INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('841415781', 'W77010737', 'W77010737', 'UT02', 'Parry, Scott A', 'Scott', 'A', 'Parry', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', '1490 E Foremaster Dr Ste 150', 'St George', 'Washington', 'UT', '84790', '4356289393', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1285611475', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841415781', 'W77010738', 'W77010738', 'UT02', 'Parry, Scott A', 'Scott', 'A', 'Parry', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '1490 E Foremaster Dr Ste 150', 'St George', 'Washington', 'UT', '84790', '4356289393', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1285611475', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841423431', 'W77010739', 'W77010739', 'UT02', 'Physical Medicine', 'Max', NULL, 'Root', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'B', '301 N 200 E Ste 2C', 'St George', 'Washington', 'UT', '84770', '4356568800', '4356271809', NULL, NULL, '', NULL, NULL, '', '', 'USTDPHMR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1295725380', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870494537', 'W77010740', 'W77010740', 'UT02', 'Dixie Pediatrics', 'Bryan', 'B', 'Hofheins', 'PA', 'Pediatrics', NULL, NULL, NULL, 'O', '1240 E 100 S Ste 14', 'St George', 'Washington', 'UT', '84790', '4356288232', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDGEIPA', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-07-25', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '835061', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519691', 'W77010741', 'W77010741', 'UT02', 'Utah Cancer Specialists', 'A Jennifer', NULL, 'Fischbach', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'B', '1121 E 3900 S Bldg C Ste 240', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012660878', '8012662074', NULL, NULL, '', NULL, NULL, '', '', 'USTDONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-06-20', '2006-02-28', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1528017456', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870494537', 'W77010742', 'W77010742', 'UT02', 'Dixie Pediatrics', 'Karl', 'T', 'McMullin', 'NP', 'Pediatrics', NULL, NULL, NULL, 'O', '1240 E 100 S Ste 14', 'St George', 'Washington', 'UT', '84790', '4356288232', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDGEIPA', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-07-25', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '835062', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870497512', 'W77010743', 'W77010743', 'UT02', 'Valley View Pediatrics', 'Kourosh', NULL, 'Ghaffari', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '1333 N Main St', 'Cedar City', 'Iron', 'UT', '84720', '4355860077', '4358671831', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833769', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870499792', 'W77010744', 'W77010744', 'UT02', 'Southwest Surgical Associates', 'John', 'T', 'Miller', 'MD', 'General Surgery', NULL, NULL, NULL, 'B', '1490 E Foremaster Dr Ste 200', 'St George', 'Washington', 'UT', '84790', '4356281641', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTGEIPA', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1639279698', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870499792', 'W77010745', 'W77010745', 'UT02', 'Southwest Surgical Associates', 'Gregory', 'L', 'Watson', 'DO', 'General Surgery', NULL, NULL, NULL, 'O', '1490 E Foremaster Dr Ste 200', 'St George', 'Washington', 'UT', '84790', '4356281641', '4356281660', NULL, NULL, '', NULL, NULL, '', '', 'USTGEIPA', NULL, NULL, '0.00', '35.00', NULL, 3, '2004-01-30', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1770676793', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870499792', 'W77010746', 'W77010746', 'UT02', 'Southwest Surgical Associates', 'Bruce', 'C', 'Williams', 'MD', 'General Surgery', NULL, NULL, NULL, 'B', '1490 E Foremaster Dr Ste 200', 'St George', 'Washington', 'UT', '84790', '4356281641', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTGEIPA', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306946231', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870527645', 'W77010747', 'W77010747', 'UT02', 'Color Country Health Express', 'Marjorie', 'K', 'Ence', 'NP', 'Family Practice', NULL, NULL, NULL, 'O', '595 S Bluff St Ste 1', 'St George', 'Washington', 'UT', '84770', '4356749929', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2006-06-08', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '830950', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77010748', 'W77010748', 'UT02', 'Central Utah Clinic', 'Richard', 'T', 'Jackson', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2002-07-01', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1144323163', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870527645', 'W77010749', 'W77010749', 'UT02', 'Color Country Health Express', 'Marjean', NULL, 'Allen', 'NP', 'Family Practice', NULL, NULL, NULL, 'B', '595 S Bluff St', 'St George', 'Washington', 'UT', '84770', '4356749929', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834845', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870532769', 'W77010750', 'W77010750', 'UT02', 'Mcdonald, Kent B', 'Kent', 'B', 'McDonald', 'MD', 'Hospitalist', 'Internal Medicine', NULL, NULL, 'B', '515 S 300 E Ste 105', 'St George', 'Washington', 'UT', '84770', '4356282814', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-08-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1093794554', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870283576', 'W77010751', 'W77010751', 'UT02', 'Excel Eye Center', 'W Scott', NULL, 'Lohner', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', '1735 N State St', 'Provo', 'Utah', 'UT', '84604', '8013757332', '8013740163', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-11-02', '2001-11-02', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992764187', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543318', 'W77010752', 'W77010752', 'UT02', 'Mountain West Gastroenterology', 'James', 'W', 'Bown', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'B', '6360 S 3000 E Ste 300', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019443188', '8019443180', NULL, NULL, '', NULL, NULL, '', '', 'USTDGSTR', 'USTDHCPC', '12180', '0.00', NULL, NULL, 3, '2003-04-01', '2006-05-31', 1, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1629081260', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543318', 'W77010753', 'W77010753', 'UT02', 'Mountain West Gastroenterology', 'Mosaab', 'A', 'Hasan', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'B', '6360 S 3000 E Ste 300', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019443188', '8019443180', NULL, NULL, '', NULL, NULL, '', '', 'USTDGSTR', 'USTDHCPC', '12180', '0.00', NULL, NULL, 3, '2003-04-01', '2006-05-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477566016', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543318', 'W77010754', 'W77010754', 'UT02', 'Mountain West Gastroenterology', 'Lee', 'J', 'Hixson', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '368 E Riverside Dr', 'St George', 'Washington', 'UT', '84790', '4356731149', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDGSTR', 'USTDHCPC', '12180', '0.00', NULL, NULL, 3, '2003-04-01', '2006-05-31', 1, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1952314593', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870519691', 'W77010755', 'W77010755', 'UT02', 'Utah Cancer Specialists', 'A Jennifer', NULL, 'Fischbach', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'O', '544 S 400 E', 'St George', 'Washington', 'UT', '84770', '4356884175', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-06-20', '2006-02-28', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1528017456', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543318', 'W77010756', 'W77010756', 'UT02', 'Mountain West Gastroenterology', 'James', 'W', 'Bown', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '368 E Riverside Dr', 'St George', 'Washington', 'UT', '84790', '4356731149', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDGSTR', 'USTDHCPC', '12180', '0.00', NULL, NULL, 3, '2003-04-01', '2006-05-31', 1, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1629081260', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870545030', 'W77010757', 'W77010757', 'UT02', 'Advanced Foot & Ankle', 'Russell', 'G', 'Olsen', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', '1811 W Royal Hunte Dr Ste 2', 'Cedar City', 'Iron', 'UT', '84720', '4355862225', '4358671909', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2003-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1639178882', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870545030', 'W77010758', 'W77010758', 'UT02', 'Advanced Foot & Ankle', 'Jeffrey', 'Lee', 'Stewart', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', '1811 W Royal Hunte Dr Ste 2', 'Cedar City', 'Iron', 'UT', '84720', '4355862225', '4358671909', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-08-26', '2003-08-26', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1184623092', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543318', 'W77010759', 'W77010759', 'UT02', 'Mountain West Gastroenterology', 'Mosaab', 'A', 'Hasan', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '368 E Riverside Dr', 'St George', 'Washington', 'UT', '84790', '4356731149', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDGSTR', 'USTDHCPC', '12180', '0.00', NULL, NULL, 3, '2003-04-01', '2006-05-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477566016', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870527645', 'W77010760', 'W77010760', 'UT02', 'Color Country Health Express', 'Marjean', NULL, 'Allen', 'NP', 'Family Practice', NULL, NULL, NULL, 'O', '595 S Bluff St Ste 1', 'St George', 'Washington', 'UT', '84770', '4356749929', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834845', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870527645', 'W77010761', 'W77010761', 'UT02', 'Color Country Health Express', 'Marjorie', 'K', 'Ence', 'NP', 'Family Practice', NULL, NULL, NULL, 'B', '595 S Bluff St', 'St George', 'Washington', 'UT', '84770', '4356749929', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2006-06-08', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '830950', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870547628', 'W77010762', 'W77010762', 'UT02', 'Nimer, Lynn R', 'Lynn', 'R', 'Nimer', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'B', '1380 E Medical Ctr Dr Ste 3500', 'St George', 'Washington', 'UT', '84790', '4352512150', '4352512151', NULL, NULL, '', NULL, NULL, '', '', 'USTDCARD', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-09-30', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1689635922', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870290108', 'W77010763', 'W77010763', 'UT02', 'Medical Associates Of St George', 'Scott', 'D', 'Barton', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356736131', '4356738557', NULL, NULL, '', NULL, NULL, '', '', 'USTGEIPA', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1376690180', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870290108', 'W77010764', 'W77010764', 'UT02', 'Medical Associates Of St George', 'Jennifer', 'L', 'Livingston', 'MD', 'Family Practice', 'Family Practice', NULL, NULL, 'B', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356736131', '4356738557', NULL, NULL, '', NULL, NULL, '', '', 'USTGEIPA', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-01-28', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '635483', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870290108', 'W77010765', 'W77010765', 'UT02', 'Medical Associates Of St George', 'Gus', 'C', 'Pendleton', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356736131', '4356738557', NULL, NULL, '', NULL, NULL, '', '', 'USTGEIPA', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1649361874', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870290108', 'W77010766', 'W77010766', 'UT02', 'Medical Associates Of St George', 'Gus', 'C', 'Pendleton', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356746065', '4356738557', NULL, NULL, '', NULL, NULL, '', '', 'USTGEIPA', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1649361874', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870290108', 'W77010767', 'W77010767', 'UT02', 'Medical Associates Of St George', 'C Kerry', NULL, 'Stratford', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356736131', '4356738557', NULL, NULL, '', NULL, NULL, '', '', 'USTGEIPA', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1275688228', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870290108', 'W77010768', 'W77010768', 'UT02', 'Medical Associates Of St George', 'C Kerry', NULL, 'Stratford', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '736 S 900 E Ste 203', 'St George', 'Washington', 'UT', '84790', '4356746065', '4356738557', NULL, NULL, '', NULL, NULL, '', '', 'USTGEIPA', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1275688228', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543111', 'W77010769', 'W77010769', 'UT02', 'Mountain Eye Institute', 'Chad', 'W', 'Anderson', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '1811 W Royal Hunte Dr Ste 1', 'Cedar City', 'Iron', 'UT', '84720', '4355861131', '4358651121', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-10-31', 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144330648', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543111', 'W77010770', 'W77010770', 'UT02', 'Mountain Eye Institute', 'Rory', 'J', 'Christian', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '1811 W Royal Hunte Dr Ste 1', 'Cedar City', 'Iron', 'UT', '84720', '4355861131', '4358651121', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-10-31', 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1326158551', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870551095', 'W77010771', 'W77010771', 'UT02', 'Yates, D Alden', 'D Alden', NULL, 'Yates', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', '736 S 900 E Ste 101', 'St George', 'Washington', 'UT', '84790', '4356747444', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528165867', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543318', 'W77010772', 'W77010772', 'UT02', 'Mountain West Gastroenterology', 'Roxie', 'Ann', 'Brown', 'NP', 'Gastroenterology', NULL, NULL, NULL, 'O', '368 E Riverside Dr', 'St George', 'Washington', 'UT', '84790', '4356731149', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDGSTR', 'USTDHCPC', '12180', '0.00', NULL, NULL, 3, '2003-04-01', '2006-05-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396851028', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870543318', 'W77010773', 'W77010773', 'UT02', 'Mountain West Gastroenterology', 'Roxie', 'Ann', 'Brown', 'NP', 'Gastroenterology', NULL, NULL, NULL, 'B', '6360 S 3000 E Ste 300', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019443188', '8019443180', NULL, NULL, '', NULL, NULL, '', '', 'USTDGSTR', 'USTDHCPC', '12180', '0.00', NULL, NULL, 3, '2003-04-01', '2006-05-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1396851028', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870395551', 'W77010836', 'W77010836', 'UT02', 'Chiropractic Health Plan', 'Justin', 'W', 'Salmon', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2005-03-25', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013993815', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870609622', 'W77010841', 'W77010841', 'UT02', 'Snow Canyon Clinic', 'Dana', 'B', 'Hardin', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '272 E Ctr St Ste 101', 'Ivins', 'Washington', 'UT', '84738', '4356564477', '4356563850', '272 E Center St', 'Ivins', '', 'UT', '84738', '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-11-30', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1053381558', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870609622', 'W77010842', 'W77010842', 'UT02', 'Snow Canyon Clinic', 'Kevin', 'A', 'Hough', 'PA', NULL, NULL, NULL, NULL, 'O', '272 E Ctr St Ste 101', 'Ivins', 'Washington', 'UT', '84738', '4356564477', '4356563850', '272 E Center St', 'Ivins', '', 'UT', '84738', '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2004-10-29', '2006-11-30', 0, 0, 0, 'Timpanogos Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1174581870', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870609622', 'W77010843', 'W77010843', 'UT02', 'Snow Canyon Clinic', 'Jane', 'Grace', 'Manalo', 'MD', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '272 E Ctr St Ste 101', 'Ivins', 'Washington', 'UT', '84738', '4356565136', '4356563850', '272 E Center St', 'Ivins', '', 'UT', '84738', '', '', 'USTDONC', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1407813470', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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('870396036', 'W77010845', 'W77010845', 'UT02', 'Enterprise Valley Medical Clinic', 'Lisa', 'A', 'Griffin', 'PA', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 370', 'Enterprise', 'Washington', 'UT', '84725', '4358782281', '4358782434', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-10-01', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831901', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870396036', 'W77010846', 'W77010846', 'UT02', 'Enterprise Valley Medical Clinic', 'James', 'R', 'Martin', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '223 S 200 E', 'Enterprise', 'Washington', 'UT', '84725', '4358782281', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-10-01', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831902', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870620808', 'W77010847', 'W77010847', 'UT02', 'Evans, Eric', 'Eric', 'A', 'Evans', 'MD', 'Pain Management', 'Anesthesiology', NULL, NULL, 'O', '354 E 600 S Ste 204', 'St George', 'Washington', 'UT', '84770', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', '100', NULL, NULL, '0.00', '0.01', NULL, 3, '1999-09-01', '2004-03-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1285724989', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870628665', 'W77010848', 'W77010848', 'UT02', 'Southern Utah Ear Nose & Throat', 'Michael', 'H', 'Stevens', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '1490 E Foremaster Dr Ste 350', 'St George', 'Washington', 'UT', '84790', '4356283334', '4356283375', NULL, NULL, '', NULL, NULL, '', '', 'USTGEIPA', NULL, NULL, '0.00', '35.00', NULL, 3, '2004-09-10', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1699959460', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870622005', 'W77010849', 'W77010849', 'UT02', 'Night Light Pediatrics', 'Jerry', 'D', 'Twiggs', 'MD', 'Urgent Care', 'Pediatrics', NULL, NULL, 'O', '1240 E 100 S', 'St George', 'Washington', 'UT', '84790', '4356288232', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDGEIPA', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1972583680', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870628665', 'W77010850', 'W77010850', 'UT02', 'Gardner MD PC, Kent E', 'Steven', 'P', 'Chase', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'B', '1490 E Foremaster Dr Ste 350', 'St George', 'Washington', 'UT', '84790', '4356283334', '4356283375', NULL, NULL, '', NULL, NULL, '', '', 'USTDENT', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-08-26', '2006-09-30', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1831108042', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870628665', 'W77010851', 'W77010851', 'UT02', 'Gardner MD PC, Kent E', 'Kent', 'E', 'Gardner', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'B', '1490 E Foremaster Dr Ste 350', 'St George', 'Washington', 'UT', '84790', '4356283334', '4356283375', NULL, NULL, '', NULL, NULL, '', '', 'USTDENT', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-09-30', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1881702355', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870628665', 'W77010852', 'W77010852', 'UT02', 'Southern Utah Ear Nose & Throat', 'Kent', 'E', 'Gardner', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '1490 E Foremaster Dr Ste 350', 'St George', 'Washington', 'UT', '84790', '4356283334', '4356283375', NULL, NULL, '', NULL, NULL, '', '', 'USTDENT', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-09-30', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1881702355', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870628665', 'W77010853', 'W77010853', 'UT02', 'Gardner MD PC, Kent E', 'Michael', 'H', 'Stevens', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'B', '1490 E Foremaster Dr Ste 350', 'St George', 'Washington', 'UT', '84790', '4356283334', '4356283375', NULL, NULL, '', NULL, NULL, '', '', 'USTGEIPA', NULL, NULL, '0.00', '35.00', NULL, 3, '2004-09-10', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1699959460', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870414618', 'W77010854', 'W77010854', 'UT02', '*Foot And Ankle Institute - 870414618', 'tute', NULL, 'Foot And Ankle Insti', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'B', '754 S Main St Ste 1', 'St George', 'Washington', 'UT', '84770', '4356282671', NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, NULL, '0.00', NULL, NULL, 3, '2002-06-01', '2004-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832246', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W77010944', 'W77010944', 'UT02', 'Bear River Hospital Physicians', 'Daniel', 'K', 'Worwood', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '90 S 700 W', 'Hurricane', 'Washington', 'UT', '84737', '4356357227', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTGEIPA', NULL, NULL, '0.00', '35.00', NULL, 8, '2004-04-30', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144241647', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010945', 'W77010945', 'UT02', 'IHC Zion Orthopaedics & Sports Medicine', 'KC', NULL, 'Hafen', 'PA', NULL, NULL, NULL, NULL, 'O', '1380 E Medical Ctr Dr', 'St George', 'Washington', 'UT', '84790', '4352512650', '4352512668', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', '0.00', 8, '2005-09-30', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000939400', 0, 'N', 0, '2006-12-15', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W77010951', 'W77010951', 'UT02', 'IHC Southwest Cardiology', 'Roger', 'C', 'Millar', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1380 E Medical Ctr Dr Ste 1500', 'St George', 'Washington', 'UT', '84790', '4352512700', '4352512525', '1380 E Medical Ctr Dr Ste 1500', 'St George', 'Washington', 'UT', '84790', '4352512700', '4352512525', 'URURAL', '', '', '0.00', '35.00', '0.00', 8, '2005-09-01', '2012-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295753549', 0, 'N', 0, '2012-06-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010952', 'W77010952', 'UT02', 'Redrock Pediatrics', 'Martin', 'J', 'Nygaard', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '1380 E Medical Ctr Dr Ste 3100', 'St George', 'Washington', 'UT', '84790', '4352512740', NULL, '1380 E Medical Ctr Dr Ste 3100', 'St George', 'Washington', 'UT', '84790', '4352512740', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', '0.00', 8, '2003-04-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1659305688', 0, 'N', 0, '2011-06-23', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010953', 'W77010953', 'UT02', 'Intermountain Health Care', 'Gordon', 'L', 'Smith', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 8, '2005-09-01', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255354718', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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('942854057', 'W77010955', 'W77010955', 'UT02', 'Intermountain Health Care', 'Kerri', 'N', 'Smith', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPEDE', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 8, '2003-04-01', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528086865', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010956', 'W77010956', 'UT02', 'IHC Zion Orthopaedics & Sports Medicine', 'Robert', 'J', 'Andruss', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '652 S Medical Ctr Dr Ste 400', 'St George', 'Washington', 'UT', '84790', '4352512650', '4352512668', NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', NULL, NULL, '0.00', '35.00', '0.00', 8, '2005-07-29', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1952326373', 0, 'N', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010957', 'W77010957', 'UT02', 'Intermountain Health Care', 'Wayne', 'O', 'Brown', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 8, '2005-03-25', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003822909', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010958', 'W77010958', 'UT02', 'Family Practice at IHC River Road', 'Lawrence', 'A', 'Cain', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '577 S River Rd', 'St George', 'Washington', 'UT', '84790', '4356886100', '4356886111', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', '0.00', 8, '2005-09-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000944935', 0, 'N', 0, '2006-12-15', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010959', 'W77010959', 'UT02', 'IHC Southwest Cardiology', 'Keshav', '', 'Chander', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1380 E Medical Ctr Dr Ste 1500', 'St George', 'Washington', 'UT', '84790', '4352512500', '4352512525', '1380 E Medical Ctr Dr Ste 1500', 'St George', 'Washington', 'UT', '84790', '4352512500', '4352512525', 'URURAL', NULL, NULL, '0.00', '35.00', '0.00', 8, '2005-09-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1700816600', 0, 'N', 0, '2013-05-17', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010960', 'W77010960', 'UT02', 'Smith DO, Kerri N', 'Kerri', 'N', 'Smith', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '352 E Riverside Dr Ste A-9', 'St George', 'Washington', 'UT', '84790', '4356565500', '4356284875', NULL, NULL, '', NULL, NULL, '', '', 'USTDPEDE', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 8, '2003-04-01', '2005-09-18', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1528086865', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010961', 'W77010961', 'UT02', 'Intermountain Health Care', 'Scott', 'M', 'Smith', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', NULL, NULL, '0.00', '35.00', NULL, 8, '2003-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588698997', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010962', 'W77010962', 'UT02', 'Family Practice at IHC River Road', 'Bruce', 'L', 'Taylor', 'DO', 'Family Practice', '', '', NULL, 'O', '577 S River Rd', 'St George', 'Washington', 'UT', '84790', '4356886100', '4356886111', NULL, NULL, 'Washington', NULL, NULL, '4356886100', '4356886111', 'URURAL', NULL, NULL, '0.00', '35.00', '0.00', 8, '2005-09-01', NULL, NULL, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1811915135', 0, 'N', 0, '2010-04-23', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010963', 'W77010963', 'UT02', 'IHC Health Center Cedar City', 'Charles', 'J', 'Thinnes', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1303 N Main St Ste C', 'Cedar City', 'Iron', 'UT', '84720', '8018685500', '8018685504', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', '0.00', 8, '2005-08-26', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861415325', 0, 'N', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010964', 'W77010964', 'UT02', 'Intermountain Health Care', 'Jeanne', 'M', 'Toutonghi', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 8, '2005-09-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '947076', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010965', 'W77010965', 'UT02', 'Intermountain Health Care', 'Keshav', NULL, 'Chander', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 8, '2005-09-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1700816600', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010966', 'W77010966', 'UT02', 'Intermountain Health Care', 'Robert', 'D', 'Corry', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 8, '2005-05-20', '2006-12-31', 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1952324410', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010967', 'W77010967', 'UT02', 'Fillmore Clinic', 'Craig', 'M', 'Grose', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '700 S Highway 99', 'Fillmore', 'Millard', 'UT', '84631', '4357435555', '4357435764', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 8, '2005-02-25', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003854878', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010968', 'W77010968', 'UT02', 'Intermountain Health Care', 'James', 'R', 'Grua', 'MD', 'Endocrinology', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 8, '2004-04-30', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1134159288', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010969', 'W77010969', 'UT02', 'Intermountain Health Care', 'Thomas', 'Randy', 'Hansen', 'MD', 'General Surgery', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDSURG', NULL, NULL, '0.00', '35.00', NULL, 8, '2004-10-29', '2004-10-29', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1861433443', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010970', 'W77010970', 'UT02', 'Family Practice at IHC River Road', 'Jonathan', 'P', 'Hubbard', 'DO', 'Family Practice', '', '', NULL, 'O', '577 S River Rd', 'St George', 'Washington', 'UT', '84790', '4356886100', '4356886111', '577 S River Rd', 'St George', 'Washington', 'UT', '84790', '4356886100', '4356886111', 'URURAL', NULL, NULL, '0.00', '35.00', '0.00', 8, '2005-09-01', '2008-05-01', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1609894922', 0, 'N', 0, '2013-09-13', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010971', 'W77010971', 'UT02', 'Intermountain Health Care', 'Jonathan', 'P', 'Hubbard', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 8, '2005-09-01', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1609894922', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010972', 'W77010972', 'UT02', 'Intermountain Health Care', 'Brent', 'D', 'Jackson', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 8, '2005-02-25', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962418210', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010973', 'W77010973', 'UT02', 'Redrock Pediatrics', 'Rajiv', 'J', 'Kaddu', 'MD', 'Pediatrics', 'Pediatric Gastroenterology', '', NULL, 'O', '1380 E Medical Ctr Dr Ste 3100', 'St George', 'Washington', 'UT', '84790', '4352512740', NULL, '1380 E Medical Ctr Dr Ste 3100', 'St George', 'Washington', 'UT', '84790', '4352512740', '', 'URURAL', NULL, NULL, '0.00', '35.00', '0.00', 8, '2003-04-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1275566291', 0, 'N', 0, '2011-09-26', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010974', 'W77010974', 'UT02', 'Intermountain Health Care', 'Gregory', 'G', 'Last', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 8, '2003-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '830964', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483604', 'W77010975', 'W77010975', 'UT02', 'Southern Utah Eyecare', 'Russell', 'M', 'Miller', 'OD', 'Optometry', NULL, NULL, NULL, 'B', '10 Diagonal St Ste 101', 'St George', 'Washington', 'UT', '84770', '8016733201', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730141375', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483604', 'W77010976', 'W77010976', 'UT02', 'Southern Utah Eyecare', 'Russell', 'M', 'Miller', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '10 Diagonal St Ste 101', 'St George', 'Washington', 'UT', '84770', '4356733201', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1730141375', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870484695', 'W77010977', 'W77010977', 'UT02', 'Delta Family Medicine', 'Alan', 'R', 'Smith', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '140 White Sage Ave', 'Delta', 'Millard', 'UT', '84624', '4358643333', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-05-30', '2006-08-31', 0, 0, 0, 'Delta Community Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1518069020', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010978', 'W77010978', 'UT02', 'IHC Health Center St George', 'Renu', NULL, 'Mahajan', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '577 S River Rd', 'St George', 'Washington', 'UT', '84790', '4356886200', '4356886222', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', '0.00', 8, '2005-09-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1609809607', 0, 'N', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77010979', 'W77010979', 'UT02', 'Intermountain Health Care', 'Michael', 'C', 'Marsden', 'DO', 'Pediatrics', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '4356565500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTGEIPA', NULL, NULL, '0.00', '35.00', NULL, 8, '2005-02-01', '2005-09-18', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1568480804', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W77011057', 'W77011057', 'UT02', 'Redrock Pediatrics', 'Michael', 'C', 'Marsden', 'DO', 'Pediatrics', NULL, NULL, NULL, 'O', '1380 E Medical Ctr Dr Ste 3100', 'St George', 'Washington', 'UT', '84790', '4352512740', NULL, NULL, NULL, 'Washington', NULL, NULL, '4352512740', '', 'USTGEIPA', NULL, NULL, '0.00', '35.00', '0.00', 8, '2005-02-01', NULL, NULL, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1568480804', 0, 'Y', 0, '2010-04-23', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('942854057', 'W77011058', 'W77011058', 'UT02', 'Intermountain Health Care', 'Russell', 'P', 'Maxwell', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 8, '2005-05-20', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083640767', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011059', 'W77011059', 'UT02', 'Intermountain Health Care', 'Martin', 'J', 'Nygaard', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 8, '2003-04-01', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1659305688', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011060', 'W77011060', 'UT02', 'IHC Health Center Cedar City', 'Julie', 'Lynn', 'Porter', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1303 N Main St Ste C', 'Cedar City', 'Iron', 'UT', '84720', '8018685500', '8018685504', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', '0.00', 8, '2004-06-04', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '0000835658', 0, 'N', 0, '2006-12-15', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011061', 'W77011061', 'UT02', 'Intermountain Health Care', 'Bruce', 'L', 'Taylor', 'DO', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '4356886123', '4356886111', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', NULL, 8, '2005-09-01', '2006-12-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1811915135', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011062', 'W77011062', 'UT02', 'IHC Health Center St George', 'Claude', 'A', 'Warner', 'MD', 'Hospitalist', '', '', NULL, 'O', '577 S River Rd', 'St George', 'Washington', 'UT', '84790', '4356886200', '4356886222', '577 S River Rd', 'St George', 'Washington', 'UT', '84790', '4356886200', '4356886222', 'URURAL', NULL, NULL, '0.00', '35.00', '0.00', 8, '2005-09-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1376561688', 0, 'N', 0, '2011-09-26', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011063', 'W77011063', 'UT02', 'IHC Southwest Cardiology', 'Kory', 'U', 'Woodbury', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '1380 E Medical Ctr Dr Ste 1500', 'St George', 'Washington', 'UT', '84790', '4352512700', '4352512525', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', NULL, NULL, '0.00', '35.00', '0.00', 8, '2005-09-01', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1225056575', 0, 'N', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('010748188', 'W77011064', 'W77011064', 'UT01', 'Emergency Medical Billing', 'Mark', 'A', 'Frazier', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 1098', 'Salem', 'Utah', 'UT', '84653', '8017146570', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-06-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831752', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('010748188', 'W77011065', 'W77011065', 'UT01', 'Emergency Medical Billing', 'Mark', 'A', 'Frazier', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '750 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8017146000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-06-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831752', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('043753766', 'W77011066', 'W77011066', 'UT01', 'Red Rock Eye Clinic', 'Shane', 'R', 'Jensen', 'OD', 'Optometry', NULL, NULL, NULL, 'B', 'PO Box 976', 'Panguitch', 'Garfield', 'UT', '84759', '4356768646', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154422822', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('043753766', 'W77011067', 'W77011067', 'UT01', 'Red Rock Eye Clinic', 'Shane', 'R', 'Jensen', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '415 E Ctr St', 'Panguitch', 'Garfield', 'UT', '84759', '4356768646', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154422822', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('043814907', 'W77011068', 'W77011068', 'UT01', 'East Layton Internal Medicine', 'John', 'M', 'Hemmersmeier', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 403944', 'Atlanta', 'Fulton', 'GA', '30384', '8017711331', '8017711330', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-12-15', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '912216', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('043814907', 'W77011069', 'W77011069', 'UT01', 'East Layton Internal Medicine', 'John', 'M', 'Hemmersmeier', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1240 E Highway 193 Ste G1', 'Layton', 'Davis', 'UT', '84040', '8017711331', '8017711330', NULL, NULL, '', NULL, NULL, '', '', 'USTDINT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-12-15', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '912216', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('050544456', 'W77011070', 'W77011070', 'UT01', 'EMG Testing Services LC', 'David', 'N', 'Johnson', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', 'PO Box 1803', 'Orem', 'Utah', 'UT', '84059', '8013675204', '8014919526', NULL, NULL, '', NULL, NULL, '', '', '10800', NULL, NULL, '0.00', NULL, '57.75', 3, '2005-11-18', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '948521', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('050544456', 'W77011071', 'W77011071', 'UT01', 'EMG Testing Services LC', 'Richard', 'P', 'Nielsen', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', 'PO Box 1803', 'Orem', 'Utah', 'UT', '84059', '8013675204', '8014919526', NULL, NULL, '', NULL, NULL, '', '', '10800', NULL, NULL, '0.00', NULL, '57.75', 3, '2006-01-25', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '949168', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('050544456', 'W77011072', 'W77011072', 'UT01', 'EMG Testing Services LC', 'LC', NULL, 'EMG Testing Services', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', 'PO Box 1803', 'Orem', 'Utah', 'UT', '84059', '8013675204', NULL, NULL, NULL, '', NULL, NULL, '', '', '10800', NULL, NULL, '0.00', NULL, '57.75', 3, '2005-06-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '949170', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('141851557', 'W77011073', 'W77011073', 'UT01', 'Wasatch Eye & Optical', 'Mark', 'A', 'Taylor', 'OD', NULL, NULL, NULL, NULL, 'B', '1747 Heritage Ln Ste A2', 'Syracuse', 'Davis', 'UT', '84075', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-01-27', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811992555', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('141851557', 'W77011074', 'W77011074', 'UT01', 'Wasatch Eye & Optical', 'Mark', 'A', 'Taylor', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '1747 Heritage Ln Ste A2', 'Syracuse', 'Davis', 'UT', '84075', '8017748707', '8017748784', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811992555', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('141851557', 'W77011075', 'W77011075', 'UT01', 'Wasatch Eye & Optical', 'Mark', 'A', 'Taylor', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '128 N Main St', 'Kaysville', 'Davis', 'UT', '84037', '8015432525', '8015931982', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811992555', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('200302299', 'W77011076', 'W77011076', 'UT01', 'Northern Utah Orthopaedics & Sports Medicine', 'David', 'B', 'Glover', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', '1486 E Skyline Dr Ste 202', 'Ogden', 'Weber', 'UT', '84405', '8014755535', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-07-29', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740371681', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('200302299', 'W77011077', 'W77011077', 'UT01', 'Northern Utah Orthopaedics & Sports Medicine', 'David', 'B', 'Glover', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '1486 E Skyline Dr Ste 202', 'South Ogden', 'Weber', 'UT', '84405', '8014755535', '8014759499', NULL, NULL, '', NULL, NULL, '', '', 'UOGORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-07-29', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740371681', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('201213932', 'W77011078', 'W77011078', 'UT01', 'The Focus Center', 'Samantha', 'P', 'Bostrom', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '4161 Lakeview Dr', 'Ogden', 'Weber', 'UT', '84403', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPEDE', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-02', '2006-01-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1881801579', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('201513999', 'W77011079', 'W77011079', 'UT01', 'Timpanogos Emergency Physicians', 'S Dwayne', NULL, 'Roberts', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 1747', 'Orem', 'Utah', 'UT', '84059', '8012220191', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316993520', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('201513999', 'W77011080', 'W77011080', 'UT01', 'Timpanogos Emergency Physicians', 'S Dwayne', NULL, 'Roberts', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '750 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8012220191', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316993520', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('202108758', 'W77011081', 'W77011081', 'UT01', 'Midvalley Clinic', 'David', 'A', 'Peterson', 'MD', 'Radiologist', NULL, NULL, NULL, 'O', '2618 W 7800 S Ste 200', 'West Jordan', 'Salt Lake', 'UT', '84088', '8019671400', '8019671515', NULL, NULL, '', NULL, NULL, '', '', 'USTDRAD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834583', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('202134065', 'W77011082', 'W77011082', 'UT01', 'Oakridge Optometry', 'David', 'B', 'Burnett', 'OD', 'Optometry', NULL, NULL, NULL, 'B', '174 Oakridge Dr', 'Farmington', 'Davis', 'UT', '84025', '8014474393', '8014472211', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073520680', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('202134065', 'W77011083', 'W77011083', 'UT01', 'Oakridge Optometry', 'David', 'B', 'Burnett', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '57 N Main St', 'Farmington', 'Davis', 'UT', '84025', '8014474393', '8014472211', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073520680', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('202421909', 'W77011084', 'W77011084', 'UT01', 'Esplin OD, David J', 'David', 'J', 'Esplin', 'OD', 'Optometry', NULL, NULL, NULL, 'B', 'PO Box 267', 'Spanish Fork', 'Utah', 'UT', '84660', '8017943937', '8017949880', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740255058', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('202421909', 'W77011085', 'W77011085', 'UT01', 'Esplin Eye Center', 'David', 'J', 'Esplin', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '24 N 100 E', 'Spanish Fork', 'Utah', 'UT', '84660', '8017943937', '8017949880', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1740255058', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('202975109', 'W77011086', 'W77011086', 'UT01', 'Tooele Vision Center', 'Edwin (Jed)', 'C', 'Winder', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '300 S Main St', 'Tooele', 'Tooele', 'UT', '84074', '4358823233', '4358821626', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '951759', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203533436', 'W77011087', 'W77011087', 'UT01', 'Advanced Family Eyecare', 'David', NULL, 'Jones', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '57 E 1000 N', 'Spanish Fork', 'Utah', 'UT', '84660', '8014236516', '8017982707', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2002-09-13', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427087741', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203620216', 'W77011088', 'W77011088', 'UT01', 'Foot and Ankle Clinic of Utah', 'Scott', NULL, 'McKell', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '157 N 400 W Ste B-7', 'Orem', 'Utah', 'UT', '84057', '8017651718', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-11-16', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1497820054', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203620216', 'W77011089', 'W77011089', 'UT01', 'Foot and Ankle Clinic of Utah', 'Gary', 'R', 'Ridge', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '157 N 400 W Ste B-7', 'Orem', 'Utah', 'UT', '84057', '8012262421', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144267089', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203620216', 'W77011090', 'W77011090', 'UT01', 'Foot and Ankle Clinic of Utah', 'Kelly', 'A', 'Gomez', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', '157 N 400 W Ste B-7', 'Orem', 'Utah', 'UT', '84057', '8012262421', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821021957', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203620216', 'W77011091', 'W77011091', 'UT01', 'Foot and Ankle Clinic of Utah', 'Kelly', 'A', 'Gomez', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '777 N 500 W Ste 103', 'Provo', 'Utah', 'UT', '84601', '8013756677', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821021957', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203620216', 'W77011092', 'W77011092', 'UT01', 'Foot and Ankle Clinic of Utah', 'Stanley', 'J', 'Phillips', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', '157 N 400 W Ste B-7', 'Orem', 'Utah', 'UT', '84057', '8012262421', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-12-01', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1841202397', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203620216', 'W77011093', 'W77011093', 'UT01', 'Foot and Ankle Clinic of Utah', 'Stanley', 'J', 'Phillips', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '9690 S 1300 E Ste 120', 'Sandy', 'Salt Lake', 'UT', '84094', '8015014335', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDPOD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-12-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1841202397', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203620216', 'W77011094', 'W77011094', 'UT01', 'Foot and Ankle Clinic of Utah', 'Matthew', 'G', 'Ollerton', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', '157 N 400 W Ste B-7', 'Orem', 'Utah', 'UT', '84057', '8012262421', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-07-19', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518959733', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('203620216', 'W77011095', 'W77011095', 'UT01', 'Foot and Ankle Clinic of Utah', 'Matthew', 'G', 'Ollerton', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '5 E 400 N', 'Springville', 'Utah', 'UT', '84663', '8014913668', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-07-19', '2005-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1518959733', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870327793', 'W77011141', 'W77011141', 'UT01', 'Vision Source at Jordan Landing', 'James', 'D', 'Sargent', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '7555 Ctr View Ct Ste 101', 'West Jordan', 'Salt Lake', 'UT', '84084', '8015665683', '8012558371', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-01-28', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1942238670', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870341960', 'W77011142', 'W77011142', 'UT01', 'Clear View Vision Center', 'Kenneth', 'E', 'Hooton', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '60 S 200 E', 'American Fork', 'Utah', 'UT', '84003', '8017564731', '8017565865', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144285925', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870345870', 'W77011143', 'W77011143', 'UT01', 'Eye Clinic & Contact Lens Center of Utah Valley', 'Roland', 'K', 'Monson', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '2230 N University Pkwy Ste 10A', 'Provo', 'Utah', 'UT', '84604', '8013734550', '8013738634', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811952799', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870354540', 'W77011144', 'W77011144', 'UT01', 'ENT Specialists', 'John', 'Edmund', 'Butler', 'MD', 'Ear, Nose and Throat', NULL, NULL, NULL, 'O', '4000 S 700 E Ste 10', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012684141', '8012618609', NULL, NULL, '', NULL, NULL, '', '', 'USTDENT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-07-01', '2006-11-30', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1598725350', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870378810', 'W77011145', 'W77011145', 'UT01', 'Spencer D Mortensen OD', 'Spencer', 'D', 'Mortensen', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '462 E 100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84111', '8015325176', '8015325179', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548321078', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870382132', 'W77011147', 'W77011147', 'UT01', 'Sandy Vision Care Center', 'Howard', 'A', 'Katzman', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '9035 S 1300 E Ste 100', 'Sandy', 'Salt Lake', 'UT', '84094', '8015664119', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-11-07', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1760492912', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011148', 'W77011148', 'UT01', 'Chiropractic Health Plan', 'Theodore', 'Allan', 'Kyle', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '1999-09-01', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833502', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011149', 'W77011149', 'UT01', 'Chiropractic Health Plan', 'Theodore', 'Allan', 'Kyle', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '2618 W 7800 S Ste 200', 'West Jordan', 'Salt Lake', 'UT', '84088', '8019671400', '8019671515', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '1999-09-01', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833502', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011150', 'W77011150', 'UT01', 'Chiropractic Health Plan', 'Loral', 'G', 'Linton', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-01-27', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194894501', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011151', 'W77011151', 'UT01', 'Loral G Linton', 'Loral', 'G', 'Linton', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '662 S 175 E', 'Kanab', 'Kane', 'UT', '84741', '4356445296', '4356445296', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-01-27', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194894501', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011152', 'W77011152', 'UT01', 'Chiropractic Health Plan', 'Rett', 'W', 'Roberts', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-01-27', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1407838139', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011153', 'W77011153', 'UT01', 'Tooele Valley Spine Center', 'Rett', 'W', 'Roberts', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '1244 N Main St', 'Tooele', 'Tooele', 'UT', '84074', '4358339200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-01-27', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1407838139', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77011154', 'W77011154', 'UT01', 'U Of U Dept Of Ob/Gyn', 'Erin', 'B', 'Wright', 'NP', NULL, NULL, NULL, NULL, 'B', 'PO Box 58859', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015855172', '8015855164', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2006-01-13', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1952464471', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77011155', 'W77011155', 'UT01', 'U Of U Dept Of Ob/Gyn', 'Erin', 'B', 'Wright', 'NP', NULL, NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812719', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2006-01-13', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1952464471', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870423799', 'W77011156', 'W77011156', 'UT01', 'Eyecare Associates', 'Angela', 'D', 'Hill', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '7400 Union Park Ave Ste 202', 'Midvale', 'Salt Lake', 'UT', '84047', '8015693698', '8015690578', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982613865', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870442845', 'W77011157', 'W77011157', 'UT01', 'U Of U Hematology/Oncology Division', 'Kelli', 'E', 'Groomer', 'PA', 'Pediatric Hematology and Oncolocy', 'Physician Assistant', NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015850124', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-12-09', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568412724', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870442845', 'W77011158', 'W77011158', 'UT01', 'U Of U Hematology/Oncology Division', 'Kelli', 'E', 'Groomer', 'PA', 'Pediatric Hematology and Oncolocy', 'Physician Assistant', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015853229', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-12-09', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568412724', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870442845', 'W77011159', 'W77011159', 'UT01', 'U Of U Hematology/Oncology Division', 'Paul', 'J', 'Shami', 'MD', 'Internal Medicine', 'Hematolgy and Oncology', NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015850124', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-13', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992895510', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870442845', 'W77011160', 'W77011160', 'UT01', 'U Of U Hematology/Oncology Division', 'Paul', 'J', 'Shami', 'MD', 'Internal Medicine', 'Hematolgy and Oncology', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015853229', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-13', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992895510', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870443687', 'W77011161', 'W77011161', 'UT01', 'U Of U Cardiology', 'David', 'H', 'Odell', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015817715', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-08-15', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437232725', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870443687', 'W77011162', 'W77011162', 'UT01', 'U Of U Cardiology-Medical Dr', 'David', 'H', 'Odell', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015817715', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-08-15', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437232725', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870446925', 'W77011163', 'W77011163', 'UT01', 'U Of U Gastroenterology', 'R Wesley', NULL, 'Keller', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012386615', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2002-04-01', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832434', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870446925', 'W77011165', 'W77011165', 'UT01', 'U Of U Gastroenterology', 'R Wesley', NULL, 'Keller', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015817802', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2002-04-01', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832434', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870446925', 'W77011166', 'W77011166', 'UT01', 'U Of U Gastroenterology', 'R Wesley', NULL, 'Keller', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8012139900', '8012139910', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2002-04-01', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832434', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870446925', 'W77011168', 'W77011168', 'UT01', 'U Of U Gastroenterology', 'William', 'R', 'Hutson', 'MD', 'Gastroenterology', NULL, NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8012139900', '8012139910', NULL, NULL, '', NULL, NULL, '', '', 'USTDGSTR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-12-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1528158128', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870446925', 'W77011169', 'W77011169', 'UT01', 'U Of U Gastroenterology', 'Triscia', 'G', 'Martin', 'PA', NULL, NULL, NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012386615', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-12-09', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477643088', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870446925', 'W77011170', 'W77011170', 'UT01', 'U Of U Gastroenterology', 'Triscia', 'G', 'Martin', 'PA', NULL, NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015817802', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-12-09', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1477643088', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870459414', 'W77011171', 'W77011171', 'UT01', 'Rogers, Charles M', 'Charles', 'M', 'Rogers', 'MD', 'Allergy', NULL, NULL, NULL, 'B', '6095 Fashion Blvd Ste 100', 'Murray', 'Salt Lake', 'UT', '84107', '8012638700', '8012638693', NULL, NULL, '', NULL, NULL, '', '', 'USTDALLE', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-08-31', 0, 0, 0, 'Jordan Valley Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1912906330', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870459414', 'W77011172', 'W77011172', 'UT01', 'Allergy Associates of Utah', 'Charles', 'M', 'Rogers', 'MD', 'Allergy', NULL, NULL, NULL, 'O', '3855 W 7800 S Ste 225', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012828700', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDALLE', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-08-31', 0, 0, 0, 'Jordan Valley Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1912906330', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870462018', 'W77011173', 'W77011173', 'UT01', 'Sugarhouse Vision Clinic', 'Jory', 'Todd', 'Kimball', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '2178 S 900 E Ste 4', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8014842020', '8014662865', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962592782', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870462018', 'W77011174', 'W77011174', 'UT01', 'Sugarhouse Vision Clinic', 'Todd', 'E', 'Kimball', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '2178 S 900 E Ste 4', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8014842020', '8014662865', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1932292281', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870465532', 'W77011175', 'W77011175', 'UT01', 'Pugh OD, Ronald M', 'Ronald', 'M', 'Pugh', 'OD', 'Optometry', NULL, NULL, NULL, 'B', '2696 N University Ave Ste 100A', 'Provo', 'Utah', 'UT', '84604', '8013730440', '8013732144', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013012715', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870465532', 'W77011176', 'W77011176', 'UT01', 'Ronald M Pugh OD', 'Ronald', 'M', 'Pugh', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '2696 N University Ave Ste 100A', 'Provo', 'Utah', 'UT', '84604', '8013730440', '8013732144', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013012715', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870465532', 'W77011177', 'W77011177', 'UT01', 'Ronald M Pugh OD', 'Ronald', 'M', 'Pugh', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '325 W Ctr St', 'Spanish Fork', 'Utah', 'UT', '84660', '8017987496', '8013732144', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013012715', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870467746', 'W77011178', 'W77011178', 'UT01', 'U Of U Human Development Division', 'Mark', 'A', 'Supiano', 'MD', 'Internal Medicine', 'Geriatric Medicine ', NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012386815', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-12-29', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083638308', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870467746', 'W77011179', 'W77011179', 'UT01', 'U Of U Human Development Division', 'Mark', 'A', 'Supiano', 'MD', 'Internal Medicine', 'Geriatric Medicine ', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812628', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-12-29', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083638308', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870469325', 'W77011180', 'W77011180', 'UT01', 'Bradley V Fellows', 'Bradley', 'V', 'Fellows', 'OD', NULL, NULL, NULL, NULL, 'B', '9035 S 1300 E Ste 100', 'Sandy', 'Salt Lake', 'UT', '84094', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-01-27', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1841473295', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870550275', 'W77011218', 'W77011218', 'UT01', 'Wasatch Pediatrics', 'Jenifer', 'L', 'Sandvig', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '7138 Highland Dr Ste 102', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019470830', '8019470864', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-01-01', '2006-05-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689657082', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870641300', 'W77011272', 'W77011272', 'UT01', 'Utah Hyperbaric Physicians', 'Jennifer', NULL, 'Ross', 'DO', 'Hyperbaric Medicine ', 'Emergency Medicine', NULL, NULL, 'O', '520 Medical Dr Ste 110', 'Bountiful', 'Davis', 'UT', '84010', '8013970890', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UEPIC', NULL, NULL, '0.00', '30.00', NULL, 3, '2000-01-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833309', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870653674', 'W77011273', 'W77011273', 'UT01', 'John A Carver, MD', 'John', 'A', 'Carver', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', '1055 N 300 W Ste 210', 'Provo', 'Utah', 'UT', '84604', '8013577704', '8013577424', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669435160', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870653674', 'W77011274', 'W77011274', 'UT01', NULL, 'John', 'A', 'Carver', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '165 W 200 S', 'Roosevelt', 'Duchesne', 'UT', '84066', '4357131122', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669435160', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870656770', 'W77011275', 'W77011275', 'UT01', 'Murray Vision Center', 'Mathew', 'G', 'Findlay', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '126 E 4800 S', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8012622411', '8012622412', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255391090', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870659348', 'W77011276', 'W77011276', 'UT01', 'University Pathology Associates', 'Xinjian', NULL, 'Chen', 'MD', 'Pathology', 'Anatomic Pathology', 'Clinical Pathology', NULL, 'B', 'PO Box 581054', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015812508', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2005-12-20', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1902996598', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870659348', 'W77011277', 'W77011277', 'UT01', 'University Pathology Associates', 'Xinjian', NULL, 'Chen', 'MD', 'Pathology', 'Anatomic Pathology', 'Clinical Pathology', NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812508', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2005-12-20', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1902996598', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870678470', 'W77011278', 'W77011278', 'UT01', 'Orem Eye Clinic', 'Bill', 'G', 'Codner', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '209 N State St', 'Orem', 'Utah', 'UT', '84057', '8012244799', '8014344051', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-27', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245299338', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870680455', 'W77011279', 'W77011279', 'UT01', 'Ogden Ortho & Neurosurgical Specialists', 'Brandon', 'D', 'Park', 'NP', NULL, NULL, NULL, NULL, 'B', '5405 S 500 E Ste 203', 'Ogden', 'Weber', 'UT', '84405', '8014799862', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UOGORTH', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-08-26', '2006-10-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1811960123', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870680455', 'W77011280', 'W77011280', 'UT01', 'Ogden Ortho & Neurosurgical Specialists', 'Brandon', 'D', 'Park', 'NP', NULL, NULL, NULL, NULL, 'O', '4403 Harrison Blvd Ste 2600', 'Ogden', 'Weber', 'UT', '84403', '8013872600', '8013872625', NULL, NULL, '', NULL, NULL, '', '', 'UOGORTH', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-08-26', '2006-10-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1811960123', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870680455', 'W77011281', 'W77011281', 'UT01', 'Ogden Ortho & Neurosurgical Specialists', 'Jeffrey', 'J', 'Rocco', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '4403 Harrison Blvd Ste 2600', 'Ogden', 'Weber', 'UT', '84403', '8013872600', '8013872625', NULL, NULL, '', NULL, NULL, '', '', 'UOGORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-01-01', '2006-10-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1306818190', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000309', 'W77011282', 'W77011282', 'UT01', 'Garfield Memorial Clinic', 'David', 'G', 'Grygla', 'DO', 'Family Practice', NULL, NULL, NULL, 'B', '1303 N Main St', 'Cedar City', 'Iron', 'UT', '84720', '4356768842', NULL, NULL, NULL, '', NULL, NULL, '', '', '110', NULL, NULL, '0.00', '10.00', NULL, 3, '2004-09-07', '2006-08-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1518075415', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000309', 'W77011283', 'W77011283', 'UT01', 'Garfield Memorial Clinic', 'David', 'G', 'Grygla', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '200 N 400 E', 'Panguitch', 'Garfield', 'UT', '84759', '4356768842', NULL, NULL, NULL, '', NULL, NULL, '', '', '110', NULL, NULL, '0.00', '10.00', NULL, 3, '2004-09-07', '2006-08-31', 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1518075415', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000616', 'W77011284', 'W77011284', 'UT01', 'San Juan Clinic', 'Paul', 'R', 'Reay', 'DO', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 1054', 'Monticello', 'San Juan', 'UT', '84535', '4355875054', '4355873004', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-05-10', '2006-10-31', 0, 0, 0, 'San Juan Hospital', NULL, NULL, NULL, 'HCFA|', '1902873425', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000616', 'W77011285', 'W77011285', 'UT01', 'San Juan Clinic', 'Paul', 'R', 'Reay', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '364 W 100 N', 'Monticello', 'San Juan', 'UT', '84535', '4355875054', '4355873004', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-05-10', '2006-10-31', 0, 0, 0, 'San Juan Hospital', NULL, NULL, NULL, 'HCFA|', '1902873425', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('876000616', 'W77011286', 'W77011286', 'UT01', 'Blanding Medical Clinic', 'Paul', 'R', 'Reay', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '804 N 400 W', 'Blanding', 'San Juan', 'UT', '84511', '4356782254', '4356782534', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-05-10', '2006-10-31', 0, 0, 0, 'San Juan Hospital', NULL, NULL, NULL, 'HCFA|', '1902873425', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000616', 'W77011287', 'W77011287', 'UT01', 'San Juan Clinic', 'Steven', 'W', 'Bloink', 'MD', 'Family Practice', 'Emergency Medicine', NULL, NULL, 'B', 'PO Box 1054', 'Monticello', 'San Juan', 'UT', '84535', '4355875054', '4355873004', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-01-27', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1891787891', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000616', 'W77011288', 'W77011288', 'UT01', 'San Juan Clinic', 'Steven', 'W', 'Bloink', 'MD', 'Family Practice', 'Emergency Medicine', NULL, NULL, 'O', '364 W 100 N', 'Monticello', 'San Juan', 'UT', '84535', '4355875054', '4355873004', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-01-27', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1891787891', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000616', 'W77011289', 'W77011289', 'UT01', 'Blanding Medical Clinic', 'Steven', 'W', 'Bloink', 'MD', 'Family Practice', 'Emergency Medicine', NULL, NULL, 'O', '804 N 400 W', 'Blanding', 'San Juan', 'UT', '84511', '4356782254', '4356782534', NULL, NULL, '', NULL, NULL, '', '', 'URURAL', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-01-27', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1891787891', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876151902', 'W77011290', 'W77011290', 'UT01', 'U of U Ophthalmology', 'David', 'A', 'Weinberg', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', '65 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015813195', '8015851295', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-04', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164502076', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876151902', 'W77011291', 'W77011291', 'UT01', 'U of U Ophthalmology', 'David', 'A', 'Weinberg', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812352', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-01-04', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164502076', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('900182081', 'W77011292', 'W77011292', 'UT01', 'Bountiful Hearing Center', 'nter', NULL, 'Bountiful Hearing Ce', 'GROUP', 'Audiology', NULL, NULL, NULL, 'O', '425 Medical Dr Ste 200', 'Bountiful', 'Davis', 'UT', '84010', '8012959644', '8012991498', NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '913018', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942764098', 'W77011293', 'W77011293', 'UT01', 'University Neurosurgery Billing', 'Corey', 'S', 'Ames', 'NP', 'Neurology', 'Family Nurse Practitioner', NULL, NULL, 'B', 'PO Box 58417', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015853198', '8015440681', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2005-12-05', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427039114', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942764098', 'W77011294', 'W77011294', 'UT01', 'U Of U Nuerosurgery-Adults', 'Corey', 'S', 'Ames', 'NP', 'Neurology', 'Family Nurse Practitioner', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812453', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2005-12-05', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427039114', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011295', 'W77011295', 'UT02', 'Intermountain Health Care', 'Bryan', 'M', 'Watabe', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2004-08-06', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245296623', 0, 'Y', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011296', 'W77011296', 'UT02', 'Ihc Legacy Ob/Gyn', 'Bryan', 'M', 'Watabe', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1159 E 200 N Ste 250', 'American Fork', 'Utah', 'UT', '84003', '8018552980', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2004-08-06', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1245296623', 0, 'Y', 0, '2008-07-29', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011297', 'W77011297', 'UT02', 'Intermountain Health Care', 'Kevin', 'L', 'Havlik', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-01-27', NULL, 0, 0, 0, NULL, 'Primary Childrens Medical Center', NULL, '', 'HCFA|UB|', '1558315796', 0, 'Y', 0, '2013-05-17', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011298', 'W77011298', 'UT02', 'IHC Memorial Health Center', 'Kevin', 'L', 'Havlik', 'MD', 'Pediatrics', '', '', NULL, 'O', '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647600', NULL, '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647600', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-01-27', NULL, 0, 0, 0, NULL, 'Primary Childrens Medical Center', NULL, '', 'HCFA|UB|', '1558315796', 0, 'Y', 0, '2013-05-17', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011299', 'W77011299', 'UT02', 'Intermountain Health Care', 'Roland', 'P', 'Dimick', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-01-27', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1932153145', 0, 'Y', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011300', 'W77011300', 'UT02', 'IHC Memorial Health Center', 'Roland', 'P', 'Dimick', 'MD', 'Pediatrics', NULL, NULL, NULL, 'O', '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8014647600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-01-27', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1932153145', 0, 'Y', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011301', 'W77011301', 'UT02', 'Intermountain Health Care', 'Jennifer', '', 'Linford', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-01-27', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316950967', 0, 'Y', 0, '2012-03-21', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011303', 'W77011303', 'UT02', 'IHC Memorial Health Center', 'Jennifer', '', 'Linford', 'MD', 'Pediatrics', '', '', NULL, 'O', '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8018329933', NULL, '2000 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8018329933', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-01-27', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316950967', 0, 'Y', 0, '2012-03-21', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011304', 'W77011304', 'UT02', 'IHC Holladay Pediatrics', 'Jennifer', '', 'Linford', 'MD', 'Pediatrics', '', '', NULL, 'O', '2180 E 4500 S Ste 210', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8012784693', '8012784850', '2180 E 4500 S Ste 210', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8012784693', '8012784850', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-01-27', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316950967', 0, 'Y', 0, '2012-03-21', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011305', 'W77011305', 'UT02', 'Intermountain Health Care', 'David', 'Grant', 'Horsley', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '8012941000', '8012928369', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-01-27', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1750320552', 0, 'Y', 0, '2008-06-16', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011306', 'W77011306', 'UT02', 'IHC Bountiful Health Center', 'David', 'Grant', 'Horsley', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '390 N Main St', 'Bountiful', 'Davis', 'UT', '84010', '8012941000', '8012928369', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-01-27', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1750320552', 0, 'Y', 0, '2008-06-16', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011307', 'W77011307', 'UT02', 'Intermountain Health Care', 'Peter', 'C', 'Lindgren', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2006-01-27', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255370961', 0, 'Y', 0, '2008-05-14', NULL, NULL, 0, 0, NULL, NULL),
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('870471677', 'W77011398', 'W77011398', 'UT01', 'Dr Jack and Matthews Office', 'Matthew', NULL, 'Andersen', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '9829 S 1300 E Ste 101', 'Sandy', 'Salt Lake', 'UT', '84094', '8015768855', '8015769800', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-02-22', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '951749', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870473288', 'W77011399', 'W77011399', 'UT01', 'U Of U Infectious Disease Division', 'Adiseshu', 'V', 'Gundlapalli', 'MD', 'Infectious Disease', 'Clinical Pathology', 'Immunology', NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015818811', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-02-15', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194815795', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870473288', 'W77011400', 'W77011400', 'UT01', 'U Of U Infectious Disease Division', 'Adiseshu', 'V', 'Gundlapalli', 'MD', 'Infectious Disease', 'Clinical Pathology', 'Immunology', NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015817606', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-02-15', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194815795', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W77011401', 'W77011401', 'UT01', 'University of Utah Orthopedic Consultants', 'Stuart', 'Charles', 'Marshall', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', 'PO Box 58108', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015813998', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-02-01', '2006-07-31', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447204821', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W77011402', 'W77011402', 'UT01', 'University Orthopedic Center', 'Stuart', 'Charles', 'Marshall', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '590 Wakara Way', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015877100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-02-01', '2006-07-31', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1447204821', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W77011403', 'W77011403', 'UT01', 'University of Utah Orthopedic Consultants', 'Jeffrey', 'T', 'Junko', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', 'PO Box 58108', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015813998', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-02-10', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '961728', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870483582', 'W77011404', 'W77011404', 'UT01', 'University Orthopedic Center', 'Jeffrey', 'T', 'Junko', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '590 Wakara Way', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015877100', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-02-10', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '961728', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870498057', 'W77011405', 'W77011405', 'UT01', NULL, 'Corey', 'B', 'Johnson', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1219 N 400 E', 'Logan', 'Cache', 'UT', '84341', '4357532842', '4357872330', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1639180698', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870502207', 'W77011406', 'W77011406', 'UT01', 'Wasatch Therapy', 'Adam', 'D', 'Morris', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', '5349 S 500 E Ste A', 'Ogden', 'Weber', 'UT', '84405', '8014799865', '8014795846', NULL, NULL, '', NULL, NULL, '', '', 'UPTWAS', NULL, '2044', '0.00', '35.00', NULL, 3, '2006-02-07', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427140342', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870502207', 'W77011407', 'W77011407', 'UT01', 'Wasatch Therapy', 'Adam', 'D', 'Morris', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '5349 S 500 E Ste A', 'Ogden', 'Weber', 'UT', '84405', '8014799865', '8014795846', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '2044', '0.00', NULL, NULL, 3, '2006-02-07', '2006-08-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427140342', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870502207', 'W77011408', 'W77011408', 'UT01', 'Wasatch Therapy', 'Adam', 'D', 'Morris', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1957 W 5700 S', 'Roy', 'Weber', 'UT', '84067', '8017748600', '8017748681', NULL, NULL, '', NULL, NULL, '', '', 'UPTWAS', NULL, '2044', '0.00', '35.00', NULL, 3, '2006-02-07', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427140342', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870516264', 'W77011410', 'W77011410', 'UT01', 'Utah County Surgical Associates', 'Bruce', 'B', 'Hill', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '3550 N University Ave Ste 250', 'Provo', 'Utah', 'UT', '84604', '8013749625', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-02-07', '2006-05-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1699715664', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870516264', 'W77011411', 'W77011411', 'UT01', 'Utah County Surgical Associates', 'Bruce', 'B', 'Hill', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '1120 E 100 N Ste 1', 'Payson', 'Utah', 'UT', '84651', '8013749625', '8013737506', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-02-07', '2006-05-31', 0, 0, 0, 'Mountain View Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1699715664', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870522947', 'W77011412', 'W77011412', 'UT01', 'Sixty Minute Eyewear and Progressive Eyecare', 'Blaine', 'F', 'Bird', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '2255 N University Pkwy Ste 1', 'Provo', 'Utah', 'UT', '84604', '8013742220', '8013735439', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-02-22', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1871581652', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870525237', 'W77011413', 'W77011413', 'UT01', 'U Of U Immunology', 'Adiseshu', 'V', 'Gundlapalli', 'MD', 'Infectious Disease', 'Clinical Pathology', 'Immunology', NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012386615', '8012367733', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-02-15', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194815795', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870525237', 'W77011414', 'W77011414', 'UT01', 'U Of U Immunology', 'Adiseshu', 'V', 'Gundlapalli', 'MD', 'Infectious Disease', 'Clinical Pathology', 'Immunology', NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015815873', '8187091085', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-02-15', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194815795', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870574059', 'W77011415', 'W77011415', 'UT01', 'Mountain Land Rehabilitation', 'Brett', 'H', 'Cook', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 711185', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019423311', NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '7140', '0.00', NULL, NULL, 3, '2005-12-16', '2005-12-16', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '949406', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870574059', 'W77011416', 'W77011416', 'UT01', 'Mountain Land Rehabilitation', 'Brett', 'H', 'Cook', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '11333 S 1000 E', 'Sandy', 'Salt Lake', 'UT', '84094', '8015620066', '8015622124', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '7140', '0.00', NULL, NULL, 3, '2005-12-16', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '949406', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870574059', 'W77011417', 'W77011417', 'UT01', 'Mountain Land Rehabilitation', 'David', NULL, 'Braski', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'B', 'PO Box 711185', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019423311', NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '7140', '0.00', NULL, NULL, 3, '2006-02-22', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '955542', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870574059', 'W77011419', 'W77011419', 'UT01', 'Mountain Land Rehabilitation', 'David', NULL, 'Braski', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '29 S Main St', 'Tooele', 'Tooele', 'UT', '84074', '4358437466', '4358439568', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '7140', '0.00', NULL, NULL, 3, '2006-02-22', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '955542', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870574059', 'W77011420', 'W77011420', 'UT01', 'Mountain Land Rehabilitation', 'David', NULL, 'Braski', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '220 Millpond Ste 109', 'Tooele', 'Tooele', 'UT', '84074', '4358824144', '4358824151', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '7140', '0.00', NULL, NULL, 3, '2006-02-22', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '955542', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77011421', 'W77011421', 'UT01', 'UUHC Billing Office', 'Gordon', 'S', 'Park', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2001-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881784403', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77011422', 'W77011422', 'UT01', 'UUHC Redwood Center', 'Gordon', 'S', 'Park', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881784403', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870617444', 'W77011423', 'W77011423', 'UT02', NULL, 'Robert', 'E', 'Nakken', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '166 W 1325 N Ste 150', 'Cedar City', 'Iron', 'UT', '84720', '4355866962', '4358671663', NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-02-17', '2006-10-31', 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1033244207', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870617733', 'W77011424', 'W77011424', 'UT01', 'Mt Ogden Eye Center', 'John', 'D', 'McCann', 'MD', 'Ophthalmology', 'Oculoplastic Surgery', NULL, NULL, 'B', 'PO Box 1529', 'Layton', 'Davis', 'UT', '84041', '8015933223', '8015939626', NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-07-01', '2006-09-30', 0, 0, 0, 'Salt Lake Regional Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1326006917', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870617733', 'W77011426', 'W77011426', 'UT01', 'Mt Ogden Eye Center', 'John', 'D', 'McCann', 'MD', 'Ophthalmology', 'Oculoplastic Surgery', NULL, NULL, 'O', '4360 Washington Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014760494', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-07-01', '2006-09-30', 0, 0, 0, 'Salt Lake Regional Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1326006917', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870617733', 'W77011427', 'W77011427', 'UT01', 'Bountiful Hills Eye Center', 'John', 'D', 'McCann', 'MD', 'Ophthalmology', 'Oculoplastic Surgery', NULL, NULL, 'O', '1551 Rennaissance Towne Dr Ste 340', 'Bountiful', 'Davis', 'UT', '84010', '8016771122', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOPHT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-07-01', '2006-09-30', 0, 0, 0, 'Salt Lake Regional Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1326006917', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870621466', 'W77011428', 'W77011428', 'UT01', 'Sellers, Daniel S', 'Daniel', 'S', 'Sellers', 'MD', 'Plastic Surgery', 'Hand Surgery', NULL, NULL, 'B', '620 Medical Dr Ste 310', 'Bountiful', 'Davis', 'UT', '84010', '8013647723', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '1999-09-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194750711', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870621466', 'W77011429', 'W77011429', 'UT01', 'Sellers, Daniel S', 'Daniel', 'S', 'Sellers', 'MD', 'Plastic Surgery', 'Hand Surgery', NULL, NULL, 'O', '440 D St Ste 202', 'Salt Lake City', 'Salt Lake', 'UT', '84103', '8014052511', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194750711', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870640775', 'W77011430', 'W77011430', 'UT01', 'Uuhc Central Billing', 'Yuki', 'K', 'Rosenkoetter', 'PA', 'Gastroenterology', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2004-10-07', '2004-10-07', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1487744009', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870640775', 'W77011431', 'W77011431', 'UT01', 'UUHC Redstone Clinic', 'Yuki', 'K', 'Rosenkoetter', 'PA', 'Gastroenterology', NULL, NULL, NULL, 'O', '1743 Redstone Ctr Dr Ste 115', 'Park City', 'Summit', 'UT', '84098', '4356589200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2004-10-07', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1487744009', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870641924', 'W77011432', 'W77011432', 'UT01', 'Integrated Physical Medicine', 'Ty', 'A', 'Glines', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', '308 E 4500 S Ste 175', 'Murray', 'Salt Lake', 'UT', '84107', '8016857700', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2293', '0.00', '35.00', NULL, 3, '2006-01-27', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '949394', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870641924', 'W77011433', 'W77011433', 'UT01', 'Integrated Physical Medicine', 'Ty', 'A', 'Glines', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '308 E 4500 S Ste 175', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8016857700', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2293', '0.00', '35.00', NULL, 3, '2006-01-27', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '949394', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870644621', 'W77011434', 'W77011434', 'UT02', 'Delta Physical Therapy & Sports Medicine', 'Mitchel', 'S', 'Anderson', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '130 S Wihte Sage Ave Ste C', 'Delta', 'Millard', 'UT', '84624', '4358642551', '4358643573', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2293', '0.00', '35.00', NULL, 3, '2006-02-07', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '955124', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('876000528', 'W77011435', 'W77011435', 'UT01', 'Wootton FNP, George', 'George', 'C', 'Wootton', 'FNP', NULL, NULL, NULL, NULL, 'O', '6802 OLD MAIN HILL', 'Logan', 'Cache', 'UT', '84322', '4357972750', '4357974054', NULL, NULL, '', NULL, NULL, '', '', 'USMITH', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-02-16', '2006-12-31', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1730246299', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W77011436', 'W77011436', 'UT02', 'Intermountain Health Care', 'Agnes', 'M', 'Szpunar', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', NULL, NULL, 'PO Box 27128', 'Salt Lake City', 'Salt Lake', 'UT', '84127', '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', '0.00', 8, '2000-08-18', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1033216858', 0, 'Y', 0, '2011-04-28', NULL, NULL, 0, 0, NULL, NULL),
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('870228470', 'W77011481', 'W77011481', 'UT01', 'Ogden Vision Center', 'Gary', 'C', 'Slaugh', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '3475 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8013948885', '8013948991', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-03-09', '2006-03-09', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376649152', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870228470', 'W77011482', 'W77011482', 'UT01', 'Ogden Vision Center', 'Gary', 'C', 'Slaugh', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '139 N State St Ste C6', 'Morgan', 'Morgan', 'UT', '84050', '8018293442', '8013948991', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-03-09', '2006-03-09', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376649152', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77011483', 'W77011483', 'UT01', 'Central Utah Clinic', 'Silvana', 'Zy', 'Bucur', 'MD', 'Internal Medicine', 'Hematology and Oncology', 'Oncology', NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-03-15', '2006-03-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '14007', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77011484', 'W77011484', 'UT01', 'Central Utah Clinic', 'Silvana', 'Zy', 'Bucur', 'MD', 'Internal Medicine', 'Hematology and Oncology', 'Oncology', NULL, 'O', '1055 N 500 W Ste 202', 'Provo', 'Utah', 'UT', '84604', '8013742367', '8014298015', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-03-15', '2006-03-15', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '14007', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77011485', 'W77011485', 'UT01', 'Central Utah Clinic', 'C William', NULL, 'Bacon', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2002-07-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962505750', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77011486', 'W77011486', 'UT01', 'Central Utah Clinic', 'C William', NULL, 'Bacon', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '680 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8012245373', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2002-07-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962505750', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77011487', 'W77011487', 'UT01', 'Central Utah Clinic', 'John', 'Kay', 'Frischknecht', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'B', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013742362', '8013742615', NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '1999-09-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235197674', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W77011488', 'W77011488', 'UT01', 'Wasatch Otolaryngology Group', 'John', 'Kay', 'Frischknecht', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '700 W 800 N Ste 230', 'Orem', 'Utah', 'UT', '84057', '8014290620', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '1999-09-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235197674', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870283830', 'W77011489', 'W77011489', 'UT01', 'Intermountain Allergy', 'Duane', 'J', 'Harris', 'MD', 'Allergy', NULL, NULL, NULL, 'B', '1682 E 5600 S', 'Ogden', 'Weber', 'UT', '84403', '8014760052', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDALLE', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2003-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275535411', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870283830', 'W77011490', 'W77011490', 'UT01', 'Intermountain Allergy', 'Duane', 'J', 'Harris', 'MD', 'Allergy', NULL, NULL, NULL, 'O', '12422 S 450 E Ste C', 'Draper', 'Salt Lake', 'UT', '84020', '8015331900', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDALLE', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2003-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275535411', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77011491', 'W77011491', 'UT01', 'Granger Medical Clinic', 'Heather', 'L', 'Campbell', 'APRN', NULL, NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', '8019653720', '8019653740', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-03-24', '2006-03-24', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427080670', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77011492', 'W77011492', 'UT01', 'Granger Medical Clinic', 'Heather', 'L', 'Campbell', 'APRN', NULL, NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653600', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-03-24', '2006-03-24', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1427080670', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77011493', 'W77011493', 'UT01', 'Granger Medical Clinic', 'Douglas', 'B', 'Jerman', 'PA', NULL, NULL, NULL, NULL, 'B', 'PO Box 70658', 'West Valley', 'Salt Lake', 'UT', '84170', '8019653720', '8019653740', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-03-01', '2006-03-01', 0, 0, 0, 'Pioneer Valley Hospital', 'Riverton Childrens Unit Operated by Primary Childrens Medical Center', NULL, NULL, 'HCFA|UB|', '1518999762', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W77011494', 'W77011494', 'UT01', 'Granger Medical Clinic', 'Douglas', 'B', 'Jerman', 'PA', NULL, NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653600', '8019683605', NULL, NULL, '', NULL, NULL, '', '', 'UGRANGER', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-03-01', '2006-03-01', 0, 0, 0, 'Pioneer Valley Hospital', 'Riverton Childrens Unit Operated by Primary Childrens Medical Center', NULL, NULL, 'HCFA|UB|', '1518999762', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77011495', 'W77011495', 'UT01', 'Ogden Clinic', 'Damon', 'B', 'Marsh', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014794621', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-06-02', '2003-06-02', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1467441089', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870286381', 'W77011496', 'W77011496', 'UT01', 'Ogden Clinic', 'Brent', 'M', 'Baranko', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014794621', '8014762670', NULL, NULL, '', NULL, NULL, '', '', 'UOGDCLIN', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2003-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306833967', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870288909', 'W77011497', 'W77011497', 'UT01', 'Planned Parenthood Assoc of Utah', 'Jennifer', 'J', 'Trauscht-Van Horn', 'MD', 'Obstetrics and Gynecology', 'Certified Nurse Midwife', NULL, NULL, 'O', '654 S 900 E', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015321586', '8015325748', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '1999-09-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306926209', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W77011498', 'W77011498', 'UT01', 'Heart And Lung Institute', 'David', 'T', 'Harris', 'MD', 'Pulmonary', NULL, NULL, NULL, 'O', '5979 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '8012651200', NULL, NULL, '', NULL, NULL, '', '', 'USTDCARD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-03-29', '2006-03-29', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992783559', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011499', 'W77011499', 'UT01', 'Chiropractic Health Plan', 'Daniel', 'R', 'Guthrie', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-03-01', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972722916', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011500', 'W77011500', 'UT01', 'Guthrie Chiropractic', 'Daniel', 'R', 'Guthrie', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '3856 W 5400 S Ste 120', 'Salt Lake City', 'Salt Lake', 'UT', '84118', '8019579696', '8019579694', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-03-01', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972722916', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011501', 'W77011501', 'UT01', 'Chiropractic Health Plan', 'Tricia', 'A', 'Chepanoske', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-03-29', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457338279', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011502', 'W77011502', 'UT01', 'Chiropractic Health Plan', 'Tricia', 'A', 'Chepanoske', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '715 E 3900 S Ste 201', 'Salt Lake City', 'Salt Lake', 'UT', '84107', '8016850588', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-03-29', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457338279', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011503', 'W77011503', 'UT01', 'Chiropractic Health Plan', 'Mark', 'V', 'Vosti', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-03-29', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669444303', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011504', 'W77011504', 'UT01', 'South Mountain Chiropractic', 'Mark', 'V', 'Vosti', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '1101 Draper Pkwy', 'Draper', 'Salt Lake', 'UT', '84020', '8016196090', '8015536323', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-03-29', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1669444303', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011505', 'W77011505', 'UT01', 'Chiropractic Health Plan', 'Jeremiah', NULL, 'Hoopes', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-03-29', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881652535', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77011506', 'W77011506', 'UT01', 'Body Needs', 'Jeremiah', NULL, 'Hoopes', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '770 S 200 E Ste 102', 'Brigham City', 'Box Elder', 'UT', '84302', '4357230517', '4357230587', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2006-03-29', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881652535', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870423799', 'W77011507', 'W77011507', 'UT01', 'Eyecare Associates', 'Kris', 'A', 'Hill', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '7400 Union Park Ave Ste 202', 'Midvale', 'Salt Lake', 'UT', '84047', '8015693698', '8015690578', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-03-09', '2006-03-09', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043228554', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870443687', 'W77011508', 'W77011508', 'UT01', 'U Of U Cardiology', 'Josef', NULL, 'Stehlik', 'MD', NULL, NULL, NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015817715', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-03-01', '2006-03-01', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1558458992', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870443687', 'W77011509', 'W77011509', 'UT01', 'U Of U Cardiology-Medical Dr', 'Josef', NULL, 'Stehlik', 'MD', NULL, NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015817715', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2006-03-01', '2006-03-01', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1558458992', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870452022', 'W77011510', 'W77011510', 'UT01', 'Mt Timpanogos Womens Healthcare', 'Amy', 'A', 'Holtsclaw', 'CNM', 'Nurse Midwife', NULL, NULL, NULL, 'O', '1886 W 800 N', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017565288', '8017567589', NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2006-03-29', '2006-03-29', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1760444335', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870467746', 'W77011511', 'W77011511', 'UT01', 'U Of U Human Development Division', 'Randall', 'W', 'Rupper', 'MD', 'Internal Medicine', 'Internal Medicine', NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012386815', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-09-30', '2005-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457398703', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870467746', 'W77011512', 'W77011512', 'UT01', 'U Of U Human Development Division', 'Randall', 'W', 'Rupper', 'MD', 'Internal Medicine', 'Internal Medicine', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812628', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-09-30', '2005-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457398703', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870480520', 'W77011513', 'W77011513', 'UT01', 'U Of U Neurology', 'Edward', 'Y', 'Zamrini', 'MD', 'Neurology', NULL, NULL, NULL, 'B', 'PO Box 58307', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015856387', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2006-03-03', '2006-03-03', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578587895', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870480520', 'W77011515', 'W77011515', 'UT01', 'U Of U Neurology', 'Edward', 'Y', 'Zamrini', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015856387', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2006-03-03', '2006-03-03', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578587895', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870480520', 'W77011516', 'W77011516', 'UT01', 'Center for Advanced Medical Technology', 'Edward', 'Y', 'Zamrini', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '729 Arapeen Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015856387', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2006-03-03', '2006-03-03', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578587895', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870482642', 'W77011518', 'W77011518', 'UT01', 'Millcreek Anesthesia', 'Jennifer', NULL, 'Layman', 'MD', 'Anesthesiology', NULL, NULL, NULL, 'O', '1200 E 3900 S', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8019939530', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '48.30', NULL, NULL, 3, '2006-04-03', '2006-04-03', 1, 12, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336172840', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870518863', 'W77011529', 'W77011529', 'UT01', 'Fred M Civish, MD', 'Frederic', 'M', 'Civish', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '3534 S 6000 W', 'Salt Lake City', 'Salt Lake', 'UT', '84128', '8019696264', '8019696333', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2002-04-01', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1124137278', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870639098', 'W77011550', 'W77011550', 'UT01', 'After Hours Medical Company', 'Bradley', 'K', 'Lewis', 'MD', 'Urgent Care', NULL, NULL, NULL, 'B', 'PO Box 1000', 'Draper', 'Salt Lake', 'UT', '84020', '8013529500', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDURGE', NULL, NULL, '0.00', '35.00', NULL, 3, '2006-02-17', '2006-02-17', 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1871609222', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870649259', 'W77011554', 'W77011554', 'UT01', 'Alpine Orthopedic Specialists', 'Brad', 'J', 'Larson', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'B', 'PO Box 6250', 'Logan', 'Cache', 'UT', '84341', '4357872000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-04-01', '2000-04-01', 0, 0, 0, 'Brigham City Community Hospital', 'Logan Regional Hospital', NULL, NULL, 'HCFA|UB|', '1396733507', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870649259', 'W77011555', 'W77011555', 'UT01', 'Alpine Orthopedic Specialists', 'Brad', 'J', 'Larson', 'MD', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '451 W 600 N', 'Tremonton', 'Box Elder', 'UT', '84337', '4352573809', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDORTH', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-04-01', '2000-04-01', 0, 0, 0, 'Brigham City Community Hospital', 'Logan Regional Hospital', NULL, NULL, 'HCFA|UB|', '1396733507', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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