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
('363317058', 'W12043179', 'W12043179', 'ILCHIGSTD', 'Access St Francis Health Center ', 'Tiy', 'N', 'Smith', 'MD', 'Pediatrics', '', '', NULL, 'O', '7464 N Clark St', 'Chicago', 'Cook', 'IL', '60626', '7733818700', NULL, '7464 N Clark St', 'Chicago', 'Cook', 'IL', '60626', '7733818700', '          ', 'CHIG514', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1972687747', 0, 'N', 0, '2014-01-10', NULL, NULL, 42.0173, -87.6755, NULL, NULL),
('363317058', 'W12043180', 'W12043180', 'ILCHIGSTD', 'Access Grand Boulevard Family and Specialty Health Center  ', 'Barbara', '', 'Spoerry', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5401 S Wentworth', 'Chicago', 'Cook', 'IL', '60609', '7732886900', NULL, '5401 S Wentworth', 'Chicago', 'Cook', 'IL', '60609', '7732886900', '          ', 'CHIG514', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275511925', 0, 'Y', 0, '2014-01-10', NULL, NULL, 41.7964, -87.6305, NULL, NULL),
('363317058', 'W12043181', 'W12043181', 'ILCHIGSTD', 'Access Grand Boulevard Family and Specialty Health Center  ', 'Shirley', '', 'Stephenson', 'NP', 'Family Practice', '', '', NULL, 'O', '5401 S Wentworth', 'Chicago', 'Cook', 'IL', '60609', '7732886900', '          ', '5401 S Wentworth', 'Chicago', 'Cook', 'IL', '60609', '7732886900', '          ', 'CHIG514', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-01-01', '2014-04-07', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1225330061', 0, 'Y', 0, '2014-04-08', NULL, NULL, 41.7964, -87.6305, NULL, NULL),
('363317058', 'W12043182', 'W12043182', 'ILCHIGSTD', 'Access Des Plaines Valley Health Center', 'Valerie', '', 'Stout', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '7450 W 63rd St', 'Summit Argo', 'Cook', 'IL', '60501', '7084580757', NULL, '7450 W 63rd St', 'Summit Argo', 'Cook', 'IL', '60501', '7084580757', '          ', 'CHIG514', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1104844885', 0, 'Y', 0, '2014-01-10', NULL, NULL, 41.7772, -87.8069, NULL, NULL),
('363317058', 'W12043183', 'W12043183', 'ILCHIGSTD', 'Access Genesis Family Health Center ', 'Beth', '', 'Sum', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1 N Broadway', 'Des Plaines', 'Cook', 'IL', '60016', '8472983150', NULL, '1 N Broadway', 'Des Plaines', 'Cook', 'IL', '60016', '8472983150', '          ', 'CHIG514', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780643734', 0, 'Y', 0, '2014-01-10', NULL, NULL, 42.0513, -87.9094, NULL, NULL),
('363317058', 'W12043184', 'W12043184', 'ILCHIGSTD', 'Access Ashland Health Center', 'Alethia', '', 'Swanson', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5159 S Ashland Ave', 'Chicago', 'Cook', 'IL', '60609', '7734349216', NULL, '5159 S Ashland Ave', 'Chicago', 'Cook', 'IL', '60609', '7734349216', '          ', 'CHIG514', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1205140019', 0, 'Y', 0, '2014-01-10', NULL, NULL, 41.8003, -87.6646, NULL, NULL),
('363317058', 'W12043185', 'W12043185', 'ILCHIGSTD', 'Access Northwest Community', 'Erwin', '', 'Szela', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '675 W Central Rd Ste 101', 'Arlington Heights', 'Cook', 'IL', '60005', '8473421554', NULL, '675 W Central Rd Ste 101', 'Arlington Heights', 'Cook', 'IL', '60005', '8473421554', '          ', 'CHIG514', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1932171949', 0, 'N', 0, '2014-01-10', NULL, NULL, 42.0665, -87.9909, NULL, NULL),
('363317058', 'W12043186', 'W12043186', 'ILCHIGSTD', 'Access Family Health Society', 'April', '', 'Szymanski', 'NP', 'Family Practice', '', '', NULL, 'O', '152 W Lincoln Hwy', 'Chicago Heights', 'Cook', 'IL', '60411', '7087549687', NULL, '152 W Lincoln Hwy', 'Chicago Heights', 'Cook', 'IL', '60411', '7087549687', '          ', 'CHIG514', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1942435821', 0, 'N', 0, '2014-01-10', NULL, NULL, 41.506, -87.6475, NULL, NULL),
('621762570', 'W12042971', 'W12042971', 'UT01', 'Ashley Valley Physician Practice', 'Alec', '', 'Rimmasch', 'FNP', 'Family Practice', '', '', NULL, 'O', '175 N 100 W Ste 104', 'Vernal', 'Uintah', 'UT', '84078', '4357813053', '4357813055', '175 N 100 W Ste 104', 'Vernal', 'Uintah', 'UT', '84078', '4357813053', '4357813055', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1013346634', 0, 'N', 0, '2014-06-27', NULL, NULL, 0, 0, NULL, NULL),
('820513481', 'W12043188', 'W12043188', 'ID02', 'Hollingshead Eye Center', 'Daniel', 'D', 'Schrempp', 'OD', 'Optometry', '', '', NULL, 'O', '360 E Mallard Dr Ste 110', 'Boise', 'Ada', 'ID', '83706', '2083368700', '2084260902', '360 E Mallard Dr Ste 110', 'Boise', 'Ada', 'ID', '83706', '2083368700', '2084260902', 'IDACN', '', '', '0.00', '15.00', '0.00', 6, '2013-12-16', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1396070470', 0, 'N', 0, '2014-02-18', NULL, NULL, 0, 0, NULL, NULL),
('271789847', 'W12043189', 'W12043189', 'ID02', 'Ontario Emergency Specialists', 'Morris', '', 'Smith', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '6500 Bowden Rd Ste 100', 'Jacksonville', 'Duval', 'FL', '32216', '9048051219', '0000000000', '6500 Bowden Rd Ste 100', 'Jacksonville', 'Duval', 'FL', '32216', '9048051219', '0000000000', 'IDACN', '', '', '0.00', '15.00', '0.00', 8, '2013-07-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA', '1487911877', 0, 'N', 0, '2014-01-13', NULL, NULL, 0, 0, NULL, NULL),
('271789847', 'W12043190', 'W12043190', 'ID02', 'Ontario Emergency Specialists', 'Nancy', '', 'Tate', 'PA-C', 'Emergency Medicine', '', '', NULL, 'B', '6500 Bowden Rd Ste 100', 'Jacksonville', 'Duval', 'FL', '32216', '9048051219', '0000000000', '6500 Bowden Rd Ste 100', 'Jacksonville', 'Duval', 'FL', '32216', '9048051219', '0000000000', 'IDACN', '', '', '0.00', '15.00', '0.00', 8, '2013-07-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA', '1023392636', 0, 'N', 0, '2014-01-13', NULL, NULL, 0, 0, NULL, NULL),
('271789847', 'W12043191', 'W12043191', 'ID02', 'Ontario Emergency Specialists', 'Harold', 'K', 'Thompson', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '6500 Bowden Rd Ste 100', 'Jacksonville', 'Duval', 'FL', '32216', '9048051219', '0000000000', '6500 Bowden Rd Ste 100', 'Jacksonville', 'Duval', 'FL', '32216', '9048051219', '0000000000', 'IDACN', '', '', '0.00', '15.00', '0.00', 8, '2013-07-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA', '1336185073', 0, 'N', 0, '2014-01-13', NULL, NULL, 0, 0, NULL, NULL),
('271789847', 'W12043192', 'W12043192', 'ID02', 'Ontario Emergency Specialists', 'Jason', 'L', 'Wilhelmsen', 'MD', 'Emergency Medicine', '', '', NULL, 'B', '6500 Bowden Rd Ste 100', 'Jacksonville', 'Duval', 'FL', '32216', '9048051219', '0000000000', '6500 Bowden Rd Ste 100', 'Jacksonville', 'Duval', 'FL', '32216', '9048051219', '0000000000', 'IDACN', '', '', '0.00', '15.00', '0.00', 8, '2013-07-01', NULL, 0, 0, 1, 'West Valley Medical Center', NULL, NULL, NULL, 'HCFA', '1912964404', 0, 'N', 0, '2014-01-20', NULL, NULL, 0, 0, NULL, NULL),
('271789847', 'W12043193', 'W12043193', 'ID02', 'Ontario Emergency Specialists', 'Rick', 'L', 'Wright', 'DO', 'Emergency Medicine', '', '', NULL, 'B', '6500 Bowden Rd Ste 100', 'Jacksonville', 'Duval', 'FL', '32216', '9048051219', '0000000000', '6500 Bowden Rd Ste 100', 'Jacksonville', 'Duval', 'FL', '32216', '9048051219', '0000000000', 'IDACN', '', '', '0.00', '15.00', '0.00', 8, '2013-07-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA', '1780706283', 0, 'N', 0, '2014-01-13', NULL, NULL, 0, 0, NULL, NULL),
('931234415', 'W12043195', 'W12043195', 'ID02', 'Treasure Valley Womens Clinic', 'Raquel', 'D', 'Johnson', 'CNM', 'Certified Nurse Midwife', '', '', NULL, 'O', '1219 Sw 4th Ave Ste 2', 'Ontario', 'Malheur', 'OR', '97914', '5418892229', '5418894378', '1219 Sw 4th Ave Ste 2', 'Ontario', 'Malheur', 'OR', '97914', '5418892229', '5418894378', 'IDACN', '', '', '0.00', '15.00', '0.00', 3, '2013-12-12', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1417000308', 0, 'N', 0, '2014-06-30', NULL, NULL, 0, 0, NULL, NULL),
('000130043', 'W12043196', 'W12043196', '', 'Donny Hansen', '', '', 'Donny Hansen', '', 'Acupuncture', '', '', NULL, NULL, 'Change', 'West Jordan', 'Salt Lake', 'UT', '84084', NULL, NULL, 'Change', 'West Jordan', 'Salt Lake', 'UT', '84084', '', '', NULL, NULL, NULL, '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|DEN|', '0000130043', 0, 'N', 1, '2014-01-13', NULL, NULL, 0, 0, NULL, NULL),
('203845479', 'W12044767', 'W12044767', 'ILCHIGSTD', 'Illinois Bone and Joint Institute', 'Jan', '', 'Szatkowsk', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '9000 Waukegan Rd Ste 200', 'Morton Grove', 'Cook', 'IL', '60053', '8473753000', '8479291190', '9000 Waukegan Rd Ste 200', 'Morton Grove', 'Cook', 'IL', '60053', '8473753000', '8479291190', 'CHIG3', 'ORTHOHCPC1', '', '0.00', '40.00', '0.00', 3, '2014-01-22', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, '', '', 'HCFA|UB|', '1902813165', 0, 'N', 0, '2014-02-21', NULL, NULL, 42.043, -87.7992, NULL, NULL),
('203845479', 'W12044765', 'W12044765', 'ILCHIGSTD', 'Illinois Bone and Joint Institute', 'William', '', 'Robb', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '2923 N California Ave Ste 300', 'Chicago', 'Cook', 'IL', '60618', '7737779900', '7737775927', '2923 N California Ave Ste 300', 'Chicago', 'Cook', 'IL', '60618', '7737779900', '7737775927', 'CHIG3', 'ORTHOHCPC1', '', '0.00', '40.00', '0.00', 3, '2014-01-22', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, '', '', 'HCFA|UB|', '1336193226', 0, 'N', 0, '2014-02-21', NULL, NULL, 41.9346, -87.6977, NULL, NULL),
('203845479', 'W12044764', 'W12044764', 'ILCHIGSTD', 'Illinois Bone and Joint Institute', 'William', '', 'Robb', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '521 Greenbay Rd Ste 100', 'Wilmette', 'Cook', 'IL', '60091', '8479985680', '8479986365', '521 Greenbay Rd Ste 100', 'Wilmette', 'Cook', 'IL', '60091', '8479985680', '8479986365', 'CHIG3', 'ORTHOHCPC1', '', '0.00', '40.00', '0.00', 3, '2014-01-22', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, '', '', 'HCFA|UB|', '1336193226', 0, 'N', 0, '2014-02-21', NULL, NULL, 42.0744, -87.7073, NULL, NULL),
('203845479', 'W12044762', 'W12044762', 'ILCHIGSTD', 'Illinois Bone and Joint Institute', 'Amy', 'J', 'Ptaszek', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '521 Greenbay Rd Ste 100', 'Wilmette', 'Cook', 'IL', '60091', '8479985680', '8479986365', '521 Greenbay Rd Ste 100', 'Wilmette', 'Cook', 'IL', '60091', '8479985680', '8479986365', 'CHIG3', 'ORTHOHCPC1', '', '0.00', '40.00', '0.00', 3, '2014-01-22', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, '', '', 'HCFA|UB|', '1356394951', 0, 'N', 0, '2014-02-21', NULL, NULL, 42.0744, -87.7073, NULL, NULL),
('203845479', 'W12044761', 'W12044761', 'ILCHIGSTD', 'Illinois Bone and Joint Institute', 'Amy', 'J', 'Ptaszek', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '2401 Ravine Way Ste 200', 'Glenview', 'Cook', 'IL', '60025', '8479985680', '8479986365', '2401 Ravine Way Ste 200', 'Glenview', 'Cook', 'IL', '60025', '8479985680', '8479986365', 'CHIG3', 'ORTHOHCPC1', '', '0.00', '40.00', '0.00', 3, '2014-01-22', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, '', '', 'HCFA|UB|', '1356394951', 0, 'N', 0, '2014-02-21', NULL, NULL, 42.1019, -87.8102, NULL, NULL),
('203845479', 'W12044758', 'W12044758', 'ILCHIGSTD', 'Illinois Bone and Joint Institute', 'Gregory', '', 'Portland', 'MD', 'Orthopedic Surgery', 'Sports Medicine', '', NULL, 'O', '521 Greenbay Rd Ste 100', 'Wilmette', 'Cook', 'IL', '60091', '8479985680', '8479986365', '521 Greenbay Rd Ste 100', 'Wilmette', 'Cook', 'IL', '60091', '8479985680', '8479986365', 'CHIG3', 'ORTHOHCPC1', '', '0.00', '40.00', '0.00', 3, '2014-01-22', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, '', '', 'HCFA|UB|', '1265487508', 0, 'N', 0, '2014-02-21', NULL, NULL, 42.0744, -87.7073, NULL, NULL),
('203845479', 'W12044759', 'W12044759', 'ILCHIGSTD', 'Illinois Bone and Joint Institute', 'Gregory', '', 'Portland', 'MD', 'Orthopedic Surgery', 'Sports Medicine', '', NULL, 'O', '2350 Ravine Way Ste 600', 'Glenview', 'Cook', 'IL', '60025', '8479985680', '8479986365', '2350 Ravine Way Ste 600', 'Glenview', 'Cook', 'IL', '60025', '8479985680', '8479986365', 'CHIG3', 'ORTHOHCPC1', '', '0.00', '40.00', '0.00', 3, '2014-01-22', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, '', '', 'HCFA|UB|', '1265487508', 0, 'N', 0, '2014-02-21', NULL, NULL, 42.101, -87.8102, NULL, NULL),
('203845479', 'W12044755', 'W12044755', 'ILCHIGSTD', 'Illinois Bone and Joint Institute', 'Gregory', '', 'Palutsis', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '2350 Ravine Way Ste 600', 'Glenview', 'Cook', 'IL', '60025', '8479985680', '8479986365', '2350 Ravine Way Ste 600', 'Glenview', 'Cook', 'IL', '60025', '8479985680', '8479986365', 'CHIG3', 'ORTHOHCPC1', '', '0.00', '40.00', '0.00', 3, '2014-01-22', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, '', '', 'HCFA|UB|', '1295789238', 0, 'N', 0, '2014-02-21', NULL, NULL, 42.101, -87.8102, NULL, NULL),
('203845479', 'W12044756', 'W12044756', 'ILCHIGSTD', 'Illinois Bone and Joint Institute', 'Gregory', '', 'Palutsis', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '521 Greenbay Rd Ste 100', 'Wilmette', 'Cook', 'IL', '60091', '8479985680', '8479986365', '521 Greenbay Rd Ste 100', 'Wilmette', 'Cook', 'IL', '60091', '8479985680', '8479986365', 'CHIG3', 'ORTHOHCPC1', '', '0.00', '40.00', '0.00', 3, '2014-01-22', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, '', '', 'HCFA|UB|', '1295789238', 0, 'N', 0, '2014-02-21', NULL, NULL, 42.0744, -87.7073, NULL, NULL),
('203845479', 'W12044750', 'W12044750', 'ILCHIGSTD', 'Illinois Bone and Joint Institute', 'Mark', 'M', 'Mikhael', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '521 Greenbay Rd Ste 100', 'Wilmette', 'Cook', 'IL', '60091', '8479985680', '8479986365', '521 Greenbay Rd Ste 100', 'Wilmette', 'Cook', 'IL', '60091', '8479985680', '8479986365', 'CHIG3', 'ORTHOHCPC1', '', '0.00', '40.00', '0.00', 3, '2014-01-22', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, '', '', 'HCFA|UB|', '1942309679', 0, 'N', 0, '2014-02-21', NULL, NULL, 42.0744, -87.7073, NULL, NULL),
('203845479', 'W12044751', 'W12044751', 'ILCHIGSTD', 'Illinois Bone and Joint Institute', 'Mark', 'M', 'Mikhael', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '2401 Ravine Way Ste 200', 'Glenview', 'Cook', 'IL', '60025', '8479985680', '8479986365', '2401 Ravine Way Ste 200', 'Glenview', 'Cook', 'IL', '60025', '8479985680', '8479986365', 'CHIG3', 'ORTHOHCPC1', '', '0.00', '40.00', '0.00', 3, '2014-01-22', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, '', '', 'HCFA|UB|', '1942309679', 0, 'N', 0, '2014-02-21', NULL, NULL, 42.1019, -87.8102, NULL, NULL),
('203845479', 'W12044753', 'W12044753', 'ILCHIGSTD', 'Illinois Bone and Joint Institute', 'Mark', 'M', 'Mikhael', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '2350 Ravine Way Ste 600', 'Glenview', 'Cook', 'IL', '60025', '8477244470', '8477244597', '2350 Ravine Way Ste 600', 'Glenview', 'Cook', 'IL', '60025', '8477244470', '8477244597', 'CHIG3', 'ORTHOHCPC1', '', '0.00', '40.00', '0.00', 3, '2014-01-22', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, '', '', 'HCFA|UB|', '1942309679', 0, 'N', 0, '2014-02-21', NULL, NULL, 42.101, -87.8102, NULL, NULL),
('203845479', 'W12044752', 'W12044752', 'ILCHIGSTD', 'Illinois Bone and Joint Institute', 'Mark', 'M', 'Mikhael', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1450 Busch Pkwy Ste 115', 'Buffalo Grove', 'Lake', 'IL', '60089', '2246767920', '2246767994', '1450 Busch Pkwy Ste 115', 'Buffalo Grove', 'Lake', 'IL', '60089', '2246767920', '2246767994', 'CHIG3', 'ORTHOHCPC1', '', '0.00', '40.00', '0.00', 3, '2014-01-22', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, '', '', 'HCFA|UB|', '1942309679', 0, 'N', 0, '2014-02-21', NULL, NULL, 42.1717, -87.9275, NULL, NULL),
('203845479', 'W12044747', 'W12044747', 'ILCHIGSTD', 'Illinois Bone and Joint Institute', 'Steven', 'L', 'Haddad', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '521 Greenbay Rd Ste 100', 'Wilmette', 'Cook', 'IL', '60091', '8479985680', '8479986365', '521 Greenbay Rd Ste 100', 'Wilmette', 'Cook', 'IL', '60091', '8479985680', '8479986365', 'CHIG3', 'ORTHOHCPC1', '', '0.00', '40.00', '0.00', 3, '2014-01-22', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, '', '', 'HCFA|UB|', '1003860750', 0, 'N', 0, '2014-02-21', NULL, NULL, 42.0744, -87.7073, NULL, NULL),
('203845479', 'W12044746', 'W12044746', 'ILCHIGSTD', 'Illinois Bone and Joint Institute', 'Steven', 'L', 'Haddad', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '2401 Ravine Way Ste 200', 'Glenview', 'Cook', 'IL', '60025', '8479985680', '8479986365', '2401 Ravine Way Ste 200', 'Glenview', 'Cook', 'IL', '60025', '8479985680', '8479986365', 'CHIG3', 'ORTHOHCPC1', '', '0.00', '40.00', '0.00', 3, '2014-01-22', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, '', '', 'HCFA|UB|', '1003860750', 0, 'N', 0, '2014-02-21', NULL, NULL, 42.1019, -87.8102, NULL, NULL),
('203845479', 'W12044744', 'W12044744', 'ILCHIGSTD', 'Illinois Bone and Joint Institute', 'Carla', 'O', 'Gamez', 'DPM', 'Podiatry', '', '', NULL, 'O', '2401 Ravine Way Ste 200', 'Glenview', 'Cook', 'IL', '60025', '8479985680', '8479986365', '2401 Ravine Way Ste 200', 'Glenview', 'Cook', 'IL', '60025', '8479985680', '8479986365', 'CHIG3', 'ORTHOHCPC1', '', '0.00', '40.00', '0.00', 3, '2014-01-22', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, '', '', 'HCFA|UB|', '1346287653', 0, 'N', 0, '2014-02-21', NULL, NULL, 42.1019, -87.8102, NULL, NULL),
('203845479', 'W12044743', 'W12044743', 'ILCHIGSTD', 'Illinois Bone and Joint Institute', 'Carla', 'O', 'Gamez', 'DPM', 'Podiatry', '', '', NULL, 'O', '521 Greenbay Rd Ste 100', 'Wilmette', 'Cook', 'IL', '60091', '8479985680', '8479986365', '521 Greenbay Rd Ste 100', 'Wilmette', 'Cook', 'IL', '60091', '8479985680', '8479986365', 'CHIG3', 'ORTHOHCPC1', '', '0.00', '40.00', '0.00', 3, '2014-01-22', NULL, 0, 0, 0, 'Presence Saint Francis Hospital', NULL, '', '', 'HCFA|UB|', '1346287653', 0, 'N', 0, '2014-02-21', NULL, NULL, 42.0744, -87.7073, NULL, NULL),
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('000010158', 'W12044715', 'W12044715', 'TXDALSTD', 'Vista Rehab Partner', '', '', 'Vista Rehab Partners', '', 'Physical Therapy', '', '', NULL, 'B', '5100 W Eldorado Pkwy Ste 102 PMB 20', 'Mckinney', 'Collin', 'TX', '75070', '9724863115', NULL, '5100 W Eldorado Pkwy Ste 102 PMB 20', 'Mckinney', 'Collin', 'TX', '75070', '9724863115', '          ', 'DME90TX', '', '', '0.00', '0.00', '82.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '0000010158', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('000010158', 'W12044523', 'W12044523', 'TXDALSTD', 'Vista Rehab Partner', '', '', 'Vista Rehab Partners', '', 'Physical Therapy', '', '', NULL, 'O', '1101 Raintree Cir Ste 150', 'Allen', 'Collin', 'TX', '75013', '2143839939', NULL, '1101 Raintree Cir Ste 150', 'Allen', 'Collin', 'TX', '75013', '2143839939', '          ', 'DME90TX', '', '', '0.00', '0.00', '82.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|', '0000010158', 0, 'Y', 0, '2014-03-10', NULL, NULL, 0, 0, NULL, NULL),
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('270852226', 'W12044646', 'W12044646', 'UT01', 'Silverton Group', 'Elizabeth ', 'A', 'Middleton', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 1249', 'Bountiful', 'Davis', 'UT', '84011', '8012962113', '8012961715', 'PO Box 1249', 'Bountiful', 'Davis', 'UT', '84011', '8012962113', '8012961715', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-04-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508010174', 0, 'N', 0, '2014-05-27', NULL, NULL, 0, 0, NULL, NULL),
('522454274', 'W12044643', 'W12044643', 'TXSATSTD', '', 'Lijuan', '', 'Tong', 'MD', 'Nephrology', '', '', NULL, 'B', 'PO Box 701543', 'San Antonio', 'Bexar', 'TX', '78270', '2102707760', '2102707767', NULL, NULL, NULL, NULL, NULL, NULL, NULL, 'TXSTD', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2014-04-03', NULL, 0, 0, NULL, 'Baptist Medical Center', NULL, '', '', 'HCFA|UB|', '1639175425', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('371625746', 'W12044682', 'W12044682', 'UT01', 'MountainStar Cardiology St Marks', 'Ashley', '', 'Majoskey', 'PA', 'Pulmonary', '', '', NULL, 'B', 'PO Box 741729', 'Atlanta', 'Fulton', 'GA', '30384', '8012663418', '8012664174', 'PO Box 741729', 'Atlanta', 'Fulton', 'GA', '30384', '8012663418', '8012664174', 'UTHCAPS', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-07-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1043561517', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
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('202220792', 'W12044631', 'W12044631', 'UT01', 'Precision EMG PLLC', 'Bryan', 'F', 'Child', 'PT', 'Physical Therapy', '', '', NULL, 'B', 'PO Box 12723', 'Ogden', 'Weber', 'UT', '84412', '8017252380', '8016755103', 'PO Box 12723', 'Ogden', 'Weber', 'UT', '84412', '8017252380', '8016755103', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639360050', 0, 'N', 0, '2014-03-14', NULL, NULL, 0, 0, NULL, NULL),
('202220792', 'W12044630', 'W12044630', 'UT01', 'Precision EMG PLLC', 'Bryan', 'F', 'Child', 'PT', 'Physical Therapy', '', '', NULL, 'O', '6360 S 3000 E Ste 210', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8017252380', '8016755103', '6360 S 3000 E Ste 210', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8017252380', '8016755103', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639360050', 0, 'N', 0, '2014-03-14', NULL, NULL, 0, 0, NULL, NULL),
('870281942', 'W12044673', 'W12044673', 'UT01', 'Brigham Medical Clinic', 'Lindee', 'P', 'Allen', 'NP', 'Family Practice', '', '', NULL, 'B', 'PO Box 719', 'Brigham City', 'Box Elder', 'UT', '84302', '4357342041', '4357238028', 'PO Box 719', 'Brigham City', 'Box Elder', 'UT', '84302', '4357342041', '4357238028', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194038489', 0, 'N', 0, '2014-03-17', NULL, NULL, 0, 0, NULL, NULL),
('452275052', 'ACC000110', 'ACC000110', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Center', '', 'Physical Therapy', '', '', NULL, 'O', '6502 W Joliet Rd  Ste B', 'Countryside', 'Cook', 'IL', '60525', '7083520547', '7083521535', '6502 W Joliet Rd  Ste B', 'Countryside', 'Cook', 'IL', '60525', '7083520547', '7083521535', '', '', '', '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1649566951', 0, 'N', 0, '2014-02-24', NULL, NULL, 0, 0, NULL, NULL),
('452275052', 'ACC000111', 'ACC000111', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Center', '', 'Physical Therapy', '', '', NULL, 'O', '781 McHenry Ave Ste C', 'Crystal Lake', 'Mchenry', 'IL', '60014', '8154557800', '8154551299', '781 McHenry Ave Ste C', 'Crystal Lake', 'Mchenry', 'IL', '60014', '8154557800', '8154551299', '', '', '', '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1649566951', 0, 'N', 0, '2014-02-24', NULL, NULL, 0, 0, NULL, NULL),
('452275052', 'ACC000109', 'ACC000109', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Center', '', 'Physical Therapy', '', '', NULL, 'O', '511 E Hawley St Ste 100', 'Mundelein', 'Lake', 'IL', '60060', '8479707099', '8479707719', '511 E Hawley St Ste 100', 'Mundelein', 'Lake', 'IL', '60060', '8479707099', '8479707719', '', '', '', '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1649566951', 0, 'N', 0, '2014-02-24', NULL, NULL, 0, 0, NULL, NULL),
('452275052', 'ACC000116', 'ACC000116', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Center', '', 'Physical Therapy', '', '', NULL, 'O', '510 Auburn Dr  Ste B', 'Island Lake', 'Lake', 'IL', '60042', '8474874609', '8474874917', '510 Auburn Dr  Ste B', 'Island Lake', 'Lake', 'IL', '60042', '8474874609', '8474874917', '', '', '', '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1649566951', 0, 'N', 0, '2014-02-24', NULL, NULL, 0, 0, NULL, NULL),
('452275052', 'ACC000114', 'ACC000114', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Center', '', 'Physical Therapy', '', '', NULL, 'O', '300 S State St', 'Marengo', 'Mchenry', 'IL', '60152', '8155684550', '8155685071', '300 S State St', 'Marengo', 'Mchenry', 'IL', '60152', '8155684550', '8155685071', '', '', '', '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1649566951', 0, 'N', 0, '2014-02-24', NULL, NULL, 0, 0, NULL, NULL),
('452275052', 'ACC000113', 'ACC000113', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Center', '', 'Physical Therapy', '', '', NULL, 'O', '15 Commerce Dr Ste 106', 'Grayslake', 'Lake', 'IL', '60030', '8475487782', '8475487784', '15 Commerce Dr Ste 106', 'Grayslake', 'Lake', 'IL', '60030', '8475487782', '8475487784', '', '', '', '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1649566951', 0, 'N', 0, '2014-02-24', NULL, NULL, 0, 0, NULL, NULL),
('452275052', 'ACC000117', 'ACC000117', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Center', '', 'Physical Therapy', '', '', NULL, 'O', '2674 Washington St', 'Waukegan', 'Lake', 'IL', '60085', '8473368089', '8473368079', '2674 Washington St', 'Waukegan', 'Lake', 'IL', '60085', '8473368089', '8473368079', '', '', '', '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1649566951', 0, 'N', 0, '2014-02-24', NULL, NULL, 0, 0, NULL, NULL),
('452275052', 'ACC000112', 'ACC000112', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Center', '', 'Physical Therapy', '', '', NULL, 'O', '1294 S Route 12', 'Fox Lake', 'Lake', 'IL', '60020', '8479739440', '8479739442', '1294 S Route 12', 'Fox Lake', 'Lake', 'IL', '60020', '8479739440', '8479739442', '', '', '', '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1649566951', 0, 'N', 0, '2014-02-24', NULL, NULL, 0, 0, NULL, NULL),
('452275052', 'ACC000115', 'ACC000115', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Center', '', 'Physical Therapy', '', '', NULL, 'O', '1118 N Seminary Ave', 'Woodstock', 'Mchenry', 'IL', '60098', '8153374260', '8153374268', '1118 N Seminary Ave', 'Woodstock', 'Mchenry', 'IL', '60098', '8153374260', '8153374268', '', '', '', '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1649566951', 0, 'N', 0, '2014-02-24', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000075', 'ACC000075', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '9634 S Pulaski Rd', 'Oak Lawn', 'Cook', 'IL', '60453', '7084234800', '7084234843', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000083', 'ACC000083', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '9300 Weber Park Pl Ste 225', 'Skokie', 'Cook', 'IL', '60077', '8477796100', '8477796102', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000057', 'ACC000057', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '900 N W Moreland Ste 104', 'Lake Forest', 'Lake', 'IL', '60045', '8474335502', '8474336682', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000082', 'ACC000082', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '8814 Niles Ctr Rd', 'Skokie', 'Cook', 'IL', '60077', '8476261100', '8476261101', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000022', 'ACC000022', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '8658 S Cottage Grove Ave Ste 400', 'Chicago', 'Cook', 'IL', '60619', '7737231270', '7737231280', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000100', 'ACC000100', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '860 W 75th St Ste 108', 'Naperville', 'Dupage', 'IL', '60565', '6303574253', '6303574254', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000016', 'ACC000016', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '850 W Jackson Blvd Ste 175', 'Chicago', 'Cook', 'IL', '60607', '3124910934', '3124910935', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000073', 'ACC000073', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '8337 W Lawrence Ave', 'Norridge', 'Cook', 'IL', '60706', '7085839500', '7085839501', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000020', 'ACC000020', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '830 W Diversey Pkwy 2nd Floor', 'Chicago', 'Cook', 'IL', '60614', '7738806065', '7738806100', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000004', 'ACC000004', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '805 N Randall Rd', 'Batavia', 'Kane', 'IL', '60510', '6305935100', '6305935101', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000012', 'ACC000012', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '8 S Michigan Ave Ste 210', 'Chicago', 'Cook', 'IL', '60603', '3129804775', '3124561741', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000029', 'ACC000029', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '76 E Monroe', 'Chicago', 'Cook', 'IL', '60603', '3127262840', '3123245796', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000078', 'ACC000078', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '7225 W College Dr', 'Palos Heights', 'Cook', 'IL', '60463', '7083615355', '7083615399', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000107', 'ACC000107', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '75 Danada Square E', 'Wheaton', 'Dupage', 'IL', '60187', '6305888840', '6305888842', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000105', 'ACC000105', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '700 W Jefferson', 'Shorewood', 'Will', 'IL', '60431', '8157251666', '8157251677', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000063', 'ACC000063', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '6933 N Lincoln Ave', 'Lincolnwood', 'Cook', 'IL', '60712', '8476742294', '8476742397', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000069', 'ACC000069', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '6759 Dempster St', 'Morton Grove', 'Cook', 'IL', '60053', '8474709995', '8474709996', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000013', 'ACC000013', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '67 W Jackson Blvd', 'Chicago', 'Cook', 'IL', '60604', '3123861100', '3123861200', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000055', 'ACC000055', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '554 B Green Bay Rd', 'Kenilworth', 'Cook', 'IL', '60043', '8472563500', '8472563513', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('363819982', 'ACC000040', 'ACC000040', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '6001 W Pershing Rd', 'Cicero', 'Cook', 'Il', '60804', '7085883330', '7085883339', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000096', 'ACC000096', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '530 W N St Ste 101', 'Manhattan', 'Will', 'IL', '60442', '8154787444', '8154787447', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000021', 'ACC000021', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '5230 S Blackstone Ave', 'Chicago', 'Cook', 'IL', '60615', '7732561475', '7732561481', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000027', 'ACC000027', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '5033 N Clark St', 'Chicago', 'Cook', 'IL', '60640', '7735616716', '7735616824', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000009', 'ACC000009', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '503 Thornhill Dr ', 'Carol Stream', 'Dupage', 'IL', '60188', '6306531918', '6306531928', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000011', 'ACC000011', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '500 W Madison Ste C024', 'Chicago', 'Cook', 'IL', '60661', '3128634900', '3128634901', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000038', 'ACC000038', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '4835 N Kedzie Ave', 'Chicago', 'Cook', 'IL', '60625', '7735965500', '7735965501', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000070', 'ACC000070', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '50 E NW Hwy', 'Mount Prospect', 'Cook', 'IL', '60056', '8477189201', '8477189205', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000088', 'ACC000088', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '4700 Gilbert Ave Ste 43A', 'Western Springs', 'Cook', 'IL', '60558', '7087831044', '7087831048', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000003', 'ACC000003', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '455 W NW Hwy', 'Barrington', 'Lake', 'IL', '60010', '8473810372', '8473814529', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000104', 'ACC000104', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '467 N Weber Rd', 'Romeoville', 'Will', 'IL', '60446', '8158868771', '8158868772', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000023', 'ACC000023', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '4412 S Pulaski Rd', 'Chicago', 'Cook', 'IL', '60632', '7738473123', '7738473778', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000044', 'ACC000044', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '43 N Waukegan Rd', 'Deerfield', 'Lake', 'IL', '60015', '8474981886', '8474985090', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000065', 'ACC000065', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '4249 Lincoln Hwy', 'Matteson Olympia Fields', 'Cook', 'IL', '60461', '7084812323', '7084813311', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000101', 'ACC000101', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '412 Nelson Rd', 'New Lenox', 'Will', 'IL', '60451', '8154621333', '8154621360', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
('363819982', 'ACC000093', 'ACC000093', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '401 N Madison St', 'Joliet', 'Will', 'IL', '60435', '8147444660', '8157447471', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
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('363819982', 'ACC000059', 'ACC000059', 'ILCHIGSTD', 'Accelerated Rehabilitation Centers', '', '', 'Accelerated Rehabilitation Centers', '', 'Physical Therapy', '', '', NULL, 'O', '17045 Torrence Ave ', 'Lansing', 'Cook', 'IL', '60438', '7084183580', '7084183931', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '0.00', '95.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA| ', '1205875713', 0, 'N', 0, '2014-02-21', NULL, NULL, 0, 0, NULL, NULL),
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('820509519', 'W12044699', 'W12044699', 'ID02', 'Counseling Services of Mountain Home', 'Glenda', 'K', 'Breslin', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'O', '1355 Juniper St', 'Mountain Home', 'Elmore', 'ID', '83647', '2085874444', NULL, '1355 Juniper St', 'Mountain Home', 'Elmore', 'ID', '83647', '2085874444', '          ', '', '', '', '0.00', '35.00', '0.00', 3, '2010-04-02', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1851414809', 0, 'N', 0, '2014-02-27', NULL, NULL, 0, 0, NULL, NULL),
('201312583', 'W12044698', 'W12044698', 'ID01', 'Life Counseling Center', 'Marni', 'E', 'Perschnick', 'LMSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '112 12th Ave Rd', 'Nampa', 'Canyon', 'ID', '83686', '2084655433', NULL, '112 12th Ave Rd', 'Nampa', 'Canyon', 'ID', '83686', '2084655433', '          ', 'IDMA', '', '', '0.00', '40.00', '0.00', 6, '2014-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1205258688', 0, 'N', 0, '2014-03-10', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('870373083', 'W12044697', 'W12044697', 'UT01', 'Heart and Lung Institute of Utah', 'David', '', 'Klein', 'MD', 'Pulmonary', '', '', NULL, 'B', 'PO Box 847112', 'Dallas', 'Dallas', 'TX', '75284', '8012632370', '8012651200', 'PO Box 847112', 'Dallas', 'Dallas', 'TX', '75284', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-03-01', '2014-04-30', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1124075437', 0, 'N', 0, '2014-02-20', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W12044695', 'W12044695', 'UT01', 'Heart and Lung Institute of Utah', 'David', '', 'Klein', 'MD', 'Pulmonary', '', '', NULL, 'O', '5979 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '8012651200', '5979 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-03-01', '2014-04-30', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1124075437', 0, 'N', 0, '2014-02-20', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W12044696', 'W12044696', 'UT01', 'Heart and Lung Institute of Utah', 'David', '', 'Klein', 'MD', 'Pulmonary', '', '', NULL, 'O', '5980 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '8012651200', '5980 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-03-01', '2014-04-30', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1124075437', 0, 'N', 0, '2014-02-20', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W12044694', 'W12044694', 'UT01', 'Heart and Lung Institute of Utah', 'David', '', 'Klein', 'MD', 'Pulmonary', '', '', NULL, 'O', '3570 W 9000 S Ste 110', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012632370', '8012651200', '3570 W 9000 S Ste 110', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-03-01', '2014-04-30', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1124075437', 0, 'N', 0, '2014-02-20', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W12044692', 'W12044692', 'UT01', 'Heart and Lung Institute of Utah', 'David', '', 'Klein', 'MD', 'Pulmonary', '', '', NULL, 'O', '82 S 1100 E Ste 103', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8012632370', '8012651200', '82 S 1100 E Ste 103', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-03-01', '2014-04-30', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1124075437', 0, 'N', 0, '2014-02-20', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W12044693', 'W12044693', 'UT01', 'Heart and Lung Institute of Utah', 'David', '', 'Klein', 'MD', 'Pulmonary', '', '', NULL, 'O', '3336 S 4155 W Ste 203', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8012632370', '8012651200', '3336 S 4155 W Ste 203', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-03-01', '2014-04-30', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1124075437', 0, 'N', 0, '2014-02-20', NULL, NULL, 0, 0, NULL, NULL),
('200075829', 'W12044691', 'W12044691', 'TXSATSTD', 'San Antonio Gastroenterology Endoscopy Center ', '', '', 'San Antonio Gastroenterology Endoscopy Center', 'Group', 'Endoscopy Center', '', '', NULL, 'O', '2833 Babcock Rd Ste 120', 'San Antonio', 'Bexar', 'TX', '78229', '2102710606', NULL, '2833 Babcock Rd Ste 120', 'San Antonio', 'Bexar', 'TX', '78229', '2102710606', '          ', '', '', 'OP-1', '0.00', '100.00', '0.00', 3, '2014-02-18', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000008566', 0, 'Y', 0, '2014-02-20', NULL, NULL, 29.513, -98.5916, NULL, NULL),
('261891316', 'W12044690', 'W12044690', 'TXHOUSTD', 'Southern Texas Physicians Network Inc-501A', 'Jose', NULL, 'Quinones', 'MD', 'Pediatric Cardiology', '', '', NULL, 'M', 'Three Maryland Farms Ste 250', 'Kingwood', 'Harris', 'TX', '77339', '0000000000', '0000000000', 'Three Maryland Farms Ste 250', 'Kingwood', 'Harris', 'TX', '77339', '0000000000', '0000000000', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1689611378', 0, 'Y', 0, '2014-02-20', NULL, NULL, 0, 0, NULL, NULL),
('770701557', 'W12044689', 'W12044689', 'UT01', 'MountainStar Medical Group St Marks Hospital', 'Joshua', '', 'Ingleby', 'PA', 'Family Practice', '', '', NULL, 'B', 'PO Box 198560', 'Atlanta', 'Fulton', 'GA', '30384', '8006613365', '8015711369', 'PO Box 198560', 'Atlanta', 'Fulton', 'GA', '30384', '8006613365', '8015711369', 'UTHCAPS', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1205178571', 0, 'N', 0, '2014-04-21', NULL, NULL, 0, 0, NULL, NULL),
('770701557', 'W12044688', 'W12044688', 'UT01', 'MountainStar Jordan Family Health', 'Joshua', '', 'Ingleby', 'PA', 'Family Practice', '', '', NULL, 'O', '8846 S Redwood Rd Ste E-121', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015691999', '8015692001', '8846 S Redwood Rd Ste E-121', 'West Jordan', 'Salt Lake', 'UT', '84088', '8015691999', '8015692001', 'UTHCAPS', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1205178571', 0, 'N', 0, '2014-04-21', NULL, NULL, 0, 0, NULL, NULL),
('261891316', 'W12044686', 'W12044686', 'TXHOUSTD', 'Pediatric Heart Specialists of Houston', 'Jose', NULL, 'Quinones', 'MD', 'Pediatric Cardiology', '', '', NULL, 'O', '500 Medical Ctr Blvd Ste 210', 'Conroe', 'Montgomery', 'TX', '77304', '2815544300', '2815544355', '500 Medical Ctr Blvd Ste 210', 'Conroe', 'Montgomery', 'TX', '77304', '2815544300', '2815544355', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1689611378', 0, 'Y', 0, '2014-04-02', NULL, NULL, 30.2831, -95.4693, NULL, NULL),
('261891316', 'W12044684', 'W12044684', 'TXHOUSTD', 'Pediatric Heart Specialists of Houston', 'Jose', NULL, 'Quinones', 'MD', 'Pediatric Cardiology', '', '', NULL, 'O', '22999 US Hwy 59 N Ste 264', 'Kingwood', 'Harris', 'TX', '77339', '2815544300', '2815544355', '22999 US Hwy 59 N Ste 264', 'Kingwood', 'Harris', 'TX', '77339', '2815544300', '2815544355', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1689611378', 0, 'Y', 0, '2014-04-02', NULL, NULL, 30.048, -95.2535, NULL, NULL),
('261891316', 'W12044685', 'W12044685', 'TXHOUSTD', 'Pediatric Heart Specialists of Houston', 'Jose', NULL, 'Quinones', 'MD', 'Pediatric Cardiology', '', '', NULL, 'O', '705 S Fry Rd Ste 230', 'Katy', 'Harris', 'TX', '77450', '2815544300', '2815544355', '705 S Fry Rd Ste 230', 'Katy', 'Harris', 'TX', '77450', '2815544300', '2815544355', 'HCA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1689611378', 0, 'Y', 0, '2014-04-02', NULL, NULL, 29.7765, -95.7189, NULL, NULL),
('800701770', 'W12044679', 'W12044679', 'UT01', 'Wasatch Neurosurgery & Spine Associates at St Marks ', 'Justin', 'B', 'Hohl', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1220 E 3900 S Ste 4E', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012618507', '8012618511', '1220 E 3900 S Ste 4E', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012618507', '8012618511', 'UTHCAPS', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'St Marks Hospital', 'Lone Peak Hospital', '', '', 'HCFA|UB|', '1639371149', 0, 'N', 0, '2014-04-21', NULL, NULL, 0, 0, NULL, NULL),
('371625746', 'W12044681', 'W12044681', 'UT01', 'MountainStar Cardiology St Marks', 'Ashley', '', 'Majoskey', 'PA', 'Pulmonary', '', '', NULL, 'O', '1160 E 3900 S Ste 2000', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012663418', '8012664174', '1160 E 3900 S Ste 2000', 'Salt Lake City', 'Salt Lake', 'UT', '84124', '8012663418', '8012664174', 'UTHCAPS', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-07-01', NULL, 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1043561517', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('800701770', 'W12044678', 'W12044678', 'UT01', 'MountainStar Medical Group Neurosurgery St Marks LLC', 'Justin', 'B', 'Hohl', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 741648', 'Atlanta', 'Fulton', 'GA', '30374', '6153737490', '8012618511', 'PO Box 741648', 'Atlanta', 'Fulton', 'GA', '30374', '6153737490', '8012618511', 'UTHCAPS', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'St Marks Hospital', 'Lone Peak Hospital', '', '', 'HCFA|UB|', '1639371149', 0, 'N', 0, '2014-04-21', NULL, NULL, 0, 0, NULL, NULL),
('800701770', 'W12044677', 'W12044677', 'UT01', 'Lone Peak General Surgery', 'Justin', 'B', 'Hohl', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '74 Kimballs Ln Ste 210', 'Draper', 'Salt Lake', 'UT', '84020', '8015663062', '8015018219', '74 Kimballs Ln Ste 210', 'Draper', 'Salt Lake', 'UT', '84020', '8015663062', '8015018219', 'UTHCAPS', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'St Marks Hospital', 'Lone Peak Hospital', '', '', 'HCFA|UB', '1639371149', 0, 'N', 0, '2014-04-21', NULL, NULL, 0, 0, NULL, NULL),
('770701557', 'W12044965', 'W12044965', 'UT01', 'MountainStar Medical Group-St Marks Hospital LLC', '', '', 'HCA Urgent Care Clinics', '', 'Urgent Care', '', '', NULL, 'B', 'PO Box 198560', 'Atlanta', 'Fulton', 'GA', '30384', '8015691999', '8015692001', 'PO Box 198560', 'Atlanta', 'Fulton', 'GA', '30384', '8015691999', '8015692001', 'UTHCAPS', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-02-14', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000010141', 0, 'N', 0, '2014-02-26', NULL, NULL, 0, 0, NULL, NULL),
('800701770', 'W12044676', 'W12044676', 'UT01', 'Coral Desert Spine Center', 'Justin', 'B', 'Hohl', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '1490 E Foremaster Dr Ste 210', 'St George', 'Washington', 'UT', '84790', '4356568366', '4356568370', '1490 E Foremaster Dr Ste 210', 'St George', 'Washington', 'UT', '84790', '4356568366', '4356568370', 'UTHCAPS', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-05-01', NULL, 0, 0, 0, 'St Marks Hospital', 'Lone Peak Hospital', '', '', 'HCFA|UB|', '1639371149', 0, 'N', 0, '2014-04-21', NULL, NULL, 0, 0, NULL, NULL),
('460838055', 'W12044634', 'W12044634', 'WY01', 'The Foot Clinc', 'Eric', 'M', 'Dash', 'DPM', 'Podiatry', '', '', NULL, 'O', '2221 W Elm', 'Rawlins', 'Carbon', 'WY', '82301', '3072664415', '3074724414', '2221 W Elm', 'Rawlins', 'Carbon', 'WY', '82301', '3072664415', '3074724414', '', '', '', '0.00', '22.00', '0.00', 3, '2014-04-15', NULL, 0, 0, 0, 'Memorial Hospital of Carbon County', '', '', '', 'HCFA|', '1568710598', 0, 'N', 0, '2014-04-18', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W12044671', 'W12044671', 'WYBILLINGS', 'Billings Clinic', 'Lindsey', '', 'Sterchi', 'RD', 'Dietician', '', '', NULL, 'M', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', '0000000000', '0000000000', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', '0000000000', '0000000000', '', '', '', '0.00', '17.00', '0.00', 3, '2014-03-06', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1538350251', 0, 'N', 0, '2014-02-20', NULL, NULL, 0, 0, NULL, NULL),
('870281942', 'W12044672', 'W12044672', 'UT01', 'Brigham Medical Clinic', 'Lindee', 'P', 'Allen', 'NP', 'Family Practice', '', '', NULL, 'O', '600 W Hospital Rd', 'Brigham City', 'Box Elder', 'UT', '84302', '4357342041', '4357238028', '600 W Hospital Rd', 'Brigham City', 'Box Elder', 'UT', '84302', '4357342041', '4357238028', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1194038489', 0, 'N', 0, '2014-03-17', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W12044670', 'W12044670', 'WYBILLINGS', 'Billings Clinic', 'Lindsey', '', 'Sterchi', 'RD', 'Dietician', '', '', NULL, 'B', 'PO Box 31315', 'Billings', 'Yellowstone', 'MT', '59107', '4062382617', '0000000000', 'PO Box 31315', 'Billings', 'Yellowstone', 'MT', '59107', '4062382617', '0000000000', '', '', '', '0.00', '17.00', '0.00', 3, '2014-03-06', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1538350251', 0, 'N', 0, '2014-02-20', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W12044669', 'W12044669', 'WYBILLINGS', 'Billings Clinic - Endocrinology', 'Lindsey', '', 'Sterchi', 'RD', 'Dietician', '', '', NULL, 'O', '1045 N 30th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', '1045 N 30th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382413', '', '', '', '0.00', '17.00', '0.00', 3, '2014-03-06', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1538350251', 0, 'N', 0, '2014-02-20', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W12044667', 'W12044667', 'WYBILLINGS', 'Billings Clinic', 'Tanner', 'J', 'Rienhart', 'PA', 'Family Practice', '', '', NULL, 'M', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', '0000000000', '0000000000', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', '0000000000', '0000000000', '', '', '', '0.00', '17.00', '0.00', 3, '2014-02-17', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659654481', 0, 'N', 0, '2014-02-20', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W12044666', 'W12044666', 'WYBILLINGS', 'Billings Clinic', 'Tanner', 'J', 'Rienhart', 'PA', 'Family Practice', '', '', NULL, 'B', 'PO Box 31315', 'Billings', 'Yellowstone', 'MT', '59107', '4062382617', '0000000000', 'PO Box 31315', 'Billings', 'Yellowstone', 'MT', '59107', '4062382617', '0000000000', '', '', '', '0.00', '17.00', '0.00', 3, '2014-02-17', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659654481', 0, 'N', 0, '2014-02-20', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W12044665', 'W12044665', 'WYBILLINGS', 'Billings Clinic - Same Day Care', 'Tanner', 'J', 'Rienhart', 'PA', 'Family Practice', '', '', NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382868', '', '', '', '0.00', '17.00', '0.00', 3, '2014-02-17', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659654481', 0, 'N', 0, '2014-04-09', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W12044662', 'W12044662', 'WYBILLINGS', 'Billings Clinic', 'Dawna', 'L', 'Wells', 'PA', 'Family Practice', '', '', NULL, 'M', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', '0000000000', '0000000000', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', '0000000000', '0000000000', '', '', '', '0.00', '17.00', '0.00', 3, '2014-02-10', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669405809', 0, 'N', 0, '2014-02-20', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W12044661', 'W12044661', 'WYBILLINGS', 'Billings Clinic', 'Dawna', 'L', 'Wells', 'PA', 'Family Practice', '', '', NULL, 'B', 'PO Box 31315', 'Billings', 'Yellowstone', 'MT', '59107', '4062382617', '0000000000', 'PO Box 31315', 'Billings', 'Yellowstone', 'MT', '59107', '4062382617', '0000000000', '', '', '', '0.00', '17.00', '0.00', 3, '2014-02-10', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669405809', 0, 'N', 0, '2014-02-20', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W12044663', 'W12044663', 'WYBILLINGS', 'Billings Clinic -Family Practice', 'Dawna', 'L', 'Wells', 'PA', 'Family Practice', '', '', NULL, 'O', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382469', '801 N 29th St', 'Billings', 'Yellowstone', 'MT', '59101', '4062382501', '4062382469', '', '', '', '0.00', '17.00', '0.00', 3, '2014-02-10', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669405809', 0, 'N', 0, '2014-02-20', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W12044659', 'W12044659', 'WYBILLINGS', 'Billings Clinic', 'Mohammad', 'I', 'Khan', 'MD', 'General Surgery', '', '', NULL, 'M', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', '0000000000', '0000000000', 'PO Box 37000', 'Billings', 'Yellowstone', 'MT', '59107', '0000000000', '0000000000', '', '', '', '0.00', '17.00', '0.00', 3, '2014-02-12', '2014-06-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558506949', 0, 'N', 0, '2014-06-23', NULL, NULL, 0, 0, NULL, NULL),
('810231784', 'W12044658', 'W12044658', 'WYBILLINGS', 'Billings Clinic', 'Mohammad', 'I', 'Khan', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 31315', 'Billings', 'Yellowstone', 'MT', '59107', '4062382617', '0000000000', 'PO Box 31315', 'Billings', 'Yellowstone', 'MT', '59107', '4062382617', '0000000000', '', '', '', '0.00', '17.00', '0.00', 3, '2014-02-12', '2014-06-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558506949', 0, 'N', 0, '2014-06-23', NULL, NULL, 0, 0, NULL, NULL),
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('270852226', 'W12044645', 'W12044645', 'UT01', 'Silverton Group', 'Elizabeth ', 'A', 'Middleton', 'MD', 'Hospitalist', '', '', NULL, 'O', '8th Ave C St', 'Salt Lake City', 'Salt Lake', 'UT', '84143', '8014087100', '8012961715', '8th Ave C St', 'Salt Lake City', 'Salt Lake', 'UT', '84143', '8014087100', '8012961715', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-04-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508010174', 0, 'N', 0, '2014-05-27', NULL, NULL, 0, 0, NULL, NULL),
('742225018', 'W12044644', 'W12044644', 'TXSATSTD', '', 'Michel', 'N', 'Laham', 'MD', 'Allergy and Immunology', '', '', NULL, 'O', '1303 McCullough Ave Ste 161', 'San Antonio', 'Bexar', 'TX', '78212', '2102263500', '2102263638', '1303 McCullough Ave Ste 161', 'San Antonio', 'Bexar', 'TX', '78212', '2102263500', '2102263638', 'TXSTD', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2014-04-03', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, '', '', 'HCFA|UB|', '1306939996', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('522454274', 'W12044642', 'W12044642', 'TXSATSTD', '', 'Lijuan', '', 'Tong', 'MD', 'Nephrology', '', '', NULL, 'O', '343 W Houston St Ste 306', 'San Antonio', 'Bexar', 'TX', '78205', '2102707760', '2102707767', '343 W Houston St Ste 306', 'San Antonio', 'Bexar', 'TX', '78205', '2102707760', '2102707767', 'TXSTD', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2014-04-03', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, '', '', 'HCFA|UB|', '1639175425', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('270733049', 'W12044640', 'W12044640', 'TXHOUSTD', 'The Woodlands', 'Laura', 'S', 'Fernandes', 'MD', 'Cardiology', '', '', NULL, 'O', '1120 Medical Plaza Dr Ste 240', 'Spring', 'Montgomery', 'TX', '77380', '8325623974', '8326639378', '1120 Medical Plaza Dr Ste 240', 'Spring', 'Montgomery', 'TX', '77380', '8325623974', '8326639378', 'HOUSTON2', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-03-28', NULL, 0, 0, 0, 'Conroe Regional Medical Center', '', '', '', 'HCFA|UB|', '1811083116', 0, 'N', 0, '2014-04-25', NULL, NULL, 0, 0, NULL, NULL),
('460838055', 'W12044637', 'W12044637', 'WYT1', 'The Foot Clinc', 'Eric', 'M', 'Dash', 'DPM', 'Podiatry', '', '', NULL, 'O', '1307 W 3rd St', 'Gillette', 'Campbell', 'WY', '82716', '3072664415', '3074724414', '1307 W 3rd St', 'Gillette', 'Campbell', 'WY', '82716', '3072664415', '3074724414', '', '', '', '0.00', '22.00', '0.00', 3, '2014-04-15', NULL, 0, 0, 0, 'Memorial Hospital of Carbon County', '', '', '', 'HCFA|', '1568710598', 0, 'N', 0, '2014-04-18', NULL, NULL, 0, 0, NULL, NULL),
('460838055', 'W12044636', 'W12044636', 'WY01', 'The Foot Clinc', 'Eric', 'M', 'Dash', 'DPM', 'Podiatry', '', '', NULL, 'O', '1307 W 3rd St', 'Gillette', 'Campbell', 'WY', '82716', '3072664415', '3074724414', '1307 W 3rd St', 'Gillette', 'Campbell', 'WY', '82716', '3072664415', '3074724414', '', '', '', '0.00', '22.00', '0.00', 3, '2014-04-15', NULL, 0, 0, 0, 'Memorial Hospital of Carbon County', '', '', '', 'HCFA|', '1568710598', 0, 'N', 0, '2014-04-18', NULL, NULL, 0, 0, NULL, NULL),
('202220792', 'W12044629', 'W12044629', 'UT01', 'Precision EMG PLLC', 'Bryan', 'F', 'Child', 'PT', 'Physical Therapy', '', '', NULL, 'O', '2200 Park Ave Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8017252380', '8016755103', '2200 Park Ave Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84121', '8017252380', '8016755103', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639360050', 0, 'N', 0, '2014-03-14', NULL, NULL, 0, 0, NULL, NULL),
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('742648823', 'W12044627', 'W12044627', 'TXSATSTD', '', 'Ana', 'M', 'Ballester-Fiallo', 'MD', 'Rheumatology', '', '', NULL, 'M', 'PO Box 781089', 'San Antonio', 'Bexar', 'TX', '78278', '0000000000', '0000000000', 'PO Box 781089', 'San Antonio', 'Bexar', 'TX', '78278', '0000000000', '0000000000', 'TXSTD', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2014-03-28', NULL, 0, 0, 0, 'Baptist Medical Center', NULL, '', '', 'HCFA|UB|', '1811007412', 0, 'N', 0, '2014-02-20', NULL, NULL, 0, 0, NULL, NULL),
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('841421665', 'W12045387', 'W12045387', 'Sinclair', 'St Lukes Woodriver Anesthesia', 'John', 'S', 'Carmichael', 'CRNA', 'Nurse Anesthetist', '', '', NULL, 'O', '3982 N 2300 E', 'Filer', 'Twin Falls', 'ID', '83328', '2083266866', '2083266866', '3982 N 2300 E', 'Filer', 'Twin Falls', 'ID', '83328', '2083266866', '2083266866', '', '', '', '0.00', '14.00', '0.00', 3, '2014-03-03', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972682060', 0, 'N', 0, '2014-06-30', NULL, NULL, 0, 0, NULL, NULL),
('463266853', 'W12044613', 'W12044613', 'UT01', 'Freedom Healthcare', 'Robert', 'M', 'Stirling', 'PA', 'Family Practice', '', '', NULL, 'O', '2015 Sidewinder Dr', 'Park City', 'Summit', 'UT', '84060', '8019878800', '8018787507', '2015 Sidewinder Dr', 'Park City', 'Summit', 'UT', '84060', '8019878800', '8018787507', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295049971', 0, 'Y', 0, '2014-07-22', NULL, NULL, 40.6641, -111.496, NULL, NULL),
('463266853', 'W12044611', 'W12044611', 'UT01', 'Freedom Healthcare', 'Robert', 'M', 'Stirling', 'PA', 'Family Practice', '', '', NULL, 'O', '460 N Main St', 'Heber City', 'Wasatch', 'UT', '84032', '8019878800', '8018787507', '460 N Main St', 'Heber City', 'Wasatch', 'UT', '84032', '8019878800', '8018787507', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295049971', 0, 'Y', 0, '2014-07-22', NULL, NULL, 40.5138, -111.413, NULL, NULL),
('463266853', 'W12044612', 'W12044612', 'UT01', 'Freedom Healthcare', 'Robert', 'M', 'Stirling', 'PA', 'Family Practice', '', '', NULL, 'O', '653 N Landmark Ste E', 'Park City', 'Summit', 'UT', '84098', '8019878800', '8018787507', '653 N Landmark Ste E', 'Park City', 'Summit', 'UT', '84098', '8019878800', '8018787507', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295049971', 0, 'Y', 0, '2014-07-22', NULL, NULL, 0, 0, NULL, NULL),
('270725506', 'W12044610', 'W12044610', 'UTMH1', '', 'Amy', 'L', 'Fehlberg', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'O', '1060 E 100 S Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8012637100', NULL, '1060 E 100 S Ste 100', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8012637100', '          ', 'UTPHD', '', '', '0.00', '40.00', '0.00', 6, '2014-02-14', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1619108057', 0, 'N', 0, '2014-02-19', NULL, NULL, 40.7672, -111.861, NULL, NULL),
('200788139', 'W12044609', 'W12044609', 'TXHOUSTD', 'Geetha Subramanyam', 'Geetha', '', 'Subramanyam', 'MD', 'Family Practice', '', '', NULL, 'O', '1015 Medical Ctr Ste 1300', 'Webster', 'Harris', 'TX', '77598', '2815572527', '2815577203', '1015 Medical Ctr Ste 1300', 'Webster', 'Harris', 'TX', '77598', '2815572527', '2815577203', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-02-14', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1487625794', 0, 'N', 0, '2014-04-16', NULL, NULL, 29.5362, -95.1332, NULL, NULL),
('850232628', 'W12044608', 'W12044608', 'NM01', 'Womens Specialists of NM', 'Alison', 'W', 'Stone', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '201 Cedar St SE Ste 5640', 'Albuquerque', 'Bernalillo', 'NM', '87106', '5058436168', '5052479743', '201 Cedar St SE Ste 5640', 'Albuquerque', 'Bernalillo', 'NM', '87106', '5058436168', '5052479743', 'NMWOMENS', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-06-01', NULL, 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1346258142', 0, 'N', 0, '2014-05-28', NULL, NULL, 0, 0, NULL, NULL),
('447288243', 'W12044607', 'W12044607', 'TX01', 'Behavioral Science Associates', 'Rosemary', 'J', 'Stauber', 'PHD', 'Mental Health', 'Psychology', '', NULL, 'O', '147 W Sunset Rd', 'San Antonio', 'Bexar', 'TX', '78209', '2108283624', NULL, '147 W Sunset Rd', 'San Antonio', 'Bexar', 'TX', '78209', '2108283624', '          ', 'TXMHPHD10', '', '', '0.00', '35.00', '0.00', 3, '2014-02-12', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649382722', 0, 'N', 0, '2014-02-19', NULL, NULL, 29.5072, -98.4675, NULL, NULL),
('870576522', 'W12044606', 'W12044606', 'UT01', 'Brigham Anesthesia LLC', 'Joel', 'D', 'Gardner', 'DO', 'Anesthesiology', '', '', NULL, 'B', 'PO Box 3810', 'Salt Lake City', 'Salt Lake', 'UT', '84110', '8015946399', '8014322601', 'PO Box 3810', 'Salt Lake City', 'Salt Lake', 'UT', '84110', '8015946399', '8014322601', '', '', '', '0.00', '25.00', '0.00', 3, '2014-02-07', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1942329883', 0, 'N', 0, '2014-02-19', NULL, NULL, 0, 0, NULL, NULL),
('870576522', 'W12044605', 'W12044605', 'UT01', 'Brigham Anesthesia', 'Joel', 'D', 'Gardner', 'DO', 'Anesthesiology', '', '', NULL, 'O', '950 Medical Dr', 'Brigham City', 'Box Elder', 'UT', '84302', '8005946399', '8015427372', '950 Medical Dr', 'Brigham City', 'Box Elder', 'UT', '84302', '8005946399', '8015427372', '', '', '', '0.00', '25.00', '0.00', 3, '2014-02-07', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1942329883', 0, 'N', 0, '2014-02-20', NULL, NULL, 41.4894, -112.026, NULL, NULL),
('870340605', 'W12044604', 'W12044604', 'UT01', 'Southwest Internal Medicine', 'John', 'J', 'Powell', 'PA-C', 'Internal Medicine', '', '', NULL, 'O', '292 S 1470 E Ste 100', 'St George', 'Washington', 'UT', '84790', '4356289200', '4356738557', '292 S 1470 E Ste 100', 'St George', 'Washington', 'UT', '84790', '4356289200', '4356738557', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-02-13', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1972597946', 0, 'N', 0, '2014-02-19', NULL, NULL, 0, 0, NULL, NULL),
('870340605', 'W12044603', 'W12044603', 'UT01', 'Southwest Internal Medicine', 'Joseph', 'H', 'Woolley', 'MD', 'Internal Medicine', 'Pediatrics', '', NULL, 'O', '292 S 1470 E Ste 100', 'St George', 'Washington', 'UT', '84790', '4356289200', '4356738557', '292 S 1470 E Ste 100', 'St George', 'Washington', 'UT', '84790', '4356289200', '4356738557', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-02-13', NULL, 0, 0, 0, 'Dixie Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1780800813', 0, 'N', 0, '2014-02-19', NULL, NULL, 0, 0, NULL, NULL),
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('201730782', 'W12044596', 'W12044596', 'UT01', '', 'Laura', 'C', 'Maw', 'APRN', 'Family Practice', '', '', NULL, 'O', '2874 Parkside Dr', 'Lehi', 'Utah', 'UT', '84043', '8013616038', '8014893492', '2874 Parkside Dr', 'Lehi', 'Utah', 'UT', '84043', '8013616038', '8014893492', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-01-28', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1982661039', 0, 'N', 0, '2014-04-14', NULL, NULL, 40.4075, -111.895, NULL, NULL),
('860735726', 'W12044595', 'W12044595', 'Sinclair', 'Flagstaff Bone and Joint', 'Kevin ', '', 'ODonnell', 'DO', 'Sports Medicine', '', '', NULL, 'O', '301 S 7th St', 'Williams', 'Coconino', 'AZ', '86046', '9282136229', '0000000000', '301 S 7th St', 'Williams', 'Coconino', 'AZ', '86046', '9282136229', '0000000000', '', '', '', '0.00', '40.00', '0.00', 3, '2014-02-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114911492', 0, 'N', 0, '2014-02-19', NULL, NULL, 0, 0, NULL, NULL),
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('752536818', 'W12044572', 'W12044572', 'TXDALSTD', 'Cardiology Consultants of Texas', 'Ravi', 'C', 'Vallabhan', 'MD', 'Cardiology', '', '', NULL, 'O', '4211 Joe Ramsey Blvd Ste 108', 'Greenville', 'Hunt', 'TX', '75401', '9034087870', '9034087879', '4211 Joe Ramsey Blvd Ste 108', 'Greenville', 'Hunt', 'TX', '75401', '9034087870', '9034087879', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2014-01-10', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1184672602', 0, 'N', 0, '2014-02-19', NULL, NULL, 33.1236, -96.1232, NULL, NULL),
('752536818', 'W12044571', 'W12044571', 'TXDALSTD', 'Cardiology Consultants of Texas', 'Ravi', 'C', 'Vallabhan', 'MD', 'Cardiology', '', '', NULL, 'O', '6435 S FM 549 Ste 201', 'Rockwall', 'Rockwall', 'TX', '75032', '4698007500', '4698007510', '6435 S FM 549 Ste 201', 'Rockwall', 'Rockwall', 'TX', '75032', '4698007500', '4698007510', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2014-01-10', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1184672602', 0, 'N', 0, '2014-02-19', NULL, NULL, 32.8645, -96.4413, 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
('752536818', 'W12044573', 'W12044573', 'TXDALSTD', '', 'Ravi', 'C', 'Vallabhan', 'MD', 'Cardiology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2014-01-10', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1184672602', 0, 'N', 0, '2014-02-19', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'W12044568', 'W12044568', 'TXDALSTD', '', 'Seungjong', 'M', 'Yoo', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'PO Box 842001', 'Dallas', 'Dallas', 'TX', '75284', '9729230620', '9729380528', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2014-01-10', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', '', 'HCFA|UB|', '1598084568', 0, 'N', 0, '2014-02-19', NULL, NULL, 0, 0, NULL, NULL),
('911947573', 'W12044567', 'W12044567', 'TXDALSTD', 'MedProvider Inpatient Care Unit', 'Seungjong', 'M', 'Yoo', 'MD', 'Internal Medicine', '', '', NULL, 'O', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', '3500 Gaston Ave Roberts Tower 4th Fl', 'Dallas', 'Dallas', 'TX', '75246', '2148203000', '2148203022', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2014-01-10', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, '', '', 'HCFA|UB|', '1598084568', 0, 'N', 0, '2014-02-19', NULL, NULL, 32.7911, -96.7802, NULL, NULL),
('752536818', 'W12044564', 'W12044564', 'TXDALSTD', '', 'Manish', 'D', 'Assar', 'MD', 'Cardiac Electrophysiology Cardiology', '', '', NULL, 'B', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'PO Box 844128', 'Dallas', 'Dallas', 'TX', '75284', '8663771650', '4694675905', 'HTPN', 'TXHCPCHTPN', '', '0.00', '45.00', '0.00', 3, '2014-01-10', NULL, 0, 0, 0, 'Baylor University Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1801863634', 0, 'N', 0, '2014-02-19', NULL, NULL, 0, 0, NULL, NULL),
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('205131219', 'W12044239', 'W12044239', 'WY01', 'Wyoming Neurologic Associates', 'Allen', 'L', 'Gee', 'MD', 'Neurology', '', '', NULL, 'O', '340 W Dow', 'Sheridan', 'Sheridan', 'WY', '82801', '3075781985', '3075781938', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '', '', '', '0.00', '12.00', '0.00', 3, '2014-02-01', NULL, 0, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083793863', 0, 'N', 0, '2014-02-18', NULL, NULL, 44.8025, -106.96, NULL, NULL),
('205131219', 'W12044235', 'W12044235', 'WY01', 'Wyoming Neurologic Associates', 'Allen', 'L', 'Gee', 'MD', 'Neurology', '', '', NULL, 'O', '1401 W Fifth St', 'Sheridan', 'Sheridan', 'WY', '82801', '3076721000', '0000000000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '', '', '', '0.00', '12.00', '0.00', 3, '2014-02-01', NULL, 0, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083793863', 0, 'N', 0, '2014-02-18', NULL, NULL, 44.8074, -106.976, 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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('205131219', 'W12044233', 'W12044233', 'WY01', 'Wyoming Neurologic Associates', 'Allen', 'L', 'Gee', 'MD', 'Neurology', '', '', NULL, 'O', '1233 E Second', 'Casper', 'Natrona', 'WY', '82601', '3075777201', '0000000000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '', '', '', '0.00', '12.00', '0.00', 3, '2014-02-01', NULL, 0, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083793863', 0, 'N', 0, '2014-02-18', NULL, NULL, 42.8487, -106.309, NULL, NULL),
('820371383', 'W12044445', 'W12044445', 'ID02', 'Valley Family Health Care', 'Robert', 'E', 'Davis', 'PA', 'Family Practice', '', '', NULL, 'O', '2327 SW 4th Ave', 'Ontario', 'Malheur', 'OR', '97914', '5418892340', '5418892593', '2327 SW 4th Ave', 'Ontario', 'Malheur', 'OR', '97914', '5418892340', '5418892593', 'IDSTDPPO', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 6, '2014-04-15', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1457352486', 0, 'N', 0, '2014-04-18', NULL, NULL, 0, 0, NULL, NULL),
('205131219', 'W12044193', 'W12044193', 'WY01', 'Wyoming Neurologic Associates', 'Allen', 'L', 'Gee', 'MD', 'Neurology', '', '', NULL, 'M', '1020 13th St Ste A', 'Casper', 'Natrona', 'WY', '82601', '3072654343', '3072346339', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '', '', '', '0.00', '12.00', '0.00', 3, '2014-02-01', NULL, 0, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083793863', 0, 'N', 0, '2014-02-18', NULL, NULL, 0, 0, NULL, NULL),
('205131219', 'W12044231', 'W12044231', 'WY01', 'Wyoming Neurologic Associates', 'Allen', 'L', 'Gee', 'MD', 'Neurology', '', '', NULL, 'O', '1115 Ln 12', 'Lovell', 'Big Horn', 'WY', '82431', '3075781985', '3075781938', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '', '', '', '0.00', '12.00', '0.00', 3, '2014-02-01', NULL, 0, 0, NULL, NULL, NULL, NULL, NULL, 'HCFA|UB|', '1083793863', 0, 'N', 0, '2014-02-18', NULL, NULL, 44.8258, -108.39, NULL, NULL),
('741724391', 'W12044515', 'W12044515', 'TXSATSTD', 'CommuniCare Health Centers', 'Maria', '', 'Creticio-Garza', 'NP', 'Pediatrics', '', '', NULL, 'O', '1102 Barclay St', 'San Antonio', 'Bexar', 'TX', '78207', '2102337000', '2104341704', '1102 Barclay St', 'San Antonio', 'Bexar', 'TX', '78207', '2102337000', '2104341704', 'TXSTD', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2014-03-28', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275962508', 0, 'Y', 0, '2014-02-28', NULL, NULL, 0, 0, NULL, NULL),
('592845290', 'W12044422', 'W12044422', 'WY01', 'Care Trust IV ', '', '', 'Care Trust IV ', '', 'Infusion Agency', '', '', NULL, 'B', 'PO Box 217', 'Wynne', 'Cross', 'AR', '72396', '3072662273', '3072662207', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '', '', '', '0.00', '0.00', '0.00', 3, '2014-02-15', NULL, 0, 0, NULL, '', '', '', '', 'HCFA|UB|', '1609887108', 0, 'N', 0, '2014-02-18', NULL, NULL, 0, 0, NULL, NULL),
('820371383', 'W12044444', 'W12044444', 'ID02', 'Valley Family Health Care', 'Carlie', 'G', 'Corbin', 'NP', 'Mental Health', 'Counseling', '', NULL, 'O', '2327 SW 4th Ave', 'Ontario', 'Malheur', 'OR', '97914', '5418892340', '5418892593', '2327 SW 4th Ave', 'Ontario', 'Malheur', 'OR', '97914', '5418892340', '5418892593', 'IDSTDPPO', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 6, '2014-04-15', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1215244793', 0, 'N', 0, '2014-04-18', NULL, NULL, 0, 0, NULL, NULL),
('592845290', 'W12044421', 'W12044421', 'WY01', 'Care Trust IV ', '', '', 'Care Trust IV ', '', 'Infusion Agency', '', '', NULL, 'M', '19387 US 19 N', 'Clearwater', 'Pinellas', 'FL', '33764', '0000000000', '0000000000', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '', '', '', '0.00', '0.00', '0.00', 3, '2014-02-15', NULL, 0, 0, NULL, '', '', '', '', 'HCFA|UB|', '1609887108', 0, 'N', 0, '2014-02-18', NULL, NULL, 0, 0, NULL, NULL),
('300266566', 'W12044065', 'W12044065', 'TXSATSTD', 'Adult Cardiovascular Consultants', 'Mark', 'L', 'Canales', 'MD', 'Cardiology', '', '', NULL, 'O', '205 Hackberry', 'Pearsall', 'Frio', 'TX', '78061', '2109490304', '2109490310', '205 Hackberry', 'Pearsall', 'Frio', 'TX', '78061', '2109490304', '2109490310', 'TXSTD', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2014-03-10', NULL, 0, 0, 0, 'St Lukes Baptist Hospital', NULL, '', '', 'HCFA|UB|', '1417956533', 0, 'N', 0, '2014-04-02', NULL, NULL, 0, 0, NULL, NULL),
('205131219', 'W12044169', 'W12044169', 'WYT1', 'Wyoming Neurologic Associates', 'Valerie', '', 'Cahoon', 'PA-C', 'Neurology', '', '', NULL, 'B', 'PO Box 848389', 'Boston', 'Suffolk', 'MA', '02284', '3072654343', '3072346339', 'PO Box 848389', 'Boston', 'Suffolk', 'MA', '02284', '3072654343', '3072346339', '', '', '', '0.00', '12.00', '0.00', 3, '2014-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1982824504', 0, 'N', 0, '2014-03-17', NULL, NULL, 0, 0, NULL, NULL),
('205131219', 'W12044167', 'W12044167', 'WYT1', 'Wyoming Neurologic Associates', 'Valerie', '', 'Cahoon', 'PA-C', 'Neurology', '', '', NULL, 'O', '1020 E 2nd St Ste 100', 'Casper', 'Natrona', 'WY', '82601', '3072654343', '3072346339', '1020 E 2nd St Ste 100', 'Casper', 'Natrona', 'WY', '82601', '3072654343', '3072346339', '', '', '', '0.00', '12.00', '0.00', 3, '2014-04-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1982824504', 0, 'N', 0, '2014-03-17', NULL, NULL, 0, 0, NULL, NULL),
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('261900472', 'W12044414', 'W12044414', 'IDBOISTD', 'Idaho Skin Surgery Center', 'Jessie ', 'M', 'Zimmerman', 'PA-C', 'Dermatology', '', '', NULL, 'O', '1906 S Vista Ave', 'Boise', 'Ada', 'ID', '83705', '2084331114', '2084331115', '1906 S Vista Ave', 'Boise', 'Ada', 'ID', '83705', '2084331114', '2084331115', 'IDSTD', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2014-04-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1164851168', 0, 'N', 0, '2014-04-15', NULL, NULL, 0, 0, NULL, NULL),
('205873288', 'W12044413', 'W12044413', 'TXDALSTD', '', 'Melissa', 'K', 'DeMasi', 'CNP', 'Pediatrics', '', '', NULL, 'O', '3501 N MacArthur Blvd Ste 360', 'Irving', 'Dallas', 'TX', '75062', '9722563700', '8666306348', '3501 N MacArthur Blvd Ste 360', 'Irving', 'Dallas', 'TX', '75062', '9722563700', '8666306348', 'SPA', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-03-28', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1619981784', 0, 'Y', 0, '2014-02-28', NULL, NULL, 0, 0, NULL, NULL),
('201635551', 'W12044412', 'W12044412', 'WYT1', 'Sterling Surgical Center', '', '', 'Sterling Surgical Center', '', 'Gastroenterology', '', '', NULL, 'M', '20 Burton Hilla Dr', 'Nashville', 'Davidson', 'TN', '37215', '0000000000', '0000000000', '20 Burton Hilla Dr', 'Nashville', 'Davidson', 'TN', '37215', '0000000000', '0000000000', '', '', '5005', '0.00', '15.00', '0.00', 3, '2014-03-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1962477539', 0, 'N', 0, '2014-05-28', NULL, NULL, 0, 0, NULL, NULL),
('201635551', 'W12044411', 'W12044411', 'WYT1', 'Sterling Surgical Center', '', '', 'Sterling Surgical Center', '', 'Gastroenterology', '', '', NULL, 'O', '1441 Wilkins Cir', 'Casper', 'Natrona', 'WY', '82601', '3072332700', '3074722883', '1441 Wilkins Cir', 'Casper', 'Natrona', 'WY', '82601', '3072332700', '3074722883', '', '', '5005', '0.00', '15.00', '0.00', 3, '2014-03-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1962477539', 0, 'N', 0, '2014-05-28', NULL, NULL, 0, 0, NULL, NULL),
('201635551', 'W12044409', 'W12044409', 'WY01', 'Sterling Surgical Center', '', '', 'Sterling Surgical Center', '', 'Gastroenterology', '', '', NULL, 'O', '1441 Wilkins Cir', 'Casper', 'Natrona', 'WY', '82601', '3072332700', '3074722883', '1441 Wilkins Cir', 'Casper', 'Natrona', 'WY', '82601', '3072332700', '3074722883', '', '', '5005', '0.00', '15.00', '0.00', 3, '2014-03-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1962477539', 0, 'N', 0, '2014-05-28', NULL, NULL, 0, 0, NULL, NULL),
('364314354', 'W12044403', 'W12044403', 'ILCHIGSTD', '', 'Asim', '', 'Nisar', 'MD', 'Cardiology', '', '', NULL, 'O', '1975 Lin Lor Ln Ste 175', 'Elgin', 'Kane', 'IL', '60123', '8477170600', '8477170297', '1975 Lin Lor Ln Ste 175', 'Elgin', 'Kane', 'IL', '60123', '8477170600', '8477170297', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-02-20', '2014-05-20', 0, 0, 0, 'Presence Saint Joseph Hospital Elgin', '', '', '', 'HCFA|UB|', '1699761973', 0, 'Y', 0, '2014-05-20', NULL, NULL, 42.0373, -88.3248, NULL, NULL),
('364314354', 'W12044402', 'W12044402', 'ILCHIGSTD', '', 'Asim', '', 'Nisar', 'MD', 'Cardiology', '', '', NULL, 'O', '2971 W Algonquin Rd Ste 106', 'Algonquin', 'Mchenry', 'IL', '60102', '8478641987', '8477170297', '2971 W Algonquin Rd Ste 106', 'Algonquin', 'Mchenry', 'IL', '60102', '8478641987', '8477170297', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-02-20', '2014-05-20', 0, 0, 0, 'Presence Saint Joseph Hospital Elgin', '', '', '', 'HCFA|UB|', '1699761973', 0, 'Y', 0, '2014-05-20', NULL, NULL, 42.1757, -88.345, NULL, NULL),
('742927135', 'W12044401', 'W12044401', 'ID01', 'Mountain States Neonatology', 'James', '', 'Berger', 'MD', 'Neonatology', '', '', NULL, 'B', 'PO Box 840532', 'Dallas', 'Dallas', 'TX', '75284', '2083677610', NULL, 'PO Box 840532', 'Dallas', 'Dallas', 'TX', '75284', '2083677610', '          ', 'IDNEONATE', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2014-03-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', '', '', '', 'HCFA|UB|', '1700849676', 0, 'N', 0, '2014-02-13', NULL, NULL, 0, 0, NULL, NULL),
('742927135', 'W12044399', 'W12044399', 'ID01', 'Mountain States Neonatology', 'James', '', 'Berger', 'MD', 'Neonatology', '', '', NULL, 'O', '777 Hospital Way', 'Pocatello', 'Bannock', 'ID', '83201', '2085354591', '2085354593', '777 Hospital Way', 'Pocatello', 'Bannock', 'ID', '83201', '2085354591', '2085354593', 'IDNEONATE', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2014-03-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', '', '', '', 'HCFA|UB|', '1700849676', 0, 'N', 0, '2014-02-13', NULL, NULL, 0, 0, NULL, NULL),
('742927135', 'W12044400', 'W12044400', 'ID01', 'Mountain States Neonatology', 'James', '', 'Berger', 'MD', 'Neonatology', '', '', NULL, 'M', '4722 N 24th St Ste 150', 'Phoenix', 'Maricopa', 'AZ', '85016', '0000000000', NULL, '4722 N 24th St Ste 150', 'Phoenix', 'Maricopa', 'AZ', '85016', '0000000000', '          ', 'IDNEONATE', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 3, '2014-03-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', '', '', '', 'HCFA|UB|', '1700849676', 0, 'N', 0, '2014-02-13', NULL, NULL, 0, 0, NULL, NULL),
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('800331521', 'W12044397', 'W12044397', 'UT01', 'Wasatch Eye Specialists', 'Heather', 'M', 'Jetton', 'OD', 'Optometry', '', '', NULL, 'B', 'PO Box 932', 'Sandy', 'Salt Lake', 'UT', '84091', '8016192175', '8015539562', 'PO Box 932', 'Sandy', 'Salt Lake', 'UT', '84091', '8016192175', '8015539562', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-02-01', NULL, 0, 0, 0, 'Logan Regional Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1699742684', 0, 'N', 0, '2014-02-13', NULL, NULL, 0, 0, NULL, NULL),
('201192861', 'W12044395', 'W12044395', 'WY01', 'Cesko Family Medicine', 'David', 'R', 'Cesko', 'MD', 'Family Practice', 'Obstetrics and Gynecology', '', NULL, 'B', 'PO Box 2476', 'Cheyenne', 'Laramie', 'WY', '82003', '3073243667', '3073245591', 'PO Box 2476', 'Cheyenne', 'Laramie', 'WY', '82003', '3073243667', '3073245591', 'WY125', 'wyhcpcs', '', '0.00', '35.00', '0.00', 3, '2014-02-05', NULL, 0, 0, 0, 'Memorial Hospital of Carbon County', NULL, NULL, NULL, 'HCFA|UB|', '1497756118', 0, 'Y', 0, '2014-02-13', NULL, NULL, 0, 0, NULL, NULL),
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('371643195', 'W12044394', 'W12044394', 'UT01', 'Timpanogos Professional Services', 'Sean', 'D', 'Overton', 'MD', 'Anesthesiology', '', '', NULL, 'O', '750 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8017146387', '8017146596', '750 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8017146387', '8017146596', 'UTHCAPS', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-02-13', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB', '1659580777', 0, 'Y', 0, '2014-02-13', NULL, NULL, 40.3121, -111.714, NULL, NULL),
('371643195', 'W12044392', 'W12044392', 'UT01', 'Timpanogos Professional Services', 'Jared', 'D', 'Johnson', 'NP', 'Hospitalist', '', '', NULL, 'O', '750 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8017146387', '8017146596', '750 W 800 N', 'Orem', 'Utah', 'UT', '84057', '8017146387', '8017146596', 'UTHCAPS', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1952631103', 0, 'N', 0, '2014-02-19', NULL, NULL, 40.3121, -111.714, NULL, NULL),
('364314354', 'W12044390', 'W12044390', 'ILCHIGSTD', '', 'Neda', '', 'Zamani', 'MD', 'Cardiology', '', '', NULL, 'O', '1975 Lin Lor Ln Ste 175', 'Elgin', 'Kane', 'IL', '60123', '8477170600', '8477170297', '1975 Lin Lor Ln Ste 175', 'Elgin', 'Kane', 'IL', '60123', '8477170600', '8477170297', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-02-20', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Elgin', NULL, NULL, NULL, 'HCFA|UB|', '1811935844', 0, 'Y', 0, '2014-02-13', NULL, NULL, 42.0373, -88.3248, NULL, NULL),
('364314354', 'W12044391', 'W12044391', 'ILCHIGSTD', '', 'Neda', '', 'Zamani', 'MD', 'Cardiology', '', '', NULL, 'O', '2971 W Algonquin Rd Ste 106', 'Algonquin', 'Mchenry', 'IL', '60102', '8478641987', '8477170297', '2971 W Algonquin Rd Ste 106', 'Algonquin', 'Mchenry', 'IL', '60102', '8478641987', '8477170297', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-02-20', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Elgin', NULL, NULL, NULL, 'HCFA|UB|', '1811935844', 0, 'Y', 0, '2014-02-13', NULL, NULL, 42.1757, -88.345, NULL, NULL),
('870286381', 'W12044389', 'W12044389', 'UT01', 'Ogden Clinic', 'Enrique', 'P', 'Baires', 'MD', 'Family Practice', '', '', NULL, 'O', '5275 S 500 E Adams Ave Ste A', 'Ogden', 'Weber', 'UT', '84405', '8014753600', '8014753601', '5275 S 500 E Adams Ave Ste A', 'Ogden', 'Weber', 'UT', '84405', '8014753600', '8014753601', 'WUOGDCLIN5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2014-02-03', NULL, 0, 0, 0, 'Ogden Regional Medical Center', '', '', '', 'HCFA|UB|', '1548373400', 0, 'N', 0, '2014-02-13', NULL, NULL, 0, 0, NULL, NULL),
('364314354', 'W12044388', 'W12044388', 'ILCHIGSTD', '', 'Muhammad', '', 'Riaz', 'MD', 'Cardiology', '', '', NULL, 'O', '2971 W Algonquin Rd Ste 106', 'Algonquin', 'Mchenry', 'IL', '60102', '8478641987', '8477170297', '2971 W Algonquin Rd Ste 106', 'Algonquin', 'Mchenry', 'IL', '60102', '8478641987', '8477170297', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-02-20', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Elgin', NULL, NULL, NULL, 'HCFA|UB|', '1356433320', 0, 'Y', 0, '2014-02-13', NULL, NULL, 42.1757, -88.345, NULL, NULL),
('364314354', 'W12044387', 'W12044387', 'ILCHIGSTD', '', 'Muhammad', '', 'Riaz', 'MD', 'Cardiology', '', '', NULL, 'O', '1975 Lin Lor Ln Ste 175', 'Elgin', 'Kane', 'IL', '60123', '8477170600', '8477170297', '1975 Lin Lor Ln Ste 175', 'Elgin', 'Kane', 'IL', '60123', '8477170600', '8477170297', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-02-20', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Elgin', NULL, NULL, NULL, 'HCFA|UB|', '1356433320', 0, 'Y', 0, '2014-02-13', NULL, NULL, 42.0373, -88.3248, NULL, NULL),
('760670938', 'W12044386', 'W12044386', 'TXHOUSTD', 'Conroe Family Medicine', 'Samson', '', 'Sheih', 'MD', 'Family Practice', '', '', NULL, 'O', '690 S Loop 336 W Ste 222', 'Conroe', 'Montgomery', 'TX', '77304', '9367566661', '9367566661', '690 S Loop 336 W Ste 222', 'Conroe', 'Montgomery', 'TX', '77304', '9367566661', '9367566661', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-02-07', NULL, 0, 0, 0, 'Conroe Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB', '1700880424', 0, 'N', 0, '2014-03-04', NULL, NULL, 30.3082, -95.5079, NULL, NULL),
('942854057', 'W12045172', 'W12045172', 'UTIHC04', '', 'Sherrie', 'I', 'Hardy', 'RD', 'Dietician', '', '', NULL, 'O', '100 Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016621000', NULL, '100 Mario Capecchi Dr', 'Salt Lake City', 'Salt Lake', 'UT', '84113', '8016621000', '          ', '', '', '', '0.00', '10.00', '0.00', 8, '2013-06-19', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902164783', 0, 'N', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('760670938', 'W12044385', 'W12044385', 'TXHOUSTD', 'College Park Medicine and Conroe Family Medicine', 'Samson', '', 'Sheih', 'MD', 'Family Practice', '', '', NULL, 'O', '3115 College Park Dr Ste 106', 'Conroe', 'Montgomery', 'TX', '77385', '9362712555', '9362712557', '3115 College Park Dr Ste 106', 'Conroe', 'Montgomery', 'TX', '77385', '9362712555', '9362712557', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-02-07', '2014-02-07', 0, 0, 0, 'Conroe Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB', '1700880424', 0, 'N', 0, '2014-03-04', NULL, NULL, 30.207, -95.4643, NULL, NULL),
('760670938', 'W12044384', 'W12044384', 'TXHOUSTD', 'Conroe Family Medicine', 'Jack', '', 'Pieniazek', 'DO', 'Family Practice', '', '', NULL, 'O', '690 S Loop 336 W Ste 222', 'Conroe', 'Montgomery', 'TX', '77304', '9367566661', '9367566661', '690 S Loop 336 W Ste 222', 'Conroe', 'Montgomery', 'TX', '77304', '9367566661', '9367566661', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-02-07', NULL, 0, 0, 0, 'Conroe Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB', '1164426870', 0, 'N', 0, '2014-03-19', NULL, NULL, 30.3082, -95.5079, NULL, NULL),
('760670938', 'W12044383', 'W12044383', 'TXHOUSTD', 'College Park Medicine and Conroe Family Medicine', 'Jack', '', 'Pieniazek', 'DO', 'Family Practice', '', '', NULL, 'O', '3115 College Park Dr Ste 106', 'Conroe', 'Montgomery', 'TX', '77385', '9362712555', '9362712557', '3115 College Park Dr Ste 106', 'Conroe', 'Montgomery', 'TX', '77385', '9362712555', '9362712557', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-02-07', '2014-02-07', 0, 0, 0, 'Conroe Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB', '1164426870', 0, 'N', 0, '2014-03-19', NULL, NULL, 30.207, -95.4643, NULL, NULL),
('760670938', 'W12044381', 'W12044381', 'TXHOUSTD', 'College Park Medicine and Conroe Family Medicine', 'Eric', 'J', 'LeBouef', 'DC', 'Chiropractic', '', '', NULL, 'O', '3115 College Park Dr Ste 106', 'Conroe', 'Montgomery', 'TX', '77385', '9362712555', '9362712557', '3115 College Park Dr Ste 106', 'Conroe', 'Montgomery', 'TX', '77385', '9362712555', '9362712557', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-02-07', '2014-02-07', 0, 0, 0, '', '', '', '', 'HCFA|UB', '1720036643', 0, 'N', 0, '2014-03-04', NULL, NULL, 30.207, -95.4643, NULL, NULL),
('760670938', 'W12044382', 'W12044382', 'TXHOUSTD', 'College Park Medicine and Conroe Family Medicine', 'Pamela', '', 'O Connor', 'MD', 'Family Practice', '', '', NULL, 'O', '3115 College Park Dr Ste 106', 'Conroe', 'Montgomery', 'TX', '77385', '9362712555', '9362712557', '3115 College Park Dr Ste 106', 'Conroe', 'Montgomery', 'TX', '77385', '9362712555', '9362712557', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-02-07', '2014-02-07', 0, 0, 0, '', '', '', '', 'HCFA|UB', '1265413256', 0, 'N', 0, '2014-03-19', NULL, NULL, 30.207, -95.4643, NULL, NULL),
('760670938', 'W12044380', 'W12044380', 'TXHOUSTD', 'Conroe Family Medicine', 'Samantha', 'L', 'Hinds Campa', 'MD', 'Family Practice', '', '', NULL, 'O', '690 S Loop 336 W Ste 222', 'Conroe', 'Montgomery', 'TX', '77304', '9367566661', '9367566661', '690 S Loop 336 W Ste 222', 'Conroe', 'Montgomery', 'TX', '77304', '9367566661', '9367566661', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-02-07', NULL, 0, 0, 0, 'Conroe Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB', '1083618797', 0, 'N', 0, '2014-03-04', NULL, NULL, 30.3082, -95.5079, NULL, NULL),
('760670938', 'W12044379', 'W12044379', 'TXHOUSTD', 'Conroe Family Medicine', 'Christopher', 'C', 'Chapman', 'MD', 'Family Practice', '', '', NULL, 'O', '690 S Loop 336 W Ste 222', 'Conroe', 'Montgomery', 'TX', '77304', '9367566661', '9367566661', '690 S Loop 336 W Ste 222', 'Conroe', 'Montgomery', 'TX', '77304', '9367566661', '9367566661', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-02-07', NULL, 0, 0, 0, 'Conroe Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB', '1164426888', 0, 'N', 0, '2014-03-04', NULL, NULL, 30.3082, -95.5079, NULL, NULL),
('760670938', 'W12044378', 'W12044378', 'TXHOUSTD', 'College Park Medicine and Conroe Family Medicine', 'Christopher', 'C', 'Chapman', 'MD', 'Family Practice', '', '', NULL, 'O', '3115 College Park Dr Ste 106', 'Conroe', 'Montgomery', 'TX', '77385', '9362712555', '9362712557', '3115 College Park Dr Ste 106', 'Conroe', 'Montgomery', 'TX', '77385', '9362712555', '9362712557', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-02-07', '2014-02-07', 0, 0, 0, 'Conroe Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB', '1164426888', 0, 'N', 0, '2014-03-04', NULL, NULL, 30.207, -95.4643, NULL, NULL),
('760670938', 'W12044377', 'W12044377', 'TXHOUSTD', 'Conroe Family Medicine', '', '', 'College Park Medicine and Conroe Family Medicine', '', 'Family Practice', '', '', NULL, 'O', '690 S Loop 336 W Ste 222', 'Conroe', 'Montgomery', 'TX', '77304', '9367566661', '9367566681', '690 S Loop 336 W Ste 222', 'Conroe', 'Montgomery', 'TX', '77304', '9367566661', '9367566681', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-02-07', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB', '1295815959', 0, 'Y', 0, '2014-03-19', NULL, NULL, 30.3082, -95.5079, NULL, NULL),
('760670938', 'W12044376', 'W12044376', 'TXHOUSTD', 'College Park Medicine ', '', '', 'College Park Medicine and Conroe Family Medicine', '', 'Family Practice', '', '', NULL, 'O', '3115 College Park Dr Ste 106', 'Conroe', 'Montgomery', 'TX', '77384', '9362712555', '9362712557', '3115 College Park Dr Ste 106', 'Conroe', 'Montgomery', 'TX', '77384', '9362712555', '9362712557', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-02-07', '2014-02-07', 0, 0, 0, '', '', '', '', 'HCFA|UB', '1295815959', 0, 'Y', 0, '2014-03-19', NULL, NULL, 30.207, -95.4643, NULL, NULL),
('455185756', 'W12044373', 'W12044373', 'TXHOUSTD', 'TMHPO Institute for Reconstructive Surgery', 'Jason', '', 'Petrungaro', 'MD', 'General Surgery', '', '', NULL, 'O', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137998428', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137998428', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2014-03-31', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, '', '', 'HCFA|UB|', '1871765057', 0, 'N', 0, '2014-02-13', NULL, NULL, 0, 0, NULL, NULL),
('455185756', 'W12044374', 'W12044374', 'TXHOUSTD', 'TMHPO Institute for Reconstructive Surgery', 'Jason', '', 'Petrungaro', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 4682', 'Houston', 'Harris', 'TX', '77210', '7134416679', NULL, 'PO Box 4682', 'Houston', 'Harris', 'TX', '77210', '7134416679', '          ', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2014-03-31', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, '', '', 'HCFA|UB|', '1871765057', 0, 'N', 0, '2014-02-13', NULL, NULL, 0, 0, NULL, NULL),
('455185756', 'W12044371', 'W12044371', 'TXHOUSTD', 'TMHPO Institute for Reconstructive Surgery', 'Jacqueline', '', 'Harris', 'PA', 'General Surgery', '', '', NULL, 'B', 'PO Box 4682', 'Houston', 'Harris', 'TX', '77210', '7134416679', NULL, 'PO Box 4682', 'Houston', 'Harris', 'TX', '77210', '7134416679', '          ', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2014-03-31', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821016403', 0, 'N', 0, '2014-02-13', NULL, NULL, 0, 0, NULL, NULL),
('455185756', 'W12044368', 'W12044368', 'TXHOUSTD', 'TMHPO Institute for Reconstructive Surgery', 'Michael', '', 'Lypka', 'MD', 'Plastic Surgery', '', '', NULL, 'O', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137998428', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137998428', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2014-03-31', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, '', '', 'HCFA|UB|', '1265687719', 0, 'N', 0, '2014-02-13', NULL, NULL, 0, 0, NULL, NULL),
('455185756', 'W12044369', 'W12044369', 'TXHOUSTD', 'TMHPO Institute for Reconstructive Surgery', 'Aldona', '', 'Spiegel', 'MD', 'Plastic Surgery', '', '', NULL, 'O', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137998428', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137998428', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2014-03-31', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1114956778', 0, 'N', 0, '2014-02-13', NULL, NULL, 0, 0, NULL, NULL),
('455185756', 'W12044367', 'W12044367', 'TXHOUSTD', 'TMHPO Institute for Reconstructive Surgery', 'Michael', '', 'Klebuc', 'MD', 'Plastic Surgery', '', '', NULL, 'O', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137998428', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137998428', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2014-03-31', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1225067887', 0, 'N', 0, '2014-02-13', NULL, NULL, 0, 0, NULL, NULL),
('455185756', 'W12044366', 'W12044366', 'TXHOUSTD', 'TMHPO Institute for Reconstructive Surgery', 'Jeffrey', '', 'Friedman', 'MD', 'Plastic Surgery', '', '', NULL, 'O', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137998428', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137998428', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2014-03-31', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1942235114', 0, 'N', 0, '2014-02-13', NULL, NULL, 0, 0, NULL, NULL),
('455185756', 'W12044365', 'W12044365', 'TXHOUSTD', 'TMHPO Institute for Reconstructive Surgery', 'Carlos', '', 'Flores', 'PAC', 'Physician Assistant Certified', '', '', NULL, 'O', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137998428', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137998428', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2014-03-31', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1609856129', 0, 'Y', 0, '2014-02-13', NULL, NULL, 0, 0, NULL, NULL),
('455185756', 'W12044363', 'W12044363', 'TXHOUSTD', 'TMHPO Institute for Reconstructive Surgery', 'Warren', '', 'Ellsworth', 'MD', 'Plastic Surgery', '', '', NULL, 'O', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137998428', '6560 Fannin St Ste 2200', 'Houston', 'Harris', 'TX', '77030', '7134416106', '7137998428', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2014-03-31', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336470343', 0, 'N', 0, '2014-02-13', NULL, NULL, 0, 0, NULL, NULL),
('455185756', 'W12044362', 'W12044362', 'TXHOUSTD', 'TMHPO Institute for Reconstructive Surgery', 'Warren', '', 'Ellsworth', 'MD', 'Plastic Surgery', '', '', NULL, 'O', '18400 Katy Fwy Ste 500', 'Houston', 'Harris', 'TX', '77094', '8325228400', '8325228401', '18400 Katy Fwy Ste 500', 'Houston', 'Harris', 'TX', '77094', '8325228400', '8325228401', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2014-03-31', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336470343', 0, 'N', 0, '2014-02-13', NULL, NULL, 0, 0, NULL, NULL),
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('571201170', 'W12044352', 'W12044352', 'TXHOUSTD', 'Houston Methodist Primary Care Group', 'Bhuvana', '', 'Muthuswamy', 'MD', 'Internal Medicine', '', '', NULL, 'O', '4710 Bellaire Blvd Ste 175', 'Bellaire', 'Harris', 'TX', '77401', '7134419040', '7138388061', '4710 Bellaire Blvd Ste 175', 'Bellaire', 'Harris', 'TX', '77401', '7134419040', '7138388061', 'TMHPHOSPC', 'TXHCPCTMH', '', '0.00', '50.00', '0.00', 6, '2014-01-29', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, '', '', 'HCFA|UB|', '1588744999', 0, 'N', 0, '2014-02-13', NULL, NULL, 29.7059, -95.4605, NULL, NULL),
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('870286381', 'W12044342', 'W12044342', 'UT01', 'Ogden Clinic', 'Van', 'G', 'Christiansen', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014753500', '8014753414', '4650 Harrison Blvd', 'Ogden', 'Weber', 'UT', '84403', '8014753500', '8014753414', 'WUOGDCLIN5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2014-02-03', NULL, 0, 0, 0, 'Ogden Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1093702672', 0, 'N', 0, '2014-02-12', NULL, NULL, 41.1787, -111.949, NULL, NULL),
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('364314354', 'W12044339', 'W12044339', 'ILCHIGSTD', 'Provena Service Corporation', 'Nighat', '', 'Nisar', 'MD', 'Radiologist', '', '', NULL, 'O', '2971 W Algonquin Rd Ste 106', 'Algonquin', 'Mchenry', 'IL', '60102', '8478641987', '8477170297', '2971 W Algonquin Rd Ste 106', 'Algonquin', 'Mchenry', 'IL', '60102', '8478641987', '8477170297', 'CHIGP1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2014-02-20', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1487774782', 0, 'Y', 0, '2014-02-12', NULL, NULL, 42.1757, -88.345, NULL, NULL),
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('870767026', 'W12044333', 'W12044333', 'IDBOISTD', 'West Valley Medical Group', 'Stephanie', 'K', 'Potter', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 277976', 'Atlanta', 'Fulton', 'GA', '30384', '6153737600', '0000000000', 'PO Box 277976', 'Atlanta', 'Fulton', 'GA', '30384', '6153737600', '0000000000', 'UTHCAPS', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2014-04-01', NULL, 0, 0, 0, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB', '1609892413', 0, 'N', 0, '2014-03-10', NULL, NULL, 0, 0, NULL, NULL),
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('000010157', 'W12044711', 'W12044711', 'TXHOUSTD', 'US Physical Therapy Services', '', '', 'US Physical Therapy Services', '', 'Physical Therapy', '', '', NULL, 'O', 'Max 80 1300 W Sam Houston Pkwy Ste 300', 'Houston', 'Harris', 'TX', '77042', '7132976320', NULL, 'Max 80 1300 W Sam Houston Pkwy Ste 300', 'Houston', 'Harris', 'TX', '77042', '7132976320', '          ', 'DME90TX', '', '', '0.00', '0.00', '80.00', 3, '2014-03-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000010157', 0, 'Y', 0, '2014-03-04', NULL, NULL, 0, 0, NULL, NULL),
('450522981', 'W12044278', 'W12044278', 'WYT1', 'Powell Valley Health Care', 'Virginia', '', 'Gee', 'MPT', 'Physical Therapy', '', '', NULL, 'O', '777 Ave H', 'Cody', 'Park', 'WY', '82414', '3075781985', '3075781938', '777 Ave H', 'Cody', 'Park', 'WY', '82414', '3075781985', '3075781938', '', '', '', '0.00', '12.00', '0.00', 3, '2014-02-15', '2014-02-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1225461783', 0, 'N', 0, '2014-02-12', NULL, NULL, 0, 0, NULL, NULL),
('450522981', 'W12044277', 'W12044277', 'WY01', 'Powell Valley Health Care', 'Virginia', '', 'Gee', 'MPT', 'Physical Therapy', '', '', NULL, 'O', '777 Ave H', 'Cody', 'Park', 'WY', '82414', '3075781985', '3075781938', '777 Ave H', 'Cody', 'Park', 'WY', '82414', '3075781985', '3075781938', '', '', '', '0.00', '12.00', '0.00', 3, '2014-02-15', '2014-02-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1225461783', 0, 'N', 0, '2014-02-12', NULL, NULL, 0, 0, NULL, NULL),
('450522981', 'W12044276', 'W12044276', 'WYT1', 'West Park Hospital', 'Virginia', '', 'Gee', 'MPT', 'Physical Therapy', '', '', NULL, 'O', '707 Sheridan Ave', 'Cody', 'Park', 'WY', '82414', '3075277501', '0000000000', '707 Sheridan Ave', 'Cody', 'Park', 'WY', '82414', '3075277501', '0000000000', '', '', '', '0.00', '12.00', '0.00', 3, '2014-02-15', '2014-02-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1225461783', 0, 'N', 0, '2014-02-12', NULL, NULL, 0, 0, NULL, NULL),
('205131219', 'W12044285', 'W12044285', 'WY01', 'Wyoming Neurologic Associates', 'Virginia', '', 'Gee', 'MPT', 'Physical Therapy', '', '', NULL, 'O', '1008 13th St Ste A', 'Cody', 'Park', 'WY', '82414', '3075781985', '3075781938', '1008 13th St Ste A', 'Cody', 'Park', 'WY', '82414', '3075781985', '3075781938', '', '', '', '0.00', '12.00', '0.00', 3, '2014-02-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1225461783', 0, 'N', 0, '2014-02-25', NULL, NULL, 44.527, -109.062, NULL, NULL),
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('464171160', 'W12044119', 'W12044119', 'SACN', '', 'Thomas', 'C', 'Manning', 'MD', 'Neurosurgery', '', '', 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, '2014-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|UB|', '1861501637', 0, 'N', 0, '2014-02-10', NULL, NULL, 0, 0, NULL, NULL),
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('942854057', 'W12044114', 'W12044114', 'UTIHCPHY', 'Southern Utah Ortho Sports Med', 'Robert', 'E', 'Nakken', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '166 W 1325 N Ste 150', 'Cedar City', 'Iron', 'UT', '84720', '4355866962', '4358671663', '166 W 1325 N Ste 150', 'Cedar City', 'Iron', 'UT', '84720', '4355866962', '4358671663', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2014-01-01', NULL, 0, 0, 0, 'Valley View Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1033244207', 0, 'N', 0, '2014-02-10', NULL, NULL, 37.7011, -113.065, NULL, NULL),
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('942854057', 'W12044109', 'W12044109', 'UTIHCPHY', 'Dixie Hospitalists', 'Brandon', 'J', 'Bonewell', 'DO', 'Hospitalist', '', '', NULL, 'O', '1380 E Medical Ctr Dr', 'St George', 'Washington', 'UT', '84790', '4352512992', '4356886222', '1380 E Medical Ctr Dr', 'St George', 'Washington', 'UT', '84790', '4352512992', '4356886222', 'USTDMULT', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 8, '2014-01-14', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114242591', 0, 'Y', 0, '2014-02-10', NULL, NULL, 37.0998, -113.554, NULL, NULL),
('510598546', 'W12044052', 'W12044052', 'TXHOUSTD', 'Arif Abudllah', 'Arif', '', 'Abdullah', 'MD PA', 'Cardiology', '', '', NULL, 'O', '601 River Point Dr  Ste 105', 'Conroe', 'Montgomery', 'TX', '77304', '9365395577', '9365395550', '601 River Point Dr  Ste 105', 'Conroe', 'Montgomery', 'TX', '77304', '9365395577', '9365395550', 'HOUSTON2', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-03-10', NULL, 0, 0, 0, 'Conroe Regional Medical Center', NULL, '', '', 'HCFA|UB|', '1801803069', 0, 'N', 0, '2014-02-10', NULL, NULL, 0, 0, NULL, NULL),
('202714504', 'W12044105', 'W12044105', 'TXHOUSTD', 'Dermatological Association of Texas', 'Lauren', 'S', 'Campbell', 'MD', 'Dermatology', '', '', NULL, 'O', '1401 Binz St Ste 200', 'Houston', 'Harris', 'TX', '77004', '7135288818', '7135288848', '1401 Binz St Ste 200', 'Houston', 'Harris', 'TX', '77004', '7135288818', '7135288848', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-02-05', NULL, 0, 0, 0, 'Houston Methodist Willowbrook Hospital', NULL, '', '', 'HCFA|UB|', '1447406400', 0, 'N', 0, '2014-02-10', NULL, NULL, 29.7237, -95.3861, NULL, NULL),
('202714504', 'W12044104', 'W12044104', 'TXHOUSTD', 'Dermatological Association of Texas', 'Stephen', '', 'Tyring', 'MD', 'Dermatology', '', '', NULL, 'O', '1401 Binz St Ste 200', 'Houston', 'Harris', 'TX', '77004', '7135288818', '7135288848', '1401 Binz St Ste 200', 'Houston', 'Harris', 'TX', '77004', '7135288818', '7135288848', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-02-05', NULL, 0, 0, 0, 'Houston Methodist Willowbrook Hospital', NULL, '', '', 'HCFA|UB|', '1245227263', 0, 'N', 0, '2014-02-10', NULL, NULL, 29.7237, -95.3861, NULL, NULL),
('202714504', 'W12044103', 'W12044103', 'TXHOUSTD', 'Dermatological Association of Texas', 'Karan', '', 'Sra', 'MD', 'Dermatology', '', '', NULL, 'O', '1401 Binz St Ste 200', 'Houston', 'Harris', 'TX', '77004', '7135288818', '7135288848', '1401 Binz St Ste 200', 'Houston', 'Harris', 'TX', '77004', '7135288818', '7135288848', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2014-02-05', NULL, 0, 0, 0, 'Houston Methodist Willowbrook Hospital', NULL, '', '', 'HCFA|UB|', '1043414634', 0, 'N', 0, '2014-02-10', NULL, NULL, 29.7237, -95.3861, NULL, NULL),
('464079077', 'W12044102', 'W12044102', 'ID02', 'Neuro Science Associates', 'Richard', 'A', 'Lochhead', 'MD', 'Neurosurgery', '', '', NULL, 'O', '6140 W Curtisian Ave Ste 400', 'Boise', 'Ada', 'ID', '83704', '2083673500', '2083672968', '6140 W Curtisian Ave Ste 400', 'Boise', 'Ada', 'ID', '83704', '2083673500', '2083672968', 'IDPPONEURO', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1578743522', 0, 'N', 0, '2014-02-10', NULL, NULL, 0, 0, NULL, NULL),
('464079077', 'W12044101', 'W12044101', 'ID02', 'Neuro Science Associates', 'Richard', 'A', 'Lochhead', 'MD', 'Neurosurgery', '', '', NULL, 'O', '3875 E Overland Ave', 'Meridian', 'Ada', 'ID', '83642', '2083673500', '2083672968', '3875 E Overland Ave', 'Meridian', 'Ada', 'ID', '83642', '2083673500', '2083672968', 'IDPPONEURO', 'WUSTDHCPC5', '', '0.00', '30.00', '0.00', 3, '2014-01-01', NULL, 0, 0, 1, 'Saint Alphonsus Medical Center Nampa', '', '', '', 'HCFA|', '1578743522', 0, 'N', 0, '2014-02-10', NULL, NULL, 0, 0, NULL, NULL),
('452976742', 'W12044097', 'W12044097', 'ID02', 'Kaleidoscope Pediatric Therapy', 'Allyson', '', 'Overton', 'SLP', 'Speech Therapy', '', '', NULL, 'O', '7211 W Franklin Rd', 'Boise', 'Ada', 'ID', '83709', '2083754200', '2083754201', '7211 W Franklin Rd', 'Boise', 'Ada', 'ID', '83709', '2083754200', '2083754201', 'WestRehab', 'WUSTDHCPC5', '', '0.00', '0.00', '73.00', 3, '2014-02-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1346474681', 0, 'N', 0, '2014-06-09', NULL, NULL, 0, 0, NULL, NULL),
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INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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