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
('260553931', 'SACN00265', 'SACN00265', 'SACN', 'Saint Alphonsus Medical Group Heart Care McCall', 'Frederick', 'E', 'Badke', 'MD', 'Cardiology', '', '', NULL, 'O', '1000 State St', 'McCall', 'Valley', 'ID', '83638', '2086342221', NULL, '1000 State St', 'McCall', 'Valley', 'ID', '83638', '2086342221', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1407814411', 0, 'Y', 0, '2014-06-11', NULL, NULL, 44.9094, -116.11, NULL, NULL),
('260553931', 'SACN00266', 'SACN00266', 'SACN', 'Saint Alphonsus Medical Group Heart Care Payette Lakes', 'Frederick', 'E', 'Badke', 'MD', 'Cardiology', '', '', NULL, 'O', '21 E Maple St Ste A', 'Hailey', 'Blaine', 'ID', '83333', '2083674278', NULL, '21 E Maple St Ste A', 'Hailey', 'Blaine', 'ID', '83333', '2083674278', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1407814411', 0, 'Y', 0, '2014-06-11', NULL, NULL, 43.5143, -114.31, NULL, NULL),
('260553931', 'SACN00267', 'SACN00267', 'SACN', 'Saint Alphonsus Specialty Services, Inc', 'Frederick', 'E', 'Badke', 'MD', 'Cardiology', '', '', NULL, 'O', '211 Forest St', 'McCall', 'Valley', 'ID', '83638', '2083674278', '2083675200', '211 Forest St', 'McCall', 'Valley', 'ID', '83638', '2083674278', '2083675200', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1407814411', 0, 'Y', 0, '2014-06-11', NULL, NULL, 44.9086, -116.11, NULL, NULL),
('260553931', 'SACN00268', 'SACN00268', 'SACN', 'Saint Alphonsus Specialty Services, Inc', 'Frederick', 'E', 'Badke', 'MD', 'Cardiology', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1407814411', 0, 'Y', 0, '2014-06-11', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('260553931', 'SACN00269', 'SACN00269', 'SACN', 'Saint Alphonsus Medical Group Heart Care Eagle', 'Frederick', 'E', 'Badke', 'MD', 'Cardiology', '', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1407814411', 0, 'N', 0, '2014-06-11', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('260553931', 'SACN00270', 'SACN00270', 'SACN', 'Saint Alphonsus Heart Care Boise ', 'Frederick', 'E', 'Badke', 'MD', 'Cardiology', '', '', NULL, 'O', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1407814411', 0, 'N', 0, '2014-06-11', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('260553931', 'SACN00271', 'SACN00271', 'SACN', 'Saint Alphonsus Medical Group Heart Care Weiser', 'Frederick', 'E', 'Badke', 'MD', 'Cardiology', '', '', NULL, 'O', '645 E 5th St', 'Weiser', 'Washington', 'ID', '83672', '2085493152', NULL, '645 E 5th St', 'Weiser', 'Washington', 'ID', '83672', '2085493152', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1407814411', 0, 'Y', 0, '2014-06-11', NULL, NULL, 44.2487, -116.962, NULL, NULL),
('331078261', 'SACN00272', 'SACN00272', 'SACN', 'St Lukes Medical Center Wood River', 'Frederick', 'E', 'Badke', 'MD', 'Cardiology', '', '', NULL, 'B', '100 Hospital Dr', 'Ketchum', 'Blaine', 'ID', '83340', '2087278240', NULL, '100 Hospital Dr', 'Ketchum', 'Blaine', 'ID', '83340', '2087278240', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1407814411', 0, 'N', 0, '2014-06-11', NULL, NULL, 43.6485, -114.35, NULL, NULL),
('331078261', 'SACN00274', 'SACN00274', 'SACN', 'Family Practice Associates', 'Frederick', 'E', 'Badke', 'MD', 'Cardiology', '', '', NULL, 'B', '21 E Maple St Ste  A', 'Hailey', 'Blaine', 'ID', '83333', '2087883200', '0', '21 E Maple St Ste  A', 'Hailey', 'Blaine', 'ID', '83333', '2087883200', '0', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1407814411', 0, 'n', 0, '2014-06-11', NULL, NULL, 43.5143, -114.31, NULL, NULL),
('331078261', 'SACN00275', 'SACN00275', 'SACN', 'Saint Alphonsus Physicians PA', 'Frederick', 'E', 'Badke', 'MD', 'Cardiology', '', '', NULL, 'o', '211 Forest St', 'McCall', 'Valley', 'ID', '83638', '2083674278', '2083675200', '211 Forest St', 'McCall', 'Valley', 'ID', '83638', '2083674278', '2083675200', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1407814411', 0, 'n', 0, '2014-06-11', NULL, NULL, 44.9086, -116.11, NULL, NULL),
('331078261', 'SACN00276', 'SACN00276', 'SACN', 'Saint Alphonsus Physicians PA', 'Frederick', 'E', 'Badke', 'MD', 'Cardiology', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1407814411', 0, 'y', 0, '2014-06-11', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('331078261', 'SACN00277', 'SACN00277', 'SACN', 'Saint Alphonsus Physicians PA', 'Frederick', 'E', 'Badke', 'MD', 'Cardiology', '', '', NULL, 'o', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1407814411', 0, 'n', 0, '2014-06-11', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('331078261', 'SACN00278', 'SACN00278', 'SACN', 'Weiser Memorial Hospital', 'Frederick', 'E', 'Badke', 'MD', 'Cardiology', '', '', NULL, 'B', '645 E 5th St', 'Weiser', 'Washington', 'ID', '83672', '2085493152', '0', '645 E 5th St', 'Weiser', 'Washington', 'ID', '83672', '2085493152', '0', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1407814411', 0, 'n', 0, '2014-06-11', NULL, NULL, 44.2487, -116.962, NULL, NULL),
('820200895', 'SACN00279', 'SACN00279', 'SACN', 'Saint Alphonsus Regional Medical Center - Reading Panel', 'Frederick', 'E', 'Badke', 'MD', 'Cardiology', '', '', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', '0', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', '0', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1407814411', 0, 'n', 0, '2014-06-11', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN01087', 'SACN01087', 'SACN', 'Saint Alphonsus Medical Group EHP Family Medicine ', 'James', 'P', 'Baker', 'MD', 'Pediatrics', '', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2014-03-31', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1497799670', 0, 'Y', 0, '2014-02-19', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('455244568', 'W12030682', 'W12030682', 'UT01', 'UPRI Murray', 'Lynn', 'A', 'Morrison', 'APRN', 'Pain Management', '', '', NULL, 'O', '32 W Winchester St Ste 200', 'Murray', 'Salt Lake', 'UT', '84107', '8012810555', '8012810444', '32 W Winchester St Ste 200', 'Murray', 'Salt Lake', 'UT', '84107', '8012810555', '8012810444', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2013-06-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB', '1467526855', 0, 'N', 0, '2013-06-04', NULL, NULL, 40.6332, -111.893, NULL, NULL),
('455244568', 'W12030683', 'W12030683', 'UT01', 'UPRI Taylorsville', 'Lynn', 'A', 'Morrison', 'APRN', 'Pain Management', '', '', NULL, 'O', '1972 W 5400 S Ste 100', 'Taylorsville', 'Salt Lake', 'UT', '84118', '8012810555', '8012810444', '1972 W 5400 S Ste 100', 'Taylorsville', 'Salt Lake', 'UT', '84118', '8012810555', '8012810444', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2013-06-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1467526855', 0, 'N', 0, '2013-06-04', NULL, NULL, 40.6531, -111.944, NULL, NULL),
('820200895', 'SACN00957', 'SACN00957', 'SACN', 'Saint Alphonsus Regional Medical Center', 'Jane', 'D', 'Baker', 'LCPC', 'Mental Health', 'Counseling', '', NULL, 'o', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083676238', '2083670285', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083676238', '2083670285', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1417000159', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN01206', 'SACN01206', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Jeffrey', 'V', 'Ball', 'PA-C', 'Family Practice', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', '', '', '', 'HCFA|', '1598790560', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820477852', 'SACN01207', 'SACN01207', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Jeffrey', 'V', 'Ball', 'PA-C', 'Family Practice', '', '', NULL, 'B', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', '', '', '', 'HCFA|UB|', '1598790560', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('461965952', 'SACN00940', 'SACN00940', 'SACN', 'NeuroScience Associate', 'Keri', 'J', 'Barnes', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '6140 W Curtisian Ave Ste 400', 'Boise', 'Ada', 'ID', '83704', '2083673500', NULL, '6140 W Curtisian Ave Ste 400', 'Boise', 'Ada', 'ID', '83704', '2083673500', '', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-09-08', 0, 0, 1, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1407001852', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN00941', 'SACN00941', 'SACN', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'Keri', 'J', 'Barnes', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1407001852', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820200895', 'SACN00942', 'SACN00942', 'SACN', 'Saint Alphonsus Express Care, Inc.', 'Keri', 'J', 'Barnes', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '1515 W State St', 'Boise', 'Ada', 'ID', '83702', '2083456768', NULL, '1515 W State St', 'Boise', 'Ada', 'ID', '83702', '2083456768', '', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1407001852', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6228, -116.21, NULL, NULL),
('820200895', 'SACN00943', 'SACN00943', 'SACN', 'Saint Alphonsus Medical Group MHP Family Medicine', 'Keri', 'J', 'Barnes', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1407001852', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN00944', 'SACN00944', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Keri', 'J', 'Barnes', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1407001852', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN00945', 'SACN00945', 'SACN', 'Saint Alphonsus Express Care, Inc.', 'Keri', 'J', 'Barnes', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '4700 N Eagle Rd', 'Boise', 'Ada', 'ID', '83713', '2089384797', NULL, '4700 N Eagle Rd', 'Boise', 'Ada', 'ID', '83713', '2089384797', '', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1407001852', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6474, -116.352, NULL, NULL),
('820200895', 'SACN00946', 'SACN00946', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Keri', 'J', 'Barnes', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1407001852', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820312175', 'SACN00835', 'SACN00835', 'SACN', 'Idaho Emergency Physicians PA', 'Randy', 'L', 'Barnes', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1295811867', 0, 'n', 0, '2012-01-30', NULL, NULL, 43.6136, -116.256, NULL, NULL),
('820312175', 'SACN00836', 'SACN00836', 'SACN', 'Idaho Emergency Physicians PA', 'Randy', 'L', 'Barnes', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1295811867', 0, 'N', 0, '2012-01-30', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00837', 'SACN00837', 'SACN', 'Idaho Emergency Physicians PA', 'Randy', 'L', 'Barnes', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1295811867', 0, 'N', 0, '2012-01-30', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00838', 'SACN00838', 'SACN', 'Idaho Emergency Physicians PA', 'Randy', 'L', 'Barnes', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1295811867', 0, 'n', 0, '2012-01-30', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('460500210', 'SACN01391', 'SACN01391', 'SACN', 'Saint Alphonsus Trauma Physician Services', 'Roberto', 'V', 'Barresi', 'MD', 'General Surgery', '', '', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '0', '0', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '0', '0', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1740231620', 0, 'Y', 0, '2012-09-24', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820297206', 'SACN01392', 'SACN01392', 'SACN', 'Boise Surgical Group PA', 'Roberto', 'V', 'Barresi', 'MD', 'General Surgery', '', '', NULL, 'O', '3399 E Louise Ave Ste 400', 'Meridian', 'Ada', 'ID', '83642', '2083643000', '2083643191', '3399 E Louise Ave Ste 400', 'Meridian', 'Ada', 'ID', '83642', '2083643000', '2083643191', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-09-10', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1740231620', 0, 'N', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
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('820487790', 'SACN00611', 'SACN00611', 'SACN', 'Selah Medical Center', 'Gloria', '', 'Beery', 'CNP', 'Family Practice', 'Obstetrics and Gynecology', '', NULL, 'O', '1618 S Millennium Way Ste 220', 'Meridian', 'Ada', 'ID', '83642', '2082881717', NULL, '1618 S Millennium Way Ste 220', 'Meridian', 'Ada', 'ID', '83642', '2082881717', '', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-12-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043263064', 0, 'N', 0, '2014-05-20', NULL, NULL, 43.5903, -116.368, NULL, NULL),
('820487790', 'SACN00612', 'SACN00612', 'SACN', 'Selah Medical Center', 'Gloria', '', 'Beery', 'CNP', 'Family Practice', 'Obstetrics and Gynecology', '', NULL, 'O', '6565 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083775055', '          ', '6565 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083775055', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2014-05-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043263064', 0, 'N', 0, '2014-05-20', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820442659', 'SACN00510', 'SACN00510', 'SACN', 'Idaho Foot & Ankle Associates', 'Randall', 'L', 'Benedict', 'DPM', 'Podiatry', '', '', NULL, 'O', '2635 Caldwell Blvd Ste 101', 'Nampa', 'Canyon', 'ID', '83651', '2084550655', '2084550654', '2635 Caldwell Blvd Ste 101', 'Nampa', 'Canyon', 'ID', '83651', '2084550655', '2084550654', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', '', 'HCFA|UB|', '1942239264', 0, 'N', 0, '2012-02-07', NULL, NULL, 0, 0, NULL, NULL),
('820442659', 'SACN00511', 'SACN00511', 'SACN', 'Idaho Foot & Ankle Associates', 'Randall', 'L', 'Benedict', 'DPM', 'Podiatry', '', '', NULL, 'O', '809 N Liberty', 'Boise', 'Ada', 'ID', '83704', '2083270627', '2083765258', '809 N Liberty', 'Boise', 'Ada', 'ID', '83704', '2083270627', '2083765258', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', '', 'HCFA|UB|', '1942239264', 0, 'N', 0, '2012-02-07', NULL, NULL, 0, 0, NULL, NULL),
('562389776', 'SACN01694', 'SACN01694', 'SACN', 'Berning Chiropractic & Wellness Center', 'Keith', 'B', 'Berning', 'DC', 'Chiropractic', '', '', NULL, 'O', '7950 Horseshoe Rd Ste 102', 'Garden City', 'Ada', 'ID', '83714', '2088532575', NULL, '7950 Horseshoe Rd Ste 102', 'Garden City', 'Ada', 'ID', '83714', '2088532575', '          ', 'IDSINCLAIRM', '', '', '0.00', '10.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528147022', 0, 'N', 0, '2011-12-01', NULL, NULL, 0, 0, NULL, NULL),
('562389776', 'SACN01695', 'SACN01695', 'SACN', 'Berning Chiropractic & Wellness Center', 'Keith', 'B', 'Berning', 'DC', 'Chiropractic', '', '', NULL, 'O', '9601 W State St Ste 108', 'Boise', 'Ada', 'ID', '83714', '2088532575', NULL, '9601 W State St Ste 108', 'Boise', 'Ada', 'ID', '83714', '2088532575', '', 'IDSINCLAIRM', NULL, NULL, '0.00', '10.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528147022', 0, 'n', 0, '2011-12-01', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00018', 'SACN00018', 'SACN', 'Boise Anesthesia, PA', 'Gary', 'D', 'Bevan', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1174579742', 0, 'N', 0, '2013-04-19', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00019', 'SACN00019', 'SACN', 'Boise Anesthesia, PA', 'Gary', 'D', 'Bevan', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1174579742', 0, 'N', 0, '2013-04-19', NULL, NULL, 0, 0, NULL, NULL),
('820478504', 'SACN01192', 'SACN01192', 'SACN', 'Personal Solutions', 'Renee', 'O', 'Bild', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '2596 N Stokesberry Pl Ste 100', 'Meridian', 'Ada', 'ID', '83646', '2089383837', NULL, '2596 N Stokesberry Pl Ste 100', 'Meridian', 'Ada', 'ID', '83646', '2089383837', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-12-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598725277', 0, 'N', 0, '2012-11-21', NULL, NULL, 0, 0, NULL, NULL),
('200197373', 'SACN01009', 'SACN01009', 'SACN', 'Pain Center Boise', 'William', 'G', 'Binegar', 'MD', 'Pain Management', '', '', NULL, 'B', 'MS 310096 PO Box 84686', 'Seattle', 'King', 'WA', '98124', '5033722740', '5033722754', 'MS 310096 PO Box 84686', 'Seattle', 'King', 'WA', '98124', '5033722740', '5033722754', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-03-14', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1457393811', 0, 'Y', 0, '2011-06-29', NULL, NULL, 0, 0, NULL, NULL),
('870299862', 'W12030675', 'W12030675', 'UTMH1', 'LDS Family Services', 'Mindy', 'R', 'Lundgreen', 'MSW', 'Mental Health', '', '', NULL, 'O', '94 E Pages Ln Ste A', 'Centerville', 'Davis', 'UT', '84014', '8012940578', NULL, '94 E Pages Ln Ste A', 'Centerville', 'Davis', 'UT', '84014', '8012940578', '          ', 'UTMA', '', '', '0.00', '40.00', '0.00', 8, '2030-01-01', '2014-02-25', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1629209247', 0, 'Y', 1, '2014-02-25', NULL, NULL, 0, 0, NULL, NULL),
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('820312175', 'SACN00646', 'SACN00646', 'SACN', 'Idaho Emergency Physicians PA', 'Dianna', 'L', 'Binnion', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1073567574', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00647', 'SACN00647', 'SACN', 'Idaho Emergency Physicians PA', 'Dianna', 'L', 'Binnion', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1073567574', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00648', 'SACN00648', 'SACN', 'Idaho Emergency Physicians PA', 'Dianna', 'L', 'Binnion', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1073567574', 0, 'n', 0, '2012-01-31', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820425454', 'SACN00103', 'SACN00103', 'SACN', 'Boise Anesthesia, PA', 'Terry', '', 'Black', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1902843584', 0, 'N', 0, '2012-10-29', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00104', 'SACN00104', 'SACN', 'Boise Anesthesia, PA', 'Terry', '', 'Black', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1902843584', 0, 'N', 0, '2012-10-29', NULL, NULL, 0, 0, NULL, NULL),
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('205934739', 'SACN00145', 'SACN00145', 'SACN', 'Family Residency of Idaho', 'Jennifer', 'R', 'Blackler', '', 'Family Practice', '', '', NULL, 'O', '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2085142500', '2083227018', '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2085142500', '2083227018', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-04-05', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1588841621', 0, 'N', 0, '2012-04-10', NULL, NULL, 0, 0, NULL, NULL),
('820532303', 'SACN01104', 'SACN01104', 'SACN', 'Boise Family Practice', 'Alice', 'P', 'Blake', 'MD', 'Internal Medicine', 'Pediatrics', '', NULL, 'O', '222 N 2nd Ste 304', 'Boise', 'Ada', 'ID', '83702', '2083427722', '2083839313', '222 N 2nd Ste 304', 'Boise', 'Ada', 'ID', '83702', '2083427722', '2083839313', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1508805078', 0, 'N', 0, '2012-02-02', NULL, NULL, 43.6131, -116.195, NULL, NULL),
('820532303', 'SACN01105', 'SACN01105', 'SACN', 'Boise Family Practice', 'Alice', 'P', 'Blake', 'MD', 'Internal Medicine', 'Pediatrics', '', NULL, 'B', '610 W Hays', 'Boise', 'Ada', 'ID', '83702', '2083427722', '2083839313', '610 W Hays', 'Boise', 'Ada', 'ID', '83702', '2083427722', '2083839313', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1508805078', 0, 'Y', 0, '2012-02-02', NULL, NULL, 0, 0, NULL, NULL),
('205934739', 'SACN00379', 'SACN00379', 'SACN', 'Family Medicine Health Center', 'Sky', 'R', 'Blue', 'MD', 'Infectious Disease', '', '', NULL, 'O', '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', NULL, '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1659365575', 0, 'n', 0, '2013-03-19', NULL, NULL, 0, 0, NULL, NULL),
('205934739', 'SACN00380', 'SACN00380', 'SACN', 'Family Medicine Health Center', 'Sky', 'R', 'Blue', 'MD', 'Infectious Disease', '', '', NULL, 'O', '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2085142500', NULL, '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2085142500', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1659365575', 0, 'n', 0, '2013-03-19', NULL, NULL, 0, 0, NULL, NULL),
('260553931', 'SACN01284', 'SACN01284', 'SACN', 'Saint Alphonsus Medical Group Maternal Fetal Medicine Boise', 'Renee', 'A', 'Bobrowski', 'MD', 'Maternal Fetal Medicine', '', '', NULL, 'O', '900 N Liberty Ste 206', 'Boise', 'Ada', 'ID', '83706', '2083675544', '2083675543', '900 N Liberty Ste 206', 'Boise', 'Ada', 'ID', '83706', '2083675544', '2083675543', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1669416954', 0, 'N', 0, '2013-12-26', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('331078261', 'SACN01285', 'SACN01285', 'SACN', 'Saint Alphonsus Physicians PA', 'Renee', 'A', 'Bobrowski', 'MD', 'Maternal Fetal Medicine', '', '', NULL, 'o', '900 N Liberty Ste 206', 'Boise', 'Ada', 'ID', '83706', '2083675544', '2083675543', '900 N Liberty Ste 206', 'Boise', 'Ada', 'ID', '83706', '2083675544', '2083675543', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1669416954', 0, 'n', 0, '2013-12-26', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820519838', 'SACN00538', 'SACN00538', 'SACN', 'Northwest Eye & Laser Center', 'Mark', 'J', 'Boerner', 'MD', 'Ophthalmology', '', '', NULL, 'O', '111 Main St Ste 200', 'Boise', 'Ada', 'ID', '83702', '2083443220', '2083440461', '111 Main St Ste 200', 'Boise', 'Ada', 'ID', '83702', '2083443220', '2083440461', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1003819459', 0, 'N', 0, '2012-07-19', NULL, NULL, 0, 0, NULL, NULL),
('820519838', 'SACN00539', 'SACN00539', 'SACN', 'Northwest Eye & Laser Center', 'Mark', 'J', 'Boerner', 'MD', 'Ophthalmology', '', '', NULL, 'B', '6063 Corporal Ln', 'Boise', 'Ada', 'ID', '83704', '2083758799', '2083758798', '6063 Corporal Ln', 'Boise', 'Ada', 'ID', '83704', '2083758799', '2083758798', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1003819459', 0, 'Y', 0, '2012-07-19', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01671', 'SACN01671', 'SACN', 'Idaho Emergency Physicians PA', 'Brian', 'M', 'Boesiger', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1982657896', 0, 'n', 0, '2012-01-31', NULL, NULL, 43.6136, -116.256, NULL, NULL),
('820312175', 'SACN01672', 'SACN01672', 'SACN', 'Idaho Emergency Physicians PA', 'Brian', 'M', 'Boesiger', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1982657896', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01673', 'SACN01673', 'SACN', 'Idaho Emergency Physicians PA', 'Brian', 'M', 'Boesiger', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1982657896', 0, 'Y', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01674', 'SACN01674', 'SACN', 'Idaho Emergency Physicians PA', 'Brian', 'M', 'Boesiger', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1982657896', 0, 'n', 0, '2012-01-31', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820200895', 'SACN00981', 'SACN00981', 'SACN', 'Saint Alphonsus Medical Group EHP Family Medicine', 'Debra', 'A', 'Bogossian', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-31', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1437175064', 0, 'N', 0, '2012-03-01', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN00982', 'SACN00982', 'SACN', 'Saint Alphonsus Medical Group Eagle ', 'Debra', 'A', 'Bogossian', 'MD', 'Internal Medicine', NULL, NULL, NULL, 'o', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-11-10', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1437175064', 0, 'N', 0, '2011-12-19', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('010858905', 'SACN00725', 'SACN00725', 'SACN', 'Booth Psychological Solutions', 'Raydell', 'J', 'Booth', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'O', '4060 E Chinden Blvd', 'Eagle', 'Ada', 'ID', '83616', '2083771131', '2089087129', '4060 E Chinden Blvd', 'Eagle', 'Ada', 'ID', '83616', '2083771131', '2089087129', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1184661175', 0, 'N', 0, '2013-05-07', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00110', 'SACN00110', 'SACN', 'Boise Anesthesia, PA', 'Jeffery', '', 'Borders', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1942288964', 0, 'N', 0, '2012-10-29', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00111', 'SACN00111', 'SACN', 'Boise Anesthesia, PA', 'Jeffery', '', 'Borders', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1942288964', 0, 'N', 0, '2012-10-29', NULL, NULL, 0, 0, NULL, NULL),
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('820482491', 'SACN00932', 'SACN00932', 'SACN', 'Intermountain Eye & Laser Centers PLLC', 'Mark', 'D', 'Borup', 'MD', 'Ophthalmology', '', '', NULL, 'B', '6063 Corporal Ln', 'Boise', 'Ada', 'ID', '83704', '2083758799', '2083758798', '6063 Corporal Ln', 'Boise', 'Ada', 'ID', '83704', '2083758799', '2083758798', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-08-14', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1386739928', 0, 'Y', 0, '2012-03-01', NULL, NULL, 0, 0, NULL, NULL),
('820482491', 'SACN00933', 'SACN00933', 'SACN', 'Intermountain Eye & Laser Centers', 'Mark', 'D', 'Borup', 'MD', 'Ophthalmology', '', '', NULL, 'O', '999 N Curtis Ste 205', 'Boise', 'Ada', 'ID', '83706', '2083731200', '2083731216', '999 N Curtis Ste 205', 'Boise', 'Ada', 'ID', '83706', '2083731200', '2083731216', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-11-21', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1386739928', 0, 'N', 0, '2012-03-01', NULL, NULL, 43.6132, -116.255, NULL, NULL),
('260553931', 'SACN01573', 'SACN01573', 'SACN', 'Saint Alphonsus Specialty Services, Inc', 'Julia', 'K', 'Bouchard', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676253', NULL, '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676253', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1861436081', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820477852', 'SACN01574', 'SACN01574', 'SACN', 'Saint Alphonsus OB Hospitalist Program', 'Julia', 'K', 'Bouchard', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083676253', '2083674505', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083676253', '2083674505', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1861436081', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820477852', 'SACN01575', 'SACN01575', 'SACN', 'CARE Maternal/Child Health Program - Do Not Publish', 'Julia', 'K', 'Bouchard', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083676253', '2083674505', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083676253', '2083674505', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1861436081', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820200895', 'SACN00458', 'SACN00458', 'SACN', 'Saint Alphonsus Regional Medical Center Behavioral Health', 'Michele', 'L', 'Boyer', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '131 N Allumbaugh', 'Boise', NULL, 'ID', '83704', '2083676500', '2083670285', '131 N Allumbaugh', 'Boise', '', 'ID', '83704', '2083676500', '2083670285', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1770513939', 0, 'N', 0, '2012-11-13', NULL, NULL, 43.6059, -116.267, NULL, NULL),
('820200895', 'SACN01636', 'SACN01636', 'SACN', 'Saint Alphonsus Regional Medical Center Behavioral Health', 'Regina', '', 'Boyer', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '131 N Allumbaugh', 'Boise', 'Ada', 'ID', '83704', '2083672175', '2083673002', '131 N Allumbaugh', 'Boise', 'Ada', 'ID', '83704', '2083672175', '2083673002', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-04-01', 0, 0, 0, '', '', '', '', 'HCFA|', '1922288638', 0, 'N', 0, '2011-08-05', NULL, NULL, 43.6059, -116.267, NULL, NULL),
('820200895', 'SACN01452', 'SACN01452', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'Donnell', 'L', 'Bradford', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083674224', '2083674505', '3025 W Cherry Lane Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083674224', '2083674505', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1770522054', 0, 'Y', 0, '2013-08-21', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN01454', 'SACN01454', 'SACN', 'Saint Alphonsus Medical Group OB/GYN Boise Moreau Bldg ', 'Donnell', 'L', 'Bradford', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1770522054', 0, 'N', 0, '2013-08-21', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN01455', 'SACN01455', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'Donnell', 'L', 'Bradford', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083677806', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1770522054', 0, 'Y', 0, '2013-08-21', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820477852', 'SACN01457', 'SACN01457', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'Donnell', 'L', 'Bradford', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1770522054', 0, 'N', 0, '2013-08-21', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN01453', 'SACN01453', 'SACN', 'Saint Alphonsus Medical Group Eagle Health Plaza', 'Donnell', 'L', 'Bradford', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083677806', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1770522054', 0, 'Y', 0, '2013-08-21', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820200895', 'SACN01456', 'SACN01456', 'SACN', 'CARE Maternal/Child Health Program - Do Not Publish', 'Donnell', 'L', 'Bradford', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083677806', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083677806', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1770522054', 0, 'Y', 0, '2013-08-21', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820477852', 'SACN01458', 'SACN01458', 'SACN', 'CARE Maternal/Child Health Program - Do Not Publish', 'Donnell', 'L', 'Bradford', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1770522054', 0, 'Y', 0, '2013-08-21', NULL, NULL, 43.6133, -116.259, 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
('820200895', 'SACN00809', 'SACN00809', 'SACN', 'Dominican Health Services', 'John', 'C', 'Brosa', 'MD', 'Family Practice', '', '', NULL, 'O', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2084522140', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2084522140', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-29', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1275559080', 0, 'N', 0, '2013-02-28', NULL, NULL, 44.025, -116.928, NULL, NULL),
('820200895', 'SACN00810', 'SACN00810', 'SACN', 'Saint Alphonsus Medical Group Garrity', 'John', 'C', 'Brosa', 'MD', 'Family Practice', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-29', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1275559080', 0, 'Y', 0, '2013-02-28', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820200895', 'SACN00811', 'SACN00811', 'SACN', 'Saint Alphonsus Medical Group McMillan Family Medicine', 'John', 'C', 'Brosa', 'MD', 'Family Practice', '', '', NULL, 'O', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-29', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1275559080', 0, 'N', 0, '2014-01-24', NULL, NULL, 43.6481, -116.335, NULL, NULL),
('820200895', 'SACN00812', 'SACN00812', 'SACN', 'Saint Alphonsus Medical Group Cherry Lane', 'John', 'C', 'Brosa', 'MD', 'Family Practice', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-29', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1275559080', 0, 'Y', 0, '2013-02-28', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN00813', 'SACN00813', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'John', 'C', 'Brosa', 'MD', 'Family Practice', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-29', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1275559080', 0, 'Y', 0, '2014-01-23', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN00814', 'SACN00814', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'John', 'C', 'Brosa', 'MD', 'Family Practice', '', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-29', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1275559080', 0, 'Y', 0, '2014-01-23', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820477852', 'SACN00815', 'SACN00815', 'SACN', 'Saint Alphonsus Medical Group Garrity', 'John', 'C', 'Brosa', 'MD', 'Family Practice', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2083674765', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2083674765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-29', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1275559080', 0, 'N', 0, '2013-02-28', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820477852', 'SACN00816', 'SACN00816', 'SACN', 'Saint Alphonsus Medical Group McMillan amily Medicine', 'John', 'C', 'Brosa', 'MD', 'Family Practice', '', '', NULL, 'O', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', '12273 W McMillan Rd', 'Boise', 'Ada', 'ID', '83713', '2083676330', '2083674765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-29', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1275559080', 0, 'N', 0, '2014-01-24', NULL, NULL, 43.6481, -116.335, NULL, NULL),
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('820477852', 'SACN01311', 'SACN01311', 'SACN', 'Saint Alphonsus Express Care', 'Bobbi', 'A', 'Bullock', 'NP-C', 'Obstetrics and Gynecology', '', '', NULL, 'B', '660 E Boise Ave', 'Boise', 'Ada', 'ID', '83706', '2083451162', NULL, '660 E Boise Ave', 'Boise', 'Ada', 'ID', '83706', '2083451162', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669620506', 0, 'Y', 0, '2013-10-14', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN00190', 'SACN00190', 'SACN', 'Saint Alphonsus Medical Group Overland Family Medicine', 'Anne', 'P', 'Burgess', 'MD', 'Family Practice', '', '', NULL, 'O', '10255 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083677205', '2083677204', '10255 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083677205', '2083677204', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1194767178', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.5899, -116.31, NULL, NULL),
('820477852', 'SACN00191', 'SACN00191', 'SACN', 'Saint Alphonsus Medical Group Overland', 'Anne', 'P', 'Burgess', 'MD', 'Family Practice', '', '', NULL, 'O', '10255 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083677205', '2083677204', '10255 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083677205', '2083677204', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1194767178', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.5899, -116.31, NULL, NULL),
('820382500', 'SACN00839', 'SACN00839', 'SACN', 'Foot & Ankle Medical Center', 'Phillip', 'R', 'Burk', 'DPM', 'Podiatry', '', '', NULL, 'O', '1818 S 10th Ste 250', 'Caldwell', 'Canyon', 'ID', '83605', '2088555955', NULL, '1818 S 10th Ste 250', 'Caldwell', 'Canyon', 'ID', '83605', '2088555955', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2013-08-26', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1306064258', 0, 'N', 0, '2014-03-26', NULL, NULL, 0, 0, NULL, NULL),
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('820312175', 'SACN01548', 'SACN01548', 'SACN', 'Idaho Emergency Physicians PA', 'Mark', 'A', 'Burriesci', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1831397835', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
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('820482736', 'SACN00257', 'SACN00257', 'SACN', '', 'Stephen', 'T', 'Bushi', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '413 N Allumbaugh Ste 103', 'Boise', 'Ada', 'ID', '83704', '2086580800', NULL, '413 N Allumbaugh Ste 103', 'Boise', 'Ada', 'ID', '83704', '2086580800', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1356336648', 0, 'N', 0, '2014-04-24', NULL, NULL, 0, 0, NULL, NULL),
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('942938348', 'W40006932', 'W40006932', 'UTMH1', 'Valley Mental Health  Inc', 'Jean', 'D', 'Zehnder', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', '', 'UTMD-2', NULL, NULL, '0.00', '40.00', '0.00', 6, '2013-02-15', NULL, 0, 0, 0, 'University Health Care University Hospital', '', '', '', 'HCFA|UB|', '1770562621', 0, 'Y', 0, '2014-04-11', NULL, NULL, 0, 0, NULL, NULL),
('942938348', 'W40006902', 'W40006902', 'UTMH1', 'Valley Mental Health  Inc', 'CLAUDIA', '', 'ZAFRAN-RONA', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'UTVMHMA', NULL, NULL, '0.00', '40.00', '0.00', 6, '2013-02-15', NULL, NULL, 0, NULL, '', '', '', '', 'HCFA|UB|', '1992880538', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
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('820200895', 'SACN00800', 'SACN00800', 'SACN', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'Ignacio', '', 'Campa-Garcia', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-08-31', 0, 0, 0, '', '', '', '', 'HCFA|', '1265478648', 0, 'Y', 0, '2012-03-29', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820200895', 'SACN00801', 'SACN00801', 'SACN', 'Saint Alphonsus Medical Group MHP Family Medical', 'Ignacio', '', 'Campa-Garcia', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-08-31', 0, 0, 0, '', '', '', '', 'HCFA|', '1265478648', 0, 'Y', 0, '2012-03-29', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN00802', 'SACN00802', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Ignacio', '', 'Campa-Garcia', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-08-31', 0, 0, 0, '', '', '', '', 'HCFA|', '1265478648', 0, 'Y', 0, '2012-03-29', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN00803', 'SACN00803', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Ignacio', '', 'Campa-Garcia', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-08-31', 0, 0, 0, '', '', '', '', 'HCFA|', '1265478648', 0, 'Y', 0, '2012-03-29', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820477852', 'SACN00804', 'SACN00804', 'SACN', 'Saint Alphonsus Medical Group Garrity', 'Ignacio', '', 'Campa-Garcia', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1265478648', 0, 'N', 0, '2012-03-29', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820477852', 'SACN00805', 'SACN00805', 'SACN', 'Saint Alphonsus Medical Group Cherry Lane', 'Ignacio', '', 'Campa-Garcia', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1265478648', 0, 'N', 0, '2012-03-29', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820477852', 'SACN00806', 'SACN00806', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Ignacio', '', 'Campa-Garcia', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084545107', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084545107', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1265478648', 0, 'N', 0, '2014-01-23', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820477852', 'SACN00807', 'SACN00807', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Ignacio', '', 'Campa-Garcia', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1265478648', 0, 'N', 0, '2014-01-23', NULL, NULL, 43.6119, -116.268, NULL, NULL),
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('820312175', 'SACN01473', 'SACN01473', 'SACN', 'Idaho Emergency Physicians PA', 'Matthew', 'B', 'Campbell', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1790981025', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01474', 'SACN01474', 'SACN', 'Idaho Emergency Physicians PA', 'Matthew', 'B', 'Campbell', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1790981025', 0, 'Y', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01475', 'SACN01475', 'SACN', 'Idaho Emergency Physicians PA', 'Matthew', 'B', 'Campbell', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1790981025', 0, 'N', 0, '2012-01-31', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('260553931', 'SACN01180', 'SACN01180', 'SACN', 'Saint Alphonsus Medical Group OB Hospitalist Boise', 'Patricia', '', 'Caplinger', 'MD', 'Hospitalist', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', '', 'ID', '83706', '2083672121', NULL, '1055 N Curtis Rd', 'Boise', '', 'ID', '83706', '2083672121', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588605364', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN00788', 'SACN00788', 'SACN', 'Saint Alphonsus Medical Group Pulmonary & Sleep Boise ', 'Paula', 'J', 'Carvalho', 'MD', 'Pulmonary', 'Sleep Medicine', 'Sleep Disorders', NULL, 'O', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', NULL, '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1255432910', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN00789', 'SACN00789', 'SACN', 'Saint Alphonsus Medical Group Pulmonary & Sleep Boise ', 'Paula', 'J', 'Carvalho', 'MD', 'Pulmonary', 'Sleep Medicine', 'Sleep Disorders', NULL, 'O', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1255432910', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6143, -116.258, NULL, NULL),
('820200895', 'SACN00790', 'SACN00790', 'SACN', 'Saint Alphonsus Medical Group Pulmonary & Sleep Boise ', 'Paula', 'J', 'Carvalho', 'MD', 'Pulmonary', 'Sleep Medicine', 'Sleep Disorders', NULL, 'O', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1255432910', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('460500210', 'SACN01212', 'SACN01212', 'SACN', 'Saint Alphonsus Trauma Physician Services', 'Steven', 'R', 'Casos', 'MD', 'General Surgery', '', '', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673079', NULL, '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673079', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-07-15', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1609849959', 0, 'Y', 0, '2014-03-07', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('460500210', 'SACN01213', 'SACN01213', 'SACN', 'Saint Alphonsus Outpatient Trauma Services', 'Steven', 'R', 'Casos', 'MD', 'General Surgery', '', '', NULL, 'O', '901 N Curtis Rd Ste 401', 'Boise', 'Ada', 'ID', '83706', '2083677676', '2083676849', '901 N Curtis Rd Ste 401', 'Boise', 'Ada', 'ID', '83706', '2083677676', '2083676849', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-07-15', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1609849959', 0, 'N', 0, '2014-03-07', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('460500210', 'SACN00662', 'SACN00662', 'SACN', 'Saint Alphonsus Pathology Physician Services', 'Jack', 'C', 'Chaffin', 'MD', 'Pathology', '', '', NULL, 'B', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672153', '2083673991', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672153', '2083673991', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1104867662', 0, 'Y', 0, '2014-06-13', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN00588', 'SACN00588', 'SACN', 'Saint Alphonsus Medical Group Pulmonary & Sleep Boise ', 'Nirmal', 'J', 'Charan', 'MD', 'Pulmonology', '', '', NULL, 'O', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1023195708', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6143, -116.258, NULL, NULL),
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('272481635', 'SACN01661', 'SACN01661', 'SACN', 'Saint Alphonsus Medical Center - Nampa', 'Jonathan', 'L', 'Chu', 'MD', 'Family Practice', 'Hospitalist', '', NULL, 'B', 'PO Box 60000', 'San Francisco', 'San Francisco', 'CA', '94160', '2536821710', NULL, 'PO Box 60000', 'San Francisco', 'San Francisco', 'CA', '94160', '2536821710', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-08-31', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1972547685', 0, 'N', 0, '2014-03-20', NULL, NULL, 0, 0, NULL, NULL),
('820477852', 'SACN01662', 'SACN01662', 'SACN', 'Saint Alphonsus Medical Group Iowa', 'Jonathan', 'L', 'Chu', 'MD', 'Family Practice', 'Hospitalist', '', NULL, 'o', '211 W Iowa Ave', 'Nampa', 'Canyon', 'ID', '83686', '2084657377', '2084657397', '211 W Iowa Ave', 'Nampa', 'Canyon', 'ID', '83686', '2084657377', '2084657397', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1972547685', 0, 'n', 0, '2014-03-20', NULL, NULL, 43.5539, -116.575, 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
('721540179', 'SACN00926', 'SACN00926', 'SACN', NULL, 'Bok', '', 'Chung', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '413 N Allumbaugh Ste 101', 'Boise', 'Ada', 'ID', '83704', '2083231125', NULL, '413 N Allumbaugh Ste 101', 'Boise', 'Ada', 'ID', '83704', '2083231125', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1386680353', 0, 'n', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01246', 'SACN01246', 'SACN', 'Saint Alphonsus Medical Group Overland Family Medicine', 'Julie', 'M', 'Clark', 'PA-C', 'Family Practice', 'Physician Assistant', '', NULL, 'O', '10255 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083677205', '2083677204', '10255 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083677205', '2083677204', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1649214131', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.5899, -116.31, NULL, NULL),
('820477852', 'SACN01247', 'SACN01247', 'SACN', 'Saint Alphonsus Medical Group Overland', 'Julie', 'M', 'Clark', 'PA-C', 'Family Practice', 'Physician Assistant', '', NULL, 'O', '10255 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083677205', '2083677204', '10255 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083677205', '2083677204', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1649214131', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.5899, -116.31, NULL, NULL),
('820425454', 'SACN00127', 'SACN00127', 'SACN', 'Boise Anesthesia PA', 'Tyler', '', 'Coburn', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1588995435', 0, 'Y', 0, '2013-02-19', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00128', 'SACN00128', 'SACN', 'Boise Anesthesia PA', 'Tyler', '', 'Coburn', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1588995435', 0, 'Y', 0, '2013-02-19', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00129', 'SACN00129', 'SACN', 'Boise Anesthesia PA', 'Tyler', '', 'Coburn', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '900 N Liberty St Ste 450', 'Boise', 'Ada', 'ID', '83704', '2083677431', NULL, '900 N Liberty St Ste 450', 'Boise', 'Ada', 'ID', '83704', '2083677431', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1588995435', 0, 'Y', 0, '2013-02-19', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('260553931', 'SACN01577', 'SACN01577', 'SACN', 'Saint Alphonsus Medical Group Heart Care Garrity', 'Michael', 'A', 'Codina', 'MD', 'Cardiology', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083674278', '2083675200', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'Saint Alphonsus Regional Medical Center', '', '', 'HCFA|UB|', '1871540708', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.587, -116.549, NULL, NULL),
('260553931', 'SACN01578', 'SACN01578', 'SACN', 'Saint Alphonsus Medical Group Heart Care Caldwell', 'Michael', 'A', 'Codina', 'MD', 'Cardiology', '', '', NULL, 'O', '1818 S 10th Ave Ste 200', 'Caldwell', 'Canyon', 'ID', '83605', '2083675734', '2083675744', '1818 S 10th Ave Ste 200', 'Caldwell', 'Canyon', 'ID', '83605', '2083675734', '2083675744', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'Saint Alphonsus Regional Medical Center', '', '', 'HCFA|UB|', '1871540708', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6538, -116.693, NULL, NULL),
('260553931', 'SACN01579', 'SACN01579', 'SACN', 'Saint Alphonsus Medical Group Heart Care Meridian', 'Michael', 'A', 'Codina', 'MD', 'Cardiology', '', '', NULL, 'O', '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083678484', '2083678456', '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083678484', '2083678456', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'Saint Alphonsus Regional Medical Center', '', '', 'HCFA|UB|', '1871540708', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('260553931', 'SACN01580', 'SACN01580', 'SACN', 'Saint Alphonsus Medical Group Heart Care Elm', 'Michael', 'A', 'Codina', 'MD', 'Cardiology', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'Saint Alphonsus Regional Medical Center', '', '', 'HCFA|UB|', '1871540708', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('260553931', 'SACN01581', 'SACN01581', 'SACN', 'Saint Alphonsus Specialty Services, Inc', 'Michael', 'A', 'Codina', 'MD', 'Cardiology', '', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083674278', '2083675200', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083674278', '2083675200', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'Saint Alphonsus Regional Medical Center', '', '', 'HCFA|UB|', '1871540708', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('260553931', 'SACN01582', 'SACN01582', 'SACN', 'Saint Alphonsus Medical Group Heart Care Boise ', 'Michael', 'A', 'Codina', 'MD', 'Cardiology', '', '', NULL, 'O', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'Saint Alphonsus Regional Medical Center', '', '', 'HCFA|UB|', '1871540708', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('331078261', 'SACN01583', 'SACN01583', 'SACN', 'Saint Alphonsus Physicians PA', 'Michael', 'A', 'Codina', 'MD', 'Cardiology', '', '', NULL, 'o', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'Saint Alphonsus Regional Medical Center', '', '', 'HCFA|UB|', '1871540708', 0, 'n', 0, '2014-07-09', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN01584', 'SACN01584', 'SACN', 'Saint Alphonsus Regional Medical Center', 'Michael', 'A', 'Codina', 'MD', 'Cardiology', '', '', NULL, 'o', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', NULL, '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'Saint Alphonsus Regional Medical Center', '', '', 'HCFA|', '1871540708', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6127, -116.254, NULL, NULL),
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('820425454', 'SACN00042', 'SACN00042', 'SACN', 'Boise Anesthesia, PA', 'Andrew', 'R', 'Cohen', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1518919943', 0, 'N', 0, '2012-10-29', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00043', 'SACN00043', 'SACN', 'Boise Anesthesia, PA', 'Andrew', 'R', 'Cohen', 'MD', 'Anesthesiology', '', '', NULL, 'o', '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', NULL, '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1518919943', 0, 'N', 0, '2012-10-29', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820425454', 'SACN00097', 'SACN00097', 'SACN', 'Boise Anesthesia, PA', 'Clara', '', 'Cohen', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1841246360', 0, 'N', 0, '2012-10-29', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00098', 'SACN00098', 'SACN', 'Boise Anesthesia, PA', 'Clara', '', 'Cohen', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1841246360', 0, 'N', 0, '2012-10-29', NULL, NULL, 0, 0, NULL, NULL),
('820533431', 'SACN01143', 'SACN01143', 'SACN', 'The Ear Nose & Throat Clinic', 'Lance', 'W', 'Coleman', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '520 S Eagle Rd Ste 1223', 'Meridian', 'Ada', 'ID', '83642', '2088884368', NULL, '520 S Eagle Rd Ste 1223', 'Meridian', 'Ada', 'ID', '83642', '2088884368', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-02-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1548204589', 0, 'N', 0, '2012-02-08', NULL, NULL, 43.5995, -116.352, NULL, NULL),
('820537848', 'SACN01005', 'SACN01005', 'SACN', 'The Shoulder Clinic of Idaho', 'Kathryn', 'A', 'Colson', 'PA-C', 'Orthopedic Surgery', '', '', NULL, 'O', '8854 W Emerald Ste 102', 'Boise', 'Ada', 'ID', '83704', '2083234747', NULL, '8854 W Emerald Ste 102', 'Boise', 'Ada', 'ID', '83704', '2083234747', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1457363970', 0, 'n', 0, '2012-04-24', NULL, NULL, 43.6123, -116.292, NULL, NULL),
('820312175', 'SACN01631', 'SACN01631', 'SACN', 'Idaho Emergency Physicians PA', 'Matthew', 'J', 'Conklin', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1922052448', 0, 'n', 0, '2012-01-31', NULL, NULL, 43.6136, -116.256, NULL, NULL),
('820312175', 'SACN01632', 'SACN01632', 'SACN', 'Idaho Emergency Physicians PA', 'Matthew', 'J', 'Conklin', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1922052448', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01633', 'SACN01633', 'SACN', 'Idaho Emergency Physicians PA', 'Matthew', 'J', 'Conklin', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1922052448', 0, 'Y', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01634', 'SACN01634', 'SACN', 'Idaho Emergency Physicians PA', 'Matthew', 'J', 'Conklin', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1922052448', 0, 'n', 0, '2012-01-31', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820200895', 'SACN01189', 'SACN01189', 'SACN', 'Saint Alphonsus Regional Medical Center Behavioral Health', 'Shelly', '', 'Conley Durkin', 'LCSW', 'Counseling', '', '', NULL, 'O', '131 N Allumbaugh', 'Boise', NULL, 'ID', '83704', '2083672175', '2083760285', '131 N Allumbaugh', 'Boise', '', 'ID', '83704', '2083672175', '2083760285', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1588862304', 0, 'N', 0, '2012-11-13', NULL, NULL, 43.6059, -116.267, NULL, NULL),
('202975807', 'SACN00530', 'SACN00530', 'SACN', 'Idaho Gynecology Oncology', 'Amy', 'L', 'Cooper', 'MD', 'Gynecologic Oncology', '', '', NULL, 'O', '100 E Idaho St', 'Boise', 'Ada', 'ID', '83712', '2083814044', '2083814002', '100 E Idaho St', 'Boise', 'Ada', 'ID', '83712', '2083814044', '2083814002', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-02-05', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1306880398', 0, 'N', 0, '2013-11-14', NULL, NULL, 43.6123, -116.194, NULL, NULL),
('202975807', 'SACN00531', 'SACN00531', 'SACN', 'Idaho Gynecology Oncology', 'Amy', 'L', 'Cooper', 'MD', 'Gynecologic Oncology', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083814044', '2083814002', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083814044', '2083814002', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-02-05', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1306880398', 0, 'N', 0, '2013-11-14', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('202975807', 'SACN00532', 'SACN00532', 'SACN', 'Idaho Gynecology Oncology', 'Amy', 'L', 'Cooper', 'MD', 'Gynecologic Oncology', '', '', NULL, 'B', 'PO Box 147', 'Caldwell', 'Canyon', 'ID', '83606', '2083814044', '2083814002', 'PO Box 147', 'Caldwell', 'Canyon', 'ID', '83606', '2083814044', '2083814002', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-02-05', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1306880398', 0, 'Y', 0, '2013-11-14', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01647', 'SACN01647', 'SACN', 'Saint Alphonsus Medical Group Hospitalist Boise', 'Clive', 'R', 'Cooper', 'MD', 'Hospitalist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672121', '2083675180', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1962446104', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('205294327', 'SACN00734', 'SACN00734', 'SACN', 'Digestive Health Clinic ', 'Nic', 'R', 'Cordum', 'MD', 'Gastroenterology', '', '', NULL, 'O', '6259 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2084891900', NULL, '6259 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2084891900', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1205803756', 0, 'n', 0, '2011-10-03', NULL, NULL, 43.6114, -116.259, NULL, NULL),
('820312175', 'SACN01536', 'SACN01536', 'SACN', 'Idaho Emergency Physicians PA', 'Benjamin', 'L', 'Cornett', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083221730', '2083221731', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1821298001', 0, 'n', 0, '2012-01-31', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820312175', 'SACN01537', 'SACN01537', 'SACN', 'Idaho Emergency Physicians PA', 'Benjamin', 'L', 'Cornett', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1821298001', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01538', 'SACN01538', 'SACN', 'Idaho Emergency Physicians PA', 'Benjamin', 'L', 'Cornett', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1821298001', 0, 'Y', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01539', 'SACN01539', 'SACN', 'Idaho Emergency Physicians PA', 'Benjamin', 'L', 'Cornett', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1821298001', 0, 'n', 0, '2012-01-31', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820425454', 'SACN00006', 'SACN00006', 'SACN', 'Boise Anesthesia, PA', 'Karen', 'K', 'Coscia', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2011-12-20', 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1033164454', 0, 'N', 0, '2012-10-29', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00007', 'SACN00007', 'SACN', 'Boise Anesthesia, PA', 'Karen', 'K', 'Coscia', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2011-12-20', 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1033164454', 0, 'N', 0, '2012-10-29', NULL, NULL, 0, 0, NULL, NULL),
('260553931', 'SACN00146', 'SACN00146', 'SACN', 'Saint Alphonsus Medical Group Coughlin Clinic Sun Valley', 'Michael', 'J', 'Coughlin', 'MD; Foot/Ankle', 'Orthopedic Surgery', '', '', NULL, 'O', '100 Hospital Dr Ste 107', 'Ketchum', 'Blaine', 'ID', '83340', '2083673330', '2083673331', '100 Hospital Dr Ste 107', 'Ketchum', 'Blaine', 'ID', '83340', '2083673330', '2083673331', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1023010824', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6485, -114.35, NULL, NULL),
('260553931', 'SACN00147', 'SACN00147', 'SACN', 'Saint Alphonsus Medical Group Coughlin Clinic Iowa', 'Michael', 'J', 'Coughlin', 'MD; Foot/Ankle', 'Orthopedic Surgery', '', '', NULL, 'O', '211 W Iowa Ave', 'Ketchum', 'Blaine', 'ID', '83686', '2084657377', '2084657397', '211 W Iowa Ave', 'Ketchum', 'Blaine', 'ID', '83686', '2084657377', '2084657397', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1023010824', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.4891, -116.589, NULL, NULL),
('260553931', 'SACN00148', 'SACN00148', 'SACN', 'Saint Alphonsus Medical Group Coughlin Clinic ', 'Michael', 'J', 'Coughlin', 'MD; Foot/Ankle', 'Orthopedic Surgery', '', '', NULL, 'O', '901 N Curtis Rd Ste 503', 'Boise', 'Ada', 'ID', '83706', '2083673330', '2083673331', '901 N Curtis Rd Ste 503', 'Boise', 'Ada', 'ID', '83706', '2083673330', '2083673331', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1023010824', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('331078261', 'SACN00149', 'SACN00149', 'SACN', 'Saint Alphonsus Medical Group Coughlin Clinic Sun Valley', 'Michael', 'J', 'Coughlin', 'MD; Foot/Ankle', 'Orthopedic Surgery', '', '', NULL, 'O', '100 Hospital Dr Ste 107', 'Ketchum', 'Blaine', 'ID', '83340', '2083673330', '2083673331', '100 Hospital Dr Ste 107', 'Ketchum', 'Blaine', 'ID', '83340', '2083673330', '2083673331', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1023010824', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6485, -114.35, NULL, NULL),
('331078261', 'SACN00150', 'SACN00150', 'SACN', 'Saint Alphonsus Coughlin Clinic', 'Michael', 'J', 'Coughlin', 'MD; Foot/Ankle', 'Orthopedic Surgery', '', '', NULL, 'O', '901 N Curtis Rd Ste 503', 'Boise', 'Ada', 'ID', '83706', '2083673330', '2083673331', '901 N Curtis Rd Ste 503', 'Boise', 'Ada', 'ID', '83706', '2083673330', '2083673331', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1023010824', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('820200895', 'SACN00595', 'SACN00595', 'SACN', 'Saint Alphonsus Medical Group Garrity', 'Ann', '', 'Cox', 'NP-C', 'Obstetrics and Gynecology', 'Nurse Practitioner', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-07-22', 0, 0, 0, '', '', '', '', 'HCFA|', '1033270236', 0, 'Y', 0, '2012-03-29', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820200895', 'SACN00596', 'SACN00596', 'SACN', 'Saint Alphonsus Express Care, Inc.', 'Ann', '', 'Cox', 'NP-C', 'Obstetrics and Gynecology', 'Nurse Practitioner', '', NULL, 'O', '1515 W State St', 'Boise', 'Ada', 'ID', '83702', '2083456768', NULL, '1515 W State St', 'Boise', 'Ada', 'ID', '83702', '2083456768', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-07-22', 0, 0, 0, '', '', '', '', 'HCFA|', '1033270236', 0, 'Y', 0, '2012-03-29', NULL, NULL, 43.6228, -116.21, NULL, NULL),
('820200895', 'SACN00597', 'SACN00597', 'SACN', 'Saint Alphonsus Medical Group Cherry Lane', 'Ann', '', 'Cox', 'NP-C', 'Obstetrics and Gynecology', 'Nurse Practitioner', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-07-22', 0, 0, 0, '', '', '', '', 'HCFA|', '1033270236', 0, 'Y', 0, '2012-03-29', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN00598', 'SACN00598', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Ann', '', 'Cox', 'NP-C', 'Obstetrics and Gynecology', 'Nurse Practitioner', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-07-22', 0, 0, 0, '', '', '', '', 'HCFA|', '1033270236', 0, 'Y', 0, '2014-01-23', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN00599', 'SACN00599', 'SACN', 'Saint Alphonsus Express Care, Inc.', 'Ann', '', 'Cox', 'NP-C', 'Obstetrics and Gynecology', 'Nurse Practitioner', '', NULL, 'O', '4700 N Eagle Rd', 'Boise', 'Ada', 'ID', '83713', '2089384797', NULL, '4700 N Eagle Rd', 'Boise', 'Ada', 'ID', '83713', '2089384797', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-07-22', 0, 0, 0, '', '', '', '', 'HCFA|', '1033270236', 0, 'Y', 0, '2012-03-29', NULL, NULL, 43.6474, -116.352, NULL, NULL),
('820200895', 'SACN00600', 'SACN00600', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'Ann', '', 'Cox', 'NP-C', 'Obstetrics and Gynecology', 'Nurse Practitioner', '', NULL, 'O', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-07-22', 0, 0, 0, '', '', '', '', 'HCFA|', '1033270236', 0, 'Y', 0, '2012-03-29', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN00601', 'SACN00601', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Ann', '', 'Cox', 'NP-C', 'Obstetrics and Gynecology', 'Nurse Practitioner', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-07-22', 0, 0, 0, '', '', '', '', 'HCFA|', '1033270236', 0, 'N', 0, '2014-01-23', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820477852', 'SACN00602', 'SACN00602', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'Ann', '', 'Cox', 'NP-C', 'Obstetrics and Gynecology', 'Nurse Practitioner', '', NULL, 'o', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83706', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83706', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1033270236', 0, 'N', 0, '2012-03-29', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('202630141', 'W40017370', 'W40017370', 'IDBOISTD', 'Primary Health Medical Group', 'Terah', 'L', 'Young', 'PA', 'Family Practice', '', '', NULL, 'B', 'PO Box 191050', 'Boise', 'Ada', 'ID', '83719', '2088788011', NULL, 'PO Box 191050', 'Boise', 'Ada', 'ID', '83719', '2088788011', '          ', 'IDPRIMARY', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2013-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508873050', 0, 'N', 0, '2013-07-02', NULL, NULL, 0, 0, NULL, NULL),
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('820200895', 'SACN00263', 'SACN00263', 'SACN', 'Saint Alphonsus Employee Assistance Program', 'Melissa', '', 'Young', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'o', '6140 W Emerald', 'Boise', 'Ada', 'ID', '83704', '2083673300', NULL, '6140 W Emerald', 'Boise', 'Ada', 'ID', '83704', '2083673300', '', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1386767333', 0, 'n', 0, '2014-06-20', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01012', 'SACN01012', 'SACN', 'Saint Alphonsus Regional Medical Center Behavioral Health', 'Carey', 'D', 'Crill', 'NP-C', 'Mental Health', '', '', NULL, 'O', '131 N Allumbaugh', 'Boise', 'Ada', 'ID', '83704', '2083672175', '2083760285', '131 N Allumbaugh', 'Boise', 'Ada', 'ID', '83704', '2083672175', '2083760285', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1457530693', 0, 'N', 0, '2012-11-14', NULL, NULL, 43.6059, -116.267, NULL, NULL),
('204344600', 'SACN00688', 'SACN00688', 'SACN', '', 'Jennifer', 'M', 'Crouder', 'LCPC', 'Mental Health', 'Counseling', '', NULL, 'O', '750 Warm Springs Ave Ste C', 'Boise', 'Ada', 'ID', '83712', '2083442850', NULL, '750 Warm Springs Ave Ste C', 'Boise', 'Ada', 'ID', '83712', '2083442850', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1124160627', 0, 'N', 0, '2012-08-07', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01325', 'SACN01325', 'SACN', 'Saint Alphonsus Medical Group Pulmonary & Sleep Boise ', 'Joseph', 'J', 'Crowley', 'MD', 'Pulmonary', '', '', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', NULL, '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1679611834', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN01326', 'SACN01326', 'SACN', 'Saint Alphonsus Medical Group Pulmonary & Sleep Boise ', 'Joseph', 'J', 'Crowley', 'MD', 'Pulmonary', '', '', NULL, 'O', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1679611834', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6143, -116.258, NULL, NULL),
('820200895', 'SACN01327', 'SACN01327', 'SACN', 'Saint Alphonsus Medical Group Pulmonary & Sleep Boise ', 'Joseph', 'J', 'Crowley', 'MD', 'Pulmonary', '', '', NULL, 'O', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1679611834', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820392395', 'SACN00774', 'SACN00774', 'SACN', '', 'Geneva', 'B', 'Crume', 'NP', 'Internal Medicine', '', '', NULL, 'O', '2036 N Cole Rd', 'Boise', 'Ada', 'ID', '83704', '2083750722', NULL, '2036 N Cole Rd', 'Boise', 'Ada', 'ID', '83704', '2083750722', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235168154', 0, 'N', 0, '2012-03-01', NULL, NULL, 43.6238, -116.273, NULL, NULL),
('272481635', 'SACN01641', 'SACN01641', 'SACN', 'Saint Alphonsus Medical Center - Nampa', 'Scott', 'A', 'Culpepper', 'MD', 'Family Practice', 'Hospitalist', '', NULL, 'B', 'PO Box 60000', 'San Francisco', 'San Francisco', 'CA', '94160', '2536821710', NULL, 'PO Box 60000', 'San Francisco', 'San Francisco', 'CA', '94160', '2536821710', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1952321606', 0, 'N', 0, '2014-06-20', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01642', 'SACN01642', 'SACN', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'Scott', 'A', 'Culpepper', 'MD', 'Family Practice', 'Hospitalist', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1952321606', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820477852', 'SACN01643', 'SACN01643', 'SACN', 'Saint Alphonsus Medical Group Garrity', 'Scott', 'A', 'Culpepper', 'MD', 'Family Practice', 'Hospitalist', '', NULL, 'o', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1952321606', 0, 'n', 0, '2014-06-20', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820425454', 'SACN00008', 'SACN00008', 'SACN', 'Boise Anesthesia, PA', 'Brett', 'E', 'Curley', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1063467637', 0, 'N', 0, '2012-10-29', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00009', 'SACN00009', 'SACN', 'Boise Anesthesia, PA', 'Brett', 'E', 'Curley', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1063467637', 0, 'N', 0, '2012-10-29', NULL, NULL, 0, 0, NULL, NULL),
('820455447', 'SACN00872', 'SACN00872', 'SACN', NULL, 'Austin', 'R', 'Cushman', 'MD', 'General Surgery', '', '', NULL, 'O', '901 N Curtis Rd Ste 103', 'Boise', 'Ada', 'ID', '83706', '2083672670', '2083672673', '901 N Curtis Rd Ste 103', 'Boise', 'Ada', 'ID', '83706', '2083672670', '2083672673', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1336290915', 0, 'N', 0, '2012-01-31', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('820200895', 'SACN01160', 'SACN01160', 'SACN', 'Saint Alphonsus Medical Group Garrity', 'Seana', 'K', 'Daly', 'MD', 'Family Practice', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1558301929', 0, 'N', 0, '2014-03-20', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820477852', 'SACN01161', 'SACN01161', 'SACN', 'Saint Alphonsus Medical Group Garrity', 'Seana', 'K', 'Daly', 'MD', 'Family Practice', '', '', NULL, 'o', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1558301929', 0, 'n', 0, '2014-03-20', NULL, NULL, 43.587, -116.549, NULL, NULL),
('518547420', 'SACN01211', 'SACN01211', 'SACN', NULL, 'Diane', 'M', 'Daniel', 'LCPC', 'Mental Health', 'Counseling', '', NULL, 'O', '3350 Americana Terrace Ste 300', 'Boise', 'Ada', 'ID', '83706', '2083431113', NULL, '3350 Americana Terrace Ste 300', 'Boise', 'Ada', 'ID', '83706', '2083431113', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1609836394', 0, 'n', 0, '2011-12-16', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00065', 'SACN00065', 'SACN', 'Boise Anesthesia, PA', 'Amber', '', 'Davidson', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1649453028', 0, 'N', 0, '2012-10-29', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00066', 'SACN00066', 'SACN', 'Boise Anesthesia, PA', 'Amber', '', 'Davidson', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1649453028', 0, 'N', 0, '2012-10-29', NULL, NULL, 0, 0, NULL, NULL),
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('260859911', 'ELHCA0242', 'ELHCA0242', 'TXHOUSTD', 'Surgical Specialists of Clear Lake ', 'In Soo', NULL, 'Yo', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 100559 ', 'Atlanta', 'Fulton', 'GA', '30384', NULL, NULL, 'PO Box 100559 ', 'Atlanta', 'Fulton', 'GA', '30384', '', '', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Clear Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104891308', 0, 'Y', 0, '2013-05-01', NULL, NULL, 0, 0, NULL, NULL),
('260859911', 'ELHCA0241', 'ELHCA0241', 'TXHOUSTD', 'Surgical Specialists of Clear Lake ', 'In Soo', NULL, 'Yo', 'MD', 'General Surgery', '', '', NULL, 'O', '450 Medical Ctr Blvd Ste 600', 'Webster', 'Harris', 'TX', '77598', '2813324596', '2815544501', '450 Medical Ctr Blvd Ste 600', 'Webster', 'Harris', 'TX', '77598', '2813324596', '2815544501', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Clear Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1104891308', 0, 'N', 0, '2013-05-01', NULL, NULL, 29.5413, -95.126, NULL, NULL),
('820200895', 'SACN00666', 'SACN00666', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Charles', 'M', 'Davis', 'DO', 'Family Practice', '', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1104877364', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('202630141', 'W40013483', 'W40013483', 'IDBOISTD', 'Primary Health Medical Group', 'James', '', 'Yerger', 'MD', 'Family Practice', '', '', NULL, 'O', '6052 W State St', 'Boise', 'Ada', 'ID', '83703', '2083447799', NULL, '6052 W State St', 'Boise', 'Ada', 'ID', '83703', '2083447799', '          ', 'IDPRIMARY', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2013-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1265477962', 0, 'Y', 0, '2013-06-10', NULL, NULL, 43.6592, -116.264, NULL, NULL),
('820227163', 'SACN00613', 'SACN00613', 'SACN', 'St Benedicts Family Medical Center', 'Keith', 'E', 'Davis', 'MD', 'Family Practice', 'Emergency Medicine', '', NULL, 'B', '709 N Lincoln', 'Jerome', 'Jerome', 'ID', '83338', '2083241122', '2083243878', '709 N Lincoln', 'Jerome', 'Jerome', 'ID', '83338', '2083241122', '2083243878', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1043277635', 0, 'Y', 0, '2011-12-19', NULL, NULL, 0, 0, NULL, NULL),
('820397963', 'SACN00614', 'SACN00614', 'SACN', 'Shoshone Family Medical Center', 'Keith', 'E', 'Davis', 'MD', 'Family Practice', 'Emergency Medicine', '', NULL, 'B', '113 S Apple', 'Shoshone', 'Lincoln', 'ID', '83352', '2088862224', '2088862634', '113 S Apple', 'Shoshone', 'Lincoln', 'ID', '83352', '2088862224', '2088862634', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1043277635', 0, 'Y', 0, '2011-12-19', NULL, NULL, 0, 0, NULL, NULL),
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('820312175', 'SACN01156', 'SACN01156', 'SACN', 'Idaho Emergency Physicians PA', 'Robert', 'L', 'Davis', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', NULL, 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', '', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1548295249', 0, 'N', 0, '2012-01-30', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01157', 'SACN01157', 'SACN', 'Idaho Emergency Physicians PA', 'Robert', 'L', 'Davis', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1548295249', 0, 'Y', 0, '2012-01-30', NULL, NULL, 0, 0, NULL, NULL),
('820445140', 'SACN01393', 'SACN01393', 'SACN', 'The Eye Associates', 'Drew', 'C', 'Dayton', 'OD', 'Optometry', '', '', NULL, 'B', '1602 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084590717', NULL, '1602 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084590717', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1740231737', 0, 'y', 0, '2012-02-24', NULL, NULL, 43.6558, -116.696, NULL, NULL),
('820445140', 'SACN01394', 'SACN01394', 'SACN', 'The Eye Associates', 'Drew', 'C', 'Dayton', 'OD', 'Optometry', '', '', NULL, 'B', '901 N Curtis Rd Ste 302', 'Boise', 'Ada', 'ID', '83706', '2083425151', NULL, '901 N Curtis Rd Ste 302', 'Boise', 'Ada', 'ID', '83706', '2083425151', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1740231737', 0, 'y', 0, '2012-02-24', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('820466081', 'SACN01395', 'SACN01395', 'SACN', 'Hometown Family Eyecare', 'Drew', 'C', 'Dayton', 'OD', 'Optometry', '', '', NULL, 'B', '622 Star Blvd', 'Middleton', 'Canyon', 'ID', '83644', '2085859500', NULL, '622 Star Blvd', 'Middleton', 'Canyon', 'ID', '83644', '2085859500', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1740231737', 0, 'Y', 0, '2012-02-24', NULL, NULL, 0, 0, NULL, NULL),
('820466081', 'SACN01396', 'SACN01396', 'SACN', 'Eye Associates', 'Drew', 'C', 'Dayton', 'OD', 'Optometry', '', '', NULL, 'B', '901 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083425151', NULL, '901 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083425151', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1740231737', 0, 'Y', 0, '2012-02-24', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('820478504', 'SACN01535', 'SACN01535', 'SACN', 'Personal Solutions', 'Gayle', '', 'Dearborn', 'LMFT', 'Mental Health', 'Marriage and Family Therapy', '', NULL, 'O', '2596 N Stokesberry Pl Ste 100', 'Meridian', 'Ada', 'ID', '83646', '2089383837', NULL, '2596 N Stokesberry Pl Ste 100', 'Meridian', 'Ada', 'ID', '83646', '2089383837', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-12-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821274770', 0, 'N', 0, '2012-11-27', NULL, NULL, 0, 0, NULL, NULL),
('942938348', 'W40008082', 'W40008082', 'UTMH1', 'Valley Mental Health  Inc', 'Thomas', 'O', 'Yee', '', 'Mental Health', '', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'UTVMHMA', '', '', '0.00', '40.00', '0.00', 6, '2013-02-15', NULL, NULL, 0, NULL, '', '', '', '', 'HCFA|UB|', '1659456754', 0, 'N', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('942938348', 'W40025042', 'W40025042', 'UTMH1', 'Valley Mental Health  Inc', 'Danet', 'J', 'Yazzie', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'UTVMHMA', NULL, NULL, '0.00', '40.00', '0.00', 6, '2013-02-15', NULL, NULL, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1881838126', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01403', 'SACN01403', 'SACN', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'Lane', '', 'Deitchler', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1740464783', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820200895', 'SACN01404', 'SACN01404', 'SACN', 'Saint Alphonsus Express Care, Inc.', 'Lane', '', 'Deitchler', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '1515 W State St', 'Boise', 'Ada', 'ID', '83702', '2083456768', NULL, '1515 W State St', 'Boise', 'Ada', 'ID', '83702', '2083456768', '', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1740464783', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6228, -116.21, 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
('820200895', 'SACN01405', 'SACN01405', 'SACN', 'Saint Alphonsus Medical Group MHP Family Medicine', 'Lane', '', 'Deitchler', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1740464783', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN01406', 'SACN01406', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Lane', '', 'Deitchler', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1740464783', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN01407', 'SACN01407', 'SACN', 'Saint Alphonsus Express Care, Inc.', 'Lane', '', 'Deitchler', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '4700 N Eagle Rd', 'Boise', 'Ada', 'ID', '83713', '2089384797', NULL, '4700 N Eagle Rd', 'Boise', 'Ada', 'ID', '83713', '2089384797', '', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1740464783', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6474, -116.352, NULL, NULL),
('820200895', 'SACN01408', 'SACN01408', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Lane', '', 'Deitchler', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1740464783', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820477852', 'SACN01409', 'SACN01409', 'SACN', 'Saint Alphonsus Medical Group Garrity', 'Lane', '', 'Deitchler', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'B', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1740464783', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820477852', 'SACN01410', 'SACN01410', 'SACN', 'Saint Alphonsus Medical Group Cherry Lane', 'Lane', '', 'Deitchler', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'B', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678500', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678500', '2083678555', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1740464783', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820477852', 'SACN01411', 'SACN01411', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Lane', '', 'Deitchler', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'B', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1740464783', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820477852', 'SACN01412', 'SACN01412', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Lane', '', 'Deitchler', 'NP-C', 'Family Practice', 'Nurse Practitioner', '', NULL, 'B', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1740464783', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('201300128', 'SACN00447', 'SACN00447', 'SACN', 'Idaho Urologic Institute', 'Derek', '', 'Derkacs', 'PA', 'Urology', 'General Surgery', '', NULL, 'O', '1613 12th Ave Rd Ste B', 'Nampa', 'Canyon', 'ID', '83686', '2086394900', NULL, '1613 12th Ave Rd Ste B', 'Nampa', 'Canyon', 'ID', '83686', '2086394900', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-08-30', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, '', '', 'HCFA|UB|', '1720157720', 0, 'N', 0, '2013-12-10', NULL, NULL, 43.5533, -116.573, NULL, NULL),
('201300128', 'SACN00448', 'SACN00448', 'SACN', 'Idaho Urologic Institute', 'Derek', '', 'Derkacs', 'PA', 'Urology', 'General Surgery', '', NULL, 'O', '2855 E Magic View Dr', 'Meridian', 'Ada', 'ID', '83642', '2086394900', NULL, '2855 E Magic View Dr', 'Meridian', 'Ada', 'ID', '83642', '2086394900', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-08-30', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, '', '', 'HCFA|UB|', '1720157720', 0, 'N', 0, '2013-12-10', NULL, NULL, 43.599, -116.36, NULL, NULL),
('820200895', 'SACN01276', 'SACN01276', 'SACN', 'Saint Alphonsus Medical Group Shoreline Family Medicine', 'Angeline "Angie"', 'G', 'Devitt', 'MD', 'Family Practice', '', '', NULL, 'O', '1673 W Shoreline Dr Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083678383', '2083677171', '1673 W Shoreline Dr Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083678383', '2083677171', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1659324358', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6171, -116.222, NULL, NULL),
('820477852', 'SACN01277', 'SACN01277', 'SACN', 'Saint Alphonsus Medical Group Shoreline', 'Angeline "Angie"', 'G', 'Devitt', 'MD', 'Family Practice', '', '', NULL, 'o', '1673 W Shoreline Dr Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083678383', '2083677171', '1673 W Shoreline Dr Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083678383', '2083677171', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1659324358', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6171, -116.222, NULL, NULL),
('820200895', 'SACN00699', 'SACN00699', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'Juliana', 'L', 'DiGiosia', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083674224', '2083677806', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1144335332', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN00700', 'SACN00700', 'SACN', 'Saint Alphonsus Medical Group Eagle Health Plaza', 'Juliana', 'L', 'DiGiosia', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083677806', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1144335332', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820200895', 'SACN00701', 'SACN00701', 'SACN', 'Saint Alphonsus Medical Group OB/GYN Boise Moreau Bldg ', 'Juliana', 'L', 'DiGiosia', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1144335332', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN00702', 'SACN00702', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'Juliana', 'L', 'DiGiosia', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1144335332', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820200895', 'SACN00703', 'SACN00703', 'SACN', 'CARE Maternal/Child Health Program - Do Not Publish', 'Juliana', 'L', 'DiGiosia', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083677806', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1144335332', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820477852', 'SACN00704', 'SACN00704', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'Juliana', 'L', 'DiGiosia', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', '3340 E Goldstone', 'Meridian', 'Ada', 'ID', '83642', '2083675170', '2083675180', '3340 E Goldstone', 'Meridian', 'Ada', 'ID', '83642', '2083675170', '2083675180', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1144335332', 0, 'Y', 0, '2014-06-20', NULL, NULL, 0, 0, NULL, NULL),
('820477852', 'SACN00705', 'SACN00705', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'Juliana', 'L', 'DiGiosia', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1144335332', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN00862', 'SACN00862', 'SACN', 'Saint Alphonsus Regional Medical Center Behavioral Health', 'Maria', 'C', 'DiMattina', 'LCSW', 'Mental Health', 'Counseling', '', NULL, 'o', '131 N Allumbaugh', 'Boise', 'Ada', 'ID', '83704', '2083672175', '2083760285', '131 N Allumbaugh', 'Boise', 'Ada', 'ID', '83704', '2083672175', '2083760285', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-04-21', 0, 0, 0, '', '', '', '', 'HCFA|', '1326069808', 0, 'N', 0, '2011-08-05', NULL, NULL, 43.6059, -116.267, NULL, NULL),
('460500210', 'SACN01004', 'SACN01004', 'SACN', 'Saint Alphonsus Pathology Physician Services', 'Martin', 'M', 'Dinges', 'MD', 'Pathology', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672153', '2083673991', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083672153', '2083673991', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-06-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447399464', 0, 'N', 0, '2011-08-16', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('331078261', 'SACN00718', 'SACN00718', 'SACN', 'Saint Alphonsus Physicians PA', 'Achini', 'P', 'Dingman', 'MD', 'Rheumatology', '', '', NULL, 'O', '1000 N Curtis Ste 305', 'Boise', 'Ada', 'ID', '83706', '2083677800', '2083678099', '1000 N Curtis Ste 305', 'Boise', 'Ada', 'ID', '83706', '2083677800', '2083678099', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-03-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1174594758', 0, 'N', 0, '2012-03-01', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN00719', 'SACN00719', 'SACN', 'Saint Alphonsus Medical Group Rheumatology Boise', 'Achini', 'P', 'Dingman', 'MD', 'Rheumatology', '', '', NULL, 'O', '1000 N Curtis Ste 305', 'Boise', 'Ada', 'ID', '83706', '2083677800', '2083678099', '1000 N Curtis Ste 305', 'Boise', 'Ada', 'ID', '83706', '2083677800', '2083678099', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-31', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1174594758', 0, 'N', 0, '2012-02-27', NULL, NULL, 0, 0, NULL, NULL),
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('820312175', 'SACN01666', 'SACN01666', 'SACN', 'Idaho Emergency Physicians PA', 'Jeffrey', 'R', 'Dingman', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1972648913', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
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('820200895', 'SACN00513', 'SACN00513', 'SACN', 'Saint Alphonsus Medical Group MHP Family Medicine', 'Matthew', 'K', 'Eastman', 'DO', 'Family Practice', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2014-04-30', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1952344962', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6188, -116.431, NULL, NULL),
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('820200895', 'SACN00850', 'SACN00850', 'SACN', 'Saint Alphonsus Medical Group Hospitalist Boise', 'Stan', 'A', 'Eisele', 'MD', 'Internal Medicine', '', '', NULL, 'B', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1306886767', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
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('820312175', 'SACN00721', 'SACN00721', 'SACN', 'Idaho Emergency Physicians PA', 'Eric', 'T', 'Elliot', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1174655740', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL);
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('820425454', 'SACN00022', 'SACN00022', 'SACN', 'Boise Anesthesia, PA', 'Amy', 'L', 'Engelmann', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2011-09-30', 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1275625238', 0, 'N', 0, '2012-10-30', NULL, NULL, 43.6127, -116.254, NULL, NULL),
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('820161600', 'SACN01570', 'SACN01570', 'SACN', 'Idaho Family Physicians Inc', 'Ann', 'E', 'Erwin', 'MD', 'Family Practice', '', '', NULL, 'O', '130 E Boise Ave', 'Boise', 'Ada', 'ID', '83706', '2083454066', NULL, '130 E Boise Ave', 'Boise', 'Ada', 'ID', '83706', '2083454066', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2011-11-07', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1851494223', 0, 'N', 0, '2013-10-16', NULL, NULL, 0, 0, NULL, NULL),
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('942938348', 'W40006946', 'W40006946', 'UTMH1', 'Valley Mental Health  Inc', 'Pamela', 'C', 'Wilkison', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', '', 'UTVMHPHD', NULL, '', '0.00', '40.00', '0.00', 6, '2013-02-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1518923226', 0, 'Y', 0, '2014-05-13', NULL, NULL, 0, 0, NULL, NULL),
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('820482491', 'SACN01231', 'SACN01231', 'SACN', 'Intermountain Eye & Laser Centers PLLC', 'Jon', 'R', 'Fishburn', 'MD', 'Ophthalmology', '', '', NULL, 'B', '6063 Corporal Ln', 'Boise', 'Ada', 'ID', '83704', '2083758799', '2083758798', '6063 Corporal Ln', 'Boise', 'Ada', 'ID', '83704', '2083758799', '2083758798', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-08-14', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1639123490', 0, 'Y', 0, '2012-02-01', NULL, NULL, 0, 0, NULL, NULL),
('820482491', 'SACN01232', 'SACN01232', 'SACN', 'Intermountain Eye & Laser Centers', 'Jon', 'R', 'Fishburn', 'MD', 'Ophthalmology', '', '', NULL, 'O', '999 N Curtis Ste 205', 'Boise', 'Ada', 'ID', '83706', '2083731200', '2083731216', '999 N Curtis Ste 205', 'Boise', 'Ada', 'ID', '83706', '2083731200', '2083731216', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1639123490', 0, 'N', 0, '2012-02-01', NULL, NULL, 43.6132, -116.255, NULL, NULL),
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('820552460', 'SACN01693', 'SACN01693', 'SACN', 'Fletcher Chiropractic Center', 'Scott', 'D', 'Fletcher', 'DC', 'Chiropractic', '', '', NULL, 'O', '3210 E Chinden Blvd Ste 106', 'Eagle', 'Ada', 'ID', '83616', '2089393000', NULL, '3210 E Chinden Blvd Ste 106', 'Eagle', 'Ada', 'ID', '83616', '2089393000', '          ', 'IDSINCLAIRM', '', '', '0.00', '10.00', '0.00', 3, '2011-01-01', '2013-07-29', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1265566855', 0, 'N', 0, '2013-08-15', NULL, NULL, 0, 0, NULL, NULL),
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('953134847', 'SACN01347', 'SACN01347', 'SACN', 'West Dermatology of Idaho', 'Gregory', 'L', 'Flint', 'MD', 'Dermatology', '', '', NULL, 'B', 'PO Box 2150', 'Redlands', 'San Bernardino', 'CA', '92373', '2083672864', NULL, 'PO Box 2150', 'Redlands', 'San Bernardino', 'CA', '92373', '2083672864', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-06-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1699866822', 0, 'N', 0, '2012-04-17', NULL, NULL, 0, 0, NULL, NULL),
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('820161600', 'SACN00178', 'SACN00178', 'SACN', 'Boise Orthopedic Clinic', 'Charles', 'T', 'Floyd', 'MD; Spine', 'Orthopedic Surgery', '', '', NULL, 'O', '703 S Americana Blvd Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083232600', NULL, '703 S Americana Blvd Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083232600', '', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1124039714', 0, 'N', 0, '2014-07-09', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN00157', 'SACN00157', 'SACN', 'Saint Alphonsus Medical Group Hospitalist Boise', 'Stephen', 'J', 'Focht', 'MD', 'Hospitalist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1043288004', 0, 'Y', 0, '2012-10-29', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('484768121', 'W40005533', 'W40005533', 'UTMH1', NULL, 'Pamela', 'C', 'Wilkison', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'O', '2700 Homestead Rd Ste 40', 'Park City', 'Summit', 'UT', '84098', '4359014307', NULL, '2700 Homestead Rd Ste 40', 'Park City', 'Summit', 'UT', '84098', '4359014307', '', 'PHD', NULL, '', '0.00', '40.00', '0.00', 3, '2013-02-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1518923226', 0, 'N', 0, '2014-05-13', NULL, NULL, 40.7561, -111.57, NULL, NULL),
('260553931', 'SACN00624', 'SACN00624', 'SACN', 'Saint Alphonsus Medical Group Heart Care Boise', 'Steven', 'J', 'Fonken', 'MD', 'Cardiology', '', '', NULL, 'O', '1070 N Curtis Ste 125', 'Boise', 'Ada', 'ID', '83706', '2083771415', '2083753451', '1070 N Curtis Ste 125', 'Boise', 'Ada', 'ID', '83706', '2083771415', '2083753451', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1063437630', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6141, -116.253, NULL, NULL),
('260553931', 'SACN00625', 'SACN00625', 'SACN', 'Saint Alphonsus Medical Group Heart Care', 'Steven', 'J', 'Fonken', 'MD', 'Cardiology', '', '', NULL, 'O', '520 S Eagle Rd Ste 2205', 'Meridian', 'Ada', 'ID', '83642', '2088840036', '2088843805', '520 S Eagle Rd Ste 2205', 'Meridian', 'Ada', 'ID', '83642', '2088840036', '2088843805', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-01-06', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1063437630', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.5995, -116.352, NULL, NULL),
('260553931', 'SACN00626', 'SACN00626', 'SACN', 'Saint Alphonsus Medical Group Heart Care Boise', 'Steven', 'J', 'Fonken', 'MD', 'Cardiology', '', '', NULL, 'O', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1063437630', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6151, -116.256, NULL, NULL),
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('460500210', 'SACN01134', 'SACN01134', 'SACN', 'Frederick Foss Physician Services', 'Frederick', 'A', 'Foss', 'MD', 'General Surgery', '', '', NULL, 'O', '999 N Curtis Ste 515', 'Boise', 'Ada', 'ID', '83706', '2083677676', '2083676849', '999 N Curtis Ste 515', 'Boise', 'Ada', 'ID', '83706', '2083677676', '2083676849', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-02-23', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1528041134', 0, 'N', 0, '2011-09-19', NULL, NULL, 43.6132, -116.255, NULL, NULL),
('880379704', 'SACN01689', 'SACN01689', 'SACN', 'Foster Chiropractic', 'Stoney', 'R', 'Foster', 'DC', 'Chiropractic', '', '', NULL, 'O', '1675 N Maple Grove', 'Boise', 'Ada', 'ID', '83704', '2083764940', NULL, '1675 N Maple Grove', 'Boise', 'Ada', 'ID', '83704', '2083764940', '', 'IDSINCLAIRM', NULL, NULL, '0.00', '10.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194756510', 0, 'n', 0, '2011-12-09', NULL, NULL, 0, 0, NULL, NULL),
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('820425454', 'SACN00037', 'SACN00037', 'SACN', 'Boise Anesthesia, PA', 'Donald', 'J', 'Fox', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1497707830', 0, 'N', 0, '2012-10-30', NULL, NULL, 0, 0, NULL, NULL),
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('201300128', 'SACN00471', 'SACN00471', 'SACN', 'Idaho Urologic Institute', 'William', 'H', 'Fredriksson', 'MD', 'Urology', '', '', NULL, 'O', '1613 12th Ave Rd Ste B', 'Nampa', 'Canyon', 'ID', '83686', '2086394900', NULL, '1613 12th Ave Rd Ste B', 'Nampa', 'Canyon', 'ID', '83686', '2086394900', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|UB|', '1841280872', 0, 'n', 0, '2014-03-20', NULL, NULL, 43.5533, -116.573, NULL, NULL),
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('820496280', 'SACN00681', 'SACN00681', 'SACN', 'Dermatology Clinic of ID', 'Stephen', 'J', 'Frelly', 'PA', 'Dermatology', '', '', NULL, 'O', '271 Duffers Ln', 'Cascade', 'Valley', 'ID', '83611', '2083764776', NULL, '271 Duffers Ln', 'Cascade', 'Valley', 'ID', '83611', '2083764776', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114966959', 0, 'N', 0, '2013-07-05', NULL, NULL, 44.5085, -116.058, NULL, NULL),
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('820496280', 'SACN00683', 'SACN00683', 'SACN', 'Dermatology Clinic of ID', 'Stephen', 'J', 'Frelly', 'PA', 'Dermatology', '', '', NULL, 'O', '7733 W Emerald', 'Boise', 'Ada', 'ID', '83704', '2083764776', NULL, '7733 W Emerald', 'Boise', 'Ada', 'ID', '83704', '2083764776', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114966959', 0, 'N', 0, '2013-07-05', NULL, NULL, 43.6127, -116.278, NULL, NULL),
('203276415', 'SACN01166', 'SACN01166', 'SACN', 'Ada West Dermatology', 'Brian', 'D', 'Friedt', 'PA-C', 'Dermatology', '', '', NULL, 'O', '1618 S Millennium Way Ste 100', 'Meridian', 'Ada', 'ID', '83642', '2088843376', NULL, '1618 S Millennium Way Ste 100', 'Meridian', 'Ada', 'ID', '83642', '2088843376', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568499713', 0, 'n', 0, '2013-03-20', NULL, NULL, 43.5903, -116.368, NULL, NULL),
('804251900', 'SACN01384', 'SACN01384', 'SACN', 'Pain Care Center Boise', 'Freddie', '', 'Friel', 'MD PA', 'Physician Assistant', '', '', NULL, 'O', '301 W Myrtle St', 'Boise', 'Ada', 'ID', '83702', '2083428200', NULL, '301 W Myrtle St', 'Boise', 'Ada', 'ID', '83702', '2083428200', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1730131178', 0, 'n', 0, '2012-02-07', NULL, NULL, 0, 0, NULL, NULL),
('804251900', 'SACN01385', 'SACN01385', 'SACN', 'Pain Care Center Boise', 'Freddie', '', 'Friel', 'MD PA', 'Physician Assistant', '', '', NULL, 'B', 'PO Box 94206', 'Seattle', 'King', 'WA', '98124', '5033722740', NULL, 'PO Box 94206', 'Seattle', 'King', 'WA', '98124', '5033722740', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1730131178', 0, 'y', 0, '2012-02-07', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01443', 'SACN01443', 'SACN', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'Charles', '', 'Frost', 'PA-C', 'Occupational Medicine', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-01-23', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1760425730', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820477852', 'SACN01444', 'SACN01444', 'SACN', 'Saint Alphonsus Medical Group Garrity', 'Charles', '', 'Frost', 'PA-C', 'Occupational Medicine', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1760425730', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820425454', 'SACN00014', 'SACN00014', 'SACN', 'Boise Anesthesia, PA', 'Darron', 'D', 'Funk', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1174560759', 0, 'N', 0, '2012-10-30', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00015', 'SACN00015', 'SACN', 'Boise Anesthesia, PA', 'Darron', 'D', 'Funk', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1174560759', 0, 'N', 0, '2012-10-30', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00001', 'SACN00001', 'SACN', 'Boise Anesthesia, PA', 'Patricia', 'A', 'Gaherty', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1396797601', 0, 'N', 0, '2012-10-30', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00002', 'SACN00002', 'SACN', 'Boise Anesthesia, PA', 'Patricia', 'A', 'Gaherty', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1396797601', 0, 'N', 0, '2012-10-30', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00003', 'SACN00003', 'SACN', 'Boise Anesthesia, PA', 'Patricia', 'A', 'Gaherty', 'MD', 'Anesthesiology', '', '', NULL, 'o', '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', NULL, '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1396797601', 0, 'N', 0, '2012-10-30', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('621560557', 'SACN00844', 'SACN00844', 'SACN', 'The Clinic at Wilder', 'Amy', 'L', 'Gallaway', 'NP', 'Family Practice', '', '', NULL, 'O', '215 3rd St', 'Wilder', 'Canyon', 'ID', '83676', '2084827430', NULL, '215 3rd St', 'Wilder', 'Canyon', 'ID', '83676', '2084827430', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1306817226', 0, 'N', 0, '2013-08-30', NULL, NULL, 43.6779, -116.91, NULL, NULL),
('680569751', 'SACN00845', 'SACN00845', 'SACN', 'The Clinic of Wilder', 'Amy', 'L', 'Gallaway', 'NP', 'Family Practice', '', '', NULL, 'O', '215 3rd St', 'Wilder', 'Canyon', 'ID', '83676', '2084827430', NULL, '215 3rd St', 'Wilder', 'Canyon', 'ID', '83676', '2084827430', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1306817226', 0, 'N', 0, '2013-08-30', NULL, NULL, 43.6779, -116.91, NULL, NULL),
('680569751', 'SACN00846', 'SACN00846', 'SACN', 'Davis Family Medicine', 'Amy', 'L', 'Gallaway', 'NP', 'Family Practice', '', '', NULL, 'O', '222 N 2nd St Ste 204', 'Boise', 'Ada', 'ID', '83702', '2084299100', NULL, '222 N 2nd St Ste 204', 'Boise', 'Ada', 'ID', '83702', '2084299100', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1306817226', 0, 'N', 0, '2013-08-30', NULL, NULL, 43.6131, -116.195, NULL, NULL),
('820425454', 'SACN00124', 'SACN00124', 'SACN', 'Boise Anesthesia PA', 'Cody', 'P', 'Gardner', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1376873430', 0, 'Y', 0, '2012-10-30', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00125', 'SACN00125', 'SACN', 'Boise Anesthesia PA', 'Cody', 'P', 'Gardner', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1376873430', 0, 'Y', 0, '2012-10-30', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00126', 'SACN00126', 'SACN', 'Boise Anesthesia PA', 'Cody', 'P', 'Gardner', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '900 N Liberty St Ste 450', 'Boise', 'Ada', 'ID', '83704', '2083677431', NULL, '900 N Liberty St Ste 450', 'Boise', 'Ada', 'ID', '83704', '2083677431', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1376873430', 0, 'Y', 0, '2012-10-30', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820200895', 'SACN00455', 'SACN00455', 'SACN', 'Dominican Health Services', 'James', 'W', 'Gardner', 'MD', 'Family Practice', '', '', NULL, 'O', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2084522140', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2084522140', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1730275876', 0, 'N', 0, '2014-03-24', NULL, NULL, 44.025, -116.928, NULL, NULL),
('820200895', 'SACN00456', 'SACN00456', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'James', 'W', 'Gardner', 'MD', 'Family Practice', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|', '1730275876', 0, 'N', 0, '2014-03-24', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820477852', 'SACN00457', 'SACN00457', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'James', 'W', 'Gardner', 'MD', 'Family Practice', '', '', NULL, 'o', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084545107', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084545107', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1730275876', 0, 'N', 0, '2014-03-24', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN00985', 'SACN00985', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Michelle', '', 'Gardner', 'MD', 'Family Practice', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', '', '', '', 'HCFA|', '1437231354', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820477852', 'SACN00986', 'SACN00986', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Michelle', '', 'Gardner', 'MD', 'Family Practice', '', '', NULL, 'o', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084545107', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084545107', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', '', '', '', 'HCFA|UB|', '1437231354', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('841394139', 'SACN00766', 'SACN00766', 'SACN', 'Southwest Idaho ENT ', 'Eric', 'T', 'Garner', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '900 N Liberty St Ste 400', 'Boise', 'Ada', 'ID', '83704', '2083673320', '          ', '900 N Liberty St Ste 400', 'Boise', 'Ada', 'ID', '83704', '2083673320', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1225011893', 0, 'N', 0, '2014-06-26', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820425454', 'SACN00010', 'SACN00010', 'SACN', 'Boise Anesthesia, PA', 'Michael', 'P', 'Garrett', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1083651665', 0, 'N', 0, '2013-04-02', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00011', 'SACN00011', 'SACN', 'Boise Anesthesia, PA', 'Michael', 'P', 'Garrett', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1083651665', 0, 'N', 0, '2013-04-02', NULL, NULL, 0, 0, NULL, NULL),
('953134847', 'SACN00754', 'SACN00754', 'SACN', '', 'Heather', 'N', 'Knutson', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '868 E Riverside Dr Ste 200', 'Eagle', 'Ada', 'ID', '83616', '2089396227', NULL, '868 E Riverside Dr Ste 200', 'Eagle', 'Ada', 'ID', '83616', '2089396227', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-06-30', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1215936034', 0, 'N', 0, '2013-09-04', NULL, NULL, 43.6891, -116.342, NULL, NULL),
('953134847', 'SACN00755', 'SACN00755', 'SACN', '', 'Heather', 'N', 'Knutson', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'B', 'PO Box 2150', 'Redlands', 'San Bernardino', 'ID', '92373', '9097986642', NULL, 'PO Box 2150', 'Redlands', 'San Bernardino', 'ID', '92373', '9097986642', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-06-30', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1215936034', 0, 'Y', 0, '2013-09-04', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00502', 'SACN00502', 'SACN', 'Idaho Emergency Physicians PA', 'Jason', 'L', 'Wilhelmsen', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1912964404', 0, 'n', 0, '2014-01-13', NULL, NULL, 0, 0, NULL, NULL),
('820297206', 'SACN00717', 'SACN00717', 'SACN', 'Boise Surgical Group PA', 'Jon', 'B', 'Getz', 'MD', 'General Surgery', NULL, NULL, NULL, 'O', '3399 E Louise Ave Ste 400', 'Meridian', 'Ada', 'ID', '83642', '2083643000', '2083643191', '3399 E Louise Ave Ste 400', 'Meridian', 'Ada', 'ID', '83642', '2083643000', '2083643191', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-09-10', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1174575138', 0, 'N', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00117', 'SACN00117', 'SACN', 'Boise Anesthesia, PA', 'Patricia', '', 'Gibbons', 'CRNA', 'Anesthesiology', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', NULL, '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1184863227', 0, 'N', 0, '2012-10-30', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00118', 'SACN00118', 'SACN', 'Boise Anesthesia, PA', 'Patricia', '', 'Gibbons', 'CRNA', 'Anesthesiology', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084554009', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084554009', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1184863227', 0, 'N', 0, '2012-10-30', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00119', 'SACN00119', 'SACN', 'Boise Anesthesia, PA', 'Patricia', '', 'Gibbons', 'CRNA', 'Anesthesiology', '', '', NULL, 'o', '900 N Liberty St Ste 450', 'Boise', 'Ada', 'ID', '83704', '2053677431', NULL, '900 N Liberty St Ste 450', 'Boise', 'Ada', 'ID', '83704', '2053677431', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1184863227', 0, 'N', 0, '2012-10-30', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820200895', 'SACN00936', 'SACN00936', 'SACN', 'Saint Alphonsus Medical Group Occupational Med Emerald ', 'Michael', 'P', 'Gibson', 'MD', 'Occupational Medicine', '', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674197', '2083678136', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674197', '2083678136', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1396789780', 0, 'N', 0, '2014-01-27', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820312175', 'SACN00501', 'SACN00501', 'SACN', 'Idaho Emergency Physicians PA', 'Jason', 'L', 'Wilhelmsen', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083221730', '2083221731', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1912964404', 0, 'n', 0, '2014-01-13', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('205294327', 'SACN01139', 'SACN01139', 'SACN', 'Digestive Health Clinic ', 'Robert', 'F', 'Gibson', 'MD', 'Gastroenterology', '', '', NULL, 'O', '6259 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2084891900', NULL, '6259 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2084891900', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1538128707', 0, 'n', 0, '2011-10-03', NULL, NULL, 43.6114, -116.259, NULL, NULL),
('205294327', 'SACN00808', 'SACN00808', 'SACN', 'Digestive Health Clinic ', 'Samuel', 'S', 'Gibson', 'MD', 'Gastroenterology', '', '', NULL, 'O', '6259 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2084891900', NULL, '6259 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2084891900', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1275500738', 0, 'n', 0, '2011-10-03', NULL, NULL, 43.6114, -116.259, NULL, NULL),
('820200895', 'SACN00575', 'SACN00575', 'SACN', 'Saint Alphonsus Medical Group Family Medicine Dominican ', 'Sheila', 'M', 'Giffen', 'MD', 'Family Practice', '', '', NULL, 'O', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2083676170', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2083676170', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1013957802', 0, 'N', 0, '2013-07-31', NULL, NULL, 44.025, -116.928, 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
('820200895', 'SACN00576', 'SACN00576', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Sheila', 'M', 'Giffen', 'MD', 'Family Practice', '', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1013957802', 0, 'N', 0, '2013-07-31', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820477852', 'SACN00577', 'SACN00577', 'SACN', 'Saint Alphonsus Medical Group Emerald', 'Sheila', 'M', 'Giffen', 'MD', 'Family Practice', '', '', NULL, 'o', '6533 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 W Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1013957802', 0, 'N', 0, '2013-07-31', NULL, NULL, 0, 0, NULL, NULL),
('204486078', 'SACN01153', 'SACN01153', 'SACN', '', 'Eric', '', 'Gilbreath', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '413 N Allumbaugh St Ste 101', 'Boise', 'Ada', 'ID', '83704', '2083231125', '          ', '413 N Allumbaugh St Ste 101', 'Boise', 'Ada', 'ID', '83704', '2083231125', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1548290711', 0, 'N', 0, '2014-07-23', NULL, NULL, 43.6086, -116.268, NULL, NULL),
('820200895', 'SACN01154', 'SACN01154', 'SACN', 'Saint Alphonsus Regional Medical Center Behavioral Health', 'Eric', '', 'Gilbreath', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '131 N Allumbaugh', 'Boise', 'Ada', 'ID', '83704', '2083676500', '2083760285', '131 N Allumbaugh', 'Boise', 'Ada', 'ID', '83704', '2083676500', '2083760285', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1548290711', 0, 'n', 0, '2014-07-23', NULL, NULL, 43.6059, -116.267, NULL, NULL),
('820312175', 'SACN01564', 'SACN01564', 'SACN', 'Idaho Emergency Physicians PA', 'Brandon', 'J', 'Wilding', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, NULL, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1851307367', 0, 'n', 0, '2013-02-28', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('460500210', 'SACN01006', 'SACN01006', 'SACN', 'Saint Alphonsus Trauma Physician Services', 'Jonathan', 'V', 'Giles', 'MD', 'General Surgery', '', '', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '0', '0', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '0', '0', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1457382723', 0, 'Y', 0, '2012-09-24', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820297206', 'SACN01007', 'SACN01007', 'SACN', 'Boise Surgical Group PA', 'Jonathan', 'V', 'Giles', 'MD', 'General Surgery', '', '', NULL, 'O', '3399 E Louise Ave Ste 400', 'Meridian', 'Ada', 'ID', '83642', '2083643000', '2083643191', '3399 E Louise Ave Ste 400', 'Meridian', 'Ada', 'ID', '83642', '2083643000', '2083643191', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-09-10', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1457382723', 0, 'N', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
('820438921', 'SACN01114', 'SACN01114', 'SACN', 'Treasure Valley Hearing and Balance Clinic', 'Angela', '', 'Gillentine', 'AUD', 'Audiology', '', '', NULL, 'O', '1084 N Cole Rd', 'Boise', 'Ada', 'ID', '83704', '2083770019', '2083770313', '1084 N Cole Rd', 'Boise', 'Ada', 'ID', '83704', '2083770019', '2083770313', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-08-01', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1518024918', 0, 'N', 0, '2012-02-29', NULL, NULL, 0, 0, NULL, NULL),
('820438921', 'SACN01115', 'SACN01115', 'SACN', 'Treasure Valley Hearing and Balance Clinic', 'Angela', '', 'Gillentine', 'AUD', 'Audiology', '', '', NULL, 'O', '1463 Caldwell Blvd', 'Nampa', 'Canyon', 'ID', '83651', '2084634900', '2084656322', '1463 Caldwell Blvd', 'Nampa', 'Canyon', 'ID', '83651', '2084634900', '2084656322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-08-01', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1518024918', 0, 'N', 0, '2012-02-29', NULL, NULL, 0, 0, NULL, NULL),
('820438921', 'SACN01116', 'SACN01116', 'SACN', 'Treasure Valley Hearing and Balance Clinic', 'Angela', '', 'Gillentine', 'AUD', 'Audiology', '', '', NULL, 'O', '52 N Palmetto Rd', 'Eagle', 'Ada', 'ID', '83616', '2089383777', '2089384093', '52 N Palmetto Rd', 'Eagle', 'Ada', 'ID', '83616', '2089383777', '2089384093', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2011-08-01', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1518024918', 0, 'N', 0, '2012-02-29', NULL, NULL, 0, 0, NULL, NULL),
('205934739', 'SACN00160', 'SACN00160', 'SACN', 'Family Medicine Health Center', 'Ryan', 'J', 'Gilles', 'MD', 'Family Practice', '', '', NULL, 'O', '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', NULL, '121 E Fort St', 'Boise', 'Ada', 'ID', '83712', '2083811775', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1053519553', 0, 'N', 0, '2012-06-29', NULL, NULL, 0, 0, NULL, NULL),
('205934739', 'SACN00161', 'SACN00161', 'SACN', 'Family Medicine Health Center', 'Ryan', 'J', 'Gilles', 'MD', 'Family Practice', '', '', NULL, 'O', '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2083676042', NULL, '777 N Raymond St', 'Boise', 'Ada', 'ID', '83704', '2083676042', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1053519553', 0, 'N', 0, '2012-06-29', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01563', 'SACN01563', 'SACN', 'Idaho Emergency Physicians PA', 'Brandon', 'J', 'Wilding', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, NULL, 0, NULL, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1851307367', 0, 'N', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN01562', 'SACN01562', 'SACN', 'Idaho Emergency Physicians PA', 'Brandon', 'J', 'Wilding', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, NULL, 0, NULL, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1851307367', 0, 'N', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('820463458', 'SACN01627', 'SACN01627', 'SACN', NULL, 'Jon', 'W', 'Glick', 'LCPC', 'Mental Health', 'Counseling', '', NULL, 'O', '200 Forest St', 'McCall', 'Valley', 'ID', '83638', '2086304248', NULL, '200 Forest St', 'McCall', 'Valley', 'ID', '83638', '2086304248', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1922039262', 0, 'n', 0, '2011-12-27', NULL, NULL, 0, 0, NULL, NULL),
('820463458', 'SACN01628', 'SACN01628', 'SACN', 'Emerald Counseling Center', 'Jon', 'W', 'Glick', 'LCPC', 'Mental Health', 'Counseling', '', NULL, 'O', '6010 Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083775720', NULL, '6010 Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083775720', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1922039262', 0, 'n', 0, '2011-12-27', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00067', 'SACN00067', 'SACN', 'Boise Anesthesia, PA', 'John', '', 'Goeddertz', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2011-08-08', 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1659424125', 0, 'N', 0, '2011-09-19', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00068', 'SACN00068', 'SACN', 'Boise Anesthesia, PA', 'John', '', 'Goeddertz', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '          ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', '2011-08-08', 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1659424125', 0, 'N', 0, '2011-09-19', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00080', 'SACN00080', 'SACN', 'Boise Anesthesia, PA', 'Michael', 'D', 'Gold', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720030166', 0, 'N', 0, '2012-10-30', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00081', 'SACN00081', 'SACN', 'Boise Anesthesia, PA', 'Michael', 'D', 'Gold', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720030166', 0, 'N', 0, '2012-10-30', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00082', 'SACN00082', 'SACN', 'Boise Anesthesia, PA', 'Michael', 'D', 'Gold', 'MD', 'Anesthesiology', '', '', NULL, 'o', '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', NULL, '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1720030166', 0, 'N', 0, '2012-10-30', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN01486', 'SACN01486', 'SACN', 'Saint Alphonsus Medical Group Family Medicine Dominican ', 'Marcel', 'A', 'Goldberg', 'MD', 'Family Practice', '', '', NULL, 'O', '1118 Nw 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2084522140', '1118 Nw 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2084522140', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1801837141', 0, 'N', 0, '2013-09-05', NULL, NULL, 44.025, -116.928, NULL, NULL),
('820200895', 'SACN01487', 'SACN01487', 'SACN', 'Saint Alphonsus Medical Group MHP Family Medicine', 'Marcel', 'A', 'Goldberg', 'MD', 'Family Practice', '', '', NULL, 'O', '3025 W Cherry Ln Ste 204', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste 204', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1801837141', 0, 'N', 0, '2013-09-05', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820477852', 'SACN01488', 'SACN01488', 'SACN', 'Saint Alphonsus Medical Group Cherry Lane', 'Marcel', 'A', 'Goldberg', 'MD', 'Family Practice', '', '', NULL, 'O', '3025 W Cherry Ln Ste 204', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste 204', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1801837141', 0, 'N', 0, '2013-09-05', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('043698413', 'SACN01188', 'SACN01188', 'SACN', 'Scott P Hoopes MD & Associates', 'Gladys', 'J', 'Gonzales', 'PA', 'Mental Health', '', '', NULL, 'O', '2273 E Gala St Ste 100', 'Meridian', 'Ada', 'ID', '83642', '2088988999', NULL, '2273 E Gala St Ste 100', 'Meridian', 'Ada', 'ID', '83642', '2088988999', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-12-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588850812', 0, 'N', 0, '2013-07-25', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01430', 'SACN01430', 'SACN', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'Rebecca', 'J', 'Goodspeed', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1750327797', 0, 'Y', 0, '2011-08-16', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820200895', 'SACN01431', 'SACN01431', 'SACN', 'Saint Alphonsus Medical Group MHP Family Medicine', 'Rebecca', 'J', 'Goodspeed', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1750327797', 0, 'N', 0, '2011-08-16', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN01432', 'SACN01432', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Rebecca', 'J', 'Goodspeed', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1750327797', 0, 'Y', 0, '2011-08-16', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN01433', 'SACN01433', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Rebecca', 'J', 'Goodspeed', 'PA-C', 'Physician Assistant', '', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1750327797', 0, 'Y', 0, '2011-08-16', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820477852', 'SACN01434', 'SACN01434', 'SACN', 'Saint Alphonsus Medical Group Garrity', 'Rebecca', 'J', 'Goodspeed', 'PA-C', 'Physician Assistant', '', '', NULL, 'B', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1750327797', 0, 'Y', 0, '2011-08-16', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820477852', 'SACN01435', 'SACN01435', 'SACN', 'Saint Alphonsus Medical Group Cherry Lane', 'Rebecca', 'J', 'Goodspeed', 'PA-C', 'Physician Assistant', '', '', NULL, 'B', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1750327797', 0, 'Y', 0, '2011-08-16', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820477852', 'SACN01436', 'SACN01436', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Rebecca', 'J', 'Goodspeed', 'PA-C', 'Physician Assistant', '', '', NULL, 'B', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1750327797', 0, 'Y', 0, '2014-01-23', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820477852', 'SACN01437', 'SACN01437', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Rebecca', 'J', 'Goodspeed', 'PA-C', 'Physician Assistant', '', '', NULL, 'B', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083775039', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083775039', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1750327797', 0, 'Y', 0, '2014-01-23', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820537848', 'SACN01235', 'SACN01235', 'SACN', 'The Shoulder Clinic of Idaho', 'Thomas', 'E', 'Goodwin', 'MD; Shoulder', 'Orthopedic Surgery', '', '', NULL, 'O', '8854 W Emerald Ste 102', 'Boise', 'Ada', 'ID', '83704', '2083234747', NULL, '8854 W Emerald Ste 102', 'Boise', 'Ada', 'ID', '83704', '2083234747', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1649208851', 0, 'n', 0, '2012-10-18', NULL, NULL, 43.6123, -116.292, NULL, NULL),
('820161600', 'SACN00793', 'SACN00793', 'SACN', 'St Lukes Idaho Endocrinology', 'Sharene', 'E', 'Watsen', 'PA-C', 'Endocrinology', '', '', NULL, 'O', '403 S 11th St Ste 100', 'Boise', 'Ada', 'ID', '83702', '2084290300', '2084290305', '403 S 11th St Ste 100', 'Boise', 'Ada', 'ID', '83702', '2084290300', '2084290305', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-06-11', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1265464036', 0, 'N', 0, '2013-10-16', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00735', 'SACN00735', 'SACN', 'Idaho Emergency Physicians PA', 'David', 'T', 'Gough', 'DO', 'Emergency Medicine', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'West Valley Medical Center', '', '', 'HCFA|UB|', '1205873247', 0, 'n', 0, '2013-09-12', NULL, NULL, 43.6136, -116.256, NULL, NULL),
('820312175', 'SACN00736', 'SACN00736', 'SACN', 'Idaho Emergency Physicians PA', 'David', 'T', 'Gough', 'DO', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'West Valley Medical Center', '', '', 'HCFA|UB|', '1205873247', 0, 'N', 0, '2013-09-12', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00737', 'SACN00737', 'SACN', 'Idaho Emergency Physicians PA', 'David', 'T', 'Gough', 'DO', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'West Valley Medical Center', '', '', 'HCFA|UB|', '1205873247', 0, 'Y', 0, '2013-09-12', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00738', 'SACN00738', 'SACN', 'Idaho Emergency Physicians PA', 'David', 'T', 'Gough', 'DO', 'Emergency Medicine', '', '', NULL, 'o', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', 'West Valley Medical Center', '', '', 'HCFA|UB|', '1205873247', 0, 'n', 0, '2013-09-12', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820200895', 'SACN00313', 'SACN00313', 'SACN', 'Northwest Pulmonary Saint Alphonsus', 'Linda', '', 'Gould', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', '1075 N Curtis Ste 201', 'Boise', 'Ada', 'ID', '83706', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-08-31', 0, 0, 0, '', '', '', '', 'HCFA|', '1457499261', 0, 'N', 0, '2011-09-19', NULL, NULL, 43.6143, -116.258, NULL, NULL),
('820200895', 'SACN00314', 'SACN00314', 'SACN', 'Northwest Pulmonary Saint Alphonsus', 'Linda', '', 'Gould', 'NP-C', 'Nurse Practitioner', '', '', NULL, 'O', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', '6140 W Curtisian Ste B10', 'Boise', 'Ada', 'ID', '83704', '2083678333', '2083672003', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-08-31', 0, 0, 0, '', '', '', '', 'HCFA|', '1457499261', 0, 'N', 0, '2011-09-19', NULL, NULL, 43.6151, -116.256, NULL, NULL),
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('205898813', 'SACN01283', 'SACN01283', 'SACN', 'Initial Point Family Medicine', 'Mark', 'S', 'Grajcar', 'DO', 'Family Practice', '', '', NULL, 'O', '2640 S Eagle Rd', 'Meridian', 'Ada', 'ID', '83642', '2088840835', NULL, '2640 S Eagle Rd', 'Meridian', 'Ada', 'ID', '83642', '2088840835', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1669416137', 0, 'n', 0, '2011-12-14', NULL, NULL, 43.5804, -116.354, NULL, NULL),
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('820482491', 'SACN00960', 'SACN00960', 'SACN', 'Intermountain Eye & Laser Centers', 'Leo', 'S', 'Harf', 'MD', 'Ophthalmology', '', '', NULL, 'O', '999 N Curtis Ste 205', 'Boise', 'Ada', 'ID', '83706', '2083731200', '2084653441', '999 N Curtis Ste 205', 'Boise', 'Ada', 'ID', '83706', '2083731200', '2084653441', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1417041849', 0, 'N', 0, '2011-08-11', NULL, NULL, 43.6132, -116.255, 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
('820200895', 'SACN01190', 'SACN01190', 'SACN', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'Calvin', 'M', 'Harrold', 'PA-C', 'Family Practice', 'Physician Assistant', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1598705311', 0, 'Y', 0, '2014-03-27', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820477852', 'SACN01191', 'SACN01191', 'SACN', 'Saint Alphonsus Medical Group Garrity', 'Calvin', 'M', 'Harrold', 'PA-C', 'Family Practice', 'Physician Assistant', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1598705311', 0, 'Y', 0, '2014-03-27', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820200895', 'SACN00730', 'SACN00730', 'SACN', 'Saint Alphonsus Medical Group MHP Family Medicine', 'Arlene', 'C', 'Hartley', 'PA-C', 'Family Practice', 'Physician Assistant', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1194792473', 0, 'N', 0, '2012-12-13', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820477852', 'SACN00731', 'SACN00731', 'SACN', 'Saint Alphonsus Medical Group Cherry Lane', 'Arlene', 'C', 'Hartley', 'PA-C', 'Family Practice', 'Physician Assistant', '', NULL, 'B', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1194792473', 0, 'Y', 0, '2012-12-13', NULL, NULL, 43.6188, -116.431, NULL, NULL),
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('460500210', 'SACN00583', 'SACN00583', 'SACN', 'Saint Alphonsus Trauma Physician Services', 'Scott', 'A', 'Henson', 'MD', 'General Surgery', '', '', NULL, 'B', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '0', '0', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '0', '0', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1023060258', 0, 'Y', 0, '2012-01-30', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820297206', 'SACN00584', 'SACN00584', 'SACN', 'Boise Surgical Group PA', 'Scott', 'A', 'Henson', 'MD', 'General Surgery', '', '', NULL, 'O', '3399 E Louise Ave Ste 400', 'Meridian', 'Ada', 'ID', '83642', '2083643000', '2083643191', '3399 E Louise Ave Ste 400', 'Meridian', 'Ada', 'ID', '83642', '2083643000', '2083643191', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-09-10', 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1023060258', 0, 'N', 0, '2012-09-24', NULL, NULL, 0, 0, NULL, NULL),
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('820312175', 'SACN00525', 'SACN00525', 'SACN', 'Idaho Emergency Physicians PA', 'Ryan', 'D', 'Heyborne', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1659573889', 0, 'N', 0, '2012-01-30', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00526', 'SACN00526', 'SACN', 'Idaho Emergency Physicians PA', 'Ryan', 'D', 'Heyborne', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1659573889', 0, 'n', 0, '2012-01-30', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820200895', 'SACN00417', 'SACN00417', 'SACN', 'Saint Alphonsus Medical Group Occupational Med Dominican', 'Douglas', 'M', 'Hill', 'MD', 'Family Practice', 'Occupational Medicine', '', NULL, 'O', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2084522140', '1118 NW 16th St Ste A', 'Fruitland', 'Payette', 'ID', '83619', '2084526851', '2084522140', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-18', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', 'Saint Alphonsus Medical Center Nampa', 'HCFA|', '1699719674', 0, 'N', 0, '2012-05-09', NULL, NULL, 44.025, -116.928, NULL, NULL),
('820200895', 'SACN00418', 'SACN00418', 'SACN', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'Douglas', 'M', 'Hill', 'MD', 'Family Practice', 'Occupational Medicine', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-18', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', 'Saint Alphonsus Medical Center Nampa', 'HCFA|', '1699719674', 0, 'N', 0, '2012-05-09', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820477852', 'SACN00419', 'SACN00419', 'SACN', 'Saint Alphonsus Medical Group Garrity', 'Douglas', 'M', 'Hill', 'MD', 'Family Practice', 'Occupational Medicine', '', NULL, 'o', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-18', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1699719674', 0, 'N', 0, '2012-05-09', NULL, NULL, 43.587, -116.549, NULL, NULL),
('260553931', 'SACN01445', 'SACN01445', 'SACN', 'Saint Alphonsus Specialty Services, Inc', 'Stephanie', '', 'Hilpert', 'NP-C', 'Neurosurgery', 'Nurse Practitioner', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083674000', '2083674052', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083674000', '2083674052', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1760584346', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('260553931', 'SACN01446', 'SACN01446', 'SACN', 'Saint Alphonsus Medical Group Neurosurgery Boise 102', 'Stephanie', '', 'Hilpert', 'NP-C', 'Neurosurgery', 'Nurse Practitioner', '', NULL, 'O', '1075 N Curtis Ste 102', 'Boise', 'Ada', 'ID', '83706', '2083674000', '2083674052', '1075 N Curtis Ste 102', 'Boise', 'Ada', 'ID', '83706', '2083674000', '2083674052', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1760584346', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6143, -116.258, NULL, NULL),
('260553931', 'SACN01447', 'SACN01447', 'SACN', 'Saint AlphonsusMedical Group Neurosurgery Fruitland', 'Stephanie', '', 'Hilpert', 'NP-C', 'Neurosurgery', 'Nurse Practitioner', '', NULL, 'O', '1118 NW 16th St', 'Fruitland', 'Payette', 'ID', '83619', '2083674000', '2083674052', '1118 NW 16th St', 'Fruitland', 'Payette', 'ID', '83619', '2083674000', '2083674052', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1760584346', 0, 'Y', 0, '2014-07-09', NULL, NULL, 44.025, -116.928, NULL, NULL),
('331078261', 'SACN01448', 'SACN01448', 'SACN', 'Saint Alphonsus Physicians PA', 'Stephanie', '', 'Hilpert', 'NP-C', 'Neurosurgery', 'Nurse Practitioner', '', NULL, 'O', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083674000', NULL, '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083674000', '', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1760584346', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('331078261', 'SACN01449', 'SACN01449', 'SACN', 'Saint Alphonsus Physicians PA', 'Stephanie', '', 'Hilpert', 'NP-C', 'Neurosurgery', 'Nurse Practitioner', '', NULL, 'O', '1075 N Curtis Rd Ste 102', 'Boise', 'Ada', 'ID', '83706', '2083674000', NULL, '1075 N Curtis Rd Ste 102', 'Boise', 'Ada', 'ID', '83706', '2083674000', '', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1760584346', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6143, -116.258, NULL, NULL),
('331078261', 'SACN01450', 'SACN01450', 'SACN', 'Saint Alphonsus Physicians PA', 'Stephanie', '', 'Hilpert', 'NP-C', 'Neurosurgery', 'Nurse Practitioner', '', NULL, 'O', '1118 NW 16th St', 'Fruitland', 'Payette', 'ID', '83619', '2083674000', NULL, '1118 NW 16th St', 'Fruitland', 'Payette', 'ID', '83619', '2083674000', '', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1760584346', 0, 'N', 0, '2014-07-09', NULL, NULL, 44.025, -116.928, NULL, NULL),
('820425454', 'SACN00058', 'SACN00058', 'SACN', 'Boise Anesthesia, PA', 'Sheri', 'L', 'Hirai', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1609821099', 0, 'N', 0, '2012-10-30', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00059', 'SACN00059', 'SACN', 'Boise Anesthesia, PA', 'Sheri', 'L', 'Hirai', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1609821099', 0, 'N', 0, '2012-10-30', NULL, NULL, 0, 0, NULL, NULL),
('260553931', 'SACN00306', 'SACN00306', 'SACN', 'Saint Alphonsus Specialty Services, Inc', 'Christopher', 'B', 'Hirose', 'MD; Foot/Ankle', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '100 Hospital Dr Ste 107', 'Boise', 'Ada', 'ID', '83706', '2083673330', '2083673331', '100 Hospital Dr Ste 107', 'Boise', 'Ada', 'ID', '83706', '2083673330', '2083673331', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1437111267', 0, 'Y', 0, '2013-09-17', NULL, NULL, 43.6335, -116.296, NULL, NULL),
('260553931', 'SACN00307', 'SACN00307', 'SACN', 'Saint Alphonsus Medical Group Coughlin Clinic Iowa', 'Christopher', 'B', 'Hirose', 'MD; Foot/Ankle', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '211 W Iowa Ave', 'Nampa', 'Canyon', 'ID', '83686', '2084657377', '2084657397', '211 W Iowa Ave', 'Nampa', 'Canyon', 'ID', '83686', '2084657377', '2084657397', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-09-17', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1437111267', 0, 'Y', 0, '2013-09-17', NULL, NULL, 43.5539, -116.575, NULL, NULL),
('260553931', 'SACN00308', 'SACN00308', 'SACN', 'Saint Alphonsus Medical Group Coughlin Clinic ', 'Christopher', 'B', 'Hirose', 'MD; Foot/Ankle', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '901 N Curtis Rd Ste 503', 'Boise', 'Ada', 'ID', '83706', '2083673330', '2083673331', '901 N Curtis Rd Ste 503', 'Boise', 'Ada', 'ID', '83706', '2083673330', '2083673331', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-09-17', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1437111267', 0, 'N', 0, '2013-09-17', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('331078261', 'SACN00309', 'SACN00309', 'SACN', 'Saint Alphonsus Coughlin Clinic', 'Christopher', 'B', 'Hirose', 'MD; Foot/Ankle', 'Orthopedic Surgery', NULL, NULL, NULL, 'O', '901 N Curtis Rd Ste 503', 'Boise', 'Ada', 'ID', '83706', '2083673330', '2083673331', '901 N Curtis Rd Ste 503', 'Boise', 'Ada', 'ID', '83706', '2083673330', '2083673331', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-09-17', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1437111267', 0, 'N', 0, '2013-09-17', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('820161600', 'SACN00253', 'SACN00253', 'SACN', 'Boise Orthopedic Clinic', 'Benjamin', '', 'Hochhalter', 'PA-C', 'Orthopedic Surgery', '', '', NULL, 'O', '520 S Eagle Rd Ste 3213', 'Meridian', 'Ada', 'ID', '83642', '2088980100', NULL, '520 S Eagle Rd Ste 3213', 'Meridian', 'Ada', 'ID', '83642', '2088980100', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1326023417', 0, 'N', 0, '2012-06-14', NULL, NULL, 43.5995, -116.352, NULL, NULL),
('820161600', 'SACN00254', 'SACN00254', 'SACN', 'Boise Orthopedic Clinic', 'Benjamin', '', 'Hochhalter', 'PA-C', 'Orthopedic Surgery', '', '', NULL, 'O', '703 S Americana Blvd Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083232600', NULL, '703 S Americana Blvd Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083232600', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1326023417', 0, 'N', 0, '2012-06-14', NULL, NULL, 0, 0, NULL, NULL),
('460500210', 'SACN00797', 'SACN00797', 'SACN', 'Saint Alphonsus Oncology Physician Services', 'Stephanie', 'B', 'Hodson', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083673131', '2083673174', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083673131', '2083673174', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-04-30', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1265478374', 0, 'N', 0, '2014-05-28', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('460500210', 'SACN00798', 'SACN00798', 'SACN', 'Saint Alphonsus Oncology Physician Services', 'Stephanie', 'B', 'Hodson', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '1202 E Locust', 'Emmett', 'Gem', 'ID', '83617', '2083653561', '0         ', '1202 E Locust', 'Emmett', 'Gem', 'ID', '83617', '2083653561', '0         ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-04-30', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1265478374', 0, 'N', 0, '2014-05-28', NULL, NULL, 43.8791, -116.485, NULL, NULL),
('460500210', 'SACN00799', 'SACN00799', 'SACN', 'Saint Alphonsus Oncology Physician Services', 'Stephanie', 'B', 'Hodson', 'MD', 'Hematology and Oncology', 'Oncology', '', NULL, 'O', '3123 Medical Dr', 'Caldwell', 'Canyon', 'ID', '83605', '2083674810', '2083674817', '3123 Medical Dr', 'Caldwell', 'Canyon', 'ID', '83605', '2083674810', '2083674817', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-04-30', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', 'West Valley Medical Center', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1265478374', 0, 'N', 0, '2014-05-28', NULL, NULL, 43.6596, -116.658, NULL, NULL),
('201300128', 'SACN00978', 'SACN00978', 'SACN', 'Idaho Urologic Institute', 'Katy', '', 'Holder', 'PA', 'Urology', '', '', NULL, 'O', '2855 E Magic View Dr', 'Meridian', 'Ada', 'ID', '83642', '2086394900', NULL, '2855 E Magic View Dr', 'Meridian', 'Ada', 'ID', '83642', '2086394900', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|UB|', '1427143346', 0, 'n', 0, '2013-07-31', NULL, NULL, 43.599, -116.36, NULL, NULL),
('201300128', 'SACN00979', 'SACN00979', 'SACN', 'Idaho Urologic Institute', 'Katy', '', 'Holder', 'PA', 'Urology', '', '', NULL, 'O', '333 N 1st', 'Boise', 'Ada', 'ID', '83702', '2086394900', NULL, '333 N 1st', 'Boise', 'Ada', 'ID', '83702', '2086394900', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-02-24', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|UB|', '1427143346', 0, 'N', 0, '2013-07-31', NULL, NULL, 43.6135, -116.194, NULL, NULL),
('272660267', 'SACN01699', 'SACN01699', 'SACN', 'Live Right Chiropractic', 'Yvonne', 'D', 'Honovich', 'DC', 'Chiropractic', '', '', NULL, 'O', '2300 S Orchard Ste A', 'Boise', 'Ada', 'ID', '83705', '2083833703', '2083833702', '2300 S Orchard Ste A', 'Boise', 'Ada', 'ID', '83705', '2083833703', '2083833702', 'IDSINCLAIRM', '', '', '0.00', '10.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1740309442', 0, 'N', 0, '2012-05-08', NULL, NULL, 0, 0, NULL, NULL),
('043698413', 'SACN00787', 'SACN00787', 'SACN', 'Scott P Hoopes MD & Associates', 'Scott', 'P', 'Hoopes', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '2273 E Gala St Ste 100', 'Meridian', 'Ada', 'ID', '83642', '2088988999', NULL, '2273 E Gala St Ste 100', 'Meridian', 'Ada', 'ID', '83642', '2088988999', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2012-12-31', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1255368635', 0, 'N', 0, '2013-07-25', NULL, NULL, 0, 0, NULL, NULL),
('820482491', 'SACN01204', 'SACN01204', 'SACN', 'Intermountain Eye and Laser Center', 'Luke', 'K', 'Hopstad', 'OD', 'Optometry', '', '', NULL, 'B', '6063 Corporal Ln', 'Boise', 'Ada', 'ID', '83704', '2083758799', '2083758798', '6063 Corporal Ln', 'Boise', 'Ada', 'ID', '83704', '2083758799', '2083758798', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1598742561', 0, 'Y', 0, '2011-09-13', NULL, NULL, 0, 0, NULL, NULL),
('820482491', 'SACN01205', 'SACN01205', 'SACN', 'Intermountain Eye and Laser Center', 'Luke', 'K', 'Hopstad', 'OD', 'Optometry', '', '', NULL, 'O', '999 N Curtis Ste 205', 'Boise', 'Ada', 'ID', '83706', '2083731200', '2083731216', '999 N Curtis Ste 205', 'Boise', 'Ada', 'ID', '83706', '2083731200', '2083731216', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1598742561', 0, 'N', 0, '2011-09-13', NULL, NULL, 43.6132, -116.255, NULL, NULL),
('203558484', 'SACN01350', 'SACN01350', 'SACN', 'Peine Osteopathic Medicine', 'Angela', 'L', 'House', 'DO', 'Family Practice', '', '', NULL, 'O', '450 W State St Ste 250', 'Eagle', 'Ada', 'ID', '83616', '2089470925', NULL, '450 W State St Ste 250', 'Eagle', 'Ada', 'ID', '83616', '2089470925', '', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-11-01', 0, 0, 1, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1700828241', 0, 'N', 0, '2014-04-18', NULL, NULL, 0, 0, NULL, NULL),
('820477852', 'SACN01351', 'SACN01351', 'SACN', 'Saint Alphonsus Medical Group Garrity', 'Angela', 'L', 'House', 'DO', 'Family Practice', '', '', NULL, 'B', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2014-03-31', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1700828241', 0, 'Y', 0, '2014-04-24', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820477852', 'SACN01352', 'SACN01352', 'SACN', 'Saint Alphonsus Medical Group Cherry Lane', 'Angela', 'L', 'House', 'DO', 'Family Practice', '', '', NULL, 'B', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2014-03-31', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1700828241', 0, 'Y', 0, '2014-04-24', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820477852', 'SACN01353', 'SACN01353', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Angela', 'L', 'House', 'DO', 'Family Practice', '', '', NULL, 'B', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084593621', '2084545107', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084593621', '2084545107', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2014-03-31', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1700828241', 0, 'Y', 0, '2014-04-24', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('202630141', 'W40017248', 'W40017248', 'IDBOISTD', 'Primary Health Medical Group', 'Sharon', 'E', 'Westbrook', 'MD', 'Family Practice', '', '', NULL, 'O', '6052 W State St', 'Boise', 'Ada', 'ID', '83703', '2083447799', '2089471945', '6052 W State St', 'Boise', 'Ada', 'ID', '83703', '2083447799', '2089471945', 'IDPRIMARY', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2013-03-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1184669889', 0, 'N', 0, '2013-04-05', NULL, NULL, 43.6592, -116.264, NULL, NULL),
('820312175', 'SACN00762', 'SACN00762', 'SACN', 'Idaho Emergency Physicians PA', 'Po', 'Y', 'Huang', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1215981741', 0, 'n', 0, '2012-01-31', NULL, NULL, 43.6136, -116.256, NULL, NULL),
('820312175', 'SACN00763', 'SACN00763', 'SACN', 'Idaho Emergency Physicians PA', 'Po', 'Y', 'Huang', 'MD', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1215981741', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00764', 'SACN00764', 'SACN', 'Idaho Emergency Physicians PA', 'Po', 'Y', 'Huang', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1215981741', 0, 'Y', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00765', 'SACN00765', 'SACN', 'Idaho Emergency Physicians PA', 'Po', 'Y', 'Huang', 'MD', 'Emergency Medicine', '', '', NULL, 'o', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1215981741', 0, 'n', 0, '2012-01-31', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820200895', 'SACN01354', 'SACN01354', 'SACN', 'Saint Alphonsus Inpatient Pain ', 'Cory', '', 'Huffine', 'NP-C', 'Wound Care', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083674030', '2083674051', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083674030', '2083674051', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1700879459', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN01355', 'SACN01355', 'SACN', 'Saint Alphonsus Inpatient Pain ', 'Cory', '', 'Huffine', 'NP-C', 'Wound Care', '', '', NULL, 'B', 'PO Box 190930', 'Boise', 'Ada', 'ID', '83719', '2083672396', '2083674051', 'PO Box 190930', 'Boise', 'Ada', 'ID', '83719', '2083672396', '2083674051', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-11-30', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1700879459', 0, 'N', 0, '2014-06-20', NULL, NULL, 0, 0, NULL, NULL),
('820490236', 'SACN01338', 'SACN01338', 'SACN', 'Treasure Valley Endocrinology PC', 'Tiffany', 'C', 'Heidt', 'FNP', 'Endocrinology', '', '', NULL, 'O', '900 N Liberty Ste 201', 'Boise', 'Ada', 'ID', '83704', '2083676740', '2083676742', '900 N Liberty Ste 201', 'Boise', 'Ada', 'ID', '83704', '2083676740', '2083676742', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1689683518', 0, 'N', 0, '2013-11-15', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820490236', 'SACN01339', 'SACN01339', 'SACN', 'Treasure Valley Endocrinology PC', 'Tiffany', 'C', 'Heidt', 'FNP', 'Endocrinology', '', '', NULL, 'B', 'PO Box 4143', 'Boise', 'Ada', 'ID', '83711', '2083239130', '2083239070', 'PO Box 4143', 'Boise', 'Ada', 'ID', '83711', '2083239130', '2083239070', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', '2013-10-15', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1689683518', 0, 'Y', 0, '2013-11-15', NULL, NULL, 0, 0, NULL, NULL),
('200324983', 'SACN01214', 'SACN01214', 'SACN', 'Idaho Sports Medicine Institute', 'Kristin', 'K', 'Hulquist', 'PT', 'Physical Therapy', NULL, NULL, NULL, 'O', '1188 University Dr', 'Boise', 'Ada', 'ID', '83706', '2083368250', '2083459514', '1188 University Dr', 'Boise', 'Ada', 'ID', '83706', '2083368250', '2083459514', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1609872241', 0, 'N', 0, '2012-08-03', NULL, NULL, 43.601, -116.196, NULL, NULL),
('820200895', 'SACN01340', 'SACN01340', 'SACN', 'Saint Alphonsus Medical Group EHP Family Medicine', 'Carrie', 'A', 'Humphrey', 'MD', 'Pediatrics', '', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-11-18', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|', '1699721837', 0, 'N', 0, '2012-10-26', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820200895', 'SACN01341', 'SACN01341', 'SACN', 'Saint Alphonsus Medical Group Pediatrics', 'Carrie', 'A', 'Humphrey', 'MD', 'Pediatrics', '', '', NULL, 'O', '999 N Curtis Ste 407', 'Boise', 'Ada', 'ID', '83706', '2083674321', '2083674525', '999 N Curtis Ste 407', 'Boise', 'Ada', 'ID', '83706', '2083674321', '2083674525', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|', '1699721837', 0, 'Y', 0, '2012-10-26', NULL, NULL, 43.6132, -116.255, NULL, NULL),
('820477852', 'SACN01342', 'SACN01342', 'SACN', 'Saint Alphonsus Medical Group Eagle Health Plaza', 'Carrie', 'A', 'Humphrey', 'MD', 'Pediatrics', '', '', NULL, 'o', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083675750', '2083675765', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1699721837', 0, 'n', 0, '2012-10-26', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820477852', 'SACN01343', 'SACN01343', 'SACN', 'Saint Alphonsus Medical Group Pediatrics', 'Carrie', 'A', 'Humphrey', 'MD', 'Pediatrics', '', '', NULL, 'B', '999 N Curtis Ste 407', 'Boise', 'Ada', 'ID', '83706', '2083674321', '2083674525', '999 N Curtis Ste 407', 'Boise', 'Ada', 'ID', '83706', '2083674321', '2083674525', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1699721837', 0, 'Y', 0, '2012-10-26', NULL, NULL, 43.6132, -116.255, NULL, NULL),
('820200895', 'SACN00767', 'SACN00767', 'SACN', 'Saint Alphonsus Medical Group Hospitalist Boise', 'Lisa', 'M', 'Hunt', 'MD', 'Hospitalist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676279', '2083675180', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1225066103', 0, 'Y', 0, '2014-06-20', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820484706', 'SACN01462', 'SACN01462', 'SACN', 'Idaho Nephrology Associates', 'Nicholas', 'C', 'Hunt', 'MD', 'Nephrology', '', '', NULL, 'O', '5610 Gage St Ste A', 'Boise', 'Ada', 'ID', '83706', '2083673370', NULL, '5610 Gage St Ste A', 'Boise', 'Ada', 'ID', '83706', '2083673370', '', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1780621771', 0, 'N', 0, '2014-03-26', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01209', 'SACN01209', 'SACN', 'Saint Alphonsus Medical Group Iowa Family Medicine', 'Randall', 'H', 'Hutchings', 'MD', 'Family Practice', '', '', NULL, 'O', '211 W Iowa Ave', 'Nampa', 'Canyon', 'ID', '83686', '2084657377', '2084657397', '211 W Iowa Ave', 'Nampa', 'Canyon', 'ID', '83686', '2084657377', '2084657397', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1609818228', 0, 'N', 0, '2014-06-20', NULL, NULL, 43.5539, -116.575, NULL, NULL),
('820477852', 'SACN01210', 'SACN01210', 'SACN', 'Saint Alphonsus Medical Group Iowa', 'Randall', 'H', 'Hutchings', 'MD', 'Family Practice', '', '', NULL, 'o', '211 W Iowa Ave', 'Nampa', 'Canyon', 'ID', '83686', '2084657377', '2084657397', '211 W Iowa Ave', 'Nampa', 'Canyon', 'ID', '83686', '2084657377', '2084657397', 'IDSINCLAIRL', NULL, '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1609818228', 0, 'n', 0, '2014-06-20', NULL, NULL, 43.5539, -116.575, NULL, NULL),
('820200895', 'SACN00969', 'SACN00969', 'SACN', 'Saint Alphonsus Regional Medical Center', 'Robert', 'G', 'Ingram', 'LCSW', 'Mental Health', 'Counseling', '', NULL, 'o', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083676238', '2083760285', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083676238', '2083760285', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-29', 0, 0, 0, '', '', '', '', 'HCFA|', '1427074384', 0, 'N', 0, '2014-06-13', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN00970', 'SACN00970', 'SACN', '', 'Robert', 'G', 'Ingram', 'LCSW', 'Mental Health', 'Counseling', '', NULL, 'O', '6138 Emerald Ste B', 'Boise', 'Ada', 'ID', '83704', '2083676238', NULL, '6138 Emerald Ste B', 'Boise', 'Ada', 'ID', '83704', '2083676238', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-29', 0, 0, 0, '', '', '', '', 'HCFA|', '1427074384', 0, 'N', 0, '2014-06-13', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN00971', 'SACN00971', 'SACN', '', 'Robert', 'G', 'Ingram', 'LCSW', 'Mental Health', 'Counseling', '', NULL, 'B', 'PO Box 190930', 'Boise', '', 'ID', '', '2083672396', NULL, 'PO Box 190930', 'Boise', '', 'ID', '', '2083672396', '', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-03-29', 0, 0, 0, '', '', '', '', 'HCFA|', '1427074384', 0, 'Y', 0, '2014-06-13', NULL, NULL, 0, 0, NULL, NULL),
('680624385', 'SACN00772', 'SACN00772', 'SACN', 'Eagle Creek Family Medicine', 'Christa', '', 'Inzer Castillo', 'PAC', 'Physician Assistant', '', '', NULL, 'O', '1281 E Iron Eagle Dr', 'Eagle', NULL, 'ID', '83616', '2089395535', '2089395536', '1281 E Iron Eagle Dr', 'Eagle', '', 'ID', '83616', '2089395535', '2089395536', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1225282486', 0, 'N', 0, '2012-02-02', NULL, NULL, 0, 0, NULL, NULL),
('820432465', 'SACN00578', 'SACN00578', 'SACN', 'Family Care Physicians', 'James', 'S', 'Irwin', 'MD', 'Family Practice', '', '', NULL, 'B', '112 5th Ave W', 'Jerome', 'Jerome', 'ID', '83338', '2083241157', '2083243406', '112 5th Ave W', 'Jerome', 'Jerome', 'ID', '83338', '2083241157', '2083243406', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1023007465', 0, 'Y', 0, '2013-06-24', NULL, NULL, 0, 0, NULL, NULL),
('900120192', 'W12020904', 'W12020904', 'TX01', 'Center for Physical Therapy and Sports Performance', 'Linda', 'F', 'Wells', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 196', 'San Antonio', 'Bexar', 'TX', '78291', '2103401479', '2103406834', 'PO Box 196', 'San Antonio', 'Bexar', 'TX', '78291', '2103401479', '2103406834', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-01', '2014-07-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669457040', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('900120192', 'W12020903', 'W12020903', 'TX01', 'Center for Physical Therapy and Sports Performance', 'Linda', 'F', 'Wells', 'PT', 'Physical Therapy', '', '', NULL, 'O', '5917 Broadway', 'San Antonio', 'Bexar', 'TX', '78209', '2102533451', '2108235429', '5917 Broadway', 'San Antonio', 'Bexar', 'TX', '78209', '2102533451', '2108235429', 'TXORTHO', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-01', '2014-07-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669457040', 0, 'N', 0, '2014-07-18', NULL, NULL, 29.481, -98.4652, NULL, NULL),
('202630141', 'W40025052', 'W40025052', 'IDBOISTD', 'Primary Health Medical Group', 'Becky', NULL, 'Wells', 'PA', 'Family Practice', '', '', NULL, 'B', 'PO Box 191050', 'Boise', 'Ada', 'ID', '83719', '2083447799', NULL, 'PO Box 191050', 'Boise', 'Ada', 'ID', '83719', '2083447799', '          ', 'IDPRIMARY', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2013-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780617811', 0, 'N', 0, '2013-06-10', NULL, NULL, 0, 0, NULL, NULL),
('202630141', 'W40025051', 'W40025051', 'IDBOISTD', 'Primary Health Medical Group', 'Becky', NULL, 'Wells', 'PA', 'Family Practice', '', '', NULL, 'O', '6052 W State St', 'Boise', 'Ada', 'ID', '83703', '2083447799', NULL, '6052 W State St', 'Boise', 'Ada', 'ID', '83703', '2083447799', '          ', 'IDPRIMARY', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2013-03-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1780617811', 0, 'N', 0, '2013-06-10', NULL, NULL, 43.6592, -116.264, NULL, NULL),
('820425454', 'SACN00071', 'SACN00071', 'SACN', 'Boise Anesthesia, PA', 'Shelley', 'M', 'Jacks', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1679524920', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00072', 'SACN00072', 'SACN', 'Boise Anesthesia, PA', 'Shelley', 'M', 'Jacks', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1679524920', 0, 'N', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00073', 'SACN00073', 'SACN', 'Boise Anesthesia, PA', 'Shelley', 'M', 'Jacks', 'MD', 'Anesthesiology', '', '', NULL, 'o', '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', NULL, '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1679524920', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820424691', 'SACN00621', 'SACN00621', 'SACN', 'Boise Family Medicine Center', 'Eric', 'S', 'Jacobsen', 'MD', 'Family Practice', '', '', NULL, 'O', '10798 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083773368', '2083224691', '10798 W Overland Rd', 'Boise', 'Ada', 'ID', '83709', '2083773368', '2083224691', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1053405969', 0, 'N', 0, '2011-11-09', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00034', 'SACN00034', 'SACN', 'Boise Anesthesia, PA', 'Denise', 'L', 'Janicek', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083676416', '2083759530', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1477509057', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820425454', 'SACN00035', 'SACN00035', 'SACN', 'Boise Anesthesia, PA', 'Denise', 'L', 'Janicek', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, '', '', '', '', 'HCFA|UB|', '1477509057', 0, 'N', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
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('820200895', 'SACN01288', 'SACN01288', 'SACN', 'Saint Alphonsus Medical Group OB/GYN Boise Moreau Bldg ', 'Mary', 'A', 'Janowiak', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1669506531', 0, 'N', 0, '2013-08-21', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN01289', 'SACN01289', 'SACN', 'Saint Alpnonsus Medical Group OB/GYN Boise Liberty Bldg', 'Mary', 'A', 'Janowiak', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083674242', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083672229', '2083674242', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1669506531', 0, 'Y', 0, '2013-08-21', NULL, NULL, 43.6133, -116.259, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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('820477852', 'SACN01291', 'SACN01291', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'Mary', 'A', 'Janowiak', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', '6140 W Curtisian Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083677806', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1669506531', 0, 'Y', 0, '2013-08-21', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820477852', 'SACN01292', 'SACN01292', 'SACN', 'Saint Alphonsus Medical Group Womens Health', 'Mary', 'A', 'Janowiak', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'o', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083674242', '900 N Liberty Ste 204', 'Boise', 'Ada', 'ID', '83704', '2083674224', '2083674242', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1669506531', 0, 'Y', 0, '2013-08-21', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820477852', 'SACN01293', 'SACN01293', 'SACN', 'CARE Maternal/Child Health Program - Do Not Publish', 'Mary', 'A', 'Janowiak', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', '900 N Liberty St Ste 100', 'Boise', 'Ada', 'ID', '83704', '2083672126', '2083674505', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1669506531', 0, 'Y', 0, '2013-08-21', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820470661', 'SACN01688', 'SACN01688', 'SACN', 'Lifeline Chiropractic', 'Lynne', 'A', 'Jellum', 'DC', 'Chiropractic', '', '', NULL, 'O', '1627 S Orchard Ste 1', 'Boise', 'Ada', 'ID', '83705', '2083367900', NULL, '1627 S Orchard Ste 1', 'Boise', 'Ada', 'ID', '83705', '2083367900', '          ', 'IDSINCLAIRM', '', '', '0.00', '10.00', '0.00', 3, '2011-01-01', '2013-09-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144347048', 0, 'N', 0, '2013-10-31', NULL, NULL, 0, 0, NULL, NULL),
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('820425454', 'SACN00108', 'SACN00108', 'SACN', 'Boise Anesthesia, PA', 'Jason', 'P', 'Jenkins', 'MD', 'Anesthesiology', '', '', NULL, 'o', '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', NULL, '1717 Arlington Ave', 'Caldwell', 'Canyon', 'ID', '83605', '2084594641', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1942252390', 0, 'N', 0, '2012-11-01', NULL, NULL, 0, 0, NULL, NULL),
('820425454', 'SACN00109', 'SACN00109', 'SACN', 'Boise Anesthesia, PA', 'Jason', 'P', 'Jenkins', 'MD', 'Anesthesiology', '', '', NULL, 'o', '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', NULL, '3025 W Cherry Ln', 'Meridian', 'Ada', 'ID', '83642', '2083678500', '0         ', '', '', '', '58.45', '10.00', '0.00', 3, '2011-01-01', NULL, 1, 15, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1942252390', 0, 'N', 0, '2012-11-01', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('204157017', 'SACN01459', 'SACN01459', 'SACN', 'Jensen Eye Associates', 'Johanna', 'M', 'Jensen', 'MD', 'Ophthalmology', '', '', NULL, 'O', '1615 12th Ave Rd Ste A', 'Nampa', 'Canyon', 'ID', '83686', '2084673271', NULL, '1615 12th Ave Rd Ste A', 'Nampa', 'Canyon', 'ID', '83686', '2084673271', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, NULL, NULL, 'HCFA|UB|', '1770552846', 0, 'n', 0, '2011-09-21', NULL, NULL, 43.5533, -116.573, NULL, NULL),
('202630141', 'W40017250', 'W40017250', 'IDBOISTD', 'Primary Health Medical Group', 'Katie', '', 'Weller', 'CFNP', 'Family Practice', '', '', NULL, 'O', '10787 W Ustick Rd', 'Boise', 'Ada', 'ID', '83713', '2089471947', '2089471945', '10787 W Ustick Rd', 'Boise', 'Ada', 'ID', '83713', '2089471947', '2089471945', 'IDPRIMARY', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2013-03-01', '2013-04-04', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1275584534', 0, 'N', 0, '2014-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312070', 'SACN00300', 'SACN00300', 'SACN', 'Boise Valley Asthma and Allergy Clinic', 'John', 'D', 'Jeppson', 'MD', 'Allergy and Immunology', 'Pediatric Allergy and Immunology', '', NULL, 'O', '16060 Idaho Ctr Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083780080', NULL, '16060 Idaho Ctr Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083780080', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417943622', 0, 'n', 0, '2012-03-01', NULL, NULL, 43.606, -116.513, NULL, NULL),
('820312070', 'SACN00301', 'SACN00301', 'SACN', 'Boise Valley Asthma and Allergy Clinic', 'John', 'D', 'Jeppson', 'MD', 'Allergy and Immunology', 'Pediatric Allergy and Immunology', '', NULL, 'O', '2320 E Gala Ste 500', 'Meridian', 'Ada', 'ID', '83642', '2088886587', NULL, '2320 E Gala Ste 500', 'Meridian', 'Ada', 'ID', '83642', '2088886587', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417943622', 0, 'N', 0, '2013-07-02', NULL, NULL, 43.59, -116.365, NULL, NULL),
('820312070', 'SACN00302', 'SACN00302', 'SACN', 'Boise Valley Asthma and Allergy Clinic', 'John', 'D', 'Jeppson', 'MD', 'Allergy and Immunology', 'Pediatric Allergy and Immunology', '', NULL, 'O', '323 E Riverside Dr Ste 204', 'Eagle', 'Ada', 'ID', '83616', '2083780080', NULL, '323 E Riverside Dr Ste 204', 'Eagle', 'Ada', 'ID', '83616', '2083780080', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417943622', 0, 'n', 0, '2012-03-01', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('820312070', 'SACN00303', 'SACN00303', 'SACN', 'Boise Valley Asthma and Allergy Clinic', 'John', 'D', 'Jeppson', 'MD', 'Allergy and Immunology', 'Pediatric Allergy and Immunology', '', NULL, 'O', '901 N Curtis Rd Ste 100', 'Boise', 'Ada', 'ID', '83706', '2083780080', NULL, '901 N Curtis Rd Ste 100', 'Boise', 'Ada', 'ID', '83706', '2083780080', '', 'IDSINCLAIRL', 'WUSTDHCPC5', NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417943622', 0, 'n', 0, '2012-03-01', NULL, NULL, 43.6126, -116.255, NULL, NULL),
('202630141', 'W40013480', 'W40013480', 'IDBOISTD', 'Primary Health Medical Group', 'James', '', 'Weiss', 'MD', 'Family Practice', '', '', NULL, 'O', '1130 E Fairview', 'Meridian', 'Ada', 'ID', '83642', '2088889393', '2088889525', '1130 E Fairview', 'Meridian', 'Ada', 'ID', '83642', '2088889393', '2088889525', 'IDPRIMARY', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2013-03-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1598701757', 0, 'N', 0, '2013-03-01', NULL, NULL, 43.6195, -116.38, NULL, NULL),
('820316249', 'SACN00226', 'SACN00226', 'SACN', 'Nampa Radiologists PA', 'Daniel', 'J', 'Wegner', 'MD', 'Radiologist', '', '', NULL, 'B', 'PO Box 9649', 'Boise', 'Ada', 'ID', '83707', '2084728103', '2084728172', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, NULL, 0, 1, '', '', '', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1275584997', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('820316249', 'SACN00225', 'SACN00225', 'SACN', 'Nampa Radiologists PA', 'Daniel', 'J', 'Wegner', 'MD', 'Radiologist', '', '', NULL, 'O', '4403 E Flamingo', 'Nampa', 'Canyon', 'ID', '83687', '2084633000', '2082884961', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, NULL, 0, 1, '', '', '', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1275584997', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('260553931', 'SACN00291', 'SACN00291', 'SACN', 'Idaho Heart Care', 'Alex', 'C', 'Johnson', 'MD', 'Cardiology', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083674278', '2083675200', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1417081399', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.587, -116.549, NULL, NULL),
('260553931', 'SACN00292', 'SACN00292', 'SACN', 'Idaho Heart Care', 'Alex', 'C', 'Johnson', 'MD', 'Cardiology', '', '', NULL, 'O', '1818 S 10th Ave Ste 200', 'Caldwell', 'Canyon', 'ID', '83605', '2083675734', '2083675744', '1818 S 10th Ave Ste 200', 'Caldwell', 'Canyon', 'ID', '83605', '2083675734', '2083675744', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1417081399', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6538, -116.693, NULL, NULL),
('260553931', 'SACN00293', 'SACN00293', 'SACN', 'Idaho Heart Care', 'Alex', 'C', 'Johnson', 'MD', 'Cardiology', '', '', NULL, 'O', '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083678484', '2083678456', '3025 W Cherry Ln Ste 205', 'Meridian', 'Ada', 'ID', '83642', '2083678484', '2083678456', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1417081399', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('260553931', 'SACN00294', 'SACN00294', 'SACN', 'Idaho Heart Care', 'Alex', 'C', 'Johnson', 'MD', 'Cardiology', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1417081399', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('260553931', 'SACN00295', 'SACN00295', 'SACN', 'Idaho Heart Care', 'Alex', 'C', 'Johnson', 'MD', 'Cardiology', '', '', NULL, 'O', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083674278', '2083675200', '323 E Riverside Dr Ste 224', 'Eagle', 'Ada', 'ID', '83616', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1417081399', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('260553931', 'SACN00296', 'SACN00296', 'SACN', 'Idaho Heart Care', 'Alex', 'C', 'Johnson', 'MD', 'Cardiology', '', '', NULL, 'B', '3340 E Goldstone', 'Meridian', 'Ada', 'ID', '83642', '2083675170', '2083675200', '3340 E Goldstone', 'Meridian', 'Ada', 'ID', '83642', '2083675170', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1417081399', 0, 'N', 0, '2014-07-09', NULL, NULL, 0, 0, NULL, NULL),
('260553931', 'SACN00297', 'SACN00297', 'SACN', 'Idaho Heart Care', 'Alex', 'C', 'Johnson', 'MD', 'Cardiology', '', '', NULL, 'O', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', '6140 W Curtisian Ste 200', 'Boise', 'Ada', 'ID', '83704', '2083674278', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1417081399', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6151, -116.256, NULL, NULL),
('820200895', 'SACN00298', 'SACN00298', 'SACN', 'Saint Alphonsus Regional Medical Center - Reading Only', 'Alex', 'C', 'Johnson', 'MD', 'Cardiology', '', '', NULL, 'O', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', '2083675200', '1055 N Curtis', 'Boise', 'Ada', 'ID', '83706', '2083673722', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1417081399', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820200895', 'SACN00299', 'SACN00299', 'SACN', 'Saint Alphonsus Regional Medical Center - Reading Only', 'Alex', 'C', 'Johnson', 'MD', 'Cardiology', '', '', NULL, 'B', 'PO Box 190930', 'Boise', 'Ada', 'ID', '83719', '2083672130', '2083675200', 'PO Box 190930', 'Boise', 'Ada', 'ID', '83719', '2083672130', '2083675200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|', '1417081399', 0, 'Y', 0, '2014-07-09', NULL, NULL, 0, 0, NULL, NULL),
('820432465', 'SACN00868', 'SACN00868', 'SACN', 'Family Care Physicians', 'Brian', 'L', 'Johnson', 'MD', 'Family Practice', '', '', NULL, 'B', '112 5th Ave W', 'Jerome', 'Jerome', 'ID', '83338', '2083241157', '2083243406', '112 5th Ave W', 'Jerome', 'Jerome', 'ID', '83338', '2083241157', '2083243406', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1336138783', 0, 'Y', 0, '2013-06-24', NULL, NULL, 0, 0, NULL, NULL),
('820432465', 'SACN01600', 'SACN01600', 'SACN', 'Family Care Physicians', 'Elizabeth', 'J', 'Johnson', 'MD', 'Family Practice', '', '', NULL, 'B', '112 5th Ave W', 'Jerome', 'Jerome', 'ID', '83338', '2083241157', '2083243406', '112 5th Ave W', 'Jerome', 'Jerome', 'ID', '83338', '2083241157', '2083243406', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1891784245', 0, 'Y', 0, '2013-06-24', NULL, NULL, 0, 0, NULL, NULL),
('820161600', 'SACN01110', 'SACN01110', 'SACN', 'Idaho Family Physicians Inc', 'Gregory', 'W', 'Johnson', 'MD', 'Family Practice', '', '', NULL, 'O', '130 E Boise Ave', 'Boise', 'Ada', 'ID', '83706', '2083454066', NULL, '130 E Boise Ave', 'Boise', 'Ada', 'ID', '83706', '2083454066', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2011-11-07', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1508969973', 0, 'N', 0, '2013-10-16', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN01489', 'SACN01489', 'SACN', 'Saint Alphonsus  Medical Group OBGYN Boise BOGA Bldg ', 'JoAnn', 'M', 'Johnson', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5966 Curtisian', 'Boise', 'Ada', 'ID', '83704', '2083758100', '2083778163', '5966 Curtisian', 'Boise', 'Ada', 'ID', '83704', '2083758100', '2083778163', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1801842257', 0, 'N', 0, '2013-08-21', NULL, NULL, 43.6149, -116.256, NULL, NULL),
('820477852', 'SACN01490', 'SACN01490', 'SACN', 'SAMG Boise OB/GYN', 'JoAnn', 'M', 'Johnson', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5966 Curtisian', 'Boise', 'Ada', 'ID', '83704', '2083758100', NULL, '5966 Curtisian', 'Boise', 'Ada', 'ID', '83704', '2083758100', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1801842257', 0, 'N', 0, '2013-08-21', NULL, NULL, 43.6149, -116.256, NULL, NULL),
('820161600', 'SACN00173', 'SACN00173', 'SACN', 'Boise Orthopedic Clinic', 'James', 'M', 'Johnston', 'MD This Provider will terminate on July 1st', 'Orthopedic Surgery', 'Sports Medicine', '', NULL, 'O', '520 S Eagle Rd Ste 3213', 'Meridian', 'Ada', 'ID', '83642', '2088980100', NULL, '520 S Eagle Rd Ste 3213', 'Meridian', 'Ada', 'ID', '83642', '2088980100', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1114940699', 0, 'N', 0, '2012-05-31', NULL, NULL, 43.5995, -116.352, NULL, NULL),
('820161600', 'SACN00174', 'SACN00174', 'SACN', 'Boise Orthopedic Clinic', 'James', 'M', 'Johnston', 'MD This Provider will terminate on July 1st', 'Orthopedic Surgery', 'Sports Medicine', '', NULL, 'O', '703 S Americana Blvd Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083232600', NULL, '703 S Americana Blvd Ste 120', 'Boise', 'Ada', 'ID', '83702', '2083232600', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 8, '2011-01-01', '2012-07-01', 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1114940699', 0, 'N', 0, '2012-05-31', NULL, NULL, 0, 0, NULL, NULL),
('841394139', 'SACN01278', 'SACN01278', 'SACN', 'McCall Clinic', 'Arthur', 'C', 'Jones', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '1000 State St', 'McCall', 'Valley', 'ID', '83638', '2083673320', '          ', '1000 State St', 'McCall', 'Valley', 'ID', '83638', '2083673320', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1659354223', 0, 'N', 0, '2014-06-26', NULL, NULL, 44.9094, -116.11, NULL, NULL),
('841394139', 'SACN01279', 'SACN01279', 'SACN', 'Southwest Idaho ENT ', 'Arthur', 'C', 'Jones', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '900 N Liberty St Ste 400', 'Boise', 'Ada', 'ID', '83704', '2083673320', '          ', '900 N Liberty St Ste 400', 'Boise', 'Ada', 'ID', '83704', '2083673320', '          ', 'IDSINCLAIRL', 'WUSTDHCPC5', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1659354223', 0, 'N', 0, '2014-06-26', NULL, NULL, 43.6133, -116.259, NULL, NULL),
('820316249', 'SACN00224', 'SACN00224', 'SACN', 'Nampa Radiologists PA', 'Daniel', 'J', 'Wegner', 'MD', 'Radiologist', '', '', NULL, 'O', '1512 12th Ave Rd', 'Nampa', 'Canyon', 'ID', '83686', '2084635431', '2084635051', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, NULL, 0, 1, '', '', '', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1275584997', 0, 'Y', 0, '2013-02-28', NULL, NULL, 43.5537, -116.573, NULL, NULL),
('204565057', 'SACN00223', 'SACN00223', 'SACN', 'Idaho Vascular Institute PLLC', 'Daniel', 'J', 'Wegner', 'MD', 'Radiologist', '', '', NULL, 'B', 'PO Box 9649', 'Boise', 'Ada', 'ID', '83707', '2084728116', '2084728172', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, NULL, 0, 1, '', '', '', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1275584997', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('204565057', 'SACN00222', 'SACN00222', 'SACN', 'Idaho Vascular Institute', 'Daniel', 'J', 'Wegner', 'MD', 'Radiologist', '', '', NULL, 'O', '4400 E Flamingo', 'Nampa', 'Canyon', 'ID', '83687', '2082884620', '2082884629', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, NULL, 0, 1, '', '', '', 'Saint Alphonsus Medical Center Nampa', 'HCFA|UB|', '1275584997', 0, 'Y', 0, '2013-02-28', NULL, NULL, 43.5976, -116.517, NULL, NULL),
('264260933', 'ELHCA0240', 'ELHCA0240', 'TXHOUSTD', 'Houston  Women''s Care Associates', 'Tammi', NULL, 'Watson', 'NP', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 281928', 'Atlanta', 'Fulton', 'GA', '30384', '          ', NULL, 'PO Box 281928', 'Atlanta', 'Fulton', 'GA', '30384', '          ', '          ', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'The Womans Hospital of Texas', NULL, NULL, NULL, 'HCFA|UB|', '1992799381', 0, 'Y', 0, '2014-01-14', NULL, NULL, 0, 0, NULL, NULL),
('942938348', 'W40021780', 'W40021780', 'UTMH1', 'Valley Mental Health  Inc', 'Dawn', 'H', 'Watts', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'UTVMHMA', NULL, NULL, '0.00', '40.00', '0.00', 6, '2013-02-15', NULL, NULL, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1952474074', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('820514419', 'SACN00540', 'SACN00540', 'SACN', 'Horizon Health PA', 'Margaret', 'M', 'Jones', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '311 W Idaho St', 'Boise', 'Ada', 'ID', '83702', '2088882080', '2088884296', '311 W Idaho St', 'Boise', 'Ada', 'ID', '83702', '2088882080', '2088884296', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1003835042', 0, 'N', 0, '2011-12-21', NULL, NULL, 0, 0, NULL, NULL),
('820514419', 'SACN00541', 'SACN00541', 'SACN', 'Horizon Health PA', 'Margaret', 'M', 'Jones', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 4598', 'Boise', 'Ada', 'ID', '83711', '2088882080', '2088884296', 'PO Box 4598', 'Boise', 'Ada', 'ID', '83711', '2088882080', '2088884296', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', NULL, '', '', 'HCFA|UB|', '1003835042', 0, 'Y', 0, '2011-12-21', NULL, NULL, 0, 0, NULL, NULL),
('264260933', 'ELHCA0239', 'ELHCA0239', 'TXHOUSTD', 'Houston  Women''s Care Associates', 'Tammi', NULL, 'Watson', 'NP', 'Obstetrics and Gynecology', '', '', NULL, 'O', '7400 Fannin St Ste 1050', 'Houston', 'Harris', 'TX', '77054', '7137951000', '7137961087', '7400 Fannin St Ste 1050', 'Houston', 'Harris', 'TX', '77054', '7137951000', '7137961087', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'The Womans Hospital of Texas', NULL, NULL, NULL, 'HCFA|UB|', '1992799381', 0, 'Y', 0, '2014-01-14', NULL, NULL, 29.6956, -95.4009, NULL, NULL),
('942938348', 'W40006869', 'W40006869', 'UTMH1', 'Valley Mental Health  Inc', 'MARIANNE', NULL, 'WATSON', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', '5965 S 900 E Ste 430', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8012637100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'UTVMHMA', NULL, NULL, '0.00', '40.00', '0.00', 6, '2013-02-15', NULL, NULL, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1629016464', 0, 'Y', 0, '2013-02-28', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN00909', 'SACN00909', 'SACN', 'Saint Alphonsus Medical Group Garrity Family Medicine', 'Kathryn', 'A', 'Josefow', 'PA-C', 'Occupational Medicine', '', '', NULL, 'O', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', '1200 Garrity Blvd', 'Nampa', 'Canyon', 'ID', '83687', '2084669092', '2084665322', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1386616720', 0, 'N', 0, '2013-01-10', NULL, NULL, 43.587, -116.549, NULL, NULL),
('820200895', 'SACN00910', 'SACN00910', 'SACN', 'Saint Alphonsus Medical Group MHP Family Medicine', 'Kathryn', 'A', 'Josefow', 'PA-C', 'Occupational Medicine', '', '', NULL, 'O', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', '3025 W Cherry Ln Ste B', 'Meridian', 'Ada', 'ID', '83642', '2083678550', '2083678555', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1386616720', 0, 'N', 0, '2013-01-10', NULL, NULL, 43.6188, -116.431, NULL, NULL),
('820200895', 'SACN00911', 'SACN00911', 'SACN', 'Saint Alphonsus Medical Group Elm Family Medicine', 'Kathryn', 'A', 'Josefow', 'PA-C', 'Occupational Medicine', '', '', NULL, 'O', '315 E Elm St Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', '315 E Elm Ste 100', 'Caldwell', 'Canyon', 'ID', '83605', '2084597415', '2084533307', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1386616720', 0, 'N', 0, '2013-01-10', NULL, NULL, 43.6539, -116.695, NULL, NULL),
('820200895', 'SACN00912', 'SACN00912', 'SACN', 'Saint Alphonsus Medical Group Emerald Family Medicine', 'Kathryn', 'A', 'Josefow', 'PA-C', 'Occupational Medicine', '', '', NULL, 'O', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', '6533 Emerald St', 'Boise', 'Ada', 'ID', '83704', '2083674170', '2083678135', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '1386616720', 0, 'N', 0, '2013-01-10', NULL, NULL, 43.6119, -116.268, NULL, NULL),
('820312175', 'SACN00552', 'SACN00552', 'SACN', 'Idaho Emergency Physicians PA', 'Matthew', 'T', 'Judd', 'DO', 'Emergency Medicine', '', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83704', '2083221730', '2083221731', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1003934100', 0, 'N', 0, '2012-01-31', NULL, NULL, 43.6136, -116.256, NULL, NULL),
('820312175', 'SACN00553', 'SACN00553', 'SACN', 'Idaho Emergency Physicians PA', 'Matthew', 'T', 'Judd', 'DO', 'Emergency Medicine', '', '', NULL, 'O', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', '1717 Arlington', 'Caldwell', 'Canyon', 'ID', '83605', '2083221730', '2083221731', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1003934100', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00554', 'SACN00554', 'SACN', 'Idaho Emergency Physicians PA', 'Matthew', 'T', 'Judd', 'DO', 'Emergency Medicine', '', '', NULL, 'B', '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', NULL, '2963 E Copper Point Dr', 'Meridian', 'Ada', 'ID', '83642', '2083221730', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1003934100', 0, 'N', 0, '2012-01-31', NULL, NULL, 0, 0, NULL, NULL),
('820312175', 'SACN00555', 'SACN00555', 'SACN', 'Idaho Emergency Physicians PA', 'Matthew', 'T', 'Judd', 'DO', 'Emergency Medicine', '', '', NULL, 'O', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', '323 E Riverside Dr', 'Eagle', 'Ada', 'ID', '83616', '2083221730', '2083221731', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', 'West Valley Medical Center', NULL, NULL, 'HCFA|UB|', '1003934100', 0, 'N', 0, '2012-01-31', NULL, NULL, 43.6892, -116.351, NULL, NULL),
('260553931', 'SACN00967', 'SACN00967', 'SACN', 'Saint Alphonsus Medical Group Spasticity Boise', 'Vivek', '', 'Kadyan', 'MD', 'Physical Medicine and Rehabilitation', 'Rehabilitation Practitioner', '', NULL, 'O', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083673000', '2083676200', '1055 N Curtis Rd', 'Boise', 'Ada', 'ID', '83706', '2083673000', '2083676200', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417950205', 0, 'Y', 0, '2014-07-09', NULL, NULL, 43.6127, -116.254, NULL, NULL),
('820444934', 'SACN00968', 'SACN00968', 'SACN', 'Boise Physical Medicine and Rehabilitation', 'Vivek', '', 'Kadyan', 'MD', 'Physical Medicine and Rehabilitation', 'Rehabilitation Practitioner', '', NULL, 'O', '1000 N Curtis Ste 202', 'Boise', 'Ada', 'ID', '83706', '2083773435', '2083773147', '1000 N Curtis Ste 202', 'Boise', 'Ada', 'ID', '83706', '2083773435', '2083773147', 'IDSINCLAIRL', NULL, NULL, '0.00', '15.00', '0.00', 3, '2011-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1417950205', 0, 'N', 0, '2012-12-05', NULL, NULL, 0, 0, NULL, NULL),
('820200895', 'SACN00336', 'SACN00336', 'SACN', 'Saint Alphonsus Medical Group OB/GYN Boise BOGA Bldg', 'Darrell', 'J', 'Ludders', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5966 Curtisian', 'Boise', 'Ada', 'ID', '83704', '2083758100', '2083778163', '5966 Curtisian', 'Boise', 'Ada', 'ID', '83704', '2083758100', '2083778163', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2013-08-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|', '1548214927', 0, 'N', 0, '2013-10-23', NULL, NULL, 43.6149, -116.256, NULL, NULL),
('820477852', 'SACN00337', 'SACN00337', 'SACN', 'SAMG Boise OB/GYN', 'Darrell', 'J', 'Ludders', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '520 S Eagle Rd Ste 1233', 'Meridian', 'Ada', 'ID', '83642', '2083758100', NULL, '520 S Eagle Rd Ste 1233', 'Meridian', 'Ada', 'ID', '83642', '2083758100', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2011-12-01', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548214927', 0, 'N', 0, '2013-10-23', NULL, NULL, 43.5995, -116.352, NULL, NULL),
('820477852', 'SACN00338', 'SACN00338', 'SACN', 'SAMG Boise OB/GYN', 'Darrell', 'J', 'Ludders', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5966 Curtisian', 'Boise', 'Ada', 'ID', '83704', '2083758100', NULL, '5966 Curtisian', 'Boise', 'Ada', 'ID', '83704', '2083758100', '          ', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-04-03', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1548214927', 0, 'N', 0, '2013-10-23', NULL, NULL, 43.6149, -116.256, NULL, NULL),
('260553931', 'SACN00856', 'SACN00856', 'SACN', 'Saint Alphonsus Medical Group Heart Care Boise', 'J Antonio', 'G', 'Lopez', 'MD', 'Cardiology', '', '', NULL, 'O', '1070 N Curtis Ste 125', 'Boise', 'Ada', 'ID', '83706', '2083771415', '2083753451', '1070 N Curtis Ste 125', 'Boise', 'Ada', 'ID', '83706', '2083771415', '2083753451', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1326011503', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.6141, -116.253, NULL, NULL),
('260553931', 'SACN00857', 'SACN00857', 'SACN', 'Saint Alphonsus Medical Group Heart Care Emmett', 'J Antonio', 'G', 'Lopez', 'MD', 'Cardiology', '', '', NULL, 'O', '1202 E Locust St', 'Emmett', 'Gem', 'ID', '83617', '2083771415', '2083753451', '1202 E Locust St', 'Emmett', 'Gem', 'ID', '83617', '2083771415', '2083753451', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', NULL, 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1326011503', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.8791, -116.485, NULL, NULL),
('260553931', 'SACN00858', 'SACN00858', 'SACN', 'Saint Alphonsus Medical Group Heart Care', 'J Antonio', 'G', 'Lopez', 'MD', 'Cardiology', '', '', NULL, 'O', '520 S Eagle Rd Ste 2205', 'Meridian', 'Ada', 'ID', '83642', '2088840036', '2088843805', '520 S Eagle Rd Ste 2205', 'Meridian', 'Ada', 'ID', '83642', '2088840036', '2088843805', 'IDSINCLAIRL', '', '', '0.00', '15.00', '0.00', 6, '2011-01-01', '2012-01-06', 0, 0, 0, 'Saint Alphonsus Regional Medical Center', '', '', '', 'HCFA|UB|', '1326011503', 0, 'N', 0, '2014-07-09', NULL, NULL, 43.5995, -116.352, NULL, NULL),
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