ARNP Abraham Medical Clinic Hollis OK InternistSHERMAN LAWTON MD (OKC) SHERMAN LAWTON MD (OKC) OKC OK NeurologySHERRI L MURRY PHD (OKC) Care for Change Inc OKC OK PsychologySIDNEY WILLIAMS MD (STILLWATER) Williams Clinic of Stillwater Stillwater OK Internist

SOONER MEDICAL SERVICES (X-RAY) SOONER MEDICAL SERVICES (X-RAY) OKC OK X-ray

SOONER MEDICAL SERVICES(PFS) SOONER MEDICAL SERVICES(PFS) OKC OK PFSSPARKS LUNG CENTER SPARKS LUNG CENTER Ft Smith AR PFSSPENCER CLARK DO (ENID) Eve Medical Enid OK InternistSPENCER CLARK DO (WEATHERFORD) Eve Medical Weatherford OK InternistSRIKANTH REDDY MD (TULSA) Tulsa Bone and Joint Associates Tulsa Ok InternistST ANTHONY HOSPITAL ST ANTHONY HOSPITAL OKC Ok PFS

ST JOHN MED CENTER (PULM)-TULSA ST JOHN MED CENTER (PULM)-TULSA Tulsa Ok PFS

ST JOHN MEDICAL CENTER (LAB)(TULSA) ST JOHN MEDICAL CENTER (LAB)(TULSA) Tulsa Ok Lab

STEPHANIE CRALL PHD (MSE) (OKC) Assessment & Consult Services PC OKC OK PsychologyStephanie Letney DO Midtown Medical Associates LLC Tulsa OK InternistSTEPHEN R CLOSE PHD (ENID) STEPHEN R CLOSE PHD (ENID) Enid OK PsychologySTEWART J KATZ MD (TULSA) Cardiovascular Specialist Inc Tulsa OK CardioSully Drotar DO Midtown Medical Associates LLC Tulsa OK InternistSUNG WOOK CHOI MD (ADA) Midwest CES Ada OK InternistSUNG WOOK CHOI MD (ARDMORE) Midwest CES Ardmore OK InternistSUNG WOOK CHOI MD (MCALESTER) Midwest CES McAlester OK InternistSUNG WOOK CHOI MD (MUSKOGEE) Midwest CES Muskogee OK InternistSUSAN M LINDE PHD (TULSA) SUSAN M LINDE PHD (TULSA) Tulsa OK PsychologySUSAN SELL SLP (WOODWARD) SUSAN SELL SLP (WOODWARD) Woodward OK Speech

SUZAN B SIMMONS PHD PLLC (PONCA CITY) SUZAN B SIMMONS PHD PLLC (PONCA CITY) Ponca City OK Psychology

SXR MEDICAL EVALUATIONS (TULSA) SXR MEDICAL EVALUATIONS (TULSA) Tulsa OK X-rays/labs

Tatyana Mayer OD Mayer Eye Care Inc Ponca City OK OptometryTAWFIK RAMADAN MD (ADA) Southern OK Pediatrics Inc Ada OK Pediatrics

TERRANCE KHASTGIR MD (OKC) Integris Cardiovascular Physicians LLC OKC OK Cardio

TERRY L KILGORE MD (PARIS) TERRY L KILGORE MD (PARIS) Paris TX Internist

TEXARKANA EYE ASSOCIATES - Sean Summers OD TEXARKANA EYE ASSOCIATES Idabel OK OptometryTexoma Medical Center Texoma Medical Center Denison TX Labs

THERESA HORTON PHD (IDABEL) (MSE) THERESA HORTON PHD (IDABEL) (MSE) Idabel OK Psychology

THERESA HORTON PHD (POTEAU) THERESA HORTON PHD (POTEAU) Poteau OK PsychologyTHERON BLISS DO (BARTLESVILLE) Eve Medical Bartlesville OK InternistTHERON BLISS DO (ENID) Eve Medical Enid OK InternistTHERON BLISS DO (MIAMI) Eve Medical Miami OK InternistTHERON BLISS DO (WEATHERFORD) Eve Medical Weatherford OK InternistThomas Wolf MD Urgent Eye Care Edmond OK OptometryTimothy Cramer MD Sooner Medical OKC OK InternistTIMOTHY DOTY PHD (TULSA) Christian Family Institute Tulsa OK Psychology

(b) (6)

TODD GRAYBILL PHD PLLC (IQ) B TODD GRAYBILL PHD PLLC (IQ) Muskogee OK Psychology

TODD GRAYBILL PHD PLLC (MSE) B TODD GRAYBILL PHD PLLC (MSE) Muskogee OK PsychologyTracie Gillispie LPC Tracie Gillispie LPC Duncan OK PsychologyTREY CARLISLE OD (BEAVER) Carlisle Vision Clinic PLLC Beaver OK OptometryTyler Freeman MD Sooner Medical Services OKC OK Internist

URSULA BOWLING PSY D (ARDMORE) URSULA BOWLING PSY D (ARDMORE) Ardmore OK Psychology

VICKI PERKINS PHD (BEAVER) VICKI PERKINS PHD (BEAVER) Beaver OK Psychology

VICTOR T WILSON MD PC (NORMAN) VICTOR T WILSON MD PC (NORMAN) Norman OK Pediatrics

VIDYA REGE MD (EL RENO) VIDYA REGE MD (EL RENO) El Reno OK OptometryVIDYA REGE MD (OKC) VIDYA REGE MD (OKC) OKC OK OptometryVirginia Burk PhD Moore Counseling Center Moore OK PsychologyVISHAL KADAKIA MD (BARTLESVILLE) Eve Medical Bartlesville OK InternistVISHAL KADAKIA MD (ENID) Eve Medical Enid OK InternistVISHAL KADAKIA MD (WEATHERFORD) Eve Medical Weatherford OK Internist

WILLIAM CHAPMAN MD (SHAWNEE) WILLIAM CHAPMAN MD (SHAWNEE) Shawnee OK Pediatrics

William Collins MD Sooner Medical Services OKC OK InternistWILLIAM GRUBB MD (TULSA) WILLIAM GRUBB MD (TULSA) Tulsa OK Internist

WILLIAM GRUBB MD (OKMULGEE) WILLIAM GRUBB MD (OKMULGEE) Okmulgee OK InternistWilliam K Russell MD Sooner Medical Services OKC OK InternistWILLIAM L COOPER PHD (TULSA) WILLIAM L COOPER PHD (TULSA) Tulsa OK Psychology

WILLIAM T BRYANT PHD (OKMULGEE) WILLIAM T BRYANT PHD (OKMULGEE) Okmulgee OK Psychology

WOJCIECH DULOWSKI MD (STILWELL) WOJCIECH DULOWSKI MD (STILWELL) Stilwell OK Internist

YEE SE CHOA ONG MD (MUSKOGEE) Cardiology Clinic of Muskogee Inc Muskogee OK Cardio

(b) (6)

Oklahomabreak taxid count paidamttotal

3428 $397,378.84 Quality Medical Clinic5277 $374,957.90 Sooner Medical Services2759 $293,775.00 Alden Clinical Evaluation SVCS1653 $202,930.00 ELN Enterprises Midwest CES1515 $193,010.76 Midtown Medical Associates LLC2746 $171,240.25 SXR MEDICAL LLC1349 $144,015.00 ADVANCING PSYCHOLOGY INC R Keith Green PhD1039 $142,200.00 CHRISTOPHER CAMPBELL PHD

(b) (6)

Oklahoma

Midwest CESALDEN CLINICAL EVALUATION SVCS Eve Medical ServicesSooner Medical ServicesMidtown Medical H&H Exams LLCJanza LLCQuality Medical ClinicDENISE LAGRAND PSY D (TAHLEQUAH) Johnnie Brasuell APRNR KEITH GREEN PHD (OKC) Advancing PsychologySHERMAN LAWTON MD (OKC) SXR Medical LLCChristopher Campbell PhD

Providers who work for the DDS only

Vendor ID letter Providers name Clinic name City state Specialty

ABDOLKARIM KHORASANCHIAN MD ABDOLKARIM KHORASANCHIAN MD McAlester OK CardioAbhilash Davlapur MD Sooner Medical Services OKC OK InternistABLETALK THERAPIES - Croley ABLETALK THERAPIES INC Tulsa OK SpeechABLETALK THERAPIES - Croley ABLETALK THERAPIES INC Tulsa OK SpeechADEL MALATI MD ADEL MALATI MD Okmulgee OK InternistADEL MALATI MD ADEL MALATI MD Okemah OK InternistAkram Abraham MD Abraham Medical Clinic Hollis OK InternistAlan Miner DO Midwest CES Ada OK InternistAlan Miner DO Midwest CES Ardmore OK InternistAlan Miner DO Midwest CES McAlester OK InternistAlan Miner DO Midwest CES Muskogee OK InternistALDEN CLINICAL EVALUATION SVCS ALDEN CLINICAL EVALUATION SVCS El Reno OK PsychologyAlison Hansen-Pitts OD The Eye Institute Inc Tulsa OK OptometryAllison Craig SLP Discovery Pediatric Therapy Poteau OK SpeechAlyssa Rippy PhD Advanced Pain Specialist Tulsa OK PsychologyAmy Ashcraft ARNP Abraham Medical Clinic Hollis OK InternistAndrea Jones MD Sooner Medical Services OKC OK InternistAndrea Miller MD Eve Medical Services Enid OK InternistAndrea Miller MD Eve Medical Services Weatherford OK InternistAndrea Miller MD Eve Medical Services Bartlesville OK InternistAndrea Miller MD Eve Medical Services Miami OK InternistAndrew White MD Sooner Medical Services OKC OK InternistAneri Gupta-Lim Sooner Medical Services OKC OK InternistANIL PATEL MD Dean McGee Eye Institute OKC OK OptometryAnna M Homen PhD Moore Counseling Center Moore OK PsychologyAnna M Homen PhD Moore Counseling Center Moore OK PsychologyArjun Ghodasara MD Midtown Medical Associates LLC Tulsa OK InternistArkansas Occupational Health Arkansas Occupational Health Clinic Springdale AR Lab/Xray/PFSArkansas Occupational Health Arkansas Occupational Health Clinic Van Buren AR Lab/Xray/PFSASHOK KACHE MD ASHOK KACHE MD Tulsa OK EMGASHOK KACHE MD ASHOK KACHE MD Tulsa OK InternistAUDIOLOGY OF TULSA - Lang, Nitzel, Russ, Worth, Alred AUDIOLOGY OF TULSA Tulsa OK AudiologyBAILEY RUNKLES DO Midtown Medical Associates LLC Tulsa OK InternistBALA KRISHNA V ARABOLU MD BALA KRISHNA V ARABOLU MD Durant OK PediatricsBENJAMIN ROBERTS DO Midtown Medical Associates LLC Tulsa OK InternistBETTY J FEIR PHD PC BETTY J FEIR PHD PC Texarkana TX PsychologyBeverly Cooper ARNP Abraham Medical Clinic Hollis OK InternistBlake Carlisle OD Blake Carlisle OD Fairview OK Optometry

(b) (6)

BRAD LISTON DO Liston LLC Ponca City OK InternistBRADLEY K FARRIS MD - Neuro Opthamologist Dean McGee Eye Institute OKC OK OptometryBrandi Duncan SLP Discovery Pediatric Therapy Poteau Ok SLPBRANDI WOFFORD SLP Wofford Speech Therapy Tulsa OK SpeechBRIAN BIRDWELL MD (LAWTON) BRIAN BIRDWELL MD (LAWTON) Lawton OK InternistBrian Snider PhD Psychological Services of Tulsa Tulsa OK PsychologyBronwyn Howard ARNP Main Street Family Clinic Stroud OK InternistBryan Peck MD Eve Medical Enid OK InternistBryan Peck MD Eve Medical Weatherford OK Internist

Mariana Navas Bryant SLP BILINGUAL COMMUNICATION POTENTIAL OKC OK SpeechCameron Smith DO H&H Exams LLC Tulsa OK InternistCatherine Fusilier MD Sooner Medical Services OKC OK InternistCE Provider Services CE Provider Services Amarillo TX InternistCharles B Fullenwider MD Midwest CES Ada OK InternistCharles B Fullenwider MD Midwest CES Ardmore OK InternistCharles B Fullenwider MD Midwest CES McAlester OK InternistCharles B Fullenwider MD Midwest CES Muskogee OK InternistCHARLES D TAYLOR MD (OKC) CHARLES D TAYLOR MD (OKC) OKC OK Internist

Charles R Vest MD Central Oklahoma Family Medical Center Ada OK InternistChelsea Berges DO Janza LLC Tulsa OK InternistChristine Beeson DO Janza LLC Tulsa OK Internist

CHRISTOPHER CAMPBELL PHD (LAWTON) CHRISTOPHER CAMPBELL PHD (LAWTON) Lawton OK Psychology

CHRISTOPHER CAMPBELL PHD (LAWTON) CHRISTOPHER CAMPBELL PHD (LAWTON) Pauls Valley OK PsychologyChristopher Thompson DO H & H Exams Tulsa OK InternistCHRISTOPHER L SUDDUTH MD (ADA) Midwest CES Ada OK InternistChristopher L Sudduth MD (Ardmore) Midwest CES Ardmore OK Internist

CHRISTOPHER L SUDDUTH MD (MCALESTER) Midwest CES McAlester OK Internist

CHRISTOPHER L SUDDUTH MD (MUSKOGEE) Midwest CES Muskogee OK InternistCINDY L ROBERTS MS CCCA (ENID) CINDY L ROBERTS MS CCCA (ENID) Enid OK AudiologyCorey Babb DO Midtown Medical Associates LLC Tulsa OK InternistCorey Matthews DO H & H Exams Tulsa OK InternistCRYSTEN CHEATWOOD DO (TULSA) Midtown Medical Associates LLC Tulsa OK InternistDANA FOLEY PHD (ARDMORE) DANA FOLEY PHD (ARDMORE) Ardmore OK PsychologyDANA GUDGEL MA CCC SLP (TULSA) DANA GUDGEL MA CCC SLP (TULSA) Tulsa OK Psychology

(b) (6)

DARIO M ESPINA MD (FT SMITH) Arkansas Heart Center Ft Smith AR CardioDARRELL L LYNCH PHD (LAWTON) DARRELL L LYNCH PHD (LAWTON) Lawton OK PsychologyDave Kerby PhD Moore Counseling Center Moore OK PsychologyDavid Bishop MD Sooner Medical Services OKC OK InternistDAVID BRINKER MD (OKC) Northwest Eye Physicians OKC OK OptometryDAVID J KING DO (OKC) Quality Medical Clinic OKC OK InternistDAVID WIEGMAN MD (BARTLESVILLE) Eve Medical Bartlesville OK InternistDAVID WIEGMAN MD (MIAMI) Eve Medical Miami OK Internist

DEANN M GATTIS PHD (NORMAN) DEANN M GATTIS Psychological Services Norman OK PsychologyDEANNA SEVERSON CCC SLP DEANNA SEVERSON CCC SLP Bartlesville OK Speech

DENISE LAGRAND PSY D (TAHLEQUAH) DENISE LAGRAND PSY D (TAHLEQUAH) Tahlequah OK PsychologyDennis Morris OD Vision Source Sapulpa OK OptometryDennis Whitehouse DO Pauls Valley Medical Center Pauls Valley OK InternistDERRISE L GARNER PSY D (MIAMI) Herndon Snider & Associates PC Miami OK PsychologyDivya Byragani MD Midtown Medical Associates LLC Tulsa OK InternistDLO (ADA) - Sooner Medical Diagnostic Laboratory of Oklahoma Ada OK LabDLO (ARDMORE) - Sooner Medical Diagnostic Laboratory of Oklahoma Ardmore OK LabDLO (CLINTON) - Sooner Medical Diagnostic Laboratory of Oklahoma Clinton OK LabDLO (DURANT) - Sooner Medical Diagnostic Laboratory of Oklahoma Durant OK LabDLO (EDMOND) - Sooner Medical Diagnostic Laboratory of Oklahoma Edmond OK LabDLO (ELK CITY) - Sooner Medical Diagnostic Laboratory of Oklahoma Elk City OK LabDLO (ENID) - Sooner Medical Diagnostic Laboratory of Oklahoma Enid OK LabDLO (GROVE) - Sooner Medical Diagnostic Laboratory of Oklahoma Grove OK LabDLO (Idabel) - Sooner Medical Diagnostic Laboratory of Oklahoma Idabel OK LabDLO (LAWTON) - Sooner Medical Diagnostic Laboratory of Oklahoma Lawton OK LabDLO (MCALESTER) - Sooner Medical Diagnostic Laboratory of Oklahoma McAlester OK LabDLO (MIAMI) - Sooner Medical Diagnostic Laboratory of Oklahoma Miami OK LabDLO (MUSKOGEE) - Sooner Medical Diagnostic Laboratory of Oklahoma Muskogee OK LabDLO (OKC) - Sooner Medical Diagnostic Laboratory of Oklahoma OKC OK LabDLO (SHAWNEE) - Sooner Medical Diagnostic Laboratory of Oklahoma Shawnee OK LabDLO (STILLWATER) - Sooner Medical Diagnostic Laboratory of Oklahoma Stillwater OK LabDLO (TULSA) - Sooner Medical Diagnostic Laboratory of Oklahoma Tulsa OK LabDragos Vesbianu MD Midtown Medical Associates LLC Tulsa OK InternistDUSTIN GANT WARD PHD (MOORE) Moore Counseling Center Moore OK PsychologyDUSTIN GANT WARD PHD (MOORE)(IQ) Moore Counseling Center Moore OK PsychologyE L JORDAN JR DO PC (JOPLIN) E L JORDAN JR DO PC (JOPLIN) Joplin MO OptometryEddie Scott PhD ALDEN CLINICAL EVALUATION SVCS El Reno OK PsychologyEmily Sullivan SLP Moore Counseling Center Moore OK SpeechERIN RAMSEY SLP Ramsey Speech Pathology PLLC Muskogee OK Speech

(b) (6)

EVE MEDICAL SERVICES (ENID) EVE MEDICAL SERVICES (ENID) Enid OK PFSEVE MEDICAL SERVICES (MIAMI) EVE MEDICAL SERVICES (MIAMI) Miami OK PFS

EVE MEDICAL SERVICES (WEATHERFORD) EVE MEDICAL SERVICES (WEATHERFORD) Weatherford OK PFSFamily Vision Clinic (Robert Head, Kyle Head, Kristina Flint) FAMILY VISION CLINIC (LAWTON) Lawton OK OptometryGAIL POYNER PHD (CHOCTAW)(IQ) GAIL POYNER PHD (CHOCTAW)(IQ) Choctaw OK PsychologyGAIL POYNER PHD (CHOCTAW)(MSE) GAIL POYNER PHD (CHOCTAW)(MSE) Choctaw OK PsychologyGARY DENSLOW MD (Muskogee) Pediatric Opthalmology Inc Muskogee OK OptometryGARY DENSLOW MD (TULSA) Pediatric Opthalmology Inc Tulsa OK OptometryGEORGE S CHRYSANT MD (ALTUS) Integris Cardiovascular Physicians LLC Altus OK CardioGEORGE S CHRYSANT MD (CHICKASHA) Integris Cardiovascular Physicians LLC Chickasha OK CardioGEORGE S CHRYSANT MD (ADA) Integris Cardiovascular Physicians LLC Ada OK CardioGEORGE S CHRYSANT MD (CLINTON) Integris Cardiovascular Physicians LLC Clinton OK CardioGEORGE S CHRYSANT MD (OKC) Integris Cardiovascular Physicians LLC OKC OK CardioGREAT PLAINS REG MEDICAL CENTER-ELK CITY

GREAT PLAINS REG MEDICAL CENTER-ELK CITY Elk City OK Lab

Guila Hall MD Sooner Medical Services OKC OK InternistGWEN FUENTES MD (ARDMORE) GWEN FUENTES MD (ARDMORE) Ardmore OK InternistHAROLD ZANE DELAUGHTER DO (TULSA) Janza LLC Tulsa OK InternistHealthcare Stat (Corbert Bercier) Healthcare Stat Chickasha OK InternistHealthcare Stat (Dustin Wade) Healthcare Stat Chickasha OK InternistHealthcare Stat (Heather Worden) Healthcare Stat Chickasha OK InternistHealthcare Stat (Lindsey Leehan) Healthcare Stat Chickasha OK InternistHealthcare Stat (Martin Christensen) Healthcare Stat Chickasha OK InternistHealthcare Stat (Shawn Bonilla) Healthcare Stat Chickasha OK InternistHealthcare Stat (Tonya Jones) Healthcare Stat Chickasha OK Internist

HEARTS FOR HEARING - (Wolfe, Neumann) HEARTS FOR HEARING OKC OK AudiologyHEATHER RANGER PHD (TULSA) HEATHER RANGER PHD (TULSA) Tulsa OK PsychologyHope Burkett DO H&H Exams LLC Tulsa OK InternistIlse Carrizales PhD Moore Counseling Center Moore OK PsychologyINNOVATIVE EXPRESSIONS INNOVATIVE EXPRESSIONS Edmond Ok Speech

JACOB AZURDIA MD (Sooner Medical OKC) Sooner Medical Services OKC OK InternistJACOB AZURDIA MD(ENID) Eve Medical Enid OK InternistJACOB AZURDIA MD(WEATHERFORD) Eve Medical Weatherford OK InternistJAMES CHAPMAN MD (GROVE) Oklahoma Heart Institute Grove Ok CardioJAMES CRUTCHER MD (BARTLESVILLE) Eve Medical Bartlesville Ok InternistJAMES CRUTCHER MD (MIAMI) Eve Medical Miami Ok InternistJAMES H GENTRY DO (ADA) Midwest CES Ada Ok Internist

(b) (6)

JAMES H GENTRY DO (ARDMORE) Midwest CES Ardmore Ok InternistJAMES H GENTRY DO (MCALESTER) Midwest CES McAlester Ok InternistJAMES H GENTRY DO (MUSKOGEE) Midwest CES Muskogee OK InternistJAMES L BURKE DO (OKC) Quality Medical Clinic OKC OK InternistJAMES SCOTT PSY D (SHAWNEE) (MSE) Ok Assessment & Therapy Services Shawnee OK PsychologyJAMES SCOTT PSY D (SHAWNEE)(IQ) Ok Assessment & Therapy Services Shawnee OK PsychologyJAN S KENT PHD (MIAMI) Herndon Snider & Associates PC Joplin MO PsychologyJANA B KLUCK MA CCC SLP (OKC) JANA B KLUCK MA CCC SLP (OKC) OKC OK SpeechJANET KATES PHD (OKC) JANET KATES PHD (OKC) OKC OK PsychologyJason Pickard OD Cornerstone Eye Care OKC OK OptometryJennifer Davis SLP Ramsey Speech Pathology PLLC Muskogee OK Speech

JENNIFER LANCASTER PHD (NORMAN)(IQ) Lancaster Psychological Services Norman OK Psychology

JENNIFER LANCASTER PHD (NORMAN)(MSE) Lancaster Psychological Services Norman OK PsychologyJENNY BENDURE PhD Serinity Mental Health Norman OK PsychologyJEROME M DILLING JR MD (ENID) JEROME M DILLING JR MD (ENID) Enid OK AudiologyJERRY CHILDS JR DO (OKC) Quality Medical Clinic OKC OK InternistJERRY D FIRST MD (TULSA) JERRY D FIRST MD (TULSA) Tulsa OK InternistJERRY D WHITE PHD (OKC) JERRY D WHITE PHD (OKC) OKC OK PsychologyJOHN B BARRINGER OD (ARDMORE) Vision Source Ardmore OK OptometryJOHN FARAG DO (Eve Medical) Eve Medical Weatherford OK InternistJOHN FARAG DO (Sooner Medical) Sooner Medical OKC OK InternistJOHN J ALPAR MD (AMARILLO) JOHN J ALPAR MD (AMARILLO) Amarillo TX OptometryJOHN RICE DO (CHECOTAH) Payne & Rice Clinic Checotah OK InternistJOHNA KAY SMASAL PHD (TULSA) JOHNA KAY SMASAL PHD (TULSA) Tulsa OK PsychologyJOHNA KAY SMASAL PHD (TULSA) JOHNA KAY SMASAL PHD (TULSA) Tulsa OK PsychologyJohnnie Brasuell APRN Johnnie Brasuell APRN Catoosa OK InternistJOHNSON GOURD MD (MIAMI) Eve Medical Miami OK InternistJOSE A ALEMPARTE MD (FT SMITH) JOSE A ALEMPARTE MD (FT SMITH) Ft Smith AR CardioJOSEPH JAMES PSY D (TULSA) (TEST) Christian Family Institute Tulsa OK PsychologyJOSEPH JAMES PSY D (TULSA)(MSE) Christian Family Institute Tulsa OK PsychologyJUAN MALDONADO MD (ANADARKO) JUAN MALDONADO MD (ANADARKO) Anadarko OK InternistJUAN RANGO MD (ADA) Midwest CES Ada OK InternistJUAN RANGO MD (ARDMORE) Midwest CES Ardmore OK InternistJUAN RANGO MD (MCALESTER) Midwest CES McAlester OK InternistJUAN RANGO MD (MUSKOGEE) Midwest CES Muskogee OK InternistJUSTIN ANDERSON MD (OKC) Quality Medical Clinic OKC Ok InternistJustin Funk OD Premier Eyecare of Enid Enid OK OptometryKARA RODGERS PSY D (OKC) Brookwood Psychological Services OKC Ok Psychology

(b) (6)

KATHLEEN A WARD PHD (MCALESTER) KATHLEEN A WARD PHD (MCALESTER) McAlester Ok PsychologyKEITH GREEN PHD (OKC) R KEITH GREEN PHD (OKC) OKC Ok PsychologyKENNY A PARIS PHD (TAHLEQUAH) KENNY A PARIS PHD (TAHLEQUAH) Tahlequah Ok PsychologyKent Abernathy DO Midtown Medical Associates LLC Tulsa OK InternistKEVIN M WHISMAN PSY D (JOPLIN) KEVIN M WHISMAN PSY D (JOPLIN) Joplin MO PsychologyKimi Carson PhD Moore Counseling Center Moore OK PsychologyKonstantin Berestnev MD Arkansas Occupational Health Clinic Springdale AR InternistKonstantin Berestnev MD Arkansas Occupational Health Clinic Van Buren AR InternistKRISTI L BRATKOVICH PHD (LAWTON) KRISTI L BRATKOVICH PHD (LAWTON) Lawton OK PsychologyLacy Crissup OD Claremore Eye Associates Claremore OK OptometryLARRY VAUGHT PHD (TULSA) LARRY VAUGHT PHD (TULSA) Tulsa OK PsychologyLeah Upton DO Jenks Health Team Jenks Ok InternistLeomar Bautista DO H & H Exams Tulsa OK InternistLesley Flores SLP Lesley Flores SLP Tulsa OK SpeechLevi Armstrong PhD Paris Counseling Center Paris TX Psychology

LINDA K CAMERON MA CCC (EDMOND) LINDA K CAMERON MA CCC (EDMOND) Edmond OK SpeechM. Said Sadeghi DO Pediatric Opthalmology Inc Tulsa OK Optometry


MARK ENGLANDER PHD (MSE) (NORMAN) MARK ENGLANDER PHD (MSE) (NORMAN) Norman OK PsychologyMARK WOOD MD (OKC) Otologic Medical Clinic OKC OK AudiologyMARTIN D BAUTISTA MD (GUYMON) Specialty Clinics Of St Anne PLLC Guymon OK InternistMARY MARGUERITE LANGILLE-HOPPE PSY D (SHAWNEE) Ok Assessment & Therapy Services Shawnee OK PsychologyMatthew Heisey APRN Pauls Valley Medical Center Pauls Valley OK InternistMATTHEW PHILIP FEIST MD (ADA) Midwest CES Ada OK InternistMATTHEW PHILIP FEIST MD (ARDMORE) Midwest CES Ardmore OK Internist

MATTHEW PHILIP FEIST MD (MCALESTER) Midwest CES McAlester OK InternistMatthew Philip Feist MD (Muskogee) Midwest CES Muskogee OK InternistMatthew Smith DO H & H Exams Tulsa OK InternistMAX CARLISLE OD (FAIRVIEW) MAX CARLISLE OD (FAIRVIEW) Fairview OK OptometryMaxwell Sencherey DO H & H Exams Tulsa OK Internist

MCCURTAIN MEMORIAL HOSPITAL-PFS MCCURTAIN MEMORIAL HOSPITAL-PFS Idabel OK PFSMELINDA SHAVER PSY D (BARTLESVILLE) (MSE)

MELINDA SHAVER PSY D (BARTLESVILLE) (MSE) Bartlesville OK Psychology

MICHAEL KARATHANOS MD (TULSA) MICHAEL KARATHANOS MD (TULSA) Tulsa OK Neurology

(b) (6)

MICHAEL MCGEE MD (OKC) Otologic Medical Clinic OKC OK AudiologyMICHAEL SCHIFF MD (PONCA CITY) Integris Cardiovascular Physicians LLC Ponca City OK Cardio

MICHELINE CHRISMAN PSYD (NORMAN) MICHELINE CHRISMAN PSYD (NORMAN) Norman OK PsychologyMINOR GORDON PHD (CLAREMORE) MINOR GORDON PHD (CLAREMORE) Claremore OK PsychologyMIRACLE GOETZ PSY D (MOORE)(IQ) Moore Counseling Center Moore OK PsychologyMIRACLE GOETZ PSY D (MOORE)(MSE) Moore Counseling Center Moore OK PsychologyNANCY FAYE BARTON PHD (TULSA) NANCY FAYE BARTON PHD (TULSA) Tulsa OK PsychologyNICK LEE CARROLL DO (TULSA) Midtown Medical Associates LLC Tulsa OK InternistOKEY NWOKOLO MD (OKC) Okey Nwololo MD & Associates OKC OK PediatricsPAUL J SCHWARTZ PHD (TULSA) PAUL J SCHWARTZ PHD (TULSA) Tulsa OK Psychology

PAUL J SCHWARTZ PHD (TULSA) (TEST) PAUL J SCHWARTZ PHD (TULSA) (TEST) Tulsa OK PsychologyPAUL S THOMAS MD (MCALESTER) Warren Clinic McAlester OK PsychologyPauls Valley Medical Center Pauls Valley Medical Center Pauls Valley OK X-rays/labsPeggy Gardner ARNP Main Street Family Clinic Stroud OK InternistPETER CIALI PHD (TULSA) Advanced Pain Specialist Tulsa OK PsychologyPeter Holm PhD Peter Holm PhD Sherman TX PsychologyPULMONARY PHYSICIANS OF OKC PULMONARY PHYSICIANS OF OKC OKC OK PFSQTC MEDICAL GROUP INC (LAWTON) QTC MEDICAL GROUP INC (LAWTON) Lawton Ok X-ray/labsQTC MEDICAL GROUP INC (OKC) QTC MEDICAL GROUP INC (OKC) OKC Ok X-ray/labs

QUALITY MEDICAL CLINIC (OKC)-PFS/LAB QUALITY MEDICAL CLINIC (OKC)-PFS/LAB OKC Ok PFS/LabsRACHEL SMILEY PHD (IQ) (MOORE) Moore Counseling Center Moore Ok PsychologyRACHEL SMILEY PHD (MOORE)(MSE) Moore Counseling Center Moore Ok PsychologyRAFAEL F OTERO PHD (TEXARKANA) RAFAEL F OTERO PHD (TEXARKANA) Texarkana TX PsychologyRAY HAND PHD (OKC) RAY HAND PHD (OKC) OKC OK PsychologyRaymond Azadgoli MD Quality Medical Clinic OKC Ok Internist



REDA RASCO PSY D (WICHITA FALLS, TX) Madden Counseling Witchita Falls TX PsychologyREDA RASCO PSY D (WICHITA FALLS,TX) Madden Counseling Witchita Falls TX PsychologyRENETTA REEVES MD (ADA) Midwest CES Ada OK InternistRENETTA REEVES MD (MCALESTER) Midwest CES McAlester OK InternistRENETTA REEVES MD (MUSKOGEE) Midwest CES Muskogee OK InternistRICHARD KAHOE PHD (WATONGA) RICHARD KAHOE PHD (WATONGA) Watonga OK PsychologyRICHARD KAHOE PHD (WOODWARD) RICHARD KAHOE PHD (WOODWARD) Woodward OK PsychologyRIVER SMITH PHD (TULSA) Advanced Pain Specialist Tulsa OK PsychologyROBERT C BALOGH MD (LAWTON) Allied Labs of Lawton Lawton OK Internist

(b) (6)

Robert Danaher PhD ALDEN CLINICAL EVALUATION SVCS El Reno OK Psychology

ROBERT L SPRAY JR PHD PA (FT SMITH) ROBERT L SPRAY JR PHD PA (FT SMITH) Ft Smith AR PsychologyROBERT R WALLER PHD (OKC) ROBERT R WALLER PHD (OKC) OKC OK PsychologyROBIN HALL MD (OKC) Quality Medical Clinic OKC OK InternistRussell Pella PhD Comprehensive Comm Rehab Services Tulsa OK PsychologyS A CHAUDHRY MD (OKC) S A CHAUDHRY MD (OKC) OKC OK InternistS KRISHNAMURTHI MD (SAPULPA) S KRISHNAMURTHI MD (SAPULPA) Sapulpa OK CardioSARAH CLAY OD (ARDMORE) Clay Optometry Ardmore OK OptometrySARAH MILLER COATS PHD (ENID) SARAH K Miller PhD Enid OK PsychologySEAN P SATTERFIELD MED CCC SLP (PONCA CITY)

SEAN P SATTERFIELD MED CCC SLP (PONCA CITY) Ponca City OK Speech

Sharon Bowen ARNP Abraham Medical Clinic Hollis OK InternistSHERMAN LAWTON MD (OKC) SHERMAN LAWTON MD (OKC) OKC OK NeurologySHERRI L MURRY PHD (OKC) Care for Change Inc OKC OK PsychologySIDNEY WILLIAMS MD (STILLWATER) Williams Clinic of Stillwater Stillwater OK InternistSOONER MEDICAL SERVICES (X-RAY) SOONER MEDICAL SERVICES (X-RAY) OKC OK X-raySOONER MEDICAL SERVICES(PFS) SOONER MEDICAL SERVICES(PFS) OKC OK PFSSPARKS LUNG CENTER SPARKS LUNG CENTER Ft Smith AR PFSSPENCER CLARK DO (ENID) Eve Medical Enid OK InternistSPENCER CLARK DO (WEATHERFORD) Eve Medical Weatherford OK InternistSRIKANTH REDDY MD (TULSA) Tulsa Bone and Joint Associates Tulsa Ok InternistST ANTHONY HOSPITAL ST ANTHONY HOSPITAL OKC Ok PFSST JOHN MED CENTER (PULM)-TULSA ST JOHN MED CENTER (PULM)-TULSA Tulsa Ok PFS

ST JOHN MEDICAL CENTER (LAB)(TULSA) ST JOHN MEDICAL CENTER (LAB)(TULSA) Tulsa Ok LabSTEPHANIE CRALL PHD (MSE) (OKC) Assessment & Consult Services PC OKC OK PsychologyStephanie Letney DO Midtown Medical Associates LLC Tulsa OK InternistSTEPHEN R CLOSE PHD (ENID) STEPHEN R CLOSE PHD (ENID) Enid OK PsychologySTEWART J KATZ MD (TULSA) Cardiovascular Specialist Inc Tulsa OK CardioSully Drotar DO Midtown Medical Associates LLC Tulsa OK InternistSUNG WOOK CHOI MD (ADA) Midwest CES Ada OK InternistSUNG WOOK CHOI MD (ARDMORE) Midwest CES Ardmore OK InternistSUNG WOOK CHOI MD (MCALESTER) Midwest CES McAlester OK InternistSUNG WOOK CHOI MD (MUSKOGEE) Midwest CES Muskogee OK InternistSUSAN M LINDE PHD (TULSA) SUSAN M LINDE PHD (TULSA) Tulsa OK PsychologySUSAN SELL SLP (WOODWARD) SUSAN SELL SLP (WOODWARD) Woodward OK Speech

SUZAN B SIMMONS PHD PLLC (PONCA CITY) SUZAN B SIMMONS PHD PLLC (PONCA CITY) Ponca City OK Psychology

SXR MEDICAL EVALUATIONS (TULSA) SXR MEDICAL EVALUATIONS (TULSA) Tulsa OK X-rays/labsTatyana Mayer OD Mayer Eye Care Inc Ponca City OK Optometry

(b) (6)

TAWFIK RAMADAN MD (ADA) Southern OK Pediatrics Inc Ada OK PediatricsTERRANCE KHASTGIR MD (OKC) Integris Cardiovascular Physicians LLC OKC OK CardioTERRY L KILGORE MD (PARIS) TERRY L KILGORE MD (PARIS) Paris TX InternistTEXARKANA EYE ASSOCIATES - Sean Summers OD TEXARKANA EYE ASSOCIATES Idabel OK OptometryTexoma Medical Center Texoma Medical Center Denison TX Labs

THERESA HORTON PHD (IDABEL) (MSE) THERESA HORTON PHD (IDABEL) (MSE) Idabel OK PsychologyTHERESA HORTON PHD (POTEAU) THERESA HORTON PHD (POTEAU) Poteau OK PsychologyTHERON BLISS DO (BARTLESVILLE) Eve Medical Bartlesville OK InternistTHERON BLISS DO (ENID) Eve Medical Enid OK InternistTHERON BLISS DO (MIAMI) Eve Medical Miami OK InternistTHERON BLISS DO (WEATHERFORD) Eve Medical Weatherford OK InternistThomas Wolf MD Urgent Eye Care Edmond OK OptometryTimothy Cramer MD Sooner Medical OKC OK InternistTIMOTHY DOTY PHD (TULSA) Christian Family Institute Tulsa OK PsychologyTODD GRAYBILL PHD PLLC (IQ) B TODD GRAYBILL PHD PLLC (IQ) Muskogee OK PsychologyTODD GRAYBILL PHD PLLC (MSE) B TODD GRAYBILL PHD PLLC (MSE) Muskogee OK PsychologyTracie Gillispie LPC Tracie Gillispie LPC Duncan OK PsychologyTREY CARLISLE OD (BEAVER) Carlisle Vision Clinic PLLC Beaver OK OptometryTyler Freeman MD Sooner Medical Services OKC OK InternistURSULA BOWLING PSY D (ARDMORE) URSULA BOWLING PSY D (ARDMORE) Ardmore OK PsychologyVICKI PERKINS PHD (BEAVER) VICKI PERKINS PHD (BEAVER) Beaver OK PsychologyVICTOR T WILSON MD PC (NORMAN) VICTOR T WILSON MD PC (NORMAN) Norman OK PediatricsVIDYA REGE MD (EL RENO) VIDYA REGE MD (EL RENO) El Reno OK OptometryVIDYA REGE MD (OKC) VIDYA REGE MD (OKC) OKC OK OptometryVirginia Burk PhD Moore Counseling Center Moore OK PsychologyVISHAL KADAKIA MD (BARTLESVILLE) Eve Medical Bartlesville OK InternistVISHAL KADAKIA MD (ENID) Eve Medical Enid OK InternistVISHAL KADAKIA MD (WEATHERFORD) Eve Medical Weatherford OK InternistWILLIAM CHAPMAN MD (SHAWNEE) WILLIAM CHAPMAN MD (SHAWNEE) Shawnee OK PediatricsWilliam Collins MD Sooner Medical Services OKC OK InternistWILLIAM GRUBB MD (TULSA) WILLIAM GRUBB MD (TULSA) Tulsa OK InternistWILLIAM GRUBB MD (OKMULGEE) WILLIAM GRUBB MD (OKMULGEE) Okmulgee OK InternistWilliam K Russell MD Sooner Medical Services OKC OK InternistWILLIAM L COOPER PHD (TULSA) WILLIAM L COOPER PHD (TULSA) Tulsa OK PsychologyWILLIAM T BRYANT PHD (OKMULGEE) WILLIAM T BRYANT PHD (OKMULGEE) Okmulgee OK PsychologyWOJCIECH DULOWSKI MD (STILWELL) WOJCIECH DULOWSKI MD (STILWELL) Stilwell OK InternistYEE SE CHOA ONG MD (MUSKOGEE) Cardiology Clinic of Muskogee Inc Muskogee OK Cardio

(b) (6)

VISHAL KADAKIA MD (ENID) VISHAL KADAKIA MD (WEATHERFORD) VIDYA REGE MD (EL RENO) Moore Counseling (Moore Okla)SPENCER CLARK DO (ENID) TERRANCE KHASTGIR MD (OKC) THERON BLISS DO (WEATHERFORD) SARAH MILLER COATS PHD (ENID) Robert Danaher PhDPULMONARY PHYSICIANS OF OKC KEITH GREEN PHD (OKC) JOHN FARAG DO (Eve Medical)JANA B KLUCK MA CCC SLP (OKC) JACOB AZURDIA MD(WEATHERFORD)Healthcare Stat (Corbert Bercier)Healthcare Stat (Dustin Wade)Healthcare Stat (Heather Worden)Healthcare Stat (Lindsey Leehan)Healthcare Stat (Martin Christensen)Healthcare Stat (Shawn Bonilla)Healthcare Stat (Tonya Jones)Midtown Medical Associates (Tulsa OK)Eddie Scott PhDBeverly Cooper ARNPAmy Ashcraft ARNPAkram Abraham MDMidtown Medical Associates Tulsa Oklahoma Audiology of TulsaBrad Liston DO Ponca City Dennis Morris OD Sapulpa OklahomaJohnnie Brausell ARNP Catoosa Oklahoma Christian Family Institute Tulsa OkClaremore Eye Associates Claremore Oklahoma H&H Exams Tulsa OklahomaPediatric Ophthalmology Tulsa OKMinor Gordon PhD Claremore OkSean Satterfield SLP Ponca City SXR Evaluations Tulsa OkMayer Eye Care Ponca City Robin Hall MD OKCQuality Medical Clinic OKCMark Englander PhD NormanVictor Wilson MD Norman

Onsite Reviews

Jerry Childs Jr DODavid King DO OKCRamond Azadgoli MD OKCJames Burke DO OKCJustin Anderson MD OKCSooner Medical Services OKCMidwest CES McAlester and Ada

Table Guide CE Licensing Check for FY 2015123456789

12345678

Column notes the providers license number.Column notes the providers license expiration date.Column notes if the provider has had any SAMS sanctions.

Column notes which is a key and non-key provider.

Oregon Hospitals doing X-Rays, Pulmonary Function Tests, Doppler's, etc. (Hospitals)Oregon providers doing Audiology and Speech Language exams (AuD & SLP)Oregon Medical Doctors and Doctors of Osteopathic Medicine doing physical exams (MD & DO)

Individual table column headings:Column notes the providers name or clinic name.Column provides the name of the clinic or group the provider is associated with.Column notes the region of Oregon and city the providers office is located in. OR groups resources regionally. Column notes the month/year of the last onsite office visit. Some providers have remote locations and visits are rare.

California providers doing exams for Oregon Claimants (CA)

Oregon providers doing Psychological Exams (PSY)Oregon providers doing Occupational Therapy and Physical Therapy Exams (OT & PT)Oregon providers doing Opthomology exams (OD)Washington providers doing exams for Oregon Claimants (WA)Idaho providers doing exams for Oregon Claimants (Idaho)

Updated 10/13/2017 WPL

OR DDS CE Licensing Check for PSY FY 2016/17

Provider Name or Clinic Name Provider Association (Group/Clinic) Location: Region / City Onsite Visit

Month/Year Key/Volume

Provider License Number Expiration SAMS Check

Adler, John, PhD: PDX NE Met: Gresham Jul-17 Non-Key 6/30/2018 NoneAlvord, Scott T, PsyD: Office space at North

Bend DHS Roseburg Met: North Bend Sep-16 Top 5 10/31/2018 None

Alvord, Scott T, PsyD: Office space at Roseburg SPD

Roseburg Met: Roseburg Sep-16 Top 5 10/31/2018 None

Alvord, Scott T, PsyD: Riverview Business Park Eugene Met: Eugene TBD New Office Top 5 10/31/2018 None

Alvord, Scott T, PsyD: Lake Oswego Medical PDX SE Met: Lake Oswego Sep-17 Top 5 10/31/2018 NoneBarnes, Andrew, PhD: (NWOM) PDX NW Met: Beaverton Jun-16 Non-Key 7/31/2018 NoneBee, Heather A, PsyD: Astoria Met: Astoria Sep-17 Non-Key 12/31/2018 NoneBelcher, Paula M, PhD: Eugene Met: Eugene Aug-16 Non-Key 6/30/2019 NoneBrischetto, Cheryl, PhD: PDX NW Met: Portland Jun-16 Non-Key 8/31/2019 NoneBroadwell, PsyD MDSI MDSI N/A N/A 12/31/2017 NoneCalkins, Roderick, PhD: Portland PSY Clinic PDX NE Met: Portland Sep-17 Non-Key 5/31/2018 NoneClausel, Jeff, PhD: Office space @ La Grande

DHSPendleton Met: La Grande Oct-15 Non-Key 9/30/2019 None

Clausel, Jeff, PhD: Office space @ Baker SPD Pendleton Met: Baker City Oct-15 Non-Key 9/30/2019 None

Clausel, Jeff, PhD: Office space @ Ontario DHS

Ontario Met: Ontario TBA New Office Non-Key 9/30/2019 None

Cogburn, Robinann, PhD: PDX NW Met: Portland Booked Out Non-Key 4/30/2019 NoneCole, Greg A, PhD: PDX NE Met: Portland Sep-17 Non-Key 8/31/2018 NoneCole, Greg A, PhD: Salem Met: McMinnville Oct-17 Non-Key 8/31/2018 None

Cole, Greg A, PhD: Medford Met: Klamath Falls May-15 Non-Key 8/31/2018 None

Cole, Greg A, PhD: Roseburg SPD Office Roseburg Met: Roseburg Sep-16 Non-Key 8/31/2018 None

Cole, Greg A, PhD: Newport OVRS Albany Met: Newport Sep-16 Non-Key 8/31/2018 None

Condon, Stephen, PhD: Pendleton Met: Pendleton Oct-15 Non-Key 2/28/2019 NoneDehaan-Sullivan, Rita, PhD: Medford Met: Medford May-15 Non-Key 5/31/2018 None

Dickinson, Mercedes, PhD: Southern OR Klamath. Medford Met: Medford May-15 Non-Key 1/31/2019 None


(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)(b) (6)(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)





Dietlein, Nick R, PsyD: Mid Valley Counseling Salem Met: Salem Jul-17 Non-Key 10/31/2018 None

Dillon, Mark G, PhD: PDX NE Met: Portland Sep-17 Non-Key 8/31/2019 None

Dooley, Tom M, PsyD: East Side PSY PDX Obgyn PDX NE Met: Portland Oct-17 Non-Key 11/22/2018 None

Doppelt, Lee H, PhD: PDX NW Met: Lake Oswego Oct-17 Non-Key 3/31/2018 None

Dudley, Kenneth, PhD: Office space at DHS Bldg. Pendleton Met: La Grande Oct-15 Moved 3/17 12/31/2017 None

Dudley, Kenneth, PhD: Pendleton Met: Baker City Oct-15 Moved 3/17 12/31/2017 None

Dudley, Kenneth, PhD: Office space at DHS Bldg. Pendleton Met: Enterprise N/A Moved 3/17 12/31/2017 None

Ethel-King, Patrick, PhD: New Horizons Wellness Serv.

PDX NW Met: Beaverton Jun-16 Non-Key 7/31/2018 None

Evans, Stephanie C, PsyD: Pendleton Professional Services

Pendleton Met: Pendleton Oct-15 Non-Key 2/28/2018 None

Ferreira, Carolyn, PsyD: Cascade Psychological Bend Met: Bend Oct-17 Non-Key 12/31/2017 None

Gibby-Smith, Barbara, PsyD: PDX NW Met: Forest Grove Jun-16 Non-Key 12/31/2017 None

Gomes, Manuel J, PhD MDSI MDSI N/A N/A 2/28/2019 None

Goodale, Kimberly, PhD: (NWOM) PDX NW Met: Beaverton Jun-16 Non-Key 6/30/2018 None

Gostnell, David R, PhD: PDX NE Met: Portland Sep-17 Key Provider 11/30/2017 None

Gostnell, David, PhD: Nehalem Bay Health District

Astoria Met: Wheeler Sep-17 Key Provider 11/30/2017 None

Greene, Katherine, PsyD: Medford Met: Phoenix May-15 Non-Key 7/31/2018 None

Greif, Elaine, PhD: PDX NW Met: Portland Jun-16 Non-Key 12/31/2017 None


(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)





Hallenburg, Kris, PhD MDSI MDSI N/A N/A 12/31/2017 None

Huggins, Stephen, PhD: PDX NE Met: Gresham Jul-17 Non-Key 7/31/2019 None

Janzen, Darren, PhD: CDRC Doernbecher PDX SW Met: Portland Jul-17 Non-Key 7/31/2018 None

Johnston, Shawn, PhD: PDX NE Met: Oregon City Jun-17 Retired 6/17 5/31/2018 None

Kaper, Scott, PhD: PDX NE Met: Clackamas Jul-17 Non-Key 2/28/2019 None

Kaper, Scott, PhD: PDX NW Met: Tualatin Jul-17 Non-Key 2/28/2019 None

Kollross, Natalie, PsyD: Pendleton Professional Services

Pendleton Met: Pendleton Oct-15 Non-Key 7/31/2018 None

Kruger, Robert, PsyD: Salem Met: Salem Jul-17 Non-Key 3/31/2019 None

Lahman, Frank, PhD: Rehab Associates NW Albany Met: Corvallis Feb-16 Non-Key 11/30/2018 None

Lake, Claudia, PsyD MDSI MDSI N/A Not using 4/17 5/31/2019 None

Larson, Jamie, PsyD MDSI MDSI N/A N/A 8/31/2018 NoneLeland, Michael, PhD: (NWOM) PDX NW Met: Beaverton Jun-16 Retired 6/17 11/30/2019 NoneMcConochie, William, PhD: Emotional Ed. Service Eugene Met: Eugene Aug-16 Non-Key 5/31/2018 NoneMDSI: MDSI Eugene Met: Eugene Aug-16 Top 5 N/A NoneMDSI: MDSI Medford Met: Medford May-15 Top 5 N/A NoneMDSI: MDSI Salem Met: Salem Apr-17 Top 5 N/A NoneMDSI: MDSI PDX NE Met: Portland Sep-17 Top 5 N/A NoneMDSI: MDSI (PSY Only) Roseburg Met: Coos Bay Sep-16 Top 5 N/A NoneMichaud, Lois, PhD: Eugene Met: Eugene Sep-16 Non-Key 8/31/2019 NoneMiller, Pamela, PhD: PDX NE Met: The Dalles Oct-15 Non-Key 5/31/2019 NoneMours, James, PhD: PDX NE Met: Oregon City Aug-15 Closed this

office 8/17 5/31/2018 None

Mours, James, PhD: PDX NE Met: Clackamas Jul-17 Non-Key 5/31/2018 None


(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)(b) (6)(b) (6)(b) (6)

(b) (6)(b) (6)(b) (6)

(b) (6)





Mours, James, PhD: PDX NE Met: Milwaukie Oct-17 Non-Key 5/31/2018 NoneNorthway, David, PhD: Eugene Met: Eugene Sep-16 Non-Key 12/31/2018 NoneO'Connell, Michael, PhD: Medford Met: Medford May-15 Non-Key 9/30/2019 NonePatrick, Luke, PhD: Wildwood PSY Resource PDX NW Met: Beaverton Jun-16 Non-Key 1/31/2018 None

Pearson, Edwin, PhD: Medford Met: Medford May-15 Non-Key 8/31/2019 NonePotter, Thomas, PhD: Salem Met: Salem Jul-17 Non-Key 11/30/2018 NonePowers, Peter, PhD: Eugene Met: Eugene Aug-16 Non-Key 7/31/2018 NoneReynolds, Rosemarie, PhD: Medford Metro: Brookings Sep-16 Non-Key 7/31/2018 NoneRoman, Pamela, PhD: Eugene Met: Eugene Sep-16 Non-Key 6/30/2019 NoneSacks, Gary, PhD: PDX NW Met: Portland Jun-16 Non-Key 5/31/2018 NoneScharf, Daniel, PhD: PDX NW Met: Beaverton Sep-17 Non-Key 2/28/2018 NoneSher, Jeffrey, PhD: PDX SW Met: Portland Sep-17 Non-Key 12/31/2017 NoneShields, Thomas, PhD: Medford Metro: Ashland May-15 Non-Key 10/31/2018 NoneShields, Thomas, PhD: Medford Met: Grants Pass May-15 Non-Key 10/31/2018 NoneSmith, Lynette, PsyD MDSI MDSI N/A N/A 7/31/2019 NoneSmith, Regan, PhD: CDRC Eugene Met: Eugene Sep-16 Non-Key 11/30/2017 NoneSmyth, Douglas, PhD: Albany Met: Corvallis Feb-16 Non-Key 8/31/2018 NoneStarbird, Jane, PhD: Nehalem Bay Health

District Astoria Met: Wheeler Sep-17 Key Provider 1/31/2018 None

Stoltzfus, Pau, PsyD: Behavioral Health Clinic Salem Met: Newberg Oct-17 Non-Key 4/30/2019 None

Stoltzfus, Paul, PsyD: Mid Valley Counseling Salem Met: Salem Apr-17 Non-Key 4/30/2019 NoneStradinger, Kay, PsyD: MDSI MDSI N/A Moved 8/17 9/30/2017 NoneStuckey, Marc, PsyD: PDX NW Met: Hillsboro Jun-16 Non-Key 4/30/2018 NoneStuckey, Marc, PsyD: Astoria Met: Astoria Sep-17 Non-Key 4/30/2018 NoneTempleman, Terrell, PhD: Pendleton Professional

ServicesPendleton Met: Pendleton Oct-15 Non-Key 12/31/2018 None

Tongue, Chris, PhD: PDX NE Met: Gresham Jul-17 Non-Key 5/31/2018 NoneTorres, Robert, PhD: PDX NE Met: Milwaukie Oct-17 Non-Key 2/28/2019 NoneTrueblood, William, PhD: Bend Met: Bend Oct-17 Non-Key 2/28/2019 NoneTucker, Brian, PsyD: PDX NE Met: Portland Sep-17 Non-Key 7/31/2018 None


(b) (6)(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)(b) (6)

(b) (6)(b) (6)(b) (6)

(b) (6)(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)





Veith, Dale, PsyD: PSY Asses. Services and TX

Salem Met: McMinnville Jul-17 Ceased 10/17 11/20/2017 None

Villanueva, Michael, PsyD: Southern OR Klamath . Fam. Practice.

Medford Met: Medford May-15 Non-Key 7/31/2019 None

Villanueva, Michael, PsyD: Roseburg Neuro Roseburg Met: Roseburg Sep-16 Non-Key 7/31/2019 NoneVillanueva, Michael, PsyD: Klamath Family Practice Medford Met: Klamath Falls May-15 Non-Key 7/31/2019 None

Wahl, Gail L, PhD: Hall Building Roseburg Met: Coos Bay Sep-16 Non-Key 6/30/2019 NoneWang, Martha, PhD: Adagio Therapy CTR LLC Salem Met: Salem Jul-17 Non-Key 5/31/2019 NoneWatson-Stites, Elizabeth, PhD: CDRC Eugene Met: Eugene Sep-16 Non-Key 2/28/2019 None

Webb, Kurt, PsyD: Salem Met: Salem Jul-17 Non-Key 7/31/2019 NoneWhitehead, Michelle, PhD: Bend Met: Bend Oct-17 Non-Key 6/30/2018 NoneWicher, Donna, PhD: PDX NW Met: Beaverton Jun-16 Non-Key 2/28/2019 NoneWicher, Donna, PhD: PDX NE Met: Clackamas Jul-17 Non-Key 2/28/2019 NoneWicher, Donna, PhD: PDX NW Met: Hillsboro Jun-16 Non-Key 2/28/2019 NoneWicher, Donna, PhD: PDX SE Met: Portland Jun-16 Non-Key 2/28/2019 NoneWilcox, Georgia, PsyD: Wilcox & Associates

The Water Tower BLDGPDX SW Met: Portland Sep-17 Non-Key 6/30/2018 None

Wong-Nagan, Julia, PhD: PDX SW Met: Portland Sep-17 Booked Out 3/31/2019 None


(b) (6)(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)(b) (6)(b) (6)

(b) (6)

(b) (6)

OR DDS CE License Check for OT and PT FY 2016/17

Provider Name or Clinic Name Provider Association (Group/Clinic) Location: Region / City

Onsite Visit Month/Year

Key/Volume Provider

License Number Expiration

Strode, Margaret C, OT: Beaverton, New Horizons Wellness Service

PDX NW Met: Beaverton Jun-16 Ceased in

4/16 5/31/2016

Ethel-King, Melodie, OT: Beaverton, New Horizons Wellness Service

PDX NW Met: Beaverton Jun-16 Non-Key

Provider 5/31/2018

Fouts, Stephanie M, OT: Beaverton, New Horizons Wellness Service

PDX NW Met: Beaverton

Jun-16 Non-Key Provider 5/31/2018


(b) (6)

(b) (6)

(b) (6)

OR DDS CE Licensing for OD (E110) FY 2016/17

Provider Name or Clinic Name Provider Association (Group/Clinic) Location: Region / City Onsite Visit Month/Year

Key/Volume Provider

License Number Expiration

Smith, Douglas, OD: Bison Vision Medford Metro: Medford May-15 Non-Key 11/30/2017Glabe, David. OD: La Grande Family Eye Care Ontario Metro: La Grande TBD Non-Key 1/31/2018Overton, Scott H, OD: Pacific Uni. OR PDX Fam. Vision PDX SW: Portland Sep-17 Non-Key 3/31/2018Kimball, Samuel, OD: La Grande Family Eye Care Ontario Metro: La Grande TBD Non-Key 4/30/2018


(b) (6)(b) (6)(b) (6)

(b) (6)(b) (6)

OR DDS CE Licensing for WA State CE Providers FY 2016/17



Provider License Number Expiration

Gaffield, Gary, OP: MDSI-Longview Astoria Met: Longview N/A Top 5 2/20/2018Gibson, Philip Vannoy, PhD: MDSI-Longview Astoria Met: Longview N/A Top 5 6/26/2018Kurdieh, Ibrahim Ishaq, PsyD: NW PSY

Astoria Met: Longview N/A Non-Key 8/9/2018

McCulloch, Katie B, PhD: NW PSY Astoria Met: Longview N/A Non-Key 4/14/2018Meharg, Stephen, PsyD: NW PSY Astoria Met: Longview N/A Non-Key 4/25/2020Patterson, Alexander, PsyD: MDSI-Longview Astoria Met: Longview N/A Top 5 5/8/2018St. John Medical CTR Hosp: X-Rays read by Longview

Radiologists Astoria Met: Longview N/A Non-Key N/A

Weir, Peter A, MD: MDSI-LongviewAstoria Met: Longview N/A Top 5 6/1/2019

Providence St Mary Hosp: NE OR: Walla Walla, WA N/A Not using N/ADooley, Tom M, PsyD: Cascade Executive STE

PDX NE Met: Vancouver, WA N/A Non-Key 11/22/2019


(b) (6)(b) (6)(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

OR DDS CE Licensing Check for Idaho State CE Providers 2016/17



Provider License Number Expiration SAMS

Check

Sturmak, Michael, AuD: Elks Hearing & Balance Ontario Metro: Eagle N/A Non-Key 1/30/2018Starr, David, PsyD: Ontario Metro: Nampa N/A Non-Key 3/20/2018Doke, Jerry D, PsyD: Ontario Metro: Boise N/A medical hold

10/17 6/18/2018

Kent, Gregory J, MD: The Eye Associates Ontario Metro: Caldwell N/A Non-Key 6/30/2018McKinnon, Ryan, MD: St Luke's Saltzer South Ontario Metro: Nampa N/A Not using

6/17 6/30/2018

Barnes-Perrin, Kristie, SLP: Elks Hearing & Balance Ontario Metro: Middleton N/A Non-Key 6/27/2019

Sant, Michael, MD: Idaho Phy & Rehab Med/ Idaho Elks Rehab Hos.

Ontario Metro: Meridian N/A Non-Key 6/30/2019

Friedman, Robert H, MD: Idaho Phy & Rehab Med/ Idaho Elks Rehab Hos.

Ontario Metro: Boise N/A Not using 6/17 6/30/2019

Gem State Radiology: Ontario Metro: Boise N/A Non-Key N/A


(b) (6)(b) (6)(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

OR DDS CE Licensing Check for California State CE Providers FY 2016/17



Provider License Number Expiration

Bowerman, Sara, PhD: Ceased using 12/16.

Southern OR: Crescent City, CA

N/A Ceased 12/16 12/31/2018

Sutter Coast Hospital: Southern OR: Crescent City, CA N/A Non-Key N/A

0


(b) (6)(b) (6)

(b) (6)

(b) (6)

OR DDS CE On-Site Visit Log for Hospitals FY 2016/17

Provider Name or Clinic Name Provider reading X-Ray X-Ray Lab PFT Location: Region / City


Key/Volume Provider

Providence Med CTR:

Radiology Specialists of NW PC: PDX NE Met: Portland Oct-17 Non-Key

Legacy Good Samaritan: Diagnostic Imaging NW: PDX NW Met: Portland Oct-17 Non-Key

Peace Harbor: Radiology Associates PC: Eugene Metro: Florence May-15 Non-Key

Ashland Community Not currently using. Medford Metro: Ashland May-15 Non-Key

Asante Three Rivers Hosp: Advanced Imaging Association: Medford Metro: Grants Pass May-15 Non-Key

Sky Lakes MED CTR: Sky Lakes Outpatient Imaging: Medford Metro: Klamath Falls May-15 Non-Key

Providence Hospital: Medford Radiology Group PC: Medford Metro: Medford May-15 Non-Key

Rogue Valley MED CTR:

Medford Radiology Group PC: Medford Metro: Medford May-15 Non-Key

Legacy Emanuel: PDX NE Met: Portland Aug-15 Non-Key

Legacy MT Hood MED: Advantage LLC: Summit Imaging: Advantage LLC:

PDX NE Metro: Gresham Aug-15 Non-Key

Legacy Meridian Park: Tualatin Imaging PC: PDX NW Metro: Tualatin Aug-15 Non-Key

Mountain View District: Bend Metro: Madras Oct-15 Non-Key

Pioneer Memorial Hosp:

Central OR Radiology: Bend Metro: Prineville Oct-15 Non-Key

Grande Ronde:

Ontario Metro: La Grande Oct-15 Non-Key

ST Alphonsus Med CTR:

Gem State Radiology (Boise): Ontario Metro: Ontario Oct-15 Non-Key

Mid-Columbia MED:

PDX NE Metro: The Dalles Oct-15 Non-Key

ST Alphonsus Med CTR St. Alphonsus Med: Pendleton Metro: Baker City Oct-15 Non-Key


(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)




Key/Volume Provider

Good Shepherd Hospital:

Good Shepherd Hospital: Pendleton Metro: Hermiston Oct-15 Non-Key

St. Anthony:

GEM STATE RADIOLOGY: Pendleton Metro: Pendleton Oct-15 Non-Key

Tuality Community Hosp: )

PDX NW Met: Hillsboro Feb-16 Non-Key

Good Samaritan Hospital:

Diagnostic Imaging NW:

PDX NW Metro: Portland Feb-16 Non-Key

SAMARITAN ALBANY GENERAL Hospital Diagnostic Imaging Association: Albany Metro: Albany Feb-16 Non-Key

Samaritan Albany Pulm Albany Metro: Albany Feb-16 Non-Key

Good Samaritan REG MED Corvallis Radiology PC: SNLH: Albany Metro: Corvallis Feb-16 Non-Key

Lebanon Community: Corvallis Rad. PC: Albany Metro: Lebanon Feb-16 Non-Key

Samaritan Pacific Com: Samaritan PC: Albany Metro: Newport Feb-16 Non-Key

Mission Medical Imaging: Willamette Valley Radiology:

Salem Metro: Salem Feb-16 Non-Key

Salem Radiology Consult: Salem Metro: Salem Feb-16 Non-Key

Providence Willamette Falls: Radiology Specialists of NW PC: PDX NE Metro: Oregon City Jun-16 Non-Key

Providence Milwaukie: Radiology Specialists of NW PC: PDX NE Metro: Milwaukie Jun-16 Non-Key

Providence St Vincent: Medford Radiology Group PC: TRG LLC:

PDX NW Metro: Portland Jun-16 Non-Key

Portland Adventist Med: Diagnostic Radiologists:

PDX SE Metro: Portland Jun-16 Non-Key

Oregon Imaging CTR: Radiology Associates PC: Eugene Metro: Eugene Sep-16 Non-Key

Peace Health Sacred Heart: Radiology Associates PC: Eugene Metro: Eugene Sep-16 Non-Key

McKenzie Willamette MED: Eugene Metro: Springfield Sep-16 Non-Key


(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)




Key/Volume Provider

Southern Coos Gen. Hospital: Southern Coos Hospital: Medford Metro: Bandon Sep-16 Non-Key

Curry Med CTR Medford Radiology Group PC: Medford Metro: Brookings Sep-16 Non-Key

Curry General Hospital: Medford Metro: Gold Beach Sep-16 Non-Key

Bay Area / NBMC: Bay Area Radiology PC: Roseburg Metro: Coos Bay Sep-16 Non-Key

Coquille Valley Not currently using. Roseburg Metro: Coquille Sep-16 Non-Key

Lower Umqua Hospital: 050004578- The read their own x-rays. Roseburg Metro: Reedsport Sep-16 Non-Key

Mercy MED CTR INC: MMC Respiratory Therapy: Roseburg Metro: Roseburg Sep-16 Non-Key

Samaritan North Lincoln: SNLH: Corvallis Rad. PC:

Salem Metro: Lincoln City Sep-16 Non-Key

Tuality Forest Grove Hosp: Not currently using. PDX SW Metro: Forest Grove Oct-16 Non-Key

Salem Hospital: Salem Metro: Salem Jul-17 Non-Key

Salem Pulmonary Associates: Salem Metro: Salem Jul-17 Non-Key

Columbia Memorial Hosp: Astoria Metro: Astoria Sep-17 Non-Key

Providence Seaside: Oregon Coast Radiology: Astoria Metro: Seaside Sep-17 Non-Key

Tillamook Regional Med: Tillamook County Gen Hospital:

Astoria Metro: Tillamook Sep-17 Non-Key

OHSU: PDX SW Metro: Portland Oct-17 Non-Key

Salem Health West Valley Hospital: West Valley Hospital: Salem Metro: Dallas Oct-17 Non-Key

Santiam Memorial: Salem Metro: Stayton Oct-17 Non-Key


(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)




Key/Volume Provider

St. Charles MED CTR Central OR Radiology: Bend Metro: Bend Oct-17 Non-Key

Central Oregon District: Central OR Radiology:

Bend Metro: Redmond Oct-17 Non-Key

Willamette Valley MED: McMinnville Imaging Assoc:

Salem Metro: McMinnville Oct-17 Non-Key

Providence Newberg Hosp: TRG LLC: Salem Metro: Newberg Oct-17 Non-Key

St. John Medical CTR: Longview Radiologists: Astoria Metro: Longview N/A Non-Key

Central Oregon Radiology: Cascade Medical Imaging: Bend Metro: Bend TBD Non-Key

Harney District: Bend Metro: Burns TBD Non-Key

Asante Three Rivers Imaging: Advanced Imaging Association: Medford Metro: Cave Junction TBD Non-Key

Mid Rogue Imaging CTR: (X-Rays)

Advanced Imaging Assoc. Medford Metro: Grants Pass TBD Non-Key

Wallowa Memorial Hosp: Central OR Radiology:

Ontario Metro: Enterprise TBD Non-Key

Blue Mountain:

Ontario Metro: John Day TBD Non-Key

Providence Hood River: Chad Foster, MD: PDX NE Metro: Hood River TBD Non-Key

Silverton Health: Diagnostic Imaging Association: Salem Metro: Silverton TBD Non-Key


(b) (6) (b) (6)

(b) (6)(b) (6)

(b) (6) (b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

OR DDS CE License Check AuD (T111) and SLP (E112) FY 2016/17




Check

Leavitt, Ron, AuD: Corvallis Hearing CTR Hearing Assis. Tech.

Albany Metro: Corvallis Sep-16 Non-Key 1/30/2018 None

Richards, Corry, AuD: Central OR Audiology Bend Metro: Bend Oct-15 Non-Key 1/30/2018 NoneKenyon, Janet, AuD: Kenyon Audiology Bend Metro: Bend Oct-17 Non-Key 1/30/2018 NoneBacuyani, Angela M, SLP: Redmond S&L Rosie Barels Com.

CampusBend Metro: Bend Oct-17 Non-Key 1/30/2018 None

Bacuyani, Angela M, SLP: Redmond S&L Rosie Barels Com. Campus

Bend Metro: Redmond Oct-17 Non-Key 1/30/2018 None

Stevenson, Christina, SLP: Redmond S&L Rosie Barels Com. Campus

Bend Metro: Redmond Oct-17 Non-Key 1/30/2018 None

Canavan, Alycia, SLP: Birdsong Speech Therapy Associates

Eugene Metro: Eugene Sep-16 Non-Key 1/30/2018 None

Embry, Hannah, SLP: Birdsong Speech Therapy Associates

Eugene Metro: Eugene Sep-16 Non-Key 1/30/2018 None

Harden, Barbara, SLP: CDRC Eugene Metro: Eugene Sep-16 Non-Key 1/30/2018 NoneSloan, Jayme W, SLP: Birdsong Speech Therapy

AssociatesEugene Metro: Eugene Sep-16 Non-Key 1/31/2018 None

Walker, Jill, SLP: Asante Rogue Reg. Med. CTR Medford Metro: Grants Pass

May-15 Non-Key 1/30/2018 None

Guthrie, Dana , SLP: Jungle Gym-Ped Therapy CTR Medford Metro: Klamath Falls

TBD Non-Key 1/30/2018 None

Du Brey, Louis, AuD: Basin Audiology Medford Metro: Klamath Falls

May-15 Not using 6/16 1/30/2018 None

Wu, Amber Nicole AuD: Basin Audiology Medford Metro: Klamath Falls


Horton, Christine A, SLP: Asante Rogue Reg. Med. CTR Medford Metro: Medford


Culligan, Tiffaney, SLP: New Horizons Wellness Service

PDX NW Metro: Beaverton

Jun-16 Non-Key 1/30/2018 None

Borgmeyer, Gregory, AuD: Adventist Health Medical CTR ENG

PDX NW Metro: PDX Jun-16 Non-Key 1/30/2018 None

Jones, Erika C, AuD: Adventist Health Medical CTR ENG

PDX NW Metro: PDX Jun-16 Non-Key 1/30/2018 None

Grenz-Neb, Melaney, SLP: Marshall BLDG PDX NW Metro: PDX Mar-15 Non-Key 1/30/2018 None


(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

OR DDS CE License Check AuD (T111) and SLP (E112) FY 2016/17




Check

Eggleston, Jessica L, AuD: OHSU Cochlear Implant Program.

PDX SW Metro: PDX Oct-17 Non-Key 1/30/2018 None

Lakin, Carrie, E, AuD: OHSU Cochlear Implant Program.


Middaugh, Jessica, AuD: OHSU Cochlear Implant Program.


Van Auken, Jessica, AuD: OHSU Cochlear Implant Program.


Wilson, Brittany, AuD: OHSU Cochlear Implant Program.


Knowles, Genessa SLP: Good Shepherd Mec. CTR S&L Dept.

Pendleton Met: Hermiston

Oct-15 Non-Key 1/30/2018 None

Price, Jennie, SLP: Good Shepherd Mec. CTR S&L Dept.



Seitz, Regina L, SLP: Good Shepherd Mec. CTR S&L Dept.



Wu, Tong, SLP: Good Shepherd Mec. CTR S&L Dept.



Tuning - Heid, Lacey A, SLP: Good Shepherd Mec. CTR S&L Dept.


Oct-15 Not using as of 6/17 1/30/2018 None

Wing, Karen, SLP: Grand Ronde Hospital Pendleton Met: La Grande


Anderson, Renata, AuD: Pendleton Met: Pendleton


Landsberg , Todd, AuD: S. Coast Hearing Pacific View Roseburg Metro: Coos Bay

Sep-16 Non-Key 1/30/2018 None

Kornbau, James, AuD: Roseburg Metro: Coquille

N/A Not Using 6/17 1/30/2018 None

Sheldon-Felton, Melodie, SLP: Sheldon Med / SW Rehab. Roseburg Metro: North Bend

Sep-16 Non-Key 1/31/2018 None

Hull, Heather M, SLPL: Redmond S&L Rosie Barels Com. Campus

Roseburg Metro: Roseburg

Sep-16 Ceased 7/17 1/30/2018 None

Grenz-Neb, Melaney, SLP: Salem Metro: Salem Jun-17 Non-Key 1/30/2018 None


(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

OR DDS CE License Check for MD and DO FY 2016/17



Provider License Number Expiration Sams Check

Smolen, Gail, MD: Piercey Neurology LLC Albany Metro: Albany Feb-16 Non-Key 12/31/2017 NoneLees, John, MD: Eye Care Associates Albany Metro: Albany Not using

6/17 Non-Key 12/31/2017 NoneMadsen, Bruce, MD: Eye Care Associates Albany Metro: Albany Feb-16 Non-Key 12/31/2017 NoneVanderwaal, Steven, C, MD: Astoria Metro: Gearhart Sep-17 Non-Key 12/31/2017 NoneHenderson, Michael D, DO: Bend Metro: Bend Oct-17 Top 5 12/31/2017 NoneDimmig, Jason, MD: Bend Opthomology Bend Metro: Bend Oct-17 Non-Key 12/31/2017 NoneVillano, Michael E, MD: Bend Metro: Bend Oct-17 Non-Key 12/31/2017 NoneLieuallen, Douglas W, MD: Madras Medical Group PC Bend Metro: Madras Not using

1/17 Non-Key 12/31/2017 None

Knackstedt, James J, MD: OR ENT Eugene Metro: Eugene Sep-16 Non-Key 12/31/2017 NoneMDSI: Eugene: Eugene Metro: Eugene Sep-16 Top 5 N/A NoneKarren, Kent A, MD: The Eye CTR Eugene Metro: Eugene Sep-16 Non-Key 12/31/2017 NoneNickel, Robert E, MD: CDRC Eugene Metro: Eugene Sep-16 Non-Key 12/31/2017 NonePetersen, Mario C, MD: CDRC Eugene Metro: Eugene Sep-16 Non-Key 12/31/2017 NoneAhmad, Mahnaz, MD MDSI MDSI N/A N/A 12/31/2017 NoneBommiasamy, Aravind, MD MDSI MDSI N/A N/A 12/31/2017 NoneBruns, Maureen P, MD: MDSI MDSI N/A N/A 12/31/2017 NoneCurtis, Zane, MD: (Psychiatrist) MDSI MDSI N/A N/A 12/31/2017 NoneCvijanovic, Milela, MD MDSI MDSI N/A Ceased 10/16 12/31/2017 None

Engelhardt, Bridgette, MD MDSI MDSI N/A N/A 12/31/2017 NoneFillingame, Ralph A, MD: MDSI MDSI N/A N/A 12/31/2017 NoneGe, Haitao, MD MDSI MDSI N/A N/A 12/31/2017 NoneGibbs, Angela, MD: MDSI MDSI N/A N/A 12/31/2017 None

Harrison, Johnathan, MD MDSI MDSI N/A Ceased 10/16 12/31/2017 None

Harvey, Sydney, DO MDSI-Psychiatrist MDSI N/A New Job 10/16 12/31/2017 None

Hoop, Heather E, MD MDSI MDSI N/A N/A 12/31/2017 None

Howerter, Stephanie S, MD: MDSI MDSI N/A N/A 12/31/2017 None

Hubbard, Stepeh D, DO MDSI MDSI N/A Ceased 11/16 Bussy 12/31/2017 None


(b) (6)(b) (6)(b) (6)

(b) (6)(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)





Kauffman, Darrel, MD MDSI MDSI N/A N/A 12/31/2017 None

Kelley, Katherine, MD MDSI MDSI N/A N/A 1/1/2018 None

Khaleeq, Erum, MD (Psychiatrist) MDSI MDSI N/A DDS ceased using 3/17 12/31/2017 None

Kujac, Tany, MD MDSI MDSI N/A N/A 12/31/2017 NoneMaughan, Cory, DO MDSI MDSI N/A N/A 12/31/2017 None

Nguyen, Khanh, MD MDSI MDSIN/A N/A 12/31/2017 None

Olshausen, K Philipp, MD: MDSI MDSI N/A Ceased 2/17 12/31/2017 None

Richmond, Judith, MD: MDSI MDSI N/A N/A 12/31/2017 NoneSanchez, Katherine Guadalupe, MD: MDSI MDSI N/A N/A 1/1/2017 NoneSelinger, Daniel, MD MDSI MDSI N/A N/A 12/31/2017 NoneSiegal, Steven R, MD: MDSI MDSI N/A Ceased 10/16 12/31/2017 None

Snider, Karla Pivik, MD: MDSI MDSI N/A Ceased 10/16 12/31/2017 None

Thomas, Scott R, DO MDSI MDSI N/A Ceased 10/16 12/31/2017 None

Urion, Frank A, DO MDSI MDSI N/A Ceased 4/3/17 12/31/2017 None

Williams, Nadine, MD MDSI MDSI N/A N/A 12/31/2017 None

Zarour, Luai, MD: MDSI MDSIN/A N/A 12/31/2017 None

Deatherage, Mark F, MD: Grants Pass Surgical Assoc. (Vascular)

Medford Metro: Grants Pass May-15 Non-Key 12/31/2017 None

Henderson, Michael, DO: Medford Metro: Klamath FallsMay-15 Top 5 12/31/2017 None

Hufnagel, Deanne M, DO: Sandfords Children's Medford Metro: Klamath Falls May-15 Only their PT 12/31/2017 None

Stevens, Scott K, MD: Klamath Eye CTR Medford Metro: Klamath Falls May-15 Non-Key 12/31/2017 None


(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)





Wingerter, Jacob J, MD: Sandfords Children's Medford Metro: Klamath Falls May-15 Only Their PT 12/31/2017 None

Barrus, Loren R, MD: Cataract Laser Inst. of S. OR Medford Metro: Medford May-15 Non-Key 12/31/2017 None

Chambers, David, MD: Oregon ENT CTR Medford Metro: Medford May-15 Non-Key 12/31/2017 None

MDSI: Medford: Medford Metro: Medford May-15 Top 5 N/A None

Reeck, Jay B, MD: Oregon ENT CTR Medford Metro: Medford May-15 Non-Key 12/31/2017 None

Rutar, Tina, MD: Cataract Laser Inst. of S. OR Medford Metro: Medford May-15 Non-Key 12/31/2017 None

Schultz, Paul N, MD: Cataract Laser Inst. of S. OR Medford Metro: Medford May-15 Non-Key 12/31/2017 None

Solomon, Jeffrey A, DO: Rehab Med Physicians Medford Metro: MedfordMay-15 Non-Key 12/31/2017 None

Stark, Frank, MD: Ontario Metro: Oct-15 Non-Key 12/31/2017 None

Sant, Michael, MD: Idaho Phy & Rehab Med/ Idaho Elks

Ontario Metro: Ontario Oct-15 Non-Key 12/31/2017 None

Cannon, Daniel E, MD: Columbia Gorge ENT PDX NE Metro: The Dalles TBA Not willing 02/17 12/31/2017 None

Leinenbach, Derek J, MD: PDX NE Metro: The Dalles Oct-17 Non-Key 12/31/2017 None

Janselewitz, Steve J, MD: Legacy Rehab Emanuel Ped. PDX NE: Portland Aug-15 Non-Key 12/31/2017 None

Pedersen, Andrew D, MD: The OR Clinic / ENT Plaza PDX NE: Portland Aug-15 Non-Key 12/31/2017 None

Rufener, Justin B, MD: The OR Clinic / ENT Plaza PDX NE: Portland Aug-15 Non-Key 12/31/2017 None

Scott, Garrett R, MD: Hillsboro Eye Clinic PC PDX NW Metro: Hillsboro Jun-16 Non-Key 12/31/2017 None

Ogisu, Tatsuro, MD: Marshall BLDG PDX NW: Marshall BLDG Mar-15 Non-Key 12/31/2017 None

Leinenbach, Derek J, MD: PDX NW: Portland Sep-17 Top 5 12/31/2017 None


(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)





Webster, Kim B, MD: Rejuvenation Med Clinic PDX NW: Portland Mar-15 Non-Key 12/31/2017 None

Ellison, John H, MD: Sellwood Medical Clinic PDX SE: Portland Aug-15 Non-Key 12/31/2017 None

Kim, Shane C, MD: Eye Health NW PDX SE: Portland Jun-16 Non-Key 12/31/2017 None

Saulson, Roger M, MD: Eye Health NW PDX SE: Portland Jun-16 Non-Key 12/31/2017 None

Almaraz, Lewis, MD: Office space at Exam Works PDX SW: Portland May-16 Non-Key 12/31/2017 None

Blasco, Peter, MD: CDRC Doernbecher PDX SW: PortlandOct-17 Non-Key 12/31/2017 None

Wolf, Solomon, MD: UPBHS PDX SW: PortlandMay-16 Non-Key 12/31/2017 None

Sethi, Sushil Mittar, MD: True Health Medicine PDX SW: Tualatin Jul-17 Non-Key 12/31/2017 None

Lubahn, Jordon, MD: Eye Health NW PDX: SW PortlandJun-16 Non-Key 12/31/2017 None

McGlynn, Robert, MD: Eye Health NW PDX: SW Portland Jun-16 Non-Key 12/31/2017 None

Davis, James Edward, MD: Pendleton Metro: Baker City Oct-15 Non-Key 12/31/2017 None

Hofmann, Charles, MD: Pendleton Metro: Baker City Oct-15 Ceased 04/17 12/31/2017 None

Petrusek, Joseph L, MD: Audio & Hearing Aid Assoc. Pendleton Metro: La Grande Oct-15 Non-Key 12/31/2017 None

Deitz, Michael E, MD: Deitz & Warner share office Pendleton Metro: Pendleton Oct-15 Non-Key 12/31/2017 None

Henderson, Michael D, DO: Pendleton Metro: Pendleton Oct-15 Top 5 12/31/2017 None

Warner, Michael A, MD: Deitz & Warner share office Pendleton Metro: Pendleton Oct-15 Retired 4/17 12/31/2017 None

MDSI: Portland: Portland Metro: Sep-17 Top 5 N/A None

McKelvey, Carla D, MD: North Bend MED CTR Roseburg Metro: Coos Bay Sep-16 Non-Key 12/31/2017 None


(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)





MDSI: Coos Bay: MDSI Roseburg Metro: Coos Bay Sep-16 Top 5 N/A None

Gilbert, Jane, MD: Bay Eye Clinic Roseburg Metro: North Bend Sep-16 Non-Key 12/31/2017 None

Graham, Debra A, MD: Bay Eye Clinic Roseburg Metro: North Bend Sep-16 Non-Key 12/31/2017 None

Nolan, Raymond P, MD Waterfall Clinic Roseburg Metro: North Bend Sep-16 Non-Key 12/31/2017 None

Ottemiller, Dennis E, MD: Bay Eye Clinic Roseburg Metro: North Bend Sep-16 Non-Key 12/31/2017 None

Gregg, Patrick J, MD Umpqua Valley Eye Roseburg Metro: Roseburg Sep-16 Non-Key 12/31/2017 None

Leinenbach, Derek J, MD: Roseburg Metro: Roseburg Sep-16 Top 5 12/31/2017 None

Blake, Eric, MD: Salem Rehabilitation Salem Metro: Keizer Jul-17 Non-Key 12/31/2017 None

Brumbaugh, Raymond, MD: Salem Rehabilitation Salem Metro: Keizer Jul-17 Retired 07/17 12/31/2017 None

French, John A, MD: Salem Rehabilitation Salem Metro: Keizer Jul-17 Non-Key 12/31/2017 None

Hook, James D, MD: Salem Rehabilitation Salem Metro: Keizer Jul-17 Non-Key 12/31/2017 None

Truong, D X Steve, MD: Salem Rehabilitation Salem Metro: Keizer Jul-17 Non-Key 12/31/2017 None

Leinenbach, Derek J, MD: Salem Metro: Lincoln City Jul-16 Top 5 12/31/2017 None

Nolan, Raymond P, MD McMinnville Internal Medicine

Salem Metro: McMinnville Oct-17 Non-Key 12/31/2017 None

Berzins, John, MD: Medical Center Eye Clinic Salem Metro: Salem Jun-17 Non-Key 12/31/2017 None

Dodd, John G, DO: Medical Center Eye Clinic Salem Metro: Salem Jun-17 Non-Key 12/31/2017 None

East, Marcus A, MD: Medical Center Eye Clinic Salem Metro: Salem Jun-17 Non-Key 12/31/2017 None

Lapour, Ryan W, MD: Medical Center Eye Clinic Salem Metro: Salem Jun-17 Non-Key 12/31/2017 None


(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)





MDSI: Salem: Salem Metro: Salem Jun-17 Top 5 N/A None

Tibolt, Robert Earl, MD: Medical Center Eye Clinic Salem Metro: Salem Jun-17 Not using as of 2015 12/31/2017 None

Allan, Joseph, MD: Willamette ENT Salem Metro: Salem Jun-17 Non-Key 12/31/2017 None

Donovan, J. Stephen, MD: Willamette ENT Salem Metro: Salem Jun-17 Non-Key 12/31/2017 None

Ellison, John H, MD: Salem Metro: Salem Jul-17 Non-Key 12/31/2017 NoneJohnson, Bruce C, MD: Willamette ENT Salem Metro: Salem Jun-17 Non-Key 12/31/2017 NoneSkarada, Douglas, MD: Willamette ENT Salem Metro: Salem Jun-17 Non-Key 12/31/2017 NoneThompson, Clark R, MD: Willamette ENT Salem Metro: Salem Jun-17 Non-Key 12/31/2017 None


(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)(b) (6)(b) (6)

Provider Date Claim # Complaint

(b) (6)

Table of ContentsState Source Web Address Notes: Conduct reviews montly and place documentation in the log

book.

California Board of Psychology

Not currently using providers in CA for this specialty. N/A

California Board of Medicine


California Board of Optometry


California Board of SLP & AuD


California Board of OT & PT Not currently using providers in CA for this specialty. N/A

Idaho Board of Psychology

https://secure.ibol.idaho.gov/eIBOLPublic/FormalActionBrowser.aspx?Bureau=PSY

Click on Disciplinary Action found towards the bottom of the column on the left hand side.

Idaho Board of Medicine

https://isecure.bom.idaho.gov/BOMPublic/FormalActionBrowser.aspx?Board=BOM

Click on Disciplinary Action found towards the bottom of the column on the right hand side.

Idaho Board of SLP & AuD

https://secure.ibol.idaho.gov/eIBOLPublic/FormalActionBrowser.aspx?Bureau=SHS

Click on Disciplinary Action found towards the bottom of the column on the left hand side.

Idaho Board of Optometry

https://secure.ibol.idaho.gov/eIBOLPublic/FormalActionBrowser.aspx?Bureau=OPT

Click on Disciplinary Action found towards the bottom of the column on the right hand side.

Oregon Board of Psychology

http://www.oregon.gov/OBPE/pages/index.aspx The link for the Disciplinary Action Report is found in the lower right hand corner of the page.

Oregon Board of Medicine

https://techmedweb.omb.state.or.us/Clients/ORMB/Public/VerificationRequest.aspx

The board has a monthly email notification of disciplinary actions.

Oregon Board of Optometry

http://www.oregon.gov/obo/pages/index.aspx Click on Disciplinar Actions link found in the midle under Consumer Information. Click on (The Listing PDF)

Oregon Board of SLP & AuD

http://www.oregon.gov/bspa/Pages/index.aspx Click link labled Past Disciplinary Actions which is on the left hand side. Click on Recent Board actions found at the bottom of the list.

Oregon Board of OT & PThttp://www.oregon.gov/OTLB/pages/index.aspx This board does not post disciplinary actions. OR DDS only uses two

providers and so I manually go in and check their license.

Washington Covers all boards https://fortress.wa.gov/doh/providercredentialsearch/ The WA web site is difficult to manuver. We only use a few providers and so I just look each up individually.

Updated 06/05/2017

Table of Contents

SAMS Covers all providers

https://www.sam.gov/portal/SAM/?navigationalstate=JBPNS_rO0ABXdcACJqYXZheC5mYWNlcy5wb3J0bGV0YnJpZGdlLlNUQVRFX0lEAAAAAQApdmlldzoxMmQyZjU4MS1hM2Q4LTQwYmEtYjIyOC02M2Q2NDFlODdmYzUAB19fRU9GX18*&portal:componentId=31be779b-ffb7-4907-b7b1-e74a85af25d6&interactionstate=JBPNS_rO0ABXc3ABBfanNmQnJpZGdlVmlld0lkAAAAAQAWL2pzZi9kYnNpZ2h0U2VhcmNoLmpzcAAHX19FT0ZfXw**&portal:type=action%20-%201#1#1

Update CE Panel when MDSI providers are added/deleted. Individual CE providers added by the CE Scheduling unit are automaticlly included in the SAMS review. Send an email to Bugbustes 1x per month and ask them to run a quary. They will email a response. Place a copy in the Log Book.

Updated 06/05/2017

IMA GROUP - KEY/VOLUME PROVIDERAdam, Stephanie* PsychologyAhdieh, Houman OphthalmologyAhmed, Rafay * NuclearAlberico-Rarig, Terry CRNP/Family HealthAmexo, Kwaku Physician/SurgeonAmundson, Russell Physician/SurgeonAmuth, Aravindan Physician/SurgeonAnon, Jack OtolaryngologyAnzalone, Anthony Physician/SurgeonAvelino, Verenys Speech and HearingBaker, David PsychologyBarras, David OtolaryngologyBenedict, Elysia PsychologyBerkowitz, Carl OptometryBetancourt, Laura PsychologyBetts, Jennifer PsychologyBillings, Rebecca PsychologyBoerio, Margaret Osteophathic Physician and SurgeonBralow, Scott Osteophathic Physician and SurgeonBrodie, Elizabeth Ann Speech and HearingBroll-Barone, Bruno PsychologyBroska, Arlene PsychologyCannon, Megan PsychologyCanseco-Berbano, Rachel Physician/SurgeonCantwell, Renee * PsychologyCarroll, Sean Osteophathic Physician and SurgeonChapman, Mark PsychologyCherfas Tysvine, Irene OphthalmologyChiodo, Angela PsychologyChoudry, Abaid Physician/SurgeonChristophe, Kathleen Physician/SurgeonChristopher, Mark * PathologyCoaxum, Barbara Speech and HearingColbert, April PsychologyCole, Andrew PsychologyColeman, Gregory PsychologyConnell, Tammy PsychologyCoons, Krista PsychologyCox, Kylie Ann Speech and HearingCrichlow, Brook PsychologyDavis, Tommy III PsychologyDeines, Chantal PsychologyDillon, Mary PsychologyDinovitser, Jay Internal MedicineDonoughe, Jennifer Speech and Hearing

PA FY 2017 CE Providers

D'Orazio, Nicholas Internal MedicineDorshimer, Brian PsychologyDoyle, Kimberly PsychologyDubro, Alan PsychologyDzurinko, David Obstetrics and GynecologyEvanov, Amy M Speech and HearingEvans, David OptometryFask, David PsychologyFleischman, Sari PsychologyFormica, Armand Physician/SurgeonFornelli, Rick OtolaryngologyFriedman, Marsha PsychologyFrommer, James Osteophathic Physician and SurgeonGiacomelli, Jodi PsychologyGibbings, Elisabeth PsychologyGipe, Christopher* PsychologyGoldman, Tatyana Physician/SurgeonGolman, Stacy PsychologyGower, Maggie H* Speech and HearingGrabon, Gregory Physician/SurgeonGrasso-Megyeri, Dawn M Speech and HearingGroves, Lindsey PsychologyHahn, Richard Internal MedicineHartman, Brett PsychologyHaytmanek, Craig Physician/SurgeonHeskeyahu, Tammy PsychologyHoffman, Jill AudiologyHoffman, Kevin PsychologyHouseman, Joshua PsychologyHuitt-Corcoran, Carla Physician/SurgeonHunt, Raselette Family Hunter, Pamela Speech and HearingJabbour, Victor Internal MedicineJacobs, Jeanne Marie Speech and HearingJaffe, Marc* Osteophathic Physician and SurgeonJahan, Sarwat Internal MedicineJenouri, Gilbert Internal MedicineJohnson, Charles PsychologyKakodkar, Vasundhara PediatricsKaplan, Richard Physical Medicine & RehabKarpf, Ronald PsychologyKatz, Michael OptometryKennedy, Charles PsychologyKibler, Lindsay OptometryKlebanoff, David Obstetrics and GynecologyKneifati, Ahmed Orthopedic SurgeryKochan-Dewey, Amanda Psychology

LaGattuta, David J AudiologyLaJeunesse, Charles PsychologyLane, Thomas PsychologyLedermann, Kathleen PsychologyLeighty, Danielle PsychologyLewis, Irwin Physician/SurgeonLindner, Marged PsychologyLipman, Sidney OtolaryngologyLombardi, Gina PsychologyMackaronis, Anthony Obstetrics and GynecologyMagurno, Justine Internal MedicineMalik, Mohammad Internal MedicineMass, Stephen * Physician/SurgeonMcGettigan, Patricia PsychologyMcHugh, Patrick PsychologyMcNeill, Daniel Physical Medicine & RehabMeltzer, Danielle PsychologyMichael, Gregory PsychologyMiller, Andrew W OptometryMiller, Anne PsychologyMiller, John Laurence PsychologyMiller, Leslie OptometryMiller, Randall Physician/SurgeonMissry, John OphthalmologyMoci, Elona PsychologyMonfared, Ziba Rahjoi Physician/SurgeonMoore, Jared PsychologyNave, Peggy PsychologyNewman, T. David PsychologyNichols, Trent Physician/SurgeonNires, Avi PsychologyNwosu, Caleb Physician/SurgeonO'Connell, David * PsychologyO'Donnell, Peter PsychologyOlivero, Daniel PediatricsOlivetti, Jennifer PsychologyOrtiz, Joseph OphthalmologyOsachy, Lisa PsychologyPacansky, Michelle Speech and HearingPacella, Steven PsychologyParameswaran, Ramalingaier * Physician/SurgeonPatrone, Christopher PsychologyPeterson, Renee OptometryPietralczyk, Kari Ann AudiologyPopovic, Jadranka PediatricsPrimavera, Joseph PsychologyPulver, David Internal Medicine

Rabinovich, Einat Internal MedicineRafferty-Hornung, Karen PsychologyRamirez, Renato Physician/SurgeonReed, Kindra Speech and HearingReese, Christopher PsychologyReinholt, Arthur OptometryRendall, Lisa PsychologyRichards, Jennifer PsychologyRobins, Michele PsychologyRogers, Robert OptometryRoscoe, Gregory ENTRosenberg, Michael Physician/SurgeonRuffin, Danielle Speech and HearingSabeh, Christina Physician/SurgeonSanders, Scott OptometrySchell, Stephen OtolaryngologySchlesinger, Julie Megan Speech and HearingSchmidt, Margaret Speech and HearingSchuman, Michael PsychologySchwarzbaum, Jeremy PsychologySeltzer, Charles Internal MedicineSiokos, Zissie OptometrySlowik, Amanda PsychologySmith-Demain, Alexandra Internal MedicineSpringer, Sarah PsychologySpurgeon, Monica Speech and HearingSt Thomas, Lindsay PsychologyStarling, Carrie Johanna Speech and HearingSteele, Cheryl Speech and HearingStein, Elicia* PsychologyStepp, Mark OptometryStrohecker, Robert OptometryStuart, Jane Speech and HearingTardibuono, John PsychologyTarner, Kathryn Speech and HearingTrafican, Sarah PsychologyTrogner, Stacy PsychologyVittone, Daniel Physician/SurgeonVittone, Michael OphthalmologyVittone, Ronald OphthalmologyVoulo, Alyse Speech and HearingWaters, Najah Simone Physician/SurgeonWaxman, Howard Mark PsychologyWeinberger, Mark PsychologyWells, Amy PsychologyWexler, Sonya Physician/SurgeonWilliams, Latoya Nicole Audiology

Wolfe, William Physician/SurgeonWoll, Andrea Physician/SurgeonWright, Michael PsychologyZehrung, David PsychologyZibelman, Mark Internal MedicineZimmerman, Kimberly Optometry

Report Date: 11/13/2017A List of CE Vendor who Performed CEs DOS in FY 2017 (CEVENFY/HUALIB)

Name Column1 Column2 Vendor# City

Key provider site review made

ABBEVILLE AREA MEDICAL CENT ABBEVILLEABNEY, LUCAS D COLUMBIAABUSHAKRA, KIMBERLY A site review NORTH MYRTLE BEACHADAIR, BRIAN ROCK HILLADVANCED DIAGNOSTIC IMAGING ORANGEBURGAFULUKWE, FOSTER HEATH SPRINGSAGHA, AMIR ANDERSONAIKEN OPHTHALMOLOGY AIKENAIKEN REG MEDICAL CENTER AIKENALEXANDER, WILLIAM T SUMTERALLENDALE COUNTY HOSPITAL FAIRFAXALLEYNE, WILLIAM ROCK HILLALSFELD, L CLARK MT PLEASANTALSFELD, LEONARD CLARK FLORENCEALSTON, SANDRA ORANGEBURGANDERSON RADIOLOGY ANDERSONANDERSON, BRYAN K FORT MILLANDERSON, EINAR W COLUMBIAANDERSON-OCONEE SPCH & HEAR SENECAANDREWS, DAVID N BISHOPVILLEANGEL OAK EYE CENTER JOHNS ISLANDANGEL, ALANNA E DUE WESTANGUELOVA, DORA site review MURRELLS INLETANMED HEALTH ANDERSON BONE/ ANDERSONANMED HEALTH CAMPUS ANDERSONANMED HEALTH MEDICAL CENTER ANDERSONARMSTRONG, HEATHER ABBEVILLEARMSTRONG, LINDSAY GREENVILLEARROJAS, ALFREDO J Top 5/Med Plus site review COLUMBIAASQUITH, SALLY A site review SUMMERVILLEATKINS, JENNIFER LYNN site review SPARTANBURGAXFORD, MARK site review WALTERBOROAXSON, WILLIAM A SENECABANG, DAVID W site review LADSONBAPTIST EASLEY HOSPITAL EASLEYBARKAND, DIXIE JOHNS ISLANDBARRELL, KELLY PORT ROYALBARRETT, RHONDA V ROCK HILLBARTELL, LARRY D FORT MILL

South Carolina FY 2017

(b) (6)

BEATY EYE CLINIC & ASSOCIAT site review BENNETTSVILLEBEAUFORT MEMORIAL HOSPITAL BEAUFORTBECKETT, TAMARA site review AIKENBEHAVIORAL SYSTEMS LLC CHARLESTONBELL, THADDEUS J site review NORTH CHARLESTONBELL, WOODROW Top 5/Med Plus site review SPARTANBURGBENEDICT, REBECCA SPARTANBURGBENNETT, KIKI T AIKENBENNETT, NICOLE G VARNVILLEBENNICE, JENNIFER A site review CHARLESTON

BENOIT-FISCHER, CAROL E EMOVED

/removed from panel ORANGEBURG

BERNAT, JEFF CLEMSONBERRY, WALTER S WEST COLUMBIABETHEA, JAMES site review CHARLESTONBLAKER, ALAN M FLORENCEBLEDSOE, HORACE W COLUMBIABLUBAUGH, MICHAEL R site review WALTERBOROBLUFFTON MEDICAL CAMPUS BLUFFTONBOGART, WALT WEST COLUMBIABOHAC, PAUL W JOHNS ISLANDBOLLIN, EMILY HILTON HEADBON SECOURS ST FRANCIS XAVI CHARLESTONBOORMAN, JILL M site review NORTH CHARLESTONBOYD, C CLARK AIKENBRACKIN, CHERYL SAVANNAHBRADLEY, JOHN B AIKENBRASHEARS, REBECCA GREENWOODBRIDGEWATER, LISA G site review ROCK HILLBRITT, MORRIS F CHARLOTTEBROWN, BRUCE COLUMBIABROWN, DAVID E JR SUMTERBROWN, ERIC EASLEYBROWN, JOSHUA site review KINGSTREEBROWNE, ALISON GREENVILLEBROWNE, NANCY MYRTLE BEACHBROWNLEE, ROBERT WILLIAMSTONBRYAN, BEAU T COLUMBIABUCKNER, MEREDITH ANDERSONBUEHNER, JACLYN site review MONCKS CORNERBULLARD, KAY S CHERAWBURBRIDGE, MARK T primary ROCK HILLBURGESS, SALLEY site review CLINTONBURNOS, VICTORIA GREERBURNS, JEREMY SPARTANBURGBURROWS, DENNIS FLORENCE

(b) (6)(b) (6)(b) (6)

(b) (6)

BUTEHORN, H FREDERICK III SPARTANBURGBYRD, EDWIN O WOODRUFFBYRD, JIM F JR Top 5/Med Plus site review AIKENBYRD, SHERI WOODRUFFBYRNE, JENNIFER A GREENVILLECALCHARY, AMY GREENWOODCAMPBELL, ALEXIS GREENVILLECAMPBELL, STACY NORTH CHARLESTONCAMPBELL, ZEKE BEAUFORTCANNON MEMORIAL HOSPITAL PICKENSCANNON PSYCHOLOGICAL ASSOCS CLEMSONCARDIOLOGY CONSULTANTS PA SPARTANBURGCARLTON, PAMELA site review COLUMBIACAROLINA CARDIAC SURGERY COLUMBIACAROLINA HEART & VASCULAR C AIKENCAROLINA HEART SPECIALISTS LANCASTERCAROLINA LUNG AND SLEEP CEN COLUMBIACAROLINA MED CTR OF WALTER WALTERBOROCAROLINA PINES REG MED CTR HARTSVILLECAROLINA PULMONARY PHYS site review ROCK HILLCAROLINA RADIOLOGY ASSOCIAT DALLASCAROLINA VASCULAR INSTITUTE site review GREENWOODCAROLINAS HOSP SYSTEM MARIO MULLINSCAROLINAS HOSPITAL SYSTEM FLORENCECARPENTER, RICHARD L JR SANTEECARTER, DENISE LADYS ISLANDCARTER, RICHARD M GREENWOODCASSONE, ROCCO D ORANGEBURGCASTELLO, LESLIE SENECACHURCH, SAMANTHA CHARLESTONCLARK-BROWN, ANNETTE FLORENCECLARY, MATTHEW T COLUMBIACLEAVELAND, BONNIE F site review CHARLESTONCLELLAND, CARLSON GREERCLEMSON EYE PA CLEMSONCLEVELAND, AMANDA J site review GREENWOODCOASTAL CAROLINA MEDICAL CT HARDEEVILLECOASTAL VASCULAR & VEIN CEN CHARLESTONCOBURN, ASHLEY M SUMMERVILLECOE, MARK STERLYN site review LANCASTERCOLEMAN, LAWRENCE R BEAUFORTCOLEMAN-LEBBY, VANESSA ORANGEBURGCOLLETON MEDICAL CENTER WALTERBOROCOLLINS, ROBERT J III WILLIAMSTONCOLPITT, PATRICK site review NORTH CHARLESTONCONGDON, GERALD F site review PAWLEYS ISLAND

(b) (6)

CONWAY HOSP O/P DIAGNOSTIC CONWAYCONWAY HOSPITAL INC CONWAYCOPPOLA, PAUL K site review WESTMINSTERCORLEY, VIRGINIA SUMTERCOVINGTON, AL H site review CHERAWCOX, KEITH S NEWBERRYCRAWFORD, CARRIE ELIZABETH site review GREENVILLECRAWFORD, KENNON FOUNTAIN INNCRAWFORD, PATRICIA A GREENVILLECRESS, ROBERT M site review ORANGEBURGCRISWELL, KAREN SAVANNAHCROOK, THEODORE G CAMDENCRYER, MICHAEL site review COLUMBIACUNNINGHAM, CALHOUN D SURFSIDE BEACHCUSTER, JOHN V site review CHARLESTONCUTTS, TRAVEA site review ANDERSONDANIELS, DAMON site review COLUMBIADAS, SUSHIL K site review ROCK HILLDAVIS, KATE L CHARLESTONDAVIS, NORDEN W site review GAFFNEYDAWKINS, PATRISE GREENVILLEDE CHAMPLAIN, RICHARD E GEORGETOWNDEAN, STEVEN SUMTERDEARING, MEGAN NORTH CHARLESTONDEHOLL, J DAVID site review ANDERSONDELGADO, ANTHONY E site review GREENVILLEDEPACE, ALFRED NICHOLAS primary site review LEXINGTONDIVITO, JASON R Top 5/Med Plus GREENWOODDIXON, MARGO L CHARLESTONDOCTORS HOSPITAL AUGUSTADRAISIN VISION GROUP CHARLESTONDRAISIN, NEIL CHARLESTONDUKES, JOHNNY R LANCASTERDUNCAN, ERIN PORT ROYALDYLEWSKI, STEFAN M MYRTLE BEACHEARLY, IRA G JR site review SPARTANBURGEDGEFIELD COUNTY HOSPITAL EDGEFIELDEDWARDS, NATHANIEL G ROCK HILLEDWARDS, NICOLE NEWBERRYEDWARDS, R MALCOLM LANCASTERELBASH, ABDEL R SUMTERELLENBURGER, KURT R BEAUFORTELLYN, JOHN C site review CHARLESTONENGELBARTS, RACHEL RIDGELANDESHENRODER, NATHAN top 5/SBS Medical site review GREENVILLEETIKERENTSE, TEMISAN L site review NORTH CHARLESTON

(b) (6)

EVANS, REGINA PAWLEYS ISLANDEVANS, VICTORIA P site review ROCK HILLFAIRFIELD MEMORIAL HOSPITAL WINNSBOROFELICIANO, ANNA E COLUMBIAFERVIL, MARIE Y. WALTERBOROFISHBURNE, FRANCIS J MT PLEASANTFLORENCE MRI & IMAGING site review FLORENCEFLOWERS, STEPHEN K SUMTERFLOYD, ALLISON KIMBLE LEXINGTONFLOYD, JOSEPH H JR BEAUFORTFOGLE, VERNELL K COLUMBIAFOLGAR, FRANCISCO A FLORENCEFORD, JEFFERY C COLUMBIAFOSTER, JOHN SPARTANBURGFOULKES-JAMISON, LESLEY site review IRMOFRANK, ADAM FLORENCEFRANKLIN, CRYSTAL L PAWLEYS ISLANDFRANKLIN, ROBERT SPARTANBURGFRIEDMAN, ROBERT ANDERSONFRISHBERG, DEBBIE ORANGEBURGFRITZ, JONATHAN P FORT MILLGABRIEL, MEGAN A CHARLESTONGALLOWAY, JERRY E site review GREENWOODGALPHIN, ROBERT LEE primary site review COLUMBIAGARDNER, LAURA SUMMERVILLEGARG, AJAY GREENVILLEGARRETT, KEVIN G JR FLORENCEGASKIN, HUGH C III FLORENCEGEORGETOWN COUNTY MEM HOSP GEORGETOWNGIBSON, TODD GREENWOODGIRI, ANSHU primary site review SUMMERVILLEGLASER, DONALD EASLEYGLENN, GERALDINE WINNSBOROGLENN, KATHRYN FULLER NEWBERRYGOLDSMITH, JOSEPH P ROCK HILLGONZALEZ-ACEVEDO, ALBERT FLORENCEGOODSON, JAMES A III SUMTERGOTTLIEB, DVORA SAVANNAHGOULAS, MARK T site review BLUFFTONGOURLEY, NEESHA site review ROCK HILLGRANTHAM, R LEE site review AIKENGRAVES, LAURIE ROCK HILLGRAY, REBEKAH NORTH CHARLESTONGRAY, TOMMI FLORENCEGREEN, AMBER S site review ROCK HILLGREENE, HOWARD site review FLORENCE

(b) (6)

GREENE-NORRIS, ENGLAND FLORENCEGREENVILLE MEMORIAL HOSPITA GREENVILLEGREGG, HARRIETTE ORANGEBURGGRIFFIN, WILLIAM site review KINGSTREEHAGENAUER, ANDREW Top 5/SBS Medical SENECAHAGGERTY, CHRISTOPHER JAY SPARTANBURGHALLER, RAPHAEL ORANGEBURGHAMMOND, ELLIE C site review GREENVILLEHAMMOND, JOSEPH K primary site review SENECAHAMPTON REG MEDICAL CENTER VARNVILLEHANNAH, JESSICA ROCK HILLHARARI, MARC COLUMBIAHARDAWAY, WILLIAM D FLORENCEHARE, ESTER R ORANGEBURGHARPER, EMILY site review GREERHARPER, RENUKA R site review GREENVILLEHARRIS, LUETTA FLORENCEHAUBERT, MATTHEW AIKENHAWKINS, KAITLIN M AIKENHAYES, DANYELLE site review SUMTERHAYNES, ANDROMEDA ORANGEBURGHAYNES, CHARLES ORANGEBURGHENRY, BRIAN NELSON DUE WESTHERRIN, TRACEY HILTON HEADHERROD, NIKKI COLUMBIAHICKLIN, ARLENE GREENWOODHICKLIN, ELIZABETH GREENVILLEHICKLIN, JONATHAN C FORT MILLHILL, ELIZABETH KAY site review SPARTANBURGHILL, JAMES F III JOHNS ISLANDHILL, LAURIE G SAVANNAHHILLCREST HOSPITAL SIMPSONVILLEHILLIARD, GABBY site review ANDERSONHILTON HEAD REG MED CTR HILTON HEADHO, KIM THIEN N LANCASTERHOBBS, STEVEN C site review LAKE CITYHOLLAND, EVANS P FLORENCEHOLMES, ESSIE L KINGSTREEHOLT, DAVID N primary SENECAHOPKINS, JOSEPH E site review GREENVILLEHOPKINS, KERRI GREENVILLEHOPKINS, ROSALIE LEE GREENVILLEHOPLA, DAN M site review FLORENCEHUDSON, ASHLEY SUMMERVILLEHUFF, BRIAN COLUMBIAHULL, WILLIAM M JR ROCK HILL

(b) (6)

HURD, SHAYE S site review NORTH CHARLESTONHURSEY, ARCHIBALD WESLEY JR COLUMBIAHYNES, JOHN DEWEY COLUMBIAILG, BORIS A ANDERSONIMAGING CENTER (SELF REGION site review GREENWOODIMAGING SPEC OF CHARLESTON MT PLEASANTINLET CARDIOPULMONARY & ASS MURRELLS INLETINLET PULMONARY CRIT CARE & MURRELLS INLETINNERVISION MRI/IMAGING GRO GREENVILLEISAYEV, JENNIFER COHEN SAVANNAHISENHOWER, W DAVID JR ABBEVILLEIWEGBUE, KWAME N MONCKS CORNERJACOBS, DEAN R site review COLUMBIAJACOBUS, DWIGHT A site review EASLEYJAMES, ALEQUE ROCK HILLJAMES, DEBORAH C site review CHERAWJANIT, ADRIAN S AUGUSTAJENKINS, SHARON F ORANGEBURGJENKINS, WILLIAM P WALHALLAJOHNSON, BRIAN EASLEYJOHNSON, DAVID BENNETTSVILLEJOHNSON, EDWARD C site review KINGSTREEJOHNSON, KIMBERLY Z AIKENJOHNSON, OWEN GEORGETOWNJOHNSON, THOMAS ROCK HILLJOHNSON-BAILEY, MELANIE NEWBERRYJONES, CHRISTOPHER T ROCK HILLJONES, CONIGLIARO COLUMBIAJONES, JUNE BARTELL site review FLORENCEJORDAN, WHITNEY TAPP site review MT PLEASANTJOUDEH, THAER site review GREENVILLEJUNKER, DAVID A Top 5/SCIME site review GREENVILLEJURS, DENNIS G SPARTANBURGKABEALO, KELLE CHARLESTONKANWISHER, MICHAEL A Top 5/Med Plus site review KINGSTREEKARNIBAD, YVETTE COOK SAVANNAHKEENEY, SARA GREENVILLEKEITH, BRIAN A site review ANDERSONKELLY, KIMBERLY SUMTERKELLY, TIMOTHY J ROCK HILLKENDALL, KRISTIN GREENVILLEKENNARD, ERIKA MYRTLE BEACHKERSHAWHEALTH MEDICAL CENTE CAMDENKILGUS, CHRISTOPHER LEE site review ORANGEBURGKING, GREGORY A FLORENCEKING, SALLY COLUMBIA

(b) (6)

KITCH, RUSSELL D site review CHARLESTONKMONICEK, JOSEPH M FLORENCEKNOWLES, MELISSA ANDERSONKNOX, KENNETH E SIMPSONVILLEKOFOED, BRUCE primary site review GREENVILLEKOLEHMA, KERRI CHARLESTONKORN, LARY RICHARD Top 5/SCIME site review GREENVILLEKOSER, ANDRAS site review GAFFNEYKOZAK, LAUREN GREERKOZLOWSKI, JEFFREY D AIKENKRAININ, FRED M FLORENCEKRUSE, KIMBERLY KAYE COLUMBIAKUHL, DANA E WALHALLAKUMAR, SANJAY WALTERBOROKURES, PETER R ROCK HILLKWAKYE, ADONTENG A primary site review BEAUFORTLABARRE, NICHOLAS SUMMERVILLELAKE CITY COMMUNITY HOSPITA LAKE CITYLANCASTER IMAGING CENTER LANCASTERLANGLEY, SHARON B ORANGEBURGLARRIMORE, BETH SAVANNAHLATTIMORE, CHARLITA SPARTANBURGLAURENS COUNTY HOSPITAL CLINTONLAWRENCE, FELICIA site review ORANGEBURGLEA, LAUREN GREERLEE, JAMES T FLORENCELEE, JASON C FLORENCELEKOUBOU LOOTI, ALAIN ZINGR Top 5/Med Plus KINGSTREELEPOROWSKI, DEBORAH K GREENVILLELESLIE, KAREN E DUE WESTLEWIS, BRETT WILLIAMSTONLIMA, STEFANIA DE MELOE CLINTONLIMBERT, JAMES G site review BLUFFTONLINK, HENRY W site review FAIRMONTLITTLE, ELIZABETH W HARTSVILLELIVINGSTON, ROBERT E III site review NEWBERRYLOFTIS, C EARL JR LEESVILLELOFTON, LATANYA D FLORENCELOMBARDI, ALYSE CATHERINE LANCASTERLONG BAY DIAGNOSTIC IMAGING site review MYRTLE BEACHLORD, LORI P Top 5/Med Plus site review NEWBERRYLORING, CALEB IV primary site review SPARTANBURGLORIS COMMUNITY HOSPITAL LORISLOVE, BRITTANY site review SIMPSONVILLELOWE, PHILLIP D site review FLORENCELUKE, ROBERT A FLORENCE

(b) (6)

LUNN, RONALD ORANGEBURGLYNES, MICHELLE SAVANNAHLYTTLE, DEANNA P FLORENCEMAGUIRE, WILLIAM JR CHARLESTONMAHLIE, NANCY CLEMSONMAHON, ROBERT JR GREENVILLEMALKA, JULIE CHARLESTONMANOS, PETER BEAUFORTMARANVILLE, JUNE K site review LEXINGTONMARCUS, ANNA MONCKS CORNERMARI-COLON, JULIA site review GREENVILLEMARION, A DOUGLAS CHESTERMARTIN, JEFFERY S COLUMBIAMARY BLACK HEALTH SYS GAFFN GAFFNEYMARY BLACK MEMORIAL HOSP SPARTANBURGMASINDET, SARBABI CHARLESTONMASON, KRISTIN J ROCK HILLMASON, MONICA site review CHARLESTONMATHIS, CAROL SPARTANBURGMATTISON, EDWARD C ANDERSONMCCLAIN, MARK A CHARLESTONMCCONNELL, KRISTIN SMITH GREERMCCULLOH THERAPEUTIC SOLUTI GREERMCCULLOH, SARAH D SPARTANBURGMCKENZIE, DAVID H JR ESTILLMCLEOD CARDIOLOGY ASSOCIATE FLORENCEMCLEOD HEALTH CHERAW CHERAWMCLEOD HEALTH CLARENDON MANNINGMCLEOD MEDICAL CTR - DARLIN DARLINGTONMCLEOD MICU FLORENCEMCLEOD REG MED CTR - DILLON DILLONMCLEOD REG MEDICAL CENTER FLORENCEMCLEOD, ANGELA N COLUMBIAMCMAHON, ALISA site review EASLEYMCMANUS, EUGENE F SPARTANBURGMCMILLAN, NINA MCKENZIE GREERMDSI PHYSICIAN GROUP INC FLORENCEMEHTA, REENA site review WEST COLUMBIAMEMORIAL MEDICAL OFC BLDG GREENVILLEMERHI, EVA site review MYRTLE BEACHMGC MEDICAL AFFILIATES N GR site review SPARTANBURGMIELE, ELLEN EASLEYMIKKELSON, MICHAEL K BLUFFTONMILFORD, WILLIAM site review ANDERSONMILLENDER, CATHERINE MEEKIN primary site review ROCK HILLMILLER, AARON WALTERBORO

(b) (6)

MILNE, H L COLUMBIAMITCHELL, CARL I COLUMBIAMOBERLY, REBECCA L NORTH AUGUSTAMODESTO, MARIA COLUMBIAMONTGOMERY, SAMUEL JACOB site review NEWBERRYMOODY, ROBIN L site review ANDERSONMOON, DAVID site review JOHNSONVILLEMORPHIS, ELIZABETH HARTSVILLEMORPHIS, JAMES O JR HARTSVILLEMORTON, TODD L GAFFNEYMOTYCKA, THOMAS J primary site review COLUMBIAMOUNTAINVIEW MEDICAL IMAGIN SENECAMOYLAN, WILLIAM J JR site review SUMMERVILLEMUIR, ELIZABETH GREENVILLEMUNSON, HOLLY Top 5/SBS Medical SENECAMYERS, KATHY IRMONAGEL, TERRY L JR site review LEXINGTONNAPPI, RONALD site review WALTERBORONASO, NICOLETTE FLORENCENAVA, MARISA site review CHARLESTONNAZARIO, NILSA I site review LAURENSNELSON, DAVID BRIAN FORT MILLNEWBERRY CNTY MEM HOSPITAL NEWBERRYNEWLAND, THOMAS WALTERBORONEWMAN, THEODORE W HARTSVILLENGUYEN, SHAUN A primary site review ORANGEBURGNICHOLS, MEGAN MYRTLE BEACHNORMAN, MATT WEST COLUMBIANOVANT HEALTH IMAGING ROCK ROCK HILLNUSZ, KEVIN LANCASTERNWAEKWU, IFEANYI MONCKS CORNEROBENG, FRANCIS MONCKS CORNEROCONEE MEMORIAL HOSPITAL SENECAOLIVER, DAVID site review ROCK HILLOLIVER, W C ROCK HILLOM, ANIL FLORENCEOMOTOSO, OMOLOLA A NORTH CHARLESTONONDERSMA, BENJAMIN COLUMBIAOSENTOSKI, MARIANNE site review HILTON HEADOSMAN, RICHARD C MYRTLE BEACHPACK, MARK STEPHEN FLORENCEPADGETT, L MICHAEL WALTERBOROPALMETTO BAPTIST PULMONARY COLUMBIAPALMETTO BAPTIST-COLUMBIA COLUMBIAPALMETTO CARDIOLOGY ASSOCS COLUMBIAPALMETTO HEALTH TUOMEY SUMTER

(b) (6)

PALMETTO IMAGING COLUMBIAPALMETTO IMAGING - IRMO site review IRMOPALMETTO LANGUAGE & SPEECH LEXINGTONPALMETTO PULMONARY & CRITIC GREENVILLEPALMETTO PULMONARY MEDICINE BEAUFORTPALMETTO RICHLAND MEM HOSP COLUMBIAPARISI, JOSEPH L CLEMSONPARKE, CHARLES W K Top 5/SCIME site review GREENVILLEPARKS-SKINNER, BILLIE GREENVILLEPARSONS, GREGORY site review NEWBERRYPATEL, PRANAY R SPARTANBURGPATEL, PRAVIN R Top 5 site review CLIOPATHEJA, NINI S AIKENPAYNE, MANDY LANCASTERPEE DEE SPEECH-HEARING CTR site review FLORENCEPENNINGTON, AMANDA site review ROCK HILLPETIT, SCOTT J COLUMBIAPEYSER, ROBERT E CHARLESTONPHILLIPS, TABITHA MAULDINPIEDMONT IMAGING SPARTANBURGPIEDMONT MEDICAL CENTER ROCK HILLPITCAVAGE, JOSEPH GOOSE CREEKPOCKL, JEFFREY S SANTEEPOLAND, ROBERT M GREENVILLEPOLLOCK, KAREN CLINTONPOOLE, BENJAMIN C CLOVERPORTER, DAVID ANDERSONPOWELL, DENISE CHARLESTONPOWERS, THERESA J MONCKS CORNERPRICE, DAVID R site review GREENVILLEPRICE, STACI SENECAPRIMECARE FAMILY PRACTICE GOOSE CREEKPRITCHARD-BOONE, ANDREA LEA FLORENCEPULMONARY DISEASES CARE site review CHARLESTONPURCELL, JERRY S site review ANDERSONQURESHI, FAROOQ site review CHERAWRADEMACHER, JAMES R FLORENCERAY, TRACY LORISRAYKOVICZ, LEE JOSEPH ROCK HILLREDDY, BHASKAR R ROCK HILLREED, DOUGLAS J site review ANDERSONREEVES, STEVE L SPARTANBURGREGIONAL MED CTR-O'BURG/CAL ORANGEBURGREIDENBACH, JENNIFER MT PLEASANTRICHARDS, CAROLINE SPARTANBURGRICHARDSON, MELISSA site review GREENVILLE

(b) (6)

RICHARDSON, SHEANA SAVANNAHRIDDLE, HARVARD K JR NEWBERRYRIDGEWAY, REUBEN B site review ORANGEBURGRIGDON, CHERYL DAVIS GREENVILLERITTERSPACH, CHAD primary site review WAXHAWRITZ, DOUGLAS R primary site review GEORGETOWNRIVERVIEW MEDICAL CENTER ROCK HILLROBINSON, INDIA Top 5/SBS Medical site review MYRTLE BEACHROBINSON, JONATHAN M FORT MILLROBINSON, LAURIE C CAMDENRODRIGUEZ-SCOTT, MARIBEL MONCKS CORNERROGERS, RICHARD L site review FLORENCEROJUGBOKAN, ADEBOLA site review GOOSE CREEKROLFSEN, MATTHEW J primary site review ROCK HILLROLLINS, PAMELA GREERROMAN, REGINA A CONWAYROPER HOSPITAL INC CHARLESTONROSNER, DANIEL L SURFSIDE BEACHROSS, MARK J FLORENCEROWLAND, RUSSELL Top 5/SCIME site review SPARTANBURGROYAL, GAIL M GEORGETOWNROZIER, HOPE ORANGEBURGRUBANO, BERNADETTE NORTH MYRTLE BEACHRUCKER, CHRISTOPHER SPARTANBURGRUFFING, JAMES N primary site review SPARTANBURGRUSHTON, FRANCIS BEAUFORTRUSSELL, SAM O III JOHNSONVILLERUST, KEVIN R NEWBERRYSANDERS, ALEXIS Y FLORENCESANDIFER, HENRI ORANGEBURGSANGER CLINIC ROCK HILLSAUSSER, GENE J KINGSTREESAVANNAH SPEECH-HEARING CTR SAVANNAHSAYRE, LARRY ANDERSONSBS MEDICAL SERVICES INC Top 5 GREENVILLESCATES, KYLE site review NEWBERRYSCHACHER, STEPHEN AUGUSTASCHEELE, LARRY M SUMTERSCHERL, STEFANI M NORTH CHARLESTONSCHLUETER, ERIC M Top 5/Med Plus COLUMBIASCHWAN, CAROL AIKENSCOTT, ERICA MT PLEASANTSCOTT, TODD A site review LANCASTERSEEHORN, SARAH GREENWOODSELF REGIONAL HEALTHCARE GREENWOODSELTZER, SAMUEL FLORENCE

(b) (6)

SETTY, RAJ ANDERSONSEXTON, LAURA SPARTANBURGSHADWICK, KELLY LANCASTERSHAH, JUGALKISHOR K ROCK HILLSHAPIRO, STEVEN D CHARLESTONSHARAF, IDRIS M AIKENSHAW, SHANITA DAWN ORANGEBURGSHERROD, FAITH site review WALTERBOROSHOOK, DAVID T Top 5/SBS Medical NORTH AUGUSTASHROUDER, JAMES III Top 5/SBS Medical GREENVILLESIEGEL, JEFFREY A GREENVILLESIMON, DANIEL J ROCK HILLSIMONS, JONATHAN ALAN SURFSIDE BEACHSINGH, PRADEEP ROCK HILLSINGHI, SUSHIL K ROCK HILLSINGLETARY, GALE ORANGEBURGSINGLETON, MONNIEQUE site review ORANGEBURGSLOAN, JEFFREY C ROCK HILLSMITH, ALLISON Top 5/Med Plus site review KINGSTREESMITH, CANDI MYRTLE BEACHSMITH, DANIEL J AIKENSMITH, LASHONDA Y site review WALTERBOROSMITH, LEILONI N SPARTANBURGSMITH, STEPHEN BROOKS Top 5/SBS Medical site review CLINTONSNOAD, NICOLE GREERSORROW, REBECCA LACEY site review ANDERSONSOUTHERN THERAPY SERVICES CHERAWSPARTANBURG REG OUTPATIENT SPARTANBURGSPITZ, A H ANDERSONSPIVEY, CASHTON B Top 5 site review CHARLESTONSPOKANE, ARNOLD R site review AIKENSPONSELLER, TRACIE site review AIKENSPRINGS MEMORIAL HOSPITAL LANCASTERST FRANCIS HOSPITAL INC GREENVILLEST PETER, ASHLEIGH J GREENVILLESTANLEY, TOMMI site review NORTH MYRTLE BEACHSTEINIGER, ERIK DAVID SPARTANBURGSTEPHENSON, DANA M MYRTLE BEACHSTEVENS, ALEXANDRA D AIKENSTEVENS, SEAN SPARTANBURGSTEWART, JOHN R GREERSTOKES, HUNTER R JR FLORENCESTOKES, J HOWARD JR FLORENCESTOKES, MARK site review SUMTERSTOOKSBERRY, TIMOTHY Top 5/Med Plus site review KINGSTREESTORY, FRANCES L LANCASTER

(b) (6)

STOUGHTON, THOMAS FLORENCESTRINI, CAROLYN NORTH CHARLESTONSTURGES, AMBER WALTERBOROSUMTER EYE CENTER site review SUMTERSURGICAL ASSOCS OF MYRTLE B MYRTLE BEACHSWITAK, JENNIFER BLUFFTONSZYPCZAK, ROBERT BLUFFTONTALLMAN, BETHANY GREERTARASIDIS, GREGORY ABBEVILLETAYLOR, CHERILYN YVETTE ORANGEBURGTAYLOR, DENTRESA A VARNVILLETAYLOR, DOREEN FLORENCETAYLOR, JOHN M COLUMBIATHE EYE & LASER CENTER site review LANCASTERTHODI-PETROU, CHRYSSOULA ORANGEBURGTHOMAS, GILL P CLINTONTHOMAS, SIDNEY F ORANGEBURGTHOMPSON, ALLAN EASLEYTHOMPSON, RONALD O primary site review CLINTONTHOMPSON, SARAH site review SPARTANBURGTILLER, GERALD R GEORGETOWNTLHABANO, L BENNY ROCK HILLTLM MEDICAL SERVICES LLC COLUMBIATOLLISON, C DAVID site review GREENVILLETOMARCHIO, JOHN B Top 5/Med Plus site review NEWBERRYTONKIN, KARIN COLUMBIATORRES, SHANNON SUMMERVILLETRACY, MICHELLE ANDERSONTRAVERS, ANGIE SUMMERVILLETRI COUNTY RADIOLOGY CHARLESTONTRI COUNTY RADIOLOGY ASSOCS NORTH CHARLESTONTRI COUNTY RADIOLOGY ASSOCS MONCKS CORNERTRIBBLE, DAVID E COLUMBIATRIBBLE, REID W COLUMBIATRIDENT MED CTR-MONCKS CORN MONCKS CORNERTRIMMIER, HAL BENNETTSVILLETROTTIER, HILARY SAVANNAHTSAI, MICHELLE WILLIAMSTONTUCKER, HOWARD W JR HARTSVILLETUCKER, TOM GREENVILLETURNER, M KEVIN AUGUSTAUCCARDI, AMANDA SAVANNAHUNION MEDICAL CENTER UNIONVAN DECAR, LAUREN M Top 5/SBS Medical site review MYRTLE BEACHVANDEGRIFT, RACHEL A SUMMERVILLEVASUKI, VIVEK P site review FLORENCE

(b) (6)

VEJNAR, MEREDITH BERGEY Top 5/SBS Medical ANDERSONVINING, SETH MT PLEASANTVITKO, CARRIE FLORENCEWACCAMAW COMMUNITY HOSPITAL MURRELLS INLETWADE, JANICE ORANGEBURGWALCK, J HARTSVILLEWARD, TANYA G site review HAMLETWATERS, ROBERT C GREENVILLEWAY, JAMES H primary site review ORANGEBURGWEAVER, DAVID GREENVILLEWELDON, ALLAN M COLUMBIAWENTZEL, SUSAN M FLORENCEWHITE, KRISTIN FLORENCEWHITLEY, JOHN C III Top 5 site review GREENWOODWHITSON, SALLY H MS ABBEVILLEWIGAND, JASON PAUL COLUMBIAWILLIAMS, JAMIE BAMBERGWILSON, GWENDOLYN D ORANGEBURGWILSON, ROBIN A GREENWOODWINDSOROVA, DORA site review FLORENCEWISE, FARAH site review BEAUFORTWOOD, ARTHUR GREENVILLEWOOD, LAURENCE W JR FLORENCEWRIGHT, JAMES A COLUMBIAWYLIE, ALLEN FLORENCEYALLAPRAGADA, RATHNA K ORANGEBURGYENSAN, JANICE LEXINGTONYOUNG, CAROLE M GEORGETOWNZAKHOUR, ISAM J FLORENCEZERDEN, STEPHANIE SAVANNAHZOLLINGER, ELIZABETH SAVANNAHZOLMAN, JENNIFER SMITH CHARLESTON

(b) (6)

Auth City Vendor # Vendor # of Exams Exam - Report # Cancel Paid Total Aberdeen John Vidoloff, M.D.Aberdeen Avera St. Luke's - RT 3 0 323.67$ Aberdeen Avera St. Luke's - Speech Therapy 2 6 274.10$ Aberdeen Pat Couglin, M.S.Aberdeen Steven Redmond, M.D. 18 10 2 4,467.59$ Aberdeen Avera St Luke's Peds PTAberdeen Marshall Dorsett. O.DAberdeen Francine Sippel, Ed.D. 4 3 1 1,489.46$ Aberdeen Edward D'Souza, M.D.Aberdeen Avera St. Luke's - RadiologyAberdeen Lutheran Social Services 2 9 1,467.57$ Aberdeen CE Provider ServicesAberdeen Sanford Aberdeen Med CtrAberdeen KLM Medical Svs - Aberdeen 24 16 3 8,283.65$ Aberdeen Dakota Counseling Group 13 6 1 4,611.00$ Bismarck Med Center OneBismarck UND Center for Family MedicineBismarck Link Psychological SvsBismarck Krista Heil, O.D.Brookings Merritt Warren, M.D. 3 27 936.39$ Brookings Yorkshire Eye Clinic 3 8 1 492.93$ Brookings Thomas Shaffer, Ph.D.Brookings Avera Brookings Medical ClinicChamberlain John Jones, M.D. 2 32 309.02$ Chamberlain Karen Wiemers, Ph.D. 1 14 3 496.32$ Chamberlain Audiology Associates 1 1 68.46$ Chamberlain CE Provider Svs - ChamberlainChamberlain Sanford Chamberlain ClinicChamberlain Alexander Permann, O.D. 2 53 286.56$ Eagle Butte Lynn Goehring, M.A, 9 10 2 8,594.96$ Freeman Kenneth Kirton, M.D. 2 18 165.95$ Gregory Gregory HealthCare Center-HospitalGregory Avera Gregory Med Clinic 5 12 1,600.56$

South Dakota FY 2017

(b) (6)

Hot Springs Daniel Hafner, M.D.Huron Frank Dame, Ph.D. 2 13 2 720.00$ Huron Community Counseling Svs 4 30 1 1,861.20$ Huron Huron Regional Med CtrHuron Gregory Wiedel, M.D.Huron CE Provider Services - HuronHuron KLM Medical Svs - Huron 24 17 5 7,899.90$ Lake Andes Richard Honke, II, M.D. 1 8 1 283.54$ Lemmon Shirley Herbel, Ph.D.Madison Bernard Heilman, M.D. 2 4 1 199.58$ Madison Richard Sample, M.D.Madison Madison Community Hospital - X-rayMadison Community Counseling SvsMiller Audiology Assoc - MillerMission Maryann Coupland, Ph.D. 13 7 6 8,375.40$ Mitchell David Malters, M.D.Mitchell Avera Queen of Peace - RT 1 0 160.75$ Mitchell Hearing PlusMitchell Avera Queen of Peace - Dr. ChoMitchell Avera Queen of Peace - SpeechMitchell Matthew Christiansen, Ph.D. 3 19 3 1,240.80$ Mitchell Children's Care Hospital & School - OT/PTMitchell Jorge Sanchez, M.D.Mitchell Mabee Eye ClinicMitchell Dakota Physical Therapy 1Mitchell Galen Van Kley, Ph.D. 12 34 2 7,830.66$ Mobridge Mobridge Regional Hospital 2Parkston Richard Honke, II, M.D. 2 7 1 661.51$ Parkston Jason Wickersham, M.D. 3 10 694.41$ Parkston Antoinette Vanderpol, M.D. 2 17 1 567.08$ Parkston Christopher Boschee, D.O.Parkston Larissa Sanger, M.D. 4 17 1 1,240.71$ Pierre Stephen Stout, M.D.Pierre Lynn Goehring, M.A. 14 10 3 8,896.68$

(b) (6)

Pierre Capital Area Counseling SvsPierre St. Mary's Hospital - RTPierre Audiology AssocPierre St. Mary's Hospital - Speech 1 1 3 121.86$ Pierre St. Mary's Hospital - OTPierre St. Mary's Hospital - X-rayPierre Jodi Owen, Psy.D. 1 13 479.84$ Pine Ridge Marv Bouska, M.S. 2Pine Ridge Greg Swenson, Ph.D. - OLC PR College CtrPine Ridge Greg Swenson, Ph.D.Rapid City Daniel Hafner, M.D. 5 15 2 804.52$ Rapid City Steven Hata, M.D.Rapid City Robert Nixon, M.D.Rapid City Richard Renka, M.D. 1 2 232.12$ Rapid City J. Geoffrey Slingsby, M.D.Rapid City Willis Sutliff, M.D.Rapid City Alvin Wessel, M.D. 5 23 1 1,882.25$ Rapid City Greg Swenson, Ph.D. 25 5 8 12,376.98$ Rapid City Rapid City Regional Hospital - RT 13 3 2 1,648.30$ Rapid City Mountain Plans Audiology Assoc 1 2 68.46$ Rapid City Scott Cherry, Ph.D.Rapid City Black Hills Rehab HospitalRapid City Craig Mills, M.D.Rapid City Mark Perrenoud, Ph.D.Rapid City Marv Bouska, M.S. 5 9 2 2,481.60$ Rapid City Jackie Gilbertson, Ed.D. 23 6 8 12,775.74$ Rapid City Lifescape - Motor SkillsRapid City Lifescape - Speech 6 9 4 822.30$ Rapid City Black Hills Rehab Hospital 1 14 1 137.05$ Rapid City Dewey Ertz, Ed.D. 12 9 2 2,946.90$ Rapid City David R. Johnson, M.D.Rapid City Paul Zimmerman, M.D.Rapid City Christina Cote, D.O.Rapid City Monte Dirks, M.D.

(b) (6)

Rapid City Dakota Radiology 76 4 16 6,151.40$ Rapid City William Moss, Psy.D.Rapid City Rolf Norlin, M.D. 56 12 12 15,327.62$ Rapid City Donald Blower, M.D.Rapid City Brett Valette, Ph.D. 28 11 8 15,121.56$ Rapid City Stuart Krause, Ph.D. 9 9 6 4,589.46$ Rapid City John Lassegard, M.D. 60 6 10 16,982.16$ Rapid City Black Hills Psychology 16 14 9,515.34$ Rapid City Scott Scrriber, O.D. 1Rapid City Regional Rehab Institute 1Sioux Falls Paul Cink, M.D. 3 37 509.24$ Sioux Falls Leonard Gutnik, M.D.Sioux Falls Michael McGrath, Ph.D. 10 35 4 9,196.18$ Sioux Falls Avera McKennan Hospital - RT 5 12 643.32$ Sioux Falls Sanford USD Medical Ctr - RT 5 12 1 732.74$ Sioux Falls Center for Family Medicine 29 9 4 8,233.83$ Sioux Falls Susan Assam, M.D.Sioux Falls Kelcey Cushman, AudSioux Falls Sanford Rehab Speech 2 11 200.10$ Sioux Falls CCHS Rehabilitation Ctr (Speech/AU, motor) 4 6 1 548.20$ Sioux Falls CCHS Rehabilitation Ctr Sioux Falls Sanford-RadiologySioux Falls Stanford Hearing 1 3 1 102.49$ Sioux Falls Thomas Price, Ph.D. 44 7 18 23,141.42$ Sioux Falls Brian Kidman, M.D. 43 11 8 14,600.21$ Sioux Falls Tracy Stephens, Ph.D.Sioux Falls Tom Styz, M.D.Sioux Falls Jorge Sanchez, M.D.Sioux Falls Rebecca Watson-Miller, Ph.D. 23 1 14 5,818.77$ Sioux Falls Galen Van Kley, Ph.D. 9 56 2 5,025.24$ Sioux Falls Martha Socolofsky, M.D.Sioux Falls Andrea McCann, O.D.Sioux Falls Ophthalmology LtdSioux Falls Emily Blegen, Psy.D. 20 5 4 10,794.96$

(b) (6)

Sioux Falls Sioux Falls Family VisionSioux Falls Kayla Norenberg, M.D. 12 9 6 3,974.04$ Sioux Falls Nicholas Venosdel, M.D. 17 9 8 5,831.02$ Sisseton Coteau Des Prairies HospitalSpearfish Mountain Plans Audiology AssocSpearfish Richard Keim, M.D.Spearfish Black Hills Psychology 3Vermillion Thomas Olson, M.D.Vermillion Robert Packard, Ph.D. 9 11 2,729.76$ Vermillion Dan Reiffenberger, M.D. 6 5 1,575.31$ Vermillion Galen Van Kley, Ph.D. 4 32 2 2,605.68$ Vermillion Michael Moran, M.D. 2 4 374.74$ Vermillion Sanford Vermillion HospitalWatertown Prairie Lakes Health Care 2 0 2 149.46$ Watertown Robert Packard, Ph.D. 4Watertown Dan Reiffenberger, M.D. 1Watertown Professional Hearing Svs 1 1 48.83$ Watertown Michael Moran, M.D. 1Watertown Prairie Lakes Hospital - X-RayWatertown Robert Buri, Ph.D. 8 14 3 5,893.80$ Watertown Jorge Sanchez, M.D.Watertown CE Provider Services - WatertownWebster Elizabeth Gravley, M.D.Winner Winner Regional Health Care CtrWinner Winner Regional Hospital - RadiologyWinner Audiology AssocWinner Avera Winner Medical Clinic 8 15 2,010.95$ Winner Winner Regional ClinicYankton Yankton Medical Clinic 2 1 257.88$ Yankton Todd Farnham, Aud, CCC-A 1 3 37.56$ Yankton Lewis & Clark Behavioral Health 5 20 2 1,768.14$ Yankton Sacred Heart Hospital - X-rayYankton Galen Van Kley, Ph.D. 10 37 1 6,204.00$ Yankton Psychological Assoc of Yankton 2 30 2 1,147.74$

(b) (6)

TOTALS 821 11 224 293,121.57$

Auth City Vendor # Vendor # of Exams Exam - Report # Cancel Paid Total Aberdeen John Vidoloff, M.D.Aberdeen Avera St. Luke's - RT 1 2 128.94$ Aberdeen Avera St. Luke's - Speech Therapy 1 3 137.05$ Aberdeen Pat Couglin, M.S.Aberdeen Steven Redmond, M.D. 3 9 1 824.02$ Aberdeen Avera St Luke's Peds PTAberdeen Marshall Dorsett. O.DAberdeen Francine Sippel, Ed.D. 1 2 1 372.24$ Aberdeen Edward D'Souza, M.D.Aberdeen Avera St. Luke's - RadiologyAberdeen Lutheran Social Services 8 16 2 4,319.64$ Aberdeen CE Provider ServicesAberdeen Sanford Aberdeen Med CtrAberdeen KLM Medical Svs - Aberdeen 20 15 5 6,895.94$ Aberdeen Dakota Counseling Group 12 7 1 4,234.00$ Bismarck Med Center OneBismarck UND Center for Family MedicineBismarck Link Psychological SvsBismarck Krista Heil, O.D.Brookings Merritt Warren, M.D. 2 18 414.81$ Brookings Yorkshire Eye Clinic 7 11 1,124.22$ Brookings Thomas Shaffer, Ph.D.Brookings Avera Brookings Medical ClinicChamberlain John Jones, M.D. 3 35 345.21$ Chamberlain Karen Wiemers, Ph.D. 2 21 1 1,302.84$ Chamberlain Audiology Associates Chamberlain CE Provider Svs - ChamberlainChamberlain Sanford Chamberlain ClinicChamberlain Alexander Permann, O.D. 1Eagle Butte Lynn Goehring, M.A, 17 9 4 16,254.48$ Freeman Kenneth Kirton, M.D. 3 20 1 912.67$ Gregory Gregory HealthCare Center-HospitalGregory Avera Gregory Med Clinic 8 20 2,241.97$ Hot Springs Daniel Hafner, M.D.Huron Frank Dame, Ph.D. 4 18 1 1,352.00$ Huron Community Counseling Svs 3 23 1 1,488.96$

(b) (6)

Huron Huron Regional Med CtrHuron Gregory Wiedel, M.D. 4 19 1 1,362.79$ Huron CE Provider Services - HuronHuron KLM Medical Svs - Huron 18 25 10 5,478.02$ Lake Andes Richard Honke, II, M.D. 4 18 1,134.16$ Lemmon Shirley Herbel, Ph.D.Madison Bernard Heilman, M.D. 2 14 2 199.58$ Madison Richard Sample, M.D.Madison Madison Community Hospital - X-rayMadison Community Counseling SvsMiller Audiology Assoc - MillerMission Maryann Coupland, Ph.D. 22 8 3 13,555.74$ Mitchell David Malters, M.D.Mitchell Avera Queen of Peace - RT 4 1 2 677.83$ Mitchell Hearing PlusMitchell Avera Queen of Peace - Dr. ChoMitchell Avera Queen of Peace - SpeechMitchell Matthew Christiansen, Ph.D. 7 15 2 2,140.38$ Mitchell Children's Care Hospital & School - OT/PTMitchell Jorge Sanchez, M.D.Mitchell Mabee Eye ClinicMitchell Dakota Physical TherapyMitchell Galen Van Kley, Ph.D. 17 45 1 11,601.48$ Mobridge Mobridge Regional Hospital 2 4 374.65$ Parkston Richard Honke, II, M.D. 4 9 1 1,143.14$ Parkston Jason Wickersham, M.D. 4 11 1 1,668.77$ Parkston Antoinette Vanderpol, M.D. 4 15 1,395.81$ Parkston Christopher Boschee, D.O.Parkston Larissa Sanger, M.D. 7 15 2,665.33$ Pierre Stephen Stout, M.D.Pierre Lynn Goehring, M.A. 16 9 8 10,174.56$ Pierre Capital Area Counseling SvsPierre St. Mary's Hospital - RT 1 1 3 96.97$ Pierre Audiology AssocPierre St. Mary's Hospital - Speech 2 2 1 243.72$ Pierre St. Mary's Hospital - OT 1 43 35.18$ Pierre St. Mary's Hospital - X-ray

(b) (6)

Pierre Jodi Owen, Psy.D.Pine Ridge Marv Bouska, M.S. 13 6 1 2,978.00$ Pine Ridge Greg Swenson, Ph.D. - OLC PR College CtrPine Ridge Greg Swenson, Ph.D.Rapid City Daniel Hafner, M.D. 7 10 1,209.80$ Rapid City Steven Hata, M.D.Rapid City Robert Nixon, M.D.Rapid City Richard Renka, M.D.Rapid City J. Geoffrey Slingsby, M.D.Rapid City Willis Sutliff, M.D.Rapid City Alvin Wessel, M.D.Rapid City Greg Swenson, Ph.D. 13 4 5 6,483.18$ Rapid City Rapid City Regional Hospital - RT 11 2 8 1,137.29$ Rapid City Mountain Plans Audiology Assoc 2 6 223.53$ Rapid City Scott Cherry, Ph.D.Rapid City Black Hills Rehab HospitalRapid City Craig Mills, M.D.Rapid City Mark Perrenoud, Ph.D.Rapid City Marv Bouska, M.S. 11 6 2 6,141.96$ Rapid City Jackie Gilbertson, Ed.D. 24 6 8 12,955.68$ Rapid City Lifescape - Motor SkillsRapid City Lifescape - Speech 8 7 2 1,096.40$ Rapid City Black Hills Rehab HospitalRapid City Dewey Ertz, Ed.D. 4 8 1 1,178.76$ Rapid City David R. Johnson, M.D.Rapid City Paul Zimmerman, M.D.Rapid City Christina Cote, D.O.Rapid City Monte Dirks, M.D.Rapid City Dakota Radiology 79 2 10 6,688.34$ Rapid City William Moss, Psy.D.Rapid City Rolf Norlin, M.D. 59 17 5 14,693.46$ Rapid City Donald Blower, M.D.Rapid City Brett Valette, Ph.D. 37 7 8 19,326.08$ Rapid City Stuart Krause, Ph.D. 15 6 6 7,251.58$ Rapid City John Lassegard, M.D. 60 6 11 17,010.24$ Rapid City Black Hills PsychologyRapid City Scott Scrriber, O.D.

(b) (6)

Rapid City Regional Rehab InstituteSioux Falls Paul Cink, M.D. 2 9 247.94$ Sioux Falls Leonard Gutnik, M.D.Sioux Falls Michael McGrath, Ph.D. 13 49 1 11,771.82$ Sioux Falls Avera McKennan Hospital - RT 2 11 297.73$ Sioux Falls Sanford USD Medical Ctr - RT 5 6 329.87$ Sioux Falls Center for Family Medicine 40 15 6 7,356.53$ Sioux Falls Susan Assam, M.D. 1 5 283.54$ Sioux Falls Kelcey Cushman, AudSioux Falls Sanford Rehab SpeechSioux Falls CCHS Rehabilitation Ctr (Speech/AU, motor) 5 5 1 685.25$ Sioux Falls CCHS Rehabilitation Ctr Sioux Falls Sanford-RadiologySioux Falls Stanford Hearing 4Sioux Falls Thomas Price, Ph.D. 33 7 8 16,564.68$ Sioux Falls Brian Kidman, M.D. 32 11 2 11,946.41$ Sioux Falls Tracy Stephens, Ph.D.Sioux Falls Tom Styz, M.D.Sioux Falls Jorge Sanchez, M.D.Sioux Falls Rebecca Watson-Miller, Ph.D. 6 1 11 1,489.83$ Sioux Falls Galen Van Kley, Ph.D. 12 43 2 6,762.36$ Sioux Falls Martha Socolofsky, M.D.Sioux Falls Andrea McCann, O.D.Sioux Falls Ophthalmology LtdSioux Falls Emily Blegen, Psy.D. 14 6 3 7,320.72$ Sioux Falls Sioux Falls Family VisionSioux Falls Kayla Norenberg, M.D. 1Sioux Falls Nicholas Venosdel, M.D. 27 13 9 8,998.13$ Sioux Falls Avera Mckennan Hospital - Audiology 1Sioux Falls Avera Audiology Clinic 1 9 142.39$ Sioux Falls Vitality Psychological Svs 9 8 5,676.66$ Sisseton Coteau Des Prairies HospitalSpearfish Mountain Plans Audiology AssocSpearfish Richard Keim, M.D.Spearfish Black Hills Psychology 14 24 4 8,612.32$ Vermillion Thomas Olson, M.D.Vermillion Robert Packard, Ph.D. 10 17 2,760.78$

(b) (6)

Vermillion Dan Reiffenberger, M.D. 6 6 1,805.77$ Vermillion Galen Van Kley, Ph.D. 7 37 2 4,404.84$ Vermillion Michael Moran, M.D. 1 1 187.37$ Vermillion Sanford Vermillion HospitalWatertown Prairie Lakes Health Care 1 1 138.51$ Watertown Robert Packard, Ph.D. 4Watertown Dan Reiffenberger, M.D.Watertown Professional Hearing SvsWatertown Michael Moran, M.D. 1Watertown Prairie Lakes Hospital - X-RayWatertown Robert Buri, Ph.D. 1 14 558.36$ Watertown Jorge Sanchez, M.D.Watertown CE Provider Services - WatertownWatertown Lee Hendricks, Psy.D. 12 14 4 7,879.08$ Webster Elizabeth Gravley, M.D.Winner Winner Regional Health Care CtrWinner Winner Regional Hospital - RadiologyWinner Audiology Assoc 1 2 68.46Winner Avera Winner Medical Clinic 3 24 1 116.47$ Winner Winner Regional ClinicYankton Yankton Medical Clinic 2 4 2 154.72$ Yankton Todd Farnham, Aud, CCC-AYankton Lewis & Clark Behavioral Health 5 29 1 1,861.20$ Yankton Sacred Heart Hospital - X-ray 1 8 197.17$ Yankton Galen Van Kley, Ph.D. 18 45 4 11,093.12$ Yankton Psychological Assoc of Yankton 1 8 744.48$

TOTALS 842 13 190 315,127.91$

(b) (6)

Auth City Vendor # Vendor # of Exams Exam - Report # Cancel Paid Total Aberdeen John Vidoloff, M.D.Aberdeen Avera St. Luke's - RT 1 1 128.94$ Aberdeen Avera St. Luke's - Speech Therapy 1 1 2 137.05$ Aberdeen Pat Couglin, M.S.Aberdeen Steven Redmond, M.D. 16 15 1 4,781.54$ Aberdeen Avera St Luke's Peds PTAberdeen Marshall Dorsett. O.D 2 14 533.57$ Aberdeen Francine Sippel, Ed.D.Aberdeen Edward D'Souza, M.D.Aberdeen Avera St. Luke's - RadiologyAberdeen Lutheran Social Services 2 29 1,329.12$ Aberdeen CE Provider ServicesAberdeen Sanford Aberdeen Med CtrAberdeen KLM Medical Svs - Aberdeen 11 15 2 4,338.57$ Aberdeen Dakota Counseling Group 8 6 4 2,813.00$ Bismarck Med Center OneBismarck UND Center for Family MedicineBismarck Link Psychological SvsBismarck Krista Heil, O.D.Brookings Merritt Warren, M.D. 2 17 614.08$ Brookings Yorkshire Eye Clinic 5 18 693.10$ Brookings Thomas Shaffer, Ph.D.Brookings Avera Brookings Medical ClinicChamberlain John Jones, M.D. 4 33 409.40$ Chamberlain Karen Wiemers, Ph.D. 4 21 1 2,667.72$ Chamberlain Audiology Associates Chamberlain CE Provider Svs - ChamberlainChamberlain Sanford Chamberlain ClinicChamberlain Alexander Permann, O.D. 4 14 841.67$ Eagle Butte Lynn Goehring, M.A, 14 8 2 12,904.32$ Freeman Kenneth Kirton, M.D. 3 17 2 1,155.34$ Gregory Gregory HealthCare Center-HospitalGregory Avera Gregory Med Clinic 3 60 686.62$ Hot Springs Daniel Hafner, M.D.Huron Frank Dame, Ph.D. 1Huron Community Counseling Svs 3 23 2 1,706.70$ Huron Huron Regional Med Ctr 1 1 2 135.43$ Huron Gregory Wiedel, M.D. 1 23 283.54$ Huron CE Provider Services - HuronHuron KLM Medical Svs - Huron 23 19 5 8,415.94$

(b) (6)

Lake Andes Richard Honke, II, M.D. 2 12 567.08$ Lemmon Shirley Herbel, Ph.D.Madison Bernard Heilman, M.D. 2 38 249.58$ Madison Richard Sample, M.D.Madison Madison Community Hospital - X-rayMadison Community Counseling SvsMiller Audiology Assoc - MillerMission Maryann Coupland, Ph.D. 24 13 5 14,561.40$ Mitchell David Malters, M.D.Mitchell Avera Queen of Peace - RT 1Mitchell Hearing Plus 2 9 410.57$ Mitchell Avera Queen of Peace - Dr. ChoMitchell Avera Queen of Peace - SpeechMitchell Matthew Christiansen, Ph.D. 1 29 2 744.48$ Mitchell Children's Care Hospital & School - OT/PTMitchell Jorge Sanchez, M.D.Mitchell Mabee Eye ClinicMitchell Dakota Physical Therapy 1 9 137.05$ Mitchell Galen Van Kley, Ph.D. 12 33 2 7,568.88$ Mobridge Mobridge Regional HospitalParkston Richard Honke, II, M.D. 1 7 3 283.54$ Parkston Jason Wickersham, M.D. 1 19 1 352.13$ Parkston Antoinette Vanderpol, M.D. 2 6 1 613.37$ Parkston Christopher Boschee, D.O.Parkston Larissa Sanger, M.D. 6 17 2,071.97$ Pierre Stephen Stout, M.D.Pierre Lynn Goehring, M.A. 6 8 3 4,094.64$ Pierre Capital Area Counseling SvsPierre St. Mary's Hospital - RTPierre Audiology AssocPierre St. Mary's Hospital - Speech 2 4 243.72$ Pierre St. Mary's Hospital - OTPierre St. Mary's Hospital - X-rayPierre Jodi Owen, Psy.D.Pine Ridge Marv Bouska, M.S. 10 20 1 5,664.62$ Pine Ridge Greg Swenson, Ph.D. - OLC PR College CtrPine Ridge Greg Swenson, Ph.D.Rapid City Daniel Hafner, M.D. 10 10 2 1,961.19$ Rapid City Steven Hata, M.D.Rapid City Robert Nixon, M.D.Rapid City Richard Renka, M.D.

(b) (6)

Rapid City J. Geoffrey Slingsby, M.D.Rapid City Willis Sutliff, M.D.Rapid City Alvin Wessel, M.D.Rapid City Greg Swenson, Ph.D. 18 6 5 9,771.30$ Rapid City Rapid City Regional Hospital - RT 4 2 1 658.88$ Rapid City Mountain Plans Audiology Assoc 4 4 2 305.39$ Rapid City Scott Cherry, Ph.D.Rapid City Black Hills Rehab HospitalRapid City Craig Mills, M.D.Rapid City Mark Perrenoud, Ph.D.Rapid City Marv Bouska, M.S. 8 6 6 4,628.92$ Rapid City Jackie Gilbertson, Ed.D. 24 7 3 14,094.80$ Rapid City Lifescape - Motor Skills 1 7 137.05$ Rapid City Lifescape - Speech 6 20 7 822.30$ Rapid City Black Hills Rehab HospitalRapid City Dewey Ertz, Ed.D. 4 9 744.48$ Rapid City David R. Johnson, M.D.Rapid City Paul Zimmerman, M.D.Rapid City Christina Cote, D.O.Rapid City Monte Dirks, M.D.Rapid City Dakota Radiology 77 2 12 7,962.43$ Rapid City William Moss, Psy.D.Rapid City Rolf Norlin, M.D. 50 13 6 12,925.76$ Rapid City Donald Blower, M.D.Rapid City Brett Valette, Ph.D. 24 5 5 Rapid City Stuart Krause, Ph.D. 5 7 4 2,549.70$ Rapid City John Lassegard, M.D. 63 5 8 17,863.02$ Rapid City Black Hills Psychology 12 25 7,252.48$ Rapid City Scott Scrriber, O.D.Rapid City Regional Rehab Institute 1Sioux Falls Paul Cink, M.D.Sioux Falls Leonard Gutnik, M.D.Sioux Falls Michael McGrath, Ph.D. 9 51 6 6,949.72$ Sioux Falls Avera McKennan Hospital - RT 1 20 133.18$ Sioux Falls Sanford USD Medical Ctr - RT 3 3 1 379.14$ Sioux Falls Center for Family Medicine 30 16 2 5,617.08$ Sioux Falls Susan Assam, M.D.Sioux Falls Kelcey Cushman, AudSioux Falls Sanford Rehab Speech 1 10 1 67.30$ Sioux Falls CCHS Rehabilitation Ctr (Speech/AU, motor) 4 7 548.20$ Sioux Falls CCHS Rehabilitation Ctr 1 2 82.51$

(b) (6)

Sioux Falls Sanford-RadiologySioux Falls Stanford Hearing 4 13 409.96$ Sioux Falls Thomas Price, Ph.D. 17 2 7,630.92$ Sioux Falls Brian Kidman, M.D. 21 10 4 8,264.42$ Sioux Falls Tracy Stephens, Ph.D.Sioux Falls Tom Styz, M.D.Sioux Falls Jorge Sanchez, M.D.Sioux Falls Rebecca Watson-Miller, Ph.D. 6 1 9 1,433.61$ Sioux Falls Galen Van Kley, Ph.D. 7 40 2 3,536.28$ Sioux Falls Martha Socolofsky, M.D.Sioux Falls Andrea McCann, O.D.Sioux Falls Ophthalmology LtdSioux Falls Emily Blegen, Psy.D. 6 1 1 3,722.40$ Sioux Falls Sioux Falls Family VisionSioux Falls Kayla Norenberg, M.D.Sioux Falls Nicholas Venosdel, M.D. 14 18 5 5,071.74$ Sioux Falls Avera Mckennan Hospital - AudiologySioux Falls Avera Audiology ClinicSioux Falls Vitality Psychological Svs 15 10 4 8,747.64$ Sioux Falls Midwest Ear, Nose & Throat 1 23 159.83$ Sisseton Coteau Des Prairies HospitalSpearfish Mountain Plans Audiology AssocSpearfish Richard Keim, M.D.Spearfish Black Hills Psychology 12 25 2 7,252.48$ Vermillion Thomas Olson, M.D.Vermillion Robert Packard, Ph.D. 9 12 1 2,233.44$ Vermillion Dan Reiffenberger, M.D. 4 4 1,223.38$ Vermillion Galen Van Kley, Ph.D.Vermillion Michael Moran, M.D.Vermillion Sanford Vermillion HospitalWatertown Prairie Lakes Health CareWatertown Robert Packard, Ph.D.Watertown Dan Reiffenberger, M.D.Watertown Professional Hearing SvsWatertown Michael Moran, M.D.Watertown Prairie Lakes Hospital - X-RayWatertown Robert Buri, Ph.D.Watertown Jorge Sanchez, M.D.Watertown CE Provider Services - WatertownWatertown Lee Hendricks, Psy.D. 8 17 1 6,328.08$ Webster Elizabeth Gravley, M.D.

(b) (6)

Winner Winner Regional Health Care CtrWinner Winner Regional Hospital - RadiologyWinner Audiology AssocWinner Avera Winner Medical Clinic 5 21 2 1,330.97$ Winner Winner Regional ClinicYankton Yankton Medical Clinic 1 1 77.36$ Yankton Todd Farnham, Aud, CCC-A 1Yankton Lewis & Clark Behavioral Health 5 27 2 1,861.20$ Yankton Sacred Heart Hospital - X-rayYankton Galen Van Kley, Ph.D. 15 37 4 10,286.60$ Yankton Psychological Assoc of Yankton 1 35 1 620.40$

TOTALS 679 12 156 254,180.14$

(b) (6)

Auth City Vendor # Vendor # of Exams Exam - Report # Cancel Paid Total 7/1/17 - 9/28/17Aberdeen John Vidoloff, M.D.Aberdeen Avera St. Luke's - RTAberdeen Avera St. Luke's - Speech TherapyAberdeen Pat Couglin, M.S.Aberdeen Steven Redmond, M.D.Aberdeen Avera St Luke's Peds PTAberdeen Marshall Dorsett. O.DAberdeen Francine Sippel, Ed.D.Aberdeen Edward D'Souza, M.D.Aberdeen Avera St. Luke's - RadiologyAberdeen Lutheran Social ServicesAberdeen CE Provider ServicesAberdeen Sanford Aberdeen Med CtrAberdeen KLM Medical Svs - AberdeenAberdeen Dakota Counseling GroupBismarck Med Center OneBismarck UND Center for Family MedicineBismarck Link Psychological SvsBismarck Krista Heil, O.D.Brookings Merritt Warren, M.D.Brookings Yorkshire Eye ClinicBrookings Thomas Shaffer, Ph.D.Brookings Avera Brookings Medical ClinicChamberlain John Jones, M.D.Chamberlain Karen Wiemers, Ph.D.Chamberlain Audiology Associates Chamberlain CE Provider Svs - ChamberlainChamberlain Sanford Chamberlain ClinicChamberlain Alexander Permann, O.D.Eagle Butte Lynn Goehring, M.A,Freeman Kenneth Kirton, M.D.Gregory Gregory HealthCare Center-HospitalGregory Avera Gregory Med ClinicHot Springs Daniel Hafner, M.D.Huron Frank Dame, Ph.D.Huron Community Counseling SvsHuron Huron Regional Med CtrHuron Gregory Wiedel, M.D.Huron CE Provider Services - HuronHuron KLM Medical Svs - HuronLake Andes Richard Honke, II, M.D.Lemmon Shirley Herbel, Ph.D.Madison Bernard Heilman, M.D.Madison Richard Sample, M.D.Madison Madison Community Hospital - X-rayMadison Community Counseling SvsMiller Audiology Assoc - MillerMission Maryann Coupland, Ph.D.

(b) (6)

Mitchell David Malters, M.D.Mitchell Avera Queen of Peace - RTMitchell Hearing PlusMitchell Avera Queen of Peace - Dr. ChoMitchell Avera Queen of Peace - SpeechMitchell Matthew Christiansen, Ph.D.Mitchell Children's Care Hospital & School - OT/PTMitchell Jorge Sanchez, M.D.Mitchell Mabee Eye ClinicMitchell Dakota Physical TherapyMitchell Galen Van Kley, Ph.D.Mobridge Mobridge Regional HospitalParkston Richard Honke, II, M.D.Parkston Jason Wickersham, M.D.Parkston Antoinette Vanderpol, M.D.Parkston Christopher Boschee, D.O.Parkston Larissa Sanger, M.D.Pierre Stephen Stout, M.D.Pierre Lynn Goehring, M.A.Pierre Capital Area Counseling SvsPierre St. Mary's Hospital - RTPierre Audiology AssocPierre St. Mary's Hospital - SpeechPierre St. Mary's Hospital - OTPierre St. Mary's Hospital - X-rayPierre Jodi Owen, Psy.D.Pine Ridge Marv Bouska, M.S.Pine Ridge Greg Swenson, Ph.D. - OLC PR College CtrPine Ridge Greg Swenson, Ph.D.Rapid City Daniel Hafner, M.D.Rapid City Steven Hata, M.D.Rapid City Robert Nixon, M.D.Rapid City Richard Renka, M.D.Rapid City J. Geoffrey Slingsby, M.D.Rapid City Willis Sutliff, M.D.Rapid City Alvin Wessel, M.D.Rapid City Greg Swenson, Ph.D.Rapid City Rapid City Regional Hospital - RTRapid City Mountain Plans Audiology AssocRapid City Scott Cherry, Ph.D.Rapid City Black Hills Rehab HospitalRapid City Craig Mills, M.D.Rapid City Mark Perrenoud, Ph.D.Rapid City Marv Bouska, M.S.Rapid City Jackie Gilbertson, Ed.D.Rapid City Lifescape - Motor SkillsRapid City Lifescape - SpeechRapid City Black Hills Rehab HospitalRapid City Dewey Ertz, Ed.D.

(b) (6)

Rapid City David R. Johnson, M.D.Rapid City Paul Zimmerman, M.D.Rapid City Christina Cote, D.O.Rapid City Monte Dirks, M.D.Rapid City Dakota RadiologyRapid City William Moss, Psy.D.Rapid City Rolf Norlin, M.D.Rapid City Donald Blower, M.D.Rapid City Brett Valette, Ph.D. Rapid City Stuart Krause, Ph.D.Rapid City John Lassegard, M.D.Rapid City Black Hills PsychologyRapid City Scott Scrriber, O.D.Rapid City Regional Rehab InstituteSioux Falls Paul Cink, M.D.Sioux Falls Leonard Gutnik, M.D.Sioux Falls Michael McGrath, Ph.D.Sioux Falls Avera McKennan Hospital - RTSioux Falls Sanford USD Medical Ctr - RTSioux Falls Center for Family MedicineSioux Falls Susan Assam, M.D.Sioux Falls Kelcey Cushman, AudSioux Falls Sanford Rehab SpeechSioux Falls CCHS Rehabilitation Ctr (Speech/AU, motor)Sioux Falls CCHS Rehabilitation Ctr Sioux Falls Sanford-RadiologySioux Falls Stanford HearingSioux Falls Thomas Price, Ph.D. Sioux Falls Brian Kidman, M.D.Sioux Falls Tracy Stephens, Ph.D.Sioux Falls Tom Styz, M.D.Sioux Falls Jorge Sanchez, M.D.Sioux Falls Rebecca Watson-Miller, Ph.D.Sioux Falls Galen Van Kley, Ph.D.Sioux Falls Martha Socolofsky, M.D.Sioux Falls Andrea McCann, O.D.Sioux Falls Ophthalmology LtdSioux Falls Emily Blegen, Psy.D.Sioux Falls Sioux Falls Family VisionSioux Falls Kayla Norenberg, M.D.Sioux Falls Nicholas Venosdel, M.D.Sioux Falls Avera Mckennan Hospital - AudiologySioux Falls Avera Audiology ClinicSioux Falls Vitality Psychological SvsSioux Falls Midwest Ear, Nose & ThroatSisseton Coteau Des Prairies HospitalSpearfish Mountain Plans Audiology AssocSpearfish Richard Keim, M.D.Spearfish Black Hills Psychology

(b) (6)

Vermillion Thomas Olson, M.D.Vermillion Robert Packard, Ph.D.Vermillion Dan Reiffenberger, M.D.Vermillion Galen Van Kley, Ph.D.Vermillion Michael Moran, M.D.Vermillion Sanford Vermillion HospitalWatertown Prairie Lakes Health CareWatertown Robert Packard, Ph.D.Watertown Dan Reiffenberger, M.D.Watertown Professional Hearing SvsWatertown Michael Moran, M.D.Watertown Prairie Lakes Hospital - X-RayWatertown Robert Buri, Ph.D.Watertown Jorge Sanchez, M.D.Watertown CE Provider Services - WatertownWatertown Lee Hendricks, Psy.D.Webster Elizabeth Gravley, M.D.Winner Winner Regional Health Care CtrWinner Winner Regional Hospital - RadiologyWinner Audiology AssocWinner Avera Winner Medical ClinicWinner Winner Regional ClinicYankton Yankton Medical ClinicYankton Todd Farnham, Aud, CCC-AYankton Lewis & Clark Behavioral HealthYankton Sacred Heart Hospital - X-rayYankton Galen Van Kley, Ph.D.Yankton Psychological Assoc of Yankton

TOTALS

(b) (6)

Auth City Vendor Volume Providers Onsite Review CompletedRapid City Brett Valette, Ph.D.Rapid City John Lassegard, M.D.Rapid City Jackie Gilbertson, Ed.D. XRapid City Rolf Norlin, M.D. XSioux Falls Brian Kidman, M.D.Sioux Falls Thomas Price, Ph.D.Eagle Butte Lynn Goehring, M.A,Mission Maryann Coupland, Ph.D.Sioux Falls Michael McGrath, Ph.D.Rapid City Greg Swenson, Ph.D.Mitchell Galen Van Kley, Ph.D.Spearfish Black Hills PsychologyPierre Lynn Goehring, M.A.Sioux Falls Emily Blegen, Psy.D.Yankton Galen Van Kley, Ph.D.Sioux Falls Vitality Psychological SvsRapid City Dakota RadiologyHuron KLM Medical Svs - Huron XSioux Falls Center for Family MedicineAberdeen KLM Medical Svs - Aberdeen XSioux Falls Nicholas Venosdel, M.D.Watertown Lee Hendricks, Psy.D.Rapid City Stuart Krause, Ph.D. XRapid City Marv Bouska, M.S.Sioux Falls Galen Van Kley, Ph.D.Pine Ridge Marv Bouska, M.S.Aberdeen Dakota Counseling GroupSioux Falls Rebecca Watson-Miller, Ph.D.Aberdeen Steven Redmond, M.D.Vermillion Robert Packard, Ph.D.Aberdeen Lutheran Social ServicesRapid City Dewey Ertz, Ed.D.Vermillion Galen Van Kley, Ph.D.

Parkston Larissa Sanger, M.D.Huron Community Counseling SvsChamberlain Karen Wiemers, Ph.D.Watertown Robert Buri, Ph.D.Aberdeen Emily Blegen, Psy.D.Vermillion Dan Reiffenberger, M.D.Gregory Avera Gregory Med ClinicYankton Lewis & Clark Behavioral HealthRapid City Daniel Hafner, M.D.Winner Avera Winner Medical ClinicMitchell Matthew Christiansen, Ph.D.Rapid City Rapid City Regional Hospital - RTParkston Antoinette Vanderpol, M.D.Rapid City Lifescape - SpeechSioux Falls Kayla Norenberg, M.D. XPierre Jodi Owen, Psy.D.Brookings Yorkshire Eye ClinicYankton Psychological Assoc of YanktonParkston Jason Wickersham, M.D.Parkston Richard Honke, II, M.D.Brookings Merritt Warren, M.D.Freeman Kenneth Kirton, M.D.Sioux Falls CCHS Rehabilitation Ctr (Speech/AU, motor)Lake Andes Richard Honke, II, M.D.Huron Gregory Wiedel, M.D.Aberdeen Francine Sippel, Ed.D.Huron Frank Dame, Ph.D.Rapid City Alvin Wessel, M.D.Sioux Falls Sanford USD Medical Ctr - RTSioux Falls Avera McKennan Hospital - RTAberdeen Marshall Dorsett. O.DChamberlain John Jones, M.D.Chamberlain Alexander Permann, O.D.Sioux Falls Paul Cink, M.D.

Mitchell Avera Queen of Peace - RTRapid City Mountain Plans Audiology AssocPierre St. Mary's Hospital - SpeechAberdeen Avera St. Luke's - RTYankton Yankton Medical ClinicMadison Bernard Heilman, M.D.Watertown Michael Moran, M.D.Mobridge Mobridge Regional HospitalAberdeen Avera St. Luke's - Speech TherapyRapid City Regional Rehab InstituteSioux Falls Stanford HearingMitchell Hearing PlusWatertown Prairie Lakes Health CarePierre St. Mary's Hospital - RTHuron Huron Regional Med CtrSioux Falls Susan Assam, M.D.Sioux Falls Sanford Rehab SpeechRapid City Lifescape - Motor SkillsRapid City Richard Renka, M.D.Sioux Falls Midwest Ear, Nose & ThroatYankton Sacred Heart Hospital - X-raySioux Falls Avera Audiology ClinicMitchell Dakota Physical TherapyRapid City Black Hills Rehab HospitalSioux Falls CCHS Rehabilitation Ctr Chamberlain Audiology Associates Winner Audiology AssocPierre Audiology AssocSpearfish Mountain Plans Audiology AssocWatertown Professional Hearing SvsRapid City Black Hills Rehab HospitalYankton Todd Farnham, Aud, CCC-APierre St. Mary's Hospital - OT

Vendor Name Key And Volume Providers

CE Panelist Onsite Review

CE Panelists Removed For Inactive License, Sanction Or Removal For Cause and

ReasonALLRED, TRACY L Key Provider Based On CE Work 11/15/2016ALL WAYS THERAPIESCook, Candice MAPPALACHIAN PSYCHOLOGICAL C 6/7/2017Spangler, RobertASSESSMENT AND FORENSIC SER 6/6/2017Birchfield, SarahFuchs, JorgeJones, ElizabethSims, WillardVisser, PrestonWhitehead, DianeATHENS MEDICAL SERVICES LLC Key Provider Based On CE Work 6/14/2017ATHENS PSYCHOLOGICAL & COUNKey Provider Based On CE Work 6/14/2017AUDIOLOGY SERVICE OF CHATTAParker, KennethAVAZA LANGUAGE SERVICES CORBARKER, MARY L 11/15/2016BARKLEY & ASSOCIATESBarkley, Janice LBarkley, Philip HQuarto, Christopher JBEHAVIORAL HEALTH & ASSESSMMoore, Hugh DBEHAVIORAL SCIENCE CONSULTI Key and Volume Provider-Top 5 11/10/2016Fulliton, William LGammel, HeatherMiller, PaulaMyszak, JessicaBLAKE, CANDICE L 11/18/2016BLANTON, KEVIN Key Provider Based On CE Work 3/7/2017BLAZINA, LINDA Key Provider Based On CE Work 8/14/2017BRENTWOOD HEARING CENTERBoling, AnneMozingo, KimberlyWilliams, TaniaBRIDGEWATER SPEECH & HEARIN 3/7/2017Baerman, Sally JRossini, TabithaBRISTOL EVALUATION SERVICES Key Provider Based On CE Work 6/6/2017Palmer, AnnaSmith, Wade

Tennessee FY 2017

BRISTOL MEDICAL SERVICES IN Key Provider Based On CE Work 6/6/2017BRISTOL PSYCH & COUNSELING Key Provider Based On CE Work 6/6/2017CALDWELL, KATHY 2/8/2017Geter, JenniferCAMP, DIANE Key Provider Based On CE Work 11/10/2016CAMPBELL CUNNINGHAM & TAYLO 3/7/2017Campbell , Philip DCole, MatthewCunningham,Leslie BEverett, GregoryHaun, AldenHildebrand, AllynHorton, DanielMolloy, BrentsStone, LaurenSussmane, ShawnTaylor, ChristopherTonks, MeredithCENTER FOR AUDIOLOGY PCCarr, Aubrey JCrockett, KatelynLeJeune, EmikoCENTER FOR SIGHT 3/9/2017Franklin, StephenO'Brien, Christopher PatrickRaulston, KennethCHATTANOOGA SERVICES LLC Key and Volume Provider 1/18/2017CLARKSVILLE SERVICES LLC Key Provider Based On CE Work 2/28/2017COGNITIVE BRIDGES INC 2/8/2017Pollack, SharonSchultz, CharlotteCOLUMBIA MEDICAL & PSYCHOLOKey Provider Based On CE Work 9/25/2017COLUMBIA ORTHOPEDIC CLINICH. James Wiesman, MDCOMMUNICATION CENTER FOR DECOOKEVILLE PSYCH & COUNSELI Key Provider Based On CE Work 8/14/2017COOKEVILLE SERVICES LLC Key Provider Based On CE Work 8/14/2017CRISLER, HERMAN JRCUMBERLAND MEDICAL EVALUATKey and Volume Provider-Top 5 6/8/2017Uzzle, Jeffrey ADEAFCONNECT OF THE MIDSOUTHDENNY, ELLEN Key Provider Based On CE Work 3/7/2017DIAGNOSTIC CENTER Key Provider Based On CE Work 6/14/2017Mullady, Thomas FDIAGNOSTIC ULTRASOUND CONSUDavis Ellis, Nancy C.

Eiland, DouglasFlinn Jr., George S.DICKSON MEDICAL INC Key Provider Based On CE Work 9/12/2017DOINEAU, DEBBIE Key Provider Based On CE Work 12/14/2016DORAN, ROBERT N 2/28/2017Phillips, MarkDR ABRAHAM BRIETSTEIN & ASS 3/7/2017Brietstein, AbrahamDR GUINLE & ASSOCS 11/19/2016Guinle, MichaelDUNCAN EYE PLLC 2/9/2017Duncan, KristenGraves, Emily TDYERSBURG MEDICAL ASSOCIATEKey Provider Based On CE Work 5/15/2017EAR NOSE & THROAT CONSULTANHayes, JonathanJohnson, Clifford Overholt, SamuelSeals, JamesSeals, MichaelSexton, DavidWheless, StephenEAST TN PSYCHOLOGICAL ASSOC Key Provider Based On CE Work 3/7/2017EDWARDS, SHARON M Key Provider Based On CE Work 12/14/2016ENGSTROM SERVICES, INC 6/14/2017Wheeler, Janice KEVALUATION SPECIALISTS Key Provider Based On CE Work 6/8/2017Brody, PamelaBrown, LarryHawthrone, Michael CEYE CARE CHATTANOOGA PLLCNicola, PaulaEYE CENTERS OF TENNESSEE LLCElder, JenniferPeek, Jennifer LeannEYE CLINIC 5/16/2017Bateman, MarkGrissom, HilaryLee, MollyLuka, AdamNeel, SeanSullivan, JasonEYE SPECIALISTS ASSOCIATIONCurrey, ThomasFAMILY EYE CARE OF JOHNSON 6/7/2017Grist, Dana

FAMILY HEARING CENTER INCGresham, JillMcDermott, AshleyStone, SueFAMILY WELLNESS CENTER 2/28/2017Martin, JanicePremeau, CheriTerrell, DavidFAYETTEVILLE MEDICAL SVCS G Key Provider Based On CE Work 6/30/2017FAYETTEVILLE PSYCHOLOGICAL Key Provider Based On CE Work 6/30/2017FISHER, TIMOTHY MFOLEY, THELMAGALE, SCOTT JGOMEZ, ALBERT JGREEN, REBECCA ANN 1/19/2017GUARDIAN EYE ASSOCIATES PLC 2/28/2017Frey, WalterHAND, BOBBIE JHARDISON, STEPHEN R Key Provider Based On CE Work 8/14/2017HARRIS SPEECH THERAPYHarris, Jennifer MHAWKINS, LEAH THEALTH MANAGEMENT SERVICES 6/14/2017Biller, BenjaminBiller, Tom Milliron, TrevorHEALTHSTAR PHYSICIANS 6/6/2017Nevils, RoyHEALTHSTAR PHYSICIANSMcConnell, David HEARING & BALANCE CENTERS OFrederick, LoriHouse, CourtneyTackett, KatherineTidwell, KaitlynHEARING BRIDGESHEARING CONSERVATION ASSOCCarroll, James R JrHENDERSONVILLE MEDICAL SVCSKey Provider Based On CE Work 2/28/2017HENDERSONVILLE PSYCHOLOGICAKey Provider Based On CE Work 2/28/2017HENRY, BERTRAMHERMAN, JEFFREY SCOTT LPCValerio, CarolynHIGHLANDS PSYCHOLOGICAL GROKey Provider Based On CE Work 9/25/2017HILLSIDE HOSPITALHOLCOMBE, SAMUEL A 2/9/2017

HOLLAND, WILLIAM A Key Provider Based On CE Work 1/18/2017HUANG, LLOYD 12/14/2016HUMPHREYS, BRIAN 3/10/2017JACKIE-D-YAK LLCDunn, JacquelineJACKSON CLINIC NORTHWarmbrod, James GJACKSON MADISON CO GEN HOSPJACKSON SERVICES LLC Key Provider Based On CE Work 5/6/2017JCIL DEAF SERVICESJD ASSOCIATES 2/22/2017Carroll, Jana AGreer, MelissaJENKINS, WILLYN 2/9/2017JOHNSON CITY EYE CLINICJohnson, JohnMiller, CalvinShahbazi, MichaelJOHNSON CITY PSYCHOLOGICAL Key Provider Based On CE Work 6/7/2017JONES THERAPY SERVICES LLCBattles, CorneliaCarrico, KailinCox, EmalyDeStefano, AndriaEibl, EmilyFerguson, JanFreel, Terah H.Hinson, RachelHitch, ChristineHorton, SusanJohns, ShannonJones, GingerKakenmaster, ClaireMaffett, ElizabethPalmer, KathleenRitz, ChelseaSepp, ChelseaShea, LoriSmith, TaraVannelli, DominiqueWomack, MargeauxWood, KendraKENNON, ROBERT W 12/14/2016KILLIAN, JERELL FKINGSPORT MEDICAL SERVICES Key Provider Based On CE Work 6/6/2017KINGSPORT PSYCH & COUNSELIN Key Provider Based On CE Work 6/6/2017

KNOXVILLE CENTER OF THE DEAFKNOXVILLE SERVICES LLC Key Provider Based On CE Work 3/7/2017KRIGER, SIDNEY H 2/9/2017Battles, Michelle ALAAMBDA HEALTHCARE, INC Key Provider Based On CE Work 11/9/2016Mohan, KamalLACY & ASSOCIATES 12/14/2016Collins, MillardLennon, ChristenSchuster, DanielYawn, RobertLAMBERT, DOROTHYLANTHORN, B WAYNE 6/7/2017Abbott, Donna LAWHON, STEVENLAWRENCE, HARRY MLITTLE, WILLIAM B 11/8/2016Little, William BLittle, William B JrLOFTIS, MARK 8/14/2017LOSKOVITZ, LEWIS 2/8/2017LUCAS, DEANNE RIESS 3/9/2017MABRY EYE CENTER 1/19/2017Mabry, ElizabethMAFFEO, PATRICIA A Key Provider Based On CE Work 3/10/2017MAURY REGIONAL HOSPITALMAY, C RANDALLMcMINNVILLE MEDICAL SERVICE Key Provider Based On CE Work 10/26/2016McMINNVILLE PSYCHOLOGICAL &Key Provider Based On CE Work 10/26/2016MEDICAL AND PSYCHOLOGICAL Key and Volume Provider-Top 5 6/30/2017MEDICAL CARE PLLCFilka, MarianneMEDICAL SPECIALISTS OF KNOX Key Provider Based On CE Work 11/15/2016Summers, Jeffrey SMEMPHIS HEARING AID & AUDIOAven, MarvaCox, BentonDawkins, SarahKillins, CarlaLunsford, RachelMcLellan Booth, RenaRude, Michael JSpringer, CatelinThompson, Marjorie LisaMEMPHIS MEDICAL ASSOCIATES Key and Volume Provider-Top 5 11/9/2016MEMPHIS NEUROLOGY PLLC

Jacob, SajishLynn, RonaldNatarajan, Shiva ShankarMID SOUTH HEART CENTER PCCunningham, LouisMIDDLE TN EAR NOSE & THROATConverse, George MFord, Vicki LFordice. James OPhelps, Aurora MSmith, AlissaMIDDLE TN OCCUPATIONAL AND 8/14/2017Johnson, Roy PChernowitz, AlexanderMISRA, EVA Key Provider Based On CE Work 3/9/2017MORRISTOWN MEDICAL ASSOCIAKey Provider Based On CE Work 6/6/2017MORRISTOWN PSYCHOLOGICAL GKey Provider Based On CE Work 6/6/2017MOUNTAIN REGION SPEECH AND 6/6/2017Arwood, KathleenBrady, MatthewClaytor, CarolCollins, BrittanyDavis, CourtneyMaas, DallasPayne, PaulaRowe, KristiRushing, BrittanySmith, JessiWatson, RebekahWolfe, RachelMURFREESBORO SERVICES LLC Key Provider Based On CE Work 10/26/2016NASHVILLE MEDICAL SERVICES Key Provider Based On CE Work 12/14/2016NASHVILLE PSYCH & COUNSELIN Key Provider Based On CE Work 12/14/2016NEUROLOGY OUTREACH CLINICSAl-Hamda, AhmadAssaf, MohammadNORTHGATE NEUROLOGY PLLCGibson, LarryMance, Cornelius JNU CARE Key Provider Based On CE Work 2/28/2017Dake, ThomasRobinson, WilliamON-SITE SWALLOWING DIAGNOSTI 2/8/2017Fleming, WendyOPTIMUM BEHAVIORAL HEALTH I 2/10/2017Amos, W. Edward

O'TOOLE, THERESA 2/9/2017PALMER, LARRYPARIS MEDICAL SERVICES INC Key Provider Based On CE Work 4/5/2017PARIS PSYCHOLOGICAL & COUNS Key Provider Based On CE Work 4/5/2017PARIS SPEECH AND LANGUAGE CL 4/5/2017Taylor-Nanney, Elizabeth LeighWatt, RhondaPARKWEST MEDICAL CENTERPARTNERSHIP FOR FAMILIESPATTERSON, LISA NPREMIER DIAGNOSTIC IMAGINGCoonce, DanielHumphrey, William M.Limbacher II, John P.Means, SethPSYCHOLOGICAL DIAGNOSTIC GRKey Provider Based On CE Work 1/19/2017Caye, David JJudd, John BMartin, CharlesRamey, AnnPSYCHOLOGICAL SERVICES Key and Volume Provider 9/12/2017Altfeld, TobyBrown, PaulCowie, JamesDietrich, DavidFitzpatrick, ElliottHooper, ValerieMcSpadden, AnnePrice-Verdell, Katie BethRnard, DeborahZager, Lynne DPSYCHOLOGICAL SERVICES OF MGary, Sharon DGoldstein, David BMyers, PaulaPSYCHOLOGY SPECIALISTSAdams, PerryMealer, CynthiaQUINCE NURSING & REHABILITAAwad-Letteri, TrinityEckard, AndreaFioranelli, Mia ClaireGatlin, MelanieSigman, SusanR. SCOTT BEEBE PHDBolton Beebe, Amy

RANDOLPH OCCUPATIONAL MEDKey Provider Based On CE Work 11/9/2016Randolph, Bruce WWisdom, Randall TRUDOLPH, CHARLES 1/19/2017SAINT FRANCIS CARDIOLOGY ASAwdeh, MahirCohen, AvrahmDas, PranabJanjua, MuhammadRudorfer, BennetSimmons, DavidZafarullah, HarisSHERROD, KATHRYN B 12/14/2016Turley, MarieSIEGEL, BARRY Key Provider Based On CE Work 11/9/2016SMITH, KATHRYN R Key Provider Based On CE Work 3/7/2017SPEECH AND HEARING CENTER 1/19/2017Andrews, AllisonChaplin, UrsulaEllis, KelliGrear, StephanieHarper, MeredithHosterman, PamLagunas, MaribelWiksell, CarlaSPEECH PATHOLOGY SERVICES OBeckmann, BobbieBradburn, JulieButtrey, BritneyCopeland, KatherineGraves, SherriGray, RebeccaHazelbaker, JillianHelton, KarenHill, Elizabeth A.Howe, DebraWyssmann, RebeccaMurname, KaelenOstrar, ElishevaPayne, DeborahSPJUT, DENNIS 6/5/2017ST FRANCIS MEDICAL PARTNERS 11/10/2016Gouveia, NurelaSTEELE, KATHRYNTAKOMA REGIONAL HOSPITAL 6/5/2017Filka, Marianne

Lewis, DanielTHE MEDICAL MATTER LLC Key and Volume Provider 12/15/2016Ellis, Ira KeithJohnson, JenniferMcBride, GaryTemple Dustin GreyWeaver, Steven GlennTRI-CITIES SERVICE GROUP IN Key and Volume Provider 6/7/2017TULLAHOMA HMATULLAHOMA SERVICES LLC Key Provider Based On CE Work 6/30/2017UNIV OF TN HEARING & SPEECHBuehler, VelvetHamby, EllenHedinger, TriciaHume, SueIrick, AshleyMills, CarrenNoss, Emily Radford, NoraSanderson, AutumnVaughn, TeresaWegman, AllisonWilson, JenniferUT LEBONHEUR PEDIATRIC 2/8/2017Banks, CasandraHaddix, VickiLong, HelenMarshall, JulieMerrill, Jo ClaireSandidge, JohnSmith, EileenTaylor, Jennifer P.Wark, MarilynWhite, MelanieVANDERBILT BILL WILKERSON CTRVIERS, JEFFREY WHanket, JenniferW R STAUFFER MD & ASSOCIATE Key and Volume Provider 12/14/2016Barnett, DonaldChuck, FrankCistola, CarolDorris, Stacy LKirkpatrick, JamesLynch, J. MichaelWATAUGA HEARING CONSERVATIOAbkes, Bruce

Howell, MarkLight, KeriPilkenton-Johnson, TobyWinstead, JohnathanZajonc Jr., TimothyWATSON PRIMARY CARE AND GEN 9/12/2017Watson, Stephen MarkWELLCARE INC Key Provider Based On CE Work 2/22/2017Dake, ThomasJackson, CharoletteRobinson, WilliamSweets, ThomasWELLMONT HLTH SYS/HOLSTON VWEST TENN HEARING & SPEECHGaston, RhondaMcGuire, JenniferMerwin, Caroline Moore, KimberliSams, KimberlyWEST TENNESSEE PSYCHOLOGICAKey and Volume Provider-Top 5 5/15/2017WILSON, DENNIS W Key Provider Based On CE Work 4/5/2017WOOD, FRANKWORDS FOR LIFE SPEECH AND LANPrestininzi, Cassie

MULTIPLE OFFICE ROTATING MEDICAL DOCTORS Blaine, RobertGoewey, StephenHuffman, WilliamKeown, DonitaLeveck, TerrenceWilson, WoodrowYates, Linda

MULTIPLE OFFICE ROTATING PSYCHOLOGISTSArsenault, AdamBerry-Sawyer, KimberleeCampbell, Jerry "Jay"Cheah, E-LingGaines, Michelle VGarland, Alice KGermek, MistieGilleylen, CarlGrant, Kristin

Hester, Sam B.Hopko, DerekJames, BarbaraKocian, AngellaLangford, Dee MoiseMcQuain, KarlaPorter, MelissaRaphaeli, TamaraSawyers, Pauline SophiaSims, ChadSmith, GretaSmith, Walter Edward "Ed"

Provider's NameState License

Expiration DateState License

Number State Disciplinary

Action? Onsite Review

Key Volume Provider? Top five or primary CE

work? CompanyAllred, Aaron 9/30/2018 No Artis Forensic as of 5/27/2016

Anderson, Chad W. 1/31/2018 No Mountain Eye Institute-9/11/17Anderson, Christopher D. 9/30/2018 No Starting with Artis June 2017

Andrus, Kyle 9/30/2018 No Optometrist, St. GeorgeArnesen, Brian 9/30/2018 No Psychologist

Baca, Edwin L. (Colorado) 4/30/2019 NoDES, CO (Bayfield or Grand Junction) as of

11/02/16. Still with DES as of 4/2017Barnett, Kathy 9/30/2018 No 7/18/2017 PsychologistBarney, Steve 9/30/2018 No Psychologist

Baxter, Amy 5/31/2019 NoSpeech pathologist, UVRMC as of 5/6/16. Still

there as of 11/07/2016

Bitton, Sidena 5/31/2019 No

Speech pathologist, Dixie Speech as of 2015. Still there as of 12/20/2016. Still there as of

5/2017

Bloom, Ashley (Colorado) 4/30/2019 No DES, CO as of 4/19/16 (Grand Junction)

Bolick, Shauna 5/31/2019 NoSpeech pathologist, UVRMC. Still there as of

11/07/2016Boman, Tel S. 5/31/2019 No Audiologist, Ogden Speech Booth, Eileen 9/30/2018 No New psychologist with Artis as of 01/2017Borja, Charlene Estrada (Colorado) 4/30/2019 No

DES, CO (Bayfield or Grand Junction) as of 11/02/16. Still with DES as of 4/2017

Bowen, Matthew 5/31/2018 No Physical doc, Vernal as of 10/2015

Bowen, Megan 9/30/2018 No

Brass, Jamie 9/30/2018 No 5/10/2017 Psychologist

Bumgardner, Jared 5/31/2019 NoAudiologist, UVRMC. Still there as of

11/07/2016

Burrows, Jacob 5/31/2019 NoAudiologist, Advanced Hearing & Balance St.

George as of 3/2015Cantor, Mark 5/31/2019 No Speech pathologist, UofU since 2/2015

Carlisle, Al (Alma) 9/30/2018

7/26/17, Price office.

Psychologist

Charlton, Kevin 1/31/2018 No Ophthalmologist, Rocky Mtn. Eye

Christian, Rory 9/30/2018 No Mountain Eye Institute-9/11/17Clark, Margaret 5/31/2019 No Audiologist, ENT Center in SLC

Colledge, Tanya 9/30/2018 NoYes-Top five & primary

CE work PsychologistCorgiat, Mark D. 9/30/2018 No Psychologist

Utah FY 2017

(b) (6)

(b) (6)

Dastrup, Benjamin 1/31/2018 No Opthalmologist, Country Hills Eye CenterDeBerard, Scott (Michael) 9/30/2018 No Psychologist

Dewey, Michael (Colorado) 4/30/2019 NoDES, CO as of 4/19/16 (Grand Junction). Still

with DES as of 4/2017

Duncan, Clinton 1/31/2018 No Mountain Eye Institute-9/11/17Duncan, Dee 9/30/2018 No PsychologistDunne, Catherine Connell (Colorado) 4/30/2019 No

DES, CO (Bayfield or Grand Junction) as of 11/02/16. Still with DES as of 4/2017

Eisemann, Sandra (Colorado) 8/31/2019 No Psychologist, COEricksen, David G. 9/30/2018 No Psychologist

Fong, Alina 9/30/2018 No

Dr. Fong owns Artis Forensic: Ogden 5/10/17,

Salt Lake City 7/18/17, Price 7/26/17.

Yes-Top five. This is the owner of the company,

Artis Forensic. Psychologist (owner of Artis Forensic)

Forbes, Kimball 5/31/2019 NoAudiologist, Advanced Hearing & Balance St.

George

Fowler, Courtney 5/31/2019 NoSpeech pathologist, UVRMC as of 5/6/2016.

Still there as of 11/07/2016Foye, Mary 5/31/2019 No UMC as of 4/25/2016

Fyans, Joseph 1/31/2018 No

Dr. Fyans & Dr. Joseph Nelson: Provo 1/30/17, St.

Mark's 2/16/17, Ogden 5/10/17 Yes-Top five Physical doc, Canyon Medical

Fue, Laurie 5/31/2019 No Speech pathologist, UMC as of 4/25/2016Gaeto, Hollie 4/30/2019 No DES, CO. Discovered 4/2017

Greenhalgh, Taylor 5/31/2019 No 7/26/2017Speech pathologist, Castleview Hospital as of

3/2015

Greer, Lance 5/31/2019 NoAudiologist, Advanced Hearing & Balance St.

George

Grotegut, Timothy 5/31/2019 NoSpeech pathologist, UVRMC. Still there as of

11/07/2016Hales, Kimberly 5/31/2019 No Speech pathologist, UofU since 4/2017Hancock, Kyle 9/30/2018 No Psychologist Hankins, Elizabeth 5/31/2019 No Audiologist, ENT Center in DraperHanson, Hugh 5/31/2019 No Speech pathologist, Ogden Speech Hanson, Ryan 5/31/2019 No 7/26/2017 Audiologist, Price

Hardy, John 9/30/2018 NoYes-Top five & primary

CE work PsychologistHarris, Emily 9/30/2018 No PsychologistHatch, Daniel 9/30/2018 No Psychologist as of 3/2015

Head, Rex 1/31/2018 NoNew physical doctor, starting in Vernal,

January 2017

Hicken, Sara 5/31/2019 No

Speech pathologist @ Pediatric Rehab in Logan. Discovered 2/3/17. She works

Monday's only but may do interpreting for usHorn, Mary Leigh 5/31/2019 No Audiologist, ENT Center in Draper

Huffman, Todd 5/31/2019 NoAudiologist, UVRMC. Still there as of

11/07/2016

(b) (6)

Ingebretsen, Richard 1/31/2018 No 7/18/17, Price location. Yes-Top five & primary

CE work Physical doc, SLC, Brigham City & Price

Jackman, Ryan (Colorado) 4/30/2019 NoDES, CO, as of 6/17/2015 (Grand Junction).

Still with DES as of 4/2017

Jay, Karla 5/31/2019 No

1/30/17, Orem location. 3/30/17, Cottonwood

Heights office. Speech pathologist, SLC & Orem

Jeppsen, Paul 1/31/2018 No Ophthalmologist, Rocky Mtn. Eye

Kamer, Kerry (Colorado) 4/30/2019 NoDES, CO (Grand Junction). Still with DES as of

4/2017

Kellersberger, Tracy 5/31/2019 NoNew speech pathologist, We Speak Speech

Therapy as of 8/2017

Kilian, Adam 1/31/2018 No DES, Utah as of 01/2017

Kirk, Ronald 9/30/2018 No Optometrist, BlandingKirsh, Janet 5/31/2019 No Speech pathologist, UofU since 2/2015Kockler, Timothy 9/30/2018 No PsychologistKraemer, Robert 5/31/2019 No Speech pathologist, UofU since 2/2015

Kuentzel, William (Bill) 1/31/2018 No Psychiatrist

LaDow, Jessica 5/31/2019 NoSpeech pathologist @ Dixie Regional as of

12/2016. Still there as of 5/2017Lidgard, Julia 5/31/2019 No Speech pathologist, UofU since 2/2015

Liu, Tracy 5/31/2019 NoSpeech pathologist, UVRMC. Still there as of

11/07/2016

Lloyd, Michael 1/31/2018 No Ophthalmologist, Utah Valley Eye CenterLeroy, Molly 5/31/2019 No Audiologist, ENT Center in DraperLobdell, Anne 5/31/2019 No Audiologist, UofU

Lyman, Michael 9/30/2018 NoNew psychologist in Blanding Utah as of

11/2016Lytle, Mary 5/31/2019 No Audiologist, UofU as of 8/2014MacDowell, Grace 9/30/2018 No Psychologist, as of 9/02/2015

Mahoney, Carla 5/31/2019 NoAudiologist, UVRMC (PRN basis only). Still

there as of 11/07/2016Mathy, Pamela 5/31/2019 No Speech pathologist, UofU since 2/2015

Maxwell, Eric 5/31/2019 NoAudiologist, Cedar City Advanced Hearing &

BalanceMcGill, Lizabeth 9/30/2018 No Psychologist, VBHMcGirk, Blair 1/31/2018 No Physical doc

McGoldrick, Keith 9/30/2018 No 7/13/2017New psychologist as of 6/2017, starting in

September 2017Mehr, David 1/31/2018 No Physical docMonson, Christian H. 9/30/2018 No Psychologist, Artis Forensic as of 5/6/2016

Morrill, Lynn (Lawrence) 5/31/2018 No Physical doc

Moss, James 5/31/2019 NoSpeech pathologist, UVRMC. Still there as of

11/07/2016

Moulton, B. Jess 5/31/2019 NoAudiologist, UVRMC. Still there as of

11/07/2016

(b) (6)

Neider, Tristan 5/31/2019 No Speech pathologist, Ogden Speech Naidu, Susan 5/31/2019 No Audiologist, UofU as of 8/2014

Nelson, Duane 1/31/2018 No Opthalmologist, Utah Valley Eye Center

Nelson, Joseph W. 5/31/2018 No

Dr. Fyans & Dr. Joseph Nelson: Provo 1/30/17, St.

Mark's 2/16/17, Ogden 5/10/17. Yes-Top five Physical doc, Canyon Medical

Nichols, Andrew 9/30/2018 No Psychologist as of 1/2/2015Norman, Leann 5/31/2019 No Audiologist, UofU as of 8/2014

Norris, Mindy 5/31/2019 NoAudiologist, UVRMC. Still there as of

11/07/2016

Oliver, Jodi (previously Jodi Stroup) 5/30/2019 No

Speech pathologist, UVRMC. No longer with UVRMC discovered 11/7/2016. Does work for

Dixie Regional, discovered 12/20/2016. Stil there 5/2017

Orozco, Ashlee 9/30/2018 No New psychologist with Artis as of 02/2017

Osborn, Paul 5/31/2019 NoSpeech pathologist, UVRMC. Still there as of

11/07/2016Parsons, Alison 9/30/2018 No Psychologist

Peters, Jane M. 5/31/2019 No

Speech pathologist, Dixie Speech, still performing exams as of 1/14/2014, stopped in 2015, started again (discovered 5/02/2016).

Still there 5/2017

Phifer, Melanie 5/31/2019 NoNew speech pathologist, We Speak Speech

Therapy as of 8/2017

Pitt, Cache 5/31/2019 NoAudiologist, USU in Logan as of 5/13/2016

(HINT testing only for now)

Potter, Sterling 1/31/2018 No 7/26/2017Physical MD, does OTO's only in Price as of

5/27/2015

Preston, Elizabeth 5/31/2019 NoAudiologist, USU in Logan as of 5/13/2016

(HINT testing only for now) Qutub, William (Colorado & Utah)

1/31/2018 (UT) & 4/30/2019 (CO) No DES UT & CO (owner)

Reber, Gregory 5/31/2019 NoSpeech pathologist, Dixie Speech. Still there as

of 12/20/16. Still there as of 5/2017Rebich, Scott 4/30/2019 No DES, CO as of 4/2017

Reeves, LeAnn 5/31/2019 NoSpeech pathologist, UVRMC. Still there as of

11/07/2016

Richards, Bradley 1/31/2018 No Ophthalmologist, Country Hills Eye CenterRirie, Jonathan 9/30/2018 No 1/30/17, Orem location. PsychologistRobinson, David M. 5/31/2019 No Audiologist, Hearing ZoneRottman, Randall (Colorado) 4/30/2019 No Ophthalmologist, Rottman Eye Care in COSchreiner, Michael 9/30/2018 No PsychologistSilberman, Hilary 5/31/2019 No Speech pathologist, UofU since 2/2015

Sparrow, Ashlee 5/31/2019 No

UVRMC speech pathologist. Still there as of 11/2016. 5/24/17: PRN basis only & may not

even do CE's for us…Steed, Marc 9/30/2018 No 1/30/2017 New Psychologist in Orem as of 11/2016

(b) (6)

Stirland, Spencer 5/31/2019 NoAudiologist, Advanced Hearing & Balance St.

George as of 12/21/2016Swaner, Craig 9/30/2018 No 5/10/2017 Psychologist

Tagge, Bryan 1/31/2018 NoPhysical doc, does OTO's only at ENT Center

SLC & Draper

Taylor, Jennifer Shamy 5/31/2019 NoSpeech pathologist, UVRMC. Still there as of

11/07/2016

Taylor, Kim 1/31/2018 No Ophthalmologist, Moran Eye Center

Tonkovich, Kathryn 5/31/2019 NoAudiologist, PCMC as of 6/7/2016 (HINT

testing)Toohill, Martin 9/30/2018 No PsychologistTurgoose, Aaron 5/31/2019 No Audiologist, Lakeside Audio in Layton

Valencia, David Christopher 4/30/2019 No DES, CO as of 4/2017

Waterman, David 1/31/2018 NoOpthalmologist, Cache Valley Eye Assoc. in

Logan as of 9/4/2014Watts, Rachel 5/31/2019 No Speech pathologist, UVRMCWhite, Shannon Noel 5/31/2019 No Audiologist @ PCMC as of 2/2017

Whitworth, Harmony 5/31/2019 NoSpeech pathologist, Cache Kids Rehab in

Logan Wilkison, Pamela 9/30/2018 No Psychologist

Williams, Brice 1/31/2018 No Opthalmologist, Fred Clayson Eye Center

Zabel, Pierre 5/31/2018 NoSee Dr. Fyans & Dr. Nelson's Yes-Top five (company

is, not this physician) Started with Canyon Medical 9/12/17

Past providers/Provider's that left this FYAllen, Jessica Cornett (Colorado)

Adams, Alicia Lynn (Colorado) Anderson, Dustin Joseph MatelBergstrand, Lauren (Colorado)Brown, Carolynn Francavilla(Colorado)

Griffiths, Ashley

Hanson, Brian (Colorado)

Herbert, Aliea (Colorado)

Jendry, Ronald (Colorado)

(b) (6)

(b) (6)

Johnson, Braeden (Colorado)Matergia, Michael (Colorado)

Moncrief, LauraNelson, Breanna

Olson, Paul F.

Osborne, Mark (Colorado)

Parbhu, Rachel

Parbhu, Sheeva Kaushik

Pardyjak, KarenSimpson, Matthew (Colorado)

Wong, Carmen (Colorado)

Fakoya, LatifaLiebing, Madolyn

Moody, Richard Y.

Tueller, Stephen

Jeppson, Mayer

Call, Matthew

Linstroth, LeeGrow, Richard-RETIRED 8/16/17Gurrister, Maria, no longer usingGurrister, TomTurner, Jeffrey Lee, no longer w/ company Wagner, William-no longer w/ company

Graziano, Stacey

(b) (6)

Organization/Provider Name Last Name First Name License Reason for RemovalADVANCED EYE CARE

* AMCE PHYSICIANS GROUP M.D.BANKS, MARK PH.D.BERGERON INGRAM, DANIELLE M.A.BONAZINGA, BARTHOLOMEW MDBRATTLEBORO HEARING CENTERBRATTLEBORO MEMORIAL HOSPITALBRUTUS, MARTIN LCMHCCAMPBELL, SANDRA PSY. D. CARPENTER, MARC M.A.CENTRAL VERMONT EYE CARECENTRAL VERMONT MEDICAL CENTERCHAMPLAIN IMAGING PLLCCONDON, ANNE LCMHCCOPLEY HOSPITALOPHTHALMIC CONSULTANTS OF VERMONT CORBITT SUZANNE O.D. DARTMOUTH HITCHCOCK (SECONDARY)DONNELLY, JOHN PH.D.DORR, MICHAEL M.S.EDITH, SALLY LCMHCELEANOR M. LUSE CENTEREUREKA DIAGNOSTIC IMAGING P.C.FERNS-LEFEBVRE, RAQUEL M.A.FILKINS, KATHLEEN M.A.FULTON, ANDREW M.A.GIFFORD MEDICAL CENTERGIROUX, MARY-ELLEN M.A.GRACE COTTAGE HOSPITALGURNEY, LORI M.S.HAYDEN, JOANNE M.A.HEDGEPETH, RONALD PHDCENTRAL VERMONT MEDICAL CENTER- CARDIOLOGY HEITZMAN MARK M.D.

Vermont FY 2017

(b) (6)

UNIVERSITY OF VERMONT MEDICAL CENTER- OTOLARYNGOLOGY HUBBELL RICHARD M.D.HUITT, JAMES PSY.DISENBERG, GAIL PH.D.ITALIA, MICHAEL M.A.KELLOGG, ROGER M.D.KNAPP, CRAIG PH.D.KORGESKI, GREGORY- onsite review completed. PH.D.LANE EYE ASSOCIATESLEMAIRE-JENKINS, ELIZABETH LCMHCLYNCH, HEATHER M.A.MIDDLEBURY RADIOLOGISTSUNIVERSITY OF VERMONT MEDICAL CENTER- OTOLARYNGOLOGY MILLAY DONNA M.D.MAPLE LEAF CLINIC MOONEY DEAN PH.D.MORRISON, RICHARD M.D.NASH, PAMELA PSY.DNEEL, HARTLEY (RADIOLOGIST) M.D. NORTH COUNTRY HOSPITALNORTHEASTERN VERMONT REGIONAL HOSPITALNORTHWESTERN VERMONT MEDICAL CENTERPADILLA, TERRY LCMHCPORTER MEDICAL CENTERRADIOLOGY ASSOICATES OF BENNINGTONREDLINK, INC.- onsite review completed M.D.REICHARDT, DENNIS- onsite review completed PH.D.RICHMOND, BARBARA M.A.RICKARD, KATHRYN PSY.DROOMET, ANDRES M.D.ROOT, RICHARD PH.D.ROSS, KATHLEEN SLPROSS, PAUL M.D.ROSSMAN, FRED M.D.RUTLAND RADIOLOGISTSRUTLAND REGIONAL MEDICAL CENTERSEYFERTH, ERIC M.D.SITKOWSKI, SUZANNE PH.D.

SOUTHWESTERN VERMONT MEDICAL CENTERSPRINGFIELD HOSPITALUNIVERSITY OF VERMONT MEDICAL CENTERUVM RADIOLOGY

*no longer performing examsKey or Volume Provider- Korgeski, Redlink, and Reichardt were visited. In FY 16 Reichardt was a volume provider, so he was visited for an onsite review in anticipation he would be again, although he was the sixth highest volume provider. Onsite Review completed for interview/orientationOnsite Review completed for other reason

AARON D RUSSELL PSYD-EVERETT EVERETTAGNES S HUANG MD SEATTLEALEXANDER L PATTERSON PSYD TACOMAALICIA S FUHRMAN MD/AMCE-SEATTLE SEATTLEALLEN D BOSTWICK PHD SPOKANEAMY FORD PSYD-ELLENSBURG ELLENSBURG Top provider - volume onsite reviewsAMY L DOWELL MD/MDSI-YAKIMA YAKIMAAMY R ROSS PSYD TACOMAANDREA A MARSHALL DO/MDSI-SEATTLE SEATTLEANDREA J OPALENIK DO/MDSI-FEDERAL WAY FEDERAL WAYANDREW PERRY MD EDMONDSANDREW WEIR MD/MDSI-BELLINGHAM BELLINGHAMANGELIQUE G TINDALL PHD/AMCE-SPOKANE SPOKANEANJALI L DSOUZA MD-FEDERAL WAY FEDERAL WAYANNA BORISOVSKAYA MD-FEDERAL WAY FEDERAL WAYANNABELL K SIMPSON MD/MDSI-EVERETT EVERETTANNE MARIE TIETJEN PHD BELLINGHAMANSELM A PARLATORE MD-POULSBO POULSBOANTHONY DIGIROLAMO DO/AMCE-SEATTLE SEATTLEAPRIL M FRITCH PHD LAKEWOODAPRIL R DELIRA MD-TACOMA TACOMAARID LEIN MD SPOKANEARNOLD A RONNING MD/AMCE-AUBURN AUBURNASHLEY D DAVIDSON MD-SEATTLE SEATTLEAUSTIN C LAMPERT MD OLYMPIABARRY MORRISON PHD CANADABEN JARAMILLO OD YAKIMABENJAMIN C ALESHIRE PHD/MDSI-BELLINGHAM BELLINGHAMBENJAMIN N KARTCHNER MD/REDLINK LEWISTONBENJAMIN R DOBBECK PSYD/AMCE-LAKEWOOD LAKEWOODBETH LIU MD LAKEWOODBEVERLEY E ALLEN MD/MDSI-SPOKANE SPOKANEBEVERLY NORFLEET PSYD SEATTLEBEVERLY S SHAPIRO MD/QTC-TUKWILA TUKWILABONNY W CHANG PHD/AMCE-AUBURN AUBURNBRENDA K HAVELLANA PHD LYNNWOODBRENDON P SCHOLTZ PHD MARYSVILLEBRETT VALETTE PHD-TACOMA TACOMA Top provider - volume onsite reviewsBRIGITTE M ENGELHARDT MD/MDSI-PORTLAND PORTLANDBRUCE DUTHIE PHD BREMERTONBRUCE J TAPPER PHD PORT TOWNSENDC MARK ANDERSON PHD/AMCE-CENTRALIA CENTRALIACARA A DALBEY PSYD SNOQUALMIECARA J ALEXANDER MD SEATTLECARL EPP PHD-MT VERNON MOUNT VERNONCARL T RIMMELE PHD/AMCE-AUBURN AUBURNCARLA VAN DAM PHD TUMWATERCARRIE A ROLLER MD SPOKANECARYN JACKSON MD YAKIMACATHERINE A MACLENNAN PHD-OMAK OMAKCECILIA R COOPER PHD-PROSSER PROSSERCERISE M VABLAIS PHD KIRKLANDCHILDRENS DEVELOPMENTAL CENTER (BENTON-FRANKLIN) RICHLANDCHILDRENS VILLAGE CHILD HLTH SVCS YAKIMACHRISTIAN M QUAYLE PHD-MILL CREEK MILL CREEKCHRISTINA H RASMUSSEN PHD UNIVERSITY PLACECHRISTOPHER D JOHNSON OD WEST RICHLANDCHRISTOPHER H EDWARDS PSYD/AMCE-AUBURN AUBURNCHRISTOPHER J NELSON PHD BELLEVUECLARK D ASHWORTH PHD COLVILLECOLLIN M BLATTNER DO/MDSI-PORTLAND PORTLANDCONSTANCE E MASH MD/MDSI-SPOKANE SPOKANECORY R HANSEN OD WEST RICHLANDCYNTHIA L TAYLOR MD/AMCE-SEATTLE SEATTLEDALE HOLDREN MD BREMERTONDANA A COCKE OD TACOMA

Washington FY 2017

DANA JUNGSCHAFFER MD BREMERTONDANA S HARMON PHD SEATTLEDANIEL PHAN MD LYNNWOODDARLENE E WALSH-MARTIN PHD SPOKANEDAVID B WIDLAN PHD SEATTLEDAVID BARRETT PHD-OCEAN SHORES OCEAN SHORESDAVID D MOORE PHD/ALLIED FEDERAL WAYDAVID G ZACHARIAS MD SEATTLEDAVID L POUNDS PHD SPOKANEDAVID M DIXON PHD KENT KENTDEBRA CIARLO MSPA CCC WENATCHEEDEBRA K MCKINNON DO/REDLINK LEWISTONDENNIS A KELLY PHD/AMCE-BELLINGHAM BELLINGHAMDENNIS G DYCK PHD/AMCE-SPOKANE SPOKANEDENNIS J HAACK MD/AMCE-SEATTLE SEATTLEDENNIS R POLLACK PHD SPOKANEDEREK J LEINENBACH MD/IMC-CENTRALIA CENTRALIADIANA L COOK PHD-EVERETT EVERETTDOUGLAS R RICKS OD YAKIMAE ANDREA SHADRACH PSYD-REDMOND REDMONDEDWIN L HILL PHD TACOMAELGA KINNEAR PSYD-ANACORTES ANACORTESELIZABETH A HOLLAND PHD ANACORTESELLEN WALKER PHD BELLINGHAMELLIKA C MCGUIRE MD SEATTLEEMMA J BILLINGS PHD YAKIMAERUM KHALEEQ MD/MDSI-LONGVIEW LONGVIEWFAULDER COLBY PHD EVERETTFRANCES L CARTER PHD/AMCE-BELLINGHAM BELLINGHAMGARY E GAFFIELD DO/AMCE-AUBURN AUBURNGARY GAFFIELD DO/MDSI-SEQUIM SEQUIMGARY MCGUFFIN PSYD-VANCOUVER VANCOUVERGARY SACKS PHD PORTLANDGENE O TEIGEN OD SPOKANEGEORGE ANKUTA PHD-BURIEN BURIENGEORGE B SYMONDS OD PORT ANGELESGRANT O GILBERT PHD-SPOKANE SPOKANEGRANT W HARDAN OD SPOKANEGREG CHARBONEAU EDD (ERE) SPOKANEGREGORY A MAY PSYD VANCOUVERHARBOR SPEECH PATHOLOGY GIG HARBORHEATHER E HOOPS MD/MDSI-PORTLAND PORTLANDHERBERT A YELVERTON PHD/AMCE-ELMA ELMAHOLLY S PETAJA PHD EVERETTIBRAHIM I KURDIEH PHD VANCOUVERIFESINACHI S OGUAKWA MD/MDSI-FEDERAL WAY FEDERAL WAYJ KEITH PETERSON PHD TACOMAJACK M LITMAN PHD VANCOUVERJACKSON R HOLLAND MD OLYMPIAJACLYN A KNUTSON MA OLYMPIAJACLYN C RUSSELL MD/AMCE-SEATTLE SEATTLEJAI C GANDHI MD-FEDERAL WAY FEDERAL WAYJAIME AB WILSON PHD TACOMAJAMES A PARKER MD/MDSI-TUMWATER TUMWATERJAMES B GADDY MD/AMCE-SPOKANE SPOKANEJAMES DAVISON JR PHD/AMCE-BELLINGHAM BELLINGHAMJAMES K SYMONDS MD/QTC TUKWILA TUKWILAJAMES L BARLOW MD/MDSI-FEDERAL WAY FEDERAL WAYJAMES OPARA MD/MDSI-WALLA WALLA WALLA WALLAJANE C HAYWARD PSYD PUYALLUPJANIS L LEWIS PHD-PT ANGELES PORT ANGELESJANITZIA SCHURCH MD/PRO CARE-PT ANGELES PORT ANGELESJARED R HELLINGS PSYD EDMONDSJASON PRINSTER PHD BELLINGHAMJEFFERSON GEN HOSPITAL - XRAY PORT TOWNSENDJEFFREY R JAMISON DO/REDLINK-WALLA WALLA WALLA WALLA

JENIFER F SCHULTZ PHD/AMCE-YAKIMA YAKIMAJENNIFER A IRWIN MD/MDSI-FEDERAL WAY FEDERAL WAYJENNIFER M GRONHOLT PSYD BELLINGHAMJENNY ZHANG MD/AMCE-SEATTLE SEATTLEJEREMY J SENSKE PSYD/AMCE-AUBURN AUBURNJESSICA VAN AUKEN CCC-A PORTLANDJOHN B SEVERINGHAUS PHD SPOKANEJOHN D ADLER PHD/MDSI-PORTLAND PORTLANDJOHN F ARNOLD PHD-SPOKANE VALLEY SPOKANE VALLEYJOHN H SCHWAB PHD SEATTLEJOHN JOK NHIAL HOBARTJOHN R COE DO/QTC TACOMA TACOMAJONATHAN D ALLISON PSYD LAKEWOODJOYCE EVERHART PHD SPOKANEJULIE A GUSTAFSON MD-EVERETT EVERETTJUSTIN D STAMSCHROR MD LYNNWOODKAREN J WEST PSYD EDMONDSKATE K LUND PSYD EDMONDSKATHERINE J KELLY PHD RENTONKATHLEEN E REAN MD-FEDERAL WAY FEDERAL WAYKATHLEEN F GALLAGHER PHD/AMCE-CENTRALIA CENTRALIAKATIA H RAMIREZ PSYD SUMNERKATRINA L HIGGINS PSYD SUMNERKAY L STRADINGER PSYD/MDSI-PORTLAND PORTLANDKAYLEEN ISLAM-ZWART PHD SPOKANEKELVIN K MA MD PUYALLUPKENNETH A HAPKE PHD-SEATTLE SEATTLEKENTON S SORENSEN MD BREMERTONKERITH A TARANTINO PSYD/MDSI-SEATTLE SEATTLEKERRY T BARTLETT PHD BELLINGHAMKHANH P NGUYEN MD/MDSI-PORTLAND PORTLANDKIRSTEN R NESTLER MD/MDSI-BELLINGHAM BELLINGHAMLANDON E POPPLETON PHD VANCOUVERLENA K SWANSON PSYD OAK HARBORLEWIS B ALMARAZ MD-SEATTLE SEATTLELEZLIE A PICKETT PHD TACOMALINDA JANSEN PHD RENTONLINDA LEE PSYD VANCOUVERLINDA NEWMAN-KENNEDY CCC-SLP ANACORTESLINDA R FELDTHAUSEN PHD/AMCE-CENTRALIA CENTRALIALINDA R MEDESKI-NICACIO OD VANCOUVERLINDSEY M RUPPEL DO/REDLINK-WALLA WALLA WALLA WALLALISA COWDEN PHD BURIENLISA KOCH PHD SPOKANELIZ A PECHOUS PHD SPOKANELONGVIEW EYE AND VISION LONGVIEWLORELI A THOMPSON PHD LACEYLUCI L CARSTENS PHD MARYSVILLELYNETTE J SCHULTZ PSYD SPOKANELYNN M ORR PHD RICHLANDM KRISTIN PRICE PHD VANCOUVERMAJID AZZEDINE PHD FEDERAL WAYMANUEL J GOMES PHD/MDSI-PORTLAND PORTLANDMARC D FOWLER PSYD/AMCE-MARYSVILLE MARYSVILLEMARC I SUFFIS MD SILVERDALEMARGARET A DOLAN PHD-SEATTLE SEATTLEMARGARET D LUKOFF MD/MDSI-SEATTLE SEATTLEMARK D AGINSKY OD BELLINGHAMMARK HEILBRUNN MD-BELLINGHAM BELLINGHAMMARKUS L FORSYTHE MD/AMCE-VANCOUVER VANCOUVERMARVIN G PALMER MD KENNEWICKMARY C LEMBERG MD TACOMAMARY K COBURN SLP TUMWATERMELINDA C LOSEE PHD-LACEY LACEYMICHAEL A JENKINS-GUARNIERI PHD TACOMAMICHAEL A SLACK PSYD/AMCE-BELLINGHAM BELLINGHAM

MICHAEL D MOORE OD OLYMPIAMICHAEL E KOSANOVICH TACOMAMICHAEL MILGROM MD CANADAMICHAEL WINGREN MD GIG HARBORMICHELA L BLAIN MD-BELLEVUE BELLEVUEMIRIAM L ALAM MD-EVERETT EVERETTMONTY SMICK OD (ERE) SPOKANEMORGAN B LIDDELL MD/MDSI-COLVILLE COLVILLEMULTICARE PULMONARY AUBURNMULTICARE PULMONARY SPECIALISTS TACOMANANCY C RUTTER SLP LYNNWOODNATASHA T HAYS MD LACEYNATHAN D HENRY PSYD SPOKANE VALLEYNATHANIAL A SOWA MD-BELLEVUE BELLEVUENEELAM K SAMPLEY MD/MDSI-BELLINGHAM BELLINGHAMNICKOLAS B JONES PHD SUMNERNORA K MARKS PHD-WALLA WALLA WALLA WALLAOWEN J BARGREEN PSYD EVERETTPAMELA G MILLER PHD THE DALLESPAMELA J MOSLIN-LYKINS MD/MDSI-FEDERAL WAY FEDERAL WAYPAMIL P SIDHU MD SPOKANEPATRICA R SYLWESTER MD/AMCE-CENTRALIA CENTRALIAPATRICK B METOYER PHD/AMCE-MOSES LAKE MOSES LAKEPAVEL S BLAGOV PHD WALLA WALLAPETER A WEISS PHD CHEHALISPETER M MEIS MD-MILL CREEK MILL CREEKPETER N MOORE PSYD MILL CREEKPHILIP G BARNARD PHD RICHLANDPHILIP V GIBSON PHD/AMCE-BELLINGHAM BELLINGHAMPRESTON SULLIVAN MD-PT ORCHARD PORT ORCHARDPULMONARY CONSULTANTS TACOMAR DEAN RUSSELL MD OLYMPIARAHUL KHURANA MD SEATTLERAY JENSEN MD OLYMPIAREBECCA A SPECKMAN MD/AMCE-AUBURN AUBURNREBECCA J ALEXANDER PHD MOSCOWREGINA M HARRINGTON PHD/AMCE-BELLINGHAM BELLINGHAMREJOICE N OPARA MD-FEDERAL WAY FEDERAL WAYRENEE S THOMPSON PSYD CHEWELAHRICHARD E BENSINGER MD SEATTLERICHARD W SEAMAN MD BREMERTONROBBY C RIDDLE MD/MDSI-SPOKANE SPOKANEROBERT G SISE MD TACOMAROBERT J ROSE MD SPOKANEROBERT L QUACKENBUSH PHD SPOKANEROBIN H BALLARD PHD OLYMPIAROCKWOOD PULMONARY & CRITICAL CARE SPOKANERODERICK CALKINS PHD PORTLANDRONALD D NIELSEN MD/AMCE-CENTRALIA CENTRALIARONALD D PAGE PHD WALLA WALLARONALD J BENVENISTE MD TACOMAROSE M SESSOMS MD/PRO CARE-MT VERNON MOUNT VERNONROSEMARY I PIPER PHD/AMCE-MT VERNON MOUNT VERNONROXANNE R MOORE PHD-BELLINGHAM BELLINGHAMRUSSELL W FARIA DO AUBURNRYAN G MASSOUD DO/REDLINK-MOSES LAKE MOSES LAKESAMANTHA L SLAUGHTER PSYD SEATTLESAMANTHA S CHANDLER PSYD SPOKANESAMUEL E COOR DO LACEYSARAH A STEWART PHD/AMCE-OLYMPIA OLYMPIASCOTT ALVORD PSYD-ABERDEEN ABERDEENSETH T COPELAND OD YAKIMASHANNON D LEDESMA PHD GIG HARBORSHIRLEY R DEEM MD/MDSI-FEDERAL WAY FEDERAL WAYSIERRA L SWING PSYD SEATTLESTEPHANIE G HANSON PHD LAKEWOOD

STEPHANIE K CHANG MD-MILL CREEK MILL CREEKSTEPHEN L WALSTON MD-BELLEVUE BELLEVUESTEPHEN MEHARG PHD LONGVIEWSTEVEN J TALMADGE PHD OAK HARBORSTEVEN S RODE DO/MDSI-RICHLAND RICHLANDSUNG-WON KIM MD OLYMPIASUSAN STEWART MS CCC-SLP LYNNWOODSUSHIL M SETHI MD VANCOUVERSYLVIA A THORPE PHD BELLINGHAMTERILEE WINGATE PHD LACEYTHE ACHIEVE CENTER-WENATCHEE WENATCHEETHOMAS B ROWE PHD WENATCHEETHOMAS GENTHE PHD SPOKANETOBIAS A RYAN PSYD VANCOUVERTODD D BOWERLY PHD VANCOUVERTOM DOOLEY PSYD-VANCOUVER VANCOUVERTOVA F FULLER MD-MILL CREEK MILL CREEKTREVOR P GESSEL MD/MDSI-SEATTLE SEATTLEUCHECHUKWU OBIH MD/AMCE-AUBURN AUBURNVANESSA G DZIVAKWE PHD/AMCE-SEATTLE SEATTLEVANESSA S MAYCUMBER MD/OLYMPUS-CLARKSTON CLARKSTONW DANIEL DAVENPORT MD/AMCE-ELMA ELMAW MICHAEL ROGERS PSYD/AMCE-OLYMPIA OLYMPIAWALTER HORAN AUD WENATCHEEWILLIAM B GUNDERSON MD FRIDAY HARBORWILLIAM J CHALSTROM PHD-PT ORCHARD PORT ORCHARDWILLIAM JACKLINE EDD SPOKANEWILLIAM R DRENGUIS MD/AMCE-KENNEWICK KENNEWICKWILLIAM U WEISS PHD VANCOUVERWING C CHAU MD RICHLANDYAKIMA VALLEY HEARING & SPEECH CENTER YAKIMAYUN-JU CHENG PHD/AMCE-POULSBO POULSBOMDSI - multiple vendors Top Provider-Primary CEs onsite reviewsAMCE - multiple vendors Top Provider-Primary CEs onsite reviewsQTC - multiple vendors Top Provider - Primary CEs onsite reviews

Individual CE Providers Key Provider/Site Visit Inactive

Inactive due to:Inactive license (L), Quality (Q), Sanction

(S)AARON S WHITNEY PHDABDUL HAFEEZ MD(dba Columbia St. Mary's Westgate)

Volume ProviderYes

ABIGAIL L ROTH OT/SPABIGAIL LEWIS MDADRIANA NEWTON OTALBERT FISHER MDALEJANDRO ARANDA MS CCC-SLPALEXIA PRINTZ MS CCC-SLPALYSON ROGERS MS CCC-SLPAMANDA HOUDEK MS CCC-SLP- 3 SitesAMY HOFKES OTAMY M MOSCHELL MDAMY SORENSEN DOANDRA M SCHMIDT OTANDREW J WRIGHT MDANGIE HOLTSKI OT

A. NEIL JOHNSON MD- 9 Sites Primary/Volume/Top 5 Provider Yes (2 Sites)

ANN VAN BUREN SLP- 2 SitesANNETTE VIELLEUX PSYDANTHONY R ROGERSON MDANTHONY WENDORF PSYD- 6 Sites(dba Solutions for Success)

Primary/Volume/New Site Provider Yes

APRIL D SMITH ODASHLEY BEECROFT OTBARBARA BLANK OTBECCA GREUB PHD- 2 SitesBENJAMIN BLAGOGEE MD- 3 SitesBENJAMIN DELLARIA MDBETH GABAVICS AUDIOLOGIST

Wisconsin FY 2017

BETHANY CARLSON MS CCC-SLP

BONNIE BEHEE-SEMLER PHD Primary Provider Yes

BRE ANNA NAGLE MD Inactive NABREANA GALEAZZI MS CCC-SLP- 2 SitesBRENDA REED PSYDBRIAN CHAPMAN MDBRIAN K ALLEN DO- 4 SitesBRIAN SIECK MDBRIAN TIENOR MD Inactive NABRUCE C HERMAN MDBRUCE H HOUTLER OTBRYAN L MYERS MDBRYAN ROBERTS MDCALLIE ENYART OD- 2 Sites Inactive NACALLIE S EHMCKE MS CCC-SLPCAMIE WHEELER AUDIOLOGIST

CATHERINE A BARD PSYD- 3 Sites Primary Provider Yes

CHAPMAN LEFFINGWELL OD CHERYL PETRUS OT Inactive NACHRISTINE RICHARDS MDCHRISTOPHER R OVIDE EDDCLARE RUIDL OT

CLAUDIA BODWAY PHD (dba WellCare Disability, NuCare Disability)

Inactive NA

CORNELIA A GREEN PHD

COURTNEY ENDRES PSYD (dba WellCare Disability, NuCare Disability)CRAIG W FLORINE MDD EVAN BESTLAND PHDDANA A TRUTTMANN AUDIOLOGIST

DANIEL STOPPENBACH AUDIOLOGIST

DARRELL L HISCHKE PHD Primary Provider Yes

DARYL J MELZER MD (dba Mobilex) Primary Provider No

DAVE NICHOLS PHD (dba Psychiatric Services of Racine)

Volume Provider Yes

DAVID MAY MDDAVID W GRAMBOW MDDEAN B SANER PSYD- 2 SitesDEBORAH K SCHERMER MS CCC-SLPDENNIS ELMERGREEN PSY DDENNIS J KONTRA MD

DHARAM JAIN MD (dba WellCare Disability, NuCare Disability)

Primary/New Provider Yes

DIANE GERLACH DODOUGLAS M SOAT PHDE OVERHOLT MDELIZABETH JENNINGS PHDERIC CARLSEN MDERIK GRAGLIA OTFRANK J ELMUDESI PSYD- 2 SitesGLEN KOHLHAGEN ODGORDON HERZ PHDGREGORY COWAN PHDGREGORY LEISCHER ODGREGORY LOCHEN MDGRETCHEN M ADAMS DO Inactive NAIRIS TORRES MDJACLYN MULLINS MD Inactive NAJAMES DICKMAN III MDJAMES GERAETS ODJAMES MARTIN MD

JAMES MATHEW MDJANET PAPENFUSS MS CCC-SLPJAY ALLEN PHDJAYNE E JASKOLSKI PHD CCC-SLPJEAN WARRIOR PHDJEFFREY BROWN MDJEFFREY L POLCZINSKI PSYDJEFFREY SARAZEN ODJENNA SEBRANEK MDJENNIFER MYSZKOWSKI MDJENNIFER PLOCH AUD Inactive NAJEREMY D MEYERS EDDJESSE J FREY PSYD- 2 SitesJESSICA LEMKE MD Inactive NAJILL M DILLON ODJILLIAN SCHERER MDJOAN R NUTTALL PHDJOANNE FINK MS CCC-SLPJOANNE PICKETT OTJOHN D RIESCH MDJOHN HENNINGSEN MDJOHN JUERN PHD- 2 SitesJOHN P FREY MDJOSEPH F ROE PSYDJOSEPH T PERRON PHD- 2 SitesJOSHUA LIBERMAN MDJUDITH B CORAN MDJUDY WARNKE OTJUI HAKER MD- 2 SitesJULIE FRAZIER MS CCC-SLPJULIE K BYRNES MS CCC-SLPJULIE KESSLER AUD Inactive NAJULIETTE KOEPP MS CCC-SLP- 3 Sites

KALPANA RAO PHD (dba Horizons Behavioral Health Solutions)

Primary/Volume Provider Yes

KAMAL SYED MUZAFFAR MDKAREN BERTE PHD- 2 SitesKAREN BUTLER MD Inactive NAKAREN K KULLA MS CCC-SLPKAREN TETER, AUDIOLOGISTKATE WASECHEK OTKATHLEEN A CLARKE PHDKATHLEEN M HAASCH AUDIOLOGISTKATHY MARSCEAU MS CCC-SLPKATIE BETRY OT- 2 SitesKAUSERUZZAMAN KHAN MDKELLY L SCHULTZ AUDIOLOGISTKELLY SCHINKE PSYDKELSEY KOERNER ODKELSEY MEALEY MS CCC-SLPKENNETH E SHERRY PHDKENT SCHAEFER MDKEVIN ROONEY PSYDKEVIN ROSTEING MDKIMBERLY SCHWABENBAUER MS CCC-SLPKIRA L FEMRITE MS CCC-SLPKIRSTEN GIERACH DO Inactive NAKRISSI DANIELSSON MD (dba Prevea Eau Claire Health Center)KRISSI DANIELSSON MD- 2 Sites (dba CE Provider Services)

Primary Provider Yes

KRISTEN GERKE MA CCC-SLPKRISTEN SISKOVICH SLP Inactive NAKRISTEN WRIGHT SLP Inactive NAKRISTIE SHAPPELL MDKRISTIN NYTES/AUDIOLOGIST

KURT L REINTJES MD- 5 Sites (dba Sagebrush LLC)

Primary/Volume/Top 5 Provider Yes

KURT WEBER PHD- 5 Sites (dba Hope Psychological Services LLC)

Primary Provider Yes

LATOYA WILLIAMS PSYD

LAUREN NATZKE-BLUME MS CCC-SLP- 2 SitesLAUREN SAUTER MD Inactive NALEE PURDY ODLESLEY CHAPIN PSYDLESLIE L BENNETT MS CCC-SLP/MDLINDA J BARBIAN AUDIOLOGISTLINDA WUNDERLICH AUDIOLOGISTLINDSEY SCHINDLER DOLISA WEBNE-BEHRMAN PHD Inactive NALISBETH HEILMANN MS CCC-SLPLONNI BRICKSON OT Inactive NAMARA JONET MA CCC-SLP- 2 SitesMARC W ZYLSTRA PHD

MARCUS DESMONDE PSYD- 4 Sites Primary/Volume Provider Yes

MARIA CHIRONIS MS CCC-SLP- 2 SitesMARIA E PEREZ PHDMARIBETH SADIE PHD (dba Psychiatric Services of Racine)

Volume Provider No

MARIE HARPER MS CCC-SLP- 2 SitesMARIE MILLER-CHRISTENSEN PSYDMARILYN BEFERA-ZIELINSKI PHD (dba Psychiatric Services of Racine)

Volume Provider Yes

MARJORIE C HAWKINS MDMARK C AUSTIN MDMARK C RHODES MDMARK L MARTIN DO

MARK PUSHKASH PHD Primary/Volume Provider Yes

MARK W SNEED MDMARLIN O TRULSEN PHDMARY B LAW PSYDMARY KAY LUZI PHDMARY L THORPE MS CCC-SLPMARY LOKKEN OTMASROOR MUNIM MDMATTHEW E BETTAG MDMATTHEW L NELSON ODMATTHEW SDANO MDMAURA J MOYLE MS CCC-SLPMAX MELBERG OD- 2 SitesMCKENZIE HOFFMAN MA CCC-SLP- 2 SitesMEENAKSHI MASKI MDMEGAN KENNEDY MA CCC-SLPMEGAN REIMER MS CCC-SLPMEGAN WISNIEWSKI OT- 2 SitesMELISSA PLUTZ SLP Inactive NAMELISSA WEGNER SLP- 2 Sites Inactive NAMICHAEL ALBANO DOMICHAEL ALEKSANDROWICZ MD Inactive NAMICHAEL BRAUNSKY DO Inactive NAMICHAEL CASE MDMICHAEL D GOLDSTEIN PHDMICHAEL E BECKER MDMICHAEL G OLACIREGUI MDMICHAEL MCAVOY DOMICHAEL OTTE MD Inactive NAMICHAEL R DAWSON MDMICHAEL R DAWSON MD Inactive NAMICHAEL SCHULTZ AUDIOLOGISTMICHELE BROWN OT Inactive NA

MILT SCHMIDA AUDIOLOGISTMOHAMMAD N FAREED MD (dba Columbia St. Mary's Westgate)

Volume Provider Yes

MONICA HAUT MS CCC-SLPMONICA STOUT MDNATALIE ALTENHOFEN SLP

NEAL H POLLACK DO (dba Mobilex) Primary Provider Yes

NEIL BARD MDNICHOLAS GLASS MD- 3 Sites (dba Allied Medical Services)

NICHOLAS GLASS MD (dba Med Plus) Volume Provider Yes

NICKOLAS T SGARLATA MS CCC-SLPNICOLE LEE MS CCC-SLPNICOLE NICHOLS MA CCC-SLP/SPNORAH C GARRITY MS CCC-SLP- 2 SitesOMUWA BRAIMAH MDPAMELA BENEDICT AUDIOLOGISTPATRICIA L BROMLEY PHDPATTI L TODD, AUDIOLOGISTPAUL E WEST PHDPAUL F DVORAK MDPAUL K THOMPSON ODPAUL STASKOWSKI MDPEGGY DENNISON PHDPETER HOLM MDPETER KORES EDD- 2 SitesPETER M IHLE MD R R FLICKINGER MDRACHEL J BUTALLA SLPRACHEL SCANNELL MS CCC-SLPRACHELLE EUGSTER MA CCC-SLP- 2 SitesREBECCA D AMARAL OD

REBECCA FLEGNER PSYDREBECCA L ANGLE PHDRENEE REETZ MS CCC-SLPRICHARD ALTHOUSE PHDRICHARD BRIGHAM PSYDRICHARD D DAVENPORT MDRICHARD J ERTL PHDRICHARD N COCKER MS LPROBERT B ROTH MDROBERT J GOGAN MDROBERT L MEYER PHDROBERT L ZOELLER JR MDROBERT S JUNE AUDIOLOGISTROBERT STUBENVOLL MD Inactive NAROBERT VERWERT PHD- 2 SitesROBIE JO LINN MA CCC-SLPROGER C GRONAU PHD- 2 SitesROGER J KLEIN PSYD

ROLAND W MANOS PHD- 2 Sites Primary/Volume Provider Yes

RONALD B JOHNSON PHD- 2 SitesRUTH MEEHAN OTRYAN HUMMEL AUDIOLOGISTSADIE A BOGNAR MS CCC-SLP- 3 SitesSAKINA SACHAK MD (dba Prevea Eau Claire Health Center) Inactive NA

SAKINA SACHAK MD- 2 Sites (dba CE Provider Services)SALLY A ANDERSEN CCC-SLPSAM KUCHINKA MDSANDRA JOHNSTON OTSANDRA L FRODIN PHDSANDRA L KING PHDSARAH B WILLIAMS SLP- 2 Sites Inactive NA

SARAH L CLEMENT MA CCC-SLP/SPSARAH VAN DUINEN MA CCC-SLP- 3 SitesSCOTT TRIPPE PSYDSEAN PETERSON OTSHAHIDA R MUNIM MDSHERYL DOLEZAL PSYDSTACEE GOEDTEL BIRR DO Inactive NASTACEY E SOELDNER PSYDSTEVEN BENISH PHDSTEVEN J MILLEN MD SC

STEVEN KRAWIEC PHD- 3 Sites Primary/Volume/Top 5 Provider Yes

STEVEN L NOTTLESON ODSTEVEN SHIRCEL ODSTEVEN VANDENBERG MDSTUART J WALTONEN PHDSUE CAVALLIN MA CCC-SLPSUSAN CARLIN MS CCC-SLPSUSAN DE ZEEUW OTTAMMY ZIMMEL PSYDTED MOLLERUD AUDIOLOGISTTERRENCE MCCANNA MDTERRY KADDATZ PSYDTHAO NGUYEN TRAN MDTHOMAS J LEONARD MD Inactive NATHOMAS J MORAN PHDTHOMAS J SPEECH PHDTHOMAS RICHARDSON MD

THOMAS S LEHMANN PHD- 2 Sites (dba Life-Span Psychological Services INC)

Primary/Volume/Top 5 Provider Yes

THOMAS SCRENOCK MDTIMOTHY LAUGHLIN PHDTIMOTHY VAN DER PERREN MS CCC-SLP

TODD VERDON ODTRACY RADKE OT

TRAVIS W HINZE PHD- 3 Sites Not a Primary Provider Yes

VICTOR S SLANA MD

WARD JANKUS MD- 4 Sites Primary Provider Yes

WEI-CHUAN WANG MD Inactive NAWENDY J CLARK MS CCC-SLPWENDY REGAN, AUDIOLOGISTWILLIAM L CAMP PHDWILLIAM W FINCH MD

Medical Facilities Performing Ancillary TestingASPIRUS MEDFORD HOSPITAL & CLINICSAURORA MEDICAL CENTER HARTFORDAURORA SINAI MEDICAL CENTER MILWAUKEE- 2 SitesBAY AREA MEDICAL CENTER MARINETTEBEAVER DAM COMMUNITY HOSPITALBELLIN HEALTH ALGOMABELOIT MEMORIAL HOSPITALBOSCOBEL AREA HEALTH CAREBURNETT MEDICAL CENTERCOLUMBIA ST MARYS MILWAUKEECUMBERLAND MEMORIAL HOSPITALDEAN MED CENTER MADISON

DIVINE SAVIOR HEALTHCARE INC PORTAGEDOOR COUNTY MEMORIAL HOSPITALEAU CLAIRE FAMILY MEDICINE Inactive NAEAU CLAIRE HEART CAREEDGERTON HOSPITAL

EYE & VISION CLINICS SC DE PERE

FAMILY RESOURCES ASSOCIATES WATERTOWNFROEDTERT MEMORIAL LUTHERAN HOSPITAL MILWAUKEE

GRANT REGIONAL HEALTH CTR LANCASTERGREENFIELD REHABGUNDERSEN LUTHERAN MEDICAL CENTER LA CROSSEHAYWARD AREA MEMORIAL HOSPITALHEALTHREACH REHABILITATION SERVICES INC BROOKFIELDHOLY FAMILY MEMORIAL MEDICAL CENTER MANITOWOCHOWARD YOUNG MEDICAL CENTER

INDIANHEAD MEDICAL CENTER SHELL LAKELAKELAND MEDICAL CENTER ELKHORNLAKEVIEW MEDICAL CNTR RICE LAKELANGLADE HOSPITAL ANTIGOMARSHFIELD CENTER

MAYO CLINIC HEALTH SYSTEM NORTHLANDMAYO CLINIC HEALTH SYSTEM RED CEDARMAYO CLINIC-FRANCISCAN HEALTHCARE LA CROSSEMEMORIAL HOSP OF LAFAYETTE COUNTY DARLINGTONMEMORIAL MEDICAL CENTER ASHLANDMERCY ASSISTED CARE JANESVILLEMERCY HOSPITAL JANESVILLEMERCY MEDICAL CENTER OSHKOSHMERITER HOSPITAL INC MADISON

MILE BLUFF MEDICAL CENTER MAUSTONMONROE CLINIC

NEUROLOGY OF BELLIN HEALTH GREEN BAYOUR LADY OF VICTORY HOSPITAL STANLEYRICHLAND MEDICAL CENTER LTD RICHLAND CENTERRIVERVIEW HOSPITAL WISCONSIN RAPIDS

RUSK CO MEMORIAL HOSPITAL LADYSMITHSACRED HEART HOSPITAL EAU CLAIRESACRED HEART HOSPITAL TOMAHAWKSHEBOYGAN CLINICSHEBOYGAN MEMORIAL MEDICAL CTRSHELL LAKE CLINICST AGNES HOSPITAL FOND DU LACST CLARE HOSPITAL BARABOOST CROIX REGIONAL MEDICAL CENTER ST CROIX FALLSST ELIZABETH HOSPITAL APPLETONST FRANCIS HOSPITAL MILWAUKEE

ST JOSEPH COMMUNITY HOSPITAL WEST BENDST JOSEPHS HOSPITAL MILWAUKEEST JOSEPHS HOSPITAL CHIPPEWA FALLSST LUKES MEDICAL CENTER MILWAUKEEST MARYS DULUTH CLINICST MARYS HOSPITAL DULUTHST MARYS HOSPITAL GREEN BAYST MARY'S HOSPITAL OF SUPERIORST MARYS HOSPITAL MADISONST MARYS HOSPITAL RACINEST MARYS HOSPITAL RHINELANDERST MARYS MEDICAL CENTER RACINE

ST MICHAELS HOSPITAL STEVENS POINTST VINCENT HOSPITAL GREEN BAYTHEDACARE APPLETONTHEDACARE NEENAHTHEDACARE SHAWANOTHEDACARE WILD ROSETHEDCARE BERLINTOMAH MEMORIAL HOSPITAL

UNITED HOSPITAL SYSTEM KENOSHA CAMPUSUW HOSPITAL MADISONWATERTOWN REGIONAL MEDICAL CENTERWAUKESHA MEMORIAL HOSPITAL INCWAUSAU HOSPITALWEST ALLIS MEMORIAL HOSPITAL

WINONA COMMUNITY MEMORIAL HOSPITALWISCONSIN CARDIOVASCULAR GROUP MILWAUKEE

VENDOR CREDENTIALING

DDS Vendor

ID #Phone # FEIN # Provider's

Specialty

Statement of

Agreement Date

License Number

License Expiration

Date

License Verification

Date

OIG & SAMS Check


Date

OIG & SAMS Check

Onsite Review

Date

Key Provider

(Y/N)

Removed from DDS CE Panel

Comments PRO Initials

Charleston Vendor Credentialing:Access Vision--Gomez, David 1623 Robert C Byrd Drive Beckley, WV 25801 256-3937 OD July-19 6/30/18 12/1/16 12/1/16 7/12/17 6/22/17 5/11/2017 N N

Appalachian Hearing & Balance 1242 Hockman PikeBluefield, VA 24605 276-326-3890 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 10/18/2016 N N

Appalachian Hearing & Balance--Larsen, William 276-326-3890 Audio Aug-19 12/31/18 12/1/16 12/1/16 1/17/17 6/22/17 " " "

Appalachian Hearing & Balance--Rhodes, Cheryl 276-326-3890 Audio Aug-19 12/31/18 12/1/16 12/1/16 1/17/17 6/22/17 " " "

Aspire Occupational Rehabilitation 88 Michigan AveSmithers, WV 25186 855-5886 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 3/8/2017 Y N

Aspire Occupational Rehabilitation 440 South Main StChapmanville, WV 25508 855-5886 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 12/21/2016 Y N

Aspire Occupational Rehabilitation 400 Allen Dr Ste 401Charleston, WV 25302 855-5886 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 7/19/2017 Y N

Aspire Occupational Rehabilitation 9 Yellow Wood WayBeckley, WV 25801 855-5886 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 6/2/2017 Y N

Aspire Occupational Rehabilitation 194 Pinnell St Bldg 7Ripley, WV 25271 372-8989 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 7/11/2017 Y N

Aspire Occupational Rehabilitation 1001 6th Ave Suite 5Huntington, WV 25701 720-0396 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 7/3/2017 Y N

Aspire--Gettman-Hughes, Kara ↑ MA Feb-18 6/30/18 12/1/16 12/1/16 6/22/17 6/22/17 " Y

Aspire--Henline, Melinda↑ MA June-19 3/31/19

New To Panel Added 7/5/17

New Added 7/5/17 7/5/17 7/5/17 " "

Aspire--Null, Angela ↑ MS Feb-18 12/31/17 12/1/16 12/1/16 6/22/17 6/22/17 " Y

Aspire--Sargent, Lester ↑ MA Feb-18 9/30/19 12/1/16 12/1/16 9/27/17 6/22/17 " Y

Aspire--Smith, Nicole ↑ MA Feb-18 6/30/18 12/1/16 12/1/16 6/22/17 6/22/17 " Y

Assessments--Bell, Sunny 300 North Kanawha StBeckley, WV 25801 763-8186 MA Feb-18 3/31/19 12/1/16 12/1/16 3/13/17 6/22/17 1/26/2017 N N

Assessments--Bell, Sunny204 Howard AveMullens, WV 25882 294-5150 MA Feb-18 3/31/19 12/1/16 12/1/16 3/13/17 6/22/17 10/12/2016 N N

Beckley ARH: Speech & Language 306 Stanaford RdBeckley, WV 25801 255-3366 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 6/7/2017 N N

Onsite ReviewsState Licensing VerificationVENDOR INFORMATION

Vendor Name & Address

West Virginia FY 2017

(b) (6) (b) (6)(b) (6)(b) (6)

(b) (6)

(b) (6)


DDS Vendor


Specialty

Statement of

Agreement Date

License Number

License Expiration

Date


Date

OIG & SAMS Check


Date

OIG & SAMS Check

Onsite Review

Date

Key Provider

(Y/N)


Comments PRO InitialsVendor Name &

AddressBeckley ARH: Speech & Language--Albright, Susan 255-3366 SLP Mar-19 12/31/18 1/3/17 12/1/16 6/27/17 6/27/17 " " "

Beckley ARH: Speech & Language--Fitzpatrick, Joanna 255-3366 SLP June-19 12/31/18


New Added 6/6/17 6/6/17 6/6/17 " " "

Beckley ARH: Speech & Language--Sites, Hannah Rae 255-3366 SLP Mar-19 12/31/18 1/3/17 12/1/16 6/27/17 6/27/17 " " "

Bodkin, Elizabeth A 90 Howard St (McDowell Co LibraryWelch, WV 24801 MA Jan-18 6/30/19 12/1/16 12/1/16 6/8/17 6/27/17 6/6/2017 N N

Bodkin, Elizabeth A

Logan, WV 25601 MA Jan-18 6/30/19 12/1/16 12/1/16 6/8/17 6/27/17 5/24/2017 N N

Browning Eye Care--Browning, Gregory, 912 Oak Street Kenova, WV 25530 453-4072 OD July-19 6/30/18 12/1/16 12/1/16 7/13/17 6/27/17 11/2/2016 N N

Cabell Huntington Family Med Ctr--Collins, Nathaniel, 750 Oak St Kenova, WV 25530 453-6136 APRN July-19 6/30/19


New Added 7/28/17 5/15/17 5/15/17 7/27/2017 N y

Clay County Health Dept-- Brown, Angela, 261 Main St Clay, WV 25043 587-4269 APRN May-19 6/30/19 5/15/17 05/15/17 5/15/17 9/27/17 6/14/2017 N N

Dagher, Ghassan 401 6th Ave Ste 110 Montgomery, WV 25136 442-8076 MD-Opth July-19 6/30/18 12/1/16 12/1/16 6/27/17 6/27/17 5/9/2017 N N

Ear Nose & Throat Assoc Of Chas 500 Donnally St Ste 200 Charleston, WV 25301 340-2200 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 8/1/2017 N N

Ear Nose & Throat Assoc Of Chas--Beasley, Michael Scott ↑ MD Feb-18 6/30/18 12/1/16 12/1/16 6/27/17 6/27/17 " N N

Ear Nose & Throat Assoc Of Chas--Dawson, G Stephen ↑ MD Feb-18 6/30/18 12/7/16 12/1/16 6/27/17 6/27/17 " " "

Ear Nose & Throat Assoc Of Chas--Goins, Michael ↑ MD Feb-18 6/30/18 12/1/16 12/1/16 6/27/17 6/27/17 " " "

Ear Nose & Throat Assoc Of Chas--Lough, David ↑ MD Feb-18 6/30/18 12/1/16 12/1/16 6/27/17 6/27/17 " " "

Ear Nose & Throat Assoc Of Chas--Nichols, Phillip ↑ MD Feb-18 6/30/19 12/1/16 12/1/16 6/28/17 6/27/17 " " "

Ear Nose & Throat Assoc Of Chas--Phillips, David ↑ MD Feb-18 6/30/19 12/1/16 12/1/16 6/22/17 6/27/17 " " "

Ear Nose & Throat Assoc Of Chas--Sporck, Frederick ↑ MD Feb-18 6/30/19 12/1/16 12/1/16 6/27/17 6/27/17 " " "

Fields, Melinda

Bluefield, WV 24701 PHD Jan-18 6/30/18 12/6/16 12/1/16 6/27/17 6/27/17 12/5/2016 N N

Greenbrier Audiology Inc 150 Dawkins Dr Lewisburg, WV 24901 647-4327 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 3/29/2017 N N

Greenbrier Audiology Inc 2216 S Kanawha St Beckley, WV 25801 255-6310 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 7/20/2017 N N

(b) (6)(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6) (b) (6) (b) (6)(b) (6)

(b) (6)

(b) (6)


DDS Vendor


Specialty

Statement of

Agreement Date

License Number

License Expiration

Date


Date

OIG & SAMS Check


Date

OIG & SAMS Check

Onsite Review

Date

Key Provider

(Y/N)



AddressGreenbrier Audiology--Shockey, Kristin ↑ Audio Feb-18 12/31/18 1/10/17 12/1/16 6/27/17 6/27/17 " " "

Greenbrier Audiology--Stout, Laura ↑ Audio Feb-18 12/31/18 1/4/17 12/1/16 6/27/17 6/27/17 " " "

Hasan Medical Inc 224 Professional Park Beckley, WV 25801 255-9444 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 1/31/2017 N N

Hasan Medical Inc-- Hassan, Surayia 255-9444 MD Nov-18 6/30/18 12/1/16 12/1/16 6/27/17 6/27/17 1/31/2017 N N

Hasan Medical Inc-- Wasylyk, Irene 255-9444 MD Nov-18 6/30/19 12/1/16 12/1/16 6/7/17 6/27/17 1/31/2017 N N

Holley, Robert M

Point Pleasant, WV 25550 MD Feb-18 6/30/18 12/2/16 12/2/16 6/27/17 6/27/17 1/11/2017 N Y

Hosman, Steven

Charleston, WV 25301 OD Feb-18 6/30/18 12/2/16 12/2/16 7/7/17 6/27/17 8/16/2017 N N

Huntington ENT Specialists--ToumaB. Joseph 5170 US Rt 60 East Huntington, WV 25705 522-8800 MD Dec-18 6/30/19 12/2/16 12/2/16 7/7/17 6/27/17 10/25/2016 N N

Jennings, Elizabeth

Bluefield, WV 24701 MA May-19 9/30/19 12/2/16 12/2/16 9/27/17 6/27/17 11/21/2016 N N

Jewell, Karen

Hurricane, WV 25526 APRN July-19 6/30/19 6/28/17 6/28/17 9/27/17 6/28/17 9/30/2017 N N

Jones-Wheeler, Misti

Oak Hill, WV 25901 MA Jan-18 6/30/18 12/2/16 12/2/16 6/27/17 6/27/17 6/28/2017 N N

Katrib, A Karim 400 Division St Ste 12 South Charleston, WV 25309 ENT Aug-19 6/30/18 12/2/16 12/2/16 6/27/17 6/27/17 1/5/2017 N N

Katrib, A Karim

Logan, WV 25601 ENT Aug-19 6/30/18 12/2/16 12/2/16 6/27/17 6/27/17 3/10/2017 N N

Key Care--Rago, Andres HC 52 Box 135 Main St Keystone, WV 24852 862-4611 MD Feb-18 6/30/17 12/2/16 12/2/16

Removed From CE Panel

Removed From CE

Panel n/a N Y

Kid Care Pediatrics--Darnell, Robin 4407 MacCorkle Ave 2nd Floor Charleston, WV 25304 925-0392 MD Nov-18 6/30/18 12/2/16 12/2/16 6/27/17 6/27/17 8/24/2027 N N

Legg, Larry (SRMC Specialty Clinic) 702 Professional Park Dr Ste 106 Summersville, WV 26651 883-2380 MA Sep-19 3/31/19 12/2/16 12/2/16 6/27/17 6/27/17 1/23/2017 N N

Legg, Larry (Clay County Health Dept) N H Dyer Medical Facility Main St Clay, WV 25043 587-4269 MA Sep-19 3/31/19 12/2/16 12/2/16 6/27/17 6/27/17 7/14/2017 N N

Lindsey Optical Inc 310 Locust St Ste 6 Princeton, WV 24740 487-2020 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 3/21/2017 N N

Lindsey Optical--Carpenter, Scott487-2020 OD July-19 6/30/18 12/2/16 12/2/16 6/29/17 6/27/17 " N N

Lindsey Optical-- Cole, Kenneth487-2020 OD July-19 6/30/18 12/2/16 12/2/16 6/29/17 6/27/17 " N N

(b) (6) (b) (6) (b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


DDS Vendor


Specialty

Statement of

Agreement Date

License Number

License Expiration

Date


Date

OIG & SAMS Check


Date

OIG & SAMS Check

Onsite Review

Date

Key Provider

(Y/N)



Address

Lindsey Optical-- Lawhorn, Zane487-2020 OD July-19 6/30/18 12/2/16 12/2/16 6/29/17 6/27/17 " N N

Logan Pediatrics Inc-Nnachi, Okpani300 Prosperity Lane Ste 100 Logan, WV 25601 831-0073 MD Mar-19 6/30/19 12/2/16 12/2/16 6/16/17 6/27/17 4/4/2017 N N

Lucas, Judith

Lewisburg (Fairlea), WV 24901 MA Aug-19 6/30/18 12/2/16 12/2/16 6/27/17 6/27/17 3/22/2027 N N

Marshall, Katherine

Welch, WV 24801 MA May-19 3/31/19 12/2/16 12/2/16 6/27/17 6/27/17 4/24/2017 N N

McFadden, Tonya

Princeton, WV 24740 MA Jan-18 9/30/19 12/2/16 12/2/16 6/27/17 6/27/17 5/2/2017 N N

Milestones Physical Therapy Inc 179 Station Place Ste 100 Hurricane, WV 25526 760-6300 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 8/28/2017 N N

Milestones Physical Therapy Inc 5187 US Rt 60 East Huntington, WV 25705 760-6300 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 6/21/2017 N N "

Milestones Physical Therapy-- Ball, Jennifer 760-6300 SLP Feb-18 12/31/18 1/19/17 12/2/16 6/27/17 6/27/17 " " " "

Milestones Physical Therapy--Blake,Julie 760-6300 SLP Feb-18 12/31/18 1/19/17 12/2/16 6/27/17 6/27/17 " " " "

Milestones Physical Therapy--Burdette, Erica 760-6300 SLP Feb-18 12/31/18 1/19/17 12/2/16 6/27/17 6/27/17 " " " "

Milestones Physical Therapy-- Casto, Lacie 760-6300 SLP Nov-18 12/31/18 1/19/17 12/2/16 6/27/17 6/27/17 " " " "

Milestones Physical Therapy--Cole, Joy 760-6300 SLP Feb-18 12/31/18 1/19/17 12/2/16 6/27/17 6/27/17 " " " "

Milestones Physical Therapy--Runyan, Jenna 760-6300 SLP Feb-18 12/31/18 1/19/17 12/2/16 6/27/17 6/27/17 " " " "

Milestones Physical Therapy--Shaffer, Linsey 760-6300 SLP Feb-18 12/31/18 1/19/17 12/2/16 6/27/17 6/27/17 " " " "

Mountain State ENT & Facial Plastic84 Brookshire Lane Beckley, WV 25801 255-2341 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 6/22/2017 N N

Mountain State ENT & Facial PlasticPaine Jr, Albert 255-2341 MD Dec-18 6/30/19 12/2/16 12/2/16 6/7/17 6/27/17 " N N

Mountain State ENT & Facial PlasticZiolkowski, Lori 255-2341 Audio Dec-18 12/31/18 1/17/17 12/2/16 6/27/17 6/27/17 " N N

PAIS:Charleston--Robinson, Kelly 4834 MacCorkle Ave SW South Charleston, WV 25309 800-998-7596 MA Mar-19 12/31/17 12/2/16 12/2/16 6/27/17 6/27/17 9/8/2017 Y N

PAIS:Beckley 330 Harper Park Rd Suite I Beckley, WV 25801 415-1500 ↑ ↑ ↑ ↑ ↑ ↑ ↑ 7/18/2017 Y N

PAIS:Barboursville 6351 US Route 60 East Suite 8 Barboursville, WV 25504 800-998-7596 ↑ ↑ ↑ ↑ ↑ ↑ ↑ 5/25/2017 Y N

(b) (6)(b) (6) (b) (6) (b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)


DDS Vendor


Specialty

Statement of

Agreement Date

License Number

License Expiration

Date


Date

OIG & SAMS Check


Date

OIG & SAMS Check

Onsite Review

Date

Key Provider

(Y/N)



AddressPAIS:Chapmanville S Main St Professional Bldg Chapmanville, WV 25508 415-1500 ↑ ↑ ↑ ↑ ↑ ↑ ↑ 4/12/2017 Y N

PAIS:Princeton 109 Thorn St Princeton, WV 24740 415-1500 ↑ ↑ ↑ ↑ ↑ ↑ ↑ 3/13/2017 Y N

Pleasant Valley Hospital:Speech 2520 Valley Dr Point Pleasant, WV 25550 675-8639 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 6/26/2017 Y N

Pleasant Valley Hospital: Speech 518 East Main St Pomeroy, OH 45769 740-992-1075 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 6/19/2017 Y N

Pleasant Valley Hospital: Speech--Ehman, Abby 675-8639 SLP Aug-19 12/31/18 1/9/17 12/5/16 6/27/17 6/27/17 " " "

Pleasant Valley Hospital: Speech--Vaughan, Pamela 675-8639 SLP Aug-19 12/31/18 1/9/17 12/5/16 6/27/17 6/27/17 " " "

Psychological Associates of Logan--Glick, Angela 306 Main St, Logan, WV 25601 752-7707 MA July-18 12/31/18 12/6/16 12/5/16 6/27/17 6/27/17 4/11/2017 N N

Psychological Testing Services--Jarrell, Teresa 114 W Main St Keystone, WV 24852 323-1627 MA Jan-18 12/31/18 12/5/16 12/5/16 6/27/17 6/27/17 4/11/2017 N N

Psyscape Inc--Vecchio, Ernie 201 6th Ave St Albans, WV 25177 552-9832 MA May-17 9/30/17 12/5/16 12/5/16 Retired Retired 2/27/2017 N Y

River Valley Associates 2828 1st Ave Ste 203 Huntington, WV 25702 302-2467 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 12/12/2016 N N

River Valley Associates-- Chaney, Mary 302-2467 MA Feb-18 9/30/18 12/5/16 12/5/16 6/27/17 6/27/17 " " "

River Valley Associates-- Wilson, Emily Engelland 302-2467 MA Feb-18 12/31/18 12/5/16 12/5/16 6/27/17 6/27/17 " " "

Roberson Orthopedic Clinic 3009 Jackson Ave Point Pleasant, WV 25550 675-8095 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 5/17/2017 N Y

Roberson Orthopedic Clinic-- Roberson, Clifford 675-8095 MD May-18 6/30/19 12/5/16 12/5/16 6/22/17 6/27/17 " " " "

Simmerman Hearing & Speech 20 Hospital Drive Logan, WV 25601 344-4400 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 4/14/2017 N N

Simmerman Hearing & Speech 101 North Court Street Ripley, WV 25601 344-4400 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 8/31/2017 N N

Simmerman Hearing & Speech 3058 Mount Vernon Road Hurricane, WV 25526 344-4400 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 6/27/2017 N N

Simmerman Hearing & Speech-- Simmerman, Gregory 344-4400 Audio Jan-18 12/31/18 1/3/17 12/5/16 6/28/17 6/28/17 " " "

Steinhoff Consult Service--Steinhoff, William 2419.5 Jackson Ave Point Pleasant, WV 25550 740-656-4599 MA Feb-18 12/31/18 1/3/17 12/5/16 6/28/17 6/28/17 7/10/2017 N N

Story Consulting Services Inc 306 Hospital Dr Ste 202D South Williamson, KY 41503 615-943-6379 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 4/25/2017 N N

(b) (6) (b) (6)(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)


DDS Vendor


Specialty

Statement of

Agreement Date

License Number

License Expiration

Date


Date

OIG & SAMS Check


Date

OIG & SAMS Check

Onsite Review

Date

Key Provider

(Y/N)



AddressStory Consulting Services Inc 3451 Highway 2565 Louisa, KY 41230 615-943-6379 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 4/3/2017 N N

Story Consulting Services Inc--Gale-Dyer, Curtis ↑ DO Apr-19 2/28/18 12/5/16 12/5/16 6/28/17 6/28/17 " " "

Story Consulting Services Inc--Karam, Anthony B ↑ DO Apr-19 2/28/18 12/5/16 12/5/16 6/28/17 6/28/17 " " "

Story Consulting Services Inc--Waltrip, William ↑ MD Apr-19 6/30/18 12/5/16 12/5/16 6/7/17 6/28/17 " " "

Synergy Psychological Services--Reynolds, Mareda 511 Sixth Ave St Albans, WV 25177 727-1302 MA Jan-18 6/30/19 12/5/16 12/5/16 6/8/17 6/28/17 12/6/2016 N N

Thakker, Ganpat 3100 MacCorkle Ave SE Ste 207 Charleston, WV 25304 MD Nov-18 6/30/19 12/5/16 12/5/16 6/16/17 6/28/17 12/29/2016 N N

The Hearing Place 420 Greenway Ave South Charleston, WV 25309 766-6555 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 12/7/2016 N N

The Hearing Place--Harris, Gary766-6555 Audio July-19 12/31/18 12/5/16 12/5/16 6/28/17 6/28/17 " " "

The Hearing Place--Porter, Bethany766-6555 Audio July-19 12/31/18 12/5/16 12/5/16 6/28/17 6/28/17 " " "

Tri State Occupational Medicine 702 6th Ave Huntington, WV 25701 800-929-8766 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 1/10/2017 Y N

Tri State Occupational Medicine 1219 Virginia St East Suite 102 Charleston, WV 25301 800-929-8766 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 8/17/2017 Y N

Tri State Occupational Medicine 200 George St Suite 1 Beckley, WV 25801 800-929-8766 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 1/12/2017 Y N

Tri State Occupational Medicine 189 Pinnell St Ripley, WV 25271 800-929-8766 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 11/28/2016 Y N

Tri State Occupational Medicine 3696 Jefferson St N Lewisburg, WV 24901 800-929-8766 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 7/13/2017 Y N

Tri State Occupational Medicine 13 White St Logan, WV 25601 800-929-8766 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 2/28/2017 Y N

Tri State Occupational Medicine 508 New Hope Rd Suite 204 Princeton, WV 24740 800-929-8766 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 5/18/2017 Y N

Tri State Occ Med SLP Beckley 200 George St Ste 1 Beckley, WV 25801 800-929-8766 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 7/21/2017 Y N

Tri State Occupational Medicine--Adkins. Jimmy Ray ↑ PA-C July-19 3/31/19


New Added 7/28/17 5/8/17 5/8/17 " " "

Tri State Occupational Medicine--Beard, Kip ↑ MD Feb-18 6/30/18 12/6/16 12/6/16 6/28/17 6/28/17 " " "

Tri State Occupational Medicine--Namsupak, James ↑ MD Dec-18 6/30/19 12/12/16 12/12/16 6/16/17 6/28/17 " " "

(b) (6) (b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


DDS Vendor


Specialty

Statement of

Agreement Date

License Number

License Expiration

Date


Date

OIG & SAMS Check


Date

OIG & SAMS Check

Onsite Review

Date

Key Provider

(Y/N)



AddressTri State Occupational Medicine--Nutter, Stephen ↑ MD Feb-18 6/30/19 12/6/16 12/6/16 6/27/17 6/28/17 " " "

Tri State Occupational Medicine--Parsley, Deidre

↑ DO Feb-18 6/30/18 12/6/16 12/6/16 6/28/17 6/28/17 " " "

Tri State Occ Med SLP Beckley-- Riffe, Kara ↑ SLP Jan-19 12/31/18 1/9/17 1/9/17 6/28/17 6/28/17 " " "

Tri State Occupational Medicine--Sabio, Arturo ↑ MD Feb-18 6/30/17 12/6/16 12/6/16

Stopped doing exams 12/2016

Stopped doing exams n/a n/a Y

Tug River Mount View Health Center950 Mount View Rd Ste 500 Welch, WV 24801 436-4798 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 9/27/2017 N NTug River Health Assoc Inc 5883 Black Diamond Hwy Gary, WV 24836 448-2101 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 6/29/2017 N N

Tug River Health Assoc Inc-- Fain, Jennifer APRN Aug 6/30/19


New Added 7/28/17 7/28/17 6/28/17 " " "

Tug River Health Assoc Inc-- Rash, Monique APRN Aug 6/30/19


New Added 7/28/17 7/28/17 6/28/17 " " "

Vision Consultants--Beres, Michael Kruger Bldg 4th Floor Hospital Dr Logan, WV 25601 792-1480 MD-Opth Feb-18 6/30/18 12/6/16 12/6/16 6/28/17 6/28/17 4/27/2017 N NWelch Family Care 922 Virginia Ave Welch, WV 24801 436-8066 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 4/13/2017 N N

Welch Family Care-- Dumapit Jr, Ruperto D ↑ MD Apr-19 6/30/18 4/17/17 4/17/17 6/28/17 6/28/17 " " "Wiles, John F

St Albans, WV 25177 OD Feb-18 6/30/18 12/6/16 12/6/16 7/13/17 6/28/17 12/7/2016 N NZeigler, Cherie

Huntington, WV 25701 MA Feb-18 6/30/19 12/6/16 12/6/16 6/8/17 6/28/17 6/5/2017 N N

Clarksburg Vendor Credentialing:Audia, Joseph OD

Salem, WV 26426 Optometrist Apr-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17Behavioral Health Assessments- Holly Coville MA- 4453 National Rd. TriadelphiaWV 26059 304-909-0185 Psych Mar-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 8/21/2017 Y NCox, Kevin

Elkins, WV 26241 Optha Feb-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 2/22/2017 N NDr. Biundo - Bethany Honce, M.D.

Morgantown, WV 26505 Internist Jun-18 6/30/2018 2/2/2017 2/2/17 11/7/2017 11/7/17 4/4/2017 Y YDunn, Paul A.

Parkersburg, WV 26105 Psych Feb-18 12/31/17 2/2/17 2/2/17 11/7/17 11/07/17 1/3/2017 N NEastern Psych SVC of WV- Jill Barnes Pyles

278 N High St. STE 1 Romney WV 26757 304-822-3429 Psych Feb-18 9/30/18 2/2/17 2/2/17 8/3/17 08/03/17 9/15/2017 N N

(b) (6) (b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)(b) (6)


DDS Vendor


Specialty

Statement of

Agreement Date

License Number

License Expiration

Date


Date

OIG & SAMS Check


Date

OIG & SAMS Check

Onsite Review

Date

Key Provider

(Y/N)



AddressEastern Psych SVC of WV- Sheri Coleman 278 N High St. STE 1 Romney WV 26757 304-822-3429 Psych Feb-18 12/31/17 2/2/17 2/2/17 8/3/17 08/03/17 9/15/2017 N NFamily and Marital Counseling Center- Robert J. Klein EDD 5 Brown Ave. Weston WV, 26452 304-269-3923 Psych Feb-18 3/31/19 2/2/17 2/2/17 8/3/17 08/03/17 2/13/2017 N NFrame, Ronald D.

Parkersburg WV, 26101 Optometrist Oct-19 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17Fremouw Sigley Psych Assoc. Traci Berry Harris- 1224 B Pineview Dr. Morgantown WV, 26505 304-598-2300 Psych Mar-18 9/30/18 2/2/17 2/2/17 8/3/17 08/03/17 9/27/2017 N NFremouw Sigley Psych Assoc. Edward Baker- 1224 B Pineview Dr. Morgantown WV, 26505 304-598-2300 Psych Mar-18 9/30/19 2/2/17 2/2/17 8/3/17 08/03/17 9/27/2017 N NGreenbrier Audiology--Stout, Laura 7 11th St. Elkins, WV 26241 304-630-6002 Audiology May-18 12/31/18 2/2/17 2/2/17 8/3/17 08/03/17 8/3/2017 N NJoseph, Sharon J PHD

Elkins, WV 26241 Psych May-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 7/7/2017 N NMangold, Terry S. OD

Keyser WV 26726 Optometrist Sep-19 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 7/20/2017 N NMansuetto Psychological Services, PLLC-Aileen Mansuetto, MA 141 Key Ave. Wheeling, WV 26003 304-243-5600 Psych Mar-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 1/18/2017 N YMarshall, Katherine M.S. C/O work force wv 200 8th street Marlinton wv 24954 304-660-7656 Psych May-19 3/31/19 12/2/16 12/2/16 6/27/17 6/27/17 4/24/2017 N NMonongahela Valley Assoc. Health-Seeta R. Vangala- 1322 Locust Ave. Fairmont, WV 26554 304-367-8719 Pediatric Mar-18 6/30/2019 2/2/17 2/2/17 8/3/17 8/3/2017 7/20/2017 N NMonongahela Valley Assoc. Health-Smitha Pati- 1322 Locust Ave. Fairmont, WV 26554 304-367-8719 Internist Mar-18 6/30/2019 2/2/17 2/2/17 8/3/2017 8/3/2017 7/20/2017 N NMonongahela Valley Assoc. Health- Himanshu Paliwal- 1322 Locust Ave. Fairmont, WV 26554 304-367-8719 Internist Mar-18 6/30/2019 2/2/17 2/2/17 8/3/2017 8/3/2017 7/20/2017 N N Monongahela Valley Assoc. Health- Ryan Hall- 1322 Locust Ave. Fairmont, WV 26554 304-367-8719 Internist Mar-18 6/30/2018 2/2/17 2/2/17 8/3/2017 8/3/2017 7/20/2017 N NMonongahela Valley Assoc. Health- Sarah Hall- 1322 Locust Ave. Fairmont, WV 26554 304-367-8719 Pediatric Mar-18 6/30/2018 2/2/17 2/2/17 8/3/2017 8/3/2017 7/20/2017 N NMorgan Psych Services- Morgan Morgan- 102 E Main St. #1 Buckhannon, WV 26201 304-472-7778 Psych Mar-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 9/13/2017 Y NMorgantown Eye Assoc. -Erica Mancini- 3000 Hampton Center STE A MorgantownWV 26505 304-598-2020 Optometrist Jul-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 2/22/2017 N NMorgantown Eye Assoc.- Dona Wratchford- 3000 Hampton Center STE A Morgantown WV 26505 304-598-2020 Optometrist Jul-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 2/22/2017 N NMorgantown Eye Assoc. Thomas Stout-3000 Hampton Center STE A MorgantownWV 26505 304-598-2020 Optometrist Jul-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 2/22/2017 N NMountain View Ear Nose & Throat- Peter Johnson- 112 Medical Circle Winchester, VA 22601 540-542-1995 ENT Apr-18 7/31/18 2/2/17 2/2/17 8/3/17 08/03/17 N N

(b) (6)(b) (6)(b) (6)(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


DDS Vendor


Specialty

Statement of

Agreement Date

License Number

License Expiration

Date


Date

OIG & SAMS Check


Date

OIG & SAMS Check

Onsite Review

Date

Key Provider

(Y/N)



AddressOrvik, Bennett D. MD

Weston WV, 26452 MD Mar-18 6/30/19 2/2/17 2/2/17 8/3/17 08/03/17 8/3/2017 N NPearse, Ronald D. EDD

Fairmont WV, 26555 Psych Mar-18 12/31/18 2/2/17 2/2/17 8/3/17 08/03/17 3/10/2017 N NPhoenix Psych Counseling Assoc.- Peggy Allman- 4579 Buckhannon Pike STE 101 Mt. Clare WV 26408 304-622-6404 Psych Mar-18 9/30/19 2/2/17 2/2/17 8/3/17 08/03/17Psychological Consulting- Harold D. Slaughter Jr. 431 S Raleigh St. Martinsburg WV 25401 304-263-9095 Psych Mar-18 9/30/18 2/2/17 2/2/17 8/3/17 08/03/17 9/11/2017 YPsychological Consulting- Harry Hood MA

431 S Raleigh St. Martinsburg WV 25401 304-263-9095 Psych Mar-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 9/11/2017 YPsychological Consulting- Michael McDaniel MA 431 S Raleigh St. Martinsburg WV 25401 304-263-9095 Psych Mar-18 3/31/18 2/2/17 2/2/17 8/3/17 08/03/17 9/11/2017 YRobinson, Jennifer

Fairmont WV, 26555 Psych Mar-18 9/30/18 2/2/17 2/2/17 8/3/17 08/03/17 3/10/2017 N NSchmitt, Thomas J. MD

New Martinsville, WV 26155 Internist Apr-18 6/30/19 2/2/17 2/2/17 8/3/17 08/03/17 5/30/2017 N N

Joseph E. Schreiber, DO , Weirton WV 26062

Internist Mar-18 6/30/19 2/2/17 2/2/17 8/3/17 08/03/17 7/11/2017 N 7/18/2017Selario, James A.

Clarksburg WV26301 Optometrist Mar-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17

Sella, Gabriel E. MD 92 N 4th St. Suite 12 Martins Ferry, OH 43935 Family Apr-18 6/30/19 2/2/17 2/2/17 8/3/17 08/03/17 12/8/2016 NSethi, Sushil M. MD MPH FCCP-Fairmont 1228 Country Club Rd Suite 14 Fairmont, WV 26554 419-756-4010 Family Feb-18 6/30/19 2/2/17 2/2/17 11/7/17 11/07/17 YSethi, Sushil M. MD MPH FCCP-Marietta 1300 Pike St - Beverly Medical Center Marietta, OH 45750 419-756-4010 Family Feb-18 6/30/19 2/2/17 2/2/17 11/7/17 11/07/17 3/28/2017 Y 3/28/2017Spaulding Psych Services- Cynthia Spaulding- 216 W North St. Harrisville WV, 26362 304-643-5399 Psych Feb-18 6/30/19 2/2/17 2/2/17 8/3/17 08/03/17 7/25/2017 NSpaulding Psych Services- Amy Guthrie MA- 1809 Dupont Rd STE 3 Parkersburg, WV 26101 304-861-5184 Psych Feb-18 12/31/18 2/2/17 2/2/17 8/3/17 08/03/17 7/25/2017 NTebay Psychological Services- Brenda Tebay- 1303 Grand central Ave. Vienna WV 26105 304-482-2917 Psych Feb-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 8/18/2017 NTherapy Source, Inc.-Tracy N. Bartlett-5215 Militia Hill Rd. Plymouth Meeting PA 19462 484-342-2000 Speech Apr-19 5/31/2019 4/5/2017 4/5/17 8/3/2017 8/3/2017 NTrainor, Gregory E. MA & Assoc.- 155 Armstrong St. Keyser WV 26726 304-788-1138 Psych Mar-18 9/30/19 2/2/17 2/2/17 8/3/17 08/03/17 9/8/2017 Y NTrainor, Gregory E.--Tracy Cosner- Shepard- 155 Armstrong St. Keyser, WV 26726 304-788-1138 Psych Mar-18 3/31/19 2/2/17 2/2/17 8/3/17 08/03/17 9/8/2017 Y NTri State Occupational Medicine 1400 Johnson Ave Blake Center Bridgeport, WV 26330 800-929-8766

Credentialing For Physicians Found With Charleston Credentialing onsite visit by Clarksburg

(b) (6)(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)


DDS Vendor


Specialty

Statement of

Agreement Date

License Number

License Expiration

Date


Date

OIG & SAMS Check


Date

OIG & SAMS Check

Onsite Review

Date

Key Provider

(Y/N)



AddressTri State Occupational Medicine Randolph Center-Harrison Ave Elkins, WV 26241 800-929-8766 3/17/17 y

Tri State Occupational Medicine 617 River St Gassaway, WV 26624 800-929-8766 3/15/17 Y

Tri State Occupational Medicine 196 Riverview Dr. Sutton, WV 26601 800-929-8766Tri State Occupational Medicine 103 South Tennesse Ave Martinsburg, WV 25401 800-929-8766 8/24/17Tri State Occupational Medicine Rt 50 E - In Sun Diagnostics Romney, WV 26757 800-929-8766 8/22/17 y

Tri State Occupational Medicine 706 Division St Parkersburg, WV 26101 800-929-8766 2/8/17 Y N

Victory Services--Jill Hornish MA 411 Main St. Rt 74 Pennsboro WV 26415 304-483-6245 Psych Mar-18 3/31/18 2/2/17 2/2/17 8/3/17 08/03/17 5/23/17 N NVirginia Center For Neuroscience--Seth Tuwiner MD, 19450 Deerfield Ave. STE 175 Leesburg VA 20176 703-858-5454 Neurology Mar-18 1/31/18 2/2/17 2/2/17 8/3/17 08/03/17 N NVision Care Assoc. Inc.--Scott Lauer 2014 Dudley Ave. Parkersburg WV 26101 304-422-1841 Optometrist Jul-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17Vision Care Assoc. Inc.--C. Robert Welshans- 2014 Dudley Ave. Parkersburg WV 26101 304-422-1841 Optometrist Jul-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17Vision Care Assoc. Inc.--Jerry Lantz 2014 Dudley Ave. Parkersburg WV 26101 304-422-1841 Optometrist Jul-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 NVision Care Assoc., Inc.--Deanna Jackson- 2014 Dudley Ave. Parkersburg WV 26101 304-422-1841 Optometrist Jul-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 NVision Care Assoc. Inc.--Vicki Lauer 2014 Dudley Ave. Parkersburg WV 26101 304-422-184 Optometrist Jul-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 NWheeling Hospital Speech--Morgan DeGarmo, 1021 MT Dschantal Rd. #2 Wheeling, WV 26003 304-243-3770 Speech Mar-18 12/31/18 2/21/17 2/21/17 8/3/17 8/3/2017 11/18/16 NWheeling Hospital Speech--Amy Toth Beaver, 1021 MT Dechantal Rd. #2 Wheeling WV, 26003 304-243-3770 Speech Mar-18 12/31/18 2/2/17 2/2/17 8/3/17 08/03/17 11/8/16 NWilkins, Krista

Clarksburg WV, 26301 Speech Mar-18 12/31/18 2/2/17 2/2/17 8/3/17 08/03/17 nWilkinson, Amos W. 1160 Johnson Ave. STE 103 Bridgeport, WV 26330 Optha Apr-18 6/30/19 2/2/17 2/2/17 8/3/17 08/03/17

Yost, T. M. EDD Fairmont

WV, 26554 Psych Mar-18 9/30/19 2/2/17 2/2/17 8/3/17 08/03/17 5/26/17 YZyznewsky, Wladimir MD--Valley Professional Center STE 301 2115 Chapline St, Wheeling WV 26003 Neurology Mar-18 6/30/19 2/2/17 2/2/17 8/3/17 08/03/17







(b) (6)

(b) (6) (b) (6) (b) (6)

(b) (6)

(b) (6)

(b) (6)(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

Vendor Name & Address Onsite Visit Date CommentsPRO

initialsCHARLESTON CHARLESTON CHARLESTONSummersville Reg. Hospital/Summersville, WV 10/5/2016Boone Memorial Hosp/Madison, WV 10/6/2016Pleasant Valley Hosp./Pt. Pleasant, WV 10/11/2016Southern Highlands Hosp/Princeton, WV 10/13/2016Community Care of WV/Clay, WV 10/26/2016Monroe Health/Peterstown, WV 11/1/2016Seneca Health Services/Maxwellton, WV 11/3/2016Southern Highlands Hosp/Welch, WV 11/9/2016Summers Co. ARH/Hinton, WV 11/15/2016Webster Co. Mem. Hosp/Webster Springs, WV 11/16/2016St. Mary's Family Medicine/Milton, WV 11/22/2016Muscari Family Medicine/Pineville, WV 11/29/2016Alderson Family Medicine/Alderson, WV 12/1/2016Tug Valley ARH/ S. Williamson, KY 1/9/2017Thomas Memorial Hosp/Charleston, WV 1/13/2017Erma Byrd Clinical Center/Huntington, WV 1/17/2017Tug River Health/Gary, WV 1/19/2017Big Otter Clinic/ Ivydale, WV 1/24/2017Clay County Health Dept/Clay, WV 1/24/2017Prestera Center / Wayne, WV 1/30/2017Valley Health/ Wayne, WV 1/30/2017New Hope Family Practice/Princeton, WV 2/1/2017Williamson Memorial Hosp/ Willaimson, WV 2/3/2017Logan Regional Hosp. Logan, WV 2/7/2017

MER Visits

WV FY 2017

(b) (6)


initials

MER Visits

Greenbrier Valley Hosp. Roncerverte, WV 2/8/2017Mercer Health Center, Bluefield, WV 2/14/2017 Rainelle Medical Ctr, Rainelle, WV 2/15/2017Jarrell Family Medicine, Ceredo, WV 2/16/2017Roane General Hosp., Spencer, WV 2/17/2017Bluestone Health Center, Princeton, WV 2/21/2017Camden Family Health Craigsville, WV 2/22/2017Three Rivers Family Pract., Kermit, WV 2/23/2017Madison Medical, Madison, WV 3/1/2017Camden Family Health Cowen, WV 3/2/2017Monroe Health/Union, WV 3/7/2017Seneca Health Services/Summersville, WV 3/9/2017Hinton Health Right/Hinton, WV 3/15/2017Greenbrier Clinic/White Sulphur Springs, WV 3/16/2017Gilbert Health/Gilbert, WV 3/23/2017Mercer Co. Health Dept, Bluefield, WV 3/28/2017Tug River Health/Gary, WV 3/30/2017Welch Family Care, Welch, WV 4/13/2017Clay County Health Dept/Clay, WV 4/17/2017Nicholas County Health Dept/Summersville, WV 5/1/2017Mingo County Health Dept/Pt. Pleasant, WV 5/23/2017ARH Tug Valley Medical Assoc., Gary, WV 6/9/2017Mercer County Health Dept, Bluefield, WV 6/13/2017Cabell Huntington Family Med.Ctr, Kenova, WV 6/30/2017Summit Orthopedics, S. Charleston, WV 7/12/2017

(b) (6)


initials

MER Visits

Moses Family Medicine, Huntington, WV 7/18/2017Boone Memorial Hosp/Madison, WV 8/6/2017Raleigh General Hospital/Beckley, WV 8/24/2017Cabell Huntington Hospital, Huntington, WV 7/31/2017Prestera Center / Wayne, WV 8/22/2017Pikeville Medical Center, Pikeville, Ky 8/25/2017King's Daughters Hospital, Ashland, Ky 8/30/2017Rainelle Med. Ctr., Rainelle, WV 9/6/2017Summersville Reg. Hospital/summersville, WV 9/6/2017Raleigh County Health Dept. Beckley, WV 9/7/2017Prestera Center / Winfield, WV 9/8/2017Pleasant Valley Internist, Pt. Pleasant, WV 9/13/2017Little Beaver Family Clinic, Beaver, WV 9/14/2017Mercer Co. Health Dept, Bluefield, WV 9/15/2017Prestera Huntington, WV 9/15/2017Boone County Health Dept, Madison, WV 8/29/2017Greenbrier Valley Hosp. Roncerverte, WV 9/19/2017Eden Family Practice, Kermit, WV 9/19/2017Ohio Valley Physician, Gallipolis, OH 9/20/2017Summersville Family Med. Summersville, WV 9/21/2017Dr. Santamaria, Logan, WV 9/26/2017Gilbert Health , Gilbert, WV 9/27/2017CLARKSBURG CLARKSBURG CLARKSBURGWVU (Ruby) Morgantown, WV 12/29/2016Mon Gen. Hosp. Morgantown, WV 10/3/2016 (b) (6)

(b) (6)


initials

MER Visits

Love Mem. Clinic Moorefield, WV 12/7/2016St. Joseph's Hospital, Buckhanon, WV 12/29/2016Broaddus Hosp., Phillippi 12/29/2016Berkeley Med. Ctr, Martinsburg, WV 11/30/2016Shenandoah Med. Serv. Martinsburg, WV 11/30/2016Davis Med. Ctr, Elkins, WV 11/3/2016Potomic Valley Hosp., Keyser, WV 10/14/2016Myers Clinic, Phillippi 12/29/2016Hampshire Mem. Hosp, Romney, WV 11/23/2016War Mem Hosp, Berkley Springs, WV 12/6/2016Preston Mem. Hosp, Kingwood, WV 12/13/2016Ohio Valley Med. Ctr., Wheeling, WV 10/6/2016Change Inc., Weirton, WV 10/22/2016Trinity Health System, Steubenville, Oh 12/8/2016Reynolds Mem. Hosp, Glen Dale, WV 12/10/2016Weirton Med. Ctr, Weirton, WV 12/21/2016Pocahontas Mem. Hosp., Buckeye, WV 10/27/2016Pendleton Comm. Care, Franklin, WV 12/12/2016Grant Mem. Hosp. Petersburg, WV 11/2/2016WVU Ruby, Morgantown, WV 1/11/2017Myers Clinic & AB Hospital , Phillipi, WV 2/21/2017Grant Mem. Hosp., Petersburg, WV 2/28/2017Pendleton Community Care, Franklin, WV 3/22/2017St. Josephs Hospital, Buckhannon, WV 2/1/2017Davis Med. Ctr., Elkins, WV 2/3/2017

(b) (6)


initials

MER Visits

Potomic Valley Hosp, Keyser, WV 1/30/2017Jefferson Med. Ctr., Ranson, WV 1/19/2017War Memorial Hosp., Berkeley Springs 3/16/2017Preston Mem. Hosp., Kingwood, WV 2/13/2017Grafton City Hosp., Grafton, WV 3/4/2017Shenandoah Mem., Martinsburg, WV 1/21/2017East Ohio Reg. Hosp., Martins Ferry, Ohio 1/5/2017Wheeling Hosp., Wheeling, WV 2/6/2017Stonewall Jackson Mem. Hosp., Weston, WV 1/15/2017Change, Inc., Weirton, WV 1/19/2017Wood Health Clinic, Moundsville, WV 2/16/2017BCH Fox Run Hospital, St. Clairsville, Ohio 1/28/2017Minnie Hamilton Health Ctr., Grantsville, WV 2/4/2017Coplin Med. Ctr, Elizabeth, WV 2/8/2017Wheeling Health Right, Wheeling, WV 2/12/2017Wetzel Co. Hosp., New Martinsville, WV 2/2/2017Family Medical Care, Weirton, WV 2/18/2017Camden Clark Medical Ctr, Parkersburg, WV 3/1/2017Ohio Valley Med. Ctr., Wheeling, WV 3/1/2017Wirt Co. Health Services, Elizabeth, WV 3/8/2017Weirton Med. Ctr., Weirton, WV 2/17/2017Stonewall Jackson Mem. Hosp., Weston, WV 3/10/2017River Valley Health, Ravenswood, WV 3/22/2017John Manchin Sr. Health Care Ctr, Fairmont, WV 3/29/2017Sistersville Gen. Hosp, Sistersville, WV 3/6/2017

(b) (6)


initials

MER Visits

Healthways, Weirton, WV 3/8/2017PARS Neurosurgical Assoc., Parkersburg, WV 2/22/2017Tri County Health, French Creek, WV 1/4/2017Webster Co. Mem. Hosp/Webster Springs, WV 1/19/2017Garrett Mem. Hosp., Oakland, MD 2/16/2017WVU Ruby, Morgantown, WV 4/4/2017Camden on Gauley, Camden on Gauley, WV 4/12/2017Grant Mem. Hosp, Petersburg, WV 5/1/2017Pocahontas Co. Health Marlinton, WV 4/25/2017War Memorial Hosp., Berkeley Springs 5/26/2017Davis Med Ctr, Elkins, WV 5/16/2017Potomic Valley Hosp, Keyser, WV 4/28/2017Jefferson Med. Ctr, Ranson, WV 5/22/2017Monongalia Gen. Hosp, Morgantown, WV 5/1/2017Preston Co. Health , Kingwood, WV 4/26/2017Berkeley Med. Ctr. Martinsburg, WV 4/14/2017Shenandoah Mem., Martinsburg, WV 4/14/2017Cardinal Ped's Morgantown, WV 5/1/2017Weirton Med. Ctr., Weirton, WV 6/7/2017Fairmont Reg. Med. Ctr. Fairmont, WV 4/13/2017Manchin Clinic South, Fairmont, WV 4/18/2017Wood Health Clinic, Moundsville, WV 4/20/2017Sistersville Gen. Hosp, Sistersville, WV 4/25/2017East Liverpool City Hosp, East Liverpool, Oh 5/2/2017Brown Family Practice, Wheeling, WV 6/16/2017

(b) (6)


initials

MER Visits

Healthways, Weirton, WV 5/16/2017Robert Sams, MD (Worthington CTR) Parkersbur 5/11/2017Reynolds Mem. Hosp, Glen Dale, WV 4/17/2017Ohio Valley Med. Ctr., Wheeling, WV 5/25/2017Wheeling Hosp., Wheeling, WV 6/1/2017Fairmont Reg. Med. Ctr, Fairmont, WV 6/8/2017Wheeling Health Right, Wheeling, WV 6/17/2017Braxton Mem. Hosp., Gassaway, WV 6/5/2017Stonewall Jackson Mem. Hosp., Weston, WV 6/9/2017East Ohio Reg. Hosp, Martins Ferry, Ohio 6/12/2017Coplin Med. Ctr, Elizabeth, WV 6/14/2017Minnie Hamilton Health Ctr., Grantsville, WV 6/21/2017PARS Neurosurgical Assoc., Parkersburg, WV 6/26/2017United Hosp. Ctr. Bridgeport, WV 6/22/2017Ritchie Co. Primary Care Assoc, Harrisville, WV 4/26/2017Grant Co. Health Dept Petersburg, WV 5/10/2017Tri County Health, French Creek, WV 5/18/2017Morgan Co. Health, Berkeley Springs, WV 5/26/2017Webster Co. Mem. Hosp/Webster Springs, WV 5/30/2017Pocahontas Mem. Hosp Buckeye, WV 6/9/2017Pendelton Community Care Franklin, WV 6/13/2017Myers Clinic & Broaddus Hospital , Phillipi, WV 6/15/2017Preston Mem. Hosp., Kingwood, WV 6/19/2017Petersburg Med. Group, Petersburg, WV 6/19/2017WVU Ruby, Morgantown, WV 7/24/2017

(b) (6)


initials

MER Visits

Hedgesville, Health Care Hedgesville, WV 8/21/2017Grant Mem. Hosp. Petersburg, WV 7/28/2017Pendeleton Com. Care. Franklin, WV 8/15/2017War Memorial Hosp., Berkeley Springs 8/11/2017Davis Med. Ctr., Elkins, WV 8/3/2017Potomic Valley Hosp, Keyser, WV 7/20/2017Grant Co. Health Dept Petersburg, WV 8/18/2017Pocahontas Mem. Hosp Buckeye, WV 7/18/2017Preston Mem. Hosp., Kingwood, WV 7/25/2017Berkeley Med. Ctr. Martinsburg, WV 7/10/2017Monongalia Gen. Hosp, Morgantown, WV 8/17/2017Camden Clark Medical Ctr, Parkersburg, WV 7/14/2017Weirton Med. Ctr, Weirton, WV 7/26/2017Minnie Hamilton Health Care Ctr. Grantsville, WV 7/26/2017Ohio Valley Med. Ctr. Wheeling, WV 7/17/2017Braxton Mem. Hosp., Gassaway, WV 8/25/2017Mid-Ohio Valley Med. Group Parkersburg, WV 8/29/2017Trinity Health System, Steubenville, Ohio 7/21/2017John Manchin Sr. Health Care Ctr, Fairmont, WV 9/16/2017Wheeling Hosp., Wheeling, WV 8/1/2017Stephen Alatis, DO Weirton, WV 9/6/2017BCH Fox Run Hospital, St. Clairsville, Ohio 9/19/2017Wood Health Care Clinic, Moundsville, WV 9/21/2017Fairmont Reg. Med. Ctr., Fairmont, WV 9/1/2017PARS Neurosurgical Assoc., Parkersburg, WV 8/23/2017

(b) (6)


initials

MER Visits

Change, Inc., Weirton, WV 8/25/2017Coplin Med. Ctr, Elizabeth, WV 8/30/2017Stonewall Jackson Mem. Hosp., Weston, WV 7/13/2017Sistersville Gen. Hosp, Sistersville, WV 7/19/2017Northwood Health System, Wheeling, WV 7/28/2017Preston Co. Health , Kingwood, WV 8/29/2017Randolph Co. Health Dept., Elkins, WV 9/6/2017Shenandoah Valley Med. Sys, Martinsburg, WV 9/11/2017Petersburg Med. Group, Petersburg, WV 9/14/2017Garrett Mem. Hosp., Oakland, MD 9/25/2017Mountaintop Health Ctr. , Thomas, WV 9/29/2017

(b) (6)

PsychologistLicense Number Expired Date

DisciplinaryAction

Last review date by DDS

SAM CheckDate of last oversite

visit Company NameRobert Bayuk Ed.D 6/30/2018 none 9/15/2017 No Exclusion none to date selfTimothy Blaney Ph.D 6/30/2018 none 9/15/2017 No Exclusion 2/26/2015 Summit Psychological ServicesMichael Enright Ph.D 6/30/2018 none 9/15/2017 No Exclusion 6/4/2015 selfMark Gibson Ph.D 6/30/2018 none 9/15/2017 No Exclusion 9/15/2015 Southwest Counseling ServicesTheo Riley Ph.D 6/30/2018 none 9/15/2017 No Exclusion 10/9/2016 selfRichard Norton Ph.D 6/30/2018 none 9/15/2017 No Exclusion 9/20/2015 selfMary Jo Jeffres Ph.D 6/30/2018 none 9/15/2017 No Exclusion 8/15/2014 selfJames Wyssmann Ph.D 6/30/2018 none 9/15/2017 No Exclusion 4/6/2016 selfEric Silk Ph.D 6/30/2018 none 9/15/2017 No Exclusion 10/9/2016 self

Pamela Fuller Ph.D 6/30/2018 none 9/15/2017 No Exclusion 8/5/2015 Frontier Psychological Associates

Cora Klotzbach Ph.D 6/30/2018 none 9/15/2017 No Exclusion 8/5/2015 Frontier Psychological Assocaites

Denise Debarre Ph.D 6/30/2018 none 9/15/2017 No Exclusion 8/5/2015 Frontier Psychological Assocaities

Julie Jett Ph.D 6/30/2018 none 9/15/2017 No Exclusion 8/5/2015 Frontier Psychological Assocaities

Melissa Jenkins Ph.D 6/30/2018 none 9/15/2017 No Exclusion 8/8/2016 Park Ridge Behavioral health careKenneth Bell Ph.D 6/30/2018 none 9/15/2017 No Exclusion 8/8/2016 Park Ridge Behavioral HealthMark Watt Ph.D 6/30/2018 none 9/15/2017 No Exclusion 8/8/2016 Snowy Range Consulting Steven Newman Ph.D 6/30/2018 none 9/15/2017 No Exclusion 4/11/2017 selfGrant Fleming Ph.D 6/30/2018 none 9/15/2017 No Exclusion 2/3/2017 Fleming Associates

Charles Powell Ph.D 6/30/2018 none 9/15/2017 No Exclusion 8/8/2016 Park Ridge Behavioral Healthcare

Cheryl Wise Ph.D 6/30/2018 none 9/15/2017 No Exclusion 6/11/2015 Fremont Counseling Center(Lander)Brent Andersen Ph.D 6/30/2018 none 9/15/2017 No Exclusion 6/3/2015 own (Rock Springs)

Matthew Hutt Ph.D12/19/2017 none 9/15/2017 No Exclusion none to date own (Scottsbluff) keeps working

with temporary license in wyoming.

Wayne Reynolds Ph.D 6/30/2018 none 9/15/2017 No Exclusion none to date Cloud Peak Counseling (Worland)Mark Holland Ph.D 6/30/2018 none 9/15/2017 No exclusion 1/1/2016 Park Ridge Behavioral healthAmanda Turlington Ph.D 6/30/2018 none 9/15/2017 No exclusion 10/3/2016 Minda Spa/ OwnLynn Heeren Ph.D 6/30/2018 none 9/15/2017 No exclusion none to date Own

Barbara St. Clair Ph.D 6/30/2018 none 9/15/2017 No Exclusion none to dateNow on own under Meadowlark(Gillette)

Carol Pastore-Watkins Ph.D 6/30/2018 none 9/15/2017 No Exclusion none to date own practice

Psychiatrist:License Number Expired Date

DisciplinaryAction

Review Date DDS SAM CheckDate of last oversite

visit Company Name

Wyoming FY 2017

(b) (6)

Frank Wheeler MD (not using) 6/30/2017 none 9/30/2016 No Exclusion 8/20/2013 Lander Valley Physicains

ConsultantsLicense Number Expired Date

Disciplinary Action


visit Company NameGrant Fleming Ph.D 6/30/2018 none 9/15/2017 No Exclusion see above Fleming AssociatesSteven Newman Ph.D 6/30/2018 none 9/15/2017 No Exclusion see above selfGrey Rich Ph.D 6/30/2018 none 9/15/2017 No Exclusion consultant only selfSheri Fluellen Ph.D 6/30/2018 none 9/15/2017 No Exclusion consultant only Mind Spa

Not using for ces/ consultingLicense Number Expired Date

Disciplinary Action


visit Company NameNohl Sandall Ph.D (not using) 6/30/2017 none 9/30/2016 No Exclusion unknown selfDean Schroeder Ed.D (retired) did ce/consult. 6/30/2017 none 9/30/2016 No Exclusion unknown selfScott Wylie Ph.D (not using) did ces/ consult. 6/30/2017 Yes-see File 9/30/2016 No Exclusion unknown Medical Psychology Associates

Stuart Krause Ph.D (not using) 6/30/2013 none 9/30/2016 No Exclusion unknown Frontier Psychological Associates

Anton Ornette Tolman Ph.D (retired) 6/3/2001 none 9/30/2016 No Exclusion unknown Frontier Psychological Assocaites

Susan Fisher-Johnston Ph.D (not using) 6/30/2017 none 9/30/2016 No Exclusion unknownLeft Wellness Centers 7/11/13, in CO

Angela Ehrlick Ph.D (no longer using) 6/30/2014 none 9/30/2016 No Exclusion 8/15/2012 Rocky Mountain Behavioral HealthJamie Brass Ph.D (not using) 7/26/2013 none 9/30/2016 No Exclusion 8/22/2012 Left southwest co 9/1/12, in UT

Marc McLaughlin Ph.D (not using) 6/30/2017 none 9/30/2016 No Exclusion 8/21/2012was under Fremont Counseling/ on own

Laura McKee Ph.D (withdrew as ce pro.) 6/30/2017 none 9/30/2016 No Exclusion none

Christine Winter Ph.D(moved out of state) 6/30/2017 none 9/30/2016 No Exclusion unknown self

Geoffrey Sherman Ph.D (too busy) 6/30/2017 none 9/30/2016 No Exclusion 5/2/2014 Abintra Psychological Associates

Brook England Ph.D (did not work out) 6/20/2016 none 9/30/2016 No Exclusion 2/27/2015 selfJerry Post Ph.D (not using) did ces/ consult. 6/30/2017 none 9/30/2016 No Exclusion none to date was a partner with WylieDina Tassione Ph.D (not using) 6/30/2017 none 9/30/2016 No Exclusion none to date Tassione Psychological ServicesAlison Ohashi Ph.D did ces/ consult. 6/30/2017 none 9/30/2016 No Exclusion 5/26/2015 selfGerald Manwill Ph.D (not using) 6/30/2017 none 9/30/2016 No Exclusion none to date selfJoshua Popkin Ph.D (not using) 6/30/2017 none 9/30/2016 No Exclusion 2/1/2016 OwnMargaret Hocheiser Ph.d did not want to do ces 6/30/2017 none 9/30/2016 No Exclusion none Own

(b) (6)

(b) (6)

(b) (6)

Wendy Gersing Ph.d did not want to do ces 6/30/2017 none 9/30/2016 No Exclusion none Comfort CareNicolas Prat Ph.D 6/30/2017 none 9/30/2016 No Exclusion 6/17/2013 self

(b) (6)

ProviderLicense Number

Expired DateDisciplinary

Action Last review date by DDS SAM check

Date of last oversite visit

Company Name

Physician (Using)

Richard Jay MD6/30/2018 none

9/15/2017 No Exclusion 10/9/2016North Big Horn Hospital

Jonathon Medina MD

6/30/2018 none9/15/2017 No Exclusion 4/16/2017

Cheyenne Family Medicine

Terry R Donaldson MD


Donaldson Medical Clinic

Michael Jording MD

6/30/2018 none9/15/2017 No Exclusion none

Cedar Hills Family Clinic (Newcastle)

Lucase Wang MD

6/30/2018 none9/15/2017 No Exclusion 7/14/2017 self

Ann MacGuire MD

6/30/2018 none9/15/2017 No Exclusion 8/13/2013 Self

Ralph Heckard MD

6/30/2018 none9/15/2017 No Exclusion 1/10/2017 self

Kirtikumar Patel MD


Gillette Internal Medicine

Thomas Simon MD

6/30/2018 none

9/15/2017 No Exclusion 8/5/2015

Evanston Internal medical Association

(b) (6)

Scott Johnston MD


Occuapational Med Of NE WY (Gillette)

Michele Bennett MD


Michele Bennett PC (Sheridan)

Peter Crane MD

6/30/2018 none9/15/2017 No Exclusion none self

Howard Willis DO

6/30/2018 none9/15/2017 No Exclusion 12/22/2017 Cedars Health

Gwen Libby MD6/30/2018 none

9/15/2017 No Exclusion 9/15/2016Lander Valley Clinic

Wilson Bernales MD

6/30/2018 none9/15/2017 No Exclusion none Cedars Health

Elizabeth Hills DO

6/30/2018 none9/15/2017 No Exclusion none Cedars Health

Timothy Maly MD

6/30/20189/15/2017 No Exclusion 6/15/2017 Cedars Health

Physician Assistances

License Number


Action Review Date SAM checkDate of last

oversite visitCompany Name

Bailey Snyder PA-C


Evanston Internal Medicine

Kenneth Sickel PA-C

12/31/20179/15/2017 No Exclusion none Cedars

Nurse Practitioner

License Number




Diane Wrenn NP

12/31/2018 none9/15/2017 No exclusion 12/22/2016 Cedars Health

(b) (6)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

Rhonda McLaughlin NP

12/31/2018 none9/15/2017 No exclusion 12/22/2016 Cedars Health

ConsultantsLicense Number




Robert Kanard MD (Consultant)

6/30/2018 none9/15/2017 No Exclusion # Consultant

Michael Herber MD (Consultant)


Darryl Bindschadler MD (Consultant)

6/30/2018 none

9/15/2017 No Exclusion # ConsultantRodney Anderson MD (Consultant) not using

6/30/2017 none

9/15/2017 No Exclusion # ConsultantHarmon H Davis (Consultant)


Thomas Toft MD (Consultant) not using

6/30/2018 none

9/15/2017 No Exclusion # Consultant

Philp Sharp MD (Consultant)


(b) (6)

(b) (6)

Gene Halpren (Consultant)


Physicians/PA/NP (Not using)

License Number


Action Review Date SAM check


Company Name

William Williams MD (no longer using)

6/30/2015 none

10/1/2016 No Exclusion 8/15/2012

Sheridan Internal Medicine

Adolfo G Bagnarello MD (no longer using)

6/30/2015 none

10/1/2016 No Exclusion none self

Edward Wilson DO (no longer using)

6/30/2015

10/1/2016 No Exclusion 8/14/2012

Coffeen clinic/ Wilson Family Practice

Nicole Caldwell MD (no longer using)

6/30/2017 none

10/1/2016 No Exclusion noneDisability Docs Inc

David Cesko MD (no longer using)

6/30/201710/1/2016 No Exclusion none

Cesko Family Medicine

Richard Sorenson MD (no longer using)

6/30/2017 none

10/1/2016 No Exclusion 8/21/2012Work Wise (Riverton)

(b) (6)

(b) (6)

(b) (6)

(b) (6)

Karel D Capek MD (no longer using)


Midtown Medical Group

Joel Pull MD (No longer using)

6/30/2017 10/1/2016 No Exclusion noneGreybull Family Clinic

Marvin W Couch II MD (no longer using)

6/30/2017

10/1/2016 No Exclusion noneRawlins Family Medical

Michael Swenson MD (not using)


Lander Medical Clinic

Carlton Huitt MD (not using)

6/30/2014 none10/1/2016 No Exclusion none self

Louis Roussalis MD (no longer using)

6/30/2017 none

10/1/2016 No Exclusion none selfKaci Gallo MD (busy)



Amy Kenworthy MD (lost office location)

6/30/2017 none

10/1/2016 No Exclusion 8/20/2012 self

Ardella Kemmler MD (retired)

6/30/2017 none

10/1/2016 No Exclusion 8/22/2012

Evanston Internal medical Association

(b) (6)

(b) (6)

Tracy Potter (AKA Jackson) PA-C


Rock Springs Family Practice

*stop using due to customer service

# #

# # # #Trisha DeClue FNP



Shirley Schatza NP



Melinda Poyer MD


Rock Springs Family Practice

*stop using due to customer service

# #

# # # #

Demar Hill MD6/30/2016 none

10/1/2016 No Exclusion noneMidway Clinic (Basin)

Kristina Behringer MD


Grasslands Medicine (Cheyenne)

David Wheeler MD

6/30/2017 none

10/1/2016 No Exclusion none

WY Neurological Associates (Casper)

Mark Schueler MD

6/30/2017 none

10/1/2016 No Exclusion 8/14/2012

Family Medical Center Of Johnson Co

(b) (6)

David Kappenman MD

6/30/2017 none


Pinedale Clinic/ Sublette Co Rural Health

Kent M Kleppinger MD


Laramie Pediatrics

Cathy Wilson NP (left cedars health)


Teresa Cady NP12/31/2016

10/1/2016 No exclusion none Cedars health

Lori Turner NP

12/31/2018 none

10/1/2016 No exclusion none

Red Desert InstaCare (Rock Springs)

Jennifer Oiler NP

12/31/2018 none

10/1/2016 No exclusion none

Plattle Valley Medical Center (Saratoga)

Mary Freund NP

12/31/2016 none10/1/2016 No exclusion none

North Big Horn Hospital

Kenneth Ferbrache PA-C



Edwin Sheils PA-C


Plattle Valley Medical Clinic (Saratoga)

(b) (6)

(b) (6)

(b) (6)

Richard Anderson PA-C

12/31/2016 none



Jonathan Said PA-C

12/31/2016 none



Brendan Fitzsimmons MD



Troy Caldwell MD



Radu Segal MD

6/30/2017 none

10/1/2016 No Exclusion 6/11/2013

North Cheyenne Family Medicine

James Naramore MD


Family Medicine of Gillette

Bille Wilkerson MD


Family Health(Gillette)

Darcy Turner MD


Red Desert Instacare(Rock Springs)

Dean Bartholomew MD

6/30/2017 none


Plattle Valley Medical Clinic(Saratoga)

(b) (6)

Angelo Santiago MD


Central Wy Neurology (Casper)

Denise Tuttle MD


(b) (6)



Action Last review date by

DDSSAM check


Company Name

Optometry

Kirby Treat OD 4/1/2018 none 9/5/2017 No exclusion none Clear Image Vision Care

William Atkinson OD 4/1/2018 none 9/5/2017 No exclusion none self

Wayne Hudson OD 4/1/2018 none 9/5/2017 No exclusion none self

Gary Poteet OD 4/1/2018 none 9/5/2017 No exclusion none Snowy Range Vision Center

Susan Lowe OD 4/1/2018 none 9/5/2017 No exclusion none Snowy Range Vision Center

James A Boucher OD 4/1/2018 none 9/5/2017 No exclusion none Snowy Range Vision Center

Amy Aldrich OD 4/1/2018 none 9/5/2017 No exclusion none Snowy Range Vision Center

Todd Sholey OD 4/1/2018 none 9/5/2017 No exclusion none Family Vision Clinic (Rock Springs)

Richard Canestrini OD 4/1/2018 none 9/5/2017 no exclusion none Family Vision Clinic (Rock Springs)

Helen D Kim OD 4/1/2018 none 9/5/2017 No exclusion none Family Vision Clinic (Rock Springs)

James Hinkle OD 4/1/2018 none 9/5/2017 No exclusion none Riverton Vision Center

Brian Ballard OD 4/1/2018 none 9/5/2017 No exclusion none Riverton Vision Center

Christopher Frazier OD 4/1/2018 none 9/5/2017 No exclusion none Riverton vision Center

Jill Miller OD 4/1/2018 none 9/5/2017 No exclusion none Sheridan Eyecare Center

Samuel Hoffmann OD 4/1/2018 none 9/5/2017 No exclusion none Sheridan Eyecare Center

Timothy Fehlauer OD 4/1/2018 none 9/5/2017 No exclusion none Sheridan Eyecare Center

Joseph C Maycock OD 4/1/2018 none 9/5/2017 No exclusion none Gillette Optometric Clinic

Roger L Jordan OD 4/1/2018 none 9/5/2017 No exclusion none Gillette Optometric Clinic

Robert Mills OD 4/1/2018 none 9/5/2017 No exclusion none Gillette Optometric Clinic

(b) (6)

Joseph L Fischer OD 4/1/2018 none 9/5/2017 No exclusion none Gillette Optometric Clinic

Melissa Younger OD 4/1/2018 none 9/5/2017 No exclusion none Gillette Optometric Clinic

Ashlee M Mills-Fischer OD 4/1/2018 none 9/5/2017 No exclusion none Gillette Optometric Clinic

Devin Davis OD 4/1/2018 none 9/5/2017 No exclusion none Split Rock Vision Clinic (Wheatland)

Daniel Perala OD 4/1/2018 none 9/5/2017 No exclusion none New Concept Optical (Cheyenne)

Michelle Chaney OD 3/31/2018 none 9/5/2017 No exclusion none Eye Center Of Northern Colo

Nathan Rains OD 3/31/2018 none 9/5/2017 No exclusion none Eye Center Of Northern Colo

Natalie Santelli OD 3/31/2018 none 9/5/2017 No exclusion none Eye Center Of Northern Colo

Benjamin Marske OD 3/31/2018 none 9/5/2017 No exclusion none Eye Center Of Northern Colo

Marcelo Saldivia OD 3/31/2018 none 9/16/2016 No exclusion none Eye Center Of Northern Colo

Benjamin Kister OD 4/1/2018 none 9/5/2017 No exclusion none Kister Eyecare (Riverton)

Kristopher Hubbard OD 4/1/2018 none 9/5/2017 No exclusion none Cheyenne Eye Clinic

James Bell OD 4/1/2018 none 9/5/2017 No exclusion none Basin Vsion Center-Cody

Jonathan Hartley OD 4/1/2018 none 9/5/2017 No exclusion none Basin Vsion Center-Cody

OpthamologyLicense Number


Action Last review Date DDS SAM check


Company Name

Ronald Gibson MD 6/30/2018 none 9/5/2017 No exclusion 8/13/2013 Central Wyoming Eye Clinic

William Ramsay MD 6/30/2018 9/5/2017 No exclusion none Teton Eye Clinic

Gary Foster MD 6/30/2018 none 9/5/2017 No exclusion none Snowy Range Vision Center

Anne Miller MD 6/30/2018 none 9/5/2017 No exclusion none Cheyenne Eye Clinic

Kyle Piwonka MD 6/30/2018 none 9/5/2017 No exclusion none Cheyenne Eye Clinic

(b) (6)

(b) (6)(b) (6)

Zachary D Pearce DO 6/30/2018 none 9/5/2017 No exclusion none Cheyenne Eye Clinic

James Cole MD 6/30/2018 none 9/5/2017 No exclusion none Cheyenne Eye clinic

Chet Reistad MD 4/30/2018 none 9/5/2017 No exclusion none Eye Center Of Northern Colo

Randall W Smith MD 4/30/2018 none 9/5/2017 No exclusion none Eye Center Of Northern Colo

William A Shachtman MD 4/30/2018 none 9/5/2017 No exclusion none Eye Center Of Northern Colo

Arthur Korotkin MD 4/30/2018 none 9/5/2017 No exclusion none Eye Center Of Northern Colo

Kent Crews MD 4/30/2018 none 9/5/2017 No exclusion none Eye Center Of Northern Colo

Patrick Arnold MD 4/30/2018 none 9/5/2017 No exclusion none Eye Center Of Northern Colo

Kent Bashford MD 4/30/2018 none 9/5/2017 No exclusion none Eye Center Of Northern Colo

Mattew Robinson MD 4/30/2018 none 9/5/2017 No exclusion none Eye Center Of Northern Colo

Josh Apple MD 4/30/2018 none 9/5/2017 No exclusion none Eye Center Of Northern Colo

Jason Mayer MD 4/30/2018 none 9/5/2017 No exclusion none Eye Center of Northern Colo

Adam McLaughlin MD 4/30/2018 none 9/5/2017 No exclusion none Eye Center of Northern Colo

Karl Olsen MD 4/30/2018 9/5/2017 No exclusion none Eye Center of Northern Colo

Judson C Martin MD 10/1/2018 none 9/5/2017 No exclusion none Oregon Trial Eye Center

Thomas J Roussel MD 10/1/2018 none 9/5/2017 No exclusion none Oregon Trial Eye Center

Shawna R Collier MD 10/1/2018 none 9/5/2017 No exclusion none Oregon Trial Eye Center

J Geoffrey Slingsby MD 3/1/2018 none 9/5/2017 No exclusion none Slingsby Eye Care (Rapid City)

Kim Taylor MD 1/31/2018 none 9/5/2017 No exclusion none Moran eye center (Salt Lake City)

Not using any longer

David Halsey OD 4/1/2018 none 9/5/2017 No exclusion none Split Rock Vision Clinic (Wheatland)

(b) (6)

(b) (6)

Provider License Number Expired DateDisciplinary

Action Last review date

by DDSSAM check

Date of last oversite visit Company Name

Michael Alley AuD 12/31/2017

none 9/15/2017 No exclusion none High country Audiology (Rock Springs/Lander)

Jan Pierson AuD 12/31/2017none 9/15/2017 No exclusion none Audiology Center

INC (Cheyenne)Thomas Laya AuD 12/31/2017 none 9/15/2017 No exclusion none

Wyo Audiology & Hearing

Ben Koperski AuD 12/31/2017

none 9/15/2017 No exclusion noneBig Horn Basin Hearing INC (Cody)

Susan Roller AuD 12/31/2017 none 9/15/2017 No exclusion noneSheridan Ear Nose & Throat

Cheryl Drost AuD 12/31/2017none 9/15/2017 No exclusion none

Wyoming Otolaryngology PC

Tracy Hayden AuD 2/1/2017

none 9/15/2017 No exclusion noneRehder Balance & Hearing Clinic (Billings)

Crystal Dvorak AuD 2/1/2017

none 9/15/2017 No exclusion noneRehder Balance & Hearing Clinic (Billings)

Douglas Rehder AuD 2/1/2017

none 9/15/2017 No exclusion none Rehder Hearing Clinic(Billing, MT)

Lauren Gunn AuD 3/31/2018

none 9/15/2017 No exclusion none Harvard Park Hearing (Denver)

(b) (6)

Meghan Safko Aud 3/31/2018


Casey Amann AuD 3/31/2018


Elissa Jodon Aud 3/31/2018none 9/15/2017 No exclusion none Harvard Park

Hearing (Denver)

Kerr McDill AuD 12/31/2017none 9/15/2017 No exclusion none

Mountian View Audiology (Casper)

Norman Sorensen Aud 6/1/2017

none 9/15/2017 No exclusion noneMountain Plains Audiology (Rapid city, SD)

Rosanne Prince AuD 12/31/2017

none 9/15/2017 No exclusion none

St. John's Audiology & Hearing Aids (Jackson)

No longer using

Stephen Harward AuD 5/31/2017

none 9/15/2016 No exclusion noneOgden Audiology Services(Ogden UT)

*also in Wy 12/31/2016

none 9/15/2016 No exclusion noneOgden Audiology Services(Ogden UT)

*never got ces back # # # # # #

(b) (6)

(b) (6)

Brandi Crockett AuD 12/31/2016

none 9/15/2016 No exclusion noneSweetwater Audiology/ Ogden Audiology

*same as Harward # # # # # #

Brant Christensen AuD 12/31/2016

none 9/15/2016 No exclusion none Brant Audiology LLC (Cheyenne)

*never got ces back # # # # # #

Ruby Zubrod AuD 12/31/2016none 9/15/2016 No exclusion None Brant Audiology

LLC (Cheyenne)

*see Christensen # # # # # #Samantha Wagner Yung AuD 12/31/2017 none 9/15/2016 No exclusion none

Brant Audiology LLC (Cheyenne)

*see Christensen # # # # # #

Amy Weaver AuD 12/31/2016

none 9/15/2016 No exclusion noneUW-Div of Communication Disorders

* no using at this point # # # # # #

Theresa Garcia AuD 12/31/2016

none 9/15/2016 No exclusion noneUW-Div of Communication Disorders

* no using at this point # # # # # #

(b) (6)

Provider License Number Expired DateDisciplinary

Action Last review date by

DDS SAM checkDate of last oversite

visitCompany Name

Haley Perl SLP (casper) 12/31/2018 none 9/11/2017No

Exclusion none works for Shriver Therapy Group

Carla Shriver SLP (Casper) 12/31/2017 none 9/11/2017No

Exclusion unknown The Shriver Therapy Group

Rebecca Crane SLP (riverton) 12/31/2017 none 9/11/2017No

Exclusion unknown Own company/ St.Stephen'S schoolDori Samson SLP (Consult/ CE Provider) 12/31/2017 none 9/11/2017

No Exclusion unknown Own company/ School Dist

No longer usingMargaret Gerrish/ Margaret Williams SLP

Lapsed 12/31/2008 none 9/15/2016

No Exclusion unknown Sage View Rehab services

Susan Nannenga SLP (was in Cody) 12/31/2016 none 9/15/2016No

Exclusion unknown Progressive Therapy Services (ND)

Anne Baures SLP (Sheridan) 12/31/2016 none 9/15/2016No

Exclusion unknownChild Development cntr/ Sch Dist./ Own

*never answered voice messages

Jane Johnston SLP (Saratoga) 12/31/2016 none 9/15/2016No

Exclusion unknown Local Therapy LLC

(b) (6)



Action Last review date by DDS SAM check


Company Name

Michael Martin MD 6/30/2018 9/11/2017 No Exclusion unknown Doc Martin's Ear Nose & ThroatScott Bateman MD 6/30/2018 none 9/11/2017 No Exclusion unknown Sheridan Ear, Nose, & ThroatJoseph Vigneri MD (retired) 6/30/2018 none 9/11/2017 No Exclusion unknown

Wyoming Otholaryngology

Eugene Podrazik MD 6/30/2018 none 9/11/2017 No Exclusion unknown Wyoming OtholaryngologyDavid (cope) Norcross MD 6/30/2018 none 9/11/2017 No Exclusion unknown

Wyoming Otholaryngology

Colby Butler APRN 12/31/2018 none 9/15/2017 No Exclusion unknown Wyoming Otholaryngology

(b) (6)(b) (6)

Sign Lang. Interpreter's Location Business name SAM checkLast review date by

DDS

Catherine Copeland BillingsCopeland Sign Language No Exclusion 9/15/2017

Gail Schenfisch Casper self No Exclusion 9/15/2017

Spanish Interpreter's Location Business Name SAM checkLast review date by

DDSNohora Groce Casper Self No Exclusion 9/15/2017Ian Caldon Cheyenne Self No Exclusion 9/15/2017Ernest Hastey Cheyenne Self No Exclusion 9/15/2017Alda Banda Gillette Self No Exclusion 9/15/2017Vida Sandez Jackson El Puente No Exclusion 9/15/2017John (Tom)Duncan Riverton Self No Exclusion 9/15/2017Bea Torrez Worland Self No Exclusion 9/15/2017

Hospital (Wyoming only) Location SAM checkLast review date by

DDSJohnston Co healthCare Center Buffalo No Exclusion 9/11/2017Wyoming Medical Center Casper No Exclusion 9/11/2017Cheyenne Regional Medical Center Cheyenne No Exclusion 9/11/2017West Park Hospital Cody No Exclusion 9/11/2017Memorial Hos Of Converse County Douglas No Exclusion 9/11/2017Evanston Regional Hosital Evanston No Exclusion 9/11/2017Wyoming State Hospital (WY Department of Health) Evanston No Exclusion 9/11/2017Campbell Co Memorial Hospital Gillette No Exclusion 9/11/2017South Big Horn County Hospital Greybull/Basin No Exclusion 9/11/2017St. John's Medical Center Jackson No Exclusion 9/11/2017Lander Valley Medical Center (Sagewest Health Care) Lander No Exclusion 9/11/2017Ivinson Memorial Hospital Laramie No Exclusion 9/11/2017North Big Horn Hospital Lovell No Exclusion 9/11/2017Niobrara Health and Life Center Lusk No Exclusion 9/11/2017Weston County Health Services Newcastle No Exclusion 9/11/2017Memorial Hospital of Carbon County Rawlins No Exclusion 9/11/2017Riverton County Hospital(SageWest Health Care) Riverton No Exclusion 9/11/2017

Memorial Hospital of Sweetwater County Rock Springs No Exclusion 9/11/2017Memorial Hospital of Sheridan County Sheridan No Exclusion 9/11/2017Crook County Memorial Hospital Sundance No Exclusion 9/11/2017Hot Springs County Memorial Hospital Thermopolis No Exclusion 9/11/2017

Community Hosptial(Banner Health) Torrington No Exclusion 9/11/2017Platte County Memorial Hospital (Banner Health) Wheatland No Exclusion 9/11/2017Washakie County Memorial Hospital Worland No Exclusion 9/11/2017Powell Valley Healthcare Powell No Exclusion 9/11/2017Star Valley Medical Center Afton No Exclusion 9/11/2017Wyoming Behavioral Institute Casper No Exclusion 9/11/2017Elkhorn Valley Rehab Casper No Exclusion 9/11/2017South Lincoln Medical Center Kemmerer No Exclusion 9/11/2017Aspen Mountain Medical Center Rock Springs No Exclusion 9/11/2017Summit Medical Center Casper No Exclusion 9/11/2017Mountain View Regional Hospital Casper No Exclusion 9/11/2017

ProviderLicense Number Expired Date Disciplinary Action

Last review date by DDS SAM check

Cheyenne Radiology Group David Michael Kellam MD 6/30/2018 none 9/11/2017 No ExlusionJames G Hubbard MD 6/30/2018 none 9/11/2017 No ExlusionJohn Wright MD 6/30/2018 none 9/11/2017 No ExlusionScott Hayden MD 6/30/2018 none 9/11/2017 No ExlusionWilliam D Ketcham MD 6/30/2018 none 9/11/2017 No ExlusionDaniel R Possehn DO 6/30/2018 none 9/11/2017 No ExlusionEric Hoyer MD 6/30/2018 none 9/11/2017 No ExlusionMark Howshar MD 6/30/2018 none 9/11/2017 No Exlusion

BlackRock Imaging Company # none 9/11/2017 No Exlusion* Blackrock uses same Cheyenne Radiologist

Casper Medical Imaging Geoffrey Smith MD 6/30/2018 none 9/11/2017 No ExlusionDaniel Sulser MD 6/30/2018 none 9/11/2017 No ExlusionMichael Sloan MD 6/30/2018 none 9/11/2017 No ExlusionCharles Bowkley MD 6/30/2018 none 9/11/2017 No ExlusionMichael Flaherty MD 6/30/2018 none 9/11/2017 No ExlusionJoseph McGinley MD 6/30/2018 none 9/11/2017 No ExlusionSeth Iverson MD 6/30/2018 none 9/11/2017 No ExlusionFrederick Cubin MD 6/30/2018 none 9/11/2017 No Exlusion

Wyoming Cardiopulmony (no longer using) multiple lic. multiple lic. none 9/11/2017 No Exlusion

(b) (6)

Cheyenne Childrens' Clinic (no longer using) multiple lic. multiple lic. none 9/11/2017 No ExlusionCheyenne IMG (No longer using) multiple lic. multiple lic. none 9/11/2017 No ExlusionAMCE (never worked out) multiple lic. multiple lic. none 9/11/2017 No Exlusion

UWFP Cheyenne (no longer using) multiple lic. multiple lic. none 9/11/2017 No ExlusionJackson Pediatrics multiple lic. multiple lic. none 9/11/2017 No Exlusion

SAM Linkhttps://www.sam.gov/portal/SAM/#1

Wyo Board of Medicinehttp://wyomedboard.wyo.gov/

Wyoming Board of Nursinghttps://nursing-online.state.wy.us/

Wyoming Board of Speech Pathology & Audiologyhttp://speech.wyo.gov/

Wyoming Board of Examiners in Optometryhttp://optometry.wyo.gov/

Wyoming Board of Psychologyhttps://sites.google.com/a/wyo.gov/psychology/public/verification

https://www.sam.gov/portal/SAM/#1

http://wyomedboard.wyo.gov/

https://nursing-online.state.wy.us/

http://speech.wyo.gov/

http://optometry.wyo.gov/

https://sites.google.com/a/wyo.gov/psychology/public/verification

alabama fy 2017 ce panelist name onsite visit · anne harris ph.d. x arizona center for chest...

Documents