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
('870574059', 'W77006614', 'W77006614', 'UT01', 'Mountain Land Rehabilitation', 'Jed', 'L', 'Crowton', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 711185', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019423311', NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '7140', '0.00', NULL, NULL, 3, '2005-12-16', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1285736041', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870574059', 'W77006615', 'W77006615', 'UT01', 'Mountain Land Rehabilitation', 'Mark', 'A', 'Flinders', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2275 N Main St', 'Clearfield', 'Davis', 'UT', '84015', '8017734191', '8017734197', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '7140', '0.00', NULL, NULL, 3, '2005-12-16', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '949404', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870574059', 'W77006616', 'W77006616', 'UT01', 'Mountain Land Rehab - Olympus Clinic', 'Joshua', 'D', 'Fuhriman', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '4624 Holladay Blvd', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8012771028', '8019425955', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '7140', '0.00', NULL, NULL, 3, '2005-12-29', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '949411', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870574059', 'W77006617', 'W77006617', 'UT01', 'Mountain Land Rehabilitation', 'Cynthia', 'J', 'Indergard', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 711185', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019423311', NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '7140', '0.00', NULL, NULL, 3, '2005-12-16', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1972606572', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870574059', 'W77006618', 'W77006618', 'UT01', 'Mountain Land Rehabilitation', 'James', 'A', 'Lewis', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '620 W 400 N', 'Moab', 'Grand', 'UT', '84532', '4352593600', '4352597715', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '7140', '0.00', NULL, NULL, 3, '2005-12-16', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992899116', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870574059', 'W77006619', 'W77006619', 'UT01', 'Mountain Land Rehabilitation', 'Jason', 'D', 'Lobb', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 711185', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019423311', NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '7140', '0.00', NULL, NULL, 3, '2005-12-16', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '949421', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870574059', 'W77006620', 'W77006620', 'UT01', 'Mountain Land Rehabilitation', 'Deanna', NULL, 'Mackay-Clark', 'OT', 'Occupational Therapy', NULL, NULL, NULL, 'O', '9301 Wights Fort Rd Ste 215', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012822200', '8012822220', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '7140', '0.00', NULL, NULL, 3, '2005-12-29', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832656', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870574059', 'W77006621', 'W77006621', 'UT01', 'Mountain Land Rehabilitation', 'Craig', 'A', 'Packham', 'PA-C', 'Orthopedic Surgery', 'Physical Therapy', NULL, NULL, 'O', '220 Millpond Ste 109', 'Tooele', 'Tooele', 'UT', '84074', '4358824144', '4358824151', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '7140', '0.00', NULL, NULL, 3, '2005-12-16', '2006-12-31', 1, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104920354', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870574059', 'W77006622', 'W77006622', 'UT01', 'Mountain Land Rehabilitation', 'Kimberly', NULL, 'Schonrock-Mazzella', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 711185', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019423311', NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '7140', '0.00', NULL, NULL, 3, '2005-12-16', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '949419', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870574059', 'W77006623', 'W77006623', 'UT01', 'Mountain Land Rehabilitation', 'Stephen', 'T', 'Simmons', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '69 E 200 N', 'Kaysville', 'Davis', 'UT', '84037', '8015471155', '8015471173', NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '7140', '0.00', NULL, NULL, 3, '2000-05-26', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '911920', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870574059', 'W77006624', 'W77006624', 'UT01', 'Mountain Land Rehabilitation', 'Stephen', 'T', 'Simmons', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 711185', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8019423311', NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '7140', '0.00', NULL, NULL, 3, '2000-05-26', '2006-12-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '911920', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006625', 'W77006625', 'UT01', 'UUHC Stansbury Center', 'Lynn', 'D', 'Falkner', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '220 Millpond Ste 100', 'Tooele', 'Tooele', 'UT', '84074', '4358433000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2000-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225128820', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006626', 'W77006626', 'UT01', 'UUHC Redwood Center', 'Michael', 'C', 'Flynn', 'MD', 'Internal Medicine', 'Pediatrics', NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2004-08-27', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306936901', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006627', 'W77006627', 'UT01', 'UUHC Redwood Urgent Care DNP', 'Brant', 'W', 'Fonnesbeck', 'DO', 'Family Practice', 'Urgent Care', NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-09-20', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033156849', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006628', 'W77006628', 'UT01', 'UUHC Redstone Clinic', 'Tina', NULL, 'Fought', 'CNM', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1743 Redstone Ctr Dr Ste 115', 'Park City', 'Summit', 'UT', '84098', '4356589200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834120', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006629', 'W77006629', 'UT01', 'UUHC Redwood Center', 'Mark', 'R', 'Greenwood', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-07-29', '2005-07-29', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832042', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006630', 'W77006630', 'UT01', 'UUHC Billing Office', 'Sumati', 'V', 'Gupta', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-07-12', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003906603', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006631', 'W77006631', 'UT01', 'UUHC Billing Office', 'Ehsan', NULL, 'Hadjbian', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2004-03-01', '2006-01-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275535742', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006632', 'W77006632', 'UT01', 'UUHC Redwood Center', 'Ehsan', NULL, 'Hadjbian', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2004-03-01', '2006-01-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275535742', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006633', 'W77006633', 'UT01', 'UUHC Billing Office', 'Phil', 'S', 'Haggerty', 'DO', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-09-30', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '937291', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006634', 'W77006634', 'UT01', 'UUHC Redwood Urgent Care DNP', 'Phil', 'S', 'Haggerty', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-09-30', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '937291', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006635', 'W77006635', 'UT01', 'UUHC Billing Office', 'Mary', 'D', 'Hall', 'NP', 'Pediatrics', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1114002805', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006636', 'W77006636', 'UT01', 'UUHC Billing Office', 'Grace', 'K', 'Harris', 'DO', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2004-09-01', '2005-07-17', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093725277', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006637', 'W77006637', 'UT01', 'UUHC Parkway Center', 'Michael', 'S', 'Kennedy', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '145 W University Pkwy', 'Orem', 'Utah', 'UT', '84058', '8012348600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-02-15', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417047010', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006638', 'W77006638', 'UT01', 'UUHC Billing Office', 'Suresh', NULL, 'Khandekar', 'MD', 'Gastroenterology', 'Gastroenterology', NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-07-01', '2004-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834677', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006639', 'W77006639', 'UT01', 'Chiropractic Health Plan', 'Nancy', 'O', 'Jeffery', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2004-01-30', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538211214', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006640', 'W77006640', 'UT01', 'Chiropractic Health Plan', 'Curt', 'C', 'Jensen', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2004-01-30', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295863694', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006641', 'W77006641', 'UT01', 'Tooele Valley Spine Center', 'Curt', 'C', 'Jensen', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '1244 N Main St', 'Tooele', 'Tooele', 'UT', '84074', '4358339200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2004-01-30', '2004-06-30', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1295863694', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006642', 'W77006642', 'UT01', 'Chiropractic Health Plan', 'Wayne', 'T', 'Johnson', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2002-04-19', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1558342105', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006643', 'W77006643', 'UT01', 'Chiropractic Health Plan', 'Mark', 'A', 'Jolley', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '790 E 700 S', 'Clearfield', 'Davis', 'UT', '84015', '8018257338', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2002-12-11', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801986310', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006644', 'W77006644', 'UT01', 'Chiropractic Health Plan', 'Chris', NULL, 'Kesler', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '1760 Fort Union Blvd', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019427272', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '1999-09-01', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720103435', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006645', 'W77006645', 'UT01', 'Chiropractic Health Plan', 'Kyle', 'D', 'Klein', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '790 E 700 S', 'Clearfield', 'Davis', 'UT', '84015', '8018257338', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2000-07-14', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1104911130', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006646', 'W77006646', 'UT01', 'Chiropractic Health Plan', 'Michael', 'P', 'Kunzler', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '471 Heritage Park Blvd Ste 3', 'Layton', 'Davis', 'UT', '84041', '8015251471', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2003-08-18', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833853', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006647', 'W77006647', 'UT01', 'Chiropractic Health Plan', 'Michael', 'P', 'Kunzler', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2003-08-18', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833853', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006648', 'W77006648', 'UT01', 'Chiropractic Health Plan', 'David', NULL, 'Lane', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '75 E 600 S', 'Brigham City', 'Box Elder', 'UT', '84302', '4357347095', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '1999-09-01', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1225138100', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006649', 'W77006649', 'UT01', 'Downtown Chiropractic Office', 'Michael', NULL, 'Lane', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '525 E 100 S Ste 420', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013223067', NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '      2303', '0.00', NULL, NULL, 3, '1998-01-01', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376637116', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006650', 'W77006650', 'UT01', 'Chiropractic Health Plan', 'Michael', NULL, 'Lane', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'SELECT', NULL, '      2303', '0.00', NULL, NULL, 3, '1998-01-01', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1376637116', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006651', 'W77006651', 'UT01', 'Chiropractic Health Plan', 'Darwin', 'K', 'Le', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '891 E 9400 S', 'Sandy', 'Salt Lake', 'UT', '84094', '8015698181', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2005-07-29', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1497876163', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006652', 'W77006652', 'UT01', 'Chiropractic Health Plan', 'Robb', 'L', 'Leishman', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '712 Fort Union Blvd', 'Midvale', 'Salt Lake', 'UT', '84047', '8015622400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2003-10-03', '2004-10-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1033151576', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870395551', 'W77006698', 'W77006698', 'UT01', 'Chiropractic Health Plan', 'Thomas', 'M', 'Malin', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '1999-09-01', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1760430359', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870395551', 'W77006700', 'W77006700', 'UT01', 'Rhett Maughan Chiropractic', 'Rhett', NULL, 'Maughan', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '249 S Main St', 'Monticello', 'San Juan', 'UT', '84535', '4355873255', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2002-04-19', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275542284', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006701', 'W77006701', 'UT01', 'Chiropractic Health Plan', 'Brent', 'J', 'Mayer', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2004-06-04', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1184618514', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006702', 'W77006702', 'UT01', 'Mayer Chiropractic and Wellness', 'Brent', 'J', 'Mayer', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '926 W 1700 S Ste B', 'Clearfield', 'Davis', 'UT', '84015', '8017758880', '8017758890', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2004-06-04', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1184618514', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870395551', 'W77006704', 'W77006704', 'UT01', 'Chiropractic Health Plan', 'Matthew', 'R', 'McClean', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2001-06-29', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1922195817', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870395551', 'W77006708', 'W77006708', 'UT01', 'Chiropractic Health Plan', 'Stephanie', 'Allen', 'Mueller-Planitz', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '1781 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015625600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2002-09-20', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437126372', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006709', 'W77006709', 'UT01', 'UUHC Billing Office', 'David', 'G', 'Owen', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154411775', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006710', 'W77006710', 'UT01', 'UUHC Westridge Center', 'Gordon', 'S', 'Park', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '3730 W 4700 S', 'Salt Lake City', 'Salt Lake', 'UT', '84118', '8012139200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881784403', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870616107', 'W77006712', 'W77006712', 'UT01', 'UUHC Redstone Clinic', 'Mary', NULL, 'Parsons', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1743 Redstone Ctr Dr Ste 115', 'Park City', 'Summit', 'UT', '84098', '4356589200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1508956129', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006713', 'W77006713', 'UT01', 'UUHC Redwood Center', 'Stephanie', NULL, 'Plunkett', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-07-05', '2005-07-05', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1720034416', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006714', 'W77006714', 'UT01', 'UUHC Billing Office', 'Sean', 'A', 'Ponce', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876303', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2004-11-01', '2006-07-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1376577049', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006715', 'W77006715', 'UT01', 'UUHC Billing Office', 'Jeffrey', 'S', 'Rasch', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-08-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598717662', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006716', 'W77006716', 'UT01', 'UUHC Redwood Urgent Care DNP', 'Jeffrey', 'S', 'Rasch', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-08-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1598717662', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006717', 'W77006717', 'UT01', 'UUHC Billing Office', 'Marta', 'M', 'Saj', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2004-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831603', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006718', 'W77006718', 'UT01', 'UUHC Billing Office', 'Colleen', 'M', 'Schubach', 'OD', 'Optometry', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-05-11', '2005-08-29', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164503959', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006719', 'W77006719', 'UT01', 'UUHC Billing Office', 'Colleen', 'M', 'Schubach', 'OD', 'Optometry', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-05-11', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164503959', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006720', 'W77006720', 'UT01', 'UUHC Stansbury Center', 'Elizabeth', 'R', 'Smith', 'MD', 'Pediatrics', 'Family Practice', 'Pediatric Internal Medicine', NULL, 'O', '220 Millpond Ste 100', 'Tooele', 'Tooele', 'UT', '84074', '4358433000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2004-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336239961', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006721', 'W77006721', 'UT01', 'UUHC Billing Office', 'Richard', 'M', 'Smoot', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2004-01-20', '2004-12-17', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831893', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006722', 'W77006722', 'UT01', 'UUHC Billing Office', 'Jay', 'M', 'Spector', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-10-28', '2005-10-28', 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1386630259', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870577952', 'W77006723', 'W77006723', 'UT01', 'Western Newborn Specialists', 'Robin', 'S', 'Smith', 'MD', 'Neonatology', NULL, NULL, NULL, 'O', '1220 E 3900 S', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8017436520', '8017436534', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-12-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245239649', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870578539', 'W77006724', 'W77006724', 'UT01', 'Prof Therapy & Rehab dba Peak Physical Therapy', 'ab', NULL, 'Prof Therapy and Reh', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'B', '77 S 400 W', 'Spanish Fork', 'Utah', 'UT', '84660', '8017981626', '8017981236', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2004-05-01', '2004-05-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834341', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870578539', 'W77006725', 'W77006725', 'UT01', 'Prof Therapy and Rehab', 'ab', NULL, 'Prof Therapy and Reh', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '77 S 400 W', 'Spanish Fork', 'Utah', 'UT', '84660', '8017981626', '8017981236', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2004-05-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834341', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870579572', 'W77006726', 'W77006726', 'UT01', 'Jordan Vision Clinic', 'Robert', 'H', 'Meek', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '9237 Redwood Rd Ste 5A', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015612020', '8012553617', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2003-04-15', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1356310940', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870580379', 'W77006727', 'W77006727', 'UT01', 'Summit View Medical', 'Vernon', 'D', 'Potter', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '9829 S 1300 E Ste 302', 'Sandy', 'Salt Lake', 'UT', '84094', '8015768988', '8015769396', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-10-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1801937263', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870581700', 'W77006728', 'W77006728', 'UT01', 'Southwest Family Medicine', 'Chuck', 'Hung', 'Gee', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '1575 W 7000 S', 'West Jordan', 'Salt Lake', 'UT', '84084', '8015699133', '8015699103', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-06-30', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1972620417', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870581700', 'W77006729', 'W77006729', 'UT01', 'Southwest Family Medicine', 'Barbara', 'P', 'Reineke', 'FNP', 'Family Practice', NULL, NULL, NULL, 'O', '1575 W 7000 S', 'West Jordan', 'Salt Lake', 'UT', '84084', '8015699133', '8015699103', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-06-30', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1073652145', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870581700', 'W77006730', 'W77006730', 'UT01', 'Southwest Family Medicine', 'Randall', 'L', 'Watson', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 71128', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8013522700', '8013520400', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-06-30', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1952341000', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870584427', 'W77006731', 'W77006731', 'UT01', 'University Of Utah Vascular Surgeons', 'Larry', 'W', 'Kraiss', 'MD', 'Pediatric Orthopedic Surgery', 'Pediatric Spine-Scoliosis Orthopedics', 'Vascular Surgery', NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015818301', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962592576', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870584427', 'W77006732', 'W77006732', 'UT01', 'University Of Utah Vascular Surgeons', 'Michelle', 'T', 'Mueller', 'MD', 'Pediatric Orthopedic Surgery', 'Pediatric Spine-Scoliosis Orthopedics', 'Vascular Surgery', NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015818301', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2004-08-16', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1437249042', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870584427', 'W77006734', 'W77006734', 'UT01', 'University Of Utah Vascular Surgeons', 'Mark', 'R', 'Sarfati', 'MD', 'Pediatric Orthopedic Surgery', 'Pediatric Spine-Scoliosis Orthopedics', 'Vascular Surgery', NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015818301', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1467542084', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870617263', 'W77006816', 'W77006816', 'UT01', 'St Marks Family Medicine', 'Laura', 'K', 'Marchiando', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1250 E 3900 S Ste 260', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012652000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-12-05', '2005-01-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831885', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870617391', 'W77006817', 'W77006817', 'UT01', 'Primary Care Pediatrics', 'Craig', 'W', 'Armstrong', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '2380 N 400 E Ste C', 'Logan', 'Cache', 'UT', '84341', '4357537337', '4357506779', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-10-04', '2006-10-31', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1558328427', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870617391', 'W77006818', 'W77006818', 'UT01', 'Primary Care Pediatrics', 'Glen', 'F', 'Huff', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '2380 N 400 E Ste C', 'Logan', 'Cache', 'UT', '84341', '4357537337', '4357506779', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-10-04', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1578520904', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870617733', 'W77006819', 'W77006819', 'UT01', 'Mt Ogden Eye Center', 'John', 'D', 'Armstrong', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', 'PO Box 1529', 'Layton', 'Davis', 'UT', '84041', '8015933223', '8015939626', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-06-11', '2004-09-14', 0, 0, 0, 'Lakeview Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1932188133', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870617733', 'W77006820', 'W77006820', 'UT01', 'Mt Ogden Eye Center', 'Mark', NULL, 'Ballif', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '4360 Washington Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014760494', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-09-30', 0, 0, 0, 'Lakeview Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1376522573', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870617733', 'W77006821', 'W77006821', 'UT01', 'Mt Ogden Eye Center', 'Justin', 'C', 'Holt', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '4360 Washington Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014760494', NULL, NULL, NULL, '', NULL, NULL, '', '', 'ULOGBMC', NULL, NULL, '0.00', '35.00', NULL, 3, '2004-04-30', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1588634521', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870617733', 'W77006822', 'W77006822', 'UT01', 'Bountiful Hills Eye Center', 'Scott', 'Owen', 'Sykes', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '425 Medical Dr Ste 218', 'Bountiful', 'Davis', 'UT', '84010', '8016771122', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2004-09-14', 0, 0, 0, 'Lakeview Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1083693204', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870617733', 'W77006823', 'W77006823', 'UT01', 'Mt Ogden Eye Center', 'Scott', 'Owen', 'Sykes', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', 'PO Box 1529', 'Layton', 'Davis', 'UT', '84041', '8015933223', '8015939626', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2004-09-14', 0, 0, 0, 'Lakeview Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1083693204', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870617733', 'W77006824', 'W77006824', 'UT01', 'Mt Ogden Eye Center', 'Scott', 'Owen', 'Sykes', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', 'PO Box 1529', 'Layton', 'Davis', 'UT', '84041', '8015933223', '8015939626', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2002-04-01', 0, 0, 0, 'Lakeview Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1083693204', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870617733', 'W77006825', 'W77006825', 'UT01', 'Mt Ogden Eye Center', 'Michael', 'B', 'Wilcox', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'B', 'PO Box 1529', 'Layton', 'Davis', 'UT', '84041', '8015933223', '8015939626', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2005-09-01', 0, 0, 0, 'Lakeview Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1053391771', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870618431', 'W77006826', 'W77006826', 'UT01', 'Bergeson, Lars', 'Lars', NULL, 'Bergeson', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 609', 'Providence', 'Cache', 'UT', '84332', '8017520330', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2006-08-31', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1497721195', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870615475', 'W77006827', 'W77006827', 'UT01', NULL, 'Daniel', 'R', 'Faber', 'MD', 'Pain Management', 'Anesthesiology', NULL, NULL, 'O', '280 W River Park Dr Ste 200', 'Provo', 'Utah', 'UT', '84604', '8012234860', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '39.38', NULL, NULL, 3, '2003-10-03', '2004-10-01', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023049418', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870615616', 'W77006828', 'W77006828', 'UT01', 'Kotter Foot and Ankle Center', 'Michael', 'W', 'Kotter', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '3590 W 9000 S Ste 215', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015667297', '8015629294', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-09-30', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1871548305', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870615760', 'W77006829', 'W77006829', 'UT01', 'Urology Clinic Of Logan', 'Ryan', 'H', 'Larsen', 'MD', 'Urology', NULL, NULL, NULL, 'O', '550 E 1400 N Ste J', 'Logan', 'Cache', 'UT', '84341', '4357531171', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDURO', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-12-31', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1235224932', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870616000', 'W77006831', 'W77006831', 'UT01', 'Park City Podiatry', 'Mark', 'E', 'Moritz', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '1820 Sidewinder Dr', 'Park City', 'Summit', 'UT', '84060', '4356556600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-08-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245297688', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616000', 'W77006832', 'W77006832', 'UT01', 'Park City Podiatry', 'Mark', 'E', 'Moritz', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '2618 W 7800 S Ste 200', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015686800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2004-12-31', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245297688', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616017', 'W77006833', 'W77006833', 'UT01', 'Hewitt, Elena', 'Mary', 'Elena', 'James', 'MD', 'Neurology', NULL, NULL, NULL, 'O', '1002 E S Temple Ste 207', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013641110', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDNEUR', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2005-03-31', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1710927975', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006834', 'W77006834', 'UT01', 'UUHC Billing Office', 'Hugh', 'M', 'Stoneburner', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2001-01-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1003991498', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006835', 'W77006835', 'UT01', 'UUHC Billing Office', 'Rebecca', 'P', 'Tanner', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2004-11-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831476', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006836', 'W77006836', 'UT01', 'UUHC Billing Office', 'Walter', NULL, 'Townson', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1548350176', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006837', 'W77006837', 'UT01', 'UUHC Billing Office', 'Gavin', 'N', 'Vanstaden', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-10-12', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1841380433', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006838', 'W77006838', 'UT01', 'UUHC Billing Office', 'Christina', 'M', 'Vokt', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-07-14', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568480895', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006839', 'W77006839', 'UT01', 'UUHC Redwood Center', 'Christina', 'M', 'Vokt', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-07-14', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1568480895', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006840', 'W77006840', 'UT01', 'UUHC Billing Office', 'J Randal', NULL, 'Young', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1700816709', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006841', 'W77006841', 'UT01', 'UUHC Westridge Center', 'J Randal', NULL, 'Young', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '3730 W 4700 S', 'Salt Lake City', 'Salt Lake', 'UT', '84118', '8012139200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1700816709', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616190', 'W77006842', 'W77006842', 'UT01', 'Therapyworks', 'yworks', NULL, 'Therap', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '53 S 700 E', 'Price', 'Carbon', 'UT', '84501', '4356130330', '4356130302', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2004-05-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832999', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616622', 'W77006843', 'W77006843', 'UT01', 'Barbuto, John P', 'John', 'P', 'Barbuto', 'MD', 'Neurology', NULL, NULL, NULL, 'B', 'PO Box 307', 'Bountiful', 'Davis', 'UT', '84011', '8015656600', '8015656774', NULL, NULL, '', NULL, NULL, '', '', 'USTDNEUR', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-02-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1366434797', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870617263', 'W77006844', 'W77006844', 'UT01', 'St Marks Family Medicine', 'John', 'A', 'Berneike', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', '1250 E 3900 S Ste 260', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012652000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2005-03-04', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1982688321', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870617263', 'W77006845', 'W77006845', 'UT01', 'St Marks Family Medicine', 'Pamela', 'L', 'Farmer', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1250 E 3900 S Ste 260', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012652000', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2005-03-04', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831080', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870617263', 'W77006847', 'W77006847', 'UT01', 'St Marks Family Medicine', 'Laura', 'K', 'Marchiando', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '2618 W 7800 S Ste 200', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015686800', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-12-05', '2005-01-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831885', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006848', 'W77006848', 'UT01', 'Chiropractic Health Plan', 'Michael', NULL, 'Smithers', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '6440 Wasatch Blvd Ste 270', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8019425814', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '1999-09-01', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1457312720', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006849', 'W77006849', 'UT01', 'J Devin Southam DC', 'J Devin', NULL, 'Southam', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '54 N 1200 W', 'Vernal', 'Uintah', 'UT', '84078', '4357890704', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2000-06-09', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834320', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006850', 'W77006850', 'UT01', 'Heber Valley Chiropractic', 'Daven', 'L', 'Spencer', 'DC', 'Chiropractic', NULL, NULL, NULL, 'O', '68 N Main St', 'Heber City', 'Wasatch', 'UT', '84032', '4356543797', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2003-05-30', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013974732', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006851', 'W77006851', 'UT01', 'Chiropractic Health Plan', 'Daven', 'L', 'Spencer', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', '8013527270', '8013527024', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2003-05-30', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013974732', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006852', 'W77006852', 'UT01', 'Chiropractic Health Plan', 'Daven', 'L', 'Spencer', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2003-05-30', '2004-11-13', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013974732', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870395551', 'W77006853', 'W77006853', 'UT01', 'Chiropractic Health Plan', 'Derrick', 'L', 'Stanbridge', 'DC', 'Chiropractic', NULL, NULL, NULL, 'B', '9135 S Monroe St Ste B', 'Sandy', 'Salt Lake', 'UT', '84070', NULL, NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, '2303', '0.00', '35.00', NULL, 3, '2001-03-30', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1326024977', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870616107', 'W77006936', 'W77006936', 'UT01', 'UUHC Parkway Center', 'Phil', 'S', 'Haggerty', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '145 W University Pkwy', 'Orem', 'Utah', 'UT', '84058', '8012348600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-09-30', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '937291', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006937', 'W77006937', 'UT01', 'UUHC Billing Office', 'Grace', 'K', 'Harris', 'DO', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2004-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093725277', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006938', 'W77006938', 'UT01', 'UUHC Billing Office', 'Ted', 'R', 'Hemsley', 'OD', 'Optometry', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '1999-09-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833594', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870616107', 'W77006939', 'W77006939', 'UT01', 'UUHC Billing Office', 'David', 'R', 'Hillam', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-11-08', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275623878', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006940', 'W77006940', 'UT01', 'UUHC Redwood Center', 'Rina', 'M', 'Hooper', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1538259130', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006941', 'W77006941', 'UT01', 'UUHC Billing Office', 'Michael', 'S', 'Kennedy', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-02-15', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1417047010', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77006942', 'W77006942', 'UT01', 'UUHC Redwood Center', 'Suresh', NULL, 'Khandekar', 'MD', 'Gastroenterology', 'Gastroenterology', NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-07-01', '2004-06-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834677', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870617995', 'W77006943', 'W77006943', 'UT01', 'Jm Clayton', 'James', 'M', 'Clayton', 'MD', 'Plastic Surgery', NULL, NULL, NULL, 'O', '280 W River Park Dr Ste 240', 'Provo', 'Utah', 'UT', '84604', '8013754646', '8013751999', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2004-09-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833084', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870618398', 'W77006944', 'W77006944', 'UT01', 'Canyonview Family Practice', 'Ronald', 'L', 'Baird', 'DO', 'Family Practice', NULL, NULL, NULL, 'O', '3200 N Canyon Rd Ste C', 'Provo', 'Utah', 'UT', '84604', '8013737373', '8013731808', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-10-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1760677520', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870618398', 'W77006945', 'W77006945', 'UT01', 'Canyonview Family Practice', 'Todd', 'D', 'Seamons', 'PA', NULL, NULL, NULL, NULL, 'O', '3200 N Canyon Rd Ste C', 'Provo', 'Utah', 'UT', '84604', '8013737373', '8013731808', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-10-01', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '908489', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870618431', 'W77006946', 'W77006946', 'UT01', 'Bergeson, Lars', 'Lars', NULL, 'Bergeson', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '169 Springcreek Pkwy Ste 100', 'Providence', 'Cache', 'UT', '84332', '4357520330', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-07-01', '2006-08-31', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1497721195', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870618776', 'W77006947', 'W77006947', 'UT01', 'Gamma West Brachytherapy', 'Robert', 'Alan', 'Harris', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'O', '425 E 5350 S Ste 180', 'Ogden', 'Weber', 'UT', '84405', '8014754571', '8014756119', NULL, NULL, '', NULL, NULL, '', '', 'USTDRONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-06-04', '2006-09-30', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1144369752', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870618776', 'W77006948', 'W77006948', 'UT01', 'Gamma West Brachytherapy', 'John', 'K', 'Hayes', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'O', '1050 E S Temple', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8013508400', '8013504021', NULL, NULL, '', NULL, NULL, '', '', 'USTDRONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-09-30', 0, 0, 0, 'Ogden Regional Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1275672933', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870618776', 'W77006949', 'W77006949', 'UT01', 'Gamma West Brachytherapy', 'John', 'K', 'Hayes', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'O', '674 W 800 N Ste B10', 'Orem', 'Utah', 'UT', '84057', '8018520210', '8018520215', NULL, NULL, '', NULL, NULL, '', '', 'USTDRONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-09-30', 0, 0, 0, 'Ogden Regional Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1275672933', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870618776', 'W77006950', 'W77006950', 'UT01', 'Gamma West Brachytherapy', 'John', 'K', 'Hayes', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'B', 'PO Box 25213', 'Salt Lake City', 'Salt Lake', 'UT', '84125', '8014754571', '8014756119', NULL, NULL, '', NULL, NULL, '', '', 'USTDRONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-09-30', 0, 0, 0, 'Ogden Regional Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1275672933', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870618776', 'W77006951', 'W77006951', 'UT01', 'Gamma West Brachytherapy', 'Charles', 'L', 'Rogers', 'MD', 'Radiation Oncology', NULL, NULL, NULL, 'B', 'PO Box 71309', 'Salt Lake City', 'Salt Lake', 'UT', '84171', '8013598956', '8013504021', NULL, NULL, '', NULL, NULL, '', '', 'USTDRONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-09-30', 0, 0, 0, 'Ogden Regional Medical Center', 'St Marks Hospital', NULL, NULL, 'HCFA|UB|', '1609915289', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870618776', 'W77006952', 'W77006952', 'UT01', 'Gamma West Brachytherapy', 'Jeremy', 'D', 'Spearman', 'PA', 'Radiation Oncology', NULL, NULL, NULL, 'O', '425 E 5350 S Ste 180', 'Ogden', 'Weber', 'UT', '84405', '8014754571', '8014756119', NULL, NULL, '', NULL, NULL, '', '', 'USTDRONC', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-05-01', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832599', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870619378', 'W77006953', 'W77006953', 'UT01', 'Tayler, Gregory Paul', 'Gregory', 'Paul', 'Tayler', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1469 S Highway 40', 'Heber City', 'Wasatch', 'UT', '84032', '4356543535', '4356542853', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-08-31', 0, 0, 0, 'Heber Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1043297815', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870619420', 'W77006954', 'W77006954', 'UT01', 'College Of Nursing', 'Angela', NULL, 'Deneris', 'RN, CNM, PHD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 581051', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012367749', '8012367733', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1235229824', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870619420', 'W77006955', 'W77006955', 'UT01', 'College Of Nursing', 'Jane', 'M', 'Dyer', 'CNM', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 581051', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012367749', '8012367733', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2001-10-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1043300635', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77006958', 'W77006958', 'UT01', 'U Of U Dept Of Ob/Gyn', 'David', 'W', 'Branch', 'MD', 'Maternal Fetal Medicine', 'Obstetrics and Gynecology', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812719', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '1999-09-01', '2006-07-31', 1, 12, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1922012830', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77006959', 'W77006959', 'UT01', 'U Of U Dept Of Ob/Gyn', 'David', 'W', 'Branch', 'MD', 'Maternal Fetal Medicine', 'Obstetrics and Gynecology', NULL, NULL, 'B', 'PO Box 58859', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015855172', '8015855164', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '1999-09-01', '2006-07-31', 1, 12, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1922012830', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77006961', 'W77006961', 'UT01', 'U Of U Dept Of Ob/Gyn', 'Steven', 'L', 'Clark', 'MD', 'Maternal Fetal Medicine', 'Perinatology', NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812719', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '1999-09-01', '2004-09-30', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255326633', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77006962', 'W77006962', 'UT01', 'U Of U Dept Of Ob/Gyn', 'Steven', 'L', 'Clark', 'MD', 'Maternal Fetal Medicine', 'Perinatology', NULL, NULL, 'B', 'PO Box 58859', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015855172', '8015855164', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '1999-09-01', '2004-09-30', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255326633', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77006963', 'W77006963', 'UT01', 'U Of U Dept Of Ob/Gyn', 'Donna', 'S', 'Dizon-Townson', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812719', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '1999-09-01', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831218', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77006964', 'W77006964', 'UT01', 'U Of U Dept Of Ob/Gyn', 'Mark', 'K', 'Dodson', 'MD', 'Obstetrics and Gynecology', 'Gynecologic Oncology', NULL, NULL, 'O', '2000 Circle of Hope Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84112', '8015812719', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '1999-09-01', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275570467', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77006965', 'W77006965', 'UT01', 'U Of U Dept Of Ob/Gyn', 'Mark', 'K', 'Dodson', 'MD', 'Obstetrics and Gynecology', 'Gynecologic Oncology', NULL, NULL, 'O', '555 Foothill Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84112', '8015855382', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '1999-09-01', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275570467', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77006967', 'W77006967', 'UT01', 'U Of U Dept Of Ob/Gyn', 'Raymond', 'C', 'Doucette', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812719', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '1999-09-01', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831252', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77006968', 'W77006968', 'UT01', 'U Of U Dept Of Ob/Gyn', 'Raymond', 'C', 'Doucette', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '555 Foothill Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84112', '8015855382', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '1999-09-01', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831252', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77006969', 'W77006969', 'UT01', 'U Of U Dept Of Ob/Gyn', 'Michael', 'L', 'Draper', 'MD', 'Maternal Fetal Medicine', 'Obstetrics and Gynecology', NULL, NULL, 'B', 'PO Box 58859', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015855172', '8015855164', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2001-09-14', '2006-07-31', 1, 12, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1992769368', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870620312', 'W77006971', 'W77006971', 'UT01', 'Advanced Integrated Medical Services PT', 'Medical - PT', NULL, 'Advanced Integrated', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 17491', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8017467123', '8017467244', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2004-09-10', '2005-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '910517', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870620312', 'W77006972', 'W77006972', 'UT01', 'Advanced Integrated Medical', 'Florentine', 'M', 'Abueg', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1025 E 3300 S Ste C', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8017462467', '8017467244', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2005-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833939', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870620312', 'W77006973', 'W77006973', 'UT01', 'Advanced Integrated Medical', 'Florentine', 'M', 'Abueg', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'B', 'PO Box 17491', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8017467123', '8017467244', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2005-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833939', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870621466', 'W77006974', 'W77006974', 'UT01', 'Sellers, Daniel S', 'Daniel', 'S', 'Sellers', 'MD', 'Plastic Surgery', 'Hand Surgery', NULL, NULL, 'B', '415 Medical Dr Ste C-101', 'Bountiful', 'Davis', 'UT', '84010', '8013647723', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '1999-09-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1194750711', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870621625', 'W77006975', 'W77006975', 'UT01', 'Zobell, Richard L', 'Richard', 'L', 'Zobell', 'MD', 'Urology', NULL, NULL, NULL, 'O', '425 E 5350 S Ste 260', 'Ogden', 'Weber', 'UT', '84405', '8014750880', '8014750881', NULL, NULL, '', NULL, NULL, '', '', 'USTDURO', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-07-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834659', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870626402', 'W77007036', 'W77007036', 'UT01', 'Flint Oral & Facial Surgery', 'Robert', 'Leon', 'Flint', 'DMD MD', 'Oral Surgeon', 'Oral/Maxillofacial Surgery', NULL, NULL, 'O', '4970 S 900 E Ste C', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8012633309', '8012881226', NULL, NULL, '', NULL, NULL, '', '', 'USTDOSRG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 6, '2005-07-29', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093738106', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870628514', 'W77007037', 'W77007037', 'UT01', 'Avec Eye Center', 'Stella', 'Y', 'Chou', 'MD', 'Ophthalmology', NULL, NULL, NULL, 'O', '9829 S 1300 E Ste 300', 'Sandy', 'Salt Lake', 'UT', '84094', '8015010035', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1649450628', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870616107', 'W77007039', 'W77007039', 'UT01', 'UUHC Parkway Center', 'Clair', 'R', 'Palmer', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '145 W University Pkwy', 'Orem', 'Utah', 'UT', '84058', '8012348600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255412045', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870616107', 'W77007041', 'W77007041', 'UT01', 'UUHC Redwood Center', 'Kevin', NULL, 'Rarick', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-10-01', '2004-06-30', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1609971506', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77007042', 'W77007042', 'UT01', 'UUHC Billing Office', 'Brian', 'C', 'Rasmussen', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-08-30', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1316058670', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870616107', 'W77007044', 'W77007044', 'UT01', 'UUHC Redstone Clinic', 'Ryan', 'T', 'Rushton', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '1743 Redstone Ctr Dr Ste 115', 'Park City', 'Summit', 'UT', '84098', '4356589200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2000-12-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1013007632', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77007045', 'W77007045', 'UT01', 'UUHC Summit Center', 'Colleen', 'M', 'Schubach', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '1750 Sun Peak Dr', 'Park City', 'Summit', 'UT', '84098', '4356475740', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-05-11', '2005-08-29', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1164503959', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77007046', 'W77007046', 'UT01', 'UUHC Billing Office', 'Hilary', 'S', 'Seibert', 'DO', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-11-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275623894', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77007047', 'W77007047', 'UT01', 'UUHC Greenwood Center', 'Mehrnoosh', NULL, 'Shakeri', 'MD', 'Internal Medicine', 'Family Practice', NULL, NULL, 'O', '7495 S State St', 'Midvale', 'Salt Lake', 'UT', '84047', '8012139400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2001-01-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831562', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77007048', 'W77007048', 'UT01', 'UUHC Billing Office', 'Craig', 'M', 'Smith', 'OD', 'Optometry', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073694865', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77007049', 'W77007049', 'UT01', 'UUHC Greenwood Center', 'Craig', 'M', 'Smith', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '7495 S State St', 'Midvale', 'Salt Lake', 'UT', '84047', '8012139400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1073694865', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77007050', 'W77007050', 'UT01', 'UUHC Billing Office', 'Elizabeth', 'R', 'Smith', 'MD', 'Pediatrics', 'Family Practice', 'Pediatric Internal Medicine', NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2004-07-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1336239961', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W77007051', 'W77007051', 'UT01', 'UUHC Billing Office', 'Jay', 'M', 'Spector', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUHC', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-10-28', '2005-10-28', 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1386630259', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870619420', 'W77007052', 'W77007052', 'UT01', 'College Of Nursing-Ellis R Shipp Clinic', 'Paula', 'G', 'Thacker', 'CNM', 'Obstetrics and Gynecology', 'Nurse Midwife', NULL, NULL, 'O', '4535 S 5600 W', 'West Valley', 'Salt Lake', 'UT', '84120', '8019637335', '8012367733', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2000-10-02', '2005-08-17', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205867553', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870619420', 'W77007053', 'W77007053', 'UT01', 'College Of Nursing-Madsen Health Center', 'Paula', 'G', 'Thacker', 'CNM', 'Obstetrics and Gynecology', 'Nurse Midwife', NULL, NULL, 'O', '555 Foothill Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84112', '8015852111', '8012367733', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2000-10-02', '2005-08-17', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1205867553', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870619420', 'W77007054', 'W77007054', 'UT01', 'College Of Nursing', 'Celeste', NULL, 'Thomas', 'CNM', 'Obstetrics and Gynecology', 'Certified Nurse Midwife', NULL, NULL, 'B', 'PO Box 581051', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012367749', '8012367733', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-08-10', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1285724815', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870619420', 'W77007055', 'W77007055', 'UT01', 'College Of Nursing', 'Jennifer', 'J', 'Trauscht-Van Horn', 'MD', 'Obstetrics and Gynecology', 'Certified Nurse Midwife', NULL, NULL, 'B', 'PO Box 581051', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012367749', '8012367733', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1306926209', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870619420', 'W77007056', 'W77007056', 'UT01', 'College Of Nursing', 'Patrice', NULL, 'White', 'CNM', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'B', 'PO Box 581051', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8012367749', '8012367733', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2000-10-02', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834491', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870620312', 'W77007057', 'W77007057', 'UT01', 'Advanced Integrated Medical - PT', 'Medical - PT', NULL, 'Advanced Integrated', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '1025 E 3300 S Ste C', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8017462467', '8017467244', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2004-09-10', '2005-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '910517', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870620312', 'W77007058', 'W77007058', 'UT01', 'Advanced Integrated Medical', 'Youssef', 'M', 'Alsaghir', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1025 E 3300 S Ste C', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8017462467', '8017467244', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-11-15', '2005-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831787', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870620312', 'W77007059', 'W77007059', 'UT01', 'Advanced Integrated Medical', 'Mark', NULL, 'Cacciamani', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1025 E 3300 S Ste C', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8017462467', '8017467244', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-07-31', '2005-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831753', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870620312', 'W77007060', 'W77007060', 'UT01', 'Advanced Integrated Medical', 'Syed', NULL, 'Nabi', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '1025 E 3300 S Ste C', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8017462467', '8017467244', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2005-02-05', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831445', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870620312', 'W77007061', 'W77007061', 'UT01', 'Advanced Integrated Medical', 'Asif', 'A', 'Saberi', 'MD', 'Internal Medicine', 'Internal Medicine', 'Pulmonary', NULL, 'O', '1025 E 3300 S Ste C', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8017462467', '8017467244', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-01-24', '2005-03-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832425', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870620702', 'W77007062', 'W77007062', 'UT01', 'Orem Foot Clinic', 'Gary', 'R', 'Ridge', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', '157 N 400 W Ste B-7', 'Orem', 'Utah', 'UT', '84057', '8012262421', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUVPN', NULL, NULL, '0.00', '35.00', NULL, 3, '1999-09-01', '2006-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1144267089', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870621188', 'W77007063', 'W77007063', 'UT01', 'Clearskin Dermatology & Surgery', 'Paul', 'E', 'Harrison', 'MD', 'Dermatology', NULL, NULL, NULL, 'O', '10011 Centennial Pkwy Ste 200', 'Sandy', 'Salt Lake', 'UT', '84070', '8012557546', '8013529502', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-09-30', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1508076928', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870623831', 'W77007166', 'W77007166', 'UT01', 'Ashley Creek Physical Therapy', 'l Therapy', NULL, 'Ashley Creek Physica', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '175 W 200 N', 'Roosevelt', 'Duchesne', 'UT', '84066', '4357223177', '4357892955', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2004-05-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832965', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870623831', 'W77007167', 'W77007167', 'UT01', 'Ashley Creek Physical Therapy', 'l Therapy', NULL, 'Ashley Creek Physica', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 1875', 'Vernal', 'Uintah', 'UT', '84078', '4357890022', NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2004-05-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832965', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870623831', 'W77007168', 'W77007168', 'UT01', 'Ashley Creek Physical Therapy', 'Jerry', NULL, 'Kulland', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '510 W 200 N', 'Roosevelt', 'Duchesne', 'UT', '84066', '4357223177', '4357892955', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2000-01-02', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834215', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870623924', 'W77007169', 'W77007169', 'UT01', 'Northern Physical Therapy Services', 'Frank', 'F', 'Romney', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1221 E 5800 S', 'South Ogden', 'Weber', 'UT', '84405', '8014762000', '8014767000', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2000-04-06', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834291', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870624273', 'W77007170', 'W77007170', 'UT01', 'Boyce, Richard', 'Richard', NULL, 'Boyce', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'B', 'PO Box 1512', 'Layton', 'Davis', 'UT', '84041', '8015939223', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '34.65', NULL, NULL, 3, '2001-12-01', '2006-12-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275535932', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870625774', 'W77007171', 'W77007171', 'UT01', 'Rocky Mountain Dermatology', 'Robert', 'P', 'Young', 'MD', 'Dermatology', NULL, NULL, NULL, 'B', '274 N Main St', 'Logan', 'Cache', 'UT', '84321', '4357531600', '4357539521', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-09-15', '2006-09-30', 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1013910744', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870625825', 'W77007172', 'W77007172', 'UT01', 'Fitquest Physical Therapy & Fitness', 'erapy & Fitness', ', Inc', 'Fitquest Physical Th', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '147 W 400 N', 'Orem', 'Utah', 'UT', '84057', '8012219060', '8012219071', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2004-05-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832969', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870626129', 'W77007174', 'W77007174', 'UT01', 'Webb Physical Therapy', 'y', NULL, 'Webb Physical Therap', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '2545 N Canyon Rd Ste 112', 'Provo', 'Utah', 'UT', '84604', '8013805495', '8014797005', NULL, NULL, '', NULL, NULL, '', '', '12280', NULL, NULL, '0.00', '0.00', '57.75', 3, '2004-05-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832995', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870626129', 'W77007176', 'W77007176', 'UT01', 'Webb Physical Therapy', 'Brent', 'A', 'Webb', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', '1452 E Ridgeline Dr Ste 51', 'Ogden', 'Weber', 'UT', '84405', '8014795777', '8017740735', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2000-02-02', '2000-02-02', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154376838', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870626129', 'W77007177', 'W77007177', 'UT01', 'Webb Physical Therapy', 'Brent', 'A', 'Webb', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2545 N Canyon Rd', 'Provo', 'Utah', 'UT', '84604', '8013805495', '8013734008', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2000-02-02', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1154376838', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870626402', 'W77007178', 'W77007178', 'UT01', 'Flint DMD MD, Robert L', 'Robert', 'Leon', 'Flint', 'DMD MD', 'Oral Surgeon', 'Oral/Maxillofacial Surgery', NULL, NULL, 'B', '4970 S 900 E Ste C', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8012633309', '8012881226', NULL, NULL, '', NULL, NULL, '', '', 'USTDOSRG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 6, '2005-07-29', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1093738106', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870410144', 'W77007179', 'W77007179', 'UT01', 'U Of U Dept Of Ob/Gyn', 'Karen', NULL, 'Zempolich', 'MD', 'Gynecologic Oncology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015812719', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2000-07-25', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834395', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870413860', 'W77007180', 'W77007180', 'UT01', 'Now Care Clinic', 'Alicia', 'K', 'Andersen', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '1937 W 5700 S', 'Roy', 'Weber', 'UT', '84067', '8017739380', '8016218811', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-05-23', '2006-01-24', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831812', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870413860', 'W77007181', 'W77007181', 'UT01', 'Now Care Clinic', 'Charles', 'A', 'Caton', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1937 W 5700 S', 'Roy', 'Weber', 'UT', '84067', '8017739380', '8016218811', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-02-02', '2006-05-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1750341210', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870413860', 'W77007182', 'W77007182', 'UT01', 'Now Care Clinic', 'Joelle', NULL, 'Creager', 'NP', 'Family Practice', NULL, NULL, NULL, 'O', '698 12th St', 'Ogden', 'Weber', 'UT', '84404', '8016213466', '8016218811', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-05-23', '2006-05-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558394692', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870413860', 'W77007183', 'W77007183', 'UT01', 'Now Care Clinic', 'Arthur', 'M', 'Davenport', 'MD', 'Family Practice', 'General Practice', NULL, NULL, 'O', '1600 W Antelope Dr', 'Layton', 'Davis', 'UT', '84041', '8018259561', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-02-02', '2005-12-20', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023079936', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870413860', 'W77007184', 'W77007184', 'UT01', 'Now Care Clinic', 'Arthur', 'M', 'Davenport', 'MD', 'Family Practice', 'General Practice', NULL, NULL, 'O', '1937 W 5700 S', 'Roy', 'Weber', 'UT', '84067', '8017739380', '8016218811', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-02-02', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023079936', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870413860', 'W77007185', 'W77007185', 'UT01', 'Now Care Clinic', 'Arthur', 'M', 'Davenport', 'MD', 'Family Practice', 'General Practice', NULL, NULL, 'B', 'PO Box 241', 'Roy', 'Weber', 'UT', '84067', '8016213466', '8016218811', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2000-02-02', '2006-05-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1023079936', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870413860', 'W77007187', 'W77007187', 'UT01', 'Now Care Clinic', 'Gary', NULL, 'Holland', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '698 12th St', 'Ogden', 'Weber', 'UT', '84404', '8016213466', '8016218811', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2005-02-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832144', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870413860', 'W77007188', 'W77007188', 'UT01', 'Now Care Clinic', 'Gary', NULL, 'Holland', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 241', 'Roy', 'Weber', 'UT', '84067', '8016213466', '8016218811', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2005-02-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832144', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870413860', 'W77007189', 'W77007189', 'UT01', 'Now Care Clinic', 'Cara', 'L', 'Lortz', 'PA', 'Family Practice', NULL, NULL, NULL, 'O', '698 12th St', 'Ogden', 'Weber', 'UT', '84404', '8016213466', '8016218811', NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-04-19', '2005-02-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '908481', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870413860', 'W77007190', 'W77007190', 'UT01', 'Now Care Clinic', 'Shiloh', 'C', 'Manning', 'FNP', 'Family Practice', NULL, NULL, NULL, 'O', '1937 W 5700 S', 'Roy', 'Weber', 'UT', '84067', '8017739380', '8016218811', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-05-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1972536001', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870413860', 'W77007191', 'W77007191', 'UT01', 'Now Care Clinic', 'Shiloh', 'C', 'Manning', 'FNP', 'Family Practice', NULL, NULL, NULL, 'O', '698 12th St', 'Ogden', 'Weber', 'UT', '84404', '8016213466', '8016218811', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-05-31', 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1972536001', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870413860', 'W77007192', 'W77007192', 'UT01', 'Now Care Clinic', 'Judith', 'S', 'Salleh', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1937 W 5700 S', 'Roy', 'Weber', 'UT', '84067', '8017739380', '8016218811', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2005-10-14', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '830910', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870413860', 'W77007193', 'W77007193', 'UT01', 'Now Care Clinic', 'Emily', 'E', 'Sandberg', 'PA-C', NULL, NULL, NULL, NULL, 'B', 'PO Box 241', 'Roy', 'Weber', 'UT', '84067', '8016213466', '8016218811', NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-12-29', '2006-05-31', 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1164440665', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870629690', 'W77007194', 'W77007194', 'UT01', 'Epic', 'R', 'Alan', 'Maurer', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '3460 Pioneer Pkwy', 'West Valley', 'Salt Lake', 'UT', '84120', '8019643100', NULL, '370 E S Temple', 'Salt Lake City', '', 'UT', '84111', '', '', 'UEPIC', NULL, NULL, '0.00', '30.00', NULL, 3, '2000-01-02', '2004-11-08', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833306', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870629690', 'W77007195', 'W77007195', 'UT01', 'Epic', 'Mark', 'S', 'May', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '3580 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015624242', NULL, '370 E S Temple', 'Salt Lake City', '', 'UT', '84111', '', '', 'UEPIC', NULL, NULL, '0.00', '30.00', NULL, 3, '2000-01-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834177', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870629690', 'W77007196', 'W77007196', 'UT01', 'Epic', 'Mark', 'S', 'May', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'B', 'PO Box 96398', 'Oklahoma', 'Oklahoma', 'OK', '73143', NULL, NULL, '370 E S Temple', 'Salt Lake City', '', 'UT', '84111', '', '', 'UEPIC', NULL, NULL, '0.00', '30.00', NULL, 3, '2000-01-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834177', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870629690', 'W77007197', 'W77007197', 'UT01', 'Epic', 'Lance', NULL, 'Owens', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '1990 W 7800 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015665691', NULL, '370 E S Temple', 'Salt Lake City', '', 'UT', '84111', '', '', 'UEPIC', NULL, NULL, '0.00', '30.00', NULL, 3, '2000-01-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834188', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870629690', 'W77007198', 'W77007198', 'UT01', 'Epic', 'Roger', 'S', 'Perry', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '3460 Pioneer Pkwy', 'West Valley', 'Salt Lake', 'UT', '84120', '8019643100', NULL, '370 E S Temple', 'Salt Lake City', '', 'UT', '84111', '', '', 'UEPIC', NULL, NULL, '0.00', '30.00', NULL, 3, '2000-01-01', '2004-11-08', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833307', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870419324', 'W77007297', 'W77007297', 'UT01', 'Nephi Medical Clinic', 'Nita', 'Beth', 'Weber', 'DO', 'Internal Medicine', 'Pediatrics', NULL, NULL, 'O', '48 W 1500 N', 'Nephi', 'Juab', 'UT', '84648', '4356233200', '4356233180', NULL, NULL, '', NULL, NULL, '', '', '111', NULL, NULL, '0.00', '11.00', NULL, 3, '2001-06-12', '2004-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831670', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870421912', 'W77007298', 'W77007298', 'UT01', 'Valley Vision Clinic', 'David', 'M', 'Graf', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '145 N 100 E', 'Richfield', 'Sevier', 'UT', '84701', '4358968142', '4358969484', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-11-18', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '948891', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870421912', 'W77007299', 'W77007299', 'UT01', 'Valley Vision Clinic', 'Richard', 'L', 'Luekenga', 'OD', 'Optometry', NULL, NULL, NULL, 'O', '145 N 100 E', 'Richfield', 'Sevier', 'UT', '84701', '4358968142', '4358969484', NULL, NULL, '', NULL, NULL, '', '', 'UTALBERT', NULL, NULL, '0.00', '25.00', NULL, 3, '2005-11-18', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1891754933', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870422134', 'W77007300', 'W77007300', 'UT01', 'Nay MD, Richard B', 'Richard', 'B', 'Nay', 'MD', 'Family Practice', NULL, NULL, NULL, 'B', 'PO Box 429', 'Gunnison', 'Sanpete', 'UT', '84634', '4355287231', '4355287232', NULL, NULL, '', NULL, NULL, '', '', 'URSTDFAM', NULL, NULL, '0.00', '35.00', NULL, 3, '2005-12-29', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780707711', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870427052', 'W77007301', 'W77007301', 'UT01', 'Louis Morales Jr, MD', 'Louis', NULL, 'Morales', 'MD', 'Plastic Surgery', NULL, NULL, NULL, 'B', '5089 S 900 E Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84117', '8017430700', '8017430701', NULL, NULL, '', NULL, NULL, '', '', 'USTDPLAS', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-07-17', '2006-11-30', 0, 0, 0, 'Primary Childrens Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1821060948', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870635422', 'W77007302', 'W77007302', 'UT01', 'Rocky Mountain Foot And Ankle', 'Kelly', 'A', 'Gomez', 'DPM', 'Podiatry', NULL, NULL, NULL, 'B', 'PO Box 98', 'Springville', 'Utah', 'UT', '84663', '8013750346', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1821021957', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870635530', 'W77007303', 'W77007303', 'UT01', 'Mount Olympus Obstetrics And Gynecology', 'Diane', 'D', 'Heubusch', 'CNM', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1220 E 3900 S Ste 3E', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8016857188', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1962449306', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870635530', 'W77007304', 'W77007304', 'UT01', 'Mount Olympus Obstetrics And Gynecology', 'Eric', 'C', 'Nielson', 'MD', 'Obstetrics and Gynecology', NULL, NULL, NULL, 'O', '1220 E 3900 S Ste 3E', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8016857188', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-09-30', 0, 0, 0, 'St Marks Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1013944289', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870635889', 'W77007305', 'W77007305', 'UT01', 'Tooele Clinic Corp', 'Marlee', 'K', 'Dalton', 'NP', 'Family Practice', NULL, NULL, NULL, 'B', '330 Franklin Rd Ste 135A', 'Brentwood', 'Williamson', 'TN', '37027', '4358821697', '4358826304', NULL, NULL, '', NULL, NULL, '', '', 'USTDOBG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2004-06-04', '2006-10-31', 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1730175761', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870635889', 'W77007306', 'W77007306', 'UT01', 'Tooele Clinic Corp', 'Jennifer', 'A', 'Ziouras', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'O', '196 E 2000 N Ste 110', 'Tooele', 'Tooele', 'UT', '84074', '4358435681', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-12-05', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831886', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870635889', 'W77007307', 'W77007307', 'UT01', 'Tooele Clinic Corp', 'Lisa', NULL, 'Zuraff-Perryman', 'MD', 'General Surgery', NULL, NULL, NULL, 'B', '330 Franklin Rd Ste 135A-304', 'Brentwood', 'Williamson', 'TN', '37027', '8885479821', '6153457340', NULL, NULL, '', NULL, NULL, '', '', 'USTDSURG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-11-07', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832831', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870635889', 'W77007308', 'W77007308', 'UT01', 'Tooele Clinic Corp At Mtn West Surg Service', 'Lisa', NULL, 'Zuraff-Perryman', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '196 E 2000 N Ste 106', 'Tooele', 'Tooele', 'UT', '84074', '4358434930', '4358439997', NULL, NULL, '', NULL, NULL, '', '', 'USTDSURG', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-11-07', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832831', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870637322', 'W77007309', 'W77007309', 'UT01', 'Boettger, David R', 'David', 'R', 'Boettger', 'MD', 'Pediatrics', NULL, NULL, NULL, 'B', '9720 S 1300 E Ste W-120', 'Sandy', 'Salt Lake', 'UT', '84094', '8015726700', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-09-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1811937006', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870638151', 'W77007310', 'W77007310', 'UT01', 'Rock Canyon Family Medicine', 'Kenneth', 'L', 'Crump', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '3200 N Canyon Rd Ste E', 'Provo', 'Utah', 'UT', '84604', '8018123200', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-08-31', 0, 0, 0, 'Timpanogos Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1891719308', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870638453', 'W77007311', 'W77007311', 'UT01', 'Alpine Sports Medicine', 'Mark', NULL, 'Moeller', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 682226', 'Park City', 'Summit', 'UT', '84068', '4356459095', '4356459092', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '1999-11-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834293', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870638577', 'W77007312', 'W77007312', 'UT01', 'Dept of Ophthalmology Peds', 'Robert', 'O', 'Hoffman', 'MD', 'Ophthalmology', 'Pediatric Ophthalmology', NULL, NULL, 'O', '100 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8015883645', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, 'University Health Care University Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1992895593', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870638577', 'W77007313', 'W77007313', 'UT01', 'Dept Of Ophthalmology Peds-Parkway Center', 'Scott', 'A', 'Larson', 'MD', 'Pediatric Ophthalmology', 'Ophthalmology', NULL, NULL, 'O', '145 W University Pkwy', 'Orem', 'Utah', 'UT', '84058', '8012267555', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUMGPED', NULL, NULL, '0.00', '15.00', NULL, 3, '2003-08-01', '2003-08-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1992757991', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870639098', 'W77007314', 'W77007314', 'UT01', 'After Hours Medical Company-Main', 'Sean', 'P', 'Collins', 'NP', 'Urgent Care', NULL, NULL, NULL, 'O', '1126 Draper Pkwy', 'Draper', 'Salt Lake', 'UT', '84020', '8015450600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2002-06-11', '2006-08-31', 0, 0, 0, 'Jordan Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1174589105', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870639098', 'W77007315', 'W77007315', 'UT01', 'After Hours Medical Company-Main', 'Renee', 'J', 'Neff', 'NP', 'Urgent Care', NULL, NULL, NULL, 'O', '1126 Draper Pkwy', 'Draper', 'Salt Lake', 'UT', '84020', '8015450600', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', NULL, NULL, '0.00', '35.00', NULL, 3, '2003-03-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1679520811', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870623034', 'W77007316', 'W77007316', 'UT01', 'Rocky Mountain Therapy Services', 'Kirk', NULL, 'Kingery', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 307', 'Bountiful', 'Davis', 'UT', '84011', '8019653545', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2293', '0.00', '35.00', NULL, 3, '2002-08-01', '2005-09-01', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1184735755', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870623034', 'W77007317', 'W77007317', 'UT01', 'Rocky Mountain Therapy Services', 'Karin', 'E', 'Monger', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653545', '8019653518', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2293', '0.00', '35.00', NULL, 3, '2002-08-01', '2006-04-15', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832269', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870623034', 'W77007318', 'W77007318', 'UT01', 'Rocky Mountain Therapy Services', 'Linda', NULL, 'Wayment', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 307', 'Bountiful', 'Davis', 'UT', '84011', '8019653545', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2293', '0.00', '35.00', NULL, 3, '2002-08-01', '2006-01-01', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834302', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870623034', 'W77007319', 'W77007319', 'UT01', 'Rocky Mountain Therapy Services', 'Rick', NULL, 'Wortley', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '3725 W 4100 S', 'West Valley', 'Salt Lake', 'UT', '84120', '8019653545', '8019653518', NULL, NULL, '', NULL, NULL, '', '', 'UDME', 'USTDHCPC', '2293', '0.00', '35.00', NULL, 3, '2002-08-01', '2006-03-31', 1, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832136', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870623386', 'W77007320', 'W77007320', 'UT01', 'We Care Family Medicine', 'Aaron', 'V', 'Barson', 'DO', 'General Practice', NULL, NULL, NULL, 'O', '1580 W Antelope Dr Ste 250', 'Layton', 'Davis', 'UT', '84041', '8017760067', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2002-04-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '830906', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870623386', 'W77007321', 'W77007321', 'UT01', 'We Care Family Medicine', 'Gary', 'Wayne', 'Page', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '1580 W Antelope Dr Ste 250', 'Layton', 'Davis', 'UT', '84041', '8017760067', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDFAM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-10-31', '2005-10-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '831437', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870623831', 'W77007322', 'W77007322', 'UT01', 'Ashley Creek Physical Therapy', 'l Therapy', NULL, 'Ashley Creek Physica', 'GROUP', 'Physical Therapy', NULL, NULL, NULL, 'O', '1180 N Vernal Ave', 'Vernal', 'Uintah', 'UT', '84078', '4357890022', '4357892955', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2004-05-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832965', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870623831', 'W77007323', 'W77007323', 'UT01', 'Ashley Creek Physical Therapy', 'Ryan', NULL, 'Kiedrowski', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', 'PO Box 1875', 'Vernal', 'Uintah', 'UT', '84078', '4357890022', '4357892955', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2004-04-02', '2004-04-02', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '835070', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870623924', 'W77007324', 'W77007324', 'UT01', 'Northern Physical Therapy Services', 'Kenneth', 'G', 'Buckmiller', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'B', '1221 E 5800 S', 'Ogden', 'Weber', 'UT', '84405', '8017820794', '8016058092', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2000-04-01', '2005-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834304', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870623924', 'W77007325', 'W77007325', 'UT01', 'Northern Physical Therapy Services', 'Kenneth', 'G', 'Buckmiller', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1221 E 5800 S', 'South Ogden', 'Weber', 'UT', '84405', '8014762000', '8014767000', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2000-04-01', '2005-04-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834304', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870624129', 'W77007326', 'W77007326', 'UT01', 'Disease Management Specialists', 'pecialists', NULL, 'Disease Management S', 'GROUP', 'Respiratory Therapy', NULL, NULL, NULL, 'O', '5620 Waterbury Way Ste A-202', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012741420', '8012746120', NULL, NULL, '', NULL, NULL, '', '', 'USTDPULM', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-06-01', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '834823', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870624273', 'W77007327', 'W77007327', 'UT01', 'Richard Boyce CRNA', 'Richard', NULL, 'Boyce', 'CRNA', 'Anesthesiology', NULL, NULL, NULL, 'O', '1050 E S Temple', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8015939223', NULL, NULL, NULL, '', NULL, NULL, '', '', '135', NULL, '1000', '34.65', NULL, NULL, 3, '2001-12-01', '2006-12-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275535932', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870626129', 'W77007328', 'W77007328', 'UT01', 'Webb Physical Therapy', 'Dean', 'A', 'Nybo', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '2545 N Canyon Rd', 'Provo', 'Utah', 'UT', '84604', '8013805495', '8013734008', NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2005-05-20', '2006-12-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '927245', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870626821', 'W77007329', 'W77007329', 'UT01', 'Humpherys, Scott', 'Scott', NULL, 'Humpherys', 'DPM', 'Podiatry', NULL, NULL, NULL, 'O', '1928 N 1120 W Ste 6', 'Provo', 'Utah', 'UT', '84604', '8017859015', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-12-05', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1275647596', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870629690', 'W77007331', 'W77007331', 'UT01', 'Epic', 'Kathleen', NULL, 'Lawliss', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '1200 E 3900 S', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012687975', NULL, '370 E S Temple', 'Salt Lake City', '', 'UT', '84111', '', '', 'UEPIC', NULL, NULL, '0.00', '30.00', NULL, 3, '2000-01-01', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1255397691', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870629690', 'W77007333', 'W77007333', 'UT01', 'Ogden Regional Medical Center', 'Mark', 'G', 'Oraskovich', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'O', '5475 S 500 E', 'Ogden', 'Weber', 'UT', '84405', '8014792111', NULL, '370 E S Temple', 'Salt Lake City', '', 'UT', '84111', '', '', 'UEPIC', NULL, NULL, '0.00', '30.00', NULL, 3, '2000-02-02', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '830986', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870629690', 'W77007334', 'W77007334', 'UT01', 'Epic', 'Mark', 'G', 'Oraskovich', 'MD', 'Emergency Medicine', NULL, NULL, NULL, 'B', 'PO Box 96398', 'Oklahoma', 'Oklahoma', 'OK', '73143', NULL, NULL, '370 E S Temple', 'Salt Lake City', '', 'UT', '84111', '', '', 'UEPIC', NULL, NULL, '0.00', '30.00', NULL, 3, '2000-02-02', '2006-08-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '830986', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870442845', 'W77007414', 'W77007414', 'UT01', 'U Of U Hematology/Oncology Division', 'Anne', 'W', 'Marceau', 'NP', 'Hematology and Oncology', NULL, NULL, NULL, 'O', '50 N Medical Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84132', '8015853229', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '2001-01-02', '2004-08-11', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265482012', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870442845', 'W77007415', 'W77007415', 'UT01', 'U Of U Hematology/Oncology Division', 'Vicki', NULL, 'McKinney', 'PA-C', 'Pediatric Hematology and Oncolocy', 'Hematology and Oncology', NULL, NULL, 'B', 'PO Box 581700', 'Salt Lake City', 'Salt Lake', 'UT', '84158', '8015850124', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1891746202', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870640775', 'W77007416', 'W77007416', 'UT01', 'Uuhc Central Billing', 'David', 'J', 'Petron', 'MD', 'Orthopedic Surgery', 'Sports Medicine', NULL, NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8015876600', '8015876396', NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881775062', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870640775', 'W77007417', 'W77007417', 'UT01', 'Uuhc Central Billing-Redwood Clinic', 'Yuki', 'K', 'Rosenkoetter', 'PA', 'Gastroenterology', NULL, NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, '1000', '37.71', NULL, NULL, 3, '2004-10-07', '2006-07-31', 1, 12, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1487744009', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870640775', 'W77007418', 'W77007418', 'UT01', 'Uuhc Central Billing-Redwood Clinic', 'Ruth', 'Ann', 'Smith', 'MD', 'Cardiovascular Disease', NULL, NULL, NULL, 'O', '1525 W 2100 S', 'Salt Lake City', 'Salt Lake', 'UT', '84119', '8018872400', NULL, NULL, NULL, '', NULL, NULL, '', '', 'UUUMG', NULL, NULL, '0.00', '25.00', NULL, 3, '1999-09-01', '2006-07-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '833363', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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('870643939', 'W77007528', 'W77007528', 'UT01', 'Utah Physiatry Associates', 'Stuart', 'W', 'King', 'MD', 'Physical Medicine and Rehabilitation', NULL, NULL, NULL, 'B', 'PO Box 970188', 'Orem', 'Utah', 'UT', '84097', '8012240891', NULL, NULL, NULL, '', NULL, NULL, '', '', 'USTDMULT', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2003-04-01', '2006-11-30', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1366518730', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870644582', 'W77007529', 'W77007529', 'UT01', 'Wasatch Cardiology Consultants', 'Michael', 'G', 'Henderson', 'PA-C', 'Emergency Medicine', 'Physician Assistant', 'Neurosurgery', NULL, 'O', '6011 S Redwood Rd', 'Taylorsville', 'Salt Lake', 'UT', '84123', '8012937001', '8012939500', NULL, NULL, '', NULL, NULL, '', '', 'USTDCARD', 'USTDHCPC', NULL, '0.00', '35.00', NULL, 3, '2005-09-30', '2006-10-31', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1265423594', 0, 'Y', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
('870645268', 'W77007530', 'W77007530', 'UT01', 'Northview Physicial Therapy', 'Brandon', NULL, 'Hepner', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '349 12th St', 'Ogden', 'Weber', 'UT', '84404', '8013930900', NULL, NULL, NULL, '', NULL, NULL, '', '', NULL, NULL, NULL, '0.00', '0.00', '57.75', 3, '2002-01-01', '2006-04-01', 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '832088', 0, 'N', 0, NULL, NULL, NULL, 0, 0, NULL, NULL),
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