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
('621801973', 'PGUTAH117', 'PGUTAH117', 'UT01', NULL, 'Heather', '', 'Berkel', 'FNP-C', 'Family Practice', '', '', NULL, 'B', '406 W South Jordan Pkwy Ste 450', 'South Jordan', 'Salt Lake', 'UT', '84095', '8019843418', '8019843479', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1326372764', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH115', 'PGUTAH115', 'UT01', 'Davis Urgent Care ', 'Heather', '', 'Berkel', 'FNP-C', 'Family Practice', '', '', NULL, 'O', '124 S Fairfield Rd', 'Layton', 'Davis', 'UT', '84041', '8019273099', '8019273088', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1326372764', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH009', 'PGUTAH009', 'UT01', 'Hyperbaric and Wound Care', 'Douglas', 'P', 'Barney', 'MD', 'Wound Care', 'Hyperbaric Wound', 'Family Practice', NULL, 'B', 'PO Box 281415', 'Atlanta', 'Fulton', 'GA', '30384', '8018077900', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1013081801', 0, 'y', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH271', 'PGUTAH271', 'UT01', 'Copper Canyon Womens Center', 'Joseph', 'W', 'Bell', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '225 Sky Hawk Dr', 'Wendover', 'Tooele', 'UT', '84083', '4355793846', '8019643894', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1851471767', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'PGUTAH344', 'PGUTAH344', 'UT01', 'Heart and Lung Institute', 'Clinton', '', 'Anderson', 'PAC', 'Pulmonary', '', '', NULL, 'B', 'PO Box 847112', 'Dallas', 'Dallas', 'TX', '75284', '8012632370', '8012651200', 'PO Box 847112', 'Dallas', 'Dallas', 'TX', '75284', '8012632370', '8012651200', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1003922790', 0, NULL, 0, '2014-06-16', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH099', 'PGUTAH099', 'UT01', 'Rock Run Medical', 'Jeff', '', 'Anderson', 'PA', 'Family Practice', '', '', NULL, 'B', '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8016014420', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255398921', 0, 'Y', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH100', 'PGUTAH100', 'UT01', 'Rock Run Medical', 'Jeff', '', 'Anderson', 'PA', 'Family Practice', '', '', NULL, 'O', '5991 S 3500 W Ste 400', 'Roy', 'Weber', 'UT', '84067', '8017732838', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1255398921', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('870354442', 'PGUTAH315', 'PGUTAH315', 'UT01', 'Rocky Mountain Womens Health Center', 'Susan', 'A', 'Arogyasami', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1580 W Antelope Dr Ste 290', 'Layton', 'Davis', 'UT', '84041', '8017760880', '8017737399', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'Davis Hospital', '', '', '', 'HCFA|UB|', '1346474764', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('870354442', 'PGUTAH316', 'PGUTAH316', 'UT01', 'Rocky Mountain Womens Health Center', 'Susan', 'A', 'Arogyasami', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 844839', 'Dallas', 'Dallas', 'TX', '75284', '8017760880', '8017737399', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'Davis Hospital', '', '', '', 'HCFA|UB|', '1346474764', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH031', 'PGUTAH031', 'UT01', 'Davis Internal Medicine', 'Sara', 'J', 'Arrington', 'APRN', 'Family Practice', '', '', NULL, 'O', '1492 W Antelope Dr Ste 203', 'Layton', 'Davis', 'UT', '84041', '8017737500', '8017737800', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093960668', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH273', 'PGUTAH273', 'UT01', 'Physician Group of Utah Inc', 'Joseph', 'W', 'Bell', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8016014420', '8016014421', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1851471767', 0, 'Y', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH272', 'PGUTAH272', 'UT01', 'Copper Canyon Womens Center', 'Joseph', 'W', 'Bell', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '3336 S Pioneer Parkway Ste 301', 'West Valley', 'Salt Lake', 'UT', '84120', '8019643865', '8019643894', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1851471767', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH030', 'PGUTAH030', 'UT01', 'Physician Group of Utah', 'Isaac', '', 'Alfaro', 'APRN', 'Mental Health', '', '', NULL, 'B', 'PO Box 281415', 'Atlanta', 'Fulton', 'GA', '30384', '8014088123', '8014088124', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1093817884', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'PGUTAH340', 'PGUTAH340', 'UT01', 'Heart and Lung Institute', 'Clinton', '', 'Anderson', 'PAC', 'Pulmonary', '', '', NULL, 'O', '3336 S 4155 W Ste 203', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8012632370', '8012651200', '3336 S 4155 W Ste 203', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8012632370', '8012651200', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1003922790', 0, NULL, 0, '2014-06-16', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'PGUTAH341', 'PGUTAH341', 'UT01', 'Heart And Lung Institute', 'Clinton', '', 'Anderson', 'PAC', 'Pulmonary', '', '', NULL, 'O', '3570 W 9000 S Ste 110', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012632370', '8012651200', '3570 W 9000 S Ste 110', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012632370', '8012651200', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1003922790', 0, NULL, 0, '2014-06-16', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'PGUTAH342', 'PGUTAH342', 'UT01', 'Heart and Lung Institute', 'Clinton', '', 'Anderson', 'PAC', 'Pulmonary', '', '', NULL, 'O', '5979 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '8012651200', '5979 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '8012651200', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1003922790', 0, NULL, 0, '2014-06-16', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'PGUTAH343', 'PGUTAH343', 'UT01', 'Heart and Lung Institute', 'Clinton', '', 'Anderson', 'PAC', 'Pulmonary', '', '', NULL, 'O', '82 S 1100 E Ste 103', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8012632370', '8012651200', '82 S 1100 E Ste 103', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8012632370', '8012651200', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1003922790', 0, NULL, 0, '2014-06-16', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH008', 'PGUTAH008', 'UT01', 'Hyperbaric and Wound Care', 'Douglas', 'P', 'Barney', 'MD', 'Wound Care', 'Hyperbaric Wound', 'Family Practice', NULL, 'O', '2132 N 1700 W Ste 100', 'Layton', 'Davis', 'UT', '84041', '8018077900', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1013081801', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH153', 'PGUTAH153', 'UT01', 'Pioneer Valley Hospital Physicians', 'J', 'D', 'Bane', 'MD', 'Internal Medicine', '', '', NULL, 'B', '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8013529500', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1477584837', 0, 'Y', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH152', 'PGUTAH152', 'UT01', 'Internal Medicine Specialist - Hospitalists', 'J', 'D', 'Bane', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3460  Pioneer Pkwy', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643101', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1477584837', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH108', 'PGUTAH108', 'UT01', 'Rocky Mountain Womens Health Center at West Valley Campus', 'Lynne', 'G', 'Atwood', 'FNP', 'Obstetrics and Gynecology', '', '', NULL, 'B', '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8019643865', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275590960', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH107', 'PGUTAH107', 'UT01', 'Rocky Mountain Womens Health Center at West Valley Campus', 'Lynne', 'G', 'Atwood', 'FNP', 'Obstetrics and Gynecology', '', '', NULL, 'O', '3336 S Pioneer Pkwy Ste 301', 'West Valley', 'Salt Lake', 'UT', '84120', '8019643865', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275590960', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH106', 'PGUTAH106', 'UT01', 'Rocky Mountain Womens Health Center at West Valley Campus', 'Lynne', 'G', 'Atwood', 'FNP', 'Obstetrics and Gynecology', '', '', NULL, 'O', '225 Sky Hawk Dr', 'Wendover', 'Tooele', 'UT', '84083', '4355793846', '8019643894', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275590960', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH033', 'PGUTAH033', 'UT01', 'Legacy Point Family Medicine Center', 'Sara', 'J', 'Arrington', 'APRN', 'Family Practice', '', '', NULL, 'B', '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8016145140', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093960668', 0, 'y', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH032', 'PGUTAH032', 'UT01', 'Legacy Point Family Medicine Center', 'Sara', 'J', 'Arrington', 'APRN', 'Family Practice', '', '', NULL, 'O', '3110 W 300 N Ste A', 'West Point', 'Davis', 'UT', '84015', '8016145140', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093960668', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH026', 'PGUTAH026', 'UT01', 'Salt Lake Regional Medical Center', 'Isaac', '', 'Alfaro', 'APRN', 'Mental Health', '', '', NULL, 'O', '1050 E S Temple', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013504111', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1093817884', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH027', 'PGUTAH027', 'UT01', 'Davis Hospital & Medical Center', 'Isaac', '', 'Alfaro', 'APRN', 'Mental Health', '', '', NULL, 'O', '1600 W Antelope Dr', 'Layton', 'Davis', 'UT', '84041', '8018071000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1093817884', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH028', 'PGUTAH028', 'UT01', 'Pioneer Valley Hospital', 'Isaac', '', 'Alfaro', 'APRN', 'Mental Health', '', '', NULL, 'O', '3460 S Pioneer Pkwy', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1093817884', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH029', 'PGUTAH029', 'UT01', 'Pioneer Valley Hospital Outpatient Behavioral Health Unit', 'Isaac', '', 'Alfaro', 'APRN', 'Mental Health', '', '', NULL, 'O', '4052 W Pioneer Pkwy Ste 105', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643111', '8019643752', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1093817884', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH004', 'PGUTAH004', 'UT01', 'Salt Lake Regional Family Practice Sports Medicine', 'Joseph', 'J', 'Albano', 'MD', 'Sports Medicine', '', '', NULL, 'O', '4888 S Highland Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8014245042', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1003836636', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH005', 'PGUTAH005', 'UT01', 'Salt Lake Regional Family Practice Sports Medicine', 'Joseph', 'J', 'Albano', 'MD', 'Sports Medicine', '', '', NULL, 'O', '9350 S 150 E Ste 460', 'Sandy', 'Salt Lake', 'UT', '84070', '8014245042', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'WUSTDSURG5', 'WUSTDHCPC5', NULL, '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, 'Salt Lake Regional Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1003836636', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'PGUTAH367', 'PGUTAH367', 'UT01', 'Heart And Lung Institute of Utah', 'Scott', 'K', 'Aberegg', 'MD', 'Pulmonary', 'Critical Care', '', NULL, 'O', '1050 E S Temple', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8012632370', '8012651200', '1050 E S Temple', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8012632370', '8012651200', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1164434486', 0, NULL, 0, '2014-06-16', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'PGUTAH368', 'PGUTAH368', 'UT01', 'Heart And Lung Institute of Utah', 'Scott', 'K', 'Aberegg', 'MD', 'Pulmonary', 'Critical Care', '', NULL, 'O', '3460 S Pioneer Pkwy', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8012632370', '8012651200', '3460 S Pioneer Pkwy', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8012632370', '8012651200', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1164434486', 0, NULL, 0, '2014-06-16', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'PGUTAH369', 'PGUTAH369', 'UT01', 'Heart And Lung Institute of Utah', 'Scott', 'K', 'Aberegg', 'MD', 'Pulmonary', 'Critical Care', '', NULL, 'O', '3580 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012632370', '8012651200', '3580 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012632370', '8012651200', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1164434486', 0, NULL, 0, '2014-06-16', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'PGUTAH370', 'PGUTAH370', 'UT01', 'Heart And Lung Institute of Utah', 'Scott', 'K', 'Aberegg', 'MD', 'Pulmonary', 'Critical Care', '', NULL, 'M', '5979 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '8012651200', '5979 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '8012651200', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1164434486', 0, NULL, 0, '2014-06-16', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'PGUTAH371', 'PGUTAH371', 'UT01', 'Heart And Lung Institute of Utah', 'Scott', 'K', 'Aberegg', 'MD', 'Pulmonary', 'Critical Care', '', NULL, 'B', 'PO Box 847112', 'Dallas', 'Dallas', 'TX', '75284', '8012632370', '8012651200', 'PO Box 847112', 'Dallas', 'Dallas', 'TX', '75284', '8012632370', '8012651200', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1164434486', 0, NULL, 0, '2014-06-16', NULL, NULL, 0, 0, NULL, NULL),
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('830335677', 'W12047412', 'W12047412', 'WYT1', 'Big Country Rehab', 'Jessica', '', 'Mangus', 'PT', 'Physical Therapy', '', '', NULL, 'O', '525 E Birch', 'Glenrock', 'Converse', 'WY', '82637', '3073589464', '3073589330', '525 E Birch', 'Glenrock', 'Converse', 'WY', '82637', '3073589464', '3073589330', '', '', '', '0.00', '0.00', '120.00', 3, '2014-05-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1093060204', 0, 'N', 0, '2014-05-28', NULL, NULL, 0, 0, NULL, NULL),
('264333033', 'W12047308', 'W12047308', 'TXSATSTD', 'Consultants in Womens Health', 'Randall', 'K', 'Sadler', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '250 E Basse Ste 205', 'San Antonio', 'Bexar', 'TX', '78209', '2106535501', '          ', '250 E Basse Ste 205', 'San Antonio', 'Bexar', 'TX', '78209', '2106535501', '          ', 'TXOBG', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2014-06-01', NULL, 0, 0, 0, 'North Central Baptist Hospital', '', '', '', 'HCFA|UB|', '1720017601', 0, 'N', 0, '2014-05-05', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W12047044', 'W12047044', 'WYBILLINGS', 'Billings Clinic', 'Theresa', 'C', 'Benock', 'OT', 'Occupational Therapy', '', '', NULL, 'B', 'PO Box 31315', 'Billings', 'Yellowstone', 'MT', '59107', '4062382617', '0000000000', 'PO Box 31315', 'Billings', 'Yellowstone', 'MT', '59107', '4062382617', '0000000000', '', '', '', '0.00', '17.00', '0.00', 3, '2014-04-22', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1376699462', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
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('810231784', 'W12047035', 'W12047035', 'WYBILLINGS', 'Billings Clinic', 'Fukami', '', 'Norio', 'MD', 'Gastroenterology', '', '', NULL, 'M', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', '0000000000', '0000000000', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', '0000000000', '0000000000', '', '', '', '0.00', '17.00', '0.00', 3, '2013-10-17', '2013-11-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1255425930', 0, 'N', 0, '2014-05-09', NULL, NULL, 0, 0, NULL, NULL),
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('363330928', 'W12047031', 'W12047031', 'ILCHIGSTD', 'Presence Healthcare Services', 'Mohammed ', '', 'Ghabra', 'MD', 'Neurology', '', '', NULL, 'B', '62311 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '8557647687', '6309142469', '62311 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '8557647687', '6309142469', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1396746822', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('363383867', 'W12047032', 'W12047032', 'ILCHIGSTD', 'Little Company of Mary Affiliated Services', 'Jawwad', '', 'Hussain', 'MD', 'Family Practice', '', '', NULL, 'O', '10961 S Kedzie', 'Chicago', 'Cook', 'IL', '60655', '7732399100', '7732399102', '10961 S Kedzie', 'Chicago', 'Cook', 'IL', '60655', '7732399100', '7732399102', 'CHIG8', 'CHIHCPCS01', '', '0.00', '40.00', '0.00', 3, '2014-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336434935', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
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('621801973', 'PGUTAH157', 'PGUTAH157', 'UT01', 'Physician Group of Utah Inc', '', '', 'Physician Group of Utah Inc', '', 'Clinic', '', '', NULL, 'B', '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8016014420', '          ', '406 W South Jordan Pkwy Ste 500', 'South Jordan', 'Salt Lake', 'UT', '84095', '8016014420', '          ', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477676930', 0, 'Y', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
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('850275777', 'W12047023', 'W12047023', 'NM01', 'Southwest Medical Associates', 'Jaya', 'N', 'Martin', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5058231010', '5057974503', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5058231010', '5057974503', 'NMSWMED', '', '', '0.00', '10.00', '0.00', 3, '2014-06-01', NULL, 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1598013716', 0, 'N', 0, '2014-05-28', NULL, NULL, 0, 0, NULL, NULL),
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('621801973', 'PGUTAH156', 'PGUTAH156', 'UT01', 'Physician Group of Utah Inc', '', '', 'Physician Group of Utah Inc', '', 'Clinic', '', '', NULL, 'O', '3336 S 4155 W Ste 204', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643492', '8019643493', '3336 S 4155 W Ste 204', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019643492', '8019643493', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477676930', 0, 'Y', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
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('850275777', 'W12047026', 'W12047026', 'NM01', 'Southwest Medical Associates', 'Jaya', 'N', 'Martin', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4801 McMahon Blvd Ste 110', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5057274025', '5057274030', '4801 McMahon Blvd Ste 110', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5057274025', '5057274030', 'NMSWMED', '', '', '0.00', '10.00', '0.00', 3, '2014-06-01', NULL, 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1598013716', 0, 'N', 0, '2014-05-28', NULL, NULL, 0, 0, NULL, NULL),
('850275777', 'W12047025', 'W12047025', 'NM01', 'Southwest Medical Associates', 'Jaya', 'N', 'Martin', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4420 Irving Blvd NW', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5058231010', '5057974503', '4420 Irving Blvd NW', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5058231010', '5057974503', 'NMSWMED', '', '', '0.00', '10.00', '0.00', 3, '2014-06-01', NULL, 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1598013716', 0, 'N', 0, '2014-05-28', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH155', 'PGUTAH155', 'UT01', 'Physician Group of Utah Inc', '', '', 'Physician Group of Utah Inc', '', 'Clinic', '', '', NULL, 'O', '2295 S Foothill Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84109', '8012147650', '8014872894', '2295 S Foothill Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84109', '8012147650', '8014872894', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477676930', 0, 'Y', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'PGUTAH154', 'PGUTAH154', 'UT01', 'Davis Internal Medicine', '', '', 'Physician Group of Utah Inc', '', 'Clinic', '', '', NULL, 'O', '1492 W Antelope Dr Ste 203', 'Layton', 'Davis', 'UT', '84041', '8017737500', '8017737800', '1492 W Antelope Dr Ste 203', 'Layton', 'Davis', 'UT', '84041', '8017737500', '8017737800', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2014-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477676930', 0, 'Y', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('260848435', 'W12047020', 'W12047020', 'UTMH1', 'Hales Counseling Center', 'Jason', 'A', 'Hales', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '124 S 400 E Ste 300', 'Salt Lake City', 'Salt Lake', 'UT', '84111', '8017839265', '4848429939', '124 S 400 E Ste 300', 'Salt Lake City', 'Salt Lake', 'UT', '84111', '8017839265', '4848429939', 'UTMA', '', '', '0.00', '40.00', '0.00', 3, '2014-04-24', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659314201', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('800701770', 'W12047019', 'W12047019', 'UT01', 'MountainStar Medical Group Neurosurgery St Marks LLC', 'Kade', 'T', 'Huntsman', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 741648', 'Atlanta', 'Fulton', 'GA', '30374', '6153737490', '8012618511', 'PO Box 741648', 'Atlanta', 'Fulton', 'GA', '30374', '6153737490', '8012618511', 'UTHCAPS', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1730171232', 0, 'N', 0, '2014-07-22', NULL, NULL, 0, 0, NULL, NULL),
('800701770', 'W12047017', 'W12047017', 'UT01', 'Coral Desert Spine Center', 'Kade', 'T', 'Huntsman', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1490 E Foremaster Dr Ste 210', 'St George', 'Washington', 'UT', '84790', '4356568366', '4356568370', '1490 E Foremaster Dr Ste 210', 'St George', 'Washington', 'UT', '84790', '4356568366', '4356568370', 'UTHCAPS', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1730171232', 0, 'N', 0, '2014-07-22', NULL, NULL, 0, 0, NULL, NULL),
('760148449', 'W12047016', 'W12047016', 'TXHOUSTD', '', 'Victor ', 'M', 'Salcedo', 'MD', 'Pulmonary', 'Sleep Disorders', 'Critical Care', NULL, 'O', '7737 Sw Fwy Ste 570', 'Houston', 'Harris', 'TX', '77074', '7137774217', '7137774387', '7737 Sw Fwy Ste 570', 'Houston', 'Harris', 'TX', '77074', '7137774217', '7137774387', 'HOUSTON4', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-06-21', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336133834', 0, 'N', 0, '2014-05-21', NULL, NULL, 0, 0, NULL, NULL),
('621762468', 'W12047015', 'W12047015', 'WY01', 'SageWest Health Care', '', '', 'Riverton Memorial Hospital, LLC', 'GROUP', 'Hospital', '', '', NULL, 'B', 'PO Box 742744', 'Atlanta', 'Fulton', 'GA', '30374', '3073324420', '          ', 'PO Box 742744', 'Atlanta', 'Fulton', 'GA', '30374', '3073324420', '          ', '', '', '', '0.00', '5.00', '0.00', 6, '2014-04-21', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1245337286', 0, 'N', 0, '2014-05-01', NULL, NULL, 0, 0, NULL, NULL),
('621762468', 'W12047014', 'W12047014', 'WYWSBAIT', 'SageWest Health Care', '', '', 'Riverton Memorial Hospital, LLC', 'GROUP', 'Hospital', '', '', NULL, 'B', 'PO Box 742744', 'Atlanta', 'Fulton', 'GA', '30374', '3073324420', '          ', 'PO Box 742744', 'Atlanta', 'Fulton', 'GA', '30374', '3073324420', '          ', '', '', '', '0.00', '10.00', '0.00', 6, '2014-04-21', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1245337286', 0, 'N', 0, '2014-05-01', NULL, NULL, 0, 0, NULL, NULL),
('621762468', 'W12047013', 'W12047013', 'WYWSBAIT', 'SageWest Health Care', '', '', 'Riverton Memorial Hospital, LLC', 'GROUP', 'Hospital', '', '', NULL, 'O', '2100 W Sunset Dr', 'Riverton', 'Fremont', 'WY', '82501', '3073324420', '          ', '2100 W Sunset Dr', 'Riverton', 'Fremont', 'WY', '82501', '3073324420', '          ', '', '', '', '0.00', '10.00', '0.00', 6, '2014-04-21', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1245337286', 0, 'N', 0, '2014-05-01', NULL, NULL, 0, 0, NULL, NULL),
('870443046', 'W12047011', 'W12047011', 'UT01', 'University Health Care Sleep Wake Center', '', '', 'University Health Care Sleep Wake Center', '', 'Sleep Disorders', '', '', NULL, 'O', '375 Chipeta Way Ste A200', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813067', '8015873349', '375 Chipeta Way Ste A200', 'Salt Lake City', 'Salt Lake', 'UT', '84108', '8015813067', '8015873349', 'WUUUMG5', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2014-04-29', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000010163', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('621762468', 'W12047012', 'W12047012', 'WY01', 'SageWest Health Care', '', '', 'Riverton Memorial Hospital, LLC', 'GROUP', 'Hospital', '', '', NULL, 'O', '2100 W Sunset Dr', 'Riverton', 'Fremont', 'WY', '82501', '3073324420', '          ', '2100 W Sunset Dr', 'Riverton', 'Fremont', 'WY', '82501', '3073324420', '          ', '', '', '', '0.00', '5.00', '0.00', 6, '2014-04-21', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1245337286', 0, 'N', 0, '2014-05-01', NULL, NULL, 0, 0, NULL, NULL),
('820484941', 'W12047007', 'W12047007', 'ID01', 'Center for Hope and Healing', 'Joyce', '', 'Yeager', 'LCPC', 'Mental Health', 'Counseling', '', NULL, 'B', 'PO Box 16820', 'Boise', 'Ada', 'ID', '83715', '2083430441', '2083434993', 'PO Box 16820', 'Boise', 'Ada', 'ID', '83715', '2083430441', '2083434993', 'IDMA', '', '', '0.00', '40.00', '0.00', 8, '2014-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1629107321', 0, 'N', 0, '2014-06-25', NULL, NULL, 0, 0, NULL, NULL),
('760473642', 'W12047008', 'W12047008', 'TXHOUSTD', '', 'Karunakar', 'P', 'Reddy', '', 'Cardiology', '', '', NULL, 'O', '2101 S Loop 336 W', 'Conroe', 'Montgomery', 'TX', '77304', '9364418010', '9367562532', '2101 S Loop 336 W', 'Conroe', 'Montgomery', 'TX', '77304', '9364418010', '9367562532', 'HOUSTON2', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-06-21', NULL, 0, 0, 0, 'Conroe Regional Medical Center', '', '', '', 'HCFA|UB|', '1538333448', 0, 'N', 0, '2014-05-21', NULL, NULL, 0, 0, NULL, NULL),
('753143209', 'W12047005', 'W12047005', 'WYT1', 'Big Horn Basin Bone and Joint', 'Brett', '', 'Argeris', 'PA', 'Orthopedic Surgery', '', '', NULL, 'O', '720 Lindsay Ln Ste C', 'Cody', 'Park', 'WY', '82414', '3075781955', '3075781996', '720 Lindsay Ln Ste C', 'Cody', 'Park', 'WY', '82414', '3075781955', '3075781996', '', '', '', '0.00', '25.00', '0.00', 3, '2014-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1790764520', 0, 'N', 0, '2014-06-25', NULL, NULL, 0, 0, NULL, NULL),
('820484941', 'W12047006', 'W12047006', 'ID01', 'Center for Hope and Healing', 'Joyce', '', 'Yeager', 'LCPC', 'Mental Health', 'Counseling', '', NULL, 'O', '660 E Franklin Rd Ste 260', 'Meridian', 'Ada', 'ID', '83642', '2083430441', '2083434993', '660 E Franklin Rd Ste 260', 'Meridian', 'Ada', 'ID', '83642', '2083430441', '2083434993', 'IDMA', '', '', '0.00', '40.00', '0.00', 8, '2014-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1629107321', 0, 'N', 0, '2014-06-25', NULL, NULL, 0, 0, NULL, NULL),
('753143209', 'W12047002', 'W12047002', 'WY01', 'Big Horn Basin Bone and Joint', 'Brett', '', 'Argeris', 'PA', 'Orthopedic Surgery', '', '', NULL, 'O', '400 S 15th St', 'Worland', 'Washakie', 'WY', '82401', '3075781955', '3075781996', '400 S 15th St', 'Worland', 'Washakie', 'WY', '82401', '3075781955', '3075781996', '', '', '', '0.00', '25.00', '0.00', 3, '2014-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1790764520', 0, 'N', 0, '2014-06-25', NULL, NULL, 0, 0, NULL, NULL),
('753143209', 'W12047004', 'W12047004', 'WY01', 'Big Horn Basin Bone and Joint', 'Brett', '', 'Argeris', 'PA', 'Orthopedic Surgery', '', '', NULL, 'O', '720 Lindsay Ln Ste C', 'Cody', 'Park', 'WY', '82414', '3075781955', '3075781996', '720 Lindsay Ln Ste C', 'Cody', 'Park', 'WY', '82414', '3075781955', '3075781996', '', '', '', '0.00', '25.00', '0.00', 3, '2014-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1790764520', 0, 'N', 0, '2014-06-25', NULL, NULL, 0, 0, NULL, NULL),
('753143209', 'W12047003', 'W12047003', 'WYT1', 'Big Horn Basin Bone and Joint', 'Brett', '', 'Argeris', 'PA', 'Orthopedic Surgery', '', '', NULL, 'O', '400 S 15th St', 'Worland', 'Washakie', 'WY', '82401', '3075781955', '3075781996', '400 S 15th St', 'Worland', 'Washakie', 'WY', '82401', '3075781955', '3075781996', '', '', '', '0.00', '25.00', '0.00', 3, '2014-07-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1790764520', 0, 'N', 0, '2014-06-25', NULL, NULL, 0, 0, NULL, NULL),
('201780406', 'W12046995', 'W12046995', 'ILCHIGSTD', 'UroPartners', 'Chantal', '', 'Lindsay', 'PAC', 'Family Practice', '', '', NULL, 'B', '3183 Paysphere Cr', 'Chicago', 'Cook', 'IL', '60674', '2242603100', '8479988112', '3183 Paysphere Cr', 'Chicago', 'Cook', 'IL', '60674', '2242603100', '8479988112', 'CHIG10', 'UROHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-04-21', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1801131933', 0, 'N', 0, '2014-04-28', NULL, NULL, 0, 0, NULL, NULL),
('830330554', 'W12046996', 'W12046996', 'WY01', 'Mountain View Medical Clinic', 'Amanda', 'M', 'Barnes', 'PA', 'General Surgery', '', '', NULL, 'O', '531 Parkway Dr', 'Mountain View', 'Uinta', 'WY', '82939', '3077891390', '          ', '531 Parkway Dr', 'Mountain View', 'Uinta', 'WY', '82939', '3077891390', '          ', 'WYSTD', 'WYHCPCS', '', '0.00', '35.00', '0.00', 3, '2014-04-24', NULL, 0, 0, 0, 'Evanston Regional Hospital', '', '', '', 'HCFA|UB|', '1841435385', 0, 'N', 0, '2014-05-13', NULL, NULL, 0, 0, NULL, NULL),
('830330554', 'W12046997', 'W12046997', 'WYT1', 'Mountain View Medical Clinic', 'Amanda', 'M', 'Barnes', 'PA', 'General Surgery', '', '', NULL, 'O', '531 Parkway Dr', 'Mountain View', 'Uinta', 'WY', '82939', '3077891390', '          ', '531 Parkway Dr', 'Mountain View', 'Uinta', 'WY', '82939', '3077891390', '          ', 'WYSTD', 'WYHCPCS', '', '0.00', '35.00', '0.00', 3, '2014-04-24', NULL, 0, 0, 0, 'Evanston Regional Hospital', '', '', '', 'HCFA|UB|', '1841435385', 0, 'N', 0, '2014-05-13', NULL, NULL, 0, 0, NULL, NULL),
('830330554', 'W12046998', 'W12046998', 'WY01', 'Evanston Clinic', 'Amanda', 'M', 'Barnes', 'PA', 'General Surgery', '', '', NULL, 'O', '107 N Main St', 'Lyman', 'Uinta', 'WY', '82937', '3077873313', '          ', '107 N Main St', 'Lyman', 'Uinta', 'WY', '82937', '3077873313', '          ', 'WYSTD', 'WYHCPCS', '', '0.00', '35.00', '0.00', 3, '2014-04-24', NULL, 0, 0, 0, 'Evanston Regional Hospital', '', '', '', 'HCFA|UB|', '1841435385', 0, 'N', 0, '2014-05-13', NULL, NULL, 0, 0, NULL, NULL),
('830330554', 'W12046999', 'W12046999', 'WYT1', 'Evanston Clinic', 'Amanda', 'M', 'Barnes', 'PA', 'General Surgery', '', '', NULL, 'O', '107 N Main St', 'Lyman', 'Uinta', 'WY', '82937', '3077873313', '          ', '107 N Main St', 'Lyman', 'Uinta', 'WY', '82937', '3077873313', '          ', 'WYSTD', 'WYHCPCS', '', '0.00', '35.00', '0.00', 3, '2014-04-24', NULL, 0, 0, 0, 'Evanston Regional Hospital', '', '', '', 'HCFA|UB|', '1841435385', 0, 'N', 0, '2014-05-13', NULL, NULL, 0, 0, NULL, NULL),
('830330554', 'W12047000', 'W12047000', 'WYT1', 'Evanston Clinic', 'Amanda', 'M', 'Barnes', 'PA', 'General Surgery', '', '', NULL, 'O', '190 Arrowhead Dr', 'Evanston', 'Uinta', 'WY', '82930', '3077873313', '          ', '190 Arrowhead Dr', 'Evanston', 'Uinta', 'WY', '82930', '3077873313', '          ', 'WYSTD', 'WYHCPCS', '', '0.00', '35.00', '0.00', 3, '2014-04-24', NULL, 0, 0, 0, 'Evanston Regional Hospital', '', '', '', 'HCFA|UB|', '1841435385', 0, 'N', 0, '2014-05-13', NULL, NULL, 0, 0, NULL, NULL),
('830330554', 'W12047001', 'W12047001', 'WY01', 'Evanston Clinic', 'Amanda', 'M', 'Barnes', 'PA', 'General Surgery', '', '', NULL, 'O', '190 Arrowhead Dr', 'Evanston', 'Uinta', 'WY', '82930', '3077873313', '          ', '190 Arrowhead Dr', 'Evanston', 'Uinta', 'WY', '82930', '3077873313', '          ', 'WYSTD', 'WYHCPCS', '', '0.00', '35.00', '0.00', 3, '2014-04-24', NULL, 0, 0, 0, 'Evanston Regional Hospital', '', '', '', 'HCFA|UB|', '1841435385', 0, 'N', 0, '2014-05-13', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12046992', 'W12046992', 'UT01', 'Central Utah Clinic PC', 'Joseph', 'F', 'Allegretto', 'MD', 'Orthopedic Surgery', '', '', NULL, 'M', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013548225', '8014298150', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013548225', '8014298150', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2014-04-22', NULL, 0, 0, 0, 'Memorial Hospital of Converse County', '', '', '', 'HCFA|UB|', '1508823964', 0, 'N', 0, '2014-04-28', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12046991', 'W12046991', 'UT01', 'Central Utah Clinic PC', 'Joseph', 'F', 'Allegretto', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '65 E 100 N', 'Gunnison', 'Sanpete', 'UT', '84634', '4355282130', '          ', '65 E 100 N', 'Gunnison', 'Sanpete', 'UT', '84634', '4355282130', '          ', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2014-04-22', NULL, 0, 0, 0, 'Memorial Hospital of Converse County', '', '', '', 'HCFA|UB|', '1508823964', 0, 'N', 0, '2014-04-28', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12046993', 'W12046993', 'UT01', 'Central Utah Clinic PC', 'Joseph', 'F', 'Allegretto', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8014298180', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8014298180', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2014-04-22', NULL, 0, 0, 0, 'Memorial Hospital of Converse County', '', '', '', 'HCFA|UB|', '1508823964', 0, 'N', 0, '2014-04-28', 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
('870373083', 'W12046988', 'W12046988', 'UT01', 'Heart and Lung Institute', 'Jared', 'M', 'Simpson', 'PA-C', 'Pulmonary', '', '', NULL, 'O', '3336 S 4155 W Ste 203', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8012632370', '8012651200', '3336 S 4155 W Ste 203', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8012632370', '8012651200', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-06-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932368925', 0, 'N', 0, '2014-05-28', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W12046986', 'W12046986', 'UT01', 'Heart and Lung Institute', 'Jared', 'M', 'Simpson', 'PA-C', 'Pulmonary', '', '', NULL, 'O', '3570 W 9000 S Ste 110', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012632370', '8012651200', '3570 W 9000 S Ste 110', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012632370', '8012651200', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-06-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932368925', 0, 'N', 0, '2014-05-28', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W12046985', 'W12046985', 'UT01', 'Heart and Lung Institute', 'Jared', 'M', 'Simpson', 'PA-C', 'Pulmonary', '', '', NULL, 'O', '5979 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '8012651200', '5979 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '8012651200', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-06-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932368925', 0, 'N', 0, '2014-05-28', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W12046989', 'W12046989', 'UT01', 'Heart and Lung Institute', 'Jared', 'M', 'Simpson', 'PA-C', 'Pulmonary', '', '', NULL, 'O', '82 S 1100 E Ste 103', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8012632370', '8012651200', '82 S 1100 E Ste 103', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8012632370', '8012651200', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-06-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932368925', 0, 'N', 0, '2014-05-28', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W12046987', 'W12046987', 'UT01', 'Heart and Lung Institute', 'Jared', 'M', 'Simpson', 'PA-C', 'Pulmonary', '', '', NULL, 'B', 'PO Box 847112', 'Dallas', 'Dallas', 'TX', '75284', '8012632370', '8012651200', 'PO Box 847112', 'Dallas', 'Dallas', 'TX', '75284', '8012632370', '8012651200', 'WUSTDSURG5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-06-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932368925', 0, 'N', 0, '2014-05-28', NULL, NULL, 0, 0, NULL, NULL),
('363145256', 'W12046990', 'W12046990', 'ILCHIGSTD', 'Chest Medicine Consultants', 'Ilja', '', 'Faibussawitsch', 'MD', 'Pulmonary', 'Internal Medicine', 'Critical Care', NULL, 'O', '2800 N Sheridan Rd Ste 301', 'Chicago', 'Cook', 'IL', '60657', '7739355556', '7739352724', '2800 N Sheridan Rd Ste 301', 'Chicago', 'Cook', 'IL', '60657', '7739355556', '7739352724', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-04-16', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1740220193', 0, 'N', 0, '2014-04-28', NULL, NULL, 0, 0, NULL, NULL),
('201780406', 'W12046994', 'W12046994', 'ILCHIGSTD', 'UroPartners', 'Chantal', '', 'Lindsay', 'PAC', 'Family Practice', '', '', NULL, 'O', '676 N St Clair St Ste 1835', 'Chicago', 'Cook', 'IL', '60611', '3129263535', '3129263585', '676 N St Clair St Ste 1835', 'Chicago', 'Cook', 'IL', '60611', '3129263535', '3129263585', 'CHIG10', 'UROHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-04-21', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1801131933', 0, 'N', 0, '2014-04-28', NULL, NULL, 0, 0, NULL, NULL),
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('20713074', 'CL0308509', 'CL0308509', 'SmartCare', 'Stonebridge Pediatrics', NULL, NULL, 'Stonebridge Pediatrics', NULL, 'Clinic', 'Pediatrics', '', NULL, 'O', '5561 Virginia Pkwy Ste 100', 'McKinney', 'Collin', 'TX', '75071', '2145442555', '2145442550', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308509', 0, 'N', 0, NULL, NULL, NULL, 33.1986, -96.6892, NULL, NULL),
('900120192', 'CL0312242', 'CL0312242', 'SmartCare', 'Sports Medicine Associates of San Antonio', NULL, NULL, 'Sports Medicine Associates of San Antonio', NULL, 'Clinic', 'Orthopedic Surgery', '', NULL, 'O', '21 Spurs Ln Ste 300', 'San Antonio', 'Bexar', 'TX', '78240', '2106998326', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00312242', 0, 'N', 0, NULL, NULL, NULL, 29.5267, -98.5922, NULL, NULL),
('850379297', 'CL0306423', 'CL0306423', 'SmartCare', 'Southwest Womens Health', NULL, NULL, 'Southwest Womens Health', NULL, 'Clinic', 'Gynecology', '', NULL, 'O', '883 Lead Ave SE Ste A', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5058437131', '5052469421', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00306423', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('760406602', 'CL0310920', 'CL0310920', 'SmartCare', 'Southwest Surgical Associates', NULL, NULL, 'Southwest Surgical Associates', NULL, 'Clinic', 'General Surgery', '', NULL, 'O', '915 Gessner Rd Ste 301', 'Houston', 'Harris', 'TX', '77024', '7137721200', '2816933522', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00310920', 0, 'N', 0, NULL, NULL, NULL, 29.7804, -95.5445, NULL, NULL),
('760406602', 'CL0310914', 'CL0310914', 'SmartCare', 'Southwest Surgical Associates', NULL, NULL, 'Southwest Surgical Associates', NULL, 'Clinic', 'General Surgery', '', NULL, 'O', '7737 SW Fwy Ste 100', 'Houston', 'Harris', 'TX', '77074', '7137721200', '7137720258', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00310914', 0, 'N', 0, NULL, NULL, NULL, 29.6951, -95.523, NULL, NULL),
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('760406602', 'CL0310919', 'CL0310919', 'SmartCare', 'Southwest Surgical Associates', NULL, NULL, 'Southwest Surgical Associates', NULL, 'Clinic', 'General Surgery', '', NULL, 'O', '16651 SW Fwy Ste 360', 'Sugar Land', 'Fort Bend', 'TX', '77479', '7137721200', '2814910426', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00310919', 0, 'N', 0, NULL, NULL, NULL, 29.5915, -95.6304, NULL, NULL),
('760406602', 'CL0310918', 'CL0310918', 'SmartCare', 'Southwest Surgical Associates', NULL, NULL, 'Southwest Surgical Associates', NULL, 'Clinic', 'General Surgery', '', NULL, 'O', '17510 W Grand Pkwy S Ste 490', 'Sugar Land', 'Fort Bend', 'TX', '77479', '7137721200', '2813423957', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00310918', 0, 'N', 0, NULL, NULL, NULL, 29.5639, -95.688, NULL, NULL),
('752511887', 'CL0308482', 'CL0308482', 'SmartCare', 'Southwest Physician Associates', NULL, NULL, 'Southwest Physician Associates', NULL, 'Clinic', 'Family Practice', '', NULL, 'O', '12200 Park Central Dr Ste 410', 'Dallas', 'Dallas', 'TX', '75251', '9724905970', '9724905632', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308482', 0, 'N', 0, NULL, NULL, NULL, 32.9142, -96.7757, 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
('751292006', 'CL0308481', 'CL0308481', 'SmartCare', 'Southwest Physician Associates', NULL, NULL, 'Southwest Physician Associates', NULL, 'Clinic', 'Family Practice', '', NULL, 'O', '403 W Campbell Rd Ste 103', 'Richardson', 'Dallas', 'TX', '75080', '9722358311', '9722352663', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308481', 0, 'N', 0, NULL, NULL, NULL, 32.9754, -96.7254, NULL, NULL),
('363708552', 'CL0305273', 'CL0305273', 'SmartCare', 'Southwest Physicians Group', NULL, NULL, 'Southwest Physicians Group', NULL, 'Clinic', 'Family Practice', '', NULL, 'O', '4861 W 95th St ', 'Oak Lawn', 'Cook', 'IL', '60453', '7084232880', '7084232933', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00305273', 0, 'N', 0, NULL, NULL, NULL, 41.72, -87.7428, NULL, NULL),
('850275777', 'CL0306401', 'CL0306401', 'SmartCare', 'Southwest Medical Associates', NULL, NULL, 'Southwest Medical Associates', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '9501 Paseo del Norte Ste C & D', 'Albuquerque', 'Bernalillo', 'NM', '87122', '5057274000', '5057274014', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00306401', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('760450457', 'CL0310891', 'CL0310891', 'SmartCare', 'Southwest OB-GYN Associates', NULL, NULL, 'Southwest OB-GYN Associates', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '16651 Southwest Fwy Ste 200', 'Sugar Land', 'Fort Bend', 'TX', '77479', '7137745131', '7137744336', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00310891', 0, 'N', 0, NULL, NULL, NULL, 29.5915, -95.6304, NULL, NULL),
('850275777', 'CL0306410', 'CL0306410', 'SmartCare', 'Southwest Medical Associates', NULL, NULL, 'Southwest Medical Associates', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '6100 Pan American Fwy, Ne Ste 100', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5058231010', '5058231010', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00306410', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('850275777', 'CL0306407', 'CL0306407', 'SmartCare', 'Southwest Medical Associates', NULL, NULL, 'Southwest Medical Associates', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '8401 Constitution NE Ste 150', 'Albuquerque', 'Bernalillo', 'NM', '87110', '5058231010', '5057974503', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00306407', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('850275777', 'CL0306413', 'CL0306413', 'SmartCare', 'Southwest Medical Associates', NULL, NULL, 'Southwest Medical Associates', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '6100 Pan American Fwy NE Ste 100', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5058231010', '5057974503', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00306413', 0, 'N', 0, NULL, NULL, NULL, 35.1537, -106.587, NULL, NULL),
('850275777', 'CL0306416', 'CL0306416', 'SmartCare', 'Southwest Medical Associates', NULL, NULL, 'Southwest Medical Associates', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '4801 McMahon Blvd Ste 110', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5057274025', '5057274030', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00306416', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('850275777', 'CL0306414', 'CL0306414', 'SmartCare', 'Southwest Medical Associates', NULL, NULL, 'Southwest Medical Associates', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '4420 Irving Blvd NW ', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5058231010', '5057974503', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00306414', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('850275777', 'CL0306415', 'CL0306415', 'SmartCare', 'Southwest Medical Associates', NULL, NULL, 'Southwest Medical Associates', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5058231010', '5057974503', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00306415', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('850275777', 'CL0306408', 'CL0306408', 'SmartCare', 'Southwest Medical Associates', NULL, NULL, 'Southwest Medical Associates', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '10511 Golf Course Rd Ste 205', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5058231010', '5057974503', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00306408', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('841394139', 'CL0302548', 'CL0302548', 'SmartCare', 'Southwest Idaho ENT ', NULL, NULL, 'Southwest Idaho ENT ', NULL, 'Clinic', 'Ear, Nose and Throat', '', NULL, 'O', '4400 E Flamingo Ave Ste 220', 'Nampa', 'Canyon', 'ID', '83687', '2083673320', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302548', 0, 'N', 0, NULL, NULL, NULL, 43.5966, -116.519, NULL, NULL),
('841394139', 'CL0302547', 'CL0302547', 'SmartCare', 'Southwest Idaho ENT ', NULL, NULL, 'Southwest Idaho ENT ', NULL, 'Clinic', 'Ear, Nose and Throat', '', NULL, 'O', '900 N Liberty St Ste 400', 'Boise', 'Ada', 'ID', '83704', '2083673320', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302547', 0, 'N', 0, NULL, NULL, NULL, 43.6124, -116.261, NULL, NULL),
('363792031', 'CL0305267', 'CL0305267', 'SmartCare', 'Southwest Infectious Disease', NULL, NULL, 'Southwest Infectious Disease', NULL, 'Clinic', 'Infectious Disease', '', NULL, 'O', '1051 Essington Rd Ste 210', 'Joliet', 'Will', 'IL', '60435', '8157261818', '8157260232', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00305267', 0, 'N', 0, NULL, NULL, NULL, 41.5408, -88.1608, NULL, NULL),
('850300232', 'CL0306239', 'CL0306239', 'SmartCare', 'Southwest Gastroenterology Associates', NULL, NULL, 'Southwest Gastroenterology Associates', NULL, 'Clinic', 'Gastroenterology', '', NULL, 'O', '7788 Jefferson NE ', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5059991600', '5059991650', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00306239', 0, 'N', 0, NULL, NULL, NULL, 35.1708, -106.589, NULL, NULL),
('742838103', 'CL0306227', 'CL0306227', 'SmartCare', 'Southwest Eyecare Specialists', NULL, NULL, 'Southwest Eyecare Specialists', NULL, 'Clinic', 'Ophthalmology', '', NULL, 'O', '7110 Wyoming Blvd NE ', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5053460500', '5053460164', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00306227', 0, 'N', 0, NULL, NULL, NULL, 35.1597, -106.56, NULL, NULL),
('742608033', 'CL0312236', 'CL0312236', 'SmartCare', 'Southwest Childrens Center', NULL, NULL, 'Southwest Childrens Center', NULL, 'Clinic', 'Pediatrics', '', NULL, 'O', '5282 Medical Dr Ste 310', 'San Antonio', 'Bexar', 'TX', '78229', '2106148687', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00312236', 0, 'N', 0, NULL, NULL, NULL, 29.5087, -98.5879, NULL, NULL),
('751608686', 'CL0308456', 'CL0308456', 'SmartCare', 'Southwest Cardiac Associates', NULL, NULL, 'Southwest Cardiac Associates', NULL, 'Clinic', 'Cardiovascular Disease', '', NULL, 'O', '5308 N Galloway Ave Ste 100', 'Mesquite', 'Dallas', 'TX', '75150', '9722260505', '9722899640', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308456', 0, 'N', 0, NULL, NULL, NULL, 32.8354, -96.6356, NULL, NULL),
('742431113', 'CL0310871', 'CL0310871', 'SmartCare', 'Southwest Asthma and Allergy', NULL, NULL, 'Southwest Asthma and Allergy', NULL, 'Clinic', 'Allergy and Immunology', '', NULL, 'O', '902 Frostwood Ste 302', 'Houston', 'Harris', 'TX', '77024', '7139730051', '7139737130', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00310871', 0, 'N', 0, NULL, NULL, NULL, 29.7795, -95.5478, NULL, NULL),
('742431113', 'CL0310881', 'CL0310881', 'SmartCare', 'Southwest Asthma and Allergy', NULL, NULL, 'Southwest Asthma and Allergy', NULL, 'Clinic', 'Allergy and Immunology', '', NULL, 'O', '21820 Kingsland Blvd Ste 110', 'Katy', 'Harris', 'TX', '77450', '2815787922', '2815783175', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00310881', 0, 'N', 0, NULL, NULL, NULL, 29.7748, -95.7492, NULL, NULL),
('742431113', 'CL0310879', 'CL0310879', 'SmartCare', 'Southwest Asthma and Allergy', NULL, NULL, 'Southwest Asthma and Allergy', NULL, 'Clinic', 'Allergy and Immunology', '', NULL, 'O', '6334 FM 2920 Ste 190', 'Spring', 'Harris', 'TX', '77379', '2813766644', '2813766645', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00310879', 0, 'N', 0, NULL, NULL, NULL, 30.074, -95.5203, NULL, NULL),
('364544615', 'CL0308447', 'CL0308447', 'SmartCare', 'Southwest Allergy and Asthma Center', NULL, NULL, 'Southwest Allergy and Asthma Center', NULL, 'Clinic', 'Allergy and Immunology', '', NULL, 'O', '6101 Windcom Ct Ste 400', 'Plano', 'Collin', 'TX', '75093', '9723983500', '9723983512', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308447', 0, 'N', 0, NULL, NULL, NULL, 33.0534, -96.8326, NULL, NULL),
('752536818', 'CL0308437', 'CL0308437', 'SmartCare', 'Southlake Family Medicine', NULL, NULL, 'Southlake Family Medicine', NULL, 'Clinic', 'Internal Medicine', '', NULL, 'O', '731 E Southlake Blvd Ste 100', 'Southlake', 'Tarrant', 'TX', '76092', '8174243366', '8174243426', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308437', 0, 'N', 0, NULL, NULL, NULL, 32.941, -97.1405, NULL, NULL),
('760467095', 'CL0306560', 'CL0306560', 'SmartCare', 'Southeast Texas Medical Associates', NULL, NULL, 'Southeast Texas Medical Associates', NULL, 'Clinic', 'Family Practice', 'Internal Medicine', NULL, 'O', '2929 Calder Ave Ste 100', 'Beaumont', 'Jefferson', 'TX', '77702', '4098339797', '4096546802', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00306560', 0, 'N', 0, NULL, NULL, NULL, 30.0856, -94.1324, NULL, NULL),
('760467095', 'CL0306561', 'CL0306561', 'SmartCare', 'Southeast Texas Medical Associates', NULL, NULL, 'Southeast Texas Medical Associates', NULL, 'Clinic', 'Family Practice', 'Internal Medicine', NULL, 'O', '2400 Hwy 365 Ste 201', 'Nederland', 'Jefferson', 'TX', '77627', '4098339797', '4096546912', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00306561', 0, 'N', 0, NULL, NULL, NULL, 29.9565, -93.9846, NULL, NULL),
('760494600', 'CL0310833', 'CL0310833', 'SmartCare', 'Southeast Dermatology', NULL, NULL, 'Southeast Dermatology', NULL, 'Clinic', 'Dermatology', '', NULL, 'O', '11003 Resource Pkwy Ste 106', 'Houston', 'Harris', 'TX', '77089', '2814810033', '2814812465', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00310833', 0, 'N', 0, NULL, NULL, NULL, 29.5862, -95.2086, NULL, NULL),
('760454034', 'CL0306542', 'CL0306542', 'SmartCare', 'Southeast Texas Ear Nose and Throat', NULL, NULL, 'Southeast Texas Ear Nose and Throat', NULL, 'Clinic', 'Ear, Nose and Throat', '', NULL, 'O', '740 Hospital Dr Ste 300', 'Beaumont', 'Jefferson', 'TX', '77701', '4092128111', '4099811787', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00306542', 0, 'N', 0, NULL, NULL, NULL, 30.0703, -94.1191, NULL, NULL),
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('760442909', 'CL0310844', 'CL0310844', 'SmartCare', 'Southeast Houston Cardiology', NULL, NULL, 'Southeast Houston Cardiology', NULL, 'Clinic', 'Cardiology', '', NULL, 'O', '5010 Crenshaw Rd Ste 110 ', 'Pasadena', 'Harris', 'TX', '77505', '8323990400', '8323990401', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00310844', 0, 'N', 0, NULL, NULL, NULL, 29.6403, -95.165, NULL, NULL),
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('820200895', 'CL0302520', 'CL0302520', 'SmartCare', 'Saint Alphonsus Regional Medical Center Behavioral Health', NULL, NULL, 'Saint Alphonsus Regional Medical Center Behavioral Health', NULL, 'Clinic', 'Mental Health', '', NULL, 'O', '131 N Allumbaugh  ', 'Boise', 'Ada', 'ID', '83704', '2083672175', '2083760285', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302520', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('820200895', 'CL0302470', 'CL0302470', 'SmartCare', 'Saint Alphonsus Medical Group Pulmonary & Sleep Boise ', NULL, NULL, 'Saint Alphonsus Medical Group Pulmonary & Sleep Boise ', NULL, 'Clinic', 'Pulmonary', '', NULL, 'O', '1075 N Curtis Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302470', 0, 'N', 0, NULL, NULL, NULL, 43.6148, -116.254, NULL, NULL),
('260553931', 'CL0302439', 'CL0302439', 'SmartCare', 'Saint Alphonsus Medical Group Orthopedics ', NULL, NULL, 'Saint Alphonsus Medical Group Orthopedics ', NULL, 'Clinic', 'Orthopedic Surgery', '', NULL, 'O', '4400 E Flamingo Ave   ', 'Nampa', 'Canyon', 'ID', '83687', '2082884700', '2082884720', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302439', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('820200895', 'CL0302419', 'CL0302419', 'SmartCare', 'Saint Alphonsus Medical Group Occupational Med NHP', NULL, NULL, 'Saint Alphonsus Medical Group Occupational Med NHP', NULL, 'Clinic', 'Family Practice', 'Occupational Medicine', NULL, 'O', '4400 E Flamingo Ave ', 'Nampa', 'Canyon', 'ID', '83687', '2084668912', '2084663403', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302419', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('271789847', 'CL0302426', 'CL0302426', 'SmartCare', 'Saint Alphonsus Medical Group Ontario', NULL, NULL, 'Saint Alphonsus Medical Group Ontario', NULL, 'Clinic', 'Family Practice', '', NULL, 'O', '1050 SW 3rd Ave Ste 3200', 'Ontario', 'Malheur', 'OR', '97914', '5418817370', '5418817379', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302426', 0, 'N', 0, NULL, NULL, NULL, 44.0258, -116.977, NULL, NULL),
('820200895', 'CL0302402', 'CL0302402', 'SmartCare', 'Saint Alphonsus Medical Group OBGYN', NULL, NULL, 'Saint Alphonsus Medical Group OBGYN', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '1072 N Liberty Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302402', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'CL0302384', 'CL0302384', 'SmartCare', 'Saint Alphonsus Medical Group NHP Family Medicine  ', NULL, NULL, 'Saint Alphonsus Medical Group NHP Family Medicine  ', NULL, 'Clinic', 'Family Practice', '', NULL, 'O', '4400 E Flamingo Ave ', 'Nampa', 'Canyon', 'ID', '83687', '2084656900', '2084656910', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302384', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'CL0302365', 'CL0302365', 'SmartCare', 'Saint Alphonsus Medical Group Neurology Mulvaney', NULL, NULL, 'Saint Alphonsus Medical Group Neurology Mulvaney', NULL, 'Clinic', 'Neurology', '', NULL, 'O', '1072 N Liberty St Ste 303', 'Boise', 'Ada', 'ID', '83706', '2083672800', '2083677111', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302365', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'CL0302349', 'CL0302349', 'SmartCare', 'Saint Alphonsus Medical Group Neurology Caldwell', NULL, NULL, 'Saint Alphonsus Medical Group Neurology Caldwell', NULL, 'Clinic', 'Neurology', '', NULL, 'O', '1906 Fairview Ave Ste 430', 'Caldwell', 'Canyon', 'ID', '83605', '2083672800', '2083672876', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302349', 0, 'N', 0, NULL, NULL, NULL, 43.6588, -116.677, NULL, NULL),
('820200895', 'CL0302327', 'CL0302327', 'SmartCare', 'Saint Alphonsus Medical Group Medical Oncology Nampa', NULL, NULL, 'Saint Alphonsus Medical Group Medical Oncology Nampa', NULL, 'Clinic', 'Hematology and Oncology', '', NULL, 'O', '319 E Hawaii Ave  ', 'Nampa', 'Canyon', 'ID', '83686', '2082884679', '0000000000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302327', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'CL0302344', 'CL0302344', 'SmartCare', 'Saint Alphonsus Medical Group MHP Family Medicine', NULL, NULL, 'Saint Alphonsus Medical Group MHP Family Medicine', NULL, 'Clinic', 'Family Practice', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302344', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'CL0302319', 'CL0302319', 'SmartCare', 'Saint Alphonsus Medical Group Medical Oncology Emmett', NULL, NULL, 'Saint Alphonsus Medical Group Medical Oncology Emmett', NULL, 'Clinic', 'Hematology and Oncology', '', NULL, 'O', '1202 E Locust ', 'Emmett', 'Gem', 'ID', '83617', '2083674810', '2083674817', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302319', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('260553931', 'CL0302261', 'CL0302261', 'SmartCare', 'Saint Alphonsus Medical group Heart Care Nampa', NULL, NULL, 'Saint Alphonsus Medical group Heart Care Nampa', NULL, 'Clinic', 'Cardiology', '', NULL, 'O', '1524 12th Ave Rd ', 'Nampa', 'Canyon', 'ID', '83686', '2084635050', '2084635040', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302261', 0, 'N', 0, NULL, NULL, NULL, 43.5537, -116.573, NULL, NULL),
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('260553931', 'CL0302230', 'CL0302230', 'SmartCare', 'Saint Alphonsus Medical Group Heart Care Boise', NULL, NULL, 'Saint Alphonsus Medical Group Heart Care Boise', NULL, 'Clinic', 'Cardiology', '', NULL, 'O', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302230', 0, 'N', 0, NULL, NULL, NULL, 43.6146, -116.258, NULL, NULL),
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('820200895', 'CL0302105', 'CL0302105', 'SmartCare', 'Saint Alphonsus Medical Group EHP Family Medicine ', NULL, NULL, 'Saint Alphonsus Medical Group EHP Family Medicine ', NULL, 'Clinic', 'Family Practice', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302105', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'CL0302095', 'CL0302095', 'SmartCare', 'Saint Alphonsus Medical Group Diabetic Education', NULL, NULL, 'Saint Alphonsus Medical Group Diabetic Education', NULL, 'Clinic', 'Diabetic Education', '', NULL, 'O', '4400 E Flamingo Ave ', 'Nampa', 'Canyon', 'ID', '83687', '2083676130', '2083677316', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302095', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('260553931', 'CL0302080', 'CL0302080', 'SmartCare', 'Saint Alphonsus Medical Group Coughlin Clinic Boise ', NULL, NULL, 'Saint Alphonsus Medical Group Coughlin Clinic Boise ', NULL, 'Clinic', 'Orthopedic Surgery', '', NULL, 'O', '1075 N Curtis Rd Ste 300', 'Boise', 'Ada', 'ID', '83706', '2083673330', '2083673331', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302080', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'CL0302061', 'CL0302061', 'SmartCare', 'Saint Alphonsus Medical Group Boise Pediatrics Mulvaney', NULL, NULL, 'Saint Alphonsus Medical Group Boise Pediatrics Mulvaney', NULL, 'Clinic', 'Pediatrics', '', NULL, 'O', '1072 N Liberty Ste 203', 'Boise', 'Ada', 'ID', '83704', '2083674321', '2083674525', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302061', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('271790052', 'CL0302044', 'CL0302044', 'SmartCare', 'Saint Alphonsus Medical Group Baker City Express Care', NULL, NULL, 'Saint Alphonsus Medical Group Baker City Express Care', NULL, 'Clinic', 'Family Practice', '', NULL, 'O', '1120 Campbell St ', 'Baker City', 'Baker', 'OR', '97814', '5415232100', '5415232108', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302044', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'CL0302025', 'CL0302025', 'SmartCare', 'Saint Alphonsus Behavioral Health', NULL, NULL, 'Saint Alphonsus Behavioral Health', NULL, 'Clinic', 'Mental Health', '', NULL, 'O', '131 N Allumbaugh ', 'Boise', 'Ada', 'ID', '83704', '2083672175', '2083760285', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00302025', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('362716924', 'CL0305216', 'CL0305216', 'SmartCare', 'RPW Obstetrics and Gynecology', NULL, NULL, 'RPW Obstetrics and Gynecology', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '360 W Butterfield Rd Ste 250', 'Elmhurst', 'Dupage', 'IL', '60126', '6308324210', '6308328110', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00305216', 0, 'N', 0, NULL, NULL, NULL, 41.8648, -87.9509, NULL, NULL),
('363954552', 'CL0305224', 'CL0305224', 'SmartCare', 'Sage Medical Group', NULL, NULL, 'Sage Medical Group', NULL, 'Clinic', 'Internal Medicine', '', NULL, 'O', '1150 W Fullerton Ave 2nd Fl', 'Chicago', 'Cook', 'IL', '60614', '7735497757', '7735491221', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00305224', 0, 'N', 0, NULL, NULL, NULL, 41.9253, -87.6576, NULL, NULL),
('752935588', 'CL0308385', 'CL0308385', 'SmartCare', 'Rowlett Cardiology Consultants', NULL, NULL, 'Rowlett Cardiology Consultants', NULL, 'Clinic', 'Cardiology', '', NULL, 'O', '7801 Lakeview Pkwy Ste 100', 'Rowlett', 'Dallas', 'TX', '75088', '9724757500', '9724756131', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308385', 0, 'N', 0, NULL, NULL, NULL, 32.9146, -96.5237, NULL, NULL),
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('742074876', 'CL0310777', 'CL0310777', 'SmartCare', 'Rosewood ENT ', NULL, NULL, 'Rosewood ENT ', NULL, 'Clinic', 'Ear, Nose and Throat', '', NULL, 'O', '18400 Katy Fwy Ste 650', 'Houston', 'Harris', 'TX', '77094', '7137819660', '8327723125', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00310777', 0, 'N', 0, NULL, NULL, NULL, 29.7855, -95.6953, NULL, NULL),
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('363330928', 'CL0305173', 'CL0305173', 'SmartCare', 'RMG North Shore Physicians Group', NULL, NULL, 'RMG North Shore Physicians Group', NULL, 'Clinic', 'Internal Medicine', '', NULL, 'O', '7380 N Lincoln Ave ', 'Lincolnwood', 'Cook', 'IL', '60712', '8475687400', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00305173', 0, 'N', 0, NULL, NULL, NULL, 42.0146, -87.7432, NULL, NULL),
('621762468', 'W12046970', 'W12046970', 'WY01', 'SageWest Health Care', '', '', 'Riverton Memorial Hospital, LLC', 'GROUP', 'Hospital', '', '', NULL, 'O', '1320 Bishop Randall Dr', 'Lander', 'Fremont', 'WY', '82520', '3073324420', '          ', '1320 Bishop Randall Dr', 'Lander', 'Fremont', 'WY', '82520', '3073324420', '          ', '', '', '', '0.00', '5.00', '0.00', 3, '2014-04-21', '2014-04-21', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1245337286', 0, 'N', 0, '2014-05-01', 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
('363330928', 'CL0305152', 'CL0305152', 'SmartCare', 'RMG Lincoln Prk Internal Medicine', NULL, NULL, 'RMG Lincoln Prk Internal Medicine', NULL, 'Clinic', 'Internal Medicine', '', NULL, 'O', '2800 N Sheridan Rd Ste 309', 'Chicago', 'Cook', 'IL', '60657', '7732486913', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00305152', 0, 'N', 0, NULL, NULL, NULL, 41.9329, -87.6393, NULL, NULL),
('363330928', 'CL0305175', 'CL0305175', 'SmartCare', 'RMG North Shore Physicians Group', NULL, NULL, 'RMG North Shore Physicians Group', NULL, 'Clinic', 'Internal Medicine', '', NULL, 'O', '1625 Sheridan Rd Ste F', 'Wilmette', 'Cook', 'IL', '60091', '8472511500', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00305175', 0, 'N', 0, NULL, NULL, NULL, 42.0878, -87.7012, NULL, NULL),
('363330928', 'CL0305129', 'CL0305129', 'SmartCare', 'RMG Belmont Cragin Family Medicine', NULL, NULL, 'RMG Belmont Cragin Family Medicine', NULL, 'Clinic', 'Family Practice', '', NULL, 'O', '3204 N Oak Park Ave ', 'Chicago', 'Cook', 'IL', '60634', '7737363131', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00305129', 0, 'N', 0, NULL, NULL, NULL, 41.9382, -87.7957, NULL, NULL),
('751453852', 'CL0308349', 'CL0308349', 'SmartCare', 'Retina Institute of Texas', NULL, NULL, 'Retina Institute of Texas', NULL, 'Clinic', 'Ophthalmology', '', NULL, 'O', '400 W I 635 Ste 320', 'Irving', 'Dallas', 'TX', '75063', '9728691242', '9728692921', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308349', 0, 'N', 0, NULL, NULL, NULL, 32.9125, -96.9492, NULL, NULL),
('752415520', 'CL0308631', 'CL0308631', 'SmartCare', 'Retina Specialists', NULL, NULL, 'Retina Specialists', NULL, 'Clinic', 'Nephrology', '', NULL, 'O', '2625 Bolton Boone ', 'DeSoto', 'Dallas', 'TX', '75115', '9722831516', '9722831448', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308631', 0, 'N', 0, NULL, NULL, NULL, 32.6429, -96.8785, NULL, NULL),
('161751617', 'CL0312045', 'CL0312045', 'SmartCare', 'Rheumatology Associates of South Texas', NULL, NULL, 'Rheumatology Associates of South Texas', NULL, 'Clinic', 'Rheumatology', '', NULL, 'O', '19272 Stone Oak Pkwy Ste 101', 'San Antonio', 'Bexar', 'TX', '78258', '2102658851', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00312045', 0, 'N', 0, NULL, NULL, NULL, 29.63, -98.4952, NULL, NULL),
('742123754', 'W12045152', 'W12045152', 'TXSATSTD', '', 'Thomas', 'C', 'Wascher', 'MD', 'Family Practice', '', '', NULL, 'O', '2221 Buena Vista St', 'San Antonio', 'Bexar', 'TX', '78207', '2102253524', '2102252081', '2221 Buena Vista St', 'San Antonio', 'Bexar', 'TX', '78207', '2102253524', '2102252081', 'TXSTD', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2014-04-18', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1609872969', 0, 'N', 0, '2014-03-18', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'W12046961', 'W12046961', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Randi', 'L', 'Luxmore', 'AUD', 'Audiology', '', '', NULL, 'O', '2040 Ogden Ave Ste 401', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924057', '2040 Ogden Ave Ste 401', 'Aurora', 'Dupage', 'IL', '60504', '6305857100', '6306924057', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2014-04-21', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710235205', 0, 'N', 0, '2014-05-22', NULL, NULL, 0, 0, NULL, NULL),
('364088232', 'W12046962', 'W12046962', 'ILCHIGSTD', 'Dreyer Medical Clinic', 'Randi', 'L', 'Luxmore', 'AUD', 'Audiology', '', '', NULL, 'B', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', '62199 Collection Ctr Dr', 'Chicago', 'Cook', 'IL', '60693', '6308596800', '          ', 'CHIG17', 'CHIHCPCSMA', '', '0.00', '35.00', '0.00', 3, '2014-04-21', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710235205', 0, 'N', 0, '2014-05-22', NULL, NULL, 0, 0, NULL, NULL),
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('465154746', 'W12046920', 'W12046920', 'WY01', 'Bridger Valley Urgent Care', 'Amanda', 'M', 'Barnes', 'PA', 'General Surgery', '', '', NULL, 'B', '740 S Woodruff', 'Idaho Falls', 'Bonneville', 'ID', '83401', '3077862042', '3077864016', '740 S Woodruff', 'Idaho Falls', 'Bonneville', 'ID', '83401', '3077862042', '3077864016', 'WYSTD', 'WYHCPCS', '', '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'Evanston Regional Hospital', '', '', '', 'HCFA|', '1841435385', 0, 'N', 0, '2014-05-13', NULL, NULL, 0, 0, NULL, NULL),
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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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('362704738', 'CL0304859', 'CL0304859', 'SmartCare', 'Nuclear Oncology', NULL, NULL, 'Nuclear Oncology', NULL, 'Clinic', 'Radiation Oncology', '', NULL, 'O', '200 Berteau Ave ', 'Elmhurst', 'Dupage', 'IL', '60126', '6307827900', '6307827910', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00304859', 0, 'N', 0, NULL, NULL, NULL, 41.9022, -87.9293, NULL, NULL),
('362667448', 'CL0304870', 'CL0304870', 'SmartCare', 'Oak Brook Allergists', NULL, NULL, 'Oak Brook Allergists', NULL, 'Clinic', 'Allergy and Immunology', '', NULL, 'O', '120 Oak Brook Ctr Mall Ste 424', 'Oak Brook', 'Dupage', 'IL', '60523', '6305740460', '6305740470', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00304870', 0, 'N', 0, NULL, NULL, NULL, 41.8477, -87.9519, NULL, NULL),
('363977608', 'CL0304848', 'CL0304848', 'SmartCare', 'Northwest Pediatric Services', NULL, NULL, 'Northwest Pediatric Services', NULL, 'Clinic', 'Pediatrics', '', NULL, 'O', '2055 W Army Trail Rd Ste 104', 'Addison', 'Dupage', 'IL', '60101', '6307051010', '6307051049', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00304848', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('363977608', 'CL0304847', 'CL0304847', 'SmartCare', 'Northwest Pediatric Services', NULL, NULL, 'Northwest Pediatric Services', NULL, 'Clinic', 'Pediatrics', '', NULL, 'O', '1515 W Lake St Ste 202', 'Hanover Park', 'Cook', 'IL', '60133', '6308305926', '6308305938', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00304847', 0, 'N', 0, NULL, NULL, NULL, 41.986, -88.1476, NULL, NULL),
('363395596', 'CL0304824', 'CL0304824', 'SmartCare', 'Northwest Oncology and Hematology Associates', NULL, NULL, 'Northwest Oncology and Hematology Associates', NULL, 'Clinic', 'Hematology and Oncology', '', NULL, 'O', '800 Biesterfield Rd Wimmer Bldg Ste 210', 'Elk Grove Villiage', 'Cook', 'IL', '60007', '8474373312', '8479565107', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00304824', 0, 'N', 0, NULL, NULL, NULL, 42.0034, -88.0174, NULL, NULL),
('363395596', 'CL0304823', 'CL0304823', 'SmartCare', 'Northwest Oncology and Hematology Associates', NULL, NULL, 'Northwest Oncology and Hematology Associates', NULL, 'Clinic', 'Hematology and Oncology', '', NULL, 'O', '3701 Algonquin Rd Ste 900', 'Rolling Meadows', 'Cook', 'IL', '60008', '8478704100', '8478700866', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00304823', 0, 'N', 0, NULL, NULL, NULL, 42.0619, -88.0252, NULL, NULL),
('363395596', 'CL0304826', 'CL0304826', 'SmartCare', 'Northwest Oncology and Hematology Associates', NULL, NULL, 'Northwest Oncology and Hematology Associates', NULL, 'Clinic', 'Hematology and Oncology', '', NULL, 'O', '27750 W Hwy 22 Ste G70', 'Barrington', 'Lake', 'IL', '60010', '8474373312', '8478429877', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00304826', 0, 'N', 0, NULL, NULL, NULL, 42.193, -88.1736, NULL, NULL),
('364014160', 'CL0304704', 'CL0304704', 'SmartCare', 'Northwest Cardiovascular Associates', NULL, NULL, 'Northwest Cardiovascular Associates', NULL, 'Clinic', 'Cardiology', '', NULL, 'O', '880 W Central Rd Ste 7100', 'Arlington Heights', 'Cook', 'IL', '60005', '8473927810', '8473927834', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00304704', 0, 'N', 0, NULL, NULL, NULL, 42.0666, -87.9939, NULL, NULL),
('363395596', 'CL0304825', 'CL0304825', 'SmartCare', 'Northwest Oncology and Hematology Associates', NULL, NULL, 'Northwest Oncology and Hematology Associates', NULL, 'Clinic', 'Hematology and Oncology', '', NULL, 'O', '1555 Barrington Rd Ste 1200', 'Hoffman Estates', 'Cook', 'IL', '60169', '8478854100', '8478854199', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00304825', 0, 'N', 0, NULL, NULL, NULL, 42.0542, -88.1444, NULL, NULL),
('841617523', 'CL0306158', 'CL0306158', 'SmartCare', 'Northside Family Medicine', NULL, NULL, 'Northside Family Medicine', NULL, 'Clinic', 'Family Practice', '', NULL, 'O', '6100 Pan American Fwy NE Ste 390', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5058231805', '5058231844', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00306158', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('161664951', 'CL0308142', 'CL0308142', 'SmartCare', 'Northern Texas Facial and Oral Surgery', NULL, NULL, 'Northern Texas Facial and Oral Surgery', NULL, 'Clinic', 'Oral/Maxillofacial Surgery', '', NULL, 'O', '1612 Lancaster Dr ', 'Grapevine', 'Tarrant', 'TX', '76051', '8173294979', '8174884483', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308142', 0, 'N', 0, NULL, NULL, NULL, 32.9337, -97.0915, NULL, NULL),
('264333033', 'CL0311959', 'CL0311959', 'SmartCare', 'Northeast OB-GYN Associates', NULL, NULL, 'Northeast OB-GYN Associates', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '8715 Village Dr Ste 410', 'San Antonio', 'Bexar', 'TX', '78217', '2106535501', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00311959', 0, 'N', 0, NULL, NULL, NULL, 29.5187, -98.4281, NULL, NULL),
('264333033', 'CL0311972', 'CL0311972', 'SmartCare', 'Northeast Pediatric Associates, PA', NULL, NULL, 'Northeast Pediatric Associates, PA', NULL, 'Clinic', 'Pediatrics', '', NULL, 'O', '18707 Hardy Oak Ste 225    ', 'San Antonio', 'Bexar', 'TX', '78258', '2106570220', '2104022868', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00311972', 0, 'N', 0, NULL, NULL, NULL, 29.6374, -98.4905, NULL, NULL),
('264333033', 'CL0311974', 'CL0311974', 'SmartCare', 'Northeast Pediatric Associates, PA', NULL, NULL, 'Northeast Pediatric Associates, PA', NULL, 'Clinic', 'Pediatrics', '', NULL, 'O', '8606 Village Dr Ste A', 'San Antonio', 'Bexar', 'TX', '78217', '2106570220', '2105907288', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00311974', 0, 'N', 0, NULL, NULL, NULL, 29.5184, -98.4275, NULL, NULL),
('264333033', 'CL0311964', 'CL0311964', 'SmartCare', 'Northeast OB-GYN Associates', NULL, NULL, 'Northeast OB-GYN Associates', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '502 Madison Oak Dr Ste 240', 'San Antonio', 'Bexar', 'TX', '78258', '2104951900', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00311964', 0, 'N', 0, NULL, NULL, NULL, 29.6212, -98.4905, NULL, NULL),
('264333033', 'CL0311963', 'CL0311963', 'SmartCare', 'Northeast OB-GYN Associates', NULL, NULL, 'Northeast OB-GYN Associates', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '5000 Schertz Pkwy Ste 100', 'Schertz', 'Guadalupe', 'TX', '78154', '2106535501', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00311963', 0, 'N', 0, NULL, NULL, NULL, 29.5641, -98.2617, NULL, NULL),
('363304094', 'CL0304697', 'CL0304697', 'SmartCare', 'Northeast Nephrology Consultants  ', NULL, NULL, 'Northeast Nephrology Consultants  ', NULL, 'Clinic', 'Nephrology', '', NULL, 'O', '815 N Larkin Ave Ste 205', 'Joliet', 'Will', 'IL', '60435', '8157445550', '8157445428', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00304697', 0, 'N', 0, NULL, NULL, NULL, 41.5367, -88.1253, NULL, NULL),
('752943993', 'CL0308116', 'CL0308116', 'SmartCare', 'North Texas Kidney Disease Associates', NULL, NULL, 'North Texas Kidney Disease Associates', NULL, 'Clinic', 'Nephrology', '', NULL, 'O', '6331 Blvd 26 Ste 220', 'North Richland Hills', 'Tarrant', 'TX', '76180', '8176280284', '8176280288', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308116', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('752943993', 'CL0308123', 'CL0308123', 'SmartCare', 'North Texas Kidney Disease Associates', NULL, NULL, 'North Texas Kidney Disease Associates', NULL, 'Clinic', 'Nephrology', '', NULL, 'O', '4240 International Pkwy Ste 154', 'Carrollton', 'Denton', 'TX', '75007', '4695740464', '4695740471', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308123', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('752943993', 'CL0308114', 'CL0308114', 'SmartCare', 'North Texas Kidney Disease Associates', NULL, NULL, 'North Texas Kidney Disease Associates', NULL, 'Clinic', 'Nephrology', '', NULL, 'O', '3315 Colorado Blvd Ste 102', 'Denton', 'Denton', 'TX', '76210', '9403201708', '9405655457', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308114', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('752943993', 'CL0308121', 'CL0308121', 'SmartCare', 'North Texas Kidney Disease Associates', NULL, NULL, 'North Texas Kidney Disease Associates', NULL, 'Clinic', 'Nephrology', '', NULL, 'O', '1600 Waters Ridge Ste A', 'Lewisville', 'Denton', 'TX', '75057', '9722190558', '9724369273', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308121', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('751412851', 'CL0308073', 'CL0308073', 'SmartCare', 'North Texas Family Practice Associates', NULL, NULL, 'North Texas Family Practice Associates', NULL, 'Clinic', 'Family Practice', '', NULL, 'O', '7777 Forest Ln C420', 'Dallas', 'Dallas', 'TX', '75230', '9725667976', '9725668164', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308073', 0, 'N', 0, NULL, NULL, NULL, 32.9095, -96.7721, NULL, NULL),
('751772118', 'CL0308089', 'CL0308089', 'SmartCare', 'North Texas Infectious Diseases Consultants', NULL, NULL, 'North Texas Infectious Diseases Consultants', NULL, 'Clinic', 'Infectious Disease', '', NULL, 'O', '3409 Worth St Ste 710', 'Dallas', 'Dallas', 'TX', '75246', '2148232533', '2143703316', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308089', 0, 'N', 0, NULL, NULL, NULL, 32.7886, -96.779, NULL, NULL),
('741996652', 'CL0311939', 'CL0311939', 'SmartCare', 'North San Antonio Healthcare Associates', NULL, NULL, 'North San Antonio Healthcare Associates', NULL, 'Clinic', 'Family Practice', '', NULL, 'O', '3338 Oakwell Ct Ste 107', 'San Antonio', 'Bexar', 'TX', '78218', '2108223646', '2108225242', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00311939', 0, 'N', 0, NULL, NULL, NULL, 29.507, -98.4311, NULL, NULL),
('752385145', 'CL0308065', 'CL0308065', 'SmartCare', 'North Texas Colon and Rectal Associates', NULL, NULL, 'North Texas Colon and Rectal Associates', NULL, 'Clinic', 'Colon and Rectal Surgery', '', NULL, 'O', '3409 Worth St Ste 600', 'Dallas', 'Dallas', 'TX', '75246', '2148241730', '2148217756', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308065', 0, 'N', 0, NULL, NULL, NULL, 32.7886, -96.779, NULL, NULL),
('760053696', 'CL0310216', 'CL0310216', 'SmartCare', 'North Houston Nephrology', NULL, NULL, 'North Houston Nephrology', NULL, 'Clinic', 'Nephrology', '', NULL, 'O', '607 Timberdale Ln Ste 201', 'Houston', 'Harris', 'TX', '77090', '2814403005', '2814449070', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00310216', 0, 'N', 0, NULL, NULL, NULL, 30.0213, -95.4381, NULL, NULL),
('752402478', 'CL0308047', 'CL0308047', 'SmartCare', 'North Dallas Urology Associates PA', NULL, NULL, 'North Dallas Urology Associates PA', NULL, 'Clinic', 'Urology', '', NULL, 'O', '5300 W Plano Pkwy Ste 200', 'Plano', 'Collin', 'TX', '75093', '9726128037', '9726124414', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308047', 0, 'N', 0, NULL, NULL, NULL, 33.0166, -96.8068, NULL, NULL),
('752402478', 'CL0308048', 'CL0308048', 'SmartCare', 'North Dallas Urology Associates PA', NULL, NULL, 'North Dallas Urology Associates PA', NULL, 'Clinic', 'Urology', '', NULL, 'O', '375 Municipal Dr Ste 126', 'Richardson', 'Dallas', 'TX', '75080', '9724800877', '9722359919', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308048', 0, 'N', 0, NULL, NULL, NULL, 32.9735, -96.7258, NULL, NULL),
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('850327237', 'CL0306038', 'CL0306038', 'SmartCare', 'Lovelace Womens Breast Care Center', NULL, NULL, 'Lovelace Womens Breast Care Center', NULL, 'Clinic', 'General Surgery', '', NULL, 'O', '4701 Montgomery NE ', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5057276900', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00306038', 0, 'N', 0, NULL, NULL, NULL, 35.131, -106.591, NULL, NULL),
('300038860', 'CL0310027', 'CL0310027', 'SmartCare', 'Lone Star Family Health Center', NULL, NULL, 'Lone Star Family Health Center', NULL, 'Clinic', 'Family Practice', '', NULL, 'O', '440 Rayford Rd Ste 150', 'Spring', 'Montgomery', 'TX', '77386', '9365394004', '9365393635', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00310027', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('204076841', 'CL0306030', 'CL0306030', 'SmartCare', 'Life Change Therapy Institute', NULL, NULL, 'Life Change Therapy Institute', NULL, 'Clinic', 'Counseling', '', NULL, 'O', '1200 Eubank Blvd NE ', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052715050', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00306030', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('202320132', 'CL0301973', 'CL0301973', 'SmartCare', 'Lifestages OB/GYN', NULL, NULL, 'Lifestages OB/GYN', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '3908 E Flamingo Ave ', 'Nampa', 'Canyon', 'ID', '83687', '2084428035', '2084428038', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00301973', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('752536818', 'CL0307832', 'CL0307832', 'SmartCare', 'Legacy Heart Group', NULL, NULL, 'Legacy Heart Group', NULL, 'Clinic', 'Cardiovascular Disease', '', NULL, 'O', '6601 Preston Rd ', 'Plano', 'Collin', 'TX', '75024', '4698006300', '4698006351', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00307832', 0, 'N', 0, NULL, NULL, NULL, 33.0625, -96.7963, NULL, NULL),
('760009637', 'CL0309993', 'CL0309993', 'SmartCare', 'Legacy Community Health Services', NULL, NULL, 'Legacy Community Health Services', NULL, 'Clinic', 'Pediatrics', '', NULL, 'O', '4301 Garth Rd Ste 400', 'Baytown', 'Harris', 'TX', '77521', '2814208400', '7135234897', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00309993', 0, 'N', 0, NULL, NULL, NULL, 29.7681, -94.9775, NULL, NULL),
('760009637', 'CL0309992', 'CL0309992', 'SmartCare', 'Legacy Community Health Services', NULL, NULL, 'Legacy Community Health Services', NULL, 'Clinic', 'Pediatrics', '', NULL, 'O', '6441 High Star ', 'Houston', 'Harris', 'TX', '77074', '8325485000', '7135234897', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00309992', 0, 'N', 0, NULL, NULL, NULL, 29.7107, -95.495, NULL, NULL),
('760095595', 'CL0309948', 'CL0309948', 'SmartCare', 'Lawndale Medical Clinic', NULL, NULL, 'Lawndale Medical Clinic', NULL, 'Clinic', 'Family Practice', '', NULL, 'O', '7109 Lawndale St Ste B', 'Houston', 'Harris', 'TX', '77023', '7139244907', '7139243012', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00309948', 0, 'N', 0, NULL, NULL, NULL, 29.7174, -95.2944, NULL, NULL),
('760009637', 'CL0309994', 'CL0309994', 'SmartCare', 'Legacy Community Health Services', NULL, NULL, 'Legacy Community Health Services', NULL, 'Clinic', 'Pediatrics', '', NULL, 'O', '1415 California St ', 'Houston', 'Harris', 'TX', '77006', '8325485000', '7135234897', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00309994', 0, 'N', 0, NULL, NULL, NULL, 29.7454, -95.3938, NULL, NULL),
('710887657', 'CL0306025', 'CL0306025', 'SmartCare', 'Laurie Ross-Brennan and Associates', NULL, NULL, 'Laurie Ross-Brennan and Associates', NULL, 'Clinic', 'Speech Therapy', '', NULL, 'O', '4811 Hardware Dr NE Ste E-1', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052685933', '5052680184', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00306025', 0, 'N', 0, NULL, NULL, NULL, 35.1358, -106.59, NULL, NULL),
('752356557', 'CL0307815', 'CL0307815', 'SmartCare', 'Las Colinas Obstetrics Gynecology Infertility Association PA', NULL, NULL, 'Las Colinas Obstetrics Gynecology Infertility Association PA', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '3501 N MacArthur Blvd Ste 350', 'Irving', 'Dallas', 'TX', '75062', '9722575300', '9722575322', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00307815', 0, 'N', 0, NULL, NULL, NULL, 32.8525, -96.9591, NULL, NULL),
('752338371', 'CL0307811', 'CL0307811', 'SmartCare', 'Las Colinas Cancer Center', NULL, NULL, 'Las Colinas Cancer Center', NULL, 'Clinic', 'Radiation Oncology', '', NULL, 'O', '7415 Las Colinas Blvd Ste 100', 'Irving', 'Dallas', 'TX', '75063', '2143792729', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00307811', 0, 'N', 0, NULL, NULL, NULL, 32.909, -96.9538, NULL, NULL),
('752828023', 'CL0307795', 'CL0307795', 'SmartCare', 'Lake Ray Hubbard Pediatrics', NULL, NULL, 'Lake Ray Hubbard Pediatrics', NULL, 'Clinic', 'Pediatrics', '', NULL, 'O', '9100 Lakeview Pkwy ', 'Rowlett', 'Dallas', 'TX', '75088', '9724123034', '9724121949', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00307795', 0, 'N', 0, NULL, NULL, NULL, 32.9193, -96.5135, NULL, NULL),
('453079083', 'CL0308048', 'CL0308048', 'SmartCare', 'Lantana Pediatrics', NULL, NULL, 'Lantana Pediatrics', NULL, 'Clinic', 'Urology', '', NULL, 'O', '74 McMakin Rd Ste 100', 'Bartonville', 'Denton', 'TX', '76226', '9404557200', '9404557214', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00308048', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('752472444', 'CL0307787', 'CL0307787', 'SmartCare', 'Lake Lewisville Pediatrics', NULL, NULL, 'Lake Lewisville Pediatrics', NULL, 'Clinic', 'Pediatrics', '', NULL, 'O', '2141 S Edmonds Ln ', 'Lewisville', 'Denton', 'TX', '75067', '9723158500', '9723158512', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00307787', 0, 'N', 0, NULL, NULL, NULL, 33.0071, -97.0056, NULL, NULL),
('741889584', 'CL0309932', 'CL0309932', 'SmartCare', 'KSF Orthopaedic Center', NULL, NULL, 'KSF Orthopaedic Center', NULL, 'Clinic', 'Orthopedic Surgery', '', NULL, 'O', '18220 State Hwy 249 Ste 200', 'Houston', 'Harris', 'TX', '77090', '2814406960', '2814406205', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00309932', 0, 'N', 0, NULL, NULL, NULL, 29.9641, -95.5508, NULL, NULL),
('741889584', 'CL0309931', 'CL0309931', 'SmartCare', 'KSF Orthopaedic Center', NULL, NULL, 'KSF Orthopaedic Center', NULL, 'Clinic', 'Orthopedic Surgery', '', NULL, 'O', '17270 Red Oak Dr Ste 200', 'Houston', 'Harris', 'TX', '77090', '2814406960', '2814406205', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00309931', 0, 'N', 0, NULL, NULL, NULL, 30.0218, -95.4471, NULL, NULL),
('760555526', 'CL0309905', 'CL0309905', 'SmartCare', 'Kidney Associates', NULL, NULL, 'Kidney Associates', NULL, 'Clinic', 'Nephrology', '', NULL, 'O', '6624 Fannin St Ste 1400', 'Houston', 'Harris', 'TX', '77030', '7137955511', '7136910194', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00309905', 0, 'N', 0, NULL, NULL, NULL, 29.7096, -95.4011, NULL, NULL),
('752947630', 'CL0307763', 'CL0307763', 'SmartCare', 'Kid Care Pediatrics', NULL, NULL, 'Kid Care Pediatrics', NULL, 'Clinic', 'Pediatrics', '', NULL, 'O', '6618 Fossil Bluff Dr Ste 116', 'Fort Worth', 'Tarrant', 'TX', '76137', '8178476420', '8178476412', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00307763', 0, 'N', 0, NULL, NULL, NULL, 32.8612, -97.3107, 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
('760555526', 'CL0309904', 'CL0309904', 'SmartCare', 'Kidney Associates', NULL, NULL, 'Kidney Associates', NULL, 'Clinic', 'Nephrology', '', NULL, 'O', '1415 N Loop W Ste 940', 'Houston', 'Harris', 'TX', '77008', '7136910107', '7136910194', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00309904', 0, 'N', 0, NULL, NULL, NULL, 29.8123, -95.4253, NULL, NULL),
('752947630', 'CL0307764', 'CL0307764', 'SmartCare', 'Kid Care Pediatrics', NULL, NULL, 'Kid Care Pediatrics', NULL, 'Clinic', 'Pediatrics', '', NULL, 'O', '230 N Rufe Snow Dr ', 'Keller', 'Tarrant', 'TX', '76248', '8173375503', '8173370110', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00307764', 0, 'N', 0, NULL, NULL, NULL, 32.9368, -97.2293, NULL, NULL),
('752646217', 'CL0307711', 'CL0307711', 'SmartCare', 'J W Eye Associates', NULL, NULL, 'J W Eye Associates', NULL, 'Clinic', 'Ophthalmology', '', NULL, 'O', '910 N Davis Ste 400', 'Arlington', 'Tarrant', 'TX', '76012', '8174602272', '8172659684', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00307711', 0, 'N', 0, NULL, NULL, NULL, 32.7467, -97.123, NULL, NULL),
('363915732', 'CL0304287', 'CL0304287', 'SmartCare', 'Joliet Oncology - Hematology Associates', NULL, NULL, 'Joliet Oncology - Hematology Associates', NULL, 'Clinic', 'Oncology', '', NULL, 'O', '2614 W Jefferson St', 'Joliet', 'Will', 'IL', '60435', '8157251355', '8157259861', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00304287', 0, 'N', 0, NULL, NULL, NULL, 41.522, -88.1474, NULL, NULL),
('752646217', 'CL0307710', 'CL0307710', 'SmartCare', 'J W Eye Associates', NULL, NULL, 'J W Eye Associates', NULL, 'Clinic', 'Ophthalmology', '', NULL, 'O', '3060 Communications Pkwy Ste 205', 'Plano', 'Collin', 'TX', '75093', '9727692020', '9727690204', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00307710', 0, 'N', 0, NULL, NULL, NULL, 33.0424, -96.833, NULL, NULL),
('760225946', 'CL0309849', 'CL0309849', 'SmartCare', 'Interventional Cardiology Associates', NULL, NULL, 'Interventional Cardiology Associates', NULL, 'Clinic', 'Cardiology', '', NULL, 'O', '6550 Fannin St Ste 2021', 'Houston', 'Harris', 'TX', '77030', '7137909125', '7137901802', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00309849', 0, 'N', 0, NULL, NULL, NULL, 29.7111, -95.3999, NULL, NULL),
('752646217', 'CL0307709', 'CL0307709', 'SmartCare', 'J W Eye Associates', NULL, NULL, 'J W Eye Associates', NULL, 'Clinic', 'Ophthalmology', '', NULL, 'O', '2801 Lemmon Ave Ste 400', 'Dallas', 'Dallas', 'TX', '75204', '2147540000', '2143791849', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00307709', 0, 'N', 0, NULL, NULL, NULL, 32.8042, -96.7963, NULL, NULL),
('752536818', 'CL0307681', 'CL0307681', 'SmartCare', 'Internal Medicine Associates at Irving', NULL, NULL, 'Internal Medicine Associates at Irving', NULL, 'Clinic', 'Internal Medicine', '', NULL, 'O', '2021 N MacArthur Blvd Ste 520', 'Irving', 'Dallas', 'TX', '75061', '9722512388', '9722512390', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00307681', 0, 'N', 0, NULL, NULL, NULL, 32.835, -96.9592, NULL, NULL),
('264333033', 'CL0311836', 'CL0311836', 'SmartCare', 'Institute for Womens Health', NULL, NULL, 'Institute for Womens Health', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '999 E Basse Rd Ste 100', 'San Antonio', 'Bexar', 'TX', '78209', '2106563040', '2106566419', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00311836', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('264333033', 'CL0311840', 'CL0311840', 'SmartCare', 'Institute for Womens Health', NULL, NULL, 'Institute for Womens Health', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '1303 McCullough Ave Ste GL70', 'San Antonio', 'Bexar', 'TX', '78212', '2102269705', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00311840', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('264333033', 'CL0311841', 'CL0311841', 'SmartCare', 'Institute for Womens Health', NULL, NULL, 'Institute for Womens Health', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '18707 Hardy Oak Ste 230', 'San Antonio', 'Bexar', 'TX', '78258', '2104942000', '0000000000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00311841', 0, 'N', 0, NULL, NULL, NULL, 29.6374, -98.4905, NULL, NULL),
('264333033', 'CL0311842', 'CL0311842', 'SmartCare', 'Institute for Womens Health', NULL, NULL, 'Institute for Womens Health', NULL, 'Clinic', 'Obstetrics and Gynecology', '', NULL, 'O', '7940 Floyd Curl Dr Ste 900', 'San Antonio', 'Bexar', 'TX', '78229', '2106141000', '2106151236', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00311842', 0, 'N', 0, NULL, NULL, NULL, 29.512, -98.5761, NULL, NULL),
('362970624', 'CL0304261', 'CL0304261', 'SmartCare', 'Illinois Retina Associates', NULL, NULL, 'Illinois Retina Associates', NULL, 'Clinic', 'Ophthalmology', '', NULL, 'O', '71 W 156th St Ste 400', 'Harvey', 'Cook', 'IL', '60426', '7085968710', '7085969820', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00304261', 0, 'N', 0, NULL, NULL, NULL, 41.6063, -87.6604, NULL, NULL),
('271383837', 'CL0304239', 'CL0304239', 'SmartCare', 'Illinois Gastroenterology Group', NULL, NULL, 'Illinois Gastroenterology Group', NULL, 'Clinic', 'Gastroenterology', '', NULL, 'O', '9921 Southwest Hwy ', 'Oak Lawn', 'Cook', 'IL', '60453', '7084259456', '7084259468', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00304239', 0, 'N', 0, NULL, NULL, NULL, 41.7121, -87.7768, NULL, NULL),
('271383837', 'CL0304237', 'CL0304237', 'SmartCare', 'Illinois Gastroenterology Group', NULL, NULL, 'Illinois Gastroenterology Group', NULL, 'Clinic', 'Gastroenterology', '', NULL, 'O', '806 Central Ave Ste 202', 'Highland Park', 'Lake', 'IL', '60035', '8474339840', '8474339842', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00304237', 0, 'N', 0, NULL, NULL, NULL, 42.1838, -87.8046, NULL, NULL),
('271383837', 'CL0304218', 'CL0304218', 'SmartCare', 'Illinois Gastroenterology Group', NULL, NULL, 'Illinois Gastroenterology Group', NULL, 'Clinic', 'Gastroenterology', '', NULL, 'O', '800 Biesterfield Rd  Ste 207', 'Elk Grove Village', 'Cook', 'IL', '60007', '8474391005', '8474397555', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00304218', 0, 'N', 0, NULL, NULL, NULL, 42.0034, -88.0174, NULL, NULL),
('271383837', 'CL0304244', 'CL0304244', 'SmartCare', 'Illinois Gastroenterology Group', NULL, NULL, 'Illinois Gastroenterology Group', NULL, 'Clinic', 'Gastroenterology', '', NULL, 'O', '745 Fletcher Dr Ste 202', 'Elgin', 'Kane', 'IL', '60123', '8478881300', '8478881341', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 0, '2014-06-10', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'NONE', 'CL00304244', 0, 'N', 0, NULL, NULL, NULL, 42.0545, -88.3352, NULL, NULL),
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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', 'W12019025', 'W12019025', 'UTIHC03', '', 'David', 'C', 'Boorman', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1303 N Main', 'Cedar City', 'Iron', 'UT', '84720', '4358685000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '', '', '', '0.00', '15.00', '0.00', 8, '2012-01-01', NULL, 0, 0, NULL, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1659344471', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('942854057', 'W12019026', 'W12019026', 'UTIHC04', '', 'David', 'C', 'Boorman', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '1303 N Main', 'Cedar City', 'Iron', 'UT', '84720', '4358685000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '', '', '', '0.00', '15.00', '0.00', 8, '2012-01-01', NULL, 0, 0, NULL, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1659344471', 0, 'N', 0, '2014-03-04', NULL, NULL, 37.6711, -113.103, NULL, NULL),
('760581851', 'USPT00004', 'USPT00004', 'TXDALSTD', 'Bosque River Physical Therapy and Rehabilitation ', NULL, NULL, 'Bosque River Physical Therapy and Rehabilitation ', NULL, 'Physical Therapy', NULL, NULL, NULL, 'O', '1200 Richland Dr Ste G', 'Waco', 'Mclennan', 'TX', '76710', '2547720118', '2547723883', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'DME90TX', NULL, NULL, '0.00', '0.00', '82.00', 3, '2014-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1114942224', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('760407118', 'USPT00005', 'USPT00005', 'TXDALSTD', 'Brazos Valley Physical Therapy', NULL, NULL, 'Brazos Valley Physical Therapy', NULL, 'Physical Therapy', NULL, NULL, NULL, 'O', '711 SW 1st St', 'Mineral Wells', 'Palo Pinto', 'TX', '76067', '9403281187', '9403280579', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'DME90TX', NULL, NULL, '0.00', '0.00', '82.00', 3, '2014-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1871518894', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('830237511', 'W12045083', 'W12045083', 'WYT1', 'Gastroenterology Associates', 'Charla', 'W', 'Bright', 'PA', 'Gastroenterology', '', '', NULL, 'O', '1441 Wilkins Cir', 'Casper', 'Natrona', 'WY', '82601', '3072651792', '3072378106', '1441 Wilkins Cir', 'Casper', 'Natrona', 'WY', '82601', '3072651792', '3072378106', '', '', '', '0.00', '15.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'Wyoming Medical Center ', '', '', '', 'HCFA|U', '1982714671', 0, 'N', 0, '2014-06-20', NULL, NULL, 0, 0, NULL, NULL),
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('580572465', 'APC000024', 'APC000024', 'APCTEST', 'Childrens Healthcare of Atlanta at Scot', NULL, NULL, 'Childrens Healthcare of Atlanta at Scot', NULL, 'Hospital', NULL, NULL, NULL, 'O', '1001 Johnson Ferry Road Northeast', 'Atlanta', 'Fulton', 'GA', '30342', NULL, NULL, '1001 Johnson Ferry Road Northeast', 'Atlanta', 'Fulton', 'GA', '30342', '', '', NULL, NULL, 'APCTEST', '0.00', '0.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922178789', 0, 'Y', 0, '2014-03-20', '113301', NULL, 0, 0, NULL, NULL),
('760410649', 'USPT00006', 'USPT00006', 'TXHOUSTD', 'Cleveland Physical and Occupational Therapy', NULL, NULL, 'Cleveland Physical and Occupational Therapy', NULL, 'Physical Therapy', NULL, NULL, NULL, 'O', '102 N Travis St', 'Cleveland', 'Liberty', 'TX', '77327', '2815922884', '2815923269', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'DME90TX', NULL, NULL, '0.00', '0.00', '80.00', 3, '2014-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1518984392', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('830237511', 'W12045095', 'W12045095', 'WYT1', 'Gastroenterology Associates', 'Jeffrey', 'W', 'Cloud', 'MD', 'Gastroenterology', '', '', NULL, 'O', '1441 Wilkins Cir', 'Casper', 'Natrona', 'WY', '82601', '3072651792', '3072378106', '1441 Wilkins Cir', 'Casper', 'Natrona', 'WY', '82601', '3072651792', '3072378106', '', '', '', '0.00', '15.00', '0.00', 3, '2014-04-01', NULL, 0, 0, 0, 'Wyoming Medical Center ', '', '', '', 'HCFA|U', '1518179126', 0, 'N', 0, '2014-06-20', NULL, NULL, 0, 0, NULL, NULL),
('455227009', 'W12045062', 'W12045062', 'UT01', 'UPRI Murray', 'Teri', 'A', 'Clubb', 'NP', 'Pain Management', '', '', NULL, 'O', '32 W Winchester St Ste 200', 'Murray', 'Salt Lake', 'UT', '84107', '8013279336', '8012810444', '32 W Winchester St Ste 200', 'Murray', 'Salt Lake', 'UT', '84107', '8013279336', '8012810444', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-04-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1801227715', 0, 'N', 0, '2014-05-08', NULL, NULL, 0, 0, NULL, NULL),
('760513962', 'USPT00007', 'USPT00007', 'TXDALSTD', 'Coppell Spine and Sports Rehab ', NULL, NULL, 'Coppell Spine and Sports Rehab ', NULL, 'Physical Therapy', NULL, NULL, NULL, 'O', '413 W Bethel Rd Ste 400', 'Coppell', 'Dallas', 'TX', '75019', '9723049100', '9723049048', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'DME90TX', NULL, NULL, '0.00', '0.00', '82.00', 3, '2014-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1669490629', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('770618862', 'W12045422', 'W12045422', 'TXSATSTD', '', 'Nader', 'G', 'Iskander', 'MD', 'Ophthalmology', '', '', NULL, 'B', 'PO Box 174', 'San Antonio', 'Bexar', 'TX', '78291', '2108229800', '2108229810', 'PO Box 174', 'San Antonio', 'Bexar', 'TX', '78291', '2108229800', '2108229810', 'TXSTD', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2014-04-18', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659369601', 0, 'N', 0, '2014-03-18', NULL, NULL, 0, 0, NULL, NULL),
('581966795', 'APC000004', 'APC000004', 'APCTEST', 'DeKalb Medical Center at Hillandale', NULL, NULL, 'DeKalb Medical Center at Hillandale', NULL, 'Hospital', NULL, NULL, NULL, 'O', '2801 Dekalb Medical Pkwy.', 'Lithonia', 'Dekalb', 'GA', '30058', NULL, NULL, '2801 Dekalb Medical Pkwy.', 'Lithonia', 'Dekalb', 'GA', '30058', '', '', NULL, NULL, 'APCTEST', '0.00', '0.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962403865', 0, 'Y', 0, '2014-03-20', '110226', NULL, 0, 0, NULL, NULL),
('581966795', 'APC000010', 'APC000010', 'APCTEST', 'DeKalb Medical Center', NULL, NULL, 'DeKalb Medical Center', NULL, 'Hospital', NULL, NULL, NULL, 'O', '2701 North Decatur Road', 'Decatur', 'Dekalb', 'GA', '30033', NULL, NULL, '2701 North Decatur Road', 'Decatur', 'Dekalb', 'GA', '30033', '', '', NULL, NULL, 'APCTEST', '0.00', '0.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093716979', 0, 'Y', 0, '2014-03-20', '112006', NULL, 0, 0, NULL, NULL),
('582433432', 'APC000007', 'APC000007', 'APCTEST', 'Emory Eastside Medical CenterHCA Affili', NULL, NULL, 'Emory Eastside Medical CenterHCA Affili', NULL, 'Hospital', NULL, NULL, NULL, 'O', '1700 Medical Way', 'Snellville', 'Gwinnett', 'GA', '30078', '          ', NULL, '1700 Medical Way', 'Snellville', 'Gwinnett', 'GA', '30078', '          ', '          ', '', '', 'APCTEST', '0.00', '0.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467406132', 0, 'Y', 0, '2014-03-20', '110092', NULL, 0, 0, NULL, NULL),
('582433436', 'APC000002', 'APC000002', 'APCTEST', 'Emory Johns Creek Hospital', NULL, NULL, 'Emory Johns Creek Hospital', NULL, 'Hospital', NULL, NULL, NULL, 'O', '6325 Hospital Pkwy.', 'Duluth', 'Fulton', 'GA', '30097', NULL, NULL, '6325 Hospital Pkwy.', 'Duluth', 'Fulton', 'GA', '30097', '', '', NULL, NULL, 'APCTEST', '0.00', '0.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679632137', 0, 'Y', 0, '2014-03-20', '110230', NULL, 0, 0, NULL, NULL),
('580566200', 'APC000014', 'APC000014', 'APCTEST', 'Emory University Hospital Midtown', NULL, NULL, 'Emory University Hospital Midtown', NULL, 'Hospital', NULL, NULL, NULL, 'O', '550 Peachtree Street Northeast', 'Atlanta', 'Fulton', 'GA', '30308', NULL, NULL, '550 Peachtree Street Northeast', 'Atlanta', 'Fulton', 'GA', '30308', '', '', NULL, NULL, 'APCTEST', '0.00', '0.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144203563', 0, 'Y', 0, '2014-03-20', '110078', NULL, 0, 0, NULL, NULL),
('580566256', 'APC000018', 'APC000018', 'APCTEST', 'Emory University Hospital', NULL, NULL, 'Emory University Hospital', NULL, 'Hospital', NULL, NULL, NULL, 'O', '1364 Clifton Road Northeast', 'Atlanta', 'Dekalb', 'GA', '30322', NULL, NULL, '1364 Clifton Road Northeast', 'Atlanta', 'Dekalb', 'GA', '30322', '', '', NULL, NULL, 'APCTEST', '0.00', '0.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588640692', 0, 'Y', 0, '2014-03-20', '110010', NULL, 0, 0, NULL, NULL),
('582171011', 'APC000016', 'APC000016', 'APCTEST', 'EmoryAdventist Hospital', NULL, NULL, 'EmoryAdventist Hospital', NULL, 'Hospital', NULL, NULL, NULL, 'O', '3949 South Cobb Drive Southeast', 'Smyrna', 'Cobb', 'GA', '30080', NULL, NULL, '3949 South Cobb Drive Southeast', 'Smyrna', 'Cobb', 'GA', '30080', '', '', NULL, NULL, 'APCTEST', '0.00', '0.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1770691115', 0, 'Y', 0, '2014-03-20', '110192', NULL, 0, 0, NULL, NULL),
('830216112', 'W12045059', 'W12045059', 'WY01', 'Lander Medical Clinic', 'Julia', 'L', 'Fairbank', 'PA', '', '', '', NULL, 'O', '745 Buena Vista Dr', 'Lander', 'Fremont', 'WY', '82520', '3073322941', '3073321920', '745 Buena Vista Dr', 'Lander', 'Fremont', 'WY', '82520', '3073322941', '3073321920', '', '', '', '0.00', '10.00', '0.00', 3, '2014-04-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1861821837', 0, 'N', 0, '2014-04-18', NULL, NULL, 0, 0, NULL, NULL),
('830216112', 'W12045060', 'W12045060', 'WY01', 'Lander Medical Clinic', 'Julia', 'L', 'Fairbank', 'PA', '', '', '', NULL, 'B', 'PO Box 9432', 'Belfast', 'Waldo', 'ME', '04915', '3073322941', '3073321920', 'PO Box 9432', 'Belfast', 'Waldo', 'ME', '04915', '3073322941', '3073321920', '', '', '', '0.00', '10.00', '0.00', 3, '2014-04-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1861821837', 0, 'N', 0, '2014-04-18', NULL, NULL, 0, 0, NULL, NULL),
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('830216112', 'W12045061', 'W12045061', 'WYT2', 'Lander Medical Clinic', 'Julia', 'L', 'Fairbank', 'PA', '', '', '', NULL, 'B', 'PO Box 9432', 'Belfast', 'Waldo', 'ME', '04915', '3073322941', '3073321920', 'PO Box 9432', 'Belfast', 'Waldo', 'ME', '04915', '3073322941', '3073321920', '', '', '', '0.00', '10.00', '0.00', 3, '2014-04-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1861821837', 0, 'N', 0, '2014-04-18', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'W12045378', 'W12045378', 'NM01', 'ABQ Health Partners', 'Robert', '', 'Gardner', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627600', '0000000000', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627600', '0000000000', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2014-01-27', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194717801', 0, 'N', 0, '2014-03-11', NULL, NULL, 0, 0, NULL, NULL),
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('760478967', 'USPT00038', 'USPT00038', 'TXDALSTD', 'R Clair Physical Therapy ', NULL, NULL, 'R Clair Physical Therapy ', NULL, 'Physical Therapy', NULL, NULL, NULL, 'O', '4621 W Park Blvd Ste 102', 'Plano', 'Collin', 'TX', '75093', '9729851776', '9729856088', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'DME90TX', NULL, NULL, '0.00', '0.00', '82.00', 3, '2014-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1316964109', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('204489003', 'USPT00039', 'USPT00039', 'TXDALSTD', 'Red River Valley Physical Therapy ', NULL, NULL, 'Red River Valley Physical Therapy ', NULL, 'Physical Therapy', NULL, NULL, NULL, 'O', '201 N Collegiate Dr Ste 550', 'Paris', 'Lamar', 'TX', '75460', '9037843173', '9037847912', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'DME90TX', NULL, NULL, '0.00', '0.00', '82.00', 3, '2014-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1851339394', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('830237511', 'W12045080', 'W12045080', 'WYT1', 'Gastroenterology Associates', 'Annette', 'M', 'Russell', 'PA', 'Gastroenterology', '', '', NULL, 'O', '1441 Wilkins Cir', 'Casper', 'Natrona', 'WY', '82601', '3072651792', '3072378106', '1441 Wilkins Cir', 'Casper', 'Natrona', 'WY', '82601', '3072651792', '3072378106', '', '', '', '0.00', '15.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'Wyoming Medical Center ', '', '', '', 'HCFA|U', '1861439838', 0, 'N', 0, '2014-06-20', NULL, NULL, 0, 0, NULL, NULL),
('580566257', 'APC000021', 'APC000021', 'APCTEST', 'Saint Josephs Hospital of Atlanta Inc', NULL, NULL, 'Saint Josephs Hospital of Atlanta Inc', NULL, 'Hospital', NULL, NULL, NULL, 'O', '5665 Peachtree Dunwoody Road Northe', 'Atlanta', 'Fulton', 'GA', '30342', NULL, NULL, '5665 Peachtree Dunwoody Road Northe', 'Atlanta', 'Fulton', 'GA', '30342', '', '', NULL, NULL, 'APCTEST', '0.00', '0.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679664395', 0, 'Y', 0, '2014-03-20', '110082', NULL, 0, 0, NULL, NULL),
('204043287', 'W12045376', 'W12045376', 'NM01', 'ABQ Health Partners', 'Robert', '', 'Gardner', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5058968618', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5058968618', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2014-01-27', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194717801', 0, 'N', 0, '2014-03-11', NULL, NULL, 0, 0, NULL, NULL),
('760513962', 'USPT00011', 'USPT00011', 'TXDALSTD', 'Southlake Physical Therapy', NULL, NULL, 'Southlake Physical Therapy', NULL, 'Physical Therapy', NULL, NULL, NULL, 'O', '731 E Southlake Blvd Ste 150', 'Southlake', 'Tarrant', 'TX', '76092', '8174428600', '8144428603', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'DME90TX', NULL, NULL, '0.00', '0.00', '82.00', 3, '2014-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1750309720', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('760384227', 'USPT00030', 'USPT00030', 'TXHOUSTD', 'Spring Klein Physical Therapy', NULL, NULL, 'Spring Klein Physical Therapy', NULL, 'Physical Therapy', NULL, NULL, NULL, 'O', '21301 Kuykendahl Ste B', 'Spring', 'Harris', 'TX', '77379', '2813792102', '2813791760', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'DME90TX', NULL, NULL, '0.00', '0.00', '80.00', 3, '2014-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1225185275', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('760389608', 'USPT00049', 'USPT00049', 'TXHOUSTD', 'Star Therapy Services of  Copperfield', NULL, NULL, 'Star Therapy Services of  Copperfield', NULL, 'Physical Therapy', NULL, NULL, NULL, 'O', '8955 Hwy 6 N Ste 190', 'Houston', 'Harris', 'TX', '77095', '8325938600', '8325938601', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'DME90TX', NULL, NULL, '0.00', '0.00', '80.00', 3, '2014-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1104903095', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('760389608', 'USPT00046', 'USPT00046', 'TXHOUSTD', 'Star Therapy Services of Cinco Ranch', NULL, NULL, 'Star Therapy Services of Cinco Ranch', NULL, 'Physical Therapy', NULL, NULL, NULL, 'O', '2840 Commercial Ctr Blvd Ste 103', 'Katy', 'Fort Bend', 'TX', '77494', '2816931063', '2816931081', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'DME90TX', NULL, NULL, '0.00', '0.00', '80.00', 3, '2014-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1710034756', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('760389608', 'USPT00047', 'USPT00047', 'TXHOUSTD', 'Star Therapy Services of Cy-Fair', NULL, NULL, 'Star Therapy Services of Cy-Fair', NULL, 'Physical Therapy', NULL, NULL, NULL, 'O', '11242 FM 1960 Rd W  Ste 104', 'Houston', 'Harris', 'TX', '77065', '2814698163', '2814695559', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'DME90TX', NULL, NULL, '0.00', '0.00', '80.00', 3, '2014-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1982781886', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('760389608', 'USPT00048', 'USPT00048', 'TXHOUSTD', 'Star Therapy Services of Spring Cypress', NULL, NULL, 'Star Therapy Services of Spring Cypress', NULL, 'Physical Therapy', NULL, NULL, NULL, 'O', '22513 Tomball Pkwy Ste 113', 'Houston', 'Harris', 'TX', '77070', '2813792345', '2813791276', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'DME90TX', NULL, NULL, '0.00', '0.00', '80.00', 3, '2014-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1730266370', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('760669263', 'USPT00051', 'USPT00051', 'TXDALSTD', 'Texstar Physical Therapy ', NULL, NULL, 'Texstar Physical Therapy ', NULL, 'Physical Therapy', NULL, NULL, NULL, 'O', '1130 Beachview Dr Ste 120', 'Dallas', 'Dallas', 'TX', '75218', '2143245851', '2143245728', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'DME90TX', NULL, NULL, '0.00', '0.00', '82.00', 3, '2014-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1043238009', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('770618862', 'W12045421', 'W12045421', 'TXSATSTD', '', 'Nader', 'G', 'Iskander', 'MD', 'Ophthalmology', '', '', NULL, 'O', '3619 Paesanos Pkwy Ste 302', 'San Antonio', 'Bexar', 'TX', '78231', '2108229800', '2108229810', '3619 Paesanos Pkwy Ste 302', 'San Antonio', 'Bexar', 'TX', '78231', '2108229800', '2108229810', 'TXSTD', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2014-04-18', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659369601', 0, 'N', 0, '2014-03-18', NULL, NULL, 0, 0, NULL, NULL),
('204406904', 'USPT00052', 'USPT00052', 'TXDALSTD', 'Victory Physical Therapy ', NULL, NULL, 'Victory Physical Therapy ', NULL, 'Physical Therapy', NULL, NULL, NULL, 'O', '1011 E Ennis Ave Ste D', 'Ennis', 'Ellis', 'TX', '75119', '9728780503', '9728786219', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'DME90TX', NULL, NULL, '0.00', '0.00', '82.00', 3, '2014-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1003863390', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('830282780', 'W12045428', 'W12045428', 'WY01', 'Pinedale Medical Clinic', 'Shannon', 'D', 'Evans', 'DO', 'Family Practice', '', '', NULL, 'O', '625 E Hennick', 'Pinedale', 'Sublette', 'WY', '82941', '3073674133', '3073676636', '625 E Hennick', 'Pinedale', 'Sublette', 'WY', '82941', '3073674133', '3073676636', 'SCRHCD13', '', '', '0.00', '20.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1003071804', 0, 'N', 0, '2014-04-21', NULL, NULL, 0, 0, NULL, NULL),
('580968382', 'APC000022', 'APC000022', 'APCTEST', 'WellStar Cobb Hospital', NULL, NULL, 'WellStar Cobb Hospital', NULL, 'Hospital', NULL, NULL, NULL, 'O', '3950 Austell Road', 'Austell', 'Cobb', 'GA', '30106', NULL, NULL, '3950 Austell Road', 'Austell', 'Cobb', 'GA', '30106', '', '', NULL, NULL, 'APCTEST', '0.00', '0.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467420448', 0, 'Y', 0, '2014-03-20', '110143', NULL, 0, 0, NULL, NULL),
('582026750', 'APC000006', 'APC000006', 'APCTEST', 'WellStar Douglas Hospital', NULL, NULL, 'WellStar Douglas Hospital', NULL, 'Hospital', NULL, NULL, NULL, 'O', '8954 Hospital Drive', 'Douglasville', 'Douglas', 'GA', '30134', NULL, NULL, '8954 Hospital Drive', 'Douglasville', 'Douglas', 'GA', '30134', '', '', NULL, NULL, 'APCTEST', '0.00', '0.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649247974', 0, 'Y', 0, '2014-03-20', '110184', NULL, 0, 0, NULL, NULL),
('582032904', 'APC000026', 'APC000026', 'APCTEST', 'WellStar Kennestone Hospital', NULL, NULL, 'WellStar Kennestone Hospital', NULL, 'Hospital', NULL, NULL, NULL, 'O', '677 Church Street Northeast', 'Marietta', 'Cobb', 'GA', '30060', NULL, NULL, '677 Church Street Northeast', 'Marietta', 'Cobb', 'GA', '30060', '', '', NULL, NULL, 'APCTEST', '0.00', '0.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649248626', 0, 'Y', 0, '2014-03-20', '110035', NULL, 0, 0, NULL, NULL),
('582095884', 'APC000013', 'APC000013', 'APCTEST', 'WellStar Paulding Hospital', NULL, NULL, 'WellStar Paulding Hospital', NULL, 'Hospital', NULL, NULL, NULL, 'O', '600 West Memorial Drive', 'Dallas', 'Paulding', 'GA', '30132', NULL, NULL, '600 West Memorial Drive', 'Dallas', 'Paulding', 'GA', '30132', '', '', NULL, NULL, 'APCTEST', '0.00', '0.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457329435', 0, 'Y', 0, '2014-03-20', '110042', NULL, 0, 0, NULL, NULL),
('582032904', 'APC000009', 'APC000009', 'APCTEST', 'WellStar Windy Hill Hospital', NULL, NULL, 'WellStar Windy Hill Hospital', NULL, 'Hospital', NULL, NULL, NULL, 'O', '2540 Windy Hill Road', 'Marietta', 'Cobb', 'GA', '30067', NULL, NULL, '2540 Windy Hill Road', 'Marietta', 'Cobb', 'GA', '30067', '', '', NULL, NULL, 'APCTEST', '0.00', '0.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1700853041', 0, 'Y', 0, '2014-03-20', '112007', NULL, 0, 0, NULL, NULL),
('760513962', 'USPT00016', 'USPT00016', 'TXDALSTD', 'West Frisco Physical Therapy', NULL, NULL, 'West Frisco Physical Therapy', NULL, 'Physical Therapy', NULL, NULL, NULL, 'O', '5000 Eldorado Pkwy Ste 430', 'Frisco', 'Denton', 'TX', '75033', '2144364606', '2144364794', '5000 Eldorado Pkwy Ste 430', 'Frisco', 'Denton', 'TX', '75033', '2144364606', '2144364794', 'DME90TX', '', '', '0.00', '0.00', '82.00', 3, '2014-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1487092904', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('205834588', 'USPT00053', 'USPT00053', 'TXDALSTD', 'West Texas Physical Therapy ', NULL, NULL, 'West Texas Physical Therapy ', NULL, 'Physical Therapy', NULL, NULL, NULL, 'O', '1901 Medi Park Dr Ste 1010', 'Amarillo', 'Potter', 'TX', '79106', '8063535425', '8063535445', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'DME90TX', NULL, NULL, '0.00', '0.00', '82.00', 3, '2014-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1669533063', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('760384227', 'USPT00032', 'USPT00032', 'TXHOUSTD', 'West Woodlands Physical Therapy', NULL, NULL, 'West Woodlands Physical Therapy', NULL, 'Physical Therapy', NULL, NULL, NULL, 'O', '6318 FM 1488 Ste 150', 'Magnolia', 'Montgomery', 'TX', '77354', '9362730808', '9362730860', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'DME90TX', NULL, NULL, '0.00', '0.00', '80.00', 3, '2014-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1477794212', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL);
